Most people believe cancer is the leading cause of death among men and women in the United States, but Jodi Cusack, MHS, PA-C, knows otherwise. “It’s heart disease,” says the associate director of clinical education and assistant clinical professor for Bryant's Physician Assistant Program.

When people think of heart disease, coronary artery disease is usually the first example to come to mind. Cusack explains that there are many other forms of heart disease including atrial fibrillation, where people experience irregular heartbeats; heart failure, which affects the heart muscles’ pumping actions; and myocarditis, involving inflammation of the heart muscle.

“Traditionally, men have more of the habits that tend to lead to heart disease — such as alcohol abuse, smoking, and higher rates of obesity — although the trends are starting to even out,” Cusack says. “We're also now seeing higher levels of high blood pressure, cholesterol, and diabetes in their teens.”

As someone who currently works per diem at the Rhode Island Free Clinic and often talks to primary care patients about heart disease, Cusack shares five ways you can create a heart-healthy lifestyle during American Heart Month:

1. Select a Mediterranean-based diet

Shift your eating habits by selecting leaner meats (chicken and fish), increasing high-fiber foods (fruits and vegetables), incorporating more fluid into your diet, and limiting saturated fats as well as sodium. Cusack adds that canned and preserved foods should be limited since they add unnecessary sodium to your diet.

“Sodium increases blood pressure and causes the coronary arteries to become more elastic which can lead to lower oxygen flow to the heart, thus leading to heart disease,” Cusack says.

2. Avoid tobacco and limit alcohol

Smoking can increase the buildup of plaque in the blood vessels and make blood sticky — meaning it's more likely to clot. Cusack encourages those with a history of tobacco use to quit in whatever means they can.

Additionally, limiting alcohol consumption can benefit heart health. She says there’s often confusion as to whether alcohol is good or bad for you, and notes that it comes down to moderation.

“A glass of red wine here and there is not going to be a major player in heart disease, but regular and consistent use of alcohol could be,” Cusack says, highlighting that heavy use means more than one beverage a day for women and more than two beverages a day for men.

3. Monitor stress

It’s easier said than done, but reducing mental, psychical, and emotional stress can positively impact heart health. Cusack suggests taking more time for yourself, partaking in hobbies, and increasing exercise.

“Exercise is actually the biggest reducer of heart disease,” Cusack says. “Walking 30 minutes a day, five days a week can reduce the risk of coronary artery disease by 50 percent.”

4. Learn to recognize heart disease

Heart disease, especially signs of heart attack, may present itself differently in men and women.

“Men may have chest pains as well as pain down the left side of the arm. For women, symptoms can present atypically and could include having a harder time breathing, fatigue, nausea, or an indigestion-like feeling,” Cusack says.

She adds that there’s a 40 percent increased risk of heart attacks and strokes among women who drink diet soda daily. 

“A lot of times, people will take a bad habit like soda consumption and switch to diet soda, but research shows that diet soda really isn't much better,” Cusack says.

5. Stay up to date on medical history

As the hardest working organ in the body, the heart pumps approximately two gallons of blood through the body every minute. Learning who in your family has heart disease or early signs of it can keep you and your health care provider informed. Cusack suggests asking parents and grandparents if they’ve had high blood pressure and cholesterol levels.

“You also want to ask men in the family if they started having heart disease earlier than 55. For women, this would be 45,” Cusack says.