Because cardiac ischemia is usually caused by “hardening of the arteries” (atherosclerosis) associated with coronary artery disease, prevention involves understanding the risk factors associated with those conditions. People can then work to either avoid or reduce those risk factors, or to manage any unavoidable risk factors with the help of their physician.

Controllable risk factors associated with hardening of the arteries and coronary artery disease include:

• Eating a diet that is high in fats and oils and cholesterol
  
  
• Inadequate control of diabetes
  
  
• Inadequate control of high blood pressure (hypertension)
  
  
• Smoking any tobacco products (e.g., cigarettes, cigars, pipes)
  
  
• Sedentary lifestyle (not exercising)
  
  
• Obesity (body mass index [BMI] of 30 or greater)
  
  
• Stress (which increases heart rate and blood pressure)

Until recently, hormone replacement therapy (HRT) was commonly prescribed to peri- and postmenopausal women to reduce their risk of heart attack. However, a large-scale study called the Women's Health Initiative showed that HRT was actually associated with increased risk of heart attack, stroke and other conditions. As a result, HRT is no longer prescribed for the primary purpose of increasing cardiac health.