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15 Myths and Surprising Facts About Your Heart!
By Marc Gillinov, MD, and Steven Nissen, MD 
Published 2/2/2012 
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15 Myths and Surprising Facts About Your Heart!
Confused by the news about heart health? Drs. Marc Gillinov and Steven Nissen, top heart docs at Cleveland Clinic, the nation’s #1 heart hospital, aren’t surprised. As they write in the opening of their new book, Heart 411: The Only Guide to Heart Health You’ll Ever Need, “Weekly health headlines skim the surface of the medical ocean — take fish oil, pass on heart scans, throw away your aspirin — but what do the studies really say? What is the message for you and your heart? We decided to explore the science behind the headlines and to explain clearly but completely the evidence supporting our plan for your heart health.” Here, they tackle 15 claims to help you get to the heart of the matter.
The Claim: Going to the Doc Can Raise Your Blood Pressure
The Truth: For many of us, a visit to the doctor causes emotional stress, and your body releases adrenaline and other hormones into your bloodstream, increasing blood pressure. We call this doctor-induced increase in blood pressure “white coat hypertension.”

If your doctor determines that you have high blood pressure, make sure that this is not simply white coat hypertension. Buy your own blood pressure monitor and check your pressure at home under less stressful conditions. If your resting blood pressure at home is normal (120/80 or less), you have white coat hypertension. If you have white coat hypertension, however, stay on top of your blood pressure (frequent blood pressure checks, exercise, good diet) to limit your chance of developing real hypertension in the future.
The Claim: Red Meat Is Black-Listed
The Truth: Red meat is relatively high in saturated fat, and as a result, it gets a bad rap. The most important point is to distinguish between processed and unprocessed products. Compared to unprocessed meats, processed meats have similar contents of saturated fat and cholesterol. The key difference is that they have four times as much sodium and 50 percent more nitrates and nitrites. The sodium can increase blood pressure, while the nitrates may promote atherosclerosis and diabetes.

In general, limit all red meats because of their high saturated fat content and try to avoid processed red meats. An occasional meal that contains a reasonable quantity of unprocessed red meat (a 6- to 8-ounce steak, not a 22-ounce rib eye) is unlikely to cause harm.
The Claim: Your Friends Can Make You Fat
The Truth: Researchers from Harvard Medical School addressed this question, examining the spread of obesity in a large social network over a thirty-two-year period. They found that obesity tended to occur in clusters, and examination of these clusters of obese people confirmed that obesity is socially contagious. A person’s risk of becoming obese increased by nearly 60 percent if he or she had a friend who became obese over the course of the study. Similarly, a sibling or spouse becoming obese resulted in a 40 percent chance that other siblings or the other spouse would also become obese. This obesity effect was transmitted over long distances—friends separated by thousands of miles had the same influence as those who lived next door.
The Claim: Sex Is Exercise
The Truth: It depends on what you do and for how long. On average (and of course none of us wants to lay claim to being average), sex lasts for five to fifteen minutes and consumes about as much energy as walking one mile in twenty minutes. The younger and more vigorous among us may double or even triple this figure, reaching the threshold of vigorous exercise. Alas, these people are the exception. So can we make an argument for sex, heart-wise? The answer is probably yes. A healthy sex life correlates with a healthy heart.
The Claim: Hormone Replacement Therapy Will Protect Your Heart
The Truth: Hormone replacement therapy (HRT) should not be used to protect the heart. But careful analysis reveals that HRT poses little to no risk when used for short periods (six months) by women who are within ten years of menopause. In these women, HRT is effective at relieving hot flashes and night sweats. In contrast, in older women and those more than ten years from menopause, HRT is riskier——it increases the likelihood of heart attack and death from heart disease.
The Claim: Eggs Are Off-Limits
The Truth: Everybody knows that eggs contain cholesterol, and it is widely believed that eating foods rich in cholesterol leads to heart disease. Ergo, we should not eat eggs, right? Not exactly. Today we understand that most people can have one to three eggs per week. Eighty percent of your body’s cholesterol is made by your liver, with diet contributing only about 20 percent. Among dietary factors, saturated fats and trans fats have a greater impact on blood cholesterol levels than does dietary cholesterol. This is not a reason to fill your meals with cholesterol, but it does mean that you can keep eggs in your diet.
The Claim: Video Games Can Make You Fit
The Truth: One creative way to get your daily dose of exercise is to play games on the Wii. One-third of the activities in the Wii sports video and fitness packages require enough energy expenditure to qualify them as moderate-intensity exercise. Golf and bowling involve only low-level exertion, but you can work up a real sweat on the Wii with boxing and tennis. The benefits of Wii and similar systems may extend even beyond the heart. Recent studies show that games that require strategic thinking boost both heart rate and cognitive abilities and memory. So, no matter what your age, you can spice up your exercise routine by including action video games in your program.
The Claim: To Get Fit Fast, Vary Your Exercise Pace
The Truth: Once reserved for competitive athletes, interval training is a real option for all of us. With this approach, you can squeeze your workouts into shorter time periods, and possibly derive even greater benefits from them. The principle of aerobic interval training is to vary the intensity of your activity, alternating periods of strenuous exertion with periods of recovery. For the runner, this may mean alternating four-minute sprints with three-minute walks, using the walk to recover from the heavier exertion. Nearly every aerobic activity can be approached in this fashion. Compared to standard, steady exercise, interval training produces greater increases in endurance, oxygen use and general fitness. In addition, studies show that interval training has beneficial effects on body weight and blood pressure.
The Claim: You Have to Be in the “Zone” to Get a Good Workout
The Truth: You don’t have to use some arbitrary percentage of your maximum calculated heart rate to guide your workouts. The truth is that you can have an excellent workout at both relatively low and relatively high heart rates, depending upon your exercise regimen and your own personal cardiac characteristics. Tailor your workout to how you feel, and make sure that you exert yourself—evidence of a good workout will be obvious as the sweat begins to flow. The real key to exercising effectively is to make sure that you are exercising consistently. As one researcher noted, the most important calculation related to exercise is not your maximum heart rate; it’s determining where in your busy schedule you can fit a daily workout.
The Claim: You Can Die of a Broken Heart
The Truth: In 2005, Johns Hopkins researchers stunned the American public with their description of a condition called stress cardiomyopathy, a potentially life-threatening heart problem brought about by intense emotion. Hopkins doctors studied nineteen people who suffered acute chest pain and catastrophic heart failure after sudden emotional stress. The most common precipitating event was death of a loved one, but in two cases the life-threatening event was a surprise party. This understanding of “broken heart syndrome” represents our best scientific evidence of a biochemical link between emotional stress and heart disease. Interestingly, almost all of the patients with stress cardiomyopathy were women. We don’t yet understand why women may be more vulnerable than men. But we do know that this story has a happy ending: all of the patients recovered.
The Claim: Exercise is Dangerous for Heart Patients
The Truth: Nearly all heart patients can benefit from exercise, and this holds true for patients with heart failure and heart damage. The benefits of aerobic exercise are actually not related to a direct effect on the heart. Aerobic exercise works by increasing muscle efficiency, improving the ability of the body’s muscles to extract oxygen from the blood. Patients with congestive heart failure usually have reduced exercise capacity, and this obviously makes it harder to exercise. Our advice is to do whatever you must to find the motivation to exercise. The keys to safety and success are to start aerobic exercise slowly and to increase gradually. Walking is the ideal form of aerobic exercise for the heart failure patient.
The Claim: Hot Tubs Can Hurt Your Heart
The Truth: Staying in a hot tub or sauna for too long can certainly cause severe dehydration and dangerous fluid and electrolyte problems. But a ten-minute session in the hot tub or sauna will not hurt you or your heart. Hot tubs and saunas do not cause heart attacks or heart problems or interfere with cardiac pacemakers. As you enter the sauna or immerse yourself in the hot tub, blood vessels near the skin dilate (enlarge), causing a slight drop in blood pressure; this is rarely dangerous. You can minimize the impact of this blood pressure change by getting in and out slowly, which gives your body a moment to adjust to the temperature change.
The Claim: A Stretch a Day Keeps the Heart Doc Away
The Truth: While American studies of work-related stress and heart disease focus primarily on the quality of the work environment, others have examined the relationship between the quantity of work and heart health. In one recent British study, researchers found that employees working three or more overtime hours per day substantially increased their risk of heart-related problems over a ten-year period. The risk was particularly high among overtime workers with low decision-making capability and high job strain. While the study did not tease out the cause of increased heart disease among overtime workers, researchers noted that employees who worked longer hours were more likely to smoke, had less favorable cholesterol profiles, and had less time for leisure-time exercise than their co-workers.
The Claim: You Can Be “Fat and Fit”
The Truth: A small but vocal cadre of doctors believes that obesity and heart health are not mutually exclusive. They use the term “metabolically healthy obese” to refer to people who are obese but who do not have changes in standard cardiac risk factors, suggesting that these people have nothing to worry about. However, recent, careful studies in this group demonstrate that they face an increased risk of developing heart disease when compared to metabolically healthy people of normal weight. The message here is clear: excess weight is a real and independent risk factor for heart disease even when other standard risk factors are absent. Don’t be lulled into a false sense of security if your weight is high but your cholesterol is normal.
The Claim: You Can be Worked to Death
The Truth: While American studies of work-related stress and heart disease focus primarily on the quality of the work environment, others have examined the relationship between the quantity of work and heart health. In one recent British study, researchers found that employees working three or more overtime hours per day substantially increased their risk of heart-related problems over a ten-year period. The risk was particularly high among overtime workers with low decision-making capability and high job strain. While the study did not tease out the cause of increased heart disease among overtime workers, researchers noted that employees who worked longer hours were more likely to smoke, had less favorable cholesterol profiles, and had less time for leisure-time exercise than their co-workers.
Meet the Docs
Marc Gillinov, MD, is a staff cardiac surgeon at the Sydell and Arnold Miller Heart and vascular Institute at Cleveland Clinic. Steven Nissen, MD, is the chairman of the Robert and Suzanne Tomisch Department of Cardiovascular Medicine at Cleveland Clinic.

Adapted from Heart 411: The Only Guide to Heart Health You’ll Ever Need by Marc Gillinov, MD and Steven Nissen, MD (Three Rivers Press, 2012)


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