Know your risk, and reduce it

Most heart attacks are preventable. Around 8 in 10 are linked to things that can be measured and changed. You don't need to do everything on this page. Doing the first two or three that apply to you makes a big difference.

Work out your risk in 5 minutes

Doctors in the UK use QRISK3, which estimates your chance of a heart attack or stroke in the next 10 years from your age, sex, ethnicity, blood pressure, cholesterol, smoking, weight, family history and medical conditions. You can run it yourself at qrisk.org. It's more accurate with a recent blood pressure and cholesterol reading, but works with estimates.

• Under 10%: low risk. Keep doing what you're doing.
• 10% or more: your GP will usually offer a statin and a conversation about blood pressure and lifestyle. Take the conversation.
• 20% or more: high risk. Worth acting on now.

The NHS Heart Age tool puts the same information in a different way: it tells you how old your heart "is" compared to your actual age.

Family history

If your father or brother had a heart attack, angina or a stent before 55, or your mother or sister before 65, your own risk is roughly doubled. Tell your GP: it changes what checks and treatment you're offered, and at what age. If several relatives were affected young, or had very high cholesterol, ask about familial hypercholesterolaemia, an inherited condition that affects about 1 in 250 people, is mostly undiagnosed, and is easily treated once found. A simple blood test for you and your children can rule it in or out.

Free checks

The changes that matter most, in order

1. Stop smoking. The biggest single thing. Smokers have about double the risk of a heart attack, and it drops sharply within a year of stopping. Free NHS stop-smoking services with a specialist adviser and medication roughly triple your chance of quitting compared with willpower alone. Vaping is much less harmful than smoking and is an accepted way to quit.
2. Get blood pressure under control. Less salt (under 6g a day, most of it is hidden in bread, cereals and ready meals), less alcohol, more movement, and medication if needed. Taking blood pressure tablets is not a failure. They're some of the most effective drugs in medicine.
3. Move more. 150 minutes of moderate activity a week (brisk walking counts) cuts risk by about a third. Going from nothing to a 20 minute daily walk is the biggest step. Sitting less matters separately.
4. Eat Mediterranean-style. More vegetables, fruit, beans, nuts, olive oil, fish and wholegrains. Less processed meat, pastry, fried food and sugary drinks. You don't need a special diet; you need the balance to shift.
5. Take the statin if it's offered. Statins lower the risk of heart attack by about 25% for every 1 mmol/L drop in LDL cholesterol. Serious side effects are rare, and muscle aches are much less common than internet forums suggest. If one doesn't suit you, there are alternatives.
6. Keep weight down, especially around the middle. A waist over 94cm (37in) for men or 80cm (31.5in) for women raises risk. Even a 5% weight loss helps blood pressure, blood sugar and cholesterol.
7. Drink less. No more than 14 units a week, spread out. There is no protective amount of alcohol, despite what you've heard about red wine.
8. Sleep and stress. Under 6 hours a night, untreated sleep apnoea (loud snoring, stopping breathing, exhausted in the day), and chronic stress all raise risk. Sleep apnoea is very treatable. Ask your GP if it sounds like you.

Risk you can't change, but should know about

• Age: risk rises steadily after 45 in men and 55 in women.
• Sex: men have heart attacks earlier on average. Women's risk catches up after the menopause, and women are more likely to be misdiagnosed. See warning signs.
• Ethnicity: South Asian heritage roughly doubles risk at a given age. African and Caribbean heritage raises blood pressure and stroke risk.
• Conditions: chronic kidney disease, rheumatoid arthritis, lupus, HIV, severe mental illness, a history of pre-eclampsia or gestational diabetes in pregnancy, and early menopause all raise risk and are built into QRISK.

Useful links

• QRISK3 calculator
• NHS Health Check
• NHS Better Health: Quit smoking
• BHF: Risk factors
• HEART UK: the cholesterol charity (familial hypercholesterolaemia)