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Nearly half of all American adults have some form of cardiovascular diseasean umbrella term that covers everything from high blood pressure to stroke. If youve been told youre among them, you may be confused or even a little scared. Thats normal, and everyone featured on HealthCentral with a chronic condition felt just like you do now. But weand theyare here for you. On this page alone, youll discover not only the realities and challenges of heart disease, but also the best treatments, helpful lifestyle changes, and critical information you need to help you not just managebut thrive. Were sure youve got a lot of questions. Were here to answer them.
The term heart disease encompasses a huge amount of cardiovascular territory. Thats because its not a single disease but one that refers to all sorts of heart-related health conditions, many of them chronic, that impact how well your heart functions.
Some of the more common forms of heart disease include:
Heart disease accounts for more deaths each year than any other health concern. According to the Centers for Disease Control and Prevention (CDC), nearly 650,000 people die of heart disease annually. Thats about one death every 37 secondsa shocking number, to be sure. And heart disease does not discriminate: Whether you are a man or a woman of any race or ethnicity, cardiovascular disease is your number-one health threat.
The good news? You can do a lot to prevent heart disease. And, if you already have some form of this condition, there are medications, lifestyle-management tips, and other strategies to help protect you and your ticker.
Before diving into what can go wrong, lets take a step-by-step look at the heart, what it does, and how it works:
How does your ticker make all this happen? For starters, the heart is made up of four chambers:
Those chambers work in tandem, employing a system of valves that open and close as your heart beats in order to bring blood in and pump blood out. Remember, the heart is a muscle, and when its healthy, its quite strong. As a pump, it provides sufficient pressure so that your entire blood supply cycles through your body every 60 seconds.
More heart smarts:
A healthy adults heart will beat anywhere from 60 to 100 times per minute while lounging around. If youre quite fitan athlete, for exampleyour heart works more efficiently, and your resting heart rate may be closer to 40 beats per minute.
Like the rest of the body, the heart requires blood in order to thrive. In fact, it needs a bigger supply of blood than any other muscle in the body, so it relies on its own network of coronary arteries to provide that blood.
Electricity powers the beating of your heart and sets its pace. Thats a critical function. You need your heart to beat properly in order to supply your body with sufficient blood and oxygen. Your heart contracts with each beat, and the timing of those beats must remain precise so that those contractions stay in sync.
These electrical signals originate in your hearts right atrium and are controlled by your central autonomic nervous system, telling your heart how fast or slow it should beat. When you exercise, your nervous system signals your heart to speed up in order to pump more blood. Other factorsnot all of them healthy, like smoking and over-indulging in alcoholcan also affect your heart rate.
Your heart functions in incredibly complex waysthis is just a thumbnail sketch. Needless to say, there are also a great number of ways in which things can go wrong that can lead to heart disease.
How does your body tell you that somethings troubling your heart? It depends on the type of trouble. While some diseases that affect the heart share similar symptoms, others vary greatly. And some types of heart disease have no symptoms at all.
Lets review some of the major types of heart disease and how to recognize them:
Having high blood pressure (HBD), aka hypertensionwhich has no symptomsups your odds of developing numerous other types of heart disease, including CAD. It is the result of plaque buildups in your arteries that reduce the amount of blood that reaches your heart, leaving you at higher risk for heart attack, heart failure, and stroke. HBP hardens and thickens your arteries, reducing blood flow. If you have a systolic pressure of 130 or higher, or a diastolic pressure of 80 or higher, its critical to reduce it.
The hearts two major arteries branch off from the aorta, the artery that sends blood to the rest of the body. These two arteries, in turn, branch off into smaller and smaller arteries that supply the heart with blood. CAD, the most common type of heart disease, develops when your arteries cant provide enough oxygen-rich blood to your heart. The heart receives its own supply of blood from the coronary arteries.
Often, CAD is caused by plaque buildups that restrict or block the flow of blood through your blood vessels. CAD often develops over many years, even decades, and it does not always make itself known until it has progressed significantly and youre closing in on a heart attack. At that stage, the affected blood vessel is about 70% blocked. Even people who have plaque blockages in the 40% to 50% range may have no symptoms. But when they do occur, they're typically:
A less common, but related, condition called coronary microvascular disease (MVD) or small vessel disease occurs when the walls of the small arteries in the heart are damaged. It is often diagnosed after a doctor finds little or no narrowing in the main arteries of your heart, despite your having symptoms that suggest heart disease, such as angina. MVD is more common in women and in people who have diabetes or HBP. The condition can be difficult to detect. Other symptoms of MVD include pain in your left arm, neck, jaw, abdomen, or back; pronounced fatigue; and shortness of breath.
A heart attack occurs when the plaque in your blood vessel ruptures, causing a clot to form as the body attempts to repair the damage. This blockage cuts off blood flow to the heart, starving the muscle of needed oxygen and other nutrients.
For men, this often happens suddenly; womens symptoms tend to be more gradual. While chest pain is the most common symptom of heart attack for both men and women, their symptoms can be different. For example, women are more likely to have shortness of breath, fatigue, and nausea. Men normally experience the classic symptom of crushing chest pain. Men are also more likely than women to have sudden heart attacks; women, on the other hand, have higher odds of developing symptoms over a period of hours, days, or even weeks.
Either way, common symptoms of heart attack include:
Angina, a radiating chest pain and pressure that can feel as if an elephant is sitting on your chest
Shortness of breath
Nausea
Indigestion
Heartburn
Abdominal pain
Fatigue
Lightheadedness and dizziness
Cold sweats
This progressive disease occurs when your tickers ability to pump blood starts to decline. CAD, heart attack, diabetes, obesity, and high blood pressure are among the common causes of heart failureso it doesnt happen overnight. As your heart can no longer pump as well as it used to, the blood that would normally cycle through it can get backed up. Your kidneys also filter less blood, leading to fluid retention and swelling in your extremities.
Several different symptoms can get worse as heart failure progresses. Some of the most common:
As its name implies, heart valve disease involves the system of four valves that helps regulate the flow of blood through the heart. For example, one of your valves might narrow to the point that a reduced amount of blood can pass through it. This is called valvular stenosis.
When one of your hearts valves stop working properly, a variety of symptoms, many of them similar to those of heart failure, can occur, including:
An abnormal heartbeat, called an arrhythmia, can trigger a variety of symptoms, some benign, some dangerous, depending on which kind of arrhythmia you have. Tachycardia, for example, accelerates your heartbeat to a too-fast rhythm, while bradycardia slows it down. Both can sometimes be dangerous and lead to higher risk of stroke and other complications, but not always. If you experience either type of arrhythmia, be sure to consult with your doctor.
Atrial fibrillation is the most common type of sustained arrhythmia, with anywhere between 2.7 and 6.1 million Americans currently sharing a diagnosis of it. (As the U.S. population ages, that number is expected to increase, reports the CDC.) A-fib, as its often called, causes your heart to beat erraticallyit can feel like it is skipping beatsrather than rhythmically. In some cases, abnormal heartbeats are not a cause of concern, but other times they can lead to stroke, heart failure, or even cardiac arrest, a quickly fatal event in which the heart stops beating. Its important to get to the root of A-fib, so you know whether or not your symptoms require treatment.
In general, abnormal heartbeats also lead to many symptoms shared by other forms of heart disease, including:
A stroke occurs when your hearts blood supply gets cut off, denying it the oxygen it needs to keep working. This can cause brain tissue to begin to die within a few minutes. Stroke is the fifth-leading cause of death in the U.S., accounting for one out of every 20 deaths that occur in this country annually, and its the leading cause of serious long-term disability, according to the CDC.
A stroke can greatly affect the brain. You may have trouble understanding what others are saying, you may slur your speech, and you may experience confusion.
Other symptoms include:
There are two major types of stroke plus a third, less-severe kind:
Lets go back to the good news: About four out of five cases of heart disease can be prevented. Thats because its most often caused by lifestyle factors, such as smoking, poor diet, lack of exercise, and by other health conditions that can arise, including diabetes and high blood pressure (HBP), that can arise from these choices. While its never too late to make positive, healthy changes, the sooner you begin, the better.
Before getting into the risk factors that you can work to reduce, lets cover the few that you cant do anything about.
Age
This ones pretty simple. The older you get, the likelier you are to develop heart disease. In fact, more than 80% people who die from heart disease are older than 65, because the heart tends to grow weaker as you move into your golden years.
Gender
While heart disease may be the number cause of death for both men and women, it tends to develop later in women. Why? Experts believe that hormones such as estrogen, which women have in much greater abundance than men, may provide some protection against heart disease. However, those hormones decline during menopause. By age 65, a womans odds of heart disease match those of a man of similar age.
Genetics and Family History
Its true: Heart disease tends to run in the family. Did your dad develop heart disease before the age of 55 or your mom before she turned 65? If so, your own risk is higher than normal because one or both of your parents may have passed along a genetic ingredient in the recipe for heart disease.
Early Menopause
According to a 2019 study in The Lancet Public Health, going through The Change before age 40 increases risk of heart diseases like CAD, heart failure, arrhythmia, and heart valve disease among the approximately 10% of women who experience early menopause. It remains unclear why, though a decline in estrogen may be a factor.
These four factors make up only part of the complex swirl of possible causes of heart disease. You cant change your genes or age, but dont despair. Instead, use that knowledge as motivation to address the risks you can change. These include:
High Blood Pressure (HBP)
Having hypertension, a.k.a. high blood pressure, is a red flag for other forms of heart disease, increasing your risk for CAD, heart attack, heart failure, and stroke. HBP results from plaque buildups in your arteries, thickening them and reducing blood flow.
High Cholesterol
Unhealthy cholesterol levels contribute to blockages in your blood vessels that can eventually lead to heart attack. Your body produces cholesterol naturallywe all need it to make important hormones and absorb Vitamin Dbut its easy to get more than you need by eating foods that are high in saturated and trans fats (like red meat, eggs, and dairy). There are two types of cholesterol: low-density lipoprotein (LDL, or bad cholesterol) and high-density lipoprotein (HDL, or good cholesterol). LDL contributes to plaque buildups in your arteries. HDL protects against heart disease by transporting excess LDL to the liver to be processed as waste.
Obesity
Being obese forces your heart to work harder because your body requires more of the oxygen and nutrients that your blood supplies. This leads to high blood pressure. Excess weight also increases risk for heart disease, or makes them worse if you already have them, including high cholesterol and type 2 diabetes. Obesity has been linked to heart failure and CAD.
Diabetes
Type 1 and type 2 diabetes both limit your bodys ability to maintain a healthy level of glucose, a form of sugar that your body produces and uses for energy. Uncontrolled blood glucose damages your blood vessels and the nerves that control your heart, eventually leading to heart disease. In fact, as many as three out of four people with diabetes die from some form of heart disease.
Physical Inactivity
The couch potato life not only directly puts you at higher risk of heart disease, it opens the door to other risk factors like HBP, high cholesterol, and type 2 diabetes.
Smoking or Vaping
Lighting up does more than damage your lungs. It accelerates your heartbeat while narrowing your blood vessels and contributes to the formation of blood clots that can lead to heart attack or stroke. Less is known about the risks of vaping, but many of the chemicals involved have been linked to heart disease.
Stress
Pressure and tension can elevate your heart rate and blood pressureand too much eventually damages your blood vessels. Stress also can lead some people to abuse alcohol and eat too much, as well as smoke. (And, remember, any amount of smoking or vaping is too much.)
Drinking Alcohol
Too much alcohol also can harm your heart. Excessive drinking ups your blood pressure and heart rate as well as your triglycerides, a type of fat linked to heart disease, because they may contribute to hardening and thickening of your arteries.
Sleep Apnea
This sleep disorder causes breathing trouble as you sleep, reducing the amount of oxygen to your blood and raising your blood pressure. Together, these can weaken your heart and put you at heightened risk chronic HBP, atherosclerosis, arrhythmia, and heart failure.
Before we get into how your doctor will determine whether you have heart disease, lets make one thing very clear: Diagnosis is your doctors job. If you have heart attack symptoms, such as shortness of breath or chest pain, dont waste time searching the internet to figure out the problem. Call 911 immediately. How fast you act just might save your life.
However, cardiac arrest is just one of many potentially serious heart concerns. Diagnosing heart disease involves a range of screening tests and, sometimes, tracking devices, too. Your doctor will ask you about your symptoms, your health history, and any risk factors you may have. He or she will also give you a physical exam in order to listen to your heart, check its rhythm and the timing of your pulse, and look for signs of swelling and accompanying weight gain due to fluid buildup in the hands, feet, legs, or abdomena possible indication of heart failure or heart valve disease.
You may undergo a variety of blood tests to measure your:
In addition to the above measurements, you could be given non-invasive diagnostic tests or tools to montior your heart rhythms. They include:
You may be given more invasive diagnostic tests, too, to screen for heart disease. They include:
There is no cure for heart disease. That said, theres a lot you can do to live well despite having it. Treating heart disease can include lifestyle changes, medication, and sometimes surgery, but this conditionor conditions, ratheris never one size fits all. Your individual plan will be based on numerous factors, such as your age, overall health, and other chronic conditions (such as diabetes or kidney disease) you might have.
You know the drill: Eat better, exercise, lose weight, and quit smoking. We knoweasier said than done, but so worth it. Thats because the everyday choices you make today can halt the progression of heart disease tomorrowleading to a healthier and likely longer life.
Lets walk through the basic lifestyle choices you can implement to help make happen:
Lower your cholesterol. Cut back and avoid plaque buildup by swapping red meats for lean poultry and fish, consuming fibrous veggies and whole grains, and limiting (or even avoiding altogether) the saturated and trans fats found in fried and processed foods. Additional ways to get your cholesterol in check? Lose a few pounds, exercise more, and if that still isnt enough, talk to your doctor about medication.
Lower your blood pressure. The same lifestyle changes that help bring down unhealthy cholesterol levels can also help manage your blood pressure, often in tandem with one of the various blood-pressure lowering medications available.
Do everything you can do to quit smoking. We knowits really hard. But we also know that smoking causes lung cancer and seriously hurts your heart. Plus, a nicotine or vaping habit damages your arteries, ups your risk of dangerous blood clots, raises your heart rate, and contributes to HBP and high cholesterol. So make quitting smoking your top priority. Going cold turkey works for some, while others have to slowly wean themselves from lighting up with the help of nicotine patches and other aids, including medications and support groups. Your doctor can walk you through your options, so have that conversation as soon as possible. Visit the American Heart Association to learn more about how to quit.
Get moving. Physical activity of just about any kind beats the couch potato life. Thats because exercise strengthens your heart muscle so that it can do its job more efficiently. It helps lower your cholesterol, blood pressure, and, if you have diabetes, blood sugar levels, too. An added benefit? Breaking a sweat leads to a slimmer, fitter you. Exactly how much exercise you can do depends on your current state of health. Talk to your doctor, who might advise you to start slow and gradually build up endurance. If a walk around the block is your limit, thats OKlace up your shoes and get going. Tomorrow, youll likely go even further. If youre recovering from a serious heart issue, cardiac rehabilitation programs can get you started safely.
Eat less, and eat better. Changing how you stock your fridge and pantry is often connected to lowering your cholesterol levelsso follow the same advice: Try lean proteins, vegetables, and whole grains, and skip overly processed junk food and fried fare. If you need guidance, consider enlisting a registered dietitian/nutritionist to outline a healthy eating plan for youand provide strategies to stick with your plan to reach your goals.
Lose weight. It cant be overstated: Being overweight or obese is hard on your heart. Your body mass index (BMI) measures body fat based on your weight in relation to your height. A BMI of 25 to 29 is considered overweight. You are considered obese if your BMI is 30 or higher. While use of BMI has been questioned by researchers as of late, partly because even the super-fit and muscle-bound may technically have unhealthy BMI numbers, some doctors still use it as a guide. More and more, however, physicians are concerned when excess body fat is concentrated around your waist, likely because a lot of belly fat can cause chronic inflammation, a risk factor for heart disease. The result? Your blood pressure and cholesterol go up and stay upand you want neither to happen.
If your heart health is at risk, and you find losing weight slowly and safely to be an impossible task, consider securing the services of a registered dietician, or ask your doctor if gastric bypass surgery is right for you.
Manage your diabetes. Diabetes and heart disease are a deadly combination. People with diabetes have as much as four times the risk of dying from heart disease than someone without this condition. This is in part due to the effect diabetes has on your blood vessels, and also because many other health conditions often accompany diabetes, including HBP, high cholesterol levels, and obesity. Controlling your diabetes through medication and lifestyle changes benefits your heart.
Consider medications for heart disease, if you need them. Many drugs treat coronary artery disease, or CAD. (Remember, CAD occurs when your arteries become clogged with plaque, restricting the flow of blood.) Here are the more commonly prescribed types of medication for CAD and other heart ailments:
Heart failure as well as heart valve disease are both treated with some of the same medications, such as diuretics, which help rid your body of excess fluids. In heart failure, for example, fluid can build up in your lungs and make it difficult to breathe. You may also be prescribed digitalis, a type of drug that strengthens the contractions of your heart and lowers your heart rate. Beta blockers and anti-clotting medications are also among the drugs that may be used to treat both conditions.
A wide range of surgical options also exists when heart disease requires more aggressive treatment, including:
Youve received your diagnosis of heart disease, and your doctor has presented you with a treatment plan. Whats next? How much of your old life will you be able to get back? Living with heart disease has challengessome physical, some emotional, some big, some small. Your goal: to take care of all of you and live your best life.
If youre not doing well emotionally, you might struggle with all of the other aspects of your treatment, from eating right and exercising to taking your medications. Often, depression is to blame. In fact, about one in five heart disease patients develops serious depression, while many others have milder cases. Research is mixed on why this is, although some scientists believe inflammation is involved. Fortunately, counseling and medication can help. Talk to your doctor if you feel down, unmotivated, or discouraged for more than a week.
Heart disease can feel scary. But those worries can overwhelm you and interfere with enjoying your life. If you struggle with anxiety, try to shift your focus to whats happening today rather than looking with worry at the future. Talk about your concerns with friends and family and ask them for support. And consider joining a support group to connect with others who face the same struggles that you do. Join the American Heart Association's Support Network.
Regular exercise and other physical activity help your heart. A minimum of 150 minutes of exercise will not only improve your heart function. It also may enable you stop taking some of your heart medications. But first, ask your doctor what exercises are right for you.
If youre recovering from a heart attack or surgery, it may be a few weeks before you can return to your job, but youll likely be able to pick up right where you left off. Of course, it depends on the jobif your current one puts too much strain on your heartphysical and, perhaps mental, in the form of stress--you may have to dial back your workload. The Americans with Disabilities Act, a federal law, offers workplace protections for people with heart disease.
You may have to wait up to six weeks before you resume your sex lifeand only your doctor can tell you when you can safely return to romance. How long abstinence lasts will depend on your symptoms, like lingering chest pain or other complications. To get the all-clear, you may have to undergo an exercise stress test to measure your hearts capacity to handle any under-the-sheets action.
Before you climb behind the steering wheel, check your states regulations for driving after a serious illness. Also, if you have symptoms like chest pain, dont drive until they clear up.
You can kickstart your new life with cardiac rehabilitation. This is a medically supervised program that typically lasts for three months. Working with doctors, nurses, exercise specialists, dietitians and mental health counselors, you will receive exercise training, lessons in healthy eating, methods to reduce stress, and other education designed to help you reduce your risk of worsening heart health.
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