What We Think We Know About the Heart

For years, heart disease has existed alongside a dangerous paradox: while it remains the leading cause of death worldwide, much of the public still interprets cardiovascular risk through inherited beliefs, family assumptions, and false certainties. 'It only happens to men.' 'I'm too young.' 'It runs in my family, so there's nothing I can do.' Or perhaps the most dangerous assumption of all: 'If something were wrong with my heart, I would feel it.' These are common beliefs. But in medicine, a misconception can delay a doctor's visit, a diagnosis, or a decision capable of changing the course of a disease. The scale of the challenge is significant. The World Health Organization estimates that cardiovascular diseases caused approximately 19.8 million deaths in 2022, making them the leading cause of death worldwide. Yet a substantial portion of cardiovascular risk can be prevented or managed through early detection and changes to known risk factors. The Heart Does Not Distinguish Between Men and Women One of the most persistent myths is that heart disease is essentially a men's problem. Luke Laffin, a cardiologist at Cleveland Clinic, warns that this perception is incorrect. Heart disease affects both men and women, although women may face particular risk factors related to menopause, certain hormonal treatments, and some pregnancy-related complications. The myth can also have practical consequences. Many women spend years prioritizing the health of children, family members, and professional responsibilities while postponing their own medical care. The result is a contradiction well known to specialists: a perception of low risk does not always match the actual risk. Being Young Does Not Mean Being Protected Age matters, but it is not an insurance policy. Cardiovascular risk increases over time, but that does not mean heart problems begin exclusively after the age of 60. High blood pressure, elevated cholesterol, and other risk factors can develop much earlier. Some people inherit a genetic predisposition to these conditions, while physical inactivity, smoking, and poor nutrition can accelerate cardiovascular damage. The Centers for Disease Control and Prevention recognizes that age and family history are important factors, but also emphasizes that many of the leading cardiovascular risks can be modified. For Laffin, the mistake is waiting until a person feels vulnerable. Preventive screenings particularly blood pressure measurements and cholesterol testing—can identify problems before they produce serious consequences. Genetics Matter, but They Do Not Write the Ending Having a parent or sibling with heart disease can increase risk, but it does not make a diagnosis inevitable. 'Genes are not destiny' is, essentially, the specialist's message. Genetics may predispose someone to high blood pressure or elevated cholesterol, but cardiovascular risk also reflects decisions accumulated over years. Regular physical activity, a healthy diet, avoiding tobacco, and managing metabolic conditions are all part of a preventive strategy supported by decades of research. When risk is higher, lifestyle changes can also be combined with medication. Prevention, therefore, does not erase genetics but it can change their impact. Silence Does Not Mean the Heart Is Healthy Perhaps the most dangerous myth is believing that the absence of symptoms means the absence of disease. Coronary artery disease often develops gradually as plaque accumulates inside the arteries. During that process, a person may feel completely healthy. High blood pressure is known precisely for its ability to progress without obvious symptoms. The same can be true of high cholesterol. In some cases, the first warning may be a serious event. The CDC recognizes that certain forms of heart disease can remain 'silent' until a heart attack, heart failure, or another major complication occurs. Aging Raises the Risk, but Disease Is Not Inevitable Finally, there is a cultural tendency to confuse aging with illness. It is true that cardiovascular risk increases with every decade. But reaching an older age does not mean that heart disease is inevitable. The distinction is crucial: age cannot be changed, but many of the factors associated with cardiovascular aging can. Managing blood pressure and cholesterol, staying physically active, avoiding smoking, and following prescribed treatments can significantly reduce risk. The underlying message is less dramatic than a miracle cure, but far more important: heart disease does not always give a warning, and it cannot always be prevented. But neither is it simply a matter of luck, sex, age, or genetics.