Every 40 seconds, an American has a heart attack, the Centers for Disease Control and Prevention (CDC) reports. While that’s a staggering statistic, about one in four of those happen to people who’ve already experienced a heart attack at least once.
The cause of reoccurrence is multi-pronged. For starters, people likely still have the same lifestyle habits and health biomarkers (like high blood pressure and abdominal obesity) that contributed to their first heart attack. And of course, their genetics haven’t changed.
Thankfully, there’s a lot heart-attack survivors can do to stop another one from happening. We spoke with three cardiologists about the evidence-backed steps that you can take right now to help you stay healthy—and potentially prevent more problems down the road. Work closely with your doctor to determine if you need medication and what lifestyle changes may be best for you.
“After a heart attack, exercise is key to restore cardiovascular health and energy,” says Francisco Lopez-Jimenez, MD, the chair of the division of preventive cardiology at the Mayo Clinic in Rochester, Minnesota. “It can also be beneficial to help you manage any depressed and anxious feelings, and help you sleep better and more soundly.”
Aim for 150 minutes of moderate activity (think: brisk walking or doubles tennis) or 75 minutes of vigorous activity (like jogging)—or a combo of both—per week, suggests Suzanne Steinbaum, MD, New York City-based director of Women’s Cardiovascular Prevention, Health and Wellness at Mount Sinai Heart and expert for the American Heart Association. Two to three days of total body strength training sessions are also essential to recover, maintain muscle, and gain strength.
“Find an activity you enjoy and stick with it,” Dr. Steinbaum says. “Being consistent with exercise and including strength training twice a week is linked to lower risk of diseases, stronger bones and muscles, and improved mental health.” (In a hurry? Try this 15-minute total-body workout that only requires a set of dumbbells.)
Make over your diet.
RICHARD DRURYGETTY IMAGES
Stock up on vegetables, fruits, nuts, legumes, and whole grains along with fish, lean protein, and low-fat dairy foods. “Studies show heart health benefits when these foods replace foods that are not good for you, such as those high in saturated fat, dietary cholesterol, trans fats, and refined carbohydrates,” Dr. Steinbaum says.
These not-so-heart-smart foods can increase blood pressure, chronic inflammation, and cholesterol levels, all of which exacerbate heart problems.
Tobacco smoke—first-hand and second-hand—damages blood vessels, making fatty build-up more likely to occur again, says Karol Watson, MD, PhD, professor of cardiology at the David Geffen School of Medicine at UCLA and the director of the UCLA Barbra Streisand Women’s Heart Health Program in Los Angeles. “It also causes the blood to be ‘stickier,’ and more prone to developing clots,” she adds, which could trigger another heart attack.
Talk to your doctor about potential ways to make it easier to kick a cigarette habit. The CDC also has a comprehensive guide to quitting smoking, should you need an extra nudge.
Find ways to manage stress.
We all know what it feels like to have our blood pressure soar from stress. That’s no good for a completely healthy heart, and researchers are currently examining if stress—and unhealthy coping strategies like binge drinking—might be even more harmful for those with a history of heart disease.
“Finding a daily practice that can help you deal with your stress is a critical part of recovery,” Dr. Steinbaum says. “Whether this is meditation, breathing, yoga, or another form of exercise, it’s essential to have a routine in place.”
A consistent sleep schedule that includes seven to nine hours of shut-eye per night can help too, she adds.
Enroll in—and graduate—from cardiac rehab.
“Cardiac rehab is an evidence-based treatment method and reduces mortality more than any other heart intervention,” Dr. Lopez-Jimenez says. Yet only about one-third of those who have had heart attacks complete cardiac rehab, according to CDC data.
In a typical cardiac rehab program, patients work with their health care team, exercise and nutrition specialists, physical therapists, and mental health professionals, according to the CDC. Patients learn how to ease back into a normal life, exercise confidently, edit their diet as needed, and manage stress.
Talk to your doctor about the best cardiac rehab prescription for you, either in-home or outpatient. Many insurance plans, including Medicaid and Medicare, cover it but require a M.D.’s referral.