While blood sugar control is most often associated with diabetes management, it also plays a critical role in heart health. Lowering your A1C can significantly reduce your risk of heart disease, the leading cause of death worldwide, but what can you actually do to bring it down? Below, experts share practical, evidence-based strategies to help lower your A1C for better heart health.
Hemoglobin A1C (HbA1C) is a blood test that’s used to assess your long-term blood sugar control.
“Hemoglobin A1C is a blood test that can let you and your doctors know the average blood glucose levels over the last 2-3 months,” Joyce Oen-Hsiao, director of cardiac rehabilitation services and associate professor of cardiovascular medicine at Yale, told Health.
HbA1C is expressed as a percentage, which represents the proportion of hemoglobin in your blood that has sugar attached to it. If your HbA1C climbs over a certain level, it indicates prediabetes or diabetes.
- Normal: Below 5.7%
- Prediabetes: 5.7%-6.4%
- Diabetes: 6.5% or higher
Elevated HbA1C means that your average blood sugar is consistently high. “A1C is the 3-month report card for blood sugar,” Nneoma Oparaji, MD, a board-certified internal medicine, obesity, and lifestyle medicine physician, told Health. ”When blood sugar is high for a long time, it damages blood vessels by making the inner lining of the blood vessels dysfunctional, more prone to injury and plaque buildup, and less flexible, which ultimately becomes the basis of heart disease and stroke,” Oparaji explained.
Research shows that people with higher HbA1C levels are significantly more likely to develop heart disease. Some studies have found that people with an HbA1C between 6.0% and 6.5% had up to an 85% greater risk of coronary heart disease, the most common type of heart disease in the U.S., compared to those with levels between 5.0% and 5.5%.
“This risk actually starts to climb even in the prediabetes range,” Thomas Tsang, a behavioral health expert and Chief Medical Officer at Omada Health, told Health.
1. Prioritize Fiber
Fiber helps slow digestion and the release of sugar into the bloodstream. Adding more fiber to your diet is an effective way to reduce short and long-term markers of blood sugar control.
Oparaji recommends choosing fiber-rich foods, like beans, lentils, whole grains, and vegetables, to prevent glucose spikes.
2. Cut Back On Refined Carbs and Added Sugar
A diet too high in added sugar and refined carbs, such as pastries, candy, and sugary drinks, can increase your blood sugar and increase diabetes risk. One of the easiest ways to cut back on added sugar is to reduce your intake of soda and other sugar-laden drinks.
“Even small changes can make a big difference, such as swapping sugary drinks like juice or soda for water or unsweetened tea,” said Tsang.
Oen-Hsiao recommends choosing fiber-rich carbs, such as whole grains and starchy vegetables, over refined carbs, like white bread and white pasta, as an easy way to make your plate more blood sugar-friendly.
3. Prioritize Protein
Like fiber, protein slows digestion, which helps prevent rapid spikes in blood sugar. It also promotes feelings of fullness after meals, making it easier to manage your calorie intake, an important factor in maintaining a healthy weight.
Aim to include a source of protein at every meal and snack to support healthy blood sugar levels.
4. Exercise Consistently
Physical activity helps your body use glucose for energy, keeping your blood sugar at a healthy level.
“Generally, it is recommended to aim for 150 minutes of exercise per week,” said Oparaji. However, she emphasised that the goal is progress, not perfection.
If you’re new to exercising, Oparaji recommends starting with an activity that you enjoy, such as taking a brisk walk, swimming, or biking, and then gradually introducing more difficult exercises, such as strength training.
And don’t underestimate the power of a short walk after meals. A 2025 study found that just 10 minutes of walking right after eating sugar significantly reduced blood sugar levels compared to resting after eating.
5. Lose Excess Body Fat
Losing extra body fat is key to lowering your HbA1C. “Weight loss can help improve the body’s sensitivity to insulin, making it easier to move glucose out of the bloodstream and into the cells so it can do its job of fueling the body,” Catherine Dowling, RDN, LDN, a clinical health educator in diabetes with MedStar Health, told Health.
You can achieve consistent weight loss through a combination of dietary changes and increased activity levels.
Studies show that improvements in fasting glucose and HbA1C can be seen with as little as 2% to 5% weight loss.
6. Improve Sleep Quality and Stress Management
“Inadequate sleep and chronic stress increase hormones such as cortisol, which worsens insulin resistance, thus making it challenging to control A1C,” explained Oparaji
For optimal health, adults are recommended to aim for at least seven hours of sleep per night. “Optimizing your sleeping environment and creating a wind-down routine at the end of the day can help with getting a better night’s rest,” noted Dowling.
To manage stress, try creating healthy boundaries and using proven stress-reduction techniques, such as breathing exercises, yoga, spending time in nature, and exercising.
7. Take Medications as Prescribed
While lifestyle and dietary changes can significantly lower HbA1C, medications may still be needed to reach optimal levels.
“When lifestyle changes are not enough to improve glucose levels, I start my patients on medications such as Metformin, Semaglutide, and Empagliflozin, as these have been consistently shown to improve blood sugar,” said Oparaji.
To maximize the benefits of diabetes medication, it’s important to continue following a healthy diet and lifestyle.
Even a small decrease in your HbA1C can lower your risk of heart disease and make a significant impact on your overall health.
“Each 1‑percentage‑point drop in HbA1C is associated with meaningfully lower microvascular risk and modestly lower cardiovascular events and mortality, especially when achieved early,” said Tsang.
A1C goals should be tailored to individual needs, but there are some general guidelines. For someone without diabetes and those with prediabetes, the goal is below 5.7%, which is considered “normal.” For most people with diabetes, the HbA1C goal is 7% or less.
A1C targets should be individualized for each patient, as there is no one-size-fits-all approach.
If your HbA1C is elevated, you should be under the care of a healthcare provider, such as an endocrinologist or primary care physician. How often you see your doctor depends on how well your blood sugar is controlled. “If your diabetes is stable and you’re meeting your goals, getting your A1C checked every six months may be enough,” explained Tsang.
However, if you’ve just changed your treatment plan or your numbers aren’t where you want them, checking every three months makes more sense.
Each patient needs a personalized care plan. This may include more frequent testing depending on other health conditions, a strong family history of heart disease, or additional risk factors.
It’s also important to see your doctor immediately if you experience medication side effects, such as severe nausea, low blood sugar, or any other health issue that needs prompt care.
