Heart Disease Myths vs. Facts

Illustration by Madeline McMahon

Heart health gets a lot of attention, as well it should. Heart disease, a term that refers to a range of conditions that affect the heart or blood vessels, is the leading cause of death in adults in the U.S., causing about one in four deaths, according to the Centers for Disease Control and Prevention.

Yet myths and misconceptions about heart disease continue. How’s your heart-health IQ? Read on to get the facts about one of your body’s most vital organs.

MYTH: High cholesterol is due solely to a bad diet.

FACT: What you eat does indeed affect the cholesterol in your body, which influences your risk of heart disease and heart attack, but factors such as age, genetics and obesity can also contribute to cholesterol levels. Cholesterol numbers can often be improved through lifestyle changes such as eating better, not smoking, limiting alcohol consumption and getting sufficient exercise, which can boost HDL or “good” cholesterol. Weight loss that often accompanies exercise can also improve cholesterol levels. When lifestyle changes aren’t enough, medication can be prescribed to help get cholesterol under control.

MYTH: All fats are bad.

FACT: Many of us have been led to believe that fat is the enemy. While it’s true that it is best to avoid saturated and trans fats such as butter, unsaturated fats, found in foods such as olive oil, avocados, most nuts, and fish such as salmon, are considered beneficial. “Fats are essential for the body,” says Vikas Veeranna, M.D., F.A.C.C., a cardiologist at Catholic Medical Center’s New England Heart & Vascular Institute. “They are a major source of energy and help us to absorb nutrients and vitamins.” Unlike saturated and trans fat that can clog arteries and raise LDL or “bad” cholesterol, unsaturated fats can raise HDL or “good” cholesterol, reduce inflammation and lower the overall risk of heart disease. “It’s the kind of fat that matters,” Veeranna says.

MYTH: To keep my heart healthy, I need to get lots of high-intensity exercise.

FACT: Keeping your heart in shape does not require that you run for miles every day or push your body to the limit. Instead, the average healthy adult needs to get at least 150 minutes of moderate aerobic activity, 75 minutes of vigorous aerobic activity, or a combination of the two each week. “Moderate” means the movement speeds up your heart rate and makes you breathe harder than normal, but not so hard that you can’t speak in full sentences.

In addition to getting aerobic exercise, strength training for all major muscle groups at least two times per week is also recommended. Strengthening exercises might include body weight, dumbbells or resistance tubes, for example.

If you can’t devote big chunks of time to exercise, try to get five minutes of movement several times a day. “Maybe [it’s] just a couple of laps around the house or your driveway,” Veeranna says. “That adds up if done on a regular basis.” The mantra to live by, he says, is “move more, sit less.”

MYTH: High blood pressure occurs mostly in workaholics or people who are always stressed.

FACT: Emotional or work-related stress can elevate blood pressure and contribute to high blood pressure or hypertension, but risk factors also include age, family history, a sedentary lifestyle, being overweight or obese, and eating unhealthful foods. Dietary sodium is “a major contributing factor to hypertension,” says Peter Dourdoufis, D.O., F.A.C.C., cardiologist and chief of cardiovascular services at Portsmouth Regional Hospital. Caffeine, excessive alcohol, and cigarette smoking can also increase blood pressure.

MYTH: A heart attack is dramatic, like in the movies when a stricken person clutches their chest and falls to the floor.

FACT: Heart attacks reveal themselves in a variety of ways, some quite subtle. Most often, Dourdoufis says, people having a heart attack experience pressure or tightness in the chest, and many have jaw, neck, arm or back discomfort or pain.

Women’s symptoms can be even less recognizable as signs of a heart attack, Veeranna says, and might include nausea or lightheadedness. “Time is of the essence” during a heart attack or stroke, he notes, so when in doubt, get it checked out.

MYTH: Heart disease occurs mostly in men.

FACT: Heart disease affects both sexes. As the leading cause of death in men and women in the U.S., it outranks breast cancer, which many women fear most as a threat to their health. The risk of heart disease increases for everyone with age, particularly for men who are 45 and older and women aged 55 and older, and heart attacks tend to be more deadly in women, with women more likely than men to die following a heart attack.

Aspirin updates

Many news outlets this past fall reported a change in recommendations for the routine daily use of low-dose or baby aspirin to reduce the risk of a first heart attack or stroke in adults. The updated recommendations, which confused many patients, stemmed from concerns about internal bleeding that can result from regular use of aspirin. While the potential harm of taking daily aspirin might not be worth it for some individuals, the benefits outweigh the risks in individuals with a certain health profile.

For example, “patients who have coronary disease, who are seeing a physician for management of coronary disease, who have stents, who have had heart attacks or stroke absolutely need to stay on their aspirin therapy without interruption,” stresses Peter Dourdoufis, D.O., F.A.C.C., cardiologist and chief of cardiovascular services at
Portsmouth Regional Hospital. Ask your doctor what is best for you.

For more information about heart health, visit the American Heart Association’s website at heart.org.