The five factors that drive heart disease

A 2025 study finds that smoking and high blood pressure are the two most important factors driving heart disease risk. Together with high cholesterol, excess weight (or being underweight), and diabetes, these five factors account for about 50% of the burden of cardiovascular disease. Compared to people with all five risk factors at age 50, those who had none of the factors were far less likely to develop cardiovascular disease or die early. On average, women with none of the risks at midlife lived 13 more years without heart disease, while men lived an additional 11 years.

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How the body’s internal clocks influence heart health

Circadian rhythms, which are hardwired into nearly every cell of the body, regulate the heart and blood vessels. Disruptions to this rhythm—from shift work, poor sleep, or unhealthy habits—can raise the risk of cardiovascular disease. For example, heart attacks are more likely to occur on Mondays than any other day of the week. That’s because people tend to stay up later than usual and then sleep in the next day. On Monday morning, when they have to wake up early again for work, the change may cause subtle changes in blood pressure, hormone secretion, and metabolism that raise heart attack risk.

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The heartfelt effects of exercise

Exercise is one of the most powerful tools for preventing heart disease and extending life. Physical activity triggers favorable changes such as making cells more sensitive to insulin and reducing inflammation. It also helps keep blood vessels supple and flexible (which supports efficient blood flow), strengthens muscles (which helps burn more calories), and remodels the heart, making it more efficient at pumping blood through the body. Together, these changes all reduce a person’s chances of developing common risk factors for heart disease, including diabetes, high blood pressure, high cholesterol, and obesity.

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How a healthy gut benefits your blood pressure

A diet low in sodium and rich in plant-based foods promotes a diverse, balanced population of gut microbes, which may help people maintain a healthy blood pressure. A salty diet increases the prevalence of bad microbes and reduces the number of beneficial microbes. When bad microbes accumulate in the gut, they form  breakdown products and toxins that promote inflammation. Beneficial microbes feed on fiber, which is why a diet that provides a mix of healthy fiber from plant-based foods helps. These microbes produce short-chain fatty acids, which interact with specific receptors on cells that help regulate blood pressure.

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Try this: Light therapy

Light therapy uses light boxes that emit a bright, white light. Exposure to this light can control a person’s circadian rhythm—the body’s internal 24-hour sleep-wake clock—and help manage and prevent seasonal affective disorder.

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The need for walking speed

Walking is often viewed as a casual form of exercise, but it also can be your primary form of moderate-intensity exercise if you increase the intensity, duration, and frequency of your workouts. You can adopt several types of workouts to help increase pace and endurance, such as intervals, timed walks, and pole walking. Wearing appropriate walking shoes and improving their walking mechanics also can improve walking speed and endurance.

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