The average American is very passive when it comes to dealing with cardiovascular disease. What most people don't realize is that the absence of symptoms does not equate to the presence of health. During the course of practicing in healthcare for 16 years, I observed thousands of patients, some of which had life-threatening cardiovascular problems.

The patients with mild to advanced cardiovascular disease were often too passive about taking the right steps to prevent and reverse the problem. This attitude came from their perception that no symptoms were present. This can be a deadly mistake. By the time symptoms appear (ie. pain, shortness of breath, etc.), a patient can be teetering on the edge of a potential crisis.

It is imperative for everybody to know the risk factors for cardiovascular disease. Then, take action to avoid them. Some risk factors can be changed, others can't.

Here are the risk factors and 5 critical tips to overcome them:

The risk factors that can't be changed are: increasing age, gender (men have a greater risk of heart attack than women), and heredity (including race).

The risk factors that can be changed are: tobacco smoke (smokers are 2-4 times more likely to develop heart disease than non-smokers), high blood cholesterol, physical inactivity, obesity, Diabetes, response to stress, and excessive alcohol consumption.

1. Be proactive - Whether you have symptoms or not, get a complete physical and have your doctor order a lipid panel on you. This panel will evaluate your triglycerides, lipoprotein levels, and total cholesterol. I've seen many patients who were otherwise healthy in appearance who had dangerously high levels on this panel. Another good test to include with this panel is C-Reactive protein. This test checks for an inflammatory marker in the blood. Being proactive means to take action before symptoms surface. Young men should especially be proactive if they have a family history of cardiovascular disease.

2. Increase physical activity - Regular, moderate-to-vigorous physical activity helps prevent heart and blood vessel disease. The more vigorous the activity, the greater the benefits. A study was done several years ago where three groups of people performed a regimen of exercise over a period of several months. One group did cardiovascular exercise for one hour, three times per week. The second group did resistance exercise for one hour, three times per week. The third group did one half hour of cardiovascular and one half hour of resistance exercise, three times per week.

At the end of the study the third group showed dramatically superior results to the other two groups. They were not only better conditioned, but their body composition showed the most improvement. Moral of the story - do a combination of cardiovascular and resistance exercises.

3. Balance your diet - We have all heard "eat a balanced diet," but don't get a good explanation of what a balanced diet is. The best way to eat a balanced diet is to maintain a 40/40/20 split with protein, carbohydrates, and fats, respectively. If you are eating an 1,800 calorie per day diet, then you would consume 720 calories of proteins, 720 calories of carbohydrates, and 360 calories from fat. Limit or eliminate fried foods. Include fruits and raw vegetables.

If you are really ambitious, you can follow Jack Lalanne's philosophy. He juices fruits and vegetables several times a week. He eats a lot of fish. His philosophy is, "If man makes it, I don't eat it." In other words, no refined foods.

4. Find an outlet to eliminate stress - My outlet has always been working out with weights or cardiovascular exercise, like bike riding. Physiologically, this releases endorphins (the feel good neurotransmitters). Pick an activity that is fun to you, otherwise you may quit. Examples: Walking, jogging, biking, tennis, raquetball, swimming, etc.

5. Eat healthy chocolate - Yes, you heard right. Dark chocolate has a group of compounds called polyphenols, which are loaded with antioxidants. There is scientific evidence that these polyphenols can reverse and prevent cardiovascular disease, and help other inflammatory conditions as well. My family history includes cardiovascular disease. The scientific proof for dark chocolate was so convincing, I immediately added it to my preventive regimen.

Healthy chocolate is not the same chocolate you get in a candy bar, or at the grocery store. That chocolate has been heated, alkalized, combined with sugars, and fats. It's junk food, and its antioxidants have been destroyed in the heating process. True healthy chocolate is taken from raw cacao and is cold pressed to preserve the polyphenols. Some people even lose weight with healthy chocolate because of the appetite suppressing effect.

Follow these five tips and remember the risk factors mentioned above. Change the ones you can, and don't worry about the ones you can't. If you are unrelenting about prevention, the rewards will be self-evident.