Heart disease is the number one cause of death in the United States.And while family history does play a part in deciding who gets heart disease, it is largely preventable. MetroHealth medical staff members work closely with patients to develop heart-healthy habits. Success requires commitment. "You have to help yourself and take responsibility to make lifestyle changes to help lower your risk for heart disease, even if you are on prescribed medications,'' says Grace Cater, MD, a cardiologist with MetroHealth's Heart & Vascular Center team. "Every day, ask yourself 'What have I done today to reduce my risk of having a heart attack?' ''

Effective ways people can lower their risk of heart disease.

Stop smoking. Nicotine causes blood vessels to narrow, which makes the heart work harder and increases blood pressure. Stopping can cut the risk of a heart attack in half.

Get moving. Physical inactivity is a major problem and leads to earlier onset of heart disease. "Just get up and get active,'' says Dr. Cater. "Walking is probably the best activity. It's enjoyable and free, and if you can't do 30 minutes or more at one time, do it in 10 or 15 minute increments.'' If you cannot walk, try to use a stationary bike or do arm exercises. Work up to longer activity intervals and "before starting very strenuous exercise, consult with your doctor first.''

Eat a healthier diet. For some patients, that also means lose weight. When adults put on weight, most of the gain comes in the form of fat rather than muscle. That fat will increase the bad cholesterol levels in the body, which increases the risk for heart disease. Eat less and consume less fat - particularly animal, also called saturated, fat - and less salt. Eat plenty of fruits and vegetables. Whole grains and low-fat dairy can help protect your heart. Look for foods with Omega-3 fatty acids, which may lessen heart problems. Drink alcohol only in moderation. Steer clear of overly processed food and fast food and avoid high-calorie drinks.

"Read the Nutrition Facts food labels. Limit your saturated fat intake to less than 7% of your total daily caloric intake, trans fats to less than 1% and total cholesterol to less than 300 mg a day,'' says Dr. Cater. "And if you already have coronary heart disease, you should limit your total cholesterol intake to less than 200 mg a day, if not to zero.''

Lessen stress. Doctors recommend reducing stress levels to lessen your risks. Make room in your life for things that make you feel good, such as friends, laughter and emotional support.

Be aware of family medical history. Know your family history of diabetes and heart disease, and be certain to share that information with all of your doctors.