Lifestyle Changes to Prevent Heart Attack, Heart Failure and Stroke
September 30, 2025
Janet O’Mahony, M.D., is an Internal Medicine Doctor and a member of Mercy Personal Physicians Downtown in Baltimore, recently responded to questions from Healthline.com regarding research indicating lifestyle changes can help prevent heart attack, stroke and heart failure in 99% of people. Here are her comments.
Unfortunately, not all heart disease is due to lifestyle factors. Sometimes heart disease is the result of bad genes. There are definite modifiable risk factors that you can work on to lower your personal risk.
The most important risk factor for heart attack, stroke and poor circulation in the legs is smoking! Smoking rates have been going down in the last decade but still up to 11% of adults smoke cigarettes regularly. This is by far the worst lifestyle risk factor. Smokers have 4 times the rate of heart disease or stroke. Quitting smoking or never starting smoking at all can reduce the risk of heart disease dramatically.
High blood pressure is not necessarily avoidable by lifestyle. There is a big genetic and age- related component. If you have high blood pressure, keeping the blood pressure controlled with medication, lifestyle and regular doctor visits can prevent complications like stroke, kidney disease and heart failure.
Diabetes is another big risk factor for heart disease. Type 1 or juvenile diabetes has nothing to do with lifestyle. It is a autoimmune disease where the body stops making insulin. This cannot be controlled with diet. They must take insulin. People with type 1 diabetes have to not only control their sugars with insulin but see their doctors regularly to reduce the risk of heart attack, stroke or amputations. Type 2 diabetes is much more sensitive to lifestyle changes. It is partly and age related and partly attributable to weight. Keeping a healthy weight and avoiding sugary foods can help control or even prevent Type 2 diabetes. Regular medical care to screen for other risk factors is especially important for heart disease prevention.
Family history of heart disease, stroke, or heart failure are important to know, particularly if these diseases happened to a close relative at a young age. You may share a genetic predisposition with your family members. You cannot help whom you are related to -- but knowing you have this genetic predisposition may help you work on preventive measures.
Cholesterol medication is really important to reduce the risk of heart attack and stroke in people who are high risk. This is generally people who smoke, have high blood pressure, diabetes, are over 55 or have family history of heart disease or stroke. If you have more than one of these risk factors the risk goes up.
The diet that is associated with lowering heat disease risk is the Mediterranean diet. This diet is high in fish and lean meat and olive oil, dairy, whole grains, fruits and vegetables. Avoid sugary “junk foods” like cake, candy cookies and sugary sodas. Avoid “junk meats” like hot dogs, pepperoni, sausages, fried chicken, chicken nuggets, lunchmeat and bacon. In addition, avoid “junk fats” like potato chips and French fries.
Regular exercise is very important for heart disease prevention. It is important to just get up and do something. Moderate exercise like brisk walking ½ hour at a time 5 days a week is great. Adding in some weight training is also recommended. Exercise that is more vigorous is even better but a mixture of vigorous and moderate exercise is probably the best. So ½ an hour a day 5 days of week with a mixture of moderate exercise, vigorous exercise and weight training is the current recommendation.
It is important to get a check-up with your doctor to discuss your heart disease risk factors like family history, blood pressure, diabetes, smoking, obesity or high cholesterol. There are absolutely measures you can take to lower this risk including medications and lifestyle changes to reduce risk.
Dr. Janet O’Mahony is an advocate for patient health and regularly contributes advice and feedback to media outlets, online resources and publications. Board Certified in Internal Medicine, Dr. O’Mahony received her medical degree from University of Maryland School of Medicine in Baltimore. She completed her Internship at Baltimore VA Medical Center and Residency at Mercy Medical Center in Baltimore, Maryland.
About Mercy
Founded in 1874 in Downtown Baltimore by the Sisters of Mercy, Mercy Medical Center is a 183-licensed bed, acute care, university-affiliated teaching hospital. Mercy has been recognized as a high-performing Maryland hospital (U.S. News & World Report); has achieved an overall 5-Star quality, safety, and patient experience rating (Centers for Medicare and Medicaid Services); is A-rated for Hospital Safety (Leapfrog Hospital Safety Grade); and is certified by the American Nurses Credentialing Center as a Magnet™ hospital. Mercy Health Services is a not-for-profit health system and the parent company of Mercy Medical Center and Mercy Personal Physicians.
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