Introduction
Heart disease remains the leading cause of death globally, claiming millions of lives each year. Despite advancements in medical science, a plethora of myths, misconceptions, and deceitful products continue to cloud public understanding of heart health. These inaccuracies can mislead individual patients to make unhealthy choices. This article aims to debunk common heart health scams and misconceptions by contrasting prevalent myths with evidence-based facts, highlighting scam devices to avoid, and exposing fake cures proliferating online. By shedding light on these issues, we hope to empower readers to make informed decisions rooted in scientific evidence.
Heart Health Myths vs. Facts
Misconceptions about heart health are widespread and can hinder effective prevention and treatment strategies. Addressing these myths with factual information is crucial for promoting cardiovascular well-being.
Myth 1: Heart Disease is a “Man’s Disease”
Fact: Women face unique challenges in the diagnosis, recognition, and treatment of cardiac conditions. According to the British Heart Foundation, in the United Kingdom approximately 100 female patients are admitted to hospitals with a heart attack every day and they have 50% higher chance than men of being initially misdiagnosed. There are several gender-specific issues that contribute to this. In the past, the majority of cardiovascular trials have predominantly included male individuals. This led to a limited understanding of how heart conditions and symptoms are perceived by women. The well known symptoms of chest pain, burning or tightness may not be as prominent in Women as in men. Female patients often present with more subtle symptoms such as breathlessness, fatigue, nausea or even widespread ache. There is a historical stereotype, that heart disease is predominantly a “man’s disease”. This misconception can lead healthcare providers to downplay or even to
overlook certain symptoms in female patients. The classical symptoms of heart problems include: chest pains, lack of breath, palpitations, blackouts, dizzy spells and legs swelling. Women, however in addition to the above, may experience more subtle signs, such as unexplained fatigue, sweating, nausea and non specific aches in jaw, neck, back or even upper abdomen. In particular, women with certain risk factors, such as diabetes, hypertension, or a family history of heart disease, should be aware of any unusual, often new to them, physical sensations. Seeking medical advice is always the best option if patients are worried or unsure.
Link to a press release by Dr Bart below:
Link to ‘Chest Pain in Women’ guideline: https://pubmed.ncbi.nlm.nih.gov/36921653/
Myth 2: Heart Disease Only Affects the Elderly
Fact: While the risk of heart disease increases with age, it can affect individuals of all ages. Factors such as obesity, hypertension, and diabetes contribute to the rise of heart disease among younger populations. Early lifestyle interventions, including a balanced diet and regular physical activity, are essential to mitigate this risk. Over 7 million people live with CardioVascular Disease in the UK. Every day 480 people will die from a heart or circulatory problem and approximately 130 of them will be younger than 75.
https://www.bhf.org.uk/what-we-do/our-research/heart-statistics
Myth 3: Exercising more than recommended can shorten your life?
Fact: According to a study published in a journal called Circulation in July 2022, the answer is the opposite. Exercising more than recommended makes you live longer.
Lower risk of dying was shown to be associated with:
– 150-299 mins per week of Moderate Physical Activity or
– 300-599 mins per week of Vigorous Physical Acitviry or
– A time combination of the above.
Moderate Physical Activity (3-6 METs) includes: walking very briskly, cycling, cleaning such as mopping or washing windows and badminton or tennis doubles. Vigorous Physical Acitivith (>6 METs) includes: Basketball, Football , Hiking, Jogging, cycling fast or even shovelling.
It was a large study, which included 116 221 adult participants and follow up lasted 30 years.
Participants, who performed VPA (75-149 min per week) versus no VPA had lower overall mortality (HR 0.81), lower non-cardiovascular mortality (HR 0.85) and lower cardiovascular mortality (HR 0.68). Individuals with weekly MPA of 150-299 mins per week showed reduction of overall, cardiovascular and non-cardiovascular risk of dying by 19-25%. However, people who exercised more than that, as mentioned at the beginning, VPA of 150-299 mins a week and MPA of 300-599 minutes a week, had lower mortality risk of 2%-4% and 3%-13%, respectively.
Exercising beyond that showed no further benefit or harm.
(https://www.ahajournals.org/doi/full/10.1161/CIRCULATIONAHA.121.058162)
Myth 4: Cold weather has no impact on the risk of a heart attack.
Fact: A historical publicationfrom 1992 (International Journal of Sports Medicine) describes, what happens to our hearts in cold weather. Some of their conclusions below :
– ‘Exposure to cold causes a vasoconstriction and a tachycardia, both resulting in a rise of blood pressure and cardiac work’.
– ‘Epidemiological studies have shown that mortality from Ischaemic Heart Disease was correlated to the ambient temperature. There will be more deaths per day in the winter, and a fewer in the summer. However, the daily number of deaths also increases during heat waves ‘.
– ‘It is concluded that people with normal cardiovascular function are unaffected by cold stress whereas those with Ischaemic Heart Disease may be crippled, although rarely, by exposure to cold, especially if the perform a physical work.’
(https://www.thieme-connect.com/products/ejournals/journals?query=*&sort=TITLE_ALPHA_ASC)
Myth 5: Skipping meals has no impact on my heart health.
Fact: Eating your first meal later than 9am and last meal later than 9pm was linked to higher risk of cardiovascular disease, according to a study published in December 2023 in Nature communications journal. The above timings were compared to having the first Meal earlier than 8am and the least earlier than 8pm. This French study included 103,389 individuals, with mean age of 42.6 years, out if which 79% were females. The participants were followed up for a median of 7.2 years and 2036 incidents of CardioVascular disease were observed. Delaying FIRST Meal of the day was linked to higher risk for overall CardioVascular disease, especially in female participants. (HR, 1.06; 95% CI, 1.01-1.12; p=0.02) Interestingly, delaying the LAST meal by each additional hour was associated with an 8% increased risk of CerebroVascular disease (HR=1.08, p=0.02). The Authors concluded: ‘Our results suggest potential benefit of adopting earlier eating timing patterns, and coupling a longer nighttime fasting period with an early last meal, rather than breakfast skipping, in CVD prevention’.
(https://www.nature.com/articles/s41467-023-43444-3.pdf)
Myth 6: Jogging has no impact on my cholesterol levels.
Fact: There are several ways to reduce Your blood Cholesterol and one of them is JOGGING, according a study published in the Journal of the International Society of Sports Nutrition in 2021. Jogging 🏃🏻♂️ is associated with a reduction of: Tryglicerides (95% CI = 5.9-14.5 mg/dL), Tryglicerides/High-density lipoprotein cholesterol ratio (95% CI = 0.22-0.49) and Increased level of High-density lipoprotein cholesterol (95% CI = 2.1-3.3 mg/dL) It was an observational study, which enrolled 27735 participants and was published in the Journal of the International Society of Sports Nutrition in May 2021. Regular jogging was defined as 30 mins of ‘exercise’ three times a week. The author concluded: ‘Regular jogging was not only associated with an increased level of HDL-C, but also the only one exercise associated with decreased level of TG and TG/HDL-C ratio. Nonetheless, jogging may be difficult to engage in for subjects with limited exercise capacity. We here found that swimming, dancing, and cycling are also significantly associated with an increased level of HDL-C. People who are seeking exercise to improve their lipoprotein-lipid profiles can have other choices now’.
(https://jissn.biomedcentral.com/articles/10.1186/s12970-021-00436-2)
Myth 7: Sleep hygiene does not influence my risk of a heart attack.
Fact: Irregular sleep patterns may increase risk of Atherosclerosis (associated with Coronary Artery Disease), claims a study published in February 2023 in the Journal of the American Heart Association. Sleep hygiene may be a modifiable goal for reducing the risk of developing atherosclerotic coronary plaques. Variation in sleep duration of more than 2 hours was associated with high coronary artery calcium burden. In addition to this sleep TIMING also mattered, with participants with irregular sleep timing (>90 mins) also had higher coronary artery calcium burden. This study included 2032 individuals with mean age of 68.6 +/- 9.2 years). The authors concluded: ‘Sleep irregularity, particularly sleep duration irregularity, was associated with several measures of subclinical atherosclerosis. Sleep regularity may be a modifiable target for reducing atherosclerosis risk. Future investigation jnto cardiovascular risk reduction interventions targeting sleep irregularity may be warranted.’
(https://www.ahajournals.org/doi/pdf/10.1161/JAHA.122.027361?download=true)
Scam Heart Health Devices to Avoid, evidence based cardiology
The market is flooded with devices claiming to improve heart health or monitor cardiovascular conditions. While some are legitimate, others are scams designed to exploit consumers. Evidence-Based Cardiology applies the principles of evidence-base medicine to the prevention, diagnosis, and treatment of cardiovascular diseases. It involves integrating the best available scientific research, clinical expertise, and patient preferences to optimize heart health outcomes. This approach relies on high-quality studies, such as randomized controlled trials, systematic reviews, and meta-analyses, to guide clinical decisions in cardiology. Examples include using statins for cholesterol management, beta-blockers for heart failure, and antiplatelet therapy for coronary artery disease, all supported by robust clinical trials.
The hierarchy of evidence in cardiology prioritizes large-scale randomised controlled tirals and well-designed observational studies over expert opinions or anecdotal experiences. Organizations like the American Heart Association (AHA) and the European Society of Cardiology (ESC) develop clinical guidelines based on this evidence to standardize care.
Evidence-Based Cardiology helps reduce variability in practice, ensuring patients receive proven, effective treatments rather than outdated or unverified interventions. However, challenges exist, such as applying broad study results to individual patients with unique risk factors and conditions. Ultimately, this approach enhances patient outcomes, reduces cardiovascular morbidity and mortality, and promotes cost-effective care, making it a cornerstone of modern cardiology practice.
Smartwatches have evolved beyond basic fitness tracking to include advanced health monitoring features, particularly ECG recording capabilities. These devices allow users to perform on-the-spot ECGs, aiding in the early detection of conditions such as atrial fibrillation (AF) and atrial flutter—both forms of atrial tachyarrhythmias. AF, commonly known as an irregular heartbeat, significantly increases the risk of stroke. In the UK, over 1 million people are affected by AF. Individuals with AF have a fivefold increased risk of stroke, contributing to 1 in 5 strokes nationwide. AF prevalence increases with age, and AF-related strokes tend to be more severe, leading to higher mortality rates and greater disability. Despite its serious consequences, AF often goes undiagnosed.
(https://www.stroke.org.uk/professionals/atrial-fibrillation-information-and-resources)
Studies on Smartwatches for AF Detection
A 2020 study by Seshadri et al. evaluated the accuracy of the Apple Watch Series 4 in detecting AF among 50 post-cardiac surgery patients on telemetry. The study excluded individuals with cardiac pacemakers, prior radial artery surgical use, chronic heart rhythm abnormalities, and wrist tattoos. The Apple Watch used two detection methods: on-screen notifications and a downloadable PDF waveform. While the watch display often failed to notify AF cases, it did not produce any false-positive results. The saved PDF waveform proved to be a more reliable tool for distinguishing AF from sinus rhythm (SR).
A larger 2019 study published in the New England Journal of Medicine by Perez et al. involved over 400,000 participants who owned both an Apple Watch and an iPhone and had no prior history of AF. Over a median monitoring period of 117 days, only 0.52% (2,161 participants) received irregular pulse notifications. Among those notified, 34% were later confirmed to have AF via ECG patch monitoring, with 84% of notifications aligning with AF detection.
(https://pubmed.ncbi.nlm.nih.gov/31722151/)
A 2022 study by Lubitz et al., published in Circulation, assessed a novel PPG-based algorithm for detecting AF in Fitbit wearable devices. The study enrolled 455,699 participants (median age 47, 71% female) and demonstrated a high positive predictive value for AF detection, suggesting that such wearables could aid in identifying undiagnosed AF.
(https://pmc.ncbi.nlm.nih.gov/articles/PMC9640290/)
In conclusion, wearable technology continues to advance in the field of health monitoring. While smartwatches may not yet replace traditional medical-grade ECGs, studies suggest they can play a valuable role in the early detection of AF, potentially helping reduce the risk of stroke in affected individuals.
Fake Heart Health Cures Online
The internet is rife with products claiming to cure or prevent heart disease. Many of these lack scientific validation and can be harmful, therefore should not be taken without prior consultation with your doctor. Three common questions answered below:
1.Does adding salt to your meals increase your risk of heart attack and heart failure?
A study published in December 2022 in the Journal of the American College of Cardiology showed that the answer is `Yes`. The researchers included 175670 participants who did not have any prior cardiovascular disease diagnosed and followed them up for a median of 11.8 years. They recorded 9963 cardiovascular events including: – 6993 cases of ischaemic heart disease (angina and heart attacks) – 2269 of the study participants suffered with heart failure
– 2007 had a stroke. Lower frequency of additional salt was linked to lower incidence of cardiovascular events. The recruited individuals were divided into three groups depending on adding salt frequency – usually, sometimes and never/rarely with Hazard Ratio of 0.81, 0.79 and 0.77 respectively (p<0.001). Interestingly, additional salt intake had the strongest link to heart failure, followed by coronary heart disease but was not associated with stroke.
(https://www.jacc.org/doi/epdf/10.1016/j.jacc.2022.09.039)
2. Does Niacin (Vitamin B3) increase your risk of heart disease?
According to a study published in February 2024 in Nature Medicine journal, terminal metabolites of excess niacin were linked to higher 3 year risk of heart attack, stroke and other adverse cardiac events. This trial studied two NIACIN metabolites, 2PY and 4PY.
The authors concluded: ‘Collectively, these results indicate that the terminal breakdown products of excess niacin, 2PY and 4PY, are both associated with residual CVD risk. They also suggest an inflammation-dependent mechanism underlying the clinical association between 4PY and Major Adverse Cardiovascular Events’.
Niacin deficiency causes a serious disease called pellagra, which was common at the beginning of the 20th century. Currently Niacin is included in flours and cereals.
(https://www.nature.com/articles/s41591-023-02793-8)
3. Can liquorice increase your blood pressure?
According to a study published in January 2024 in the American Journal of Clinical Nutrition, licorice intake, containing 100mg of glycyrrhizic acid (GA) significantly raised blood pressure. Liquorice (or licorice) is derived from a plant glycyrrhiza glabra and is used as a sweetener and flavouring agent. WHO recommended upper limit of GA is 100 mg per day, which is equivalent to 60-70 g of liquorice sweets. This study included 28 young (median age of 24 years) individuals and randomly assigned them to consume 100 mg of GA in a form of lozenges or a control product. During the study period the participants Blood Pressure who were assigned licorice increased by 3.1 mmHg compared with -0.3 mmHg in individuals consuming control products (p=0.018). Researchers also noted suppression renin and aldosterone and in the most affected individuals even raised NT-ProBNP levels. The Authors concluded: ‘We found licorice to be more potent than previously known, with significant increases in BP, after a daily intake of only 100mg GA. Thus, the safe limit of intake of this substance might need to be reconsidered.’
(https://ajcn.nutrition.org/action/showPdf?pii=S0002-9165%2824%2900019-4)
Conclusion
Misinformation about heart health can have severe consequences, leading individuals to make poor lifestyle choices or fall victim to scams. By understanding the facts behind common myths, recognizing fraudulent products, and embracing evidence-based cardiology, individuals can take proactive steps to protect their heart health. Always consult reputable medical sources, such as BHF, NICE, ESC or American Heart Association, and seek guidance from healthcare professionals before making health-related decisions. Awareness and education are key to combating misinformation and ensuring long-term cardiovascular well-being.
