12 simple ways to prevent a heart attack

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The evidence is piling up that the answer is - yes, stress is bad for your ticker.

"There are studies to show that stress is comparable to other risk factors that we traditionally think of as major, like hypertension, poor diet, and lack of exercise," says Dr. Kathi Heffner, assistant professor of psychiatry at the Rochester Center for Mind-Body Research at the University of Rochester Medical Center in New York.

Here, from our friends at Health.com, are 12 steps you can take to fight stress and protect your heart.

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Focus on relaxation

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Stress-reduction techniques and exercises such as yoga, meditation, and tai chi have been shown to lower stress hormones and bolster immune function, says Heffner.

In one study, people who practiced yoga regularly experienced a decrease in some of their body's inflammatory responses. Inflammation is emerging as a key culprit in heart disease, among many other chronic conditions.

"Dedicating a certain time of the day to focus on your body and on actually relaxing, (not) caring about the other things that are going on your day, is very useful," says Dr. John Simmons Jr., assistant professor of family medicine at Texas A&M Health Science Center College of Medicine.

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Connect with friends

Spending too much time on your own can affect not only your mental health but your heart health as well. This holds true whether or not you've been actually diagnosed with heart disease.

According to one study, women in particular were more prone to angina, a heart-disease-related chest pain, and other problems if they had little social support when they were recovering from a heart attack.

So get out and about. However, make sure you're connecting with true friends. "If you have a lot of friends but they're all mean to you, that won't be beneficial," Heffner says. And that's backed up by research.

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Forget perfect

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We all know that the type A personality - the one constantly striving for perfection - seems more prone to heart disease. But what it really boils down to, says Heffner, is hostility. "Hostility has been shown to be the key ingredient in what used to be termed the type A personality," she says. "Hostility is behavior that's fueled by anger toward other people." Research suggests that hostility may be a better predictor of heart disease than things like high blood pressure and being overweight.

So play nice and think nice thoughts about the future, as optimism has also been shown to protect the heart.

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Don't hold grudges

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Nursing a grudge isn't going to help in the heart-health department. Research suggests that people experience more psychological stress and higher heart rates when they hold grudges than when they grant forgiveness.

"You would be amazed at how strongly they can take root in your psyche and how long they can gnaw at you. Getting that monkey off your back psychologically is very important, and allows you to move on and quit perseverating," Dr. Simmons says.

So be quick to forgive. This is also likely to lead to better social relationships, another boost for the heart, Heffner says.

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Lighten up

Laughter can burn up to 20% more calories than keeping that poker face, according to a 2005 study, which monitored adults while they watched funny and not-so-funny film clips.

And fewer calories, as we all know, mean a better chance of staying slim, which is one of the best ways to protect your heart for the long-term. Mirth also increased heart rate and, in a 2010 study in the American Journal of Cardiology, was shown to improve vascular function. So laugh a little or, better yet, a lot. The first study found that the more you laugh, the more calories you use up and the harder your heart works.

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Don't drink (too much) alcohol

Having too many drinks can raise triglycerides and blood pressure and even lead to heart failure. However, moderate drinking may actually ward off heart disease. Moderate means no more than one drink a day for women and two for men.

If you don't drink, this isn't a reason to start, according to Dr. Simmons. "But if you have always enjoyed a glass of wine and want reassurance, it's perfectly fine," he says.

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Cut the caffeine

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Caffeine can quickly raise your fight-or-flight response and all the attendant stress hormones, explains Dr. Simmons. That's good if you're being chased by a saber-toothed tiger but not so good if you're caught in traffic.

Elevated stress hormones contribute to inflammation. So cut down on your coffee or tea habit. And even your diet soda habit. Preliminary studies have linked diet sodas to an increased risk of diabetes, a major risk factor for heart disease.

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Limit emotional involvement

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Not with people! But avoid getting too emotionally invested in things that don't matter that much.

For example, researchers recently linked football team losses with a greater risk of heart attack. In Los Angeles County, deaths from heart attacks and just deaths in general (mostly in elderly people) spiked after the Pittsburgh Steelers routed the Los Angeles Rams 31-19 in the 1980 Super Bowl. But when the Rams pounced the Washington Redskins 38-9 in 1984, deaths in the county declined. So don't sweat the small stuff and remember that it's all small stuff.

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Eat right

Eating a balanced diet - low in red meat and processed foods, high in fruits and vegetables, poultry, fish, and whole grains - will not only keep your weight down but also have a more direct effect on the heart's functioning: It keeps your blood sugar stable throughout the day so you can avoid destructive peaks and valleys. "Eating a more balanced diet with complex carbs means you're going to be stable throughout the day," Dr. Simmons says. "You're not going to have a carb high, then a drop down. Your mood isn't going to fluctuate."

Healthy eating can help prevent or delay diabetes, a major risk factor for heart trouble.

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Seek help for depression

Depression can increase the risk of heart disease and may shorten life span. If you're depressed, medication, psychotherapy or cognitive behavioral therapy, and other treatments may help. The Cleveland Clinic recommends antidepressants known as selective serotonin reuptake inhibitors (SSRIs, such as Prozac and Zoloft) because they don't raise blood pressure.

But ask your doctor if this is the best drug for your depression and make sure you know about any interactions.

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Get some sleep

So many people in our sleep-deprived culture just aren't getting enough z's, or enough of the right kind of rest. An average of six to eight hours of sleep is recommended, according to Dr. Simmons.

However, quality of sleep is key. Sleep apnea - a condition in which you wake up periodically due to interrupted breathing - has been linked with cardiovascular disease.

People who awake in the middle of the night from sleep apnea are unable to complete normal sleep cycles, a time when the body naturally lowers hormone levels and blood pressure. This can lead to hypertension and heart disease.

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Exercise more

Want a cure-all? Try aerobic exercises like running, walking, swimming, and even dancing. These activities help you feel better, lower your risk for diabetes, and make your heart stronger, a trifecta of health benefits. Exercise can also help depression.

Study after study has shown the benefits of physical activity, even active housework or gardening. The reason? It pumps your heart, moving blood all around the body.

The American Heart Association recommends exercising aerobically at least 30 minutes all or most days of the week. But talk to your doctor before hitting the track.

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