Serve Your Heart the Way You Serve Your Country

Research suggests that up to 90% of cardiovascular disease risks are linked to modifiable factors, meaning simple, daily changes can drastically reduce the likelihood of heart attacks or strokes.

“One flag, one land, one heart, one hand, one Nation, evermore!”
— Oliver Wendell Holmes Sr., American poet and physician

Throughout American Heart Month in February, TriWest Healthcare Alliance (TriWest) has been encouraging you—active duty service members and Veterans—to prioritize your cardiovascular health as an essential part of your mission. By “serving your hearts” and focusing on self-care, you are applying the same discipline, proactive maintenance, and commitment to yourself that you selflessly give to your country.

As active duty military and Veterans, you must take special care of your heart because the unique, high stress and physically demanding nature of service places you at a significantly higher risk for heart disease, high blood pressure, and related cardiovascular conditions compared to civilians. According to VA, these factors, combined with other lifestyle factors like environmental exposures and sleep disturbances, create a unique, heightened risk profile for this group.

The good news is that you possess the power to improve your heart health through daily, manageable lifestyle choices, regardless of your risk. Research suggests that up to 90% of cardiovascular disease risks are linked to modifiable factors, meaning simple, daily changes can drastically reduce the likelihood of heart attacks or strokes.

Focusing on small, actionable steps—such as improving dietary choices—makes the process more manageable. It is never too late to start, as a positive, proactive mindset contributes to a lower risk of cardiovascular events.

We spoke with Lori Hendrix, R.N., TriWest Disease Manager, about ways you can proactively navigate heart health with your provider and develop a roadmap for daily improvements. As a cardiac nurse, Lori’s focus has been on treating patients with heart disease, providing compassionate wellness through education, and improving outcomes.

“When I studied the circulatory system and the heart in nursing school, cardiology was always my first love. I went from nursing school directly to a cardiac care unit and eventually into cardiac Intensive Care,” she explains. “Our heartbeat is one of the very first signs of life and is often one of the very last signs of life as well. Heart health is vital at all stages of life.”

An Interview With Lori Hendrix, R.N.

TriWest: What are five questions active duty military and Veterans should ask their providers about their heart health, even if they feel healthy?

Lori Hendrix: This is a great question, as being proactive regarding heart health pays off, especially for active duty military and Veterans, where stress, sleep disruption, and past exposures can quietly add up.

You can literally say to your provider: “I feel fine, but I want to stay mission-ready long term. Can we do a quick heart health check?” Providers love proactive patients!

Here are five smart, specific questions to bring to your provider, even if you feel totally fine:

1. What is my actual heart risk now?

   1. Can you review my blood pressure, cholesterol, blood sugar, and family history with me?
   2. Based on my age and history, am I low, moderate, or high risk for heart disease? (This helps you catch issues early before symptoms appear.)

2. Do any of my service-related factors increase my risk of heart disease? (This question is important because it frames your health in the context of your service.)

   1. Do deployments, burn pit exposure, sleep deprivation, or chronic stress affect my heart risk?
   2. Does my past tobacco/nicotine use matter for my heart long term?

3. What screening should I be getting and how often? (Don’t assume the “basics” are enough. Early screening = fewer surprises later.)

   1. How often should I check blood pressure and cholesterol?
   2. Do I need an ECG, coronary calcium scan, or other tests at my age?
   3. Are there VA or DOW screenings that I qualify for?

4. What are one to two nutritional changes that would help my heart the most? (Make it doable, not overwhelming! Ask for one or two changes that you can stick with during duty shifts or busy civilian life.)

   1. Given my schedule, what’s the highest impact food swap I could make?
   2. How much sodium and caffeine should I aim for daily?
   3. Are energy drinks hurting my heart health?

5. What warning signs should I never ignore? (Knowing what is normal versus what is urgent cuts down on dangerous delays.)

   1. What symptoms should make me seek help right away?
   2. Are heart attack symptoms different in men than in women?
   3. When should I go to the ER versus calling my clinic?

TriWest: What are the most important lifestyle changes the military and Veteran populations can make to prevent heart disease and why?

Lori Hendrix: Consistent, heart-smart nutrition (most days of the week). This matters most because what you eat hits every major heart risk factor at once! It lowers blood pressure, improves cholesterol, reduces inflammation, helps with weight and blood sugar, and it supports energy and recovery for physical training and long shifts.

Daily movement is almost tied with nutrition in importance. Plan for 10-30 minutes of brisk exercise like walking fast, biking, or swimming. This level of activity lowers blood pressure, improves cholesterol, reduces stress, and offsets long hours sitting.

TriWest: Can you talk more about the connection between good nutrition and heart health?

Lori Hendrix: What you eat directly affects your arteries. Good nutrition:

• Lowers “bad” LDL cholesterol => less plaque buildup
• Keeps blood pressure in check => less strain on the heart
• Stabilizes blood sugar => reduces inflammation and vessel damage
• Supports a healthy weight => lowers risk of heart disease and diabetes
• Reduces chronic inflammation => calmer blood vessels, healthier heart rhythm

Heart-helping foods to prioritize:

• Fiber – helps sweep out cholesterol
• Omega-3s (salmon, sardines, tuna, chia, and flax) – lower triglycerides and calms inflammation
• Unsaturated fats (olive oil, nuts, and avocado) – improve cholesterol profile
• Potassium and magnesium (greens, beans, potatoes, bananas) – support blood pressure
• Hydration – helps blood pressure and performance

Go easy on:

• Excess sodium (blood pressure goes up)
• Ultra-processed foods (lead to inflammation and poor lipid profiles)
• Added sugars (triglycerides and insulin spikes)
• Processed meats (salt and saturated fat combo)

TriWest: How does stress and chronic stress affect heart health, and why is this a concern for active duty and Veterans?

Lori Hendrix: Stress isn’t just in your head. It physically changes your heart and blood vessels over time.

When you are stressed, your body flips into fight or flight mode: adrenaline, heart rate goes up, blood pressure goes up, blood vessels tighten, and blood sugar rises. This is great in the short term (good for danger, PT tests, and combat). Chronic stress is when that switch never really turns off. Over time, this can lead to higher blood pressure, inflammation inside your blood vessels, worse cholesterol patterns, blood sugar problems, and riskier coping behaviors.

TriWest: What are some modalities for active duty military and Veterans to help them manage stress?

Lori Hendrix: At TriWest, we have multiple clinicians who focus on a multimodal approach that combines professional therapy, mind-body practices, lifestyle habits, social support, and community engagement. This tends to be the most effective for active duty service members and Veterans navigating stress and trauma.

Proactive Heart Care for Active Duty Military and Veterans

Military heart health focuses on the Performance Triad—optimizing fitness, diet, and sleep to ensure a medically ready force.

• Annual screenings: Mandated Periodic Health Assessments (PHA) track cardiovascular risk factors like blood pressure, cholesterol, and body composition.
• Targeted programs: The Cardiovascular Health Assessment, Management, and Prevention (CHAMP) program provides specialized lipid management through a team of dietitians, pharmacists, and exercise physiologists.
• TRICARE preventive services: Covers cardiovascular screenings, including blood pressure checks and cholesterol testing, to help identify heart disease before symptoms appear.

The VA offers specialized services tailored to the higher cardiovascular risks often faced by former service members.

• Home-based cardiac rehabilitation: A 12-week telehealth program that provides coaching on exercise, nutrition, and stress management, proven to lower the risk of death by 36% compared to non-participants.
• The MOVE! Weight Management Program: This VA initiative assists Veterans in making healthy lifestyle changes to reduce hypertension and improve heart strength.
• Whole health approach: VA providers use a Whole Health model that incorporates mental health and spiritual well-being, as chronic stress and poor sleep are critical drivers of heart disease.

Taking action during Heart Month will help you establish healthy habits that can be maintained throughout the year to prevent heart disease. Do your part, care for your heart!