A Cardiologist Answers Your Most Pressing Questions About Preventing Heart Disease

Building a heart-healthy lifestyle

Q: What are the most important lifestyle changes people can make to prevent heart disease?

Dr. Haider is clear: consistent lifestyle choices form the foundation of heart disease prevention.

Movement

“Staying active is key, even if it’s just walking,” he says.

Multiple studies have shown that taking at least 7,000 to 8,000 steps a day is associated with lower cardiovascular mortality.

For structured activity, he recommends either 150 minutes of moderate exercise, such as walking, cycling, or gardening, or 75 minutes of vigorous exercise, such as jogging, swimming, or tennis, each week.

Diet

Movement alone, however, isn’t enough. What you eat matters just as much. “The Mediterranean diet is the most heart-healthy diet, and we have good data to support this,” he explains.

This way of eating emphasizes whole foods, including fruits, vegetables, legumes, nuts, olive oil, lean proteins, and whole grains. It limits processed foods and saturated fats, both of which have been linked to heart disease.

“The Mediterranean diet has the most data for lower cardiac events,” he says.

Habits to avoid

Other essential habits include not smoking, limiting alcohol, and managing weight. Dr. Haider warns that smoking is one of the most dangerous things you can do for your heart, and there’s no safe level.

As for alcohol, Dr. Haider urges people to “limit intake.”

Alcohol doesn’t protect your heart, no matter what old headlines might suggest. In fact, the more recent guidelines on alcohol consumption recommend eliminating alcohol from your diet entirely for optimal overall health.

Q: How does stress affect heart health, and what can people do about it?

Dr. Haider explains that chronic stress, whether emotional, mental, or physical, has been repeatedly linked to heart disease.

“We see links between heart disease and mental health issues, so it is always important to address these,” he explains.

While stress alone doesn’t cause clogged arteries, it can increase inflammation, elevate blood pressure, and lead to maladaptive habits, such as overeating, smoking, or skipping exercise.

That makes stress management a vital part of prevention. Techniques like mindfulness, therapy, exercise, and prioritizing sleep and connection can all help.

Q: At what age should someone start paying attention to their heart disease risk, even if they feel healthy?

“It’s never too early to start,” Dr. Haider stresses. In fact, Dr. Haider suggests having conversations with your doctor about heart health earlier than you might think.

“When you hit your 20s, everyone should have a visit to their doctor to check numbers, including cholesterol, blood sugar, blood pressure, weight, and waist circumference,” he urges.

These numbers provide a foundation for understanding and managing your risk.

Knowing your numbers

Q: What are the key health numbers people should track, and how often should they get checked?

Dr. Haider emphasizes that monitoring one’s health stats can make all the difference. He explains that cholesterol should be checked at least once a year, or more frequently if treatment is being adjusted.

“Blood pressure should be checked with each physical, and if numbers have come out elevated, then they may need to be tracked at home. Blood sugar or HbA1c should also be checked periodically in at-risk individuals.”

Dr. Haider also monitors his clients’ weight, BMI, and waist circumference.

These are all pieces of the heart health puzzle, explains.

Q: Can someone have heart disease without any symptoms?

Dr. Haider gives an emphatic “yes.”

“By the time someone has symptoms of heart disease, it means that the disease has become severe enough to cause a problem, such as a blocked coronary artery.”

In other words, heart disease often develops quietly and can progress for years without obvious warning signs. That’s why being proactive with lifestyle changes and managing risk factors early is so important. It can help prevent or slow plaque buildup long before symptoms appear.

In some patients, Dr. Haider may also recommend screening tools such as a coronary artery calcium (CAC) score or a CT scan. Depending on a person’s risk profile, these imaging tests can help detect early signs of heart disease before it becomes symptomatic.

Incorporating medication and supplements

Q: When is it appropriate to start medications like statins, even if you haven’t had a heart attack?

Statins, which help lower cholesterol, can be used both for people who’ve already had cardiac events and for those at increased risk.

“If someone has any evidence of coronary artery disease or atherosclerosis in any blood vessels, for example on an imaging study, they should be on a statin,” Dr. Haider explains.

Even in people without signs of existing disease, statins may still be appropriate. For true primary prevention (i.e., no known coronary artery disease), treatment decisions are based on overall risk.

Dr. Haider notes that “the cutoffs of what LDL level to treat with statins often depends on individual risk factors,” such as whether someone has diabetes and their estimated 10-year risk of a cardiac event calculated using the ASCVD risk calculator.

“If LDL cholesterol is very high (over 190) despite lifestyle modification, then there is likely a statin should be utilized regardless.”

Q: Do heart health supplements like fish oil or CoQ10 actually help?

Dr. Haider is cautious about over-the-counter heart supplements.

“In general, fish oil supplements, though effective in reducing triglyceride levels, have not been shown to reduce the risk of cardiac events,” he explains.

The same is true for CoQ10 usage.

“Similarly, CoQ10, which was often used alongside statins to mitigate side effects, has not been shown to be effective in multiple trials.”

In other words, while some supplements may affect certain lab values or symptoms, the evidence doesn’t support their effectiveness for cardiovascular disease prevention.

Dr. Haider instead recommends focusing on approaches with clear benefits, such as lifestyle changes, evidence-based medications when appropriate, and routine monitoring.

Addressing common misconceptions

Q: What are some of the biggest myths people still believe about heart disease?

There’s still a lot of misinformation circulating about heart health. One common myth, Dr. Haider says, is the idea that cholesterol or saturated fat doesn’t play a role in heart disease.

“Some of the myths that I see circulating include people claiming high cholesterol does not cause heart disease, and high saturated fats do not impact cholesterol levels or the risk of heart disease, which are simply false.”

Instead, the evidence clearly links a high saturated fat diet with increased heart disease risk. Instead, it’s best to limit saturated fats and replace them with polyunsaturated fat sources.

Another widespread misconception is that coronary artery disease can be fully reversed once it’s diagnosed.

“Once you have heart disease, we can stabilize it. We can slow it using lifestyle measures and medications, but we can never fully reverse it.”

Lastly, Dr. Haider also pushes back on the idea that heart disease only affects a narrow group of people.

“There’s some who still think heart disease is a disease of middle-aged and elderly men and young people and women are not at risk, but we know that is not true,” he says.

That’s why he emphasizes that prevention and risk awareness matter for everyone, not just those who fit outdated stereotypes.

Takeaway

Dr. Haider makes it clear that preventing heart disease begins well before symptoms appear and requires consistent, evidence-based habits.

Regular physical activity, a balanced diet, avoiding smoking, managing stress, and tracking key health numbers are all essential.

While medications are often an essential part of treatment, the foundation of heart health lies in everyday decisions made over time.

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