Debby Schrecengast's blood pressure was "through the roof". She had gained a lot of weight. A history of heart disease was deeply ingrained in his immediate family.

When she turns around in 2014, the year she suffers a stroke, she sees an "old stubborn donkey" denying her health.

"I had left my blood pressure uncontrollable and I remained obese for so long," said Schrecengast, 56. "There is damage that I can not fix, now I am trying to prevent it from getting worse."

Schrecengast, who lives in LaFargeville, NY, has resumed the exercise routine of her local YMCA. She attended nutrition classes and spent evenings sharing healthy recipes.

Since then, she has lost 30 pounds and ran a half marathon. She no longer needs medication for blood pressure.

"I know now that I have to be diligent," she said. "It's really not," I have to be good for six months or I have to be good for a year. "I have to be good forever."

Genetics can play a role in cardiovascular health, as can lifestyle changes. Here are seven factors that can affect the heart and what to do about them:

1. cholesterol

What you need to know: A "bad" LDL cholesterol can clog the arteries that fuel your heart and brain – and increase the risk of heart attack and stroke. The "good" HDL cholesterol can help eliminate the bad, but only to a certain extent. The body also absorbs extra cholesterol from certain foods, such as meat, eggs and dairy products.

What to do: Take a blood test and know your cholesterol level. Next, discuss with your health care provider any changes that may be necessary.

2. resting heart rate

What you need to know: The lower it is, the better it is. For most people, a resting heart rate of between 60 and 100 beats per minute is considered normal. It is negatively affected by stress, hormones and medications. Better fitness can not only reduce your resting heart rate, but also save your life: studies have shown that a higher rate is associated with a higher risk of death, even in people who do not exhibit not traditional risk factors for heart disease.

What to do: Check your resting heart rate, preferably in the morning, before getting up.

3. Cardiorespiratory fitness

What you need to know: Aerobic exercises can make the heart beat and develop endurance. Over the last three decades, more and more evidence has shown that a low level of cardiorespiratory fitness is associated with an increased risk of cardiovascular disease and death. High levels are linked to a lower risk of developing dementia, Alzheimer's disease, diabetes and even some types of cancer.

What to do: A health care provider can evaluate your cardiovascular endurance and overall fitness. It is often measured with the help of VO2 max, the maximum amount of oxygen that a person can absorb during intense aerobic exercise.

To improve your cardiorespiratory fitness, go running or ride a bike. Any type of aerobic exercise that increases breathing and heart rate has the ability to develop endurance if practiced regularly. If you have not been active for a while, start slowly and develop gradually.

4. blood pressure

What you need to know: High blood pressure, or high blood pressure, is often called the "silent killer" because it usually lacks obvious symptoms. When it is not controlled, it constitutes a major risk factor for heart attack, stroke and heart failure.

What to do: Learn your numbers and their meaning. High blood pressure is defined as a reading of 130 or higher for the top digit, or 80 or higher for the bottom digit. Be sure to take regular steps to detect patterns and recognize when numbers are coming up.

5. Blood glucose level

What you need to know: Blood sugar can vary depending on the time of day, what you eat and when you eat it. Too high or low can affect your concentration, make you feel dizzy and affect your vital organs. Diabetes develops when there is too much blood sugar because the body is not producing enough insulin or can not use it effectively.

What to do: Type 2 diabetes is associated with obesity and physical inactivity. Diet and exercise can reduce the chances of developing it or slow its progression. A low-fat diet that reduces sweets, added sugars and processed meats can help stabilize blood sugar levels.

6. waistline

What you need to know: Some experts consider that the distance around your natural waist is a better way to measure body fat than relying solely on the body mass index. A person whose BMI index is relatively low may have a large waist and people who wear fat around the abdomen, as opposed to hips or elsewhere, are at a higher risk of heart disease and Type 2 diabetes.

What to do: Take an old tape measure and wrap it around your waist while standing. Place the tape measure just above your hips. Then exhale and note the measurement. Men should aim for less than 40 inches, while women should aim for less than 35 inches.

7. Family history

What you need to know: Family history is considered a "risk factor", according to recent cholesterol management guidelines. This means that if a parent, grandparent, or sibling has had a stroke, heart attack, or other type of heart disease, this information should be shared with your doctor as soon as possible.

What to do: If you do not know all the medical history of a member of your family, look for the family who ignores it. Details such as the age of someone at the time of development of heart disease can be crucial. Family history can give your health care provider a better perspective of your overall risk of cardiovascular disease in the future.