You can avoid many of the causes of heart attack if you want to. The first step is to work with your doctor to evaluate risk factors in your own life. Then alter any lifestyle habits that increase your risk for heart disease.

Two of the main controllable risk factors, high blood cholesterol and high blood pressure, have no symptoms in the early stages. Nor does diabetes. When you get regular medical checkups you can find out if you're free of these risk factors. And if one does turn up, you can work with your doctor to control it.

It's a good idea for people to have their total cholesterol and HDL ("good") cholesterol checked at age 20. If the total is less than 200mg and the HDL cholesterol is 35mg or above, testing should be repeated in five years. People with higher levels need to have their cholesterol checked more often. Blood pressure should be checked every two years, because it can rise unexpectedly. Regular checkups are even more important for anyone with a family history of heart disease, high blood pressure, high cholesterol levels or diabetes.

Decades of research have shown us that when people alter their lifestyles to reduce the risk factors for heart disease, they stay healthier longer. And they can help prevent heart attack. Making these lifestyle changes doesn't mean you can forego regular medical checkups. Still, it's the best thing you can do to help keep your heart healthy. After working with your doctor to make sure your medical risk factors are treated, here's how to help yourself.

1. Don't smoke. If you're a nonsmoker already, don't start. Avoiding the smoking habit is the single best thing you can do to maintain your health and prevent a heart attack.

2. Reach your best weight. Being overweight raises your chances of having high cholesterol, high triglycerides, low HDL, high blood pressure and diabetes. Your local AHA has materials on healthy ways to lose weight.

3. Eat foods low in saturated fat and cholesterol. For decades the AHA has encouraged Americans to eat a low-fat, low-cholesterol diet. Why? Because saturated fat and cholesterol raise the blood cholesterol level, which in turn promotes atherosclerosis, a disease process in which cholesterol and other fatty substances build up in the arteries. This build-up is called plaque, and it narrows the artery walls, reducing blood supply to the heart. If the artery becomes completely blocked, blood will not reach the heart and that part of the heart begins to die. This is a heart attack.

4. Engage in regular physical activity. Regular aerobic exercise helps protect against heart attack. Any physical activity will do. Try to do something that works your heart and lungs for 30-60 minutes, three or four times a week.

5. Keep your stress to a minimum. If you think that your reactions to stress may be hurting your health or increasing your risk, do something about it. Make efforts to avoid situations that cause stress, like saying yes to a commitment that you know you don't have time for.

© 2006 Cardiology Associates, P.S.C. All rights reserved.