Myths and Facts: Heart Disease

On average, every 39 seconds, a person in the U.S. dies from a heart attack, which totals more than 2,500 people dying each day. Every year, about 785,000 Americans have a first heart attack, and another 470,000 who have already had one or more heart attacks have another attack. Heart disease is the No. 1 killer in the world, causing more deaths than all forms of cancer combined. And, it does not discriminate. It occurs in all ethnicities, in both sexes and at all ages. What’s more, it’s expensive: In 2010, coronary heart disease alone was projected to cost the U.S. $108.9 billion, which includes the cost of healthcare services, medications and lost productivity.^1,2

With such alarming statistics, it’s safe to say that almost every individual in the U.S. has likely been affected by heart disease in some way — whether they have suffered a heart attack themselves or they have a family member or friend who has heart disease. Yet, since heart disease has touched so many lives, it makes one wonder why more is not known about this deadly killer. The answer, says Dr. Ralph Sacco, president of the American Heart Association, is that “there’s a lack of awareness of what ideal cardiovascular health really is.” People think they’re healthier than they are, which makes them less likely to take steps to reduce their risk of heart disease.² Added to this is a widespread lack of awareness of the facts about heart disease.

Separating Myth from Fact

Myth: All heart disease results in heart attacks.

Fact: Heart disease is an umbrella term that includes conditions such as coronary artery disease, heart attack, cardiac arrest, congestive heart failure and congenital heart diseases. The most common cause of heart disease is coronary artery disease, which is a blocked or narrowed coronary artery that supplies the heart with blood.³ In 2008, 405,309 people died from coronary artery disease.¹

Myth: All heart attacks are the same.

Fact: There are actually two types of attacks that can occur due to heart disease. The first is a heart attack (myocardial infarction), which occurs when blood supply to the heart muscle stops and the heart muscle dies. The second is a sudden cardiac arrest, which occurs when the heart suddenly stops pumping due to an electrical problem in the heart. It’s possible for a heart attack and a sudden cardiac arrest to occur simultaneously.³

Myth: Heart disease affects only older adults.

Fact: The risk of heart disease does increase with age, and heart disease in general and angina and coronary disease in particular occur more often in people over the age of 54, with incidence rates increasing even more sharply for people over the age of 64.⁴ However, the roots of heart disease often begin as early as childhood. In fact, one in three Americans has cardiovascular disease,which includes young and middle-aged people.⁵

Myth: Heart disease doesn’t affect children.

Fact: With the growing prevalence of obesity in children, more and more are experiencing heart disease. Cardiac arrest strikes an estimated 5,920 children each year, and most unexpected deaths in young athletes are the result of heart disease. In fact, heart disease accounts for up to one death per 100,000 high school athletes.² In addition, other childhood diseases, such as Kawasaki disease and acute rheumatic fever, can be the main causes of acquired heart disease in children in the U.S.³

Myth: Heart disease primarily occurs in men.

Fact: Not anymore. Since 1984, more women than men have died each year from heart disease, and the gap between men’s and women’s survival continues to widen. Worldwide, 8.6 million women die from heart disease each year, accounting for a third of all deaths in women. Eight million women in the U.S. are currently living with heart disease, and 435,000 American women have heart attacks annually, 83,000 of whom are under age 65 and 35,000 of whom are under age 55. Under age 50, women’s heart attacks are twice as likely as men’s to be fatal, with 267,000 women dying each year from heart attacks. What may be surprising to many is that heart attacks kill six times as many women as breast cancer does.⁶

Myth: The symptoms of a heart attack are easy to detect.

Fact: In a 2005 survey, 92 percent of respondents recognized chest pain as a symptom of a heart attack. Yet, only 27 percent were aware of all the major symptoms.¹ Although it’s common to have chest pain or discomfort, a heart attack may cause even subtle symptoms, including shortness of breath, nausea, feeling lightheaded, and pain or discomfort in one or both arms, the jaw, neck and back. In addition, leg pain felt in the muscles could be a sign of peripheral artery disease (PAD), which results from blocked arteries in the legs caused by plaque buildup. People with PAD have a fivefold increased risk of a heart attack.⁵

It’s also common for people not to experience any symptoms of a heart attack. In fact, research suggests that 25 percent of heart attacks go unrecognized, and they are discovered only later when a routine ECG is performed. But, individuals shouldn’t assume that with regular checkups, their doctor will order tests for heart disease. Simple heart tests, such as a CT scan that can detect plaque buildup in the arteries at an early, easily treatable stage, are not routinely recommended.²

Myth: The symptoms of a heart attack are the same in men and women.

Fact: While both men and women can experience the classic symptoms of a heart attack such as chest pain and cold sweat, women typically have subtler and less-recognizable symptoms such as abdominal pain, achiness in the jaw or back, nausea and shortness of breath. Half of women have no chest pain at all.² And two-thirds of deaths from heart attacks in women occur in those who have experienced no history of chest pain.³

A common symptom of a heart attack in women is unusual tiredness. Kathy Magliato of St. John’s Health Center in Santa Monica, Calif., and author of Heart Matters: A Memoir of a Female Heart Surgeon, says that too often, women “blow off” their symptoms, mistaking them for indigestion or a sign of being out of shape. “The No. 1 way women present with heart disease is dead,” she adds. “They don’t come in with chest pain or fatigue. It’s sudden cardiac death.”²

Myth: It’s OK to drive someone to the hospital while they are experiencing heart attack symptoms.

Fact: In that same 2005 survey mentioned earlier, those 27 percent of people who were unaware of all the major symptoms of a heart attack also didn’t know to call 9-1-1 when experiencing symptoms.¹ It takes only four to six minutes after a cardiac arrest before a person experiences brain death and then complete death. Indeed, the survival rate outside a hospital is less than 1 percent to 2 percent.³

Myth: Heart disease is hereditary, so people whose parents don’t have it won’t get it either.

Fact: People can’t change their genes. It’s true that heart disease is genetic. A person with both a first-degree relative (a parent or sibling) and a second-degree relative (uncle or grandparent) who suffer from heart disease before age 60 is nearly 10 times more likely to suffer from heart disease early in life.³ But that doesn’t mean that risk can’t be mitigated with a healthy lifestyle.

Myth: Heart disease can’t be prevented.

Fact: Heart disease can be prevented. Most importantly, cholesterol and blood pressure need to be kept within the recommended levels. A healthy cholesterol level is lower than 200, and a normal blood pressure range is a diastolic reading of less than 80 and a systolic reading of less than 120. The American Heart Association recommends that individuals start getting their cholesterol checked at age 20. For those without heart disease, lowering cholesterol and blood pressure levels can reduce the risk from it developing. Lowering cholesterol and blood pressure levels also can have a positive effect on those who already have heart disease, including reducing the risk of dying from heart disease, having a nonfatal heart attack, and needing heart bypass surgery or angioplasty.¹

The chances of developing heart disease also can be prevented by exercising regularly, maintaining a healthy weight and not smoking. In fact, 53 percent of U.S. adults between 2005 and 2008 who were inactive, 34 percent who were obese, 32 percent who had high blood pressure, 21 percent who smoked, 15 percent who had high cholesterol and 11 percent who had diabetes were at risk of developing heart disease.¹

Myth: Diabetics who keep their blood sugar level in control aren’t at increased risk of having a heart attack.

Fact: Even diabetics whose blood sugar levels are under control are at risk of heart disease. This is because diabetes causes inflammation that can damage blood vessels.²

Myth: Exercise is unsafe for people who have experienced a heart attack.

Fact: Heart attack survivors should exercise as soon as possible after an attack. Those who are regularly active and make other heart-healthy changes live longer than those who don’t.⁵

Myth: Heart disease is curable with treatment.

Fact: There is no magic pill or procedure that will cure heart disease, but it is treatable. Treatments vary, from lifestyle changes to medication, surgery and other medical procedures. Whether mild or severe, lifestyle changes will be needed, including eating a low-fat and low-sodium diet, getting at least 30 minutes of moderate exercise on most days of the week, quitting smoking and limiting alcohol intake. If lifestyle changes aren’t enough, doctors will prescribe medications such as diuretics, angiotensin-converting enzyme (ACE) inhibitors or beta blockers to lower blood pressure; daily aspirin therapy to thin the blood; and statins or fibrates to lower cholesterol.

Medical procedures or surgery also may be needed to clear blockages in the heart. A common procedure is angioplasty, which is performed by placing a catheter in an artery in the arm or groin, threading a small balloon to the blocked artery and inflating it to reopen the artery. During angioplasty, a small metal coil called a stent is often placed in the artery to help keep the artery open. If needed, coronary bypass surgery is performed, which involves using a vein from another part of the body (usually the leg) to bypass the blocked section of the artery.⁷

Dispelling the Myths Now

Today, more than 79,400,000 Americans have one or more forms of heart disease. Understanding the risks of developing this deadly disease and how to deal with it once it has developed can mean the difference between life and death.