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When thinking about heart disease, some of the usual suspects like smoking, a lack of exercise, and high blood pressure might come to mind. And while these are certainly central players, they don’t tell the whole story.
Research is increasingly showing that the causes of heart disease are far more diverse and complex, with many risk factors sitting quietly under the radar. From sleep and stress to loneliness and oral hygiene, learning to recognise and manage these lesser-known contributors can be a powerful way to take control of your heart health.
The World Health Organization (WHO) estimates that around 80% of heart disease cases could be prevented with lifestyle changes – so you may have more influence over your heart health than you realise.
With that said, we’ll explore nine things that could be silently having an impact.
1. Lack of vitamin D
Vitamin D is a fat-soluble vitamin that we need to stay healthy. Among other things, it helps to regulate the amount of calcium and phosphate in the body, which are important for healthy teeth, bones, and muscles.
However, vitamin D also plays a key role in heart health, and studies have found a strong link between deficiency and a greater risk of high blood pressure and heart disease. According to research, this is mainly due to vitamin D’s ability to help regulate blood pressure, lower inflammation, and maintain healthy blood sugar levels.
Some of the best sources of vitamin D include sunlight, egg yolks, mushrooms, and fatty fish like salmon. For ideas on how to up your intake, check out our guide to vitamin D.
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#Data from over 1,000 Rest Less members surveyed in 2025
^Data from HMCA members who joined between 01/01/25 and 30/06/25
2. Hidden inflammation
Inflammation is the body’s natural defence mechanism against injury and infection, helping to remove harmful cells and initiate healing. However, chronic, long-term inflammation is linked with a host of health issues, including heart disease.
Among other things, inflammation can damage blood vessel linings, leaving them more prone to plaque buildup (atherosclerosis). Atherosclerosis restricts blood flow and is a significant risk factor for stroke, heart attacks, and heart disease. According to experts, in many cases, inflammation may trump cholesterol when it comes to heart disease risk, with studies showing that even people with ‘healthy’ cholesterol levels can develop heart disease if inflammation is high.
However, while some inflammation markers are easier to spot, such as swelling, recurring infections, and skin issues like eczema, others can be less visible. According to experts, hidden or chronic, low-level inflammation can cause subtle symptoms like brain fog, digestive issues, joint pain, persistent fatigue, and stubborn weight gain.
Simple steps like reducing stress, managing underlying health conditions, and adding more anti-inflammatory foods to your diet can help to lower inflammation. Check out our article, 14 anti-inflammatory foods, for inspiration.
3. Loneliness
Humans are social creatures by design, so it’s no wonder that connection and community play a key role in how healthy we are. However, it might come as a surprise just how much loneliness can influence heart health.
Take this study, which identified loneliness and social isolation as significant risk factors for heart issues, including a 29% increased risk of heart disease and a 32% greater risk of stroke. Among other things, experts suggest this could be due to the impact on sleep, inflammation, blood pressure, and stress. Loneliness is also associated with a higher risk of depression – another misunderstood heart disease risk factor.
On the other hand, research by the BHF found that increasing social activities over time may improve physical health. Specifically, of the British men studied, 71% were more likely to reverse frailty and susceptibility to health conditions if they increased their social activities, compared to those who didn’t.
If you’ve been feeling isolated recently, it’s important to remember that you’re not alone. For ideas on how to make new connections, you might be interested in our articles: 12 ways to make new friends and 8 ways to help tackle feelings of loneliness.
4. Poor oral hygiene
In a healthy mouth, there are over 700 species of bacteria: some beneficial, and some potentially harmful. If oral hygiene is poor, bacteria can increase the risk of oral infections, tooth decay, and gum disease, and may begin to affect the rest of the body, such as the heart.
Research shows that gum disease may increase the risk of heart disease by two to three times. Other studies also suggest that the body’s immune response (inflammation) to overgrown mouth bacteria may set off a cascade of damage to blood vessels throughout the body, including in the heart and brain.
Experts at the World Health Organization explain, “Most oral diseases and conditions share modifiable risk factors with leading noncommunicable diseases (including heart disease, diabetes, cancer, and chronic respiratory diseases).” Yet alarmingly, statistics from NICE estimate that between 50-90% of UK and American adults have some degree of gum disease, so it’s clearly an area that needs more focus.
Luckily, there are several things you can do to improve your oral health. To learn more, check out our article: 9 ways to improve oral hygiene. You can also read more about the importance of oral hygiene in our article: 8 reasons why oral hygiene is key for overall health.
Note: Gum disease risk factors like receding gums and saliva production issues become more common with age, so it’s even more important to take care of your oral health.
5. Mental health struggles
According to research, nearly one in three people with a long-term physical health condition also struggle with their mental health, most often depression or anxiety. When it comes to heart health specifically, studies have linked anxiety and depression with an increased risk of stroke, heart attacks, abnormal heart rhythms, and high blood pressure.
Experts believe this link may be because poor mental health can impact energy, motivation, and decision-making, making it more difficult to create healthy habits.
For example, studies have identified higher rates of smoking, poor diet, lack of exercise, medication nonadherence, and unhealthy lifestyles among people with mental health conditions.
6. An unbalanced gut microbiome
The gut contains trillions of tiny organisms called microbes, including bacteria, viruses, and fungi, known collectively as the gut microbiome. While some gut bacteria can be harmful and are linked with disease, good gut bacteria, known as probiotics, help to keep us healthy – for example, by allowing us to digest food and supporting the function of various body systems, including the heart.
Research has identified a clear connection between gut and heart health, including studies that link changes in the gut microbiota with a higher risk of heart and circulatory diseases.
It’s not yet fully understood how the gut microbiome affects heart health, but there’s evidence that an imbalanced gut microbiome can produce harmful compounds, including trimethylamine N-oxide (TMAO). TMAO may cause inflammation of the blood vessels and lead to high blood pressure. Meanwhile, research suggests that a healthy gut can help reduce the risk of heart disease.
For further reading, check out our article: How does the gut microbiome affect overall health? Or, if you’d like to take steps to improve your gut health, head over to our gut health section.
7. Poor sleep
During sleep, our heart rate slows, breathing stabilises, and blood pressure drops; functions that, together, reduce stress on the heart and allow it to recover from strains of the day.
Without sufficient sleep, the heart can become overstressed, resulting in elevated heart rates and blood pressure, increased inflammation, and a higher risk of stroke and heart attack.
In this study, for example, people who slept less than seven hours per night had a higher risk of heart failure. And another study found that sleeping fewer than six hours per night increased the risk of a heart attack by 20%.
Research also shows that it’s not just about how many hours you get: sleep quality matters, too. For example, experts have identified conditions like sleep apnoea (a primary cause of non-restorative, fragmented sleep) as one of the most underdiagnosed yet treatable contributors to heart disease.
While certain factors can make it more difficult to sleep (including underlying health conditions), simple improvements to your sleep hygiene can make all the difference. In this study, for example, when participants cut out alcohol for one month, they reported better sleep, mood, weight loss, and blood pressure.
Head over to our sleep and fatigue section to learn more about everything from ways to wind down to creating a healthy sleep environment.
Note: Various factors can influence both sleep and heart health, so it’s important to speak to your GP if you’ve been struggling.
Worried about accessing the NHS care you need?
83% of Rest Less members are worried about accessing the healthcare they need on the NHS#, making fast access to treatment more important than ever.
HMCA private medical cover offers affordable, flexible plans, with 90% of members saving money when they switch. Enjoy peace of mind. Join today and get £150 off your subscription.
#Data from over 1,000 Rest Less members surveyed in 2025
^Data from HMCA members who joined between 01/01/25 and 30/06/25
8. Chronic stress
When we’re stressed, the body releases hormones, like cortisol and adrenaline, initiating the ‘fight or flight’ response, which is key for survival.
Although stress itself isn’t entirely a bad thing, chronic, excessive, or unmanaged stress can negatively affect our health. According to experts, stress may lead to high blood pressure and an increased risk of heart attack and stroke. There’s also evidence that it makes people more likely to engage in heart disease risk factors like smoking, overeating, and lack of exercise.
If you’ve been feeling stressed recently, it’s worth considering things you can do to help. For help with this, you might like to read our articles: 7 ways to manage stress and anxiety and 9 simple stress-relieving activities.
9. Menopause
During menopause, many women experience physical symptoms like hot flushes, insomnia, and brain fog – largely due to shifting levels of hormones like oestrogen, progesterone, and testosterone, which play a role in heart health.
For example, oestrogen helps to regulate cholesterol levels and supports blood vessel health. So, when levels decline, fat can build up in arteries, causing them to narrow and become more susceptible to heart issues.
Other factors, such as changes in weight and fat distribution, may also be at play. For example, experts have confirmed a shift in where women tend to store fat during and after menopause (from the hips to the waist), a factor known to increase the risk of heart disease.
As a result, while women generally have a lower risk of heart disease than men before menopause, research shows that this trend reverses after menopause. According to statistics, over 3.6 million women are currently living with heart disease, and sadly, it’s the leading cause of death among women in the UK.
While these stats can be daunting, the better news is that there are several things you can do to help reduce your risk, which you can read about in our article: Menopause and heart health – what’s the link?
Final thoughts…
Rather than being solely driven by factors like diet and exercise, research shows that heart health is complex. Luckily, there are plenty of ways to take charge of your heart health. And, by doing so, it’s likely that you’ll be benefiting your overall health, too.
For further reading, head over to our heart health section. Here, you’ll find information on everything from tips to help lower cholesterol to possible warning signs of heart disease.
What steps have you taken to improve your heart health? Did any of the examples in our article surprise you? We’d be interested to hear from you in the comments below.
* Links with an * by them are affiliate links which help Rest Less stay free to use as they can result in a payment or benefit to us. You can read more on how we make money here.
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