While we tend to accept heart disease as an inevitable result of ageing, the overwhelming evidence is that heart disease is preventable through simple changes in lifestyle. Some of the suggestions here may quite literally save your life.
* Eat fewer animal products. Eat less meat and more plant foods rich in vitamin C and beta-carotene to reduce heart disease and stroke (Am J Epidemiol, 1995; 142: 1269-78; Epidemiology, 1992; 3: 194-202; BMJ, 1990; 300: 771-3).
* Be sensible with salt. Less salt can substantially lower hypertension (N Engl J Med, 2001; 344: 3-10, 53-4). Combined with eating fruits and vegetables rich in potassium and magnesium, a salt intake of 1-2 mg daily is considered healthy and sufficient (Lancet, 1981; ii: 895-900).
* Increase fibre intake. Water-soluble fibres such as oat bran, apple pectin and psyllium lower both cholesterol and blood pressure (Am J Clin Nutr, 1979; 32: 346-63).
* Find support. California heart specialist Dr Dean Ornish finds that the usual risk factors for heart disease - sedentary lifestyle, smoking, obesity and a high-fat diet - account for only half of all heart disease. The rest is down to a person's level of isolation (Am J Empidemiol, 1979; 109: 186-204; Am J Epidemiol, 1988; 128: 370-80). Unexpressed emotions are also a factor in premature heart-disease death (Lancet, 1996; 347: 417-21). To deal with isolation, explore your spirituality, express your feelings, make friends, get involved in your local community, own a pet or sponsor a child - it may save your life.
* Limit dairy. Studies suggest an association between dairy and increased heart-disease risk (Air Med Rev, 1998; 4: 281-94). Excess calcium intake also plays a role in atherosclerotic plaque development (Int J Cardiol, 1991; 33: 191-8).
* Quit smoking. How many times do we have to say it?
* Think antioxidants. Wine (in moderation), grape juice, green tea, dark berries and all fresh, brightly coloured fruits and vegetables are rich
in heart-protective flavonoid antioxidants. As flavonoid intake rises, heart disease risk drops significantly (J Nutr, 2000; 130: 53-6). Pycnogenol contains proanthocyanidins and tannins that strengthen capillaries (Bordeaux Med, 1980; 13: 903-7) and reduce venous insufficiency (Ther Rev Med, 1981; 27-28 Sept: 1793-802).
* Wholegrains. Eating at least two-and-a-half servings a day of dark breads, wheat or bran cereals, popcorn, oatmeal, brown rice or other wholegrains can reduce coronary disease risk by 33 per cent (Am J Clin Nutr, 1999; 70: 412-9).
* Lighten up. Losing excess weight can reduce blood pressure (JAMA, 1996; 275: 1549-56).
* Take care of your teeth. Bacterial infection can spread from the mouth via the bloodstream to remote parts of the body. Those with periodontal (gum) disease had three to seven times the risk
of fatal heart disease (J Cardiovasc Risk, 1999; 6: 7-11; BMJ, 1993; 306: 688-91.
* Bacterial and parasitic infections. These can lead to chronic inflammation and disease (BMJ, 1996; 312: 1061-5), even death. Culprits include Chlamydia pneumoniae (Eur Heart J, 1996; 17: 902- 10) and Helicobacter pylori, which causes stomach ulcers (BMJ, 1995; 311: 11-4). Exposure to other 'poisonous' substances, such as allergens and environmental pollutants, can also produce heart inflammation and subsequent heart disease (N Engl J Med, 1997; 337: 422-4).
* Exercise. Exercise of any kind, including brisk walking, lowers the risk of heart disease (N Engl J Med, 1999; 341: 650-8), especially when accompanied by a sensible eating regime (J Hypertens, 1996; 14: 779-90).
* Increase good fats. Omega-3 fatty acids, found in fish and flaxseed oils, lower triglycerides and LDL ('bad') cholesterol, while increasing HDL ('good') cholesterol (Am J Cardiol, 1995; 76: 459-62).
* Good old garlic (Allium sativum) can reduce cholesterol (Ann Intern Med, 1993; 119: 599-605) and the risk of blood clots (J Orthomolec Med, 1987; 36: 766-8), and act as a vasodilator (New Drug Clin, 1996; 45: 456-66; Am J Clin Nutr, 1996; 64: 866-70).