Prioritizing heart health often seems like a simple formula, exercise regularly, eat nutritiously, manage stress, and get adequate sleep. Yet, daily life frequently turns these straightforward habits into complex challenges. Even leading cardiologists, who are well-versed in cardiovascular wellness, face similar struggles—from dining out on less-than-ideal meals to working late, caring for children, or battling low motivation for exercise. Despite these universal hurdles, these experts have developed practical strategies and routines that make it easier to stay consistent and protect the heart, especially important as heart disease remains the leading cause of death among women.

One significant challenge is getting enough sleep. Sharonne N. Hayes, MD, a cardiologist and professor of cardiovascular medicine at the Mayo Clinic, once prided herself on functioning with just five hours of sleep. However, mounting research highlighted the vital role of adequate rest in heart health. Quality sleep is strongly associated with lower mortality from cardiovascular disease and all causes, benefiting blood pressure, blood sugar, and weight control. Recognizing the need for seven to nine hours of restorative sleep, Dr. Hayes realized that meaningful change required teamwork. She and her husband committed to going to bed at the same time each night—a habit research suggests can help reduce coronary artery plaque. They also eliminated late-night television, acknowledging it was more of a routine than a need, and instead turned to quiet reading when not sleepy. This small adjustment resulted in more restful, consistent sleep.

Maintaining consistency with exercise poses another common obstacle. Cardiovascular activity is essential for heart health, and engaging in 75 to 150 minutes of moderate to vigorous exercise per week can lower the risk of cardiovascular death by up to 31 percent. Dr. Martha Gulati, a women’s heart health specialist at the Smidt Heart Institute, found her motivation through companionship. An avid runner, she now jogs with her dogs, Binkley and CocoBella, using a hands-free leash, turning workouts into a joyful experience for all three. Beyond companionship, dog ownership itself has been linked to reduced blood pressure, adding another layer of heart-health benefits.

Eating well while dining out can be particularly challenging. Dr. Amparo C. Villablanca, director of the Women’s Cardiovascular Medicine Program at the University of California, Davis Health, rarely orders from the main entrée menu. She notes that entrées are often overloaded with ingredients and served in overly large portions. Her approach is to order two or three appetizers or side dishes instead, prioritizing plant-based options rich in heart-healthy oils such as olive oil, while keeping sweets, processed foods, and red meat to a minimum.

Maintaining a positive mindset also plays a vital role in heart health. Optimism has been associated with a 35 percent lower risk of cardiovascular events. Dr. Stacey Ellyn Rosen, executive director of the Katz Institute for Women’s Health, practices gratitude through the Five Minute Journal, using its prompts to reflect on what would make her day great, as well as daily highlights and lessons learned. This mindfulness routine helps redirect focus from negative thoughts toward appreciation and positivity. Dr. Rosen believes this practice has contributed to better sleep, improved diet, and increased physical activity, key factors in overall heart wellness.

For many, finding time to exercise amid demanding work schedules and family responsibilities is another hurdle. Emily S. Lau, MD, MPH, director of the Women’s Heart Health Program at Brigham and Women’s Hospital, balances her medical career and young children through “exercise snacks.” This strategy incorporates short bursts of movement throughout the day, taking the stairs, walking during breaks, or parking farther away. Studies show these brief sessions significantly improve cardiorespiratory fitness, a crucial factor in longevity. When longer workouts are possible, Dr. Lau coordinates childcare with her husband, emphasizing the importance of creatively integrating exercise into daily routines.

Finally, staying active despite injuries presents its own set of challenges. C. Noel Bairey Merz, MD, director at Cedars-Sinai, developed chronic back pain decades ago, a condition affecting up to 85 percent of Americans. The pain interfered with her ability to exercise, sleep, and socialize, all vital components of heart protection. After years of discomfort, she learned a set of physical therapy stretches, including the cat-cow pose, which she now practices for 12 minutes daily. This consistent routine has prevented flare-ups for 30 years. Her advice: learn what your body needs to stay healthy, dedicate a few minutes each day to maintenance, and never let pain compromise your commitment to heart health.