AHA/ACC guidelines stress the importance of lifestyle modification as the foundation to lowering cardiovascular disease risk. This includes eating a heart-healthy diet, regular aerobic exercises, maintenance of desirable body weight and avoidance of tobacco products.

Supporting Guideline Recommendations

Exercise

• In general, advise adults to engage in aerobic physical activity to lower BP and/or reduce LDL and non-HDL-C: 3–4 sessions per week, lasting on average 40 min per session, and involving moderate to vigorous-intensity physical activity (IIa, A).

For adults with elevated BP or hypertension:

• Increased physical activity with a structured exercise program is recommended (I, A).

Diet

Advise adults who would benefit from BP and/or LDL-C lowering to:

• Consume a dietary pattern that emphasizes intake of vegetables, fruits, and whole grains; includes low-fat dairy products, poultry, fish, legumes, nontropical vegetable oils, and nuts; and limits intake of sweets, sugar-sweetened beverages, and red meats (I, A).
  a. Adapt this dietary pattern to appropriate calorie requirements, personal and cultural food preferences, and nutrition therapy for other medical conditions (including diabetes).
  b. Achieve this pattern by following plans such as the DASH dietary pattern, the USDA Food Pattern, or the AHA Diet.

In addition, for LDL-C lowering in adults:

• Aim for a dietary pattern that achieves 5%–6% of calories from saturated fat (I, A).
• Reduce percent of calories from saturated fat (I, A).
• Reduce percent of calories from trans fat (I, A).

In addition, for BP lowering in adults:

• Sodium reduction is recommended in adults with elevated BP or hypertension (I, A).
  a. Consume no more than 2,400 mg of sodium (IIa, B);
  b. Further reduction of sodium intake to 1,500 mg/d can result in even greater reduction in BP (IIa, B) and
  c. Even without achieving these goals, reducing sodium intake by at least 1,000 mg/d lowers BP (IIa, B).
• A heart healthy diet, such as the DASH diet, that facilitates achieving a desirable weight is recommended for adults with elevated BP or hypertension (I, A).
• Potassium supplementation, preferably in dietary modification, is recommended in adults with elevated BP or hypertension, unless contraindicated by the presence of CKD or use of drugs that reduce potassium excretion (I, A).

Smoking and Alcohol Consumption

• After assessment of 10-year risk for eligible patients, counseling and efforts aimed at smoking cessation should be considered for all current smokers (Expert Consensus).
• Adults with elevated BP or hypertension who currently consume alcohol should be advised to drink no more than 2 and 1 standard drinks per day, respectively (I, A). In the United States, one "standard" drink contains roughly 14 grams of pure alcohol, which is typically found in
  - 12 ounces of regular beer (usually about 5% alcohol)
  - 5 ounces of wine (usually about 12% alcohol), and
  - 1.5 ounces of distilled spirits (usually about 40% alcohol).

Link to Full ACC/AHA Lifestyle Guideline
Link to Full ACC/AHA Obesity Guideline