Although COVID-19 has dominated headlines since 2020, it is not the most dangerous health threat seniors face. That honor belongs to heart disease, America's leading cause of death.

Healthy lifestyle changes can help you avoid a diagnosis of heart disease. And if you've already been diagnosed, these changes can improve your symptoms and lower your risk of death.

As always, talk to your doctor before making any significant changes to diet and exercise. And for more information on how to set and achieve SMART goals, click here.

About heart disease

The term heart disease refers to a variety of heart conditions, the most common of which is  coronary artery disease  (CAD).

Heart disease risk increases as you get older thanks to the cumulative effect of many lifestyle choices, such as following an unhealthy diet or excessive alcohol use. The three most common risk factors for heart disease are:

• High blood pressure
• High blood cholesterol
• Smoking

You're also more likely to develop heart disease if you have diabetes, are overweight or obese, and are not physically active. You can lower your risk of heart disease, though, by implementing the following six healthy lifestyle changes.

1. Be more physically active

The one thing all doctors seem to agree on is that Americans need to be more physically active. And it doesn't take much – only 30 minutes a day of moderate activity, 5 days a week for optimum health. The benefits are huge, too. People who exercise regularly sleep better, are both physically and mentally healthier, and even have a better sex life.

If you're new to exercise, first talk to a doctor about how you can safely incorporate more physical activity. You may need to start slowly at 10 minutes a day, working your way up to 30 minutes. Or, you may be able to do three 10-minute sessions. Any amount of physical activity is good for your heart. And over time, your strength and stamina will improve, so you'll be up to those 30-minute sessions in no time.

In addition to aerobic exercise, you need to add some weight-bearing activities. That doesn't necessarily mean heading to the gym to pump some iron (although that's great, too). "Weight-bearing" literally just means any activity where you bear your own weight. Walking, hiking, dancing – even performing household chores qualifies as weight-bearing. Activities like biking and swimming, however, do not.

The best type of exercise is whatever you enjoy doing and will do regularly. Do you like to dance? Take a Zumba class, pull up some YouTube videos, or look for some dance classes at your local community center. Like being outside? Talk a walk, go for a hike, ride a bike, go swimming – even working in the garden counts as being physically active. Your aim is clocking in 150 minutes a week. How you get there is up to you.

2. Quit smoking for your heart

By now, everyone knows that smoking is bad for your health. But what many people don't seem to realize is that smoking is bad for their heart, too.

The chemicals in cigarettes and other tobacco products damage your heart and blood vessels, shrink your arteries, and double your risk of dying from heart disease compared to non-smokers. A single cigarette contains:

• Nicotine
• Hydrogen cyanide
• Formaldehyde
• Lead
• Arsenic
• Ammonia
• Radioactive elements courtesy of the soil and fertilizer use in growing tobacco
• Benzene
• Carbon monoxide

And much more. Not only can each of these chemicals cause cancer, but they also damage your heart and circulatory system.

The carbon monoxide in cigarettes replaces some of the oxygen in your bloodstream, meaning your heart has to work harder to get oxygen to your lungs. Nicotine and other chemicals cause your arteries to narrow, making plaque buildup more likely, again placing extra stress on your heart. It's why smokers tend to have higher blood pressure and an elevated heart rate compared to nonsmokers.

The good news is that, when you quit smoking, your risk of heart disease decreases rapidly. Your blood pressure will be lower within only a few hours. Within 15 years, your heart disease risk is nearly identical to that of a lifelong non-smoker.

3. Eat a heart-healthy, plant-based diet

The average American diet is loaded with processed foods that are high in sodium, fats, and sugars. You'll reduce your risk of heart disease by eating a heart-healthy, plant-based diet consisting of real food instead of pre-packaged, processed items.

Making the following dietary changes will reduce your risk of heart disease:

• Eat five to seven servings of fruits and vegetables per day, with at least one serving of vegetables with every meal.
• Reduce trans fats by cutting back on prepackaged foods (chips, cookies, etc.) as well as bakery items and fast food.
• Only eat red meat once or twice a week, focusing on lean cuts whenever possible. Replace red meat with fish and poultry.
• Try going vegetarian once or twice a week, getting your protein from lentils, beans, quinoa, tofu, and other vegetarian sources.
• Limit dairy to one or two servings per day.
• Drink alcohol in moderation – one drink per day for women; one to two drinks per day for men.
• Replace trans fats with healthy fats such as avocado, olive oil, and coconut oil.
• Reduce sugar consumption by drinking water instead of soda.
• Reduce caffeine by drinking herbal tea (0 mg of caffeine) or green tea (35 mg) instead of black tea (70 mg) or coffee (95 mg).

You don't have to make all of these changes at once. Small changes can have a big impact and are easier to turn into habits.

4. Maintain a healthy weight for a healthy heart

Extra weight forces your heart to work harder to pump blood through your body, raising your risk of heart disease and early death. The healthy lifestyle changes recommended here should make maintaining a healthy weight easy, though. As always, though, talk to your doctor before making changes to your diet and exercise routine – and to understand what a healthy weight is for you.

5. Get a good night's sleep

According to the American Sleep Association, around one-third of Americans don't get the recommended seven to nine hours of sleep each night. What's more, our sleep needs change throughout our lives.

Sleep is when your body repairs itself. Sleep deprivation can cause a variety of health problems, including memory issues, high blood pressure, a weakened immune system, weight gain, increased risk of heart disease, and more.

Around one-third of Americans also feel that they live extremely stressful lives. To cope with their stress, many people turn to unhealthy habits like smoking, drinking, and overeating. These stress relievers may supply short-term relief, but they lead to long-term problems.

The following stress reducing techniques can also help you enjoy a good night's sleep:

• Turn off the TV and other electronic devices at least an hour before bed. Reading, journaling, and meditation are good alternatives.
• Taking a warm bath about an hour before bedtime helps relax you. And the cooling sensation you feel when you get out of the tub sends signals to your body that it's time to sleep.

It's also important to follow the same bedtime routine every night. This reinforces the idea that it's time to go to sleep.

When stress pops up during the day, look for physical outlets to relieve it, like taking a walk, climbing stairs, or any type of exercise. Listening to music and meditation are also great stress relievers.

6. Talk to your doctor

Your Medicare benefits include a variety of preventive services and screenings, starting with your yearly wellness visit. This service is free to you – there is no coinsurance payment and the Part B deductible does not apply. It includes routine measurements like weight and blood pressure and is the perfect time to ask your doctor for personalized health advice.

Additional resources

• ClearMatch Medicare: Find a Medicare Plan
• Centers for Disease Control & Prevention: Heart Disease Facts
• Centers for Disease Control & Prevention: Coronary Artery Disease
• American Cancer Society: Harmful Chemicals in Tobacco Products
• The Sleep Doctor: Sleep and Disorder Statistics