Having a healthy heart is essential for everyday well-being and longevity, but many people unknowingly undermine it. Cardiovascular disease has been the leading cause of death in the U.S. for the last century, responsible for about 919,000 deaths in 2023. For American Heart Month, we asked four cardiologists the top heart-health mistakes they see people make.
Salt is a sneaky staple in the American diet, lurking in everything from soup and deli meat to bread and condiments. “If you are an adult living in the United States, chances are you eat way too much salt,” said Nilay Shah, MD, a cardiologist at Northwestern Medicine.
One of the main minerals in salt is sodium (table salt is about 40% sodium and 60% chloride). Your body needs some sodium to function properly, but having too much can raise your blood pressure—and high blood pressure is one of the strongest risk factors for cardiovascular disease, including heart attacks and heart failure, Shah told Health.
The fix: Pay attention to your sodium intake. Add up the sodium on nutrition labels and try not to exceed the daily limit of 2,300 milligrams, or about 1 teaspoon of salt. More than 70% of the sodium Americans eat comes from packaged foods or restaurant meals, so it also helps to cook at home and focus on whole foods.
Experts agreed that many of us need to move more. Only about a quarter of adults meet the physical activity guidelines for Americans of at least 150 minutes of moderate-intensity aerobic activity and two days of strength training each week.
When you’re inactive, you don’t burn as many calories and you’re prone to putting on weight, which can lead to high blood pressure, diabetes, and a host of problems that can harm your heart, explained Brian Downey, MD, director of General Cardiology Services at Tufts Medical Center. “There’s this saying now that ‘sitting is the new smoking,’” he told Health.
The fix: Get up and move. Going to the gym is great, but staying active can be even simpler, Shah said. “If you work a desk job, getting up and walking every hour can help build up your daily activity,” he said. “Walking with friends, on your lunch break, walking your dog—all of these count.”
It can be tempting to unwind on your phone before going to sleep, but research has found that this habit really can disrupt your rest. The blue light can suppress melatonin (a sleep hormone), the stimulation may increase cortisol (a stress hormone), and the hour you spend scrolling could be an extra hour of sleep.
Not getting enough sleep is a major risk factor for cardiovascular disease, Harmony Reynolds, MD, a cardiologist at NYU Langone and an American Heart Association volunteer, told Health. Your blood pressure naturally drops when you sleep. When you don’t get enough rest, your blood pressure stays higher for longer, raising your risk of heart disease and stroke.
The fix: Put the phone down, or keep it out of your bedroom entirely. Try reading before bed instead, and build better sleep habits, like getting enough natural light and physical activity during the day, and keeping your bedroom cool, dark, and quiet at night.
Reynolds said a big mistake she sees is putting unhealthy snacks in your grocery cart. “People think that one little thing won’t hurt you. It’s true that one won’t, but for most people, it’s really easy to make junk food a habit,” she said.
Unhealthy foods, especially heavily processed snacks and treats, raise blood pressure and cholesterol and lead to weight gain, Reynolds explained. “Many of them make us feel tired an hour or two later as blood sugar goes down,” she said, “and then we reach for another snack.”
The fix: Leave the junk food at the store. When you feel like you need a pick-me-up, try getting up to move for a few minutes or drinking a glass of water, Reynolds suggested. “I know how it sounds, but try it and you may be surprised,” she added.
You may think of social isolation and loneliness as risks for your brain health. But a lack of social connection is also a problem for your heart; it’s been linked to a higher risk of heart disease, heart attack, and stroke.
“It’s known that stress, anxiety, lack of social connections, and loneliness—all of these are some of the softer risk factors for heart disease,” Baljash Cheema, MD, an advanced heart failure and transplant cardiologist at Northwestern Medicine, told Health.
The fix: Prioritize your social connections. Each week, make time to get together with friends, call a family member, or volunteer in your community. If certain barriers, such as physical ailments, are preventing you from socializing, a healthcare provider may be able to help identify solutions.
Have you had a check-up in the last year? Shah said people, especially younger adults in their 20s to 40s, tend to visit their primary care doctor less often—or they don’t have one at all. But these appointments are essential for identifying preventable risk factors for heart disease, such as high blood pressure, high cholesterol, and high blood sugar.
You may think these problems only occur at older ages, but “younger people are increasingly experiencing things like hypertension (high blood pressure) and diabetes (high blood sugar),” Shah said.
The fix: Get your check-ups and take note of your blood pressure, cholesterol, and blood sugar levels. These appointments are also a chance to talk to your doctor about your individual risk of cardiovascular disease.
Cheema told Health that his patients can feel discouraged by their current habits. “People sometimes worry they’re too far gone. Like, ‘I’ve been smoking for too long,’ or ‘I’ve been overweight for too long,’ or ‘I haven’t exercised for too long. Why would I start doing it now?'” he said.
Downey also sees his patients feeling dejected, especially when they don’t see results right away. “People expect to lose 30 pounds in a month, and when they don’t, they can be frustrated or disheartened and then just quit,” he said.
The fix: Start small. Simple changes, such as cutting out after-dinner snacks or reducing portion sizes, can make a difference over time if you stick to them, Downey said. “If you’re not doing anything, that’s the best time to start,” Cheema added. “You can do anything and make an improvement.”
It can be surprisingly easy to dismiss signs of serious heart problems. Both Downey and Reynolds have seen patients ignore chest pain or chalk it up to a minor problem like heartburn—but chest pain is also the most common heart attack symptom.
“I have seen too many people (especially women) who have waited until the last minute to come in because they think their symptoms are going to go away, or they’re hoping what they’re feeling isn’t really coming from their heart,” Reynolds said.
It’s important to address heart symptoms as soon as possible, since timely treatment for major cardiac events reduces the risk of disability and death. “The longer you wait to seek care, the more damage can happen to the heart,” Reynolds said. “Damage from heart attack is permanent.”
The fix: Know the symptoms, and don’t hesitate to seek medical attention. “If you feel tightness in your chest, pain, numbing, or even jaw, neck, or arm pain—call 911 if it lasts 15 minutes or more and go to an ER, where doctors can figure out if that is heart attack and treat it right away,” Reynolds said.
