This Is the Worst Habit for Heart Health, According to Cardiologists

Yep, you're definitely going to want to avoid this one.

If you have a family history of heart disease or other cardiovascular issues, it can seem like the cards are stacked against you. But the reality is, you are not doomed to experience the same health outcomes. While genetics do play a role in heart health, they’re far from anyone’s deciding fate. In fact, an estimated 90 percent of heart disease is preventable through diet and lifestyle habits.

While there isn’t one deciding diet or lifestyle factor that affects heart health, cardiologists do say that there are some habits that have a greater impact than others. In fact, there’s one habit in particular that can have absolutely devastating effects, not only on the heart but on overall health.

Related: What Is HCM? Shining a Light on the Most Commonly Inherited Heart Disease

What Is the Worst Habit for Heart Health?

According to both Cedars Sinai cardiologist Dr. Norman Lepor, MD, and Dr. Michael Levine, MD, a clinical instructor in the Department of Medicine at the Leon H. Charney Division of Cardiology at NYU Langone Health, the absolute worst habit for heart health is using tobacco. That includes both smoking and vaping.

Smoking and vaping significantly increase the risk of stroke, heart attack and peripheral vascular disease, which can lead to leg amputations in severe cases,” Dr. Lepor says. He adds that regular tobacco use can also cause plaque to build up in the coronary arteries, which can raise LDL cholesterol levels.

Dr. Levine doesn’t sugarcoat the impact smoking or vaping can have on heart health. “The single worst habit related to cardiovascular health remains the use of tobacco. There is a significant risk of overall cardiovascular disease as well as the increased risk of cancer,” he says.

Related: Smoking vs. Vaping: Is One Better for Your Lungs? Here's What Experts Say

If you do smoke or vape, it can be hard to quit; neither doctor says it’s an easy habit to give up. But both do say that actively taking steps to quit is the single best thing you can do for your health. “There are numerous aids to help with this, including nicotine replacement and also prescription medication,” Dr. Levine says. He encourages anyone who smokes or vapes to talk to their healthcare provider about what their options are in terms of medications that may help them quit.

Other Habits That Can Negatively Impact Heart Health

If you don’t smoke or vape, you’re not off the hook just yet; both doctors say that there are many other habits that can negatively impact heart health. “Other common behaviors which are detrimental to heart and cardiovascular health include a sedentary lifestyle and having a poor diet with high saturated fat content and high sodium intake,” Dr. Levine says, adding that being overweight can lead to a variety of associated health issues which will raise cardiovascular risk.

Dr. Lepor says that it’s especially important to keep LDL cholesterol levels in check. “Using tobacco is the worst habit for heart health, but having high levels of LDL cholesterol is the biggest risk factor [for experiencing cardiovascular health issues],” he says, differentiating the two by saying that habits are more about human behavior than risk factors are.

Related: Want to Lower Your Cholesterol Naturally? These 10 Lifestyle Tweaks Could Make a Big Difference

That said, there is still plenty you can do to keep your LDL cholesterol levels from rising. Dr. Lepor says that avoiding trans fats (found in fried foods), minimizing foods high in sodium and saturated fat, eating foods high in unsaturated fats (such as seafood, avocado and nuts), and regularly exercising are all ways to keep LDL cholesterol levels down. If you do have high cholesterol, he strongly encourages talking to your doctor about prescription medications such as statins, which can help.

What Is the Best Habit for Heart Health?

Now that you know the worst habits for heart health, you may be wondering what the very best habit is. What is the one action you can take every single day that will work in your favor? The doctors struggle to narrow it down to just one but both say that eating a healthy diet and getting regular exercise is key. (Sometimes, the best advice is the most expected.) Dr. Lepor says that he regularly recommends the Mediterranean diet to patients, which emphasizes plant-based foods and healthy fats. As for movement, Dr. Levine says to aim for at least 150 minutes a week of brisk walking or exercise.

Last, if you are taking prescription medication for heart health, such as statins, Dr. Lepor says that it’s important to remember to take them; many of his patients forget! “It’s easy to forget to take your heart health medication because you aren’t necessarily seeing or feeling a difference, but they really do help keep LDL cholesterol levels down,” he says.

The best part about prioritizing diet and lifestyle habits with heart health in mind is that the benefits extend to the entire body. The same diet and lifestyle habits that are good for your heart are good for your brain.

As for that very worst habit both named, if everyone collectively stopped using tobacco, we just may see heart disease diagnoses go up in smoke.

Next up, see a list of 25 foods that are good for your heart.


  • Dr. Norman Lepor, MD, cardiologist at Cedars Sinai in Beverly Hills, California

  • Dr. Michael Levine, MD, clinical instructor in the Department of Medicine at the Leon H. Charney Division of Cardiology at NYU Langone Health