It is never too early to start! Whether or not you develop heart disease will depend on modifiable factors (your behaviors and environment), genetic factors, or a combination of both.

The most common form of heart disease, coronary artery disease, typically begins in early adulthood. Some people are born with inherited heart or metabolic problems that raise their risk for the early appearance of heart health issues. Knowing something about your family's health history is a good start.

Get screened regularly to find out if you have high LDL (low density lipoprotein) cholesterol, high blood pressure or high blood sugar—conditions that are relatively symptomless but that raise your risk for coronary artery disease.

You can calculate your risk of having a heart attack or stroke over the next 10 years by entering your personal risk factor information at tools.cardiosource.org/ASCVD-Risk-Estimator.

For most of us, reducing our risk of heart disease means adopting behaviors long known to keep a heart healthy:

• Eating heart-healthy food
• Being physically active
• Not smoking
• Maintaining an appropriate weight

The DASH and Mediterranean diets have both proven effective as heart-healthy. Learning how to manage stress is also important because long-term stress can contribute to unhealthy behaviors, increase blood pressure and may independently cause heart attacks.

Control of risk factors with lifestyle change, and sometimes with medications like statins, can reduce the risk of heart attacks.

For some people with specific genetic conditions, like familial hypercholesterolemia and hypertrophic cardiomyopathy, the effect of their genes tends to dominate the effect of environment, although environment continues to play a role.

For people without such a strong genetic component, a family history of heart disease may still provide clues. Some drugs, including cocaine and methamphetamines, and medical treatments, such as chemotherapy, can also damage the heart.

Other medical conditions, like diabetes and sleep apnea, can also raise your risk for heart disease, so finding good care for those conditions is also important. As you grow older, it also makes sense to know the symptoms of a heart attack, so you can seek prompt medical attention if they occur.

Heart attack symptoms in women can be very different from those seen in men; knowing those symptoms will allow you to seek prompt treatment.

The intensity of exercise is less important than just being active. In other words, moving off the couch and becoming a regular walker does more to reduce the risk of heart disease than increasing the intensity of exercise from moderate to high.

The heart is a muscle, and like any muscle, responds well to exercise. Those of us who did not grow up playing sports or doing exercise may be discouraged by the thought of running, bicycling, swimming, skiing and rowing.

It is important to know that activities like gardening, vacuuming, and walking up stairs count as activities that help your heart. Try to get at least 30 minutes of physical activity every day. Wearing a pedometer or using some other device that can be downloaded to a smart phone can help motivate people to reach their physical activity goals.

In recent years, research has identified some important genetic influences on heart health—and clinical care has become more effective in preventing the worst consequences. That increased level of knowledge has added genetic analysis as a tool to find new therapeutic drugs and to better understand the disease process.

Research has also confirmed without question that smoking, diet, and exercise are directly related to heart health. In certain people, such as those with a strong family history of heart attacks, screening for coronary artery calcium has become an effective way to detect early deposits of cholesterol in coronary arteries before they cause symptoms. This discovery often leads to better risk factor control that can reduce the chances of having a heart attack.

It is never too late to make changes to reduce the risk of having a heart attack. Amazingly enough, when people who have smoked for decades quit smoking, within two years their risk of having a heart attack falls within two years to that of someone who has never smoked.