A group of adults attending a fitness class outdoors are doing leg stretches. The participants are arranged in a line. The focus is on a mature ethnic woman who is smiling toward the camera.

MARQUETTE — February is American Heart Month, when having a healthy heart is brought into the spotlight around the United States.

UP Health System-Marquette’s Dr. Kristofer Dosh reminds people that preventing cardiovascular disease is possible in many cases, something that can be controlled with effort.

“Particularly with how big a problem it is,” Dr. Dosh said. “Heart disease is still the No. 1 killer of both men and women.”

While genetic factors cannot be changed, many lifestyles choices can be made to help promote individual heart health, Dr. Dosh said.

“For things like smoking, high blood pressure, high cholesterol and obesity, a person should be able to take steps to control them,” he said. “And diabetes is a big risk factor for hearts and there are a many effective options for therapy to help to control that.”

Dr. Dosh said an individual should talk to his or her primary care physician about changes that can be made.

“Exercise can make a big difference in a person’s health,” he said. “And having a heart-healthy diet is absolutely important.”

Starting youngsters on a good nutrition path will establish building blocks for a healthier future, Dr. Dosh said.

“Trying to prevent heart disease is an effort that can start when a person is young, especially if there is a family history of cardiovascular disease.”

Knowing the guidelines for blood pressure, cholesterol and other risk factors is another key.

“And so is detecting any potential heart issue before it becomes a problem,” he said.

Beyond that, being aware of the symptoms of a heart attack is important.

“The most common signs of heart attack include pain or pressure on the left side of the chest, jaw discomfort or shortness of breath,” Dr. Dosh said. “Or it could be shoulder pain or neck pain. With any of those symptoms, seek medical help.

“As they say, ‘time is muscle’ so the longer you go without treatment, the higher the likelihood of permanent damage or death.”

Anyone experiencing these symptoms should call 9-1-1 to seek medical help.

For women, symptoms may be more atypical, Dr. Dosh said.

“Women may experience pain in the jaw, neck or shoulder blades or just shortness of breath or dizziness. Up to two-thirds of women didn’t complain of any symptoms at all before their heart attack,” he said.

All ages and genders can boost heart health with exercise,” Dr. Dosh added.

“Exercise is always a good idea,” he said. “We get busy with our family, with our jobs, and become less active. We become sedentary. Even those who were athletic as young adults can become couch sitters.

“Becoming active is a good idea. Speaking with your primary care doctor can help you find the type of exercise that is best for you in your current state of health.”

With the Upper Peninsula being mostly rural, there is an unfortunate trend toward a lifestyle activity that exponentially increases cardiovascular disease risk: smoking.

“Many rural communities have a high percentage of smokers,” Dr. Dosh said. “Nicotine has become a real health concern, especially because those who sell nicotine products are targeting younger audiences.”

Vaping, while not yet the subject of intense research, also can affect heart health.

“It may be safer than smoking but it’s still not safe,” Dr. Dosh said. “Nicotine, in whatever form, can have an effect on the heart.”

To learn more about cardiovascular services at UP Health System-Marquette, visit http://www.mgh.org/our-services/heart-and-vascular.

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