There is no magic bullet. Prevention of heart attack requires a wide ranging approach and often radical change in lifestyle.

Exercise. The usual suggestion is that you should take up vigorous exercise such as swimming, cycling or brisk walking. This does not suit everyone and has recently been challenged through the medical press. Regular programmes of walking can be even more beneficial. Yoga, which combines relaxation, stretching and flexibility, will lower your chances of having another attack (BMJ [Clin Res], 1985; 13: 1103-6; Lancet, 1975; ii: 93-5).Lose weight. Being overweight does not put you at increased risk of heart disease, but it does increase your risk of high blood pressure.

Weight loss usually involves diet changes. Rather than just restricting calories, a more sensible approach would, be to pay attention to what you eat. Certain foods are more effective heart protectors than others. In general Mediterranean or Indian diets high in fresh fruit and vegetables, onion and garlic, fish and chicken and polyunsaturated and monosaturated oils offer the best protection (J Cardiol, 1992; 69: 879-85).

In one study those on a Mediterranean diet decreased their risk of heart problems by a staggering 70 per cent (Am J Clin Nutri, 1995; 61(6 Suppl): 1360S-67S). The clinical effects of altering your diet in this way are thought to be the same as taking 180 mg of aspirin daily (Nutrition, 1991; 7: 119-23).

Increase folate. High levels of the amino acid homocysteine can cause cardiovascular disease, which affects the heart and blood vessels. Homocysteine levels can be lowered with even a small amount of folate (JAMA, June 26, 1996).

Supplement with antioxidant vitamins A, C and E for a general protective action (Lancet, 1991; 337: 1-5). Vitamin C has cardioprotective qualities (BMJ, 1995; 310: 1559-62). As little as one orange a day (equivalent to an extra 60mg daily) can decrease risk of heart attack by 10 per cent (Lancet, 1994; 343: 1454-9). Vitamin E is associated with a reduced risk of heart disease (N Eng J Med, 1993; 328: 1444-9; N Eng J Med, 1993; 328: 1450-55).

Coenzyme Q-10 is a vitamin like substance which is found in the heart muscle. Daily doses of around 150mg can also reduce angina attacks substantially. It can also help increase stamina (Am J Cardiol, 1985; 56: 247).

Increase fibre intake. Studies show that fibre (especially soluble fibre), has an role to play in the prevention of cardiovascular disease (JAMA, 1996; 275: 447-51) which is independent of other dietary measures. Fibre decreases LDL ("bad" cholesterol) and has little or no effect on HDL ("good") cholesterol.

Avoid hydrogenated fats. Consumption of trans fatty acids produced by the partial hydrogenation of vegetable oils can lead to heart disease (Lancet, 1993; 341: 581-5). They interfere with essential fatty acids metabolism (Proc Natl Acad Sci, 1982; 79: 953-57), as well have having other deleterious effects on our health (N Eng J Med, 1990; 323: 439-45; Acta Paed Int J Paed, 1992; 81: 302-6). TFAs may be a greater health hazard than both dairy products and natural saturated fats (Lancet, 1993; 341: 1093).

Check toxic metal levels. High levels of cadmium are associated with potentially fatal cardiovascular disease (J Am Med Assoc, 1966; 198: 267; Ecologist, 1971; 1: 11).

Lead in your drinking water, especially in soft water areas, can contribute to hypertension (Medycyna Pracy, 1994; 45(2): 163-70). Consider chelation therapy a method which employs molecules called chelators to remove toxic metals in the body.