Four Steps to Lowering Your Risk for a Heart Attack

June 16, 2008— -- Every day, 3,000 Americans suffer heart attacks. And a few hundred die. What's most frightening, perhaps, is that it usually happens without any warning.

"This disease can strike out of the blue," Dr. Peter Libby of Brigham and Women's Hospital in Boston told ABC News. "In about half of men and almost two-thirds of women, a sudden heart attack, or mini heart attack, can be the first sign that they have any trouble with their heart."

There are plenty of sophisticated ways to test the heart: stress tests, CT scans or angiograms -- real-time X-rays looking for blocked arteries.

These tests are good at detecting the slow, chronic build-up of plaque in the arteries that can cause blockages, but that's not the way most heart attacks occur. Most are triggered by something smaller and more violent -- often, a tiny piece of plaque in an artery that suddenly ruptures.

"Think of a popcorn kernel and what happens when you put it in a microwave," Libby said. "It all of a sudden bursts open. ... Plaque is like the popcorn kernel."

Once a piece of plaque bursts on an artery wall, it can cause a blood clot, completely blocking the flow of blood within seconds. This is how someone with no visible symptoms can experience sudden heart death.

Click here to learn more about the warning signs of a heart attack, stroke or cardiac arrest, and how you should respond to potentially save someone's life.

If doctors cannot reliably predict whether you're likely to have a deadly heart attack, prevention becomes all the more critical. Here are a list of some of the most effective measures.

Keep cholesterol levels low: If you have high cholesterol, you can often lower it with the use of medications called statins, which not only prevent the buildup of plaque in arteries, but "stabilize" the plaque so it's less likely to rupture.

Do not smoke: Smoking is extremely damaging to blood vessels.

Avoid excess weight: Fat is especially dangerous around the stomach. Dr. Cam Patterson of the University of North Carolina explains: "Abdominal obesity is so bad because we know now that fat cells in the abdomen secrete chemicals that irritate the arteries around the heart, making it more likely that the plaque is going to rupture."