Heart health at a glance
Heart disease includes several conditions that affect how your heart and blood vessels work. It is a leading cause of death, but many cases are preventable with healthy habits, regular checkups, and control of blood pressure, cholesterol, blood sugar, and tobacco exposure. Knowing your personal risks helps you act early.
Major risk factors for heart disease
High blood pressure. High blood pressure makes the heart work harder and damages blood vessels over time. It raises the risk of heart attack and stroke. Treatment includes lifestyle changes and, if needed, medicines. Home monitoring helps you and your clinician track progress.
High LDL cholesterol. LDL is sometimes called “bad” cholesterol because it contributes to plaque in arteries. Lowering LDL with diet, activity, and medicines when needed reduces events like heart attack.
Smoking and vaping nicotine. Tobacco damages blood vessels and the heart. Quitting lowers risk at any age. Avoid secondhand smoke when possible.
Diabetes and prediabetes. High blood sugar harms blood vessels and nerves that control the heart. Keeping A1C, blood pressure, and cholesterol in range lowers complications.
Excess body weight and unhealthy diet. Extra weight and diets high in sodium, saturated fat, and added sugars raise blood pressure and cholesterol. Heart-healthy eating patterns lower risk.
Low physical activity and long sitting time. Moving more and sitting less supports healthy blood pressure, weight, and cholesterol. Any activity is better than none.
Sleep problems. Short sleep and untreated sleep disorders are linked with higher heart risk. AHA lists healthy sleep among its core measures of cardiovascular health.
Stress and mental health. Ongoing stress can drive unhealthy coping, raise blood pressure, and affect sleep. Managing stress supports heart health.
Family history and age. Risk rises with age and with a family history of early heart disease. You cannot change these, so managing the risks you can change becomes even more important.
Blood pressure and cholesterol: the numbers that matter
Ask your clinician which targets fit your situation.
- Blood pressure: Keeping readings in a healthy range lowers risk of heart attack and stroke. Track at home and during visits. Lifestyle changes such as less sodium, more activity, limiting alcohol, and taking medicines as prescribed help control it.
- Cholesterol: Aim to lower LDL and keep HDL and triglycerides in a healthy range. Diet changes, physical activity, and medicines when needed can improve your lipid profile.
What to do: a practical game plan
Eat heart-healthy foods
Build most meals from vegetables, fruits, whole grains, beans, nuts, seeds, and healthy oils. Choose fish or skinless poultry more often than red or processed meats. Limit sodium, saturated fat, added sugars, and ultra-processed foods.
Be physically active
Adults should aim for 150 to 300 minutes each week of moderate activity like brisk walking, or 75 to 150 minutes of vigorous activity like running, or a mix of both. Add muscle-strengthening activities on 2 or more days. Move more and sit less throughout the day.
Get healthy sleep
Most adults need 7 to 9 hours of quality sleep. Keep a steady schedule, limit late caffeine and screens, and ask about snoring or possible sleep apnea if you wake unrefreshed. AHA includes sleep as a core measure of heart health.
Manage stress in healthy ways
Use brief daily tools such as walks, stretching, breathing exercises, and time outdoors. Stay connected with supportive people. Ask your clinician about counseling or programs if stress feels unmanageable.
Quit smoking and avoid secondhand smoke
Quitting greatly reduces risk within months and continues to lower risk over time. Your clinician can help with medications and counseling. Free help lines and text programs are available.
Keep regular checkups
Schedule annual wellness visits and recommended screenings. Work with your clinician to check blood pressure, cholesterol, blood sugar, weight, family history, and medicines. Early action prevents problems later.
Stress and your heart
Chronic stress can raise blood pressure, affect sleep, and push people toward unhealthy habits. Build daily stress relief into your routine, and consider counseling if stress affects work, relationships, or health behaviors.
Sleep
Aim for consistent sleep and a calming wind-down routine. Poor sleep quality is linked with higher heart risk, which is why AHA includes sleep in its core metrics. If you have loud snoring, choking at night, or persistent daytime sleepiness, ask about screening for sleep apnea.
Women and heart disease risk
Heart disease is the leading cause of death for women, and risks can look different across life stages such as pregnancy and menopause. Awareness has improved over time, yet many women still underestimate their risk. Symptoms can be subtle, and some groups face higher risk than others. Tailored prevention and early recognition help close these gaps.
What to know: learn personal risk factors, track blood pressure and cholesterol, keep up with prenatal and postpartum care if pregnant or recently pregnant, and seek care promptly for chest discomfort, shortness of breath, unusual fatigue, or jaw, neck, or back pain.
Heart health and HIV
Why heart health deserves extra attention
People living with HIV have a higher risk of heart and blood vessel problems than people without HIV. Research summaries from the American Heart Association report roughly 1.5 to 2 times higher rates of conditions like heart attack and stroke in this population. The reasons include traditional risk factors that many people share, plus HIV-related immune activation and long-term inflammation.
How HIV can affect cholesterol and triglycerides
HIV and some HIV treatments can be linked with higher LDL cholesterol or triglycerides in some people. High LDL and high triglycerides can contribute to plaque build-up in arteries over time. NIH HIVinfo recommends regular lipid testing for people with HIV and using a combination of lifestyle changes and, when appropriate, cholesterol-lowering treatment to reduce risk.
Why standard risk calculators may underestimate risk
Some commonly used heart risk calculators were not designed for people with HIV. Expert statements highlight that risk may be underestimated, so many clinicians take a more cautious approach and consider HIV itself as a factor that raises cardiovascular risk. This supports earlier lifestyle changes and earlier discussion of preventive therapies when overall risk is not clearly low.
What screening to ask for
Work with your HIV care team and primary care team to build a routine plan. A practical checklist includes:
- Blood pressure at every visit or home monitoring if readings have been high.
- Fasting lipid panel to check LDL, HDL, and triglycerides at baseline and at regular intervals.
- Blood sugar or A1C to screen for diabetes or prediabetes.
- Weight and waist measurement to track body composition changes.
- Kidney and liver tests as part of regular HIV care, since these organs affect heart risk and treatment choices.
These steps come from HIVinfo guidance on heart risk and cholesterol in the context of HIV.
What prevention looks like in everyday life
Most of the same habits that help everyone’s heart are especially important if you live with HIV:
- Eat for your heart. Base meals around vegetables, fruits, beans, whole grains, nuts, seeds, and healthy oils. Choose fish or skinless poultry more often and limit excess sodium, added sugars, and highly processed foods. These patterns are linked with healthier cholesterol and blood pressure.
- Move more, sit less. Aim for about 150 minutes each week of moderate activity like brisk walking, plus muscle-strengthening on at least two days. Physical activity improves cholesterol, blood pressure, blood sugar, weight, mood, and sleep.
- Quit smoking and avoid secondhand smoke. Stopping tobacco use quickly lowers heart risk and the benefits keep growing over time. Free counseling and quit-lines can help.
- Sleep well and manage stress. Adults need 7 to 9 hours of quality sleep. Healthy stress relief such as walks, breathing exercises, time outdoors, or counseling supports blood pressure and heart-protective routines.
- Take HIV medicines exactly as prescribed. Staying on treatment controls the virus, lowers inflammation, and supports overall heart health. Tell your care team if mood, sleep, or other side effects make adherence hard so they can help you problem-solve.
Coordinated care matters
Ask your clinicians to coordinate HIV care with primary care and, when needed, cardiology or lipid specialists. Coordination helps with three things:
- Checking for interactions between HIV treatment and any heart-related treatments.
- Choosing prevention strategies that fit your overall health.
- Tracking a single plan for blood pressure, cholesterol, blood sugar, and weight.
These points reflect expert guidance that stresses integrated, team-based prevention for people with HIV.
“Things to do to improve” checklist
Use this list to plan your next steps.
- Fill half your plate with vegetables and fruits at most meals. Choose whole grains. Limit sodium and added sugars.
- Walk briskly most days. Add strength exercises twice a week. Break up long sitting time.
- Check blood pressure at home and during visits. Know your readings and goals.
- Ask for a fasting lipid panel and discuss your LDL target.
- Quit smoking or vaping. Get help with medicines and counseling.
- Aim for 7 to 9 hours of sleep. Address snoring or daytime sleepiness.
- Manage stress with daily habits and support.
- Keep vaccinations up to date and stay engaged with routine care.
- If you live with HIV, ask about lipid checks, possible drug interactions, and a heart-healthy plan that fits your regimen.
When to seek care
Call emergency services for chest pain, pressure, or discomfort that lasts more than a few minutes, shortness of breath, fainting, or new weakness on one side of the body.