Lance C. Dalleck by Lance C. Dalleck

February is American Heart Month, a designation intended to remind people to focus on improving their cardiovascular health. What are the best ways to prevent cardiovascular disease? Can we make up for the sins of our youth by adopting a healthy lifestyle later in life? What is the best antidote for heart disease? This blog provides ideas and inspiration for helping you move more and be heart healthy.  

Three Types of Prevention 

According to the most recent statistics from the American Heart Association, in 2020 nearly 127.9 million Americans ages 20 years and older were affected by cardiovascular disease (CVD), which includes coronary heart disease, heart failure, stroke and hypertension. That number represents nearly 50% of that age group. Since 1910, with the exception of 19181920 when there was a worldwide influenza pandemic, the most common cause of mortality among American adults each year has been CVD. To combat the epidemic of CVD, three categories of preventative strategies have been developed: 

  • Measures that promote healthy lifestyle behaviors that will prevent risk factors for CVD from ever arising in the first place 

  • Actions taken to treat existing risk factors, such as increasing physical-activity levels to lower known CVD risk factors like type 2 diabetes and hypertension   

  • Measures taken to prevent recurrent CVD-related events, such as attending programs like cardiac rehabilitation that are designed to positively modify lifestyle behaviors and reduce the likelihood of experiencing a future heart attack    

The Importance of Starting Early 

It should be no secret that bad habits, such as smoking, physical inactivity and poor diet, contribute to the development of numerous CVD risk factors, including obesity, high cholesterol, hypertension and type 2 diabetes. Adhering to a healthy lifestyle reduces the likelihood of developing these risk factors earlier in life and lowering lifetime risk for heart disease.  

As an example, individuals who reach 50 years of age without any known risk factors have a markedly lower lifetime risk of CVD. Men and women with two or more CVD risk factors have a lifetime risk of 68.9% and 50.2%, respectively. By comparison, men and women with no CVD risk factors have a lifetime risk for CVD of 5.2% and 8.2%, respectively. 

In addition, these same researchers report that men and women who are risk-factor free by the time they reach age 50 live approximately eight to 10 years longer than their same-aged counterparts who have two or more CVD risk factors. These research findings truly underscore the power of risk-factor prevention.  

It’s Never Too Late to Start Making Positive Changes 

While ideally everyone would reach age 50 without the burden of CVD risk factors, the more realistic scenario is that most individuals in our society will arrive at that age with numerous CVD risk factors in tow as the result of poor health choices made throughout their lives. Now what? Is there any chance for redemption? Next, let’s examine some inspirational strategies highlighting that it’s never too late to get started.

Eliminate CVD risk factors with the right volume of exercise: Despite current estimates indicating that more than 40% of American adults have obesity, a substantial portion of these individuals are essentially metabolically healthy. These individuals are often referred to as metabolically healthy but having obesity (MHO), meaning that their blood pressure, blood lipids and blood glucose profiles are all within normal and healthy ranges even though they have obesity. Individuals with MHO are more resistant to the adverse CVD-related consequences than are those who are considered to have metabolically abnormal obesity (MAO), meaning they have elevated levels of the above measures. For instance, it has been shown that risk of CVD mortality is 76% lower in those who are considered to have MHO when compared to those who are considered to have MAO.  

The right volume of exercise can help individuals move from having MAO to MHO, as it can help to eliminate various CVD risk factors, including high blood pressure, abnormal blood lipids and elevated blood glucose. Some of my previous research has demonstrated that a greater volume of personalized exercise is the key to risk-factor elimination, as individuals who performed approximately five hours per week of exercise were nearly 12 times more likely to eliminate CVD risk factors and transition to having MHO than those individuals who only performed one hour per week of exercise.  

The ultimate heart-disease antidote is better cardiorespiratory fitness: While hypertension, high cholesterol and obesity undoubtedly contribute to heart-disease risk, the most powerful predictor of heart health is cardiorespiratory fitness. In fact, low levels of cardiorespiratory fitness better predict an individual’s risk of developing heart disease and heart-disease mortality compared to the previously mentioned CVD risk factors.  

So, just how important is cardiorespiratory fitness to overall health? One study showed that if we could eradicate low cardiorespiratory fitness across the population, more premature deaths would be avoided, including those from CVD, when compared to deaths that could be prevented by eliminating traditional risk factors, such as obesity, smoking, hypertension, high cholesterol and type 2 diabetes.  

Given these exciting facts, here are a couple of evidence-based ideas for improving cardiorespiratory fitness. Previous ACE-sponsored research has shown that personalized exercise programming that adheres to the ACE Integrated Fitness Training® Model consistently improves cardiorespiratory fitness by 15% in most individuals. Similarly, another ACE-sponsored study showed that personalized reduced-exertion high-intensity interval training (REHIT) increased individuals cardiorespiratory fitness by 12%. Visit these links to learn more: 

The improvements seen in this research provide substantial heart-health protection, as for each 10% improvement in cardiorespiratory fitness, there is a corresponding 15% reduction in the risk for mortality from CVD. Furthermore, an approximately 10% increase in cardiorespiratory fitness has also been linked in previous studies to an increase in lifespan by about two years. 

Embracing healthy habits early in life that thwart risk factors for CVD from ever arising in the first place is undoubtedly your best strategy for avoiding heart disease. Nevertheless, it is reassuring to know that it is never too late to improve your cardiorespiratory fitness with structured exercise and by adopting healthy lifestyle behaviors at any age.   


If you a health coach or exercise professional interested in learning more about the relationship between physical activity and disease prevention and management, check out this course bundle: Helping Clients Manage Disease Through Exercise (worth 0.3 ACE CECs). The bundle includes the following courses:  

  • Exercise for the Prevention and Management of Type 2 Diabetes 

  • Understanding Thyroid Disease: Exercise Programming for Client Success 

  • Working with Cancer Patients