You have more control over your heart health than you might think. In fact, researchers estimate that almost one in three heart attacks are linked with eating an unhealthy diet while an unhealthy lifestyle – smoking, not exercising, drinking too much alcohol – accounts for many of the others.

Following a heart-friendly diet and lifestyle can reduce your future risk of a heart attack whether or not you have already experienced one.

Ask yourself these 10 questions to see if you need to take action.

Of course, none of the following information is intended to be medical advice, but, we hope that it gives you something to discuss with your doctor on your next visit.

What is My Risk?

Your doctor can calculate your risk of having a heart attack within the next 10 years based on factors such as your age, gender, blood pressure, weight and cholesterol. You can also calculate your own risk, on-line, if you have the results of a recent full health check-up. If you live in the UK, click on QRisk and if you live in the US, click on National Institutes of Health.

How Often Should I Have My Blood Pressure Checked?

High blood pressure, or hypertension, is one of the most important conditions your doctor will ever screen you for. If you haven’t had your blood pressure (BP) checked in the last year, it’s a good idea to get it checked as high blood pressure rarely causes symptoms – even when it’s dangerously high. I recommend an annual check as blood pressure tends to increase with age and greatly increases your risk of a heart attack, stroke, eye and kidney problems.

Is My Blood Pressure Okay?

An ideal blood pressure is one that’s below 120/80 mmHg. If your BP is high-normal (120/80 mmHg to 139/89 mmHg), diet and lifestyle changes can help stop it creeping up further. If your BP is consistently at 140/90 mmHg or higher, you have hypertension. Diet and lifestyle changes will help bring it down and could avoid the need for antihypertensive medication.

Investing in a clinically validated home blood pressure monitor will provide readings that aren’t raised due to the stress of seeing your doctor (a phenomenon called White Coat Hypertension). Click here for my advice on how to choose a home blood pressure monitor.

Is My Cholesterol Okay?

An ideal total cholesterol is 5 mmol/l (200mg/dl) or less for healthy adults. Lower limits may be advised if you are at higher risk of heart disease. The balance between total cholesterol and “good” HDL is also important.

You should have your cholesterol checked if you have a family history of heart, circulatory or cholesterol problems, are overweight, have high blood pressure or diabetes or if you are over 40 years old. If your cholesterol is normal, then a recheck every 5 years is a good idea. If it is raised and/or you are on cholesterol lowering medication it should be checked at least every year, or as often as your doctor advises.

Should I Be Screened for Diabetes?

Early identification of diabetes is important to reduce the long-term risk of side effects, including heart disease. While Type 1 diabetes causes symptoms such as thirst, passing more urine, hunger, and weight loss, Type 2 diabetes tends to creep up with less obvious signs, which can include tiredness or recurrent urinary infections, boils or thrush. Type 2 diabetes is associated with being overweight, family history, and some ethnic backgrounds. Ask your doctor when you were last screened, and if another check is due.

 Do I Need to Lose Weight?

Being overweight increases the work load of your heart and tends to cause your blood pressure and cholesterol to rise. Your weight and height can be used to calculate your Body Mass Index (BMI). If the resulting number is above 25 Kg/M2 then you probably need to lose some weight. You can find a BMI calculator and information on how weight affects your heart here.

 Is My Waist Size Okay?

While your BMI is a good indicator of general health risk, people who store fat around their waist are more likely to develop heart disease than those who store fat elsewhere. Fat stored around your organs adversely affects your liver, cholesterol balance, glucose control and blood pressure. Your health is at risk if your waist measurement is over 94 cm (37 inches) for men, or over 80 cm (31.5 inches) for women. Reducing your waist size by between 5 cm and 10 cm can significantly reduce your risk of future heart problems.

How Many Calories Do I Need per Day?

Your weight, height, age and activity level can be used to estimate how many calories you need per day. If you want to lose weight, aim to eat around 500 kcal less per day than you need. By exercising more you will also burn off more energy as heat. You can estimate your daily energy needs in the calculator towards the end of the post here.

When if Comes to Heart Health, Which is Better – A Low Fat Diet or a Low Carb Diet?

This remains controversial, but increasing evidence suggests that fats are less harmful than carbohydrates – especially sugar. The key is to concentrate on eating a balanced diet, choosing healthy fats (e.g., from olive oil, rapeseed/canola oil, nut oils, oily fish) and cutting back on stodgy foods and sugar.

Cut back on salt intake, too, as salt can increase your blood pressure and thicken the walls of your arteries and heart. The best diet for your heart, blood pressure and cholesterol balance is the Mediterranean based DASH Diet.

How Much Alcohol Can I Drink?

Drinking one or two glasses (100ml each, or 10g alcohol) of wine, two or three times a week is generally considered beneficial. However, a high alcohol consumption (three or more drinks per day) can lead to sodium and fluid retention so your blood pressure increases.

Every additional drink can increase your average systolic blood pressure (upper reading) by 1-2 mmHg, and your diastolic blood pressure (lower reading) by 1 mmHg. High intakes can also cause abnormal heart rhythms. Your doctor can advise what alcohol intake is safe for you.

Have you asked yourself any of the above heart health questions recently? If so, did they prompt you to take action? Which issues have you raised with your doctor? Please join in the conversation.

Sarah BrewerDr. Sarah Brewer is a medical nutritionist, nutritional therapist and the author of over 60 popular health books. Follow her Nutritional Medicine blog at DrSarahBrewer.com, her blood pressure advice at MyLowerBloodPressure.com and her health product reviews at ExpertHealthReviews.com. For nutrition and recipe tweets follow @DrSarahB and for general health and fitness tweets follow @DrSarahBHealthy.

Let's Have a Conversation!