How Can I Prevent a Heart Attack?
A Life-Changing Heart Attack: Why Prevention Matters
A 55-year-old patient was seen at our clinic following a recent hospitalization for a heart attack. He had been playing with his dog when he suddenly developed chest pressure that lasted more than a few minutes. The discomfort was intense and felt like a squeezing sensation in the center of his chest. He became nauseated, diaphoretic, and called for his wife, who immediately dialed 911.
Upon arrival at the hospital, he was rapidly triaged and taken for emergent cardiac catheterization. The cardiologist explained that he was extremely fortunate to survive what is commonly referred to as a “widow maker” heart attack—caused by an occlusion of the left anterior descending (LAD) coronary artery. In an instant, his life changed.
Heart disease remains the leading cause of death in the United States.
What Causes a Heart Attack (Myocardial Infarction)?
A heart attack, or myocardial infarction (MI), occurs when blood flow to the heart muscle is abruptly reduced or blocked. This most often results from rupture of an atherosclerotic plaque within a coronary artery, followed by thrombus (clot) formation.
Plaque builds up gradually along the inner walls of the coronary arteries. When a plaque becomes unstable and ruptures, a clot forms and obstructs blood flow, impairing myocardial perfusion. This leads to ischemia (lack of oxygen) and, if not promptly treated, irreversible damage to the heart muscle.
What Can Be Done to Help Prevent a Heart Attack?
Discussing modifiable cardiovascular risk factors during annual wellness exams is a routine—and essential—part of preventive care. Lifestyle behaviors combined with targeted laboratory testing can identify cardiovascular risk early, allowing for timely intervention and a more personalized, proactive approach to heart health.
Blood Pressure Control
Maintaining blood pressure below 130/80 mmHg is a cornerstone of cardiovascular disease prevention. Poorly controlled hypertension damages the vascular endothelium—the inner lining of blood vessels responsible for regulating blood flow, preventing clot formation, and maintaining vascular integrity. Endothelial dysfunction accelerates atherosclerosis and increases cardiovascular risk.
Lipid Management and Advanced Testing
A standard lipid panel evaluates:
Low-density lipoprotein cholesterol (LDL-C)
High-density lipoprotein cholesterol (HDL-C)
Triglycerides
Total cholesterol (calculated)
For some individuals—particularly those with a personal or family history of premature heart disease—advanced lipid testing may provide additional risk stratification:
Lipoprotein(a) [Lp(a)]: A genetically determined, independent risk factor for premature atherosclerotic cardiovascular disease.
Apolipoprotein B (ApoB): Reflects the total number of atherogenic lipoprotein particles and may predict cardiovascular risk more accurately than LDL-C alone.
High-sensitivity C-reactive protein (hs-CRP): A marker of systemic inflammation; elevated levels are associated with plaque instability and increased cardiovascular events.
Control of Diabetes and Insulin Resistance
Diabetes mellitus and insulin resistance significantly increase the risk of cardiovascular disease. Chronic hyperglycemia contributes to endothelial dysfunction, inflammation, and accelerated atherosclerosis. Early identification and aggressive management are essential to prevent long-term vascular complications.
Lifestyle Interventions
Physical Activity
Aim for at least 150 minutes of moderate-intensity aerobic activity per week, as recommended by current cardiovascular guidelines.
Nutrition
Adopt a dietary pattern rich in vegetables, fruits, whole grains, legumes, and lean protein sources. A good source to follow is the Mediterranean Diet. These nutritional approaches support vascular health, improve lipid profiles, and reduce systemic inflammation.
Tobacco Cessation
Simply put: quit smoking and avoid vaping. Tobacco exposure damages the vascular endothelium, promotes chronic inflammation, increases thrombosis risk, and accelerates atherosclerotic plaque formation.
Stress and Sleep Regulation
Chronic stress and inadequate sleep contribute to elevated cortisol levels, hypertension, insulin resistance, and systemic inflammation. These factors are increasingly recognized as important—and modifiable—contributors to cardiovascular risk.
Bottom Line
Preventing a heart attack requires more than just checking cholesterol levels. Routine preventive screening, blood pressure control, lifestyle modification, and—when appropriate—advanced laboratory testing are critical components of cardiovascular risk reduction.
Work with your healthcare provider to develop a personalized prevention strategy that may include advanced markers such as Lp(a), ApoB, and hs-CRP.
Prevention is personal—and it starts long before symptoms appear.