There are a lot of assumptions we make about our hearts. And for each myth, there is often some truth upon which it is founded.
Take heart attacks, for instance.
Most people imagine they would know when they are having a heart attack. It would be difficult not to recognize symptoms of "the big one" – sweating, soreness in the left arm, and sudden, disabling chest pain.
But that’s not always the case. Sometimes the signs are much more subtle or mimic other conditions.
"I have heard of instances when a cardiologist was having a heart attack and thought they were having indigestion," says Elizabeth Jackson, MD, assistant professor of cardiovascular medicine at the University of Michigan Health Systems.
As with any health issue, knowledge is power. And when your heart is on the line, you need all the power you can get.
So here are six major heart health myths and the reality behind them.
Heart Myth #1: I would know if I had high blood pressure or high cholesterol.
Risk factors are usually silent, meaning they have no obvious associated symptoms.
"Hypertension is the silent killer, you are not going to know you have it," says Jennifer Mieres, MD, a cardiologist at North Shore-Long Island Jewish Health System. "When high blood pressure presents as a symptom like headaches or renal failure, it is more difficult to control at that stage. Early treatment is essential to preventing end organ damage, which is often irreversible."
The same goes for high cholesterol. A person can be thin and in good shape and still have high cholesterol.
"These can all silently be doing damage even though we may think we are in the best of health," Mieres says.
Heart Myth #2: Heart disease treats men and women the same.
Heart disease can affect the sexes very differently.
This begins with symptoms. Although many people experience the classic "elephant sitting on the chest" sensation when they have a heart attack, there are also less traditional symptoms, and they are more common among women.
In 2003, a study published in Circulation examined the symptoms that 515 women, (average age 66), had experienced before having a heart attack. The researchers found that for at least one month prior to the acute event 70% of the women experienced unusual fatigue, and nearly 50% had weakness, sleep disturbance, or shortness of breath. What's more, 43% of the women felt no chest pain at the time of their heart attack presentation.
"Men can have less classic symptoms, but there is a higher prevalence with these in women," Mieres says. "Older women tend to present more like men, with the classic chest pain, which is still the overwhelming symptom of a heart attack."
Putting all of this in context is important. Not all unusual symptoms mean you have heart disease. But if you have risk factors, pay attention to how you feel. New or changing symptoms, even if not typical, could be a sign of problems with the ticker.
Heart Myth #3: Younger Women Aren't at Risk
"I think one of the most common myths is that women still tend to think they are not vulnerable" to heart disease, Mieres says. "They think it is a disease of older women and men. So women in their 40s and 50s still believe they are safe."
But heart disease is the No. 1 killer of U.S. women, causing more than 460,000 deaths annually, not all of which are among the elderly.
Risk factors that contribute to heart disease -- including obesity, Type II diabetes, and hypertension -- are showing up earlier now in women, Mieres says. As these factors become more common at a younger age, heart disease may follow.
On average, there tends to be a 10-year gap in the age at which heart attacks occur in men and women, says Rita Redberg, MD, professor of medicine at the University of California San Francisco and director of women’s cardiovascular services. Men are more likely to get them in their mid-50s and women in their mid-60s.
Heart Myth #4: Exercise is too risky if you have heart disease.
This is almost always false.
After a coronary event, such as a heart attack, people are typically encouraged to get right into rehabilitation and start working out within a two-week period.
"There are really very few people who have significant long-term restrictions in terms of never doing exercise," Jackson says.
Redberg says exercise reduces the progression of heart disease, and makes people with heart disease less likely to have a first or recurrent heart attack.
She recommends starting with 10 minutes of exercise daily and increasing it weekly by 10 minutes until they are getting at least 30 minutes of moderate activity most days. But your doctor should give you guidelines tailored to your particular case.
Heart Myth #5: Aspirin and Omega-3 fatty Acids Are All Good
Most people have heard that aspirin and omega-3 fatty acids are good deterrents to heart disease. For the most part, this is true, but there are some caveats to their protective benefits.
Redberg recommends taking aspirin for prevention at age 50 for men and 65 for women if there are no contraindications.
Aspirin can exacerbate stomach problems and some people can have aspirin allergies. Every supplement and medication has pros and cons, Jackson says. A young woman’s risk of excessive bleeding from taking aspirin may be greater than its potential heart benefits, Jackson says.
Omega-3 fatty acids are particularly beneficial for people who have already had a heart issue and are trying to prevent another, Jackson says. The American Heart Association (AHA) recommends eating fatty fish at least twice a week or taking up to three grams of omega-3 fatty acids in the form of a daily supplement. The AHA cautions that higher doses can cause excessive bleeding in some people.
Aspirin and omega-3 fatty acids both can cut the risk of blood clots, such as those that lead to heart attacks. But you don't want to curb your clotting ability too much, or you could be at risk of excessive bleeding.
Talk with your doctor before taking any kind of medication or supplement. And if you're already taking something, tell your doctor. Your doctor needs to note it in your medical records and may advise you to stop if you have surgery scheduled.
Heart Health Myth #6: Once I Have Heart Disease, That's It
Absolutely not. There has been research showing that in some cases you may be able to undo the damage -- and that your lifestyle is a crucial part of turning the tide.
"It is never too late" to treat heart disease, Mieres says. "Small lifestyle changes are key factors in preventing heart disease and controlling risk factors."