Myths and Misconceptions About Heart Disease

 

Believing myths and misconceptions about heart disease may increase heart attack risk, from the Harvard Heart Letter

BOSTON—Knowledge about heart disease changes quickly, but our beliefs don’t always keep up. As a result, misconceptions abound. The June 2013 issue of the Harvard Heart Letter addresses ten commonly held but mistaken, ideas about heart disease.

For example, many people believe that everyone with heart disease should eat as little fat as possible. In reality, eating some fats actually lowers the risk of heart disease. These healthy fats include unsaturated fats found in vegetable oils and other foods, and omega-3 fatty acids found in salmon and other fatty fishes. The ones to be avoided, because they boost heart attack risk, are saturated and trans fats.

Another myth is that people with heart disease should take it easy. Not so. Physical activity is beneficial for both the healthy heart and the diseased heart. It strengthens the heart muscle, increases blood flow to the heart and brain, and improves overall health.

Here’s another: it’s okay for blood pressure to rise with age. High blood pressure is a sign that artery walls are becoming stiff. That forces the heart to pump harder, which damages arteries over time. When blood pressure rises above 140/90 millimeters of mercury at any age, it needs attention.

Another common belief is that it’s okay to eat anything if you take a cholesterol-lowering drug. In reality, eating foods high in cholesterol and saturated fat make these drugs less effective or even ineffective.

Other myths and misconceptions cover diabetes and cardiovascular disease, the benefits of taking vitamins and minerals, “it’s too late to quit smoking,” small heart attacks, angioplasty and stenting or bypass surgery as “cures” for heart disease, and gender.

Believing in these outdated ideas may increase your risk of a heart attack. Here’s what you need to know to protect yourself.

Over the past decade, we’ve learned a great deal about what causes heart attacks and how to prevent them. But unless you follow medical news closely, there’s a chance you might have misconceptions about the risk factors for heart disease, or heart disease itself. Here are 10 commonly held but mistaken beliefs. Replacing these myths with truths will give you the information you need so you and your doctor can plan the best path to a healthy heart.

MYTH 1: If you have heart disease, you need to take it easy.

“For the vast majority of people with heart disease, being sedentary is a bad idea. It can lead to blood clots in the legs and a decline in overall physical condition,” says cardiologist Dr. Richard T. Lee, co-editor in chief of the Harvard Heart Letter. Physical activity helps strengthen the heart muscle, improves blood flow to the brain and internal organs, and improves overall health and well-being.

What you can do: Ask your doctor what kind of exercise would be right for you, and how much you should do. Most people can walk, and any amount of walking is good for your heart.

MYTH 2: If you take a cholesterol-lowering drug, you can eat anything.

Cholesterol in the bloodstream comes from two sources—your liver makes some, and you get some from certain foods. Statins reduce the amount of cholesterol made by the liver. This causes blood levels of cholesterol to drop, which, in turn, reduces the amount of cholesterol deposited in your arteries. If you take a statin and continue to eat foods that are high in cholesterol plus saturated fat, the drug will not be as effective, and your cholesterol level will not fall, and may even rise.

What you can do: Limit your cholesterol and saturated fat intake, so your statin can do its job.

MYTH 3: It’s okay to have higher blood pressure when you’re older.

Blood pressure tends to rise with age, but the fact that this trend is “normal” doesn’t mean that it is good for you. It happens because artery walls become stiff with age. Stiff arteries force the heart to pump harder. This sets up a vicious cycle. Blood pounding against the artery walls damages them over time. The overworked heart muscle becomes less effective and pumps harder to meet the body’s demands for blood. This further damages the arteries and invites fat into the artery walls. This is how high blood pressure increases the risk of heart attack and stroke.

What you can do: Have your blood pressure checked. If it’s above 140/90 millimeters of mercury, ask your doctor what you can do to bring it down.

MYTH 4: Diabetes won’t cause heart disease if you take diabetes medication.

Diabetes medication helps lower blood sugar levels. Maintaining normal blood sugar levels is important for preventing complications that affect the smaller blood vessels (microvascular complications), such as kidney disease, loss of vision, erectile dysfunction, and nerve damage.

But blood sugar control has less effect on the large blood vessels that become inflamed and diseased, increasing the risk of heart attack and stroke. “These vessels benefit more from lowering cholesterol and blood pressure,” says Dr. Alan Malabanan, a diabetes specialist at Harvard-affiliated Brigham and Women’s Hospital.

What you can do: Take your diabetes medication to prevent microvascular complications. Also do everything you can to lower high cholesterol and high blood pressure, stop smoking and drop extra weight. These measures will reduce your risk of heart disease and stroke.

MYTH 5: You can lower your risk of heart disease with vitamins and supplements.

The antioxidant vitamins E, C, and beta carotene factor into lowering heart disease risk. However, clinical trials of supplementation with these vitamins have either failed to confirm benefit or were conducted in such a way that no conclusion could be drawn. The American Heart Association has stated that there is no scientific evidence to justify using these vitamins to prevent or treat cardiovascular disease.

What you can do: For reasons not yet understood, the body absorbs and utilizes vitamins and minerals best when they are acquired through foods. To ensure you get the vitamins and minerals you need, skip store-bought supplements and eat a wide variety of nutritious foods of every color of the rainbow.

MYTH 6: If you have smoked for years, you can’t reduce your risk of heart disease by quitting.

The benefits of quitting smoking start the minute you quit, no matter your age, how long you have smoked, or how many cigarettes a day you have smoked. Only one year after quitting, your heart attack risk will have dropped by 50%; in 10 years, it will be the same as if you never smoked.

What you can do: Seek help to quit smoking. Many people require stop-smoking aids, such as nicotine patches, nicotine gum, or a stop-smoking medication, to be successful.

MYTH 7: Heart disease is really a man’s problem.

Since 1984, more women than men have died each year from heart disease. Heart disease is the leading cause of death in women over age 65, just as it’s the leading killer of men.

What you can do: Whether you are a man or a woman, ask your doctor to conduct a baseline heart examination that includes checking your cholesterol and blood pressure. Then follow your doctor’s recommendations.

MYTH 8: If you have heart disease, you should eat as little fat as possible.

It’s true you should eat a diet low in saturated fat, partially hydrogenated fat, and trans fat. But other fats, notably the unsaturated fats in vegetable oils and other foods, are beneficial. In fact, eating fish high in omega-3 fatty acids, such as salmon, twice a week can lower the risk of heart disease.

What you can do: Include low-fat dairy products, fatty fishes, nuts, and olive oil in your diet. If you eat meat, make sure the cuts are lean, and remove the skin from your poultry.

MYTH 9: A small heart attack is no big deal.

“A small heart attack isn’t a big deal in terms of how well your heart can function. It may even pass unnoticed. But it’s a huge warning sign that you have serious heart disease, and your next heart attack may kill you,” says Dr. Lee.

What you can do: Minimize your risk of heart attack by keeping your weight, cholesterol, and blood pressure in a normal range, not smoking, and seeing your doctor regularly to make sure no risk factors are elevated.

MYTH 10: Angioplasty and stenting or bypass surgery “fix” your heart.

Angioplasty and bypass surgery can do wonders for relieving chest pain (angina) and improving quality of life. But they don’t stop the underlying disease—atherosclerosis. Without correcting the problems that contribute to atherosclerosis, arteries will continue to become clogged with fatty plaque, which may mean the return of angina or worse—a heart attack or stroke.

What you can do: After undergoing angioplasty or bypass surgery, it’s important to correct the problems that led to the need for the procedure, such as high cholesterol or blood pressure, a poor diet, smoking, or lack of exercise.

Read the full-length article: “10 myths about heart disease”

Also in the June 2013 issue of the Harvard Heart Letter: