Heart Attack: How Do You Prevent It and What Are the Ways to Reduce It?

Do you know that in Singapore, 15 people on average die from heart disease and stroke every day? Fortunately, basic lifestyle changes can go a long way towards keeping heart disease at bay.

5 lifestyle changes to care for your heart and prevent heart attack

1. Stop smoking

Everyone knows cigarette smoking causes lung cancer but did you know that smokers are 3 times more likely to have a heart attack than to develop lung cancer? “If you’ve had a heart attack, the single most important thing you can do to prevent a second one is to quit smoking,” says Asst Prof Tan. Smoking up to 5 cigarettes daily increases the risk of a heart attack by 40 percent. This would effectively cancel the protective effects conferred by taking medication.

How smoking affects the heart:

Inhaled nicotine causes blood vessels to clamp down, forcing the heart to pump harder and faster to push blood through the smaller vessels. This affects the lining of the blood vessels making it easier for fat and calcium deposits to accumulate, further narrowing the arteries. The carbon monoxide in cigarette smoke also reduces the oxygen supply in tissues. Lung irritation and breathing difficulties further strain your heart.

How to quit smoking:

  • Make a conscious effort to cut down smoking over 2 or 3 weeks and then stop smoking altogether. At first, you may want to change your daily routine if you associate smoking with specific activities.
  • Begin by giving up the first cigarette of the day. Subsequently, give up the second, then the third. Every day, try to go a little longer without a cigarette.
  • Take more fluids, fresh fruits, and vegetables. If you are used to having a cigarette in your mouth, have non-sugar lozenges or low-calorie sweets instead.
  • Tell your friends and family that you’re quitting, and politely (but firmly) decline when invited for ‘smoke breaks’. During the first days, try spending more time with non-smokers.
  • Speak to your doctor. Your doctor may refer you to a specialist smoking cessation clinic which has been shown to improve your chances of quitting the habit. There are also medications, special nicotine patches, and chewing gum that can help someone kick the smoking habit.

Studies have shown that giving up smoking lowers the risk of heart attack by up to 50 percent, regardless of how long you’ve smoked.

2. Maintain a healthy weight

Excess weight is associated with a higher incidence of high cholesterol, high blood pressure (hypertension), and type 2 diabetes (diabetes mellitus) – all of which contribute to the onset of heart disease. For every 10 kg of weight you lose, you can potentially reduce your systolic blood pressure by 20 mmHg.

The Body Mass Index (BMI) is a good way to check if your weight is in the healthy range. The BMI formula is:

BMI = Weight (kg) / Height (m) x Height (m)

Having a BMI between 18 to 22.9 is considered ideal.

Your risk for heart disease is also influenced by your body shape. Accumulation of fat around the waist (central obesity or so-called “apple” body shape) has been linked to a higher cardiovascular disease than fat accumulated around the hips and thighs (“pear” body shape).

Beyond your general body shape, your body fat distribution can also be assessed by the following waist-to-hip ratio (WHR) formula:

WHR = Waist circumference (cm) / Hip circumference (cm)

The healthy ratio for males should be less than 1. In females, it should be less than 0.8. Studies have shown that individuals of an acceptable weight but with central obesity are at 3 times higher risk of heart disease compared to individuals with no accumulation of fat around their abdomen.

3. Eat healthily

“By choosing foods low in fat, cholesterol, sodium, and sugar but high in fiber, you can reduce your risk of developing heart disease and other chronic illnesses,” says Asst Prof Tan. Here are the basic ways you can improve your diet for the sake of your heart:

  • Lower your fat intake. Avoid deep-fried foods, adopt low-fat cooking methods and choose lean meat. Stir-frying, boiling, or even steaming methods of food preparation will significantly lower the fat content of your dishes.
  • Reduce your cholesterol intake. Limit your consumption of organ meats, shellfish, prawns, and crabs.
  • Cut down on your sodium intake. If you cook, use less salt and monosodium glutamate. Foods with hidden salt such as preserved vegetables should be consumed in moderation. A salt-free diet can potentially lower systolic blood pressure by up to 8 mmHg.
  • Consume less sugar. “Choose plain water, plain tea or coffee instead of highly sweetened fruit-flavored and syrup drinks,” says Asst Prof Tan. Processed drinks and fruit juices are “hidden calories”. Recent studies have demonstrated that up to 22 percent of our dietary calories may come from sweetened drinks and fruit juices.
  • Increase your fiber intake. Eat more fruits and vegetables, and choose high-fiber alternatives to rice and cereal products. Celery, for example, is a good source of fiber. It only gives 6 calories per stalk which may be less than what is required by the body to digest it.

4. Exercise regularly

Exercise is an essential component in maintaining a healthy heart. This is good for healthy individuals and patients with existing coronary artery disease. Regular physical activity, especially those types that involve large muscle groups such as swimming, walking, Pilates, and yoga, produces cardiovascular adaptations that increase exercise capacity, endurance, and strength.

Besides fending off cardiovascular disease and other death-causing disorders, regular exercise also helps you to:

  • Lose weight effectively. Combining dieting with regular exercise is the most effective way to burn excess kilos.
  • Relieve stress. Feel-good brain chemicals called endorphins are released during exercise, helping to combat anxiety and depression. Although blood pressure is elevated during exercise (which is normal), after the activity, the blood pressure is generally lower as most of our blood vessels are dilated. Exercise will generally lead to lower blood pressure, helping you to keep it under control.
  • Sleep better. With regular exercise, you’ll fall asleep faster and have little trouble staying awake during the day.

Generally, it is advised to partake in 30 minutes of moderate exercise daily to experience the above health benefits.

5. Manage your stress

Apart from causing headaches, insomnia, and digestive problems, stress can also raise blood pressure and cholesterol levels, as well as encourage you to eat too much and smoke more. “Recent research shows that within two hours of an angry outburst, a person’s risk of heart attack nearly gets multiplied by 5,” says Asst Prof Tan.

While no one can eliminate stress, you can learn to cope with stress better.

  • Exercise regularly as it offers a calming effect that lasts longer than the exercise itself.
  • Take a short walk or have a quiet moment alone when stress starts to build.
  • Have enough sleep. Studies have shown sleeping less than 4 hours daily is associated with an increase in coronary artery disease. Ideally one should sleep for 6-8 hours each day.

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