Anyone who has ever had a heart attack desperately wants to avoid a second. Not only is a heart attack a potentially deadly and painful medical problem, but it can also be hard to recover from — making survivors want to never experience the danger and ordeal again. That’s when many of us turn to diet and exercise to lose weight and get fitter. However, new research shows that there is a significant link between belly fat, strokes and heart attacks, especially for people who have experienced a heart attack before.

Before this, research had shown that belly fat was linked to high blood sugar, blood lipids, blood pressure and insulin resistance — all of which are related to heart health. However, no studies focused on abdominal fat and repeat heart problems. The scientists looked at more than 22,000 who had previously had a heart attack. They watched people for almost four years on average. The risk for future strokes and heart attacks were heightened incrementally by the amount of belly fat they had.

“In our study, patients with increasing levels of abdominal obesity still had a raised risk for recurrent events despite being on therapies that lower traditional risk factors connected with abdominal obesity – such as anti-hypertensives, [blood sugar] medication and lipid-lowering drugs,” said study author Dr. Hanieh Mohammadi of the Karolinska Institute.

“Abdominal obesity not only increases your risk for a first heart attack or stroke, but also the risk for recurrent events after the first misfortune,” Dr. Maintaining Mohammadi continued, “a healthy waist circumference is important for preventing future heart attacks and strokes regardless of how many drugs you may be taking or how healthy your blood tests are. Abdominal obesity can be tackled by eating a healthy and balanced diet and regular physical activity.”

The results were separate from any other habits that could add to the likelihood of cardiac events — blood sugar concerns, smoking and weight were all ruled out as the causes. Dr. Mohammadi pointed out a weakness in the study: there were three times as many men as women. More studies are needed to see how and if gender relates to the link between abdominal fat and heart health. That research could cause a significant change in our understanding and might show that women aren’t as at risk as men.

“Some studies have suggested that abdominal obesity may be more directly associated with the evil visceral fat (fat that sits around your organs) in men compared to women,” she explained. “In women, it is thought that a greater portion of the abdominal fat is constituted by subcutaneous fat which is relatively harmless.”

The visceral fat that men tend to have can become artery-blocking cholesterol. Diet alone is not the answer when it comes to losing belly fat. The good news is that activities like walking 30 minutes a day can help you lose weight around your abdomen. Focusing less on weight and more on overall health and waist circumference might be the best way for you to prevent future heart health problems.