How to Keep Your Heart Healthy: A Complete and Practical Guide

Heart disease is still the leading cause of death in Indonesia, and in fact, many cases appear at an age when people are at their busiest with work and family. That is why it is natural for you to start looking for ways to keep your heart healthy early on, especially if you have ever felt mild chest pain, a racing heart for no clear reason, or tiredness even when your activities are not strenuous. Many people are in the same situation: they want to make sure their heart is fine, but are unsure whether their symptoms need to be checked or simply monitored.

However, before your worries grow any bigger, let us clarify one important thing: keeping your heart healthy does not have to start with big changes that feel intimidating. In fact, research shows that small but consistent steps, such as walking a little more, cutting back on salty foods, or improving your sleep schedule, can already lower the risk of heart disease meaningfully.

According to the World Heart Federation and the European Society of Cardiology, simple lifestyle changes play a major role in reducing the risk of cardiovascular disease worldwide.

To understand this further, imagine the heart as a powerful pump the size of your fist that has been working nonstop since the first day of your life. Its job is to circulate blood that carries oxygen and nutrients throughout the body. The network of blood vessels then acts like a “highway” that keeps this delivery running smoothly. When the blood vessels are healthy, the heart works more efficiently. On the other hand, when blood flow is blocked by cholesterol or high blood pressure, the heart has to work harder, and this is where problems begin.

Unfortunately, many risk factors for heart disease develop silently. Hypertension is often called the “silent killer” because it causes no symptoms until complications occur. High cholesterol, diabetes, smoking, obesity, and lack of physical activity also put extra pressure on the heart. Data from the Indonesian Ministry of Health show a rising trend in cardiovascular disease linked to an increasingly sedentary modern lifestyle and diets high in salt and saturated fat.

That is why taking care of your heart before symptoms appear is the wisest step. Even if you do not yet have any clear risk factors, the small efforts you make today can be an investment in your health for decades to come. And if you already have high blood pressure, a family history, or mild complaints that come up often, prevention becomes even more important.

01 / Healthy Lifestyle

Everyday Habits to Keep Your Heart Healthy

Adopting a healthy lifestyle is one of the easiest ways to keep your heart healthy to start with. In fact, organizations such as the WHO, the American Heart Association (AHA), and the Indonesian Ministry of Health (Kemenkes) emphasize that four lifestyle pillars, namely eating healthy, staying active, being smoke-free, and managing stress and sleep, directly help lower the risk of heart disease.

1. Eat Healthy for Your Heart

Choose a Balanced Diet (High in Fiber, Low in Saturated Fat, Low in Salt)

Diet is an important foundation of keeping your heart healthy. Fiber from vegetables, fruits, nuts, and whole grains helps lower LDL cholesterol, while cutting back on saturated fat and salt helps keep blood pressure stable. These recommendations are in line with the guidelines of the Indonesian Ministry of Health as well as the DASH and Mediterranean diets, which are associated with a lower risk of cardiovascular disease.

Examples of heart-friendly everyday food choices:

• Leafy greens: spinach, water spinach, broccoli
• Fruits: bananas, papaya, apples, oranges
• Nuts, beans & seeds: kidney beans, peanuts, almonds, chia seeds
• Fatty fish (omega-3): salmon, sardines, mackerel tuna, Indian mackerel
• Whole grains: brown rice, oats/oatmeal, whole wheat bread

Limit Indonesian Dishes That Are High in Fat or Salt

Indonesian food is delicious, but many dishes contain saturated fat or too much salt:

• Deep-fried snacks (gorengan) → repeatedly heated oil increases saturated fat.
• Dishes rich in thick coconut milk → coconut milk (santan) is high in saturated fat.
• Fatty meat & chicken skin → raise LDL cholesterol.
• Very salty foods: instant noodles, chips, processed foods → may raise blood pressure.

Practical Tips That Are Easy to Follow

• Change your cooking methods: boil, steam, grill, or stir-fry with a little oil.
• Cut back on salt & MSG: use spices, onions and garlic, and lime.
• Use the “half-plate model”: ½ vegetables & fruit, ¼ protein, ¼ complex carbohydrates.
• Watch your portions: start by cutting down portions of fatty foods little by little.

By adjusting your diet gradually, you are laying a strong foundation for keeping your heart working optimally.

Read also:

• Heart-Healthy Diet Menu: Food Choices & Simple Tips
• Why Keeping Your Cholesterol in Balance Matters
• How to Lose Weight for Better Heart Health

2. Safe and Effective Exercise

Aerobic Activity as the Main Choice

Regular exercise helps lower blood pressure, improve cholesterol, maintain a healthy weight, and improve blood vessel function, all of which contribute to keeping your heart healthy as a whole.

Guidelines from the American Heart Association (AHA) and the World Health Organization (WHO) recommend 150 minutes/week of moderate-intensity aerobic activity, or about 30 minutes a day, 5 days a week.

Suitable types of exercise:

• Brisk walking
• Leisurely cycling
• Swimming
• Aerobics
• Climbing up and down stairs

Is Walking Alone Enough?

For many people, brisk walking is indeed effective enough. If done for 20 to 30 minutes every day at moderate intensity (slightly out of breath but still able to talk), walking helps strengthen the heart, improve metabolism, and lower the risk of high blood pressure.

That said, if you are already used to being active, additional training such as light strength training can be considered to strengthen your muscles and metabolism.

Safe Recommendations for Beginners

• Start gradually: 10 to 15 minutes per session, then increase slowly.
• Consistency matters more than intensity: choose activities you enjoy.
• Monitor how your body responds: if you experience chest pain, severe shortness of breath, dizziness, or an abnormally racing heart, stop immediately and consult a doctor.

The right exercise should leave your body feeling refreshed, not excessively exhausted.

Read also:

• 7 Types of Exercise for a Healthy Heart: Where to Start and How Long
• 6 Benefits of Regular Exercise That Few People Know About
• 3 Tips for Living a Strong and Healthy Life for the Long Term

3. Quit Smoking and Limit Alcohol

How Smoking Affects Blood Pressure and Blood Vessels

The nicotine in cigarettes raises blood pressure, speeds up the heart rate, and damages the blood vessel walls. The WHO notes that smokers have a higher risk of coronary heart disease and stroke than nonsmokers.

This is why quitting smoking is one of the most powerful steps you can take to keep your heart healthy.

More Realistic Tips for Quitting Smoking

• Set a quit date and line up support from the people closest to you.
• Recognize your triggers and prepare alternatives (a short walk, a glass of water, a healthy snack).
• See a doctor or a smoking cessation clinic if needed.

Every cigarette you do not light is a real investment in your heart.

What About Alcohol?

According to the WHO, excessive alcohol consumption is linked to high blood pressure, heart disease, and stroke. If someone chooses to drink alcohol, the limits must be strict and adjusted to their medical condition.

However, to keep your heart as healthy as possible, avoiding or minimizing alcohol is the recommended choice.

Read also:

• How to Quit Smoking? Tips for a Stronger Heart

4. Manage Stress and Get Enough Sleep

Why Does Chronic Stress Affect Heart Health?

During prolonged stress, the body releases hormones such as adrenaline and cortisol, which raise blood pressure and heart rate. If this happens continuously, it can speed up the development of risk factors for heart disease.

Studies from the AHA note that stress management plays an important role in preventing hypertension and cardiovascular disease.

Simple Techniques to Reduce Stress

• Deep breathing exercises or meditation for a few minutes.
• Journaling to help untangle your thoughts.
• Limit phone screen time before bed to calm your nervous system.
• Connect with the people closest to you, including seeking professional help if your stress becomes unmanageable.

Sleep 7 to 9 Hours for Cardiovascular Recovery

Lack of sleep disrupts blood pressure, blood sugar, and the balance of stress hormones. To support heart health:

• Sleep 7 to 9 hours a night.
• Build a consistent sleep routine.
• Avoid caffeine and heavy meals close to bedtime.

Read also:

• 10 Easy Ways to Manage Stress
• 7 Ways to Get Quality Sleep and Wake Up Feeling Refreshed Every Day
• Strategies for Coping With Excessive Stress
• Beware of Stroke! Recognize the Early Symptoms, Recovery, and Prevention

Start With Small Steps, Do Them Consistently

In the end, keeping your heart healthy does not have to start with extreme changes. Sometimes, simple steps such as walking for 15 minutes, cutting out one serving of fried food, or going to bed 30 minutes earlier are enough to start a big change.

02 / Healthy Lifestyle

Keeping Your Heart Healthy When You Have Risk Factors

Having risk factors such as hypertension, high cholesterol, a family history of heart disease, or even a “weak heart” does not mean you cannot take good care of your heart. In fact, at this stage, keeping your heart healthy requires more targeted steps, because every small decision, from what you eat and how you stay active to how you follow your treatment, can make a big difference to your future health.

To make things easier to understand, this section covers the three situations people most often face and what you can do starting now.

1. If You Have High Cholesterol or High Blood Pressure

Why Do These Conditions Increase the Risk of Heart Disease?

Hypertension and high cholesterol are the two risk factors that cause the most heart disease in Indonesia and around the world. Organizations such as the WHO, the AHA, and the Indonesian Ministry of Health emphasize that:

• High blood pressure makes blood vessels stiff and narrow, so the heart has to work harder to pump blood. If left untreated, this condition can lead to a heart attack, stroke, or even heart failure.
• High LDL cholesterol can build up in the blood vessel walls and form plaque. Over time, blood flow to the heart muscle decreases and the risk of coronary heart disease increases.

When these two conditions occur together, their impact on the heart increases significantly.

Read also:

• A Guide to Normal Blood Pressure, Cholesterol, and Blood Sugar Levels
• HbA1c: An Important Test for Knowing Your Long-Term Blood Sugar Levels

Important Steps You Need to Take

To make sure your efforts to keep your heart healthy stay effective, take the following steps:

1. Have your blood pressure and lipid profile checked regularly: Regular checks help your doctor assess whether your condition is stable or whether your medication needs to be adjusted.
2. Take your medication as prescribed and do not stop without consulting your doctor: Guidelines from PERKI (the Indonesian Heart Association) and InaSH (the Indonesian Society of Hypertension) emphasize that treatment for hypertension and cholesterol must be continuous to prevent heart complications.
3. Combine it with a healthy lifestyle: Eating a low-salt diet, exercising regularly, quitting smoking, and managing stress will help your medication work better.

Warning Signs to Watch For

Seek emergency help right away if you experience:

• Severe chest pain that feels like pressure or spreads to the arm/jaw
• Severe or sudden shortness of breath
• Very high blood pressure (e.g., ≥180/120 mmHg) with symptoms
• Severe dizziness, facial drooping, difficulty speaking (stroke symptoms)

For milder complaints that keep coming back, such as palpitations, getting tired easily, or brief chest pain, schedule a consultation with a cardiologist so that the steps you take to keep your heart healthy are even more on target.

2. If You Have a Family History of Heart Disease

Why Does Family History Increase the Risk?

It is not something we can choose, but family history often gives a picture of a biological tendency toward heart disease. Research summarized by the European Society of Cardiology and the American Heart Association shows that:

• If a parent or sibling has had heart disease at a young age, your risk increases meaningfully.
• The risk increases further when combined with lifestyle factors such as smoking, obesity, and physical inactivity.

However, genetic risk is not a certainty. A healthy lifestyle can help lower the risk even if someone has a genetic predisposition.

What Can You Do From a Young Age?

• Know your risk profile: Have your blood pressure, cholesterol, and blood sugar checked starting in your 20s, then repeat the checks as your doctor advises.
• Build healthy habits as early as possible: Regular exercise, a diet high in fiber and low in saturated fat, and avoiding cigarettes play a major role in reducing long-term risk.
• Avoid piling up risk factors: One risk factor may still be tolerable, but when several factors appear together, the risk rises sharply.

When Should You Get Checked Earlier?

If you have a family history of heart disease, consider getting the following checks sooner:

• Basic checks: blood pressure, lipid profile, blood sugar
• Noninvasive heart tests as indicated: ECG, echocardiography, or a treadmill test
• Regular consultations with a cardiologist to assess your level of risk and plan how to keep your heart healthy over the long term

An early diagnosis is not meant to frighten you, but to provide an opportunity for faster and more appropriate intervention.

3. How to Keep Your Heart Healthy If You Have a “Weak Heart” or Heart Failure

What Is a “Weak Heart”?

The term “weak heart” (jantung lemah) usually refers to heart failure, a condition in which the heart does not pump blood as strongly as usual. It can be caused by chronic high blood pressure, coronary heart disease, a previous heart attack, or a heart muscle disorder.

Symptoms include:

• Shortness of breath (especially during activity or when lying down)
• Getting tired easily
• Swelling of the legs or abdomen
• Rapid weight gain due to fluid buildup

Safe Activities and Activities to Limit

Many people with heart failure think they “should not move.” In fact, measured physical activity is highly recommended because it can improve functional capacity and quality of life.

Activities that are generally safe (after your doctor approves):

• Leisurely to moderate walking
• Breathing exercises and light stretching
• A structured cardiac rehabilitation program

Activities that should be limited:

• High-intensity exercise that triggers severe shortness of breath
• Suddenly lifting heavy weights
• Activities in extreme weather (too hot or too cold)

Manage fluids, salt, and medication with discipline

To keep your condition stable, doctors usually recommend:

• Limiting salt intake: Many people with heart failure need to reduce sodium so that fluid buildup does not get worse.
• Limiting daily fluids (if advised): Each patient’s needs are different, so it is important to follow your doctor’s instructions.
• Taking medication consistently over the long term: Medications such as ACE inhibitors, ARBs, beta blockers, and diuretics can help reduce symptoms and the risk of hospitalization.
• Daily monitoring: Record your weight, shortness of breath, and swelling. A sudden gain of 1 to 2 kg may indicate fluid buildup.

Why Are Regular Consultations So Important?

Heart failure is a condition that requires ongoing monitoring. With regular visits:

• Your doctor can assess whether your treatment is optimal
• Your medication can be adjusted if your symptoms change
• You can get further education on how to keep your heart healthy while living with a chronic condition

Most importantly, you do not have to feel that you are going through it alone. At Heartology Cardiovascular Hospital, cardiologists can support you with regular monitoring of your condition.

Read also:

• The Importance of Heart Checkups: Types, Differences, and Costs
• Just 30 Minutes! Find Out Your Heart Condition With Echocardiography

03 / Healthy Lifestyle

Keeping Your Heart & Other Organs Healthy (Lungs, Kidneys, Blood Vessels)

When you follow the steps to keep your heart healthy, you are actually also taking care of your lungs, kidneys, and the network of blood vessels throughout your body. These four systems are interconnected: the heart pumps blood, the lungs exchange oxygen and carbon dioxide, the kidneys regulate fluids and blood pressure, while the blood vessels serve as the “highway” that delivers oxygen and nutrients to every cell.

Indeed, when one system is disrupted, other organs are often affected too. That is why understanding how the heart is connected to the lungs, kidneys, and blood vessels helps you see that a single healthy habit can bring many benefits at once.

1. The Connection Between the Heart and the Lungs

A. The Role of the Lungs in Oxygenation

The lungs are not just “air bags,” but important organs that:

• Take in oxygen from the air you breathe
• Remove carbon dioxide, a waste product of cell metabolism
• Exchange gases in tiny air sacs (alveoli) surrounded by fine blood vessels

Oxygen-poor blood is pumped by the heart to the lungs, then returns to the heart rich in oxygen before being distributed throughout the body. This process goes on continuously, without stopping.

So keeping your heart healthy cannot be separated from keeping your lungs healthy. The two work as one team: if the lungs have trouble supplying oxygen, the heart has to work harder.

B. How a Sedentary Lifestyle Affects the Heart and Lungs

A sedentary lifestyle (sitting a lot, moving very little) leaves the heart and lung system less trained. The WHO and various fitness studies show that:

• People who are very inactive have a higher risk of death than those who are physically active.
• Low heart and lung fitness (cardiorespiratory fitness) increases the risk of heart disease and premature death.

On the other hand, regular physical activity, even brisk walking for 10 to 15 minutes a few times a day, already helps:

• Improve the lungs’ ability to supply oxygen
• Help the heart pump blood more efficiently
• Become an important part of keeping your heart healthy over the long term

2. The Connection Between the Heart and the Kidneys

A. Linked Through Blood Pressure and Body Fluids

The heart and kidneys work in the same circuit:

• The heart pumps blood to the kidneys.
• The kidneys filter the blood, regulate the amount of fluid and electrolytes, and help control blood pressure through a hormone system.

If kidney function declines (chronic kidney disease / CKD), the risk of heart disease rises sharply. CKD is recognized as an independent risk factor for cardiovascular disease, including coronary heart disease and heart failure.

Conversely, when the heart weakens (for example, in heart failure), blood flow to the kidneys decreases, so kidney function declines as well. This two-way relationship is known as cardiorenal syndrome.

B. If You Have a History of Kidney Problems, What Should You Watch?

If you already have a history of kidney problems, the steps you take to keep your heart healthy need to be aligned with protecting your kidneys:

• Keep your blood pressure tightly controlled: High blood pressure speeds up kidney damage and puts a strain on the heart at the same time. Many guidelines (KDIGO, AHA) recommend stricter blood pressure targets for patients with CKD, based on your doctor’s assessment.
• Manage your blood sugar (if you have diabetes): Uncontrolled blood sugar damages the small blood vessels in the kidneys and heart.
• Limit salt and maintain fluid balance: Reducing sodium intake helps lower blood pressure and eases the workload of the heart and kidneys.
• Be careful with medications and supplements: Some medications (for example, certain pain relievers) and herbal supplements can worsen kidney problems. Discuss them with your doctor before taking them.

With regular monitoring and the right lifestyle, you can protect your kidneys while also strengthening the effects of the steps you are already taking to keep your heart healthy.

3. Blood Vessels as the Heart’s “Highway”

A. How Does Cholesterol Narrow the Blood Vessels?

Imagine your blood vessels as a network of toll roads connecting the heart to every organ. When the artery walls are clean and elastic, blood flows smoothly. However, if fat and cholesterol build up in the artery walls, plaque forms that narrows and hardens the blood vessels. This condition is called atherosclerosis.

Over time:

• Plaque can reduce blood flow to the heart → triggering chest pain (angina).
• Plaque can rupture and form a blood clot that suddenly blocks an artery → causing a heart attack or stroke.

The World Heart Federation emphasizes that high cholesterol, an unhealthy diet, physical inactivity, smoking, obesity, and kidney disease all increase the risk of atherosclerosis and cardiovascular disease.

That is why managing cholesterol and other risk factors is an important part of keeping your heart healthy and keeping your blood vessel “highway” open.

B. Simple Ways to Keep Your Blood Vessels Elastic

The good news is that many daily steps can help maintain the function and elasticity of your blood vessels:

• Regular physical activity: Moderate aerobic exercise (brisk walking, cycling) helps improve the function of the inner lining of the blood vessels (the endothelium) and lowers the risk of atherosclerosis.
• A diet that is friendly to your blood vessels: Eat more vegetables, fruits, nuts, fatty fish, and whole grains; limit saturated fat, trans fat, added sugar, and excess salt.
• Quit smoking: Smoking damages the blood vessel walls, speeds up plaque formation, and increases the risk of blood clots.
• Control your blood pressure, cholesterol, and blood sugar: When these factors are uncontrolled together, they speed up damage to the blood vessels.
• Manage your weight and stress: Obesity and chronic stress are linked to higher blood pressure and cholesterol, as well as an increased risk of atherosclerosis.

Each of these small steps helps the heart pump into a cleaner and more flexible “highway,” so the heart’s workload becomes lighter.

Read also:

• Optimal Health at 40+: How to Prevent Disease and Stay Active

Caring for a System, Not Just One Organ

In short, when you follow the steps to keep your heart healthy, such as managing your diet, moving more, quitting smoking, and managing stress, you are not only protecting your heart. You are caring for one large system: the heart, lungs, kidneys, and blood vessels, which work together every second to keep your body alive and energized.

04 / Healthy Lifestyle

Are There Warning Signs to Watch Out For?

Following the steps to keep your heart healthy every day is important, but it is just as important to know when your body is signaling that your heart needs more attention. Some symptoms can appear subtly, while others come on suddenly and must be treated right away. Understanding the difference helps you act quickly and appropriately, so the risk of complications can be reduced.

Here are the warning signs you need to recognize, along with the conditions that require you to go straight to the emergency department (ER).

1. Symptoms That May Point to Heart Disease

Not all heart symptoms feel dramatic. Many develop slowly and are often mistaken for “masuk angin” (a common Indonesian term for feeling unwell with bloating, chills, and body aches) or “ordinary gastritis.” Even so, the following symptoms should be suspected as early signs of a heart problem.

A. Chest Pain: Typical Features and How It Differs From Gastritis/Acid Reflux

Chest pain that points to the heart usually has the following typical features:

• It feels like pressure, heaviness, or squeezing in the center of the chest.
• It may spread to the left arm, both arms, the neck, jaw, back, or upper abdomen.
• It appears during physical activity or emotional stress, and eases with rest (stable angina).
• It is often accompanied by a cold sweat, nausea, dizziness, or shortness of breath.

In contrast, chest pain caused by gastritis/GERD usually:

• Feels hot or burning in the chest.
• Appears after a large meal, fatty/spicy food, or when lying down.
• Comes with burping or a sour taste in the mouth.
• Tends to improve with antacids.

Even so, heart and stomach symptoms can look similar. If you have risk factors (hypertension, diabetes, high cholesterol, smoking, family history), it is safer to treat chest pain as a serious condition until proven otherwise.

B. Sudden Heart Palpitations

Palpitations can feel like:

• A very fast heartbeat,
• An irregular heartbeat, or
• A heart that seems to “skip.”

This may be a sign of an arrhythmia, especially when accompanied by:

• Shortness of breath,
• Chest pain,
• Dizziness, or nearly fainting.

Occasional palpitations can be normal, but if they become more frequent or are associated with other complaints, the recommended step is an evaluation by a cardiologist.

C. Shortness of Breath During Light Activity

Shortness of breath that occurs when:

• Walking a short distance,
• Climbing a few stairs, or
• Talking for too long,

may point to heart or lung disease. In heart failure, shortness of breath often gets worse when lying down and comes with leg swelling or getting tired easily.

If your shortness of breath keeps getting worse or feels different from usual, your body is sending an important signal that your efforts to keep your heart healthy need to be followed up with a medical examination.

D. Other Symptoms That Are Often Ignored

• Getting tired easily during light activities that used to feel easy.
• Fainting or nearly fainting, which can happen due to a heart rhythm disorder or a sharp drop in blood pressure.
• Swelling in the feet, ankles, or abdomen, as a sign of fluid buildup due to heart failure.

A combination of symptoms, even if they are not severe, is often more significant than a single symptom on its own. If your complaints keep coming back or get worse, a medical evaluation is strongly recommended.

2. When Should You Go to the ER Right Away?

There are moments when waiting is not an option. The American Heart Association and the Indonesian Ministry of Health emphasize that prompt treatment is key to saving the heart muscle; every minute counts. If you or someone close to you experiences the following, go to the ER right away (do not wait, and do not drive yourself).

A. Severe Chest Pain Lasting More Than 10 Minutes

• Very strong, persistent chest pain, as if a heavy weight is pressing on the chest.
• Pain that lasts >10 minutes, or comes and goes but becomes more intense.
• Pain that spreads to the arm, jaw, neck, back, or upper abdomen.

This is the most classic sign of a heart attack.

B. Sudden Severe Shortness of Breath

• Sudden difficulty breathing.
• Being unable to lie down or talk comfortably.
• It may come with a frothy cough (a sign of pulmonary edema/acute heart failure).

This is a medical emergency that requires immediate treatment.

C. Fainting or Loss of Consciousness

• Sudden fainting without a clear trigger.
• Repeated near fainting, especially when accompanied by palpitations or chest pain.

This may be a sign of a serious arrhythmia or a problem with blood flow to the brain.

D. Cold Sweat + Nausea + Spreading Pain

The following combination is a red flag for a heart attack, in both men and women:

• Cold sweat,
• Nausea or vomiting,
• Chest pain that spreads to the arm/jaw/back,
• A feeling that “something is very wrong.”

In women, older adults, and people with diabetes, the symptoms can be more subtle, for example only extreme fatigue or severe nausea. But whatever the complaint, if it feels different from usual, seek help right away.

Staying Alert Is Part of Keeping Your Heart Healthy

Ultimately, recognizing warning signs is not meant to make you anxious, but to make sure you take action at the right time. Keeping your heart healthy is not only about diet or exercise; it is also about listening to your body and acting quickly when something does not feel right.

05 / Healthy Lifestyle

When Should You Have Your Heart Checked?

Following the steps to keep your heart healthy is not only about eating healthy, exercising, or quitting smoking. Regular heart checkups are also an important part of prevention. Many heart problems develop slowly without any symptoms. Routine checkups help find changes earlier, when the chances of success are much higher and treatment is simpler.

1. Routine Heart Screening: When Should You Start?

Heart health screening does not have to wait until symptoms appear. Countries with strong health guidelines, including the recommendations of the American Heart Association (AHA) and the noncommunicable disease (PTM) screening program of the Indonesian Ministry of Health, recommend checking risk factors regularly from early adulthood. This is done to prevent hypertension, diabetes, and heart disease, which often develop silently.

Ages 20 to 30: Know Your Basic Health Numbers

At this age, the focus is on knowing your “health baseline.” Recommended checks:

• Blood pressure
• BMI (body weight & body mass index)
• Blood sugar and cholesterol (more important if you have a family history or obesity)

This first step helps determine the right long-term strategy for keeping your heart healthy.

Ages 30 to 40: Start More Targeted Screening

From your 30s, the risk of heart disease starts to rise, especially when combined with risk factors such as:

• A family history of heart disease
• Smoking
• Rising blood pressure
• High cholesterol
• Significant weight gain

Blood pressure, cholesterol, and blood sugar checks should be done more regularly, for example once a year.

Age >40 or Younger With Strong Risk Factors

At this stage, more comprehensive screening is recommended:

• Check your blood pressure and blood sugar at least once a year
• Regular lipid profile tests
• A thorough cardiovascular risk evaluation
• A doctor’s consultation to decide whether further heart tests are needed

The bottom line: The more risk factors you have, the earlier and more regularly you need to have your heart checked. This is not meant to scare you, but to give you full control over your heart health.

2. Common Heart Tests

Not everyone needs every test. Your doctor will assess what you need based on your age, symptoms, and risk factors. Here are the most commonly used tests, presented simply so they are easy to understand.

A. ECG (Electrocardiogram): A Quick Test of the Heart’s Electrical Activity

What is it for?

• Detecting rhythm disorders (arrhythmias)
• Looking for signs of a current or past heart attack
• Identifying electrical conduction problems in the heart

When is it recommended?

• During initial screening
• If you have palpitations or chest pain
• Before certain medical procedures

B. Echocardiography (Heart Ultrasound): Seeing the Heart’s Structure and Function Directly

What is it for?

• Assessing the heart’s pumping strength
• Observing valve function
• Detecting an enlarged heart or abnormal heart wall motion
• Looking for fluid around the heart

When is it recommended?

• If your doctor suspects heart failure or a valve disorder
• After a heart attack or prolonged shortness of breath

C. Treadmill Test (Exercise Test / Stress Test)

What is it for?

• Assessing how the heart responds when it works harder
• Detecting possible reduced blood flow to the heart (ischemia)
• Measuring heart and lung fitness capacity

When is it recommended?

• If symptoms appear during activity
• To assess fitness and the risk of coronary heart disease

D. Cardiac CT Scan (Coronary CT or Calcium Scoring)

What is it for?

• Assessing calcium plaque buildup in the heart’s blood vessels
• Used as a consideration for cholesterol therapy or long-term heart risk

When is it recommended?

• For people at intermediate to high risk
• Not a routine test for everyone; it requires a doctor’s referral

3. Estimated Costs & Preparing for Screening

Many people put off heart checkups because they worry about the cost or fear the process will be complicated. In fact, most screening tests are fairly simple, quick, and comfortable.

A. Estimated Costs: What Makes Them Differ?

Without mentioning specific figures, costs are generally influenced by:

• Type of facility (community health center or puskesmas, clinic, private hospital, national referral hospital)
• Type of checkup package (basic vs. comprehensive)
• Technology used (for example, cardiac ultrasound machines or advanced CT scanners)
• Private insurance coverage (Heartology’s services cannot currently be used with BPJS Kesehatan, Indonesia’s national health insurance program)

Basic checkups are usually affordable, while advanced procedures such as echocardiography or cardiac CT fall into a higher cost bracket.

B. For Accurate Results and a Comfortable Process

• Clothing: wear clothes that are easy to open around the chest; for a treadmill test, wear sports shoes.
• Fasting: about 8 to 12 hours of fasting is required if you will have your cholesterol and fasting blood sugar checked.
• Medications: do not stop your regular medications without your doctor’s instructions; tell your doctor about all the medications and supplements you take.
• Documents: bring your previous test results so your doctor can compare changes over time.

C. A Heart Checkup Is Nothing to Be Afraid Of

Early screening actually brings peace of mind. By having your heart checked before symptoms appear:

• You get a clear picture of your current heart condition
• Your doctor can develop a strategy for keeping your heart healthy that suits your needs
• The risk of serious disease can be reduced early on

At Heartology Cardiovascular Hospital, the screening approach is not just about lab numbers. The medical team will translate your results into steps that are realistic, easy to follow, and supportive.

06 / Healthy Lifestyle

Small Steps You Can Start This Week

When starting to take care of their heart, many people feel they have to make big changes right away. In reality, the body responds much better to small steps taken consistently. Simple changes such as taking short walks, cutting back on salt, or improving your sleep can already help lower blood pressure, boost energy, and strengthen heart health.

Choose one or two steps to start with this week. Once they feel comfortable, add more slowly. The goal is not perfection, but sustainability.

1. Start Walking 10 to 15 Minutes a Day, Then Increase Gradually

Walking is one of the easiest and safest activities to support keeping your heart healthy. The WHO and the American Heart Association recommend at least 150 minutes of moderate-intensity activity per week, and brisk walking is one of the most recommended options.

How to get started:

• Start with 10 to 15 minutes a day, without pressure.
• After 1 to 2 weeks, increase it to 20 to 30 minutes.
• Try walking after meals, around your neighborhood, or getting off the elevator one floor early.
• Focus on consistency, not speed.

The benefits come quickly: better sleep, less stress, and more energy.

2. Cut Out One Serving of Salty Food Every Day

Eating too much salt raises blood pressure, one of the main risk factors for heart disease. The WHO recommends a sodium intake of less than 5 grams of salt per day (about 1 teaspoon, including the hidden salt in prepared foods).

Start with simple steps:

1. Choose one salty food per day to cut back on, for example:
   • Salty crackers (kerupuk)
   • Instant noodles
   • Processed foods
   • Side dishes with salty sauces
2. Make a habit of tasting your food before adding salt or sauce.

By cutting back little by little, your blood pressure will be better controlled, which supports your heart’s work.

3. Fill Half Your Plate With Vegetables at Every Meal

A diet rich in vegetables and fruits helps lower blood pressure, improve cholesterol, and control your weight, which are important pillars of keeping your heart healthy. This recommendation is in line with the DASH diet and the Mediterranean diet recommended by the American Heart Association and the European Society of Cardiology.

Easy tips:

• Fill half your plate with vegetables at every meal.
• Mix the colors of your vegetables: green, orange, red.
• Use low-oil cooking methods: boiling, steaming, or stir-frying with a little oil.

This habit naturally reduces portions of heavy foods, without feeling like you are on a “strict diet.”

4. Swap Fried Foods for Boiled or Grilled Dishes 2 to 3 Times a Week

Fried foods contain saturated fat and trans fat that can raise LDL cholesterol and trigger narrowing of the blood vessels. The American Heart Association emphasizes that choosing healthier cooking methods can reduce the risk of heart disease.

A realistic approach:

1. Pick 2 to 3 days a week when you do not eat fried foods.
2. Replace them with:
   • Grilled chicken
   • Grilled fish or pepes (fish cooked in banana leaves)
   • Steamed tofu/tempeh or tofu/tempeh stir-fried with minimal oil
3. If you cook for yourself, avoid reusing cooking oil.

This is one of the changes with the greatest long-term impact.

5. Sleep at Least 7 Hours Every Night

Getting enough sleep is a foundation of heart health that is often forgotten. Studies show that lack of sleep (less than 7 hours) increases the risk of hypertension, diabetes, and weight gain.

Small steps for this week:

• Go to bed and wake up at the same time every day.
• Reduce screen time 30 to 60 minutes before bed.
• Use a relaxing routine: light reading, a warm bath, or breathing exercises.

Getting enough sleep strengthens the positive effects of all the other steps, from exercise to stress management.

6. Cut Down by One Cigarette a Day (If You Smoke)

There is no safe level of smoking. The World Health Organization (WHO) and the American Heart Association emphasize that smoking, even just a little, still damages the heart and blood vessels. However, quitting completely often takes time. Cutting down by one cigarette a day can be a realistic first step.

Start by:

1. Smoking at least 1 fewer cigarette per day than usual.
2. Setting “smoke-free zones,” such as your bedroom or car.
3. Finding substitutes when cravings hit: drink water, chew sugar-free gum, or take a short walk.

Little by little, your body will start to adjust, and the urge to smoke will gradually decrease.

From Small Steps to a Sustainable Lifestyle

Not every change has to happen all at once. The key to keeping your heart healthy is choosing the step you are most likely to take today, then continuing it tomorrow, the day after, and so on.

With this approach:

• New habits feel light, not forced
• You can still enjoy food and your social life
• Health changes start to show within a few weeks
• Your confidence grows because you know you are moving in the right direction

07 / Healthy Lifestyle

When Should You See a Cardiologist?

Keeping your heart healthy is not only about exercise, diet, or reducing stress. There are times when you need direct guidance from a cardiologist, not because you are panicking, but because you want to make sure the steps you are taking are right, safe, and suited to your condition. A timely consultation can actually help prevent bigger problems in the future.

Here are three main situations that signal it is time to see a cardiologist.

1. If You Have Risk Factors

A number of risk factors make a person more vulnerable to heart disease, even if they have no complaints yet. People at high risk need an evaluation earlier and more regularly.

Risk factors to watch out for:

• High blood pressure or blood pressure that tends to rise
• High blood sugar, prediabetes, or diabetes
• High LDL cholesterol / low HDL / high triglycerides
• A smoking habit
• Excess weight or obesity
• A family history of heart disease or sudden death

If you fall into one of the categories above, a consultation with a cardiologist can help:

• Measure your overall cardiovascular risk
• Develop a personal strategy for keeping your heart healthy
• Determine whether further tests are needed, such as an ECG, echocardiography, or a treadmill test
• Prevent complications that can develop without early symptoms

In other words, an early consultation is a long-term investment in your heart health.

2. If You Have Recurring Complaints (Palpitations, Chest Pain, or Getting Tired Easily)

Complaints that keep coming back, even if they are not severe, are signals that should not be ignored. Heart symptoms often appear subtly and get worse over time.

Complaints that should be checked:

• Recurring palpitations, especially if your heart feels very fast or irregular
• Chest pain that feels like pressure or heaviness, or appears during activity
• Shortness of breath or getting tired easily during activities that used to feel light
• Dizziness or nearly fainting
• Swelling in the ankles or legs

Recurring complaints do not mean a heart attack is happening, but they are a sign that your heart function needs to be evaluated before it develops into a serious problem.

A cardiologist can:

• Distinguish whether your complaints come from the heart, the lungs, or another condition
• Determine which tests are most needed
• Plan treatment steps to support a stable heart

This is an important part of keeping your heart healthy proactively, not reactively.

3. If You Want to Start a New Lifestyle but Need Medical Guidance

Many people start wanting to exercise more regularly, lose weight, or try a new diet. This is very good for the heart, but if you have risk factors or have had complaints before, guidance from a doctor is highly recommended.

When should you consider a consultation first?

• When you want to start intense exercise (running, HIIT, weightlifting, long-distance cycling)
• Before starting a specific diet such as a low-carb diet, a strict calorie-restricted diet, or an aggressive weight loss program
• If you want to combine exercise, dietary changes, and medications but want to make sure everything is safe

A cardiologist will help:

• Assess your heart condition and risk level before you start a program
• Recommend safe physical activities at an appropriate intensity
• Make sure your diet and weight loss targets do not strain your heart
• Create a plan for keeping your heart healthy that is realistic, safe, and measurable

This helps you move forward with more confidence, because every step is backed by an objective medical assessment.

Consultation Is an Important Part of Your Heart Health Journey

Seeing a cardiologist is not a sign of fear, but a way of caring for yourself. With the right support:

• You understand your heart condition clearly
• You know what steps you need to take
• You do not have to guess or follow advice that may not suit you
• You move forward feeling safe and confident that your decisions are right

And in the end, this consultation helps make sure that every effort to keep your heart healthy, from walking and eating healthy to quitting smoking, is carried out safely and brings real benefits to your life.

08 / Healthy Lifestyle

Conclusion

Keeping your heart healthy is not just a “short-term healthy living” effort, but a long-term investment in a better quality of life. A strong heart gives you the energy to work, stay active, and enjoy time with the people closest to you. In fact, various international guidelines, such as those from the American Heart Association, emphasize that healthy lifestyle steps can significantly lower the risk of heart disease and stroke.

On the other hand, keeping your heart healthy does not have to start with big changes. In fact, small changes made consistently have the greatest impact.

Small Changes, Real Impact

Many people imagine that keeping your heart healthy requires an extreme lifestyle. In reality, what matters more are the small steps you can repeat every day. For example:

• Walking for 10 to 15 minutes and gradually increasing it
• Filling half your plate with vegetables at every meal
• Cutting back on salt and fried foods
• Sleeping on a more regular schedule
• Smoking one fewer cigarette a day (for smokers)

In addition, small changes like these are easier to stick with, do not feel burdensome, and are more likely to become long-term habits. As a result, blood pressure improves, cholesterol becomes more stable, and the risk of heart problems goes down.

The bottom line: consistency matters more than perfection.

Need Guidance?

Not everyone feels comfortable or sure about where to start. This is where a doctor’s support plays a role. At Heartology Cardiovascular Hospital, our cardiologists can help assess your personal risk factors, recommend tests when needed, create a plan for keeping your heart healthy that fits your routine and abilities, and monitor your progress regularly. You do not have to wait for symptoms to appear before seeking a consultation.