February 15, 2019

Five myths about heart disease

A woman in athletic wear holding a heart over her chest

Think you know about your heart? Your doctor might disagree.

UW Health cardiologists say they've heard plenty of myths about heart disease — and patients who believe them might be at increased risk because of the misinformation.

To shine some truth on the subject, these cardiologists have provided a quick list of some of the most common myths they encounter in patient care. Think of it as a heart reality check.

Myth: "Nobody in my family has heart disease, so I'm not going to get it."

Not true, said James Stein, MD director of UW Health's Preventive Cardiology Program. Only 47 percent of people with heart disease have a family history of the disease, which means the other 53 percent develop it in the absence of an obvious genetic component.

"Risk factors like unhealthy eating habits and a sedentary lifestyle predict heart disease. The presence of any risk factors increases your risk of developing heart disease," said Stein. "But not having a family history does not protect you."

Myth: "I don't have high blood pressure. My bottom number has always been normal."

It's true that when you're young, the bottom number — the diastolic blood pressure — is a marker of heart disease and stroke risk. But after the age of 35 or 40 years, the key number to pay attention to is the top number, the systolic blood pressure.

"As you age, your arteries get stiffer, and as a result, the top number goes up and the bottom number goes down," said Stein. "Actually, a low bottom number is very dangerous."

Stein notes that, contrary to popular belief, increased blood pressure is not a normal part of aging. Any increase in the top number is an indication of greater risk.

Myth: "My angiography showed that I have an artery with a 50 percent blockage. We just have to take care of that one spot, right?"

Unfortunately, no. Atherosclerosis, sometimes called "hardening of the arteries," is a diffuse disease.

"Chances are, if you have one blockage that is easy to see, you almost assuredly have blockages elsewhere that are harder to see," said Jon Keevil, MD, UW Health preventive cardiologist. "Unfortunately, even those can be risky for heart attacks."

Myth: "I'm thin and I'm in shape. I don't have to worry about bad cholesterol."

Wrong again.

Mary Zasadil, MD, a UW Health preventive cardiologist, says that obese patients may be more likely to suffer from cholesterol issues. But, like heart disease, cholesterol is largely genetic. If your parents or relatives struggled with cholesterol, you and your primary care physician need to pay close attention to your cholesterol numbers and have them tested frequently.

And speaking of cholesterol, Zasadil also frequently hears another head-slapper from patients.

Myth: "I stopped taking my cholesterol medication because my cholesterol improved. I didn't think I needed them any more."

You need them.

Cholesterol medications, including statins, aren't like antibiotics, which can be stopped once the infection has been resolved and you've completed your course. The protective benefits of cholesterol medications disappear once a patient stops taking them, and what has gone down (a patient's cholesterol numbers) can quickly shoot back up again.

"When you stop taking your medications, your risk of a heart event increases right back to where it was before you started taking them," said Zasadil. "That's why it's important to discuss any change in your medications with your primary care physician."