Medical myths: All about heart disease
Written by Tim Newman on February 15, 2021 — Fact checked by Hilary Guite, FFPH, MRCGP
This week’s edition of Medical Myths will focus its beams on the many half-truths and misconceptions that surround heart disease. Among other topics, we cover smoking, coughing, exercising, supplements, and statins.
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Globally, heart disease is the number one cause of death. It is responsible for 17.9 million deaths each year.
According to the Centers for Disease Control and Prevention (CDC), in the United States, one person dies every 36 seconds from cardiovascular disease. Heart disease accounts for 1 in 4 deaths in the U.S.
As February is American Heart Month, today, we will tackle some persistent myths about heart disease.
1. Young people do not need to worry about heart disease
It is true that heart disease is more likely to affect people over the age of 65, but 4–10% of heart attacks occur in people under the age of 45 years, mainly in men. In addition, it is how we live our lives as children, adolescents, and adults that lays the groundwork for heart health as we age.
For instance, eating a diet that is high in trans and saturated fats or smoking tobacco slowly increases the risk of heart disease as we age. Changes to lifestyle today build the foundation for a healthier heart in later life.
In the U.S. as a whole, heart disease mortality has slowly dropped since the 1970s, although the trend seems to be slowing. However, in some regions, rates have increased.
One study that investigated heart disease mortality in different age groups in the U.S. found that “over 50% of counties [experienced] increases in heart disease mortality from 2010 through 2015 among adults aged 35–64 years.”
2. People should avoid exercise if they have heart disease
This is a myth. Exercise helps strengthen the heart muscle and improve blood flow around the body.
In August 2020, the European Society of Cardiology published guidelines on exercise in patients with cardiovascular disease. Prof. Sanjay Sharma, who was involved in creating the guidelines, explains:
“The chance of exercise triggering a cardiac arrest or heart attack is extremely low.” However, he also adds a note of caution: “People who are completely inactive and those with advanced heart disease should consult their doctor before taking up sports.”
3. I take cholesterol-lowering drugs, so I can eat whatever I like
Some drugs, such as statins, reduce the level of cholesterol in the blood. However, this does not mean that a person who is taking statins can consume foods containing saturated fats with abandon.
Cholesterol is either consumed in the food that you eat or produced in the liver. Statins block an enzyme in the liver that is necessary for producing cholesterol, reducing overall blood cholesterol levels. However, this means that ingested cholesterol can still make it into the blood.
In short, statins may just be able to override the adverse effects of a poor diet, but a poor diet will increase risk of other independent risk factors for heart disease, such as obesity, hypertension, and diabetes.
4. Heart disease runs in my family, so there is nothing I can do to stop it
If close family members have experienced heart disease, it could mean that you have an increased risk. However, it is not set in stone, and there are a number of ways to reduce the risk, even for people with a genetic susceptibility.
These include eating a healthful diet, stopping smoking, managing blood pressure, and exercising regularly.
It is also worth noting that if heart disease runs in the family, it may not be a sign of genetic susceptibility. Families tend to share lifestyle factors, such as diet and exercise habits, both of which can impact the risk of heart disease.
5. Vitamins can prevent heart disease
Although most vitamins, taken at the recommended doses, are unlikely to be bad for heart health, there is no evidence that taking any vitamin supplements can reduce the risk of heart disease. And they certainly cannot replace a healthful diet and regular exercise.
For instance, a systematic review and meta-analysis looked for associations between multivitamin and mineral supplements and a number of cardiovascular outcomes, including coronary heart disease and stroke.
The analysis, published in 2018, took data from 18 existing studies, including 2,019,862 participants.
The authors concluded that multivitamin and mineral “supplementation does not improve cardiovascular outcomes in the general population.”
According to Victoria Taylor, the nutrition lead at the British Heart Foundation: “There are no shortcuts when it comes to nutrition — supplements are not a replacement for healthy food. You might be prescribed a vitamin or mineral supplement by a health professional for other reasons, but we do not recommend people take multivitamins to help prevent heart and circulatory diseases.”