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People with systemic inflammatory conditions such as rheumatoid arthritis, lupus, and psoriasis are more likely to have heart attacks and to die of cardiovascular disease than people in the general public. The 2019 expert guidelines for preventing heart disease says these conditions should be considered “risk enhancers” when estimating heart attack risk. But this added risk may be underrecognized and undertreated.

People who want to reinvigorate their walking workouts might try interval walking, which adds short bursts of fast walking that elevates the heart rate and improves fitness. Another option is Nordic walking, which uses special poles with hand straps that help engage the upper body and burn more calories. On the other hand, a mindful walk (also known as walking meditation) can help relieve stress.

Physicians’ understanding of how a COVID-19 infection affects the heart is still evolving. More definitive answers require long-term, randomized clinical trials that control for different factors (including varied medical histories and medication use) to study how COVID-19—and possible therapies—affect people who have or are at risk for heart disease. Like other infectious organisms, SARS-CoV-2 (the virus that causes COVID-19) can increase the risk of blood clots and may damage the heart, but the danger is less common than initial reports suggested.

Diets that contain low-quality, highly refined carbohydrates (such as sugary drinks, candy, white rice, and foods made with white flour) have a high glycemic index and are linked to an increased risk of cardiovascular disease. Whole and minimally processed carbs that contain fiber and resistant starch (whole grains, legumes, nuts, and fruits and vegetables) have a lower glycemic index and are better for cardiovascular health.

After receiving an implanted cardiac defibrillator, people are often anxious about receiving a shock from the device. But relaxation therapy, cognitive behavioral therapy, and support groups may help people cope with this anxiety.

The heart-protecting benefits of a daily low-dose aspirin have to be weighed against the risk of bleeding, a common side effect that is usually minor but sometimes serious. The calculation depends on age and whether a person has cardiovascular disease, diabetes, or a condition that raises risk of bleeding.