The first new cholesterol guidelines released by the American Heart Association in eight years recommend changing lifestyle habits much sooner. Now, according to the guidelines, the discussion about health and cholesterol should begin at age 30, and medications may be prescribed from that age onwards to help.
But the goal isn’t to prescribe statins to everyone at the first sign of trouble, cardiologists told .com.
Rather, it’s about shifting the focus to take into account the “lifetime risk of high cholesterol,” said Dr. Leslie Cho, director of the Women’s Cardiovascular Center at the Cleveland Clinic, who was part of the committee that developed the guidelines.
“We often get cholesterol tested in our 40s and 50s, and we kind of think the risk starts there,” but we know that’s not really the case, Cho told .com.
Experts now consider cholesterol more of an exposure risk, they said, and the longer you are exposed to high cholesterol, the greater your risk of heart attacks and strokes in the future.
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Starting the conversation about cholesterol control earlier in life gives patients the opportunity to not only treat the disease, but get ahead of it, Dr. Matthew Tomey, a cardiologist and professor of medicine at Mount Sinai Fuster Heart Hospital, told .com.
Discuss these risks with your patients by comparing them to compound interest over time, he said. That way, investments made in early adulthood to create heart-healthy habits can ‘translate into large-scale benefits for individuals—and for society—as we enter middle and old age,’ said Tomey, who was not involved in developing the new guidelines.
Habits formed in your 20s and 30s can have benefits for your cholesterol levels and overall health for decades to come. These are some of the most important habits for heart health, according to cardiologists.
The Most Important Thing You Can Do to Improve Your Cardiovascular Health in Your 30s
Get tested and know your values
Cho and Dr. John Wilkins, a cardiologist at Northwestern Medicine’s Blum Cardiovascular Institute, agreed that this is the best starting point.
“If you don’t get tested, you don’t know,” Cho said, adding that he sees many patients who have never had their cholesterol measured. More than 40% of adults with high cholesterol are unaware that their levels are high enough to require treatment, according to a recent estimate.
Cholesterol testing is also important for children.
Since 2011, some expert groups have recommended that children receive a cholesterol screening test between ages 9 and 11 to determine high cholesterol, as well as certain inherited risk factors that can raise cholesterol levels.
The new AHA guidelines also specifically recommend perform lipoprotein (a) screening tests in children, a protein that transports cholesterol in the blood. A person’s lipoprotein (a) level is determined primarily by hereditary risk factors and can have a major impact on cholesterol levels.
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“It’s not reduced by diet and exercise in the same way, but it is strongly correlated with plaque formation and the development of (heart attacks and strokes) later in life,” Dr. Harmony Reynolds, a cardiologist and director of the Center for Women’s Cardiovascular Health at NYU Langone Heart, told .com.
“So it’s one more factor we use to determine who needs more care,” said Reynolds, who also served on the writing committee that created the guidelines.
Once you know your cholesterol levels and some other data (such as your blood pressure), you can use the AHA’s free calculator tool to get an idea of your heart disease risks.
From there, Wilkins, who also worked on the new guidelines, recommends talking to your doctor for more personalized advice on what steps you can take. This could include medication to help control cholesterol.
Other healthy habits for the heart that should be adopted after 30
No matter what your cholesterol levels are, these are healthy habits to incorporate into early adulthood that will benefit your heart for the rest of your life.
Of course, even if you start incorporating these habits after age 30, you’ll still reap the health benefits.
Move more
If you want to get started right away, Reynolds suggests incorporating a little more physical activity into your day.
Your overall goal should be to achieve the 150 minutes of moderate-intensity aerobic exercise per week recommended by the AHA, experts agree. Although cardiovascular exercise is still the best option for heart health benefits, experts recommend incorporating some strength training as well, especially as we age.
But instead of trying to give it their all in the gym, “adults should really focus on consistency and finding a physical activity that they enjoy,” Wilkins said, “and also trying to prevent injuries.”
Tomey agrees: Instead of setting a specific number, she explained, start where you are on your fitness journey and set a realistic goal. “We all have the opportunity to improve and do more,” he said. “We should focus more on individual progress as much as possible.”
Don’t underestimate “the impact that a little intermittent physical activity has on your lifestyle,” Reynolds said. Just a few minutes of this type of brief but vigorous exercise, such as running to catch the bus or carrying heavy groceries up the stairs, has been shown to provide cardiovascular benefits, he explained.
Create a healthy eating pattern
Another cornerstone of heart health is eating well.
Exactly how that translates will vary from person to person, but experts generally agree that an eating plan based on the Mediterranean diet or the DASH diet will have the greatest long-term benefits for heart health.
Both eating patterns emphasize fruits, vegetables, lean proteins and heart-healthy unsaturated fats, Wilkins explained.
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If you have been diagnosed with high cholesterol, there are other specific guidelines you should follow to help you control it, he added. If you’re looking for help using diet as a tool to control cholesterol, your doctor can connect you with dietitians for personalized help, Tomey said.
In particular, soluble fiber is known to help keep cholesterol levels in check, as .com previously explained.
On the other hand, it’s helpful to avoid saturated fats, Reynolds said, which are found in butter, full-fat dairy, coconut oil and fried foods.
While these suggestions don’t usually surprise people, what does surprise people is “how small changes in your daily life can influence your cholesterol by reducing saturated fat,” Reynolds explained.
Stop smoking and vaping
If you smoke cigarettes, one of the most impactful things you can do to improve your heart health is to quit, Wilkins added. Although nicotine e-cigarettes do not contain as many harmful chemicals as combustible cigarettes, the AHA urges people to stop vaping.
Also consider your relationship with alcohol, he said, adding that the old idea of drinking red wine for heart health is not something doctors recommend today. Drinking any amount of alcohol also increases the risk of several types of cancer, .com previously explained.
Prioritize good sleep
Sleep also plays a critical role in heart health and your overall well-being, Cho said. This is partly because people who are sleep-deprived may make less healthy choices when it comes to eating, he said.
Some people don’t need as much sleep as others, but you should aim to get at least seven hours of sleep each night, according to the Mayo Clinic.
Wilkins recommends developing good sleep hygiene habits, such as having a consistent bedtime routine and avoid screens before bedto get quality rest.
