Good question: Can you prevent heart disease?
February 20, 2025 | 3 min read
Heart disease is one of the most pervasive chronic illnesses in Canada. The good news? The risk of developing it can be mitigated greatly by preventive behaviours.
Consider the numbers: While heart disease remains the second-leading cause of death in Canada and the top cause of premature death among women, the number of adults with new heart disease diagnoses has been steadily dropping since 2000, and the mortality rate associated with heart disease has declined by 21% in the same period.1 Experts attribute this downward trend in part to more effective risk factor management strategies2—in other words, better prevention.
So how, exactly, can proactive lifestyle changes play a role in lowering the risk of heart disease? Below, Nurse Practitioner Julie Kim and Dr. Al Qahwash of St. Mary’s General Hospital in Kitchener, ON, home of the St. Mary’s PREVENT Clinic, get to the heart of the matter.
Can lifestyle changes actually prevent heart disease?
Dr. Al Qahwash: While it is important to note that genetics and age play a role that cannot be fully controlled, studies show lower rates of heart attacks and better outcomes with lifestyle changes—even among those with genetic predispositions.
Julie Kim: We know that almost 80% of premature stroke and heart disease is preventable.3 That’s a massive number. So, prevention really starts with knowing your individual risk factors. If you don’t know what those are, how can you make the kind of changes that you need to make to lower your risk?
What risk factors associated with heart disease are out of our control?
Julie Kim: There are a few. Genetics do play a role in increasing peoples’ risks, but perhaps not to the extent people think. We don’t consider a grandparent who had a heart attack at 85 to be a major risk factor. We’re really talking about parents or siblings who had heart disease at an early age—a mother or a sister, before the age of 65; or a father or brother, before 55.
Age is also a powerful risk factor for heart disease. So is sex – women tend to develop heart disease at a later age than men, and have more small vessel, or “microvascular” disease of the heart. So is ethnic background—people with South Asian and African heritage have an increased risk of heart disease. So are personal circumstances—we know many people don’t have access to healthy food, safe drinking water, or health services. These are risk factors we can’t change.
What risk factors can we change?
Julie Kim: There are five main pillars people can influence with lifestyle changes.
The first is diet. The Mediterranean diet—rich in fruits, vegetables, beans, legumes, whole grains, lean meats, fish, and healthy oils—is scientifically approved for better heart health, but every individual’s needs will be a bit different when it comes to reducing risk through what you eat. If you have access to a dietician [covered by some benefits plans], you can get some very good guidance about what will work for you.
Second: Stay active and move more. Find more ways to be active in your daily life. We really can’t emphasize this enough. The Canadian Society for Exercise Physiology’s 24 Hour Movement4 Guidelines provide recommendations by age, and there’s some really good scientific evidence behind them. And staying active has so many other benefits, like maintaining a healthy body weight, reducing stress, improving sleep, just to name a few.
The third modifiable risk factor is smoking, which triples your risk of developing cardiovascular disease. We know that the minute people stop smoking, their risk of heart disease starts to go down; within a year, they’ll have already cut their risk in half. It’s never too late to quit.
The fourth pillar relates to sleep. People who don’t get enough sleep have higher rates of obesity, hypertension and diabetes, which can all increase the risk of heart disease. Developing a sleep hygiene routine and aiming for seven to eight hours of sleep a night is important.
Finally, weight is a risk factor. It’s not only about body mass index (BMI); you can have a ‘healthy’ BMI and still be at increased risk, depending on how the weight is distributed. When you carry extra weight, particularly around your abdomen, you increase your risk of cardiovascular disease.
What’s the one thing you wish more people understood about preventing heart disease?
Dr. Qahwash: It’s essential for people to understand these lifestyle changes can significantly improve your heart health; heathier habits can control your blood pressure, cholesterol and weight, which are the biggest factors that can significantly reduce the risk of heart disease.
Julie Kim: It’s also incredibly important for people to know their numbers—the indicators that can signal heart health. I call them the ABCs.
“A” is for A1C, which measures your average blood sugar levels over the past three months—it can indicate whether you’re diabetic, or pre-diabetic. Screening for diabetes starts at age 40, or earlier if you have additional risk factors.
“B” is for blood pressure. It’s one of those things that can creep up quietly, with no symptoms at all—and it’s a powerful risk factor for developing stroke and a major risk factor for heart disease. Get it checked yearly, at least. And “C” is for cholesterol. Screening starts at 40 years of age, or earlier if you have additional risk factors. Both A1C and cholesterol screenings require a blood test.
Diabetes, high blood pressure and high cholesterol are all conditions that increase your risk of heart disease. Talk to your primary care provider about when you should start screenings, so you can better understand your risks. So much of heart disease really is preventable.
Heart disease numbers to know
2x
Men are twice as likely as women to suffer a heart attack
#1
Heart disease and stroke is the top cause of premature death among women5
35%
The increase in the number of people aged 18-24 using medication6 for cardiovascular conditions between 2019 and 2023, according to 2023 Manulife aggregate drug claims data.
This article is for informational purposes only. It is not intended to diagnose or treat a condition. If you have questions or concerns about your specific situation or are seeking medical advice, contact your medical doctor or your healthcare provider.
St. Mary’s PREVENT Clinic
In alignment with our Impact Agenda7 and our commitment to sustained health and well-being, Manulife Canada is proud to support the PREVENT Clinic powered by Manulife. Located within the St. Mary's Cardio Pulmonary Rehabilitation, the clinic serves as a multidisciplinary, risk-factor reduction program for primary prevention of cardiovascular disease.