Heart disease is one of the tops killers of both men and women. So it’s no surprise that every week, experts publish new research connecting a behaviour or environmental factor with heart disease.

Recent studies have linked loud noise exposure to heart damage and flu viruses to heart attacks. And just last week, a new study found that taking omega-3 supplements may not provide any protection for people with heart disease—a finding that contradicts earlier research.

Confronted with so much confusing and contradictory information, it can be difficult for health-conscious people to figure out what factors and behaviours truly lower their heart disease risks. Making the right choices can seem like a struggle.

“First and foremost, it’s critically important to be aware of your family risk and history of heart disease—especially early heart disease,” says Dr Laurence Sperling.

While heart disease is so common that it strikes every family, cases of heart disease that arise at an early age—before 50 for men, or before 60 for women—may be indicative of an underlying genetic predisposition to heart trouble, Sperling says.

“For most people, heart disease risk comes from a mixture of genes and environment and behaviour,” he explains. “But some people get a really strong dose of risk from their genes.”

If you know your parents, grandparents or close relatives suffered from heart disease at young ages, your doctor needs to know. He or she can order specific gene or blood tests that may reveal you have a high risk for heart trouble. In some cases, a super-healthy lifestyle may not be enough to safeguard your heart. “These people may need medications—a daily aspirin or statins—to reduce their risks,” Sperling says.

So, step one if you’re worried about heart disease: Know your family history, and let your doctor know if you have relatives who suffered from heart trouble at a young age.

Assuming you’ve taken that precaution, what else can you do to significantly lower your risks? A lot. A large-scale 2016 study in the New England Journal of Medicine found that, even among patients with a strong heredity risk for heart disease, the right lifestyle choices could slash that risk by roughly 50%.

Here are six tips backed by substantial, consistent scientific evidence.

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