It’s never too late to start taking care of your heart health. But cardiologist Dr. Katharine Decena says it is also never too early.

“If you have a family history of hypertension, high cholesterol or heart disease, it is never too soon to start paying attention to your diet and lifestyle,” she said.

A family history includes anyone in your immediate family who is diagnosed with high blood pressure (hypertension), high cholesterol, or has had a cardiac event like a heart attack under the age of 60.

“There is no earliest time to pay attention to your risk factors,” she said.

She added that if you have a history of high cholesterol in your family, your doctor should begin monitoring your levels when you are 20 years old.

“There are so many tools and so much technology available to us now, when we have the data and the knowledge it is easier to be proactive,” she said.

The key is to make changes that are sustainable, she said, not drastic and restrictive.

“If it doesn’t fit into your life, you won’t do it,” she said.

So making small changes, like having one meat-free meal a week to start, is a good strategy.

Decena also stressed that it is important for your overall health — as well as your heart health — to schedule regular checkups with your primary care provider, and to report any new or unusual symptoms.

“During the pandemic, our behaviors changed, and people were reluctant to see their doctor or schedule tests,” she said.

On top of that many people were experiencing anxiety, stress and depression, which can affect heart and overall health.

“Any symptom that is new to you, call your doctor,” she said. “We have lots of channels available now, and with telehealth you can start there and then determine next steps. Don’t ignore symptoms.”


Dr. Decena, who practices in Norwich, said a healthy lifestyle can help keep your blood pressure in a healthy range. Preventing high blood pressure, which is also called hypertension, can lower your risk for heart disease and stroke. The goal is a pressure of no higher than 130/80. And if your doctor has prescribed medication to control your blood pressure, Decena noted that it is critically important to take it consistently and as prescribed.

Eat a Healthy Diet

Eat a variety of foods rich in potassium, fiber, and protein and lower in salt (sodium) and saturated fat. DASH (Dietary Approaches to Stop Hypertension) is a good place to start if you are unsure.

This plan recommends:

  • Eating vegetables, fruits and whole grains.
  • Including fat-free or low-fat dairy products, fish, poultry, beans, nuts and vegetable oils.
  • Limiting foods that are high in saturated fat, such as fatty meats, full-fat dairy products, and tropical oils such as coconut, palm kernel and palm oils.
  • Limiting sugar-sweetened beverages and sweets.

Decena said a plant-based diet is optimal, but the so-called Mediterranean Diet is also heart healthy. This is a way of eating that’s based on the traditional cuisines of Greece, Italy and other countries that border the Mediterranean Sea.

Plant-based foods, such as whole grains, vegetables, legumes, fruits, nuts, seeds, herbs and spices, are the foundation of the diet. Fish, seafood, dairy and poultry are included in moderation. Red meat and sweets are eaten only occasionally.

Maintain a Healthy Weight

Being overweight increases your risk of high blood pressure. Talk to your doctor about what is considered a healthy weight range for you.

Be Physically Active

Physical activity can help keep you at a healthy weight and lower your blood pressure. The Physical Activity Guidelines for Americans recommends that adults get at least 2 hours and 30 minutes of moderate-intensity exercise, such as brisk walking or bicycling, every week. That’s about 30 minutes a day, five days a week. Children and adolescents should get one hour of physical activity every day.

“Everything counts,” Decena said. “Don’t feel like this means you have to join a gym and go every day and exhaust yourself. Take walks. Take the stairs instead of the elevator. If you golf, don’t rent a cart. Use a standing desk. If you have a smart watch, program it so it reminds you to get up and move every hour.”

Don’t Smoke

Smoking raises your blood pressure and puts you at higher risk for heart attack and stroke. If you do not smoke, don’t start. If you do smoke, quitting lowers your risk for heart disease:

  • Within 20 minutes of quitting, your blood pressure and heart rate recover from the cigarette-induced spike.
  • Within three months of quitting, your blood circulation and lung function begin to improve.
  • Within a year of quitting, your risk of heart disease is half that of a smoker.

Limit Your Alcohol

Alcohol can raise your blood pressure. Men should have no more than two alcoholic drinks per day, and women should have no more than one alcoholic drink per day.

Get Enough Sleep

Not getting enough sleep on a regular basis is linked to an increased risk of heart disease, high blood pressure, and stroke. It is recommended that adults get between seven and nine hours of sleep a night.


Your body needs cholesterol to build healthy cells, but high levels of cholesterol can increase your risk of heart disease. With high cholesterol, you can develop fatty deposits in your blood vessels. Eventually, these deposits grow, making it difficult for enough blood to flow through your arteries. Sometimes, those deposits can break suddenly and form a clot that causes a heart attack or stroke.

Total cholesterol levels under 200 mg/dl are healthy for adults. Doctors treat readings of 200–239 mg/dl as borderline high, and readings of at least 240 mg/dl as high.

The same basic advice provided for hypertension also applies to cholesterol. Healthy diet, exercise, don’t smoke, maintain a healthy weight, limit alcohol, Decena said.

When it comes to what you eat (or don’t eat), a healthy cholesterol diet involves:

  • Reduce saturated fats. Saturated fats, found primarily in red meat and full-fat dairy products, raise your total cholesterol. Decreasing your consumption of saturated fats can reduce your low-density lipoprotein (LDL) cholesterol — the “bad” cholesterol.
  • Eliminate trans fats. Trans fats, sometimes listed on food labels as “partially hydrogenated vegetable oil,” are often used in margarines and store-bought cookies, crackers and cakes. Trans fats raise overall cholesterol levels. The Food and Drug Administration banned the use of partially hydrogenated vegetable oils as of Jan. 1, 2021.
  • Eat foods rich in omega-3 fatty acids. Omega-3 fatty acids don’t affect LDL cholesterol. But they have other heart-healthy benefits, including reducing blood pressure. Foods with omega-3 fatty acids include salmon, mackerel, herring, walnuts and flaxseeds.
  • Increase soluble fiber. Soluble fiber can reduce the absorption of cholesterol into your bloodstream. Soluble fiber is found in such foods as oatmeal, kidney beans, Brussels sprouts, apples and pears.