Abu Dhabi/Dubai: Everyone knows that an unhealthy lifestyle is precursor to a cardiac episode, and that diseases like diabetes, hypercholesterolaemia, and hypertension are closely linked to it.
The hazards of smoking and family history are also well acknowledged. But a series of misconceptions continue to persist, and these sadly stand in the way of people paying serious heed to their heart health.
This World Heart Day which is marked on September 29, five UAE experts are busting 12 common myths about heart disease and cardiovascular disease (CVD) with Gulf News.
The experts include Dr Gopal Bhatnagar, department chair for cardiac surgery at Cleveland Clinic Abu Dhabu, and interim chair for the hospital’s Heart, Vascular and Thoracic Institute, Dr Jose John, specialist cardiologist at LLH Hospital, Musaffah, Dr Sachin Upadhyaya, specialist cardiology at Aster Hospital, Mankhool, Dr Debabrata Dash, interventional cardiology consultant at Aster Hospital, Mankhool, and Dr Haider Ali, family medicine consultant at Medcare Medical Centre Town Square.
1. Myth: Heart attacks don’t affect people younger than 40 years old
Fact: “Today, one in five heart attack patients is younger than 40 years of age. And having heart attack in your 20s or early 30s is becoming more and more common. Between 2000 and 2016, the heart attack rate increased by 2 per cent every year in this young age group,” Dr John said.
“We see cardiac disease in younger people and while you may not have symptoms of heart disease till later the damage can happen at any age owing to poor lifestyle. Once you have the disease then it’s no longer at a preventative phase; you’ll need medications and possible surgery,” Dr Bhatnagar added.
2. Myth: If I have survived one cardiac episode, I am safe
Fact: “Your outlook isn’t better following a heart attack just because you’re younger. Patients with a heart attack in their 20s or 30s face the same risks as older patients. Once you have that first heart attack, you have the same chance of dying from a second major heart event or a stroke, regardless of your age, as shown in the young MI registry,” Dr John said.
3. Myth: Women have a lower risk of dying from heart disease
Fact: “CVD is the leading cause of death in women worldwide. Heart attacks in women, which account for one-third of all female deaths globally, actually have worse outcomes and higher mortality than in men. In addition, women over 35 years of age who smoke and take birth control pills are at much greater risk for heart disease or stroke,” Dr John said.
“Just as importantly, CVD kills more women than men, and even in women aged less than 65 years, more than twice as many women die of cardiovascular diseases than of breast cancer. Unfortunately, cardiovascular mortality in women is - in contrast to cancer - not on a decline but has stagnated or increased and many women live with chronic, non-curable cardiovascular diseases. Therefore, more awareness of CVD is urgently needed,” he added.
A study presented at the European Society of Cardiology’s Acute Cardiovascular Care 2021 Congress showed that 41 per cent of women wait more than 12 hours before seeking help in case of chest pain.
“Many women do not realise that they are at risk for heart disease. Understanding that women may have unique risk factors and can present with non-typical symptoms is critical to fighting heart disease in women,” Dr John said.
4. Myth: I am safe from CVD risks if I vape instead of smoking
Fact: “While cigarette smoking has a much higher chance of causing a heart attack than vaping, you’re still not off the hook if you vape. E-cigarettes contain nicotine and other toxic compounds that accelerate your heart rate and raise your blood pressure. A recent study found that vaping made you 34 per cent more likely to have a heart attack than non-vapers,” Dr John clarified.
5. Myth: I am not overweight, so I need not be worried about my excess belly fat
Fact: “If you are male and your waist size is above 94 to 102 centimetres, or if you are female and your waist size is over 80 to 88 centimetres, you are considered to be in the high-risk range for cardiac disease. A big tummy increases the risk of metabolic syndrome, meaning that the fat around the stomach is more damaging to the body,” Dr Bhatnagar warned.
6. Myth: Heart disease runs in my family, so I cannot do anything to stop it from affecting me
Fact: “In fact, 80 percent of your risk of getting heart disease is in your own hands. Family history only plays a 20 percent role. The other eighty percent of cardiac disease events are related to lifestyle, including high blood pressure, diabetes, high cholesterol, and hypertension. And smoking is one of the worst things that we can do to our body. [The bottom line is that ] lifestyle choices such as insufficient exercise, obesity, smoking, and high cholesterol are conducive to cardiovascular diseases,” Dr Bhatnagar said.
7. Myth: I have smoked for years, and there is no real benefit to my heart health if I stop now
Fact: “Of all the things that contribute to heart attacks in young adults, smoking cigarettes is one of the top risk factors. Your risk of a heart attack increases in direct proportion to the number of cigarettes you smoke. Smoking one pack a day doubles your risk for a heart attack compared with nonsmokers. With that being said, the damage is rapidly repaired for most smokers who stop smoking. Even long-time smokers can see rapid health improvements when they quit. Within a year, heart attack risk drops dramatically. Within five years, most smokers cut their risk of stroke to nearly that of nonsmokers,” Dr John countered.
8. Myth: Stress is overrated when it comes to heart disease
Fact: “Chronic stress has been shown to be associated with increased heart disease. It raises your cortisol level, which stimulates the formation of abdominal fat. Stress may also lead to high blood pressure, which can the risks of heart attacks and stroke. Work-related stress can also harm your heart, and research has found that people who are more worried about losing their job are nearly 20 percent more likely to have heart disease,” Dr John said.
“Stress often leads to other bad coping habits, such as overeating, smoking and avoidance of exercise,” Dr Bhatnagar added.
9. Myth: I follow a keto diet, so I have minimal risk of developing heart disease
Fact: “The Keto diet will help people lose weight, however, could increase the risk of heart disease for some people because of the high saturated fats that accompany that diet. You shouldn’t continue a keto high-fat diet for a long period of time,” Dr Bhatnagar advised.
“[In] keto [diets], the focus is on foods that may contain high levels of cholesterol but low level of carbs. While it may be excellent for weight loss, it is drastically increasing the risk of heart disease in the long term,” Dr Ali added.
10. Myth: Strenuous workouts are always good for heart health
Fact: “Regular exercise helps in strengthening the heart and lowers the risk of cardiovascular problems. But extreme or high-intensity training or exercises can lead to heart damage and rhythm disorders. When a person engages in extreme physical activity, it may lead to remodelling of the heart and can lead to issues like thicker heart walls and scarring of the heart. Various studies have found that people engaging in high-intensity exercising and overexertion possessed increased risks for sudden cardiac arrest or sudden cardiac death,” Dr Upadhyaya said.
This does not mean, however, that exercise is bad for health. “One should not over exert the body by pushing beyond the limit. Whether you are a beginner or a pro, do not overdo exercising. It is also important that one give proper time for body to rest and repair itself,” he said.
11. Myth: Crash diets and sudden weight loss are safe
Fact: “Shedding the extra kilos might be helpful to people struggling with lifestyle disorders such as diabetes, hypertension, and cholesterol, and the weight loss can not only control the disease but even reverse it in some cases. But weight loss has to be done carefully, and only after consulting an expert. Being on a weight loss journey does not mean that you eat less and starve, and following crash diets or low-calorie diets for immediate results can actually be harmful to your heart,” Dr Dash said.
“Low-calorie diets can lead to irregular heart rate, fluctuation in the heart rate, and might increase the risk of heart failure. Rapid weight loss might also trigger severe dehyrdration that might cause blood clots that can lead to heart attacks. Also, rapid changes in the diet affect the electrolyte balance of the body. So, it is always advisable that you consult a doctor or an expert, analyse your problems, and then design a diet plan that actually works for you,” he added.
Dr Ali also shared the results of a 2018 study by the European Society of Cardiology. “It found that crash diets which restrict caloric intake to 600-800 calories a day do have some benefits, such as showing a drastic reduction in body fat percentages as well as improvements to cholesterol and insulin resistance. Despite this, it was also found that such diets had an extremely negative impact on the heart within the first week. The heart fat content rose by about 44 per cent and the heart’s ability to function, i.e., pump blood was reduced. The reason this happens is because fat is released from different areas around the body into the blood stream which is subsequently taken up by the heart. [The study went on to warn] that those with heart disease considering embarking on a ‘crash’ diet should consult their physician first,” Dr Ali explained.
“Diets fail. People need to make sustainable changes in their eating habits. Half of all diets actually fail and most people who are trying to diet end up gaining weight. Therefore, sustainable small changes in your dietary habits are important. Intermittent fasting is quite useful in controlling blood sugar and weight; it existed before the invention of insulin, and diabetic patients were controlled by intermittent fasting,” Dr Bhatnagar added.
12. Myth: I have had cardiac interventional surgery, so I am safe from heart disease
Fact: “The surgery is not a cure , so take your medications as advised. Realise [too] that the surgery was needed because of an underlying reason, [which still has to be corrected]. If people are overweight, they should lose weight. If they smoke, they should quit smoking. If their blood sugar is out of control, they need to take medications to control it. Patients who have valve replacement, in addition to taking their medications reliably every day, they should also attend regular follow-up appointments,” Dr Bhatnagar said.