A heart attack is a lifetime in the making. Over the years, the excess low-density lipoproteins (LDL) and triglycerides that result from poor food choices, bad habits such as smoking, unfortunate genetics, or even just natural processes can collect on the walls of blood vessels, forming atherosclerotic lesions called plaque. The plaque can rupture if they become too large, creating a blood clot that blocks the blood vessel. If that blood vessel happens to be a coronary artery, then the heart is cut off from its blood supply-the very definition of a heart attack, which is also formally known as a myocardial infarction-and when the heart is starved of blood for more than a few minutes, the heart muscle starts to die, causing disabling damage or even death.

Though they may creep up stealthily on their victims, heart attacks usually don't occur in a vacuum. One final event typically causes the plaque to rupture. Some of these triggers can't be dodged, but there are others, like the ones below, that you can circumvent.

A heavy meal. A study conducted at Brigham and Women's Hospital in Boston found that eating a repast high in fat and calories may increase the chances of a heart attack fourfold within two hours following the meal.[1] The digestion process releases hormones such as insulin into the bloodstream that raise your heart rate and blood pressure, make your blood more readily clottable, and cause your blood vessels to constrict. This rise in blood pressure not only places a strain on your heart, it can also induce plaque to rupture and form a blood clot.

Going from 0 to 60. In a 2005 issue of Psychosomatic Medicine, researchers Philip Strike and Andrew Steptoe of the University College London reviewed a dozen studies of the link between stress and heart attacks conducted from 1970 to 2004 in which they pointed out that people who rarely exercised were seven times more prone to a heart attack after strenuous exercise than people who worked out three times a week.[2] So if you want to do right by your heart and get physically active again, start slow if it's been a while since the last time you exercised regularly.

Infections. Researchers revealed in an October 2008 issue of the Canadian Medical Association Journal (CMAJ) that people who were vaccinated against pneumonia were 50 percent less likely to have a heart attack in the two years following the vaccination.[3] The flu has also been associated with a higher likelihood of heart attack, so in a related commentary appearing in the same issue of CMAJ, Dr. Mohammed Madjid from the Texas Heart Institute recommended pneumococcal and influenza vaccinations for people at high risk for heart attack.

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[1] Francisco Lopez-Jimenez, M.D., M.Sc., American Heart Association (2000, November 21). Heavy Meals May Trigger Heart Attacks; http://www.sciencedaily.com/releases/2000/11/001120072759.htm

[2] Philip Strike and Andrew Steptoe, University College London, Center For The Advancement Of Health (2005, April 21). Extreme Exertion, Emotion Can Spark Repeat Heart Attacks; http://www.sciencedaily.com/releases/2005/04/050420090707.htm

[3] François Lamontagne, Marie-Pierre Garant, Jean-Christophe Carvalho, Luc Lanthier, Marek Smieja, and Danielle Pilon. Pneumococcal vaccination and risk of myocardial infarction. CMAJ, 2008; 179: 773-777 DOI: 10.1503/cmaj.070221