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4 Harmful Myths About Heart Disease

What you need to know about America's deadliest condition.

Key points

  • Although the heart is essential to physical health, it is also an important contributor to the capacity for happiness.
  • Heart disease kills a person slowly—usually over decades.
  • Contrary to public perception, up to 90 percent of the causes of heart disease are behavioral, environmental, and psychosocial.

We all know that looks can be deceiving. Take your own heart, for example. Although you probably can't tell just by looking at the 11 ounces of throbbing cardiac muscle in your chest, your heart may be your body's best-kept secret for health and happiness. This indefatigable organ continuously fuels the thousands of miles of blood vessels in your body, responds with unparalleled precision to the challenges of your environment, and orchestrates the passage of nutrient-rich blood through your lungs, brain, and bodily tissues with skills exceeding any maestro.

The purpose behind these "heart-culean" feats? To provide you with the biological power to survive and potentially even thrive. To move and make a difference. To connect with others and create a meaningful journey. Your heart toils tirelessly to give you life and the possibility of a great life.

Whatever your heart lacks aesthetically, it more than makes up for in versatility. Like a superhero living in your chest, your heart is part Mighty Mouse (incredibly powerful for its diminutive size), part Einstein (possessing genius-level skills in matching cardiac output to your physical and emotional demands), and part The Little Engine That Could (enduring, conscientious, and reliable beyond any manmade device). For the typical person, their heart will perform ceaselessly for some 80 years—during which time their heart will beat some 2.5 billion times and produce enough energy to drive a pickup truck to the moon (and back)—until finally even the tenacity and adaptability of this miraculous muscle will meet its match.

We all know that death is the inevitable result when our heart becomes too weak or diseased to function. For far too many, more than from any other cause, heart disease is how their life story ends. According to the CDC, for instance, a staggering 1,390,000 deaths in the U.S. were attributed to heart disease just during 2020-2021 (for reference, about 800,000 died from COVID-19 during these two years). Across a dozen presidential administrations, multiple financial crises, pandemics, cold wars, and enormous health and technology advancements, heart disease was unwavering. It has remained the leading cause of death in the U.S. for more than 70 consecutive years.

Heart Disease: Myth vs. Reality

Thankfully, disability and death from heart disease don't have to be the end of your story or mine. We can rewrite the script of this disease and enjoy a more dynamic life. However, doing so will require that we shatter prevailing myths about heart disease, apply newfound knowledge, and commit to making changes in our habits and lifestyles.

Here are four of the arguably most harmful myths many of us have learned about heart disease and the evidence-based reality on each point.

1. Perception: Heart disease is an old person's disease.

Reality (see figure): Heart disease is a lifelong disease. Signs of heart disease are increasingly measurable even among adolescents, common by middle age, and nearly universal among the elderly1. Because heart disease isn't reversible, our primary tool is prevention.

Thomas Rutledge
Source: Thomas Rutledge

2. Perception: Heart disease is a man's disease.

Reality: Heart disease discriminates by neither sex nor ethnicity. Although men do experience a higher incidence of heart disease than women during youth and early adulthood, heart disease differences between men and women collapse by middle age. Among U.S. women (see figure), most don't know that heart disease is 8-10 times more deadly than breast cancer2!

Thomas Rutledge
Source: Thomas Rutledge

3. Perception: Heart disease is caused mostly by genetic factors and family history, making it out of our personal control. Treatment for heart disease has to come from our doctors.

Reality: For the typical person, research indicates that up to 90 percent of their heart disease risk is explained by modifiable behavioral and psychosocial factors3. Although heart disease is primarily due to genetic factors in rare cases, for the rest of us, heart disease is a disease of our behavior, emotions, and environment. When doctors "treat" heart disease and heart disease risk factors, they are usually treating the damage caused by our own lifestyles.

Stress and mental health (see figure) appear to be—for both women and men—just as important to heart disease as traditional risk factors such as smoking, diabetes, and exercise.

Thomas Rutledge
Source: Thomas Rutledge

4. Perception: Heart disease kills us quickly, such as by a heart attack. At least that makes heart disease better than cancer or Alzheimer's Disease.

Reality: Heart disease kills us slowly—usually over decades—before typically delivering the coup de grâce in late life. By middle age for the typical American, heart disease is increasingly stealing their quality of life through reduced energy and vitality, impaired brain function, and dysfunction in physical and sexual performance, among many other areas.

Although most people think of heart disease as a lightning bolt that strikes suddenly in old age, heart disease is more like death by a thousand cuts.

Summary

Want a life filled with fulfillment and adventure? Contribution and memorable relationships? Personal growth and peak experiences? If so, then the deeply personal threat of heart disease is a challenge we all must face and win. The more science investigates the mind-body relationship, the more the evidence reveals that the health of your heart and cardiovascular system corresponds directly to your capacity for happiness. This means that exercise, sleep, nutrition, meditation, and stress management practices comprise not only the fundamentals for a healthy heart, but they are also equally foundational ingredients for a rewarding life.

References

1. Benjamin, E. J. et al. Heart Disease and Stroke Statistics-2017 Update: A Report From the American Heart Association. Circulation 135, e146-e603, doi:10.1161/CIR.0000000000000485 (2017).

2. Mehta LS, Watson KE, Barac A, Beckie TM, Bittner V, Cruz-Flores S, Dent S, Kondapalli L, Ky B, Okwuosa T, Piña IL, Volgman AS; American Heart Association Cardiovascular Disease in Women and Special Populations Committee of the Council on Clinical Cardiology; Council on Cardiovascular and Stroke Nursing; and Council on Quality of Care and Outcomes Research. Cardiovascular Disease and Breast Cancer: Where These Entities Intersect: A Scientific Statement From the American Heart Association. Circulation. 2018 Feb 20;137(8):e30-e66. doi: 10.1161/CIR.0000000000000556.

3. Rosengren A, Hawken S, Ounpuu S, Sliwa K, Zubaid M, Almahmeed WA, Blackett KN, Sitthi-amorn C, Sato H, Yusuf S; INTERHEART investigators. Association of psychosocial risk factors with risk of acute myocardial infarction in 11119 cases and 13648 controls from 52 countries (the INTERHEART study): case-control study. Lancet. 2004 Sep 11-17;364(9438):953-62. doi: 10.1016/S0140-6736(04)17019-0.

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