Symptoms of heart disease and how to prevent the “American curse”

More than half of adults in the United States don’t know that heart disease is the leading cause of death, according to the American Heart Association. This is concerning because many of these deaths are preventable.

Heart disease, or cardiovascular disease, is a broad term for a series of health problems that interfere with the way the heart works. Some causes of heart disease are hereditary, but most develop over time. The most common type of heart disease in the United States is coronary artery disease, in which plaque builds up in the arteries and blocks blood flow.

People can prevent or reduce their risk of this type of heart disease even if they have a genetic predisposition, such as high cholesterol that runs in the family. But many of our daily habits — not eating enough healthy foods, sitting too much and not sleeping enough — all constitute what Dr. Andrew Freeman, a cardiologist at the National Jewish Health Center in Denver, calls “the American curse.”

“These are exact prescriptions for premature death and disability,” Freeman said, adding that much of the Western world suffers from the same “curse.”

Here’s what to know about the symptoms of heart disease and the common health concerns that can accompany it, plus cardiologist-endorsed tips for improving your heart health in ways you’ll actually enjoy.

What are the symptoms of heart disease?

Your symptoms will depend on what’s happening with your heart (if you have any symptoms at all). According to the Cleveland Clinic, some early signs of heart disease include chest pain, shortness of breath, leg swelling, fatigue and dizziness.

Most people with heart disease have coronary artery disease, which often causes chest pain (angina). If your chest pain has not already been diagnosed, and the pain does not stop when you stop moving, you may be having a heart attack and should call 911. Acting quickly greatly improves your chances of surviving a heart attack.

In some cases, the first clue that someone has heart disease is having a heart attack. Symptoms of a heart attack, according to the US Centers for Disease Control and Prevention, include chest pain or discomfort, weakness or dizziness, nausea, cold sweats, shoulder pain and shortness of breath. Women may be more likely to have less obvious symptoms during a heart attack, such as jaw or back pain, so don’t ignore symptoms if you think there’s a possibility of a heart attack.

Since the symptoms of heart disease vary greatly and may not be present at all, the best course of action is to focus on prevention, get regular checkups, and speak with a doctor immediately about any concerns.

What to know if you have high blood pressure

About half of adults in the United States have high blood pressure (hypertension). This is important in a conversation about heart disease because high blood pressure is a risk factor, as it can lead to damage to blood vessels.

The good news, according to Dr. Jonathan Favai, a cardiologist at Delray Medical Center, is that high blood pressure can be managed or reversed. Many of the things that make your heart healthier can also help control blood pressure. In some cases (and with the express permission of the doctor who checked your heart health), your need for medication may be eliminated.

“My favorite thing to do is stop blood pressure medications when appropriate,” Favai said.

What about high cholesterol?

The plaque that builds up in your arteries is made up of cholesterol (and other substances), which is why doctors recommend monitoring your cholesterol to keep it in a healthy range. Although the general understanding of cholesterol is complex, doctors know that too much “bad” cholesterol can cause coronary artery disease and blood vessel and heart problems.

For some middle-aged patients who have a risk factor for heart disease (high cholesterol or diabetes, for example, or a family history of heart disease), Favai said he recommends a calcium score or other screening.

This is a series of X-rays that look for calcium-containing plaque, so it’s a non-invasive way to check for risks before symptoms of the disease appear.

High cholesterol is similar to other chronic diseases (often asymptomatic) that go hand in hand and affect quality of life. But while the health conditions themselves may seem complicated, your risk of developing them in the first place can be mitigated through the same small changes to your daily routine and improvements to your overall health.

1. Eat more plants and whole foods

To reduce your risk of heart disease, Freeman recommends a diet that is primarily plant-based, low in fat and full of “whole foods.” Whole foods don’t have to be fancy, quite the opposite. You can think of whole foods as “component” foods – fruits, vegetables, beans, meat, rice, bread, etc. (No, that doesn’t mean you can’t season it or that it has to be boring — the goal is to get the most out of the food source itself and leave out things like added preservatives or sugars.)

One way to start incorporating more nutritious foods into your diet is to focus on adding color to your plate.

2. Be wary of meat-containing or restrictive diets

High-protein diets and the more extreme “lion diet” have had their moment on social media because some people have attributed relief from chronic pain or health conditions to removing things from their plates, leaving behind a meat-focused approach to eating. But the experts we spoke to advised caution, if only because your protein choices may come with other health risks, like eating too much red or processed meat, for example.

There’s also the keto diet, which has been supported by research for weight loss. It can be a healthy option for some people, but it won’t be for everyone.

“When you cut out carbs, people lose weight,” Freeman said, referring to carbohydrates that people may eat in excess.

“But this does not necessarily mean that they are healthier,” he added.

3. Move your body (it doesn’t matter how)

Sitting too much is bad for your health. But you’d be surprised at how little effort you need to put into physical activity to start reaping the heart-health benefits.

“I would encourage people to do whatever they can,” Vafai said, adding that he has seen people’s health improve after they get a dog walker. Just find some activities every day to get your body moving.

How do you know you’ve achieved a good bout of exercise? Freeman recommends trying to get to the point where it’s difficult to speak.

Here’s more information on how to exercise when you don’t feel like it and how to have a “kinetic” snack.

4. Watch what you drink and smoke

You probably know by now that smoking is not good for your health, and that it is linked to heart disease. But drugs and other substances, including alcohol and weed, may also have an effect, according to Freeman.

Water is the obvious choice for the most heart-healthy beverage, but unsweetened tea and coffee are good options, too, Freeman said. He said that in addition to the high sugar content in regular soda, one should reconsider before resorting to diet soda, because diet soda can affect insulin.

5. Learn from the “Blue Zone”

The hype is real. Freeman recommends taking notes from people who live in the “Blue Zone” (in the US, that’s Loma Linda, California). These are areas where people tend to live longer lives, where their communities, nutrition, activity and sleep patterns are likely to contribute to their longevity.

6. De-stress and connect

We are in a “loneliness epidemic” for a reason. Experts know that loneliness and social isolation are linked to poor health outcomes — including heart disease and premature death — but pinpointing an exact mechanism is difficult. Stress hormones and lifestyle effects from lack of relationships may play a role.

The cultural phenomenon of suffering social connections, in particular, is a risk factor for heart disease, according to Freeman. Although there’s no quick fix for something so pervasive and embedded in our culture, Freeman recommends engaging in an activity like meditation or going for a walk in the woods.

For more, here are some strategies to reduce feelings of loneliness and how to manage daily stress.