Lower your heart attack risk

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What is a heart attack or stroke?

A heart attack happens when blood stops flowing to part of your heart

A stroke happens when blood stops flowing to part of your brain

A blood clot can block an artery feeding blood to your heart, causing a heart attack, or to your brain, causing a stroke. This clot is often the result of a build-up of plaque in your arteries (called coronary artery disease). When one of these plaques ruptures, it can cause a blood clot to form, and block an artery.

Heart and diabetes checks

A ‘ heart and diabetes check ’ is an appointment with your doctor or nurse. Together, you will estimate your risk of having a heart attack or stroke in the next five years, and discuss options and choices you have to protect your heart.

What happens during a heart and diabetes check?

Together with your doctor or nurse, you are likely to:

  • discuss any family history of heart attack or stroke
  • measure your blood pressure, height and weight
  • discuss your cholesterol and blood sugar levels
  • talk about anything in your life that might be increasing the chance of you having a heart attack or stroke, or developing diabetes. These things are called risk factors.

Many of us don’t know whether we’re at risk of having a heart attack or stroke. A heart and diabetes check ensures we learn about our risk, and find out what steps we can take to protect our heart.

Just because you are at ‘low risk’, doesn’t mean you are at ‘no risk’.

You may still have a heart attack or stroke even if you are at low risk. That’s why it is so important to look at the choices you can make to improve your life-long heart health.

Risk of heart attack and stroke

What is risk and what does it mean for me?

Your risk is an estimate of how likely you are to have a heart attack or stroke in the next five years. If you have a 10% risk, it means that if there were 100 people like you, we’d expect 10 of them to have a heart attack or stroke in the next five years.

Risk factors and overall risk

In the past, your doctor may have talked to you about each one of these risk factors separately. We now know it is better to focus on all your risk factors combined rather than just individual risk factors.

There are some risk factors you can change to help lower your risk, but there are others you can’t change.

Risk factors you can’t change :

  • Family history of heart disease
  • Personal history of heart disease
  • Gender
  • Ethnicity
  • Age

Risk factors you can change :

  • Smoking
  • Diabetes
  • High blood pressure
  • Poor diet
  • High cholesterol
  • Overweight
  • Not enough exercise

What does your overall risk look like ?

Your overall risk is worked out by looking at all of your risk factors added together. It’s like building a tower out of building blocks. The risk factors are the blocks, but it’s the tower they build that is important.

When deciding what you would like to do about your risk of heart attack and stroke, it is important to consider your personal beliefs and concerns, and those of your family. You may like to think about:

  • what your risk means for you and your family
  • what your risk will mean for you in a few years’ time
  • the pros and cons of any changes you make
  • how any change you make might affect both you and your family
  • who you would ask for support.

Questions you may like to ask your doctor or nurse

  • What’s the best thing I could do to lower my risk?
  • What support is available to help me stop smoking?
  • I’ve tried to make lifestyle changes before and failed what can I do differently this time to be successful?

Note: If you are thinking about taking natural, complementary or traditional therapies to manage your risk, please talk to your doctor, nurse or pharmacist.

Choices you have to manage your risk    

Making choices to lower your risk

You have an important role to play in your health.

No matter how high or how low your risk of heart attack or stroke, there are always choices you can make to lower your risk.

The choices you make every day can change your risk of heart attack and stroke:

  • stop smoking
  • make heart healthy eating and drinking choices
  • move more
  • lose weight
  • take medications

Even small changes have a positive effect on your risk factors and your overall risk of heart attack and stroke.

Making one small change that you’re able to stick to is more valuable than making a big change that’s hard to stick to. As you get comfortable with one small change, you may like to add another one. Slowly you can start building sustainable, healthier habits.

Note: The choices you make to lower your risk of heart attack and stroke will also help you manage high blood pressure, high cholesterol or diabetes.

Stop smoking

If you smoke, stopping smoking is the best thing you can do for your heart.

There is lots of support available to help you stop smoking. Talk to your doctor or nurse about what support may work best for you:

  • Phone, online and text-to-quit
  • Local one-on-one or group support programme
  • Patches, lozenges and/or gum
  • Other medications


  • It’s much easier to stop smoking when you have support from family – who can you ask to help you?
  • Nicotine cravings last for three minutes, so you only need to hold out for 180 seconds to beat the urge to smoke

Goal: To have stopped smoking by your next birthday

Make heart healthy eating and drinking choices

Heart healthy eating is all about balancing the different types of food you eat to get a range of nutrients. Try balancing your day’s eating like this:

Follow these simple steps to help you make realistic changes to what you eat and to improve your heart health:

  1. Share and enjoy meals with family and friends that focus mostly on whole and less-processed foods
  2. Include plenty of colourful non-starchy vegetables* and/ or fruit at every meal and for most snacks
  3. Choose whole grains in place of refined grain products e.g. choose brown rice instead of white rice
  4. Use legumes like chickpeas, kidney beans, black beans and lentils in place of meat or mix into a dish and use less meat
  5. Include fresh or canned oily fish like mackerel, sardines and salmon a couple of times a week
  6. Use mostly reduced or low-fat milk, cheese and yoghurt (or calcium-rich alternatives) everyday
  7. Choose healthy oils, nuts and seeds instead of animal and coconut fats
  8. Drink water to quench thirst, and limit sugary drinks and alcohol
  9. When preparing meals, snacks and drinks, use pepper, herbs, spices or fruit to add flavour rather than using salt or sugar

* Does not include starchy vegetables like potatoes, kumara, corn, parsnip, yams, cassava/tapioca, green banana and taro

Goal: To follow a heart healthy eating and drinking pattern throughout the week

Lose weight

There are steps you can start taking today to manage your weight. It’s all about balancing what you eat and drink with the exercise that you do.

  • Use a small plate rather than a big one
  • Cut down on alcohol
  • Swap a can of fizzy drink to water
  • Try walking or biking to work rather than driving
  • Keep a food diary to help you keep on track


  • If you’re feeling hungry, have a glass of water first. Often we can mistake the feeling of thirst for hunger
  • Listen to your stomach, not your eyes, for when it’s time to stop eating

Goal: If overweight, aim to lose 5 – 10% of your body weight

Move more

Getting active can be simple. Why not try one of these ideas each day?

  • Take the stairs instead of the elevator
  • Deliver a message in person to a co-worker instead of sending an email
  • Get off the bus one stop early and walk
  • Catch up with friends during a walk instead of by phone
  • Talk to your doctor or nurse about a green prescription
  • Get in the pool and try walking in water


When doing moderate exercise, you should feel your heart pumping harder but still be able to talk comfortably.

  • If you are too breathless to talk, then it’s time to slow down
  • If you are able to sing or whistle, then step up the pace

Goal: Work up to doing 2.5 hours of moderate exercise over a week

Take medications

Even if you start making some lifestyle changes, your doctor may still like to talk to you about medications.

To keep safe when taking medication, you need to understand:

  • what the medication does
  • why you are on the medication
  • which unwanted effects, you should look out for.

Feeling uncomfortable?

If you have questions or concerns about your medications or if you have any unwanted side effects, please talk to your doctor, nurse or pharmacist. There may be other medications available that would suit you better.


When taking medication, it’s important to take it regularly. You may like to:

  • Set reminders on your cellphone
  • Talk to your pharmacist about a blister pack

Goal: To understand any medication you are on and why you are taking it

Watch and wait

Risk means something different to everyone.

You may decide you’d like to simply monitor your health for a while. Then, if your health or life changes in any way, you might decide at a later date to start taking steps to lower your risk of heart attack and stroke.

If you decide to take a ‘watch and wait’ approach, you won’t have to make any lifestyle changes or remember to take any medication.

You also won’t have any side effects or complications. However, you will need to monitor your health, which may mean extra visits to the doctor.

Making a lifestyle change can help improve your overall health and wellbeing, and lower your risk of other illnesses. If you decide to watch and wait, you will miss out on these benefits. Over time, it is likely that without treatment or making lifestyle changes, your risk of heart attack or stroke will increase. Please think about what this may mean for you and your family.


  • Schedule a regular check-up with your doctor or nurse to monitor your health
  • Learn the warning signs and symptoms of a heart attack and stroke so you can react quickly

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