Heart Health
Women's Health

Uncovering the myths about heart disease

by Diamond Fernandes

heart disease concept

How does a 55-year-old women, a marathon runner, end up having heart bypass surgery? Let’s uncover some myths about heart disease.

We are still in the era where we think cholesterol accumulates in our arteries, we have one last cheeseburger and fries, and we end up with a heart attack. The most important thing to understand is these arteries are a muscle not a pipe.

Heart disease is a man’s disease

It is the leading cause of death of men and women. Women have arteries too and sometimes can be protected up until menopause. However, we don’t always have to wait until menopause. Up to 20% of female heart attacks are not due to an artery blockage.

Understand these arteries are very complicated and many conventional cardiology testing can miss heart attack risk. In addition, symptoms of heart disease in women tend to be ignored as something other than heart such as acid reflux, indigestion, back pain, fatigue and/or jaw pain.

Arteries are a pipe

Arteries expand, and contract and they are responsible for delivering the blood throughout the body, including vital organs like the brain and the heart. These arteries have a lot of biology to them and if we were to attach all your arteries together it would go around the earth nearly three times. Yes, three times!

The inner lining of the artery wall is all skin called the endothelium, just like the skin on the outside of our body. The largest organ of our body is the endothelium. When this endothelium gets damaged, this is inflammation, and is the biggest culprit for artery disease.

Coming back to our marathon runner. Over exercise and possibly poor nutrition or nutritional imbalances can lead to inflammation. Inflammation damages the endothelium.

Cholesterol causes artery disease

The concern is our healthcare system is following an archaic model when it comes to heart disease. Cholesterol does not accumulate to an artery wall like a pipe.

You have the good cholesterol called the HDL, the bad cholesterol called the LDL, and the ugly called the Triglycerides. Not all good cholesterol is good and not all bad cholesterol is bad. Imagine you have a bucket of HDL, bucket of LDL and another bucket of Triglyceride cholesterol. Inside each of these buckets are golf balls and tennis balls.

Imagine the endothelium is like a tennis net like structure. Tennis balls don’t go through this endothelium, but small golf balls do. One must understand particle sizes; however, it is more important to make sure you stop the first event which is inflammation. Inflammation damages the lining of the artery wall making it easier for those golf balls to go into the artery wall and cause havoc.

You could be told you have high cholesterol and are now being prescribed a cholesterol lowering drug like a statin when you have more tennis balls or worse told everything is okay and you have buckets full of golf balls.

Cholesterol is not what causes heart disease. These particles are innocent bystanders. A study of 136,905 people found that 83% of people who have coronary artery disease have normal LDL cholesterol. 70% have normal Triglycerides. This shows it is not just about cholesterol.

Taking a statin or cholesterol lowering drug

If you are taking a cholesterol lowering drug it is important to know why you are taking it. The benefits must outweigh the side effects. The benefits are very minimal if you do not have coronary artery disease. If you have coronary artery disease, then this benefit may be worth it. This can be important to have a further discussion.

Cardiology testing will save my life

Cardiologists love you; however, their job is to determine if you have advanced stages of artery disease where you require a heart stent or bypass surgery. None of the conventional testing will determine heart attack risk. Imagine your arteries like a five-lane highway system. If all five lanes are open all good.

However, if you have 3 lanes closed (60%) you would still get a clean bill of health. How? Cardiology testing is designed to look for advanced stages of artery disease. In fact, a stress test will miss 90% of heart attacks as most heart attacks occur with blockages that are less than 50% blocked.

Inflammation is what causes heart disease. The small cholesterol particles “sliver” into the lining of the artery wall.

Everyone has had a sliver in their hand, and if you are not able to get it out, it gets infected and pusses. When these cholesterol particles sliver into an inflamed artery wall, it gets infected, and this is what causes artery disease. This builds up like a pimple inside the lining of the artery wall.

If this pimple pops inside the lining of the artery wall… this is your heart attack! And 70% of heart attacks occur with blockages that are less than 50% blocked. Emergency heart events is rarely a plumbing issue.

Heart stents and bypass will save my life

If you are having a heart attack, a heart stent or bypass surgery will save your life. However, if you are not having a heart attack and you have stable coronary artery disease, it will not save your life.

We have seen this numerous times, where someone gets a less invasive test like a stress test, or a CT Angiogram then fail those tests and go to an angiogram at the catheterization lab in the hospital to get a heart stent or do bypass surgery.

This is not necessary the best option anymore and this has been proven with decades of research such as the COURAGE and ISCHEMIA Trials, showing that heart surgery for blockages is often unwarranted and that medical therapy is just as good as a treatment option. Cardiologists are trained to not tolerate a lack of blood flow and can be challenging to see the literature in a new light.

What do we do?

How does a fit women end up with heart disease. It is not a man’s disease. Next there are hundreds of things that can affect the artery wall, and the arteries do not know the difference whether it is smoking or poor nutrition, to over-exercise.

Understand that seeing a cardiologist is very important to rule out something that requires further attention.

If you want to prevent a heart attack or another heart event, this is where it is important to get the right tests without any radiation and harmful dye to understand cardiovascular disease risk.

Diamond Fernandes is the author of the book Beating Heart Disease. He is also the founder and director of the Heart Fit Clinic. For further information please visit HeartFit.ca