Most Americans survive a first heart attack but are at increased risk for another one. By taking action, however, they can significantly reduce their chances for a second heart attack.

Risk factors

These factors increase your risk for another heart attack, according to the American Academy of Family Physicians (AAFP):

• Sedentary lifestyle
• Being overweight or obese
• High cholesterol
• High blood sugar if you have diabetes
• High blood pressure
• Smoking
• Excess stress

The American Heart Association (AHA) recommends the following actions to reduce your risk for a second heart attack.

Quit smoking Tobacco is the top modifiable risk factor for heart disease. You can cut your risk of another heart attack in half by kicking the habit. Need help? Visit the American Cancer Society.

Eat a heart-healthy diet By cutting back on saturated fat and trans fat, you can lower your LDL (“bad”) cholesterol, one of the primary substances that causes heart attacks. Food manufacturers are currently reducing or eliminating trans fats from their products. You can avoid most trans fatty acids by eating less margarine and fewer cookies, crackers, fries, doughnuts and other snack foods that contain partially hydrogenated oils.

Control your cholesterol Besides eating a heart-healthy diet such as the Mediterranean-American diet, you can help keep your cholesterol under control by exercising regularly. Your doctor may also prescribe a cholesterol-lowering medication such as a statin.

Exercise regularly A study published in the journal Circulation found that heart attack survivors who increased their activity levels were nearly twice as likely as inactive patients to still be alive seven years after their attacks. Exercise is important because it strengthens the heart muscle. It also boosts your energy level and helps with weight management, cholesterol and blood pressure. The AHA recommends a minimum of 30 to 60 minutes of walking or other moderately vigorous exercise at least three or four times each week.

If you’ve had a heart attack, you must get your doctor’s approval before starting an exercise program.

If you have any of these symptoms during exercise, call your doctor immediately, the AAFP says:

• Shortness of breath that lasts for more than 10 minutes
• Chest pain or pain in your arms, neck, jaw or stomach
• Dizzy spells
• Pale or splotchy skin
• Very fast heartbeat or irregular heartbeat
• Cold sweats
• Nausea and vomiting
• Weakness, swelling or pain in your legs

Maintain a healthy weight Being overweight dramatically increases your risk of having a second heart attack. If you need to lose weight, ask your doctor for help. Your BMI (body mass index) is calculated using your height and weight and should be between 18.5 and 24.9. Try our BMI calculator tool to find out your number.

Assess your mental health Depression, stress, anxiety and anger can damage your heart and overall health. See a therapist if you need help maintaining your emotional balance.

Take your medications as directed Taking your heart, cholesterol and blood pressure medications as directed and having regular doctor visits are imperative.

Evaluate how you live your life and what you can change to improve your heart health. Exercising, losing weight and eating right are all steps to make sure you have the best chance of avoiding a second heart attack.

Watch Dr. Telly Meadows’ video and learn more about Rowan Regional’s Smith Heart & Vascular Center