Eight in 10 men can avoid a heart attack by adapting five simple lifestyle changes, said an 11-year study involving 20,271 men.

Swedish researchers said having a waist measuring below 38 inches; quitting smoking; drinking in moderation; walking for 40 minutes a day and eating more fruits and vegetables drastically lowers the risk of heart attack among men. This reduced risk was observed even in men taking medication.

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They said even making one change reduced the risk by up to a third. If all five changes were made, the heart attack risk among men fell by a massive 86 percent.

Quitting smoking cut the heart attack risk by 36 percent. A healthy reduced this risk by 25 percent.

Drinking less than three units (or one-and-a-half pints) of alcohol a day led to an 8 percent risk reduction.

Having a waist measuring less than 38 inches reduced the risk by 13 percent. Walking or biking for at least 40 minutes a day cut the risk by 7 percent.

Researchers said the more changes men made, the greater the reduction in risk.

If a man ate a healthy diet and drank less, his risk dropped by 35 percent. If he exercised, followed a healthy diet and cut drinking, the risk fell by 64 percent.

Researchers estimated that 80 percent of heart attacks in men could be avoided with these changes.

"It is not surprising that healthy lifestyle choices would lead to a reduction in heart attacks. What is surprising is how drastically the risk dropped," said Dr. Agneta Akesson, an associate professor at the Karolinska Institutet in Stockholm.

She noted these lifestyle behaviors are modifiable, and that changing from high-risk to low-risk behaviors can have great impact on cardiovascular health.

"The best thing one can do is to adopt healthy lifestyle choices early in life."

The researchers followed the men (all aged 45 to 79) for 11 years. At the beginning of the study, they answered a series of questions about their lifestyle. The study was published in the Journal of the American College of Cardiology.