Heart and Vascular

Seven lifestyle changes to reduce risks and improve cardiovascular health

Life's Simple 7

By Dr. Sunny Intwala


You have just received the results of your bloodwork and your sugars and cholesterol numbers are higher than you expected. Your blood pressure is approaching alarming levels and the scale is tipping in the wrong direction. What now?
  First and foremost, you must talk to your doctor about next steps, whether you will need further testing and/or medication. But even then, there are some small steps you can take immediately to bring down those numbers and feel better.


The American Heart Association (AHA) defines Life’s Simple 7 as risk factors that can be improved by making lifestyle changes that will, in turn, help you achieve optimal cardiovascular health. Let’s break them down.


Manage Blood Pressure

High blood pressure is a major risk factor for heart disease and stroke. The first step to managing your blood pressure is understanding what the levels mean and what is considered normal, elevated and high. The top number, or systolic, measures the pressure in the arteries when the heart beats. The bottom number, or diastolic, measures the pressure in the arteries when the heart is resting between beats.


Blood pressure categories are broken down as follows:

  • Normal: systolic less than 120 mm Hg and diastolic less than 80 mm Hg
  • Elevated Blood Pressure: diastolic 120 to 129 mm Hg and diastolic less than 80 mm Hg.
  • High Blood Pressure (Hypertension) Stage 1: systolic 130 to 139 mm Hg or diastolic 80 to 89 mm Hg.
  • High Blood Pressure (Hypertension) Stage 2: systolic 140 or higher mm Hg or diastolic 90 or higher mm Hg.
  • Hypertensive Crisis (Call your doctor immediately): systolic higher than 180 mm Hg and/or diastolic higher than 120 mm Hg.

Now that we understand the numbers, here are some tips to control your blood pressure.

  • Eat healthy: Consume a diet rich in vegetables, fruits, whole grains, beans, legumes, nuts, plant-based proteins, lean animal proteins and fish. Limit sodium, saturated fats and added sugars. Limit sugary foods and drinks, fatty or processed meats, salty foods, refined carbohydrates and highly processed foods.
  • Exercise: Aim for at least 150 minutes of moderate intensity physical activity per week.
  • Sleep at least 7-8 hours a night.
  • Don’t smoke: Every time you smoke or vape, the nicotine causes an increase in blood pressure.
  • Manage weight: Even a slight decrease in weight can lower blood pressure levels.

Control Cholesterol

High cholesterol contributes to plaque, which can clog arteries and then lead to heart disease and stroke. Cholesterol is a fat-like substance that comes from food and your body. High-density lipoprotein (HDL) is known as good cholesterol and low-density lipoprotein (LDL) is known as bad cholesterol. HDL helps keep LDL from sticking to artery walls and reduces plaque buildup. Total cholesterol levels include HDL, LDL and 1/5 of triglyceride levels. Triglycerides are the most common type of fat in the body.


Similar to managing blood pressure, control cholesterol by eating healthy, exercising and not smoking. Also, know what fats you eat and replace saturated fats with unsaturated fats, i.e., avocados instead of butter.


Reduce Blood Sugar

To manage your blood sugar, you must first understand what makes blood sugar rise. The carbohydrates and sugar you eat turn into glucose in the stomach and digestive system. That glucose can then enter the bloodstream. Insulin is a hormone made in the pancreas that helps the body take up the blood glucose and lower blood sugar levels.


In type 2 diabetes, glucose builds up in the blood instead of heading to your cells because the body can’t use the insulin it makes efficiently and/or the pancreas stops producing insulin.

Fasting blood glucose levels include:

  • Lower than 100 mg/dl — Normal — Healthy range
  • 100 to 125 mg/dl — Prediabetes (Impaired Fasting Glucose) — At increased risk of developing diabetes
  • 126 mg/dl or higher — Diabetes Mellitus (type 2 diabetes) — At increased risk of heart disease or stroke

Like controlling blood pressure and cholesterol, reduce blood sugar levels by eating healthy, exercising, managing weight and not smoking.


Physical Activity

Adults should aim for at least 150 minutes of moderate cardio activity per week or 75 minutes of vigorous cardio activity per week. Some ways to boost your physical activity include walking more, setting realistic goals and gradually increasing each day. Also, include strength training (weights, resistance bands) at least twice a week.


Lastly, set your calendar and plan to exercise around the same time each day to create a habit. Remember, you are never too old to start exercising, and doing something is better than nothing at all.


Eat Better

We all know eating a diet high in vegetables, fruits, whole grains, beans and lean meats is one of the best ways to stay healthy. But how do we get there?


Some ways of creating healthy dietary patterns include watching caloric intake and eating smaller portions. Make a habit of reading nutrition labels and select foods low in sodium, sugars and saturated fat. Cook more at home and make smart choices by swapping out, for example, pasta with zucchini noodles or rice with cauliflower rice.


Lose Weight

When you shed fat and pounds, your heart, lungs, blood vessels and skeleton begin to work better because they are not carrying around that extra burden. To lose weight, you must burn more calories than you consume.


Keep track of your caloric intake and physical activity. Learn your body mass index so you can determine whether you are at a healthy weight or not.


Quit Smoking

Tobacco users have a higher risk of developing cardiovascular disease. Smoking is linked to about one-third of all heart disease fatalities and 90 percent of lung cancer.


If you smoke, map out a plan to quit. The AHA recommends the following:

  • Set a quit date within the next 7 days.
  • Choose a method: cold turkey or gradually.
  • Decide if you need help from a healthcare provider, nicotine replacement or medicine.
  • Prepare for your quit day by planning how to deal with cravings and urges.
  • Quit on your quit day.

You should also figure out what your smoking triggers are and avoid them, have someone to support you and find ways to reduce stress, like exercising and meditation.


Life’s Simple 7 was developed so everyone can have the ability to make small changes and reap big rewards. Start by managing one or two risk factors and see what a difference that makes. I’m certain it will motivate you to keep going and make good choices for a long and healthy life.


Learn more about Dr. Sunny Intwala,a cardiologist and clinical exercise physiologist with Nuvance Health.

** The content is not intended to be a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.