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Every 12 minutes an Australian loses their life to cardiovascular disease (and every 90 mins for New Zealanders)[1,36], yet up to 80% of these deaths are preventable.[2] The secret to prevention lies not in a pill, but in how we live our lives. From the food on our plates to the quality of our sleep, the habits we develop over our lifetime shape our cardiovascular health – for better, or worse.

In our last article we introduced readers to the six pillars of lifestyle medicine, and their vital role in maintaining wellbeing. Let’s take a closer look at how each pillar impacts heart health, and share simple ways to protect your heart and optimise your cardiovascular health.

What does the term ‘cardiovascular’ mean?

Cardio = heart
Vascular = blood vessels.
Your heart is the central organ of the cardiovascular system which functions like a pump to push blood through your blood vessels (including arteries, veins and capillaries), supplying oxygen and nutrients to all of your cells, nerves, muscles and other organs in your body.

Cardiovascular disease (CVD) describes a group of conditions affecting the heart and blood vessels, including coronary heart disease, heart failure, stroke, and vascular dementia. These conditions all impair blood flow throughout the body.[3]

The primary cause of CVD is atherosclerosis, where fatty deposits called plaque build up inside artery walls. This process begins with damage to arteries, triggered by high blood pressure, high cholesterol, smoking, and other risk factors. Cholesterol and fats become trapped, inducing an immune response resulting in the formation of plaques. Over time, plaque narrows and hardens the arteries, making blood flow difficult. If a blockage occurs or, more commonly, if a plaque ruptures, it can cause a blood clot that blocks circulation, leading to a heart attack or stroke.[4]

High levels of cholesterol play a critical role in the development of CVD. Low-density lipoprotein (LDL) cholesterol carries cholesterol from the liver throughout the body, is primarily implicated in the formation of arterial plaque, and is often given the moniker ‘bad cholesterol’. High-density lipoprotein (HDL) carries cholesterol back to the liver to be processed and ‘flushed’ from the body – hence it is often referred to as ‘good cholesterol’. HDL cholesterol, however, may not protect against CVD as much as once thought, with high levels being linked with increased risk of cardiovascular events.[5,6] Current evidence emphasises focusing on lowering LDL cholesterol and maintaining a healthy balance of lipoproteins rather than simply raising HDL levels. Managing cholesterol levels alongside other risk factors remains essential for protecting heart and blood vessel health.[4,7]

Protect your heart with simple lifestyle modifications

Whole food plant-based eating patterns

The type and amount of fat you consume through your diet are key factors in determining your cholesterol levels. Eating foods high in saturated and trans fats causes the liver to produce more cholesterol, slows its removal from the blood and elevates LDL cholesterol levels. Trans fats are particularly harmful. They raise LDL and lower HDL cholesterol levels, thereby significantly increasing the risk of heart disease.[8.9]

Foods that can raise cholesterol levels due to their saturated fat content:

• Eggs (also high in cholesterol)[10,11]
• Processed (e.g. ham, sausages, salami) and red meat
• Dairy products e.g. cream, cheese, butter, milk, yogurt, and ice cream
• Commercially baked goods e.g. pastries, biscuits, cakes, brownies
• Deep-fried and takeaway foods, e.g. crisps, hot chips, burgers and pizza

Trans fats occur naturally in small amounts in animal products and can exist in higher amounts in processed foods where they are deliberately added. You can easily spot these in packaged goods as they’ll have “hydrogenated oils” or “partially hydrogenated vegetable oils” listed on the packaging.

While plant-based meat alternatives generally contain less saturated fat than their animal-based counterparts, and can help reduce CVD risk when they replace meat, they can still be a significant source of saturated fat and typically contain more fat than whole plant foods.[12] Reducing saturated and trans-fat intake is key to lowering cholesterol and CVD risk.

Conversely, diets rich in fibre, antioxidants, unsaturated fats, and phytonutrients help reduce cholesterol, blood pressure, vascular inflammation, and tissue-damaging oxidative stress.[13]

→ Aim to incorporate the following heart-healthy foods in your diet daily

• Whole grains, e.g. oats, brown rice, quinoa
• Legumes, e.g. lentils, beans, chickpeas, peas, edamame. soybeans
• Dark leafy greens, e.g. spinach, kale
• Cruciferous vegetables, e.g. broccoli, cauliflower, cabbage
• Fruit, e.g. berries, apples, citrus, kiwifruit
• Nuts and seeds e.g. walnuts, almonds (¼ cup max), flaxseed & chia (1 Tbsp)
• Garlic, onions, herbs and spices
• Colourful vegetables, e.g. capsicum, beetroot, carrots

Physical activity

Regular physical activity helps your heart work more efficiently, improves blood flow, and supports healthier cholesterol levels.[18] It can also help lower blood pressure and improve how your body uses insulin to manage glucose, both important for protecting heart health.[19,20] Exercise keeps your arteries flexible by increasing the natural production of nitric oxide—a compound made by the vessel walls that helps them relax and widen for better circulation.[21]

On the flip side, sedentary behaviours have wide-ranging adverse impacts on the human body, increasing the risk for hypertension and CVD.

→ Aim for at least 2 ½ hours of moderate-intensity or 1 ¼ hours of vigorous physical activity spread across the week. Bump the time spent active up to 5 and 2 ½ hours, respectively, and enjoy even greater heart health benefits.[22] Try to spread these activities across the week and aim to do muscle-strengthening exercises at least twice a week.

Restorative sleep

Sleep is a critical regulator of cardiovascular health. Getting less than 6 hours of sleep is strongly linked to higher risks of heart disease, stroke and high blood pressure.[23,24] Inadequate sleep disrupts blood pressure regulation, increases stress hormones such as cortisol, and elevates inflammation, all of which can damage blood vessels over time. Even when sleep quantity is adequate, poor sleep timing can also raise risks. Shift workers, for example, experience up to a 26% higher risk of coronary heart disease compared to day workers due to disruption of natural sleep–wake cycles.[25]

Improving sleep can be one of the most powerful ways to protect your heart. If you struggle with persistent insomnia, loud snoring, or daytime sleepiness despite adequate time in bed, it is important to speak with your doctor. Early assessment and treatment can significantly improve long-term heart health.

→ Aim for 7–9 hours of good-quality sleep per night (or 7–8 hours for those over 65).[26] Maintain a regular sleep schedule, create a cool, dark, quiet bedroom, avoid screens close to bedtime, and limit caffeine, and heavy meals in the evening.

Stress management

Chronic stress is insidious. It keeps your cardiovascular system activated, maintains elevated cortisol and adrenaline, promotes inflammation, dysregulates blood pressure, and deteriorates the function of the inner lining of blood vessels (endothelium). Over time, these damaging effects promote hypertension, plaque buildup, and vascular stiffening. Stress can also reduce blood flow to the heart, triggering chest pain, irregular heartbeats, or even heart attacks in vulnerable people—sometimes even in those without prior heart disease.[27,28]

Research indicates that those with high stress hormones have a 63% higher risk of cardiovascular events.[29] So, if stress feels overwhelming, leads to anxiety, sleep disturbance, or persistent low mood, it is important to see your doctor. They can assess underlying health issues, refer you to support services, and connect you with effective therapies. And if you ever notice new, severe, or worrying physical or other symptoms, it’s safest to seek medical help immediately.

→ Aim to adopt regular stress-management practices, e.g. mindfulness, breathing exercises, yoga, meditation, progressive muscle relaxation, and nature walks. Cultivate hobbies, work–life balance, and downtime.

Avoidance of risky substances

Smoking and vaping

An overall downward trend in daily smoking rates among adults in New Zealand and Australia is cause for celebration.[30,37] Tobacco smoke contains numerous toxins that injure the endothelium, increase blood pressure, decrease HDL, promote inflammation, and accelerate plaque formation. [31] While e-cigarettes and vaping are often promoted as alternatives to smoking, they are not risk-free. Growing evidence highlights significant cardiovascular risks associated with their use.[32] Being both tobacco-free and nicotine-free is the ideal option for maintaining a healthy heart.[31}

Alcohol

Alcohol intake raises blood pressure, promotes arrhythmias, increases triglycerides, contributes to weight gain, and can trigger cardiomyopathy (weakening of the heart). Over time, drinking accelerates vascular ageing and increases CVD risk.[33]
Alcohol is a carcinogen, and no level of consumption is safe for health[35].

→ Aim to reduce or quit smoking, vaping or alcohol for optimum cardiovascular health. Seek counselling, social support, and connect with quit programs or addiction services when necessary. These services will help you establish healthier routines and environments that support your long-term wellbeing.

Positive social connections

Studies show that strong, meaningful relationships— with family, friends, whānau, community—buffer stress, offer emotional support, reduce loneliness, and promote healthier behaviours. Conversely, loneliness and social isolation have been shown to increase inflammation, blood pressure, and overall cardiovascular disease risk. One meta-analysis found that social isolation increased heart disease risk by up to 50%[32].

→ Aim to prioritise relationships—schedule regular catch-ups, join community or interest groups, volunteer, lean into family, community and cultural connections. Nurture a support network and reciprocate support.

Interested in learning more?

Sign up for our Tackling Heart Disease course. This online on-demand course designed for anyone living with—or wanting to prevent—cardiovascular disease. Whether you’re dealing with health concerns or simply want to keep your heart strong, this course equips you with the knowledge, tools, and expert guidance to make lasting, positive changes. Developed by expert healthcare practitioners, you’ll gain valuable knowledge and learn practical strategies to support better heart health and longevity.