In the time it takes a reader to peruse this article — three minutes — six Americans will have passed away from heart failure. That’s a case of heart failure somewhere in America happening twice a minute, 24 hours a day, seven days a week.

Over 40 million American women have a heart problem, and a startling nine out of 10 American women are at risk for heart failure. High cholesterol and smoking are cited as major factors in the development of heart disease for both women and men.

Congenital heart disease affects over 1 million Americans, and those patients’ treatments require interventional cardiology in the form of medication and/or surgery. The cause of congenital heart defects is not always known, but research continues at an urgent pace all around the world. Consulting a cardiac surgeon for surgical intervention is a necessity in these cases.

For the rest of us with heart problems, poor diet and low levels of exercise are major causes of heart disease. A heart-healthy diet is low in fat: poultry instead of red meat, olive oil instead of butter. Lower cholesterol is linked to lower incidences of heart attacks in both women and men. Foods with “healthy fats” like avocado and dark chocolate are also recommended.

Limiting how much saturated and trans fats are eaten regularly is an important step to reducing blood cholesterol and lowering the risk of coronary artery disease. A high blood cholesterol level can lead to toxic internal buildup in a person’s arteries and internal organs and can drastically raise the risk of fatal heart disease.

Exercising every week can also lower the risk of heart problems in both women and men. Experts recommend an active lifestyle: walking to the store or to work, riding a bicycle on the weekends, lifting weights at the gym or at home. Three to four hours of aerobic activity on a weekly basis imparts strength and improved circulation to the person doing the exercise and can lower the risk of heart attack and stroke.

Ultimately, the goal is to avoid seeing a cardiac surgeon for heart problems: with proper diet and exercise, a person is more likely to maintain heart health and to avoid the necessity of medical intervention entirely. While cardiac surgeons can assist with severe cases of heart disease, people can actively curb their risk with diet and exercise.