Heart Disease

The human heart beats about 2.5 billion times over an average lifetime, pushing millions of gallons of blood throughout the body. This steady blood flow carries oxygen, hormones, and other compounds. It also whisks away the waste products of metabolism. 

Given the heart's never-ending workload, it's a wonder it performs so well for so long. But it can also fail, brought down by poor diet, lack of exercise, smoking, infection, unfavorable  genes, and more. 

Heart disease and cardiovascular disease are two of the most significant heart health issues. They are often used interchangeably, but they are not the same. 

Heart disease refers to diseases of the heart, such as coronary artery disease, heart failure, heart valve abnormalities, and abnormal heart rhythms.

Cardiovascular disease is a catch-all term for all heart and blood vessel diseases. It includes heart disease, but also stroke.


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What are the different types of heart disease?

Heart disease refers to diseases that affect the function and condition of the heart. There are several kinds of heart disease, including: 

  • cardiomyopathy: a heart muscle disease that causes the heart to become abnormally enlarged, thickened, and/or stiffened.
  • congenital heart disease: heart disease or abnormalities in the heart's structure that are present at birth.
  • coronary artery disease: accumulation of cholesterol-filled plaques, which clog the arteries that supply blood and oxygen to the heart. 
  • endocarditis: infection and inflammation of the heart valves and the inner lining of the heart chambers, called the endocardium.
  • heart attack (myocardial infarction): the sudden stopping of blood flow to part of the heart muscle
  • heart failure: the inability of the heart to pump as forcefully or efficiently as needed to supply the body with oxygenated blood.
  • heart rhythm disorders (arrhythmias): heartbeats that are too fast, too slow, or irregular.
  • heart valve disorders: problems with the valves that control blood flow from one part of the heart to another part of the heart or to the body.
  • myocarditis: inflammation of the myocardium, the middle layer of the heart wall, that decreases the ability of the heart to pump blood normally.
  • pericarditis: inflammation of the pericardium, a thin sac surrounding the heart. 
  • sudden cardiac arrest: the sudden cessation of the heartbeat.

What causes heart disease?

The most common type of heart disease is coronary artery disease (CAD), and the leading cause of CAD is atherosclerosis, the buildup of cholesterol plaque inside the coronary arteries. Too much plaque limits blood flow through the arteries that supply blood to the heart. Restricted blood flow can cause chest pain or pressure (known as angina) and requires immediate medical attention. When plaque ruptures, it can form a blood clot that stops blood flow and triggers a heart attack. The risk factors for atherosclerosis (and thus CAD) include:

  • High total blood cholesterol level
  • High level of LDL (bad) cholesterol
  • High levels of triglycerides
  • High levels of lipoprotein(a)
  • High blood pressure (hypertension)
  • Diabetes
  • Family history of heart disease
  • Smoking
  • Obesity
  • Physical inactivity
  • Inflammation

Heart disease symptoms

A variety of symptoms and signs may indicate heart disease. If you experience any of the following for no apparent reason, immediately report them to your doctor.

Fatigue. Fatigue can be caused by many illnesses and medicines. But constant, new fatigue can sometimes signal two kinds of heart disease: heart failure and coronary artery disease. 

Unexplained aches or pains. Blockage of blood to the heart muscle can cause pain or pressure in the chest, shoulders, arms, back, jaw, or abdomen, primarily when pain in these locations occurs with exercise and disappears with rest.

Shortness of breath. Unexplained shortness of breath that occurs with small amounts of activity. 

Swollen legs, feet, or ankles. The kind of swelling that leaves an indentation if you press your finger into it could be a sign of heart failure. 

Heart palpitations. Palpitations refers to a heartbeat that feels irregular or rapid. Most palpitations may be caused by anxiety, caffeine intake, or dehydration. But sometimes they indicate a heart problem.

How can you prevent heart disease?

The best way to prevent heart disease is to adopt heart-healthy habits. These include managing blood pressure and cholesterol levels, eating a plant-based diet, adopting regular exercise, maintaining a proper weight, getting enough sleep, and not smoking.

Blood pressure. High blood pressure makes the heart work harder, which can weaken the heart muscle over time. Blood pressure is measured in millimeters of mercury (mm Hg) and is categorized as follows: 

  • Normal: Less than 120/80 mm Hg
  • Elevated: 120/less than 80 to 129/less than 80 mm Hg
  • Stage 1 hypertension: 130/80 to 139/89 mm Hg
  • Stage 2 hypertension: 140/90 mm Hg and above

Cholesterol. There are two main types: “bad” low-density lipoprotein (LDL) and “good” high-density lipoprotein (HDL). Ideally, most adults should keep their LDL below 100 milligrams per deciliter (mg/dL) and their HDL above 40 mg/dL. However, your ideal numbers may differ based on your health, risk factors for heart disease, and individual goals, as determined in consultation with your doctor.

Diet. Following a plant-based diet is known to protect against heart disease. The plant diets that have been most studied for heart health are the Mediterranean diet and the DASH (Dietary Approaches to Stop Hypertension) diet. Each emphasizes eating foods associated with heart-healthy benefits, such as whole grains, fruits, vegetables, legumes, nuts and seeds, fatty fish, and healthy oils like olive oil, and reducing the intake of red meat and processed foods.

Exercise. Guidelines recommend that adults engage in at least 150 minutes of moderate-intensity aerobic activity per week, which breaks down to 30 minutes daily, five days a week. But this is the minimum. Evidence suggests that doing more is better.

Weight. About 30% of American adults are classified as overweight. While it’s natural for people’s weight to increase somewhat with age, even five to 10 pounds over your ideal number is associated with an increased risk of heart disease. Check with your doctor to determine your weight range for your gender, age, and body type. 

Sleep. Experts recommend that adults get at least seven hours of sleep per night. Studies have found that less than this amount is associated with heart disease risk factors like higher stress levels, increased inflammation, high blood pressure, and weight gain. 

Smoking. Smokers have a much higher heart disease risk than never-smokers and two to three times the risk of early death. Certain medications and nicotine replacement therapies can help people quit. Speak with your doctor about these or other options.

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