February marks Heart Month—a time dedicated to raising awareness around cardiovascular health and empowering individuals to take proactive steps toward long-term wellness. To guide this important conversation, we turned to one of the nation’s most respected voices in cardiology and integrative medicine: Dr. Mimi Guarneri.
Board-certified in Cardiovascular Disease, Internal Medicine, and Integrative Holistic Medicine, Dr. Guarneri serves as President of the Academy of Integrative Health and Medicine (AIHM).
After years as an interventional cardiologist, she went on to pioneer the Scripps Center for Integrative Medicine and later co-founded Guarneri Integrative Health, Inc. at Pacific Pearl La Jolla, where she continues her work in advancing a comprehensive, lifestyle-centered approach to heart health and serves as Medical Director to a team of experts in Conventional, Integrative, and Natural Medicine.
Drawing on decades of expertise, Dr. Guarneri offers clear guidance on the early signs of heart disease, the tests that matter most, and the simple daily habits that make a measurable difference.
What are the most common early warning signs of heart disease that people tend to overlook?
The first sign of heart disease may be subtle, like the onset of shortness of breath on exertion or chest tightness. Some individuals may experience tightness or pressure in their neck, arm, or throat. Others may experience indigestion or fatigue.
How often should adults get their heart health screened, and what tests are most important?
Everyone should know the basics: your blood pressure, blood sugar, and cholesterol. Everyone should have routine labs by age 40 to check for risk. Women who developed diabetes or high blood pressure during pregnancy are at a particularly high risk. It’s also ideal to have a genetic test called Lp(a), since high levels are linked to an increased risk of heart disease.
What lifestyle changes have the biggest impact on reducing the risk of heart disease?
Research shows that smoking cessation, maintaining an ideal body weight, exercise, and eating a high-fiber Mediterranean diet decrease the risk of heart disease. Meditation has also been shown to reduce the risk of cardiovascular events by up to 48%.
How much does family history play a role, and what should someone do if heart disease runs in their family?
You are more than your genes. Family history is very important, but it is not your destiny. Even if you have high-risk genes genes, lifestyle changes can lower the risk by up to 50%.
What are some heart-healthy foods people should incorporate into their daily routine?
Fiber in all its forms. Green leafy vegetables, nuts, seeds, whole grains, and legumes are excellent foods for the heart. Good fats, such as avocado and olive oil, should be used in small amounts. Eliminate sugar, fruit juice, soda, and excess alcohol. Remember that all white products such as bread, potatoes, rice, cookies, and candy turn into sugar and to avoid excess high-sugar fruits.
How much exercise is recommended for maintaining good heart health, and does the type of exercise matter?
Exercise lowers blood pressure, triglycerides, and blood sugar. It's important to try to bring some exercise into your life every day. This should include aerobic exercise like walking and biking, as well as strength training. Dance is a wonderful form of exercise, as is swimming. Remember to stretch and check with your doctor if exercise is safe for you.
Can stress really affect the heart, and what are some effective ways to manage stress for cardiovascular health?
Stress is a risk factor for heart disease. It increases blood pressure, can trigger heart arrhythmias, and raises blood sugar. Stress can even cause the vessels of the heart to constrict and decrease blood flow, leading to discomfort called angina.
What are the key numbers everyone should know — like blood pressure, cholesterol, and blood sugar — and why do they matter?
Basic tests should include blood pressure, fasting blood sugar, HbA1c (three-month blood sugar), and cholesterol. Because inflammation contributes to heart disease, hsCRP should also be checked. Additional testing may include evaluating nutrient levels and screening for heavy metals, which can further inform risk and treatment.
Is there anything about heart disease you wish people understood better?
Heart disease is the number one cause of morbidity in both men and women. It is, however, preventable through lifestyle change, supplements, and medication.
What small, realistic habits can someone start today to significantly improve their heart health over time?
Know your numbers and make daily physical activity a priority. Aim to reduce added sugar, and fill your plate with whole grains, fiber-rich foods, leafy greens, and legumes. Eat the colors of the rainbow. If you include animal products, choose lean options like sardines, wild salmon, and organic poultry.
Don’t stress the small things—stress strains the heart. Find joy, connect with loved ones, get involved in your community, and above all, remember to laugh.