Every day, I see patients in my office who are well informed and proactive about their health. But I am often surprised at some of the beliefs people have that are actually myths. When it comes to heart health, knowing your facts from myths is really important.
Heart disease is more of an issue for men
Hold on there! Heart disease is the leading cause of death in women. Most people are surprised to hear that more women than men die of heart disease each year. That bias often leads to women being underdiagnosed and undertreated.
Women tend to be safeguarded from heart disease prior to menopause because of the protective effect of estrogen, but not always. For example, pre-menopausal women with diabetes have similar risk to men of the same age because diabetes cancels out the protective effect that estrogen provides to pre-menopausal women.
Everyone should take an aspirin a day to prevent heart disease
Well, that too is not true. In fact, the U.S. Preventive Services Task Force (USPSTF) recommends against the use of aspirin for stroke prevention in women younger than 55 and recommends against aspirin use for heart attack prevention in men younger than 45. ASA is recommended for men 45-79 when the potential benefit outweighs the potential harm of an increase in a gastrointestinal bleed. Similarly, its use is recommended in women 55 to 79 when the benefit outweighs the risk.
Heart disease begins in adulthood
Sadly so, we know that teenagers can already have diseased arteries. With obesity, metabolic disease and hypertension now being seen in younger people, we know that heart disease can start early in life. Research in countries such as ours shows that as much as 1/3 or so of heart attacks and 1/4 of strokes happen in people below the age of 65
Heart attack is easy to recognize
While the classic signs of heart attack are chest pain, and pain in the arm, neck, or jaw, a heart attack can present with nausea, indigestion, vomiting, sweating and difficulty breathing. The way a heart attack feels in women may be different than in men. Women can develop disease in smaller vessels and their symptoms can be vague. Symptoms can include fatigue and anxiety- not your typical symptoms!
Both women and men may experience typical or non-typical symptoms such as nausea, sweating, pain in the arm, throat, jaw or pain that is unusual. However, women may describe their pain differently than men. Nevertheless, the most common symptom in women is still chest pain.
Cholesterol is the leading cause of heart attack
Would it surprise you to know that many people who die of heart disease may have normal cholesterol? While this is clearly a risk factor, don’t ignore other risk factors such as smoking, diabetes, hypertension, obesity, excessive alcohol, poor diet and a sedentary lifestyle. Excessive stress is associated with heart disease as well and while the exact relationship is not known, it is known that high stress can lead you to have an unhealthy lifestyle.
As long as I eat cholesterol-free, I am not at risk
Don’t forget about trans fat and hydrogenated fats. Saturated fat and trans fat increase the risk of coronary artery disease. But remember that you need healthy fats. Omega-3 fatty acids are polyunsaturated and they can decrease the risk of heart attack.
I take vitamins so I am not at risk
OK now, that is a complicated statement to address. Firstly, vitamins do NOT replace the role of healthy diet such as the DASH diet ( to reduce high blood pressure) or the Mediterranean Diet. Vitamins do not replace the role of a healthy lifestyle. The data on vitamins has been complicated to follow. Some studies have shown that vitamins such as C and E might prevent LDL cholesterol from producing plaques but overall the evidence has not shown that those who take vitamins have a real difference in heart disease risk than those who don’t take vitamins.
There are two kinds of cholesterol- good and bad
Well there are more than two kinds of cholesterol. There is also VLDL- very low density cholesterol that can be very harmful to the heart! It is not as simple as just good and bad cholesterol
I will know if I have hypertension
It’s not called the silent killer for nothing!! There are usually no symptoms. The only way to find out if you have high blood pressure is to get your blood pressure checked by your doctor or other qualified healthcare provider. Know your blood pressure readings and find out how often you should have it checked.
Many of us are unaware of what we can do to reduce our risk of heart disease. While age, gender and family history are things we can’t control, we can control many of the risk factors and adopt a healthy lifestyle!