It is easier to prevent a heart attack than to heal from one. But even if you have already had a heart attack, there are many things you can do to reduce your risk of having another.

1. Know your risk
   A coronary risk profile can help measure your risk of having a heart attack in the next 10 years. This knowledge can be helpful to both you and your doctor. A coronary risk profile is calculated by taking several different risk factors into account, such as your levels of HDL ("good") cholesterol, LDL ("bad") cholesterol and triglycerides as well as your height and weight. It is a good idea to talk to your doctor about having your coronary risk profile calculated. The American Heart Association recommends that people have their blood pressure, body mass index, waist circumference and pulse checked at least every two years, beginning at age 20. Cholesterol and glucose levels should be checked at least every five years.
   
   
2. Know your personal and family medical history
   Detailed information about your own and your family's health history is important to know because it can provide insight into your risk of developing certain medical conditions, including those that may lead to heart attacks.
   
   Learn as much as possible about the medical diagnoses of your biological parents, grandparents, siblings, aunts, uncles and cousins, and keep good records concerning your own. Your children will also need to know as much as they can about the family medical histories of both parents.
   
   Information that needs to be recorded about yourself and your family members includes:
   
   
   • Any known congenital or hereditary disorders
   • Major illnesses
   • Chronic ailments or risk factors (such as smoking, obesity or alcohol problems)
   • The cause of death and age at death of any deceased relatives
   • Childhood illnesses, vaccinations, surgeries, treatments
   
   
3. Improve your cholesterol ratio
   High blood cholesterol is one of the major risk factors for heart disease and heart attack. You can find out your cholesterol level from a blood lipid (fat) profile, which can be determined with a simple blood test. The results will provide information on your:
   
   
   • Total cholesterol (calculated as follows: HDL plus LDL plus one-fifth the triglyceride level). Total cholesterol levels between 160 and 200 are desirable, between 200 and 239 are borderline high and levels equal to or above 240 are high.
     
     
   • LDL cholesterol (calculated as follows: subtracting HDL and triglycerides from total cholesterol). LDL levels should be less than 130 (levels of 160 or greater are considered high).
     
     
   • HDL cholesterol. A woman's HDL level should be 40 or higher.
     
     
   • Triglycerides. A triglyceride level below 150 is normal, between 150 and 199 is borderline high, between 200 and 499 is high and 500 or greater is very high.
     
     
   • Cholesterol ratio (the ratio of total cholesterol to HDL). The desired cholesterol ratio is at most 5 to 1. Strategies for improving this ratio include lowering cholesterol and triglycerides. You may be able to reduce your levels of total cholesterol, LDL cholesterol and triglycerides by eating a heart-healthy diet and exercising regularly. If these strategies do not reduce total cholesterol levels, a doctor may prescribe cholesterol-reducing drugs, such as statins. Increasing HDL cholesterol is also helpful. Strategies to help improve HDL include eating monosaturated fats instead of saturated fats, quitting smoking, exercising regularly and maintaining a healthy weight.
   
   
4. Prevent or control high blood pressure
   Women with high blood pressure, or hypertension, are at greater risk of heart attack and other problems resulting from cardiovascular disease. For women, optimal blood pressure is under 120/under 80 mmHg. Blood pressure of 120-139/80-89 mmHg indicates prehypertension. Anything 140 and greater/90 and greater indicates high blood pressure. Prehypertension and hypertension should be treated under the supervision of a doctor.
   
   Hypertension can be controlled by taking blood pressure medications; self-monitoring; eating a heart-healthy, low-salt diet; and engaging in regular exercise. You should also have regular checkups with your doctor.

    

   5. Exercise regularly
      Some experts have proposed that not exercising is as damaging to your cardiovascular system as smoking. Exercise strengthens the heart muscle, helps it to work more efficiently, helps to maintain a healthy blood pressure, improves the cholesterol ratio, helps to keep the blood vessels free of blood clots and plaque buildup, and may even reverse atherosclerosis (hardening of the arteries), a process that can lead to heart attack. It is also essential for achieving and maintaining a healthy weight.
      
      Consult with your doctor before beginning a new exercise routine, especially after having experienced a heart attack. A cardiac rehabilitation program, which may have been recommended by your doctor after your initial heart attack, can help with getting back into a safe exercise routine with appropriate activities and supervision. If your doctor recommends one, a cardiac rehabilitation plan is tailored to meet your individual needs. The programs are designed and overseen by your doctor (usually your cardiologist ), along with a team of other health care professionals.

       

   6. Achieve and maintain a healthy weight
      Being overweight or obese is a major risk factor for a host of serious health conditions, including coronary artery disease, high blood pressure, diabetes, heart attack and stroke. Some weight control methods include limiting calories, increasing activity, counseling, medication and surgical interventions.

       

      7. Eat a heart-healthy diet
         Research has consistently supported the idea that health is largely determined by what you choose to eat. Certain minerals such as calcium and magnesium and B vitamins have been shown to be helpful to heart health. Omega-3 fatty acids, found in fatty fish, such as tuna, salmon and sardines, may keep arteries healthy and elastic. However, saturated fats and tropical oils, such as palm and coconut oil, have been shown to be harmful. This is because they can speed up the development of coronary artery disease, atherosclerosis and obesity. Trans fat, which is often found in processed foods, has been linked to heart damage.

          

      8. Quit smoking and avoid secondhand smoke
         Tobacco smoking is a major cause of coronary artery disease and cardiac arrest. According to the United States Centers for Disease Control and Prevention, from 1995 to 1999 nearly 450,000 people in the United States died prematurely from smoking. Of these, nearly 150,000 deaths were attributed to cardiovascular diseases. It is also estimated that secondhand smoke was responsible for more than 35,000 deaths annually from ischemic heart disease during the same period.

          

         9. Control diabetes
            If you have diabetes, you may be more likely to develop heart-related diseases. However, recent studies have shown that women with diabetes may reduce their risk of heart attack by taking a medication called acarbose. This medication helps control blood sugar levels by slowing carbohydrate digestion. It has been shown to improve blood pressure and lipid levels, which may play a role in reducing the risk of heart attack. However, these findings are still considered experimental.

             

         10. Use stress-management techniques
             Stress, excessive anger and fatigue can lead to high-risk practices such as overeating, smoking and failing to exercise. In addition, stress increases blood pressure. Basic stress management techniques include getting enough sleep and exercising regularly. The three steps to stress management are relaxing in a healthy way, identifying the cause of stress (stressor) and addressing or resolving the stressor. Reducing stress levels can help a person who has had a heart attack to lower their blood pressure, reducing the likelihood of a second heart attack or other cardiovascular event occurring.

              

         11. Recognize and treat chronic depression
             Depression has been linked to heart disease and heart attack in several ways: It raises risk of developing high blood pressure, abnormal heart rhythms, blood clots and sudden cardiac death. It may also alter the amount of blood flowing to the coronary arteries. These links are especially important for those who have had a previous heart attack, since depression is common after the event. Exercise, visiting support groups and talking to a therapist are proven methods of treating depression. In some instances, a doctor may decide that medication is the best treatment for depression in some patients.
             
             A recent study of the antidepressant drug sertraline found that it was a safe and effective therapy in men and women who have had a recent heart attack or unstable angina. It has also been shown to have anticlotting properties.

              

             12. Take any recommended medications as prescribed
                 If you have had a heart attack, your doctor may have prescribed medications to help prevent future heart attacks. Follow your doctor's orders closely. Many of these medications need to be continued for life. If you have any questions about your medications, ask your doctor or pharmacist.

                  

             13. Commit to lifestyle changes
                 Up to two-thirds of women who have had a heart attack do not make lifestyle changes. It is estimated that up to one-third of fatal heart attacks could be prevented with the proper pre-attack medical treatments and lifestyle modifications. Even after a heart attack, the chances of avoiding future attacks can be increased with appropriate preventive care.