The first-line defense against atherosclerosis is to limit the damage caused by the disease and prevent it from worsening. To do this, physicians will often recommend the following strategies:

• Quitting smoking. Tobacco smoking is a major cause of coronary artery disease (CAD) and cardiac arrest. Research from the Centers for Disease Control and Prevention (CDC) shows heart disease as the leading smoking-related cause of death in the United States among men and women, resulting in about 150,000 deaths from cardiovascular disease each year. The average smoker dies nearly seven years earlier than a nonsmoker, according to the CDC. 
  
  
• Controlling diabetes. Persons with diabetes may be more likely to develop heart-related diseases, and diabetes is associated with more severe atherosclerosis. Proper glucose control is crucial to the overall health and heart function of diabetic patients.
  
  
• Controlling high blood pressure (hypertension). Individuals with high blood pressure are at greater risk of cardiovascular problems resulting from CAD. Hypertension can be controlled through taking blood pressure medications (antihypertensives), self-monitoring blood pressure, eating a heart-healthy diet that is low in salt and engaging in regular exercise. People are also encouraged to have regular check–ups with their physician.
  
  
• Reducing the amount of fats and cholesterol in one’s diet to lower total cholesterol levels. High cholesterol levels are not thought to cause atherosclerosis directly. However, cholesterol is thought to trigger other abnormalities that may speed the process of plaque build-up.
  
  
• Achieving and maintaining a healthy weight. Obesity and being overweight are major risk factors for a host of serious health conditions, including coronary artery disease, high blood pressure, diabetes, heart attack and stroke. Some weight control methods include limiting unhealthy fats (e.g, saturated and trans fats) in a patient’s diet, increasing activity levels, counseling, medication and surgical interventions.
  
  
• Keeping a routine of moderate to vigorous exercise, depending on an individual’s overall health. This is valuable in maintaining a healthy cardiovascular system. Exercise keeps obesity at bay and keeps the heart from being unduly stressed. It also lowers cholesterol levels and blood pressure. Furthermore, when accompanied by a low-fat diet, exercise may help to reduce plaque deposits, reversing the process of atherosclerosis. Current guidelines recommend 30 minutes of exercise most days of the week.
  
  
• Learn your family medical history. A patient’s family medical history can greatly increase (or decrease) the risk of the patient developing certain medical conditions, including atherosclerosis and coronary artery disease. Some patients prefer to develop their own medical family tree and bring it with them to their medical appointment. A complete family tree traces the medical history of an individual (and spouse, if applicable) through at least two generations.
  
  
• Getting regular physical examinations, particularly if in a high-risk category for heart disease.
  
  
• Stress management. Stress can lead to high-risk practices such as overeating, smoking, high blood pressure (hypertension) and a lack of exercise. In addition, chronic stress may be a direct contributor to poor heart health because it produces increases in blood pressure that could become permanent.
  
  
• Controlling chronic depression. Depression has been linked with a higher risk of developing high blood pressure, heart disease and having a heart attack.

Until recently, high estrogen levels had been believed to provide younger women a significant degree of protection from the development of heart disease in their premenopausal years. Indeed, earlier studies investigated a role for hormone replacement therapy (HRT) in continuing this protection in postmenopausal women.

However, a major study of cardiovascular protective effects of estrogen-progesterone HRT, called the Women’s Health Initiative, yielded unexpected results. Researchers found that HRT consisting of estrogen and progesterone increased the risks of heart attack, breast cancer, blood clots and overall cardiovascular disease. A second portion of the same study found that estrogen-only HRT also raises the risk of heart disease. Neither form of HRT is recommended for the primary prevention of heart disease, although they might still be recommended for prevention of osteoporosis or to prevent the symptoms of menopause. Research is ongoing into the benefits and risks of low-dose HRT.