How to Lower Your Risk of Heart Attack: Actions You Can Take From Your 30s Onwards

When most men think about heart attacks, they picture a guy in his 60s clutching his chest in a movie scene.

Reality check:

Heart disease starts decades earlier.

Fatty streaks in arteries can be seen in people in their 20s. By your 30s and 40s, the habits you’ve built are already shaping whether you’ll be the guy doing laps with his grandkids… or meeting a cardiologist much sooner than you’d like.

The good news?

There are clear, practical steps you can take from your 30s onwards to dramatically lower your risk.

This isn’t about perfection. It’s about stacking the odds in your favour.

1. Know Your Numbers – and Track Them Over Time

You can’t improve what you don’t measure.

From your early 30s, get a proper cardiovascular risk check every 1–2 years. At minimum, that should include:

• Blood pressure

• Fasting lipid panel (total cholesterol, LDL, HDL, triglycerides)

• Fasting glucose / HbA1c

• Weight, waist circumference, BMI

• Family history of early heart disease or stroke

From your 40s (or earlier if you have risk factors), consider coronary artery calcium (CAC) scoring – a low-dose CT scan that looks for calcified plaque in your coronary arteries. A CAC score:

• 0 → very low near-term risk (if everything else is ok)

• Higher scores → more plaque → more aggressive prevention is justified

Major guidelines (like the American Heart Association and European cardiology societies) increasingly use CAC to refine risk and guide who should start statins earlier, even if “traditional” risk looks moderate.

Action step:

If you’re 30+ and haven’t had a proper check in years, book in. Ask specifically for a heart health assessment, not just “a quick blood test.”

2. Get Serious About Blood Pressure (Even “High-Normal”)

High blood pressure quietly damages arteries and the heart for years before you feel anything.

• Ideal: around 120/80 mmHg

• “High-normal”: 130–139 / 80–89 – this already increases long-term risk

• ≥140/90 – hypertension, which significantly increases heart attack and stroke risk

Lowering systolic BP by just 10 mmHg can cut your risk of major cardiovascular events by roughly 20%.

What you can do:

• Buy a home BP monitor and track readings (relaxed, seated, at home)

• Reduce processed foods

• Lose even 5–10% of body weight if you’re overweight

• Prioritise sleep and stress management (they matter more than most men think)

• If lifestyle isn’t enough, don’t fear medication – BP tablets are some of the most effective “lifespan extenders” we have

3. Cholesterol: Don’t Just Aim for “Normal” – Aim for Optimal

LDL (“bad”) cholesterol is one of the main drivers of plaque buildup in your arteries.

• Lower LDL over your lifetime = less plaque = fewer heart attacks.

• Men with genetically low LDL often have dramatically lower rates of coronary disease.

From your 30s, especially if you have family history or other risks, it’s worth aiming for better-than-average numbers:

• LDL ideally <2.6 mmol/L for most healthy men

• Even <1.8 mmol/L if you have higher risk (family history, high CAC score, diabetes, etc.)

Lifestyle is the foundation:

• More plants, fibre, nuts, olive oil, oily fish

• Less ultra-processed food, deep-fried takeaway, and excess alcohol

• Maintain a healthy weight and move daily

But don’t ignore medication when appropriate:

• Statins have a very strong evidence base for preventing heart attacks, particularly in men with higher LDL or established risk.

• Newer agents (like PCSK9 inhibitors and inclisiran) can be considered in higher-risk men or those who can’t tolerate statins.

Action step:

If your LDL is creeping up in your 30s or 40s, don’t just “recheck next year.” Talk about targets and whether you should treat earlier and harder based on your overall risk, not just the lab reference range.

4. Weight, Waist and the “Hidden” Risk of Visceral Fat

It’s not about a six-pack. It’s about what’s happening inside.

Fat around your organs (visceral fat) is strongly linked to:

• Insulin resistance

• High BP

• Inflammation

• Higher heart attack risk

A simple red flag is waist circumference:

• Aim for <94 cm (ideally <90 cm) for most men

• Above 102 cm is strongly associated with metabolic and cardiovascular risk

You don’t need crazy diets. Focus on:

• Slight calorie deficit most days

• Plenty of protein and fibre

• Minimising sugary drinks and “liquid calories”

• Consistent movement

Even a 5–10% weight loss can significantly improve BP, cholesterol and glucose control.

5. Move Like Your Life Depends On It (Because It Does)

Exercise is one of the most powerful “drugs” for heart health.

Goal (from your 30s onward):

• 150–300 minutes of moderate cardio per week (brisk walking, cycling, swimming)

  OR

• 75–150 minutes of vigorous cardio (running, intervals, hill sprints, sport)

• Plus 2–3 days of resistance training

Benefits:

• Lowers BP and resting heart rate

• Improves cholesterol and insulin sensitivity

• Reduces visceral fat

• Boosts mood, stress tolerance and sleep

If you’re currently doing almost nothing:

1. Start with 10–15 minutes of brisk walking daily.

2. Add one resistance session per week.

3. Build up over months, not days.

The aim is not perfection – it’s staying consistently active for decades.

6. Blood Sugar and Metabolic Health – Long Before Diabetes

You don’t need a diabetes diagnosis for high blood sugar to be damaging.

Even “pre-diabetes” increases your risk of heart attack and stroke. The process of insulin resistance and endothelial damage starts earlier than most men realise.

Key checks:

• Fasting glucose

• HbA1c

• Sometimes a 2-hour glucose tolerance test if there’s doubt

What helps:

• Weight loss (especially around the waist)

• Exercise (both cardio and weights)

• Minimising ultra-processed carbs and sugar

• Prioritising sleep (poor sleep drives insulin resistance)

In some higher-risk men, medication such as metformin or newer agents (GLP-1 agonists like semaglutide / tirzepatide, or SGLT2 inhibitors) can have significant cardiometabolic benefits on top of lifestyle – this is individualised and needs a proper medical assessment.

7. Smoking, Vaping and Alcohol – No Surprises Here

Smoking & Vaping

• Smoking is still one of the biggest modifiable risk factors for heart attack.

• Vaping is as bad – emerging data suggest it still harms blood vessels and increases BP.

Quitting smoking at 30, 40 or 50 dramatically reduces your future risk. The body is incredibly forgiving.

Alcohol

• Regular heavy drinking and binge episodes raise BP, arrhythmia risk, and triglycerides.

If you drink:

• Stick to low-risk guidelines.

• Aim for several alcohol-free days per week.

• If you’re using alcohol to cope with stress or sleep, that’s a red flag worth addressing.

8. Sleep, Stress and the “Invisible” Heart Attack Risks

Sleep and stress are often ignored by men… until burnout or a health scare.

Sleep

Chronic short sleep (regularly <6 hours) is linked to:

• Higher BP

• Weight gain

• Insulin resistance

• Increased cardiovascular events

Aim for 7–9 hours most nights. If your partner says you snore loudly, stop breathing at night, or you wake unrefreshed, get checked for sleep apnoea – treating it significantly improves heart risk.

Stress

Ongoing high stress adds to:

• High BP

• Poor lifestyle choices (comfort food, alcohol, inactivity)

• Inflammation

You can’t eliminate stress, but you can build a better buffer:

• Daily movement

• Breathwork or short mindfulness sessions

• Time outdoors

• Strong relationships and social connection

Stress management is not “soft” – it’s part of serious cardiovascular prevention.

9. Hormones and Heart Health (Testosterone, Thyroid, etc.)

Hormonal health and cardiovascular health are deeply linked.

Testosterone

Low testosterone in men is associated with:

• Increased fat mass and visceral fat

• Insulin resistance

• Diabetes and metabolic syndrome

• Higher cardiovascular mortality in observational studies

For some men, properly-indicated testosterone replacement therapy (TRT) can improve body composition, energy and metabolic health. But TRT is not for everyone – it needs:

• Correct diagnosis (symptoms + low levels on repeated tests)

• Assessment of cardiovascular and prostate risk

• Ongoing monitoring (hematocrit, PSA, lipids, BP)

If you’re in your 30s–50s with low libido, fatigue, poor recovery and central weight gain, it’s worth discussing a full hormonal and metabolic work-up with a doctor who understands men’s health and longevity.

Thyroid and others

Thyroid disorders, sleep apnoea, and certain medications (like some antidepressants or antipsychotics) can all affect weight, cholesterol and blood sugar. Addressing these is part of comprehensive prevention.

10. Build a Long-Term Plan With a Doctor Who “Gets It”

Heart-attack prevention isn’t a one-off test. It’s an ongoing strategy.

From your 30s onwards, you ideally want:

• A baseline assessment (bloods, BP, metabolic markers ± CAC score)

• A clear risk profile

• A combination of lifestyle changes + targeted medical prevention (when indicated)

• Regular follow-up and refinement as you age

For some men, that will include:

• BP medication

• Cholesterol-lowering drugs (statins ± others)

• Diabetes or metabolic medication

• Possibly hormone optimisation in selected cases

  … alongside training, nutrition and sleep dialled in.

The Bottom Line

You don’t go from “healthy” to “heart attack” overnight.

Your arteries are keeping score from your 20s and 30s onwards.

If you:

• Know your numbers

• Keep your BP and cholesterol controlled

• Maintain a healthy waist and strong metabolism

• Move your body, sleep decently and manage stress

• Stay away from smoking and heavy drinking

• Work with a doctor who thinks prevention-first

…you massively tilt the odds towards a longer, stronger, sharper. life.