The No. 1 killer in America? Heart disease, for both men and women.

Here are three of the biggest, doable steps to help maintain your heart and give yourself the best shot possible at a long and healthy life.

Talk with a primary care physician about your heart health.

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Manage stress levels

Mindfulness, meditation, deep breathing exercises and getting outside are all ways to de-stress. This isn’t just New Age babble. The science is behind it. “The American Heart Association first endorsed meditation in 2017 as a complement to traditional treatment and prevention of cardiovascular disease,” we wrote in this Healthy Headlines story. “Studies have shown practicing mindfulness and meditation can lower blood pressure, reduce anxiety and depression, and improve sleep, which is important for cardiovascular and overall health.”

Dr. Fisher is smiling for the camera in a white lab coat.
Dr. Jonathan Fisher

Getting started with mindfulness meditation is as easy as breathing in, holding it and breathing out, said Dr. Jonathan Fisher, a Novant Health cardiologist who has worked to incorporate mindfulness into his daily life for more than 10 years. It’s all about focusing on the moment and blotting out distractions.

Managing stress is one of the easiest things you can do for a healthy heart. Spending just five minutes in nature each day can calm your stress hormones

Follow a Mediterranean diet

This heart-healthy diet is based on the long-standing, healthy eating habits of the residents of Mediterranean countries — Italy, Greece, parts of Spain and France, and several Middle Eastern and north African countries. Here, people have a longer life expectancy and a lower prevalence of disease.

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Because it includes so many varying cuisines, the Mediterranean diet has no set rules. (Hence, it’s easier to follow than one with a lot of prescribed dos and don’ts.) Here are several key components of a Mediterranean diet:

  • Fruits and vegetables of all varieties.
  • Plenty of beans, legumes (lentils, peas and peanuts), whole grains and potatoes. (Some diets forbid potatoes; not this one.)
  • Unsaturated fats, including olive oil, nuts, seeds and avocados.
  • Oily fish, such as tuna, salmon, mackerel and sardines.
  • Shellfish, such as scallops, mussels and clams.
  • Low-fat dairy, including cheese and plain or Greek yogurt.
  • Skinless chicken breasts.
  • Infrequent sugary sweets, few processed foods and very little red meat.
  • Red wine (in moderation) instead of liquor: Usually one glass a day for women or two for men.
  • Lots of water.

Get moving

You don’t have to be an endurance athlete for exercise to have benefits. A walk around the block can do a world of good for your physical and mental health. The important thing is to find an activity – or, preferably, more than one – you enjoy so you’ll keep at it.

Dr. Culver is smiling and wearing a white lab coat
Dr. Adam Culver

Home workouts can be just as effective as a trip to the gym. Don’t have free weights? Use elastic bands, suggested Dr. Adam Culver of Novant Health Waxhaw Family & Sports Medicine. Run in place, take the stairs, find an online workout you like.

Any time is a good time to take stock of your heart health and make changes, if you need to.

It all starts with a single inhale and exhale.

Early heart attack care

Symptoms of a heart attack can start two weeks before the actual event. Early warning signs and symptoms may include:

  • Chest discomfort: pressure, squeezing, fullness, pain, tightness.
  • Discomfort or pain in one or both arms, jaw, neck, back, stomach.
  • Shortness of breath with or without chest discomfort.

Other symptoms may include:

  • Cold sweats.
  • Light-headedness.
  • Feeling nervous.
  • Being more tired than normal.
  • Sick to your stomach.
The takeaway: Early recognition of heart attack warning signs and symptoms can save lives. Call 911 right away.

Other heart attack symptoms:

Women, older adults and people with diabetes who use insulin may have unusual symptoms of heart attack. These symptoms may include:

  • Heartburn.
  • Indigestion.
  • Aching in the chest.
  • Pain in the shoulders.
  • Pain across the back, neck, arms, jaw, and the part above the stomach.

Heart attack symptoms in women:

Women having a heart attack may have:

  • Pain above the stomach.
  • Shortness of breath.
  • Sick to your stomach.
  • Lightheadedness.
  • Fainting.
  • Sweating.
  • A feeling that their heart is pounding or racing.
  • Feeling tired.

Women are more likely to have chest pain at rest, at night, and because of stress, and to ignore their symptoms and put off getting care.