More than 805,000 people in the U.S. experience a heart attack each year, a staggering number that continues to increase.1 February is American Heart Month and today, we're shedding light on a leading public health crisis in the U.S. – cardiovascular disease (CVD).2
Amgen recently sat down with Dr. Michael Gibson, cardiologist and President of the Baim Institute for Clinical Research, and Angelica, a graduate student at Boston University and a cardiovascular health advocate who has familial hypercholesterolemia, an inherited genetic condition that causes high LDL ("bad") cholesterol. Continue reading to learn their thoughts on the importance of prioritizing heart health, associated misconceptions and how people can take control of their LDL cholesterol levels.
What do you think are the biggest misconceptions people have when they think of heart attacks and strokes?
Dr. Gibson: There are several misconceptions regarding heart attacks and strokes, but a few common ones are related to misunderstanding the role of LDL ("bad") cholesterol. This is a type of cholesterol that can lead to a buildup of fatty deposits, or "plaques," inside arteries, that may gradually lead to reduced blood flow. When that happens, this is known as atherosclerosis.
Misperceptions I hear from my patients include:
- "Only older adults need to worry about LDL cholesterol." It is possible that high LDL cholesterol and heart disease can manifest among younger adults.3
- "If I feel fine, my LDL cholesterol level must be fine." Unfortunately, you can have high LDL without symptoms.4
- "If I just get rid of fatty foods, I can lower my LDL cholesterol." Although diet is critical, it may take more than diet to get a patient's LDL cholesterol into the target range. Medication may also need to be considered for these patients.5,6
Angelica: I often hear from people that heart attacks and strokes only affect those who are overweight or have unhealthy habits. However, it's important to recognize that there are cases like mine, where young individuals maintain a healthy weight, exercise regularly and eat well, yet still face the risk of heart attack and stroke. In some cases, like mine, the underlying cause can be associated with genetically high LDL cholesterol, which cannot be addressed solely through lifestyle changes. The missing piece in dispelling this misconception is awareness that high cholesterol could be inherited.
What are the key steps to addressing high levels of "bad" cholesterol for your patients?
Dr. Gibson: I like to start by discussing the risks associated with high LDL cholesterol and how getting that number down can improve their cardiovascular health, especially for my patients at high risk. Some cornerstones of treating high LDL cholesterol may include lifestyle modifications (i.e., a diet that's low in saturated and trans fats, exercise, smoking cessation, etc.), however as mentioned earlier, it may not always be enough for some patients. If lifestyle modifications are not enough to lower cholesterol, getting started on cholesterol lowering medication is critical.
What tips would you have for people who may not feel heard in the doctor's office?
Angelica: Two voices are better than one. In my experience, having a relative or close friend accompany me to doctor's visits gives me the support I need to make myself feel heard. It's a bonus if your relative or friend has a similar health issue – having the support of someone who not only knows you but also understands what you're going through is invaluable. There are days when I can speak in front of thousands of people as an advocate for heart health, but being in a doctor's office is different, and so I really value having extra support at appointments.
What do you wish people knew it was like living with a condition that causes high cholesterol ?
Angelica: Living with a genetic cholesterol disorder like mine is knowing that something is not right in your body and that sometimes you need to advocate for your own health even with healthcare professionals, as they may not always conduct the necessary tests or recommend appropriate preventative measures. My favorite TV medical drama featured a main character who, despite being a respected doctor, did not receive the proper care she deserved when she said she was experiencing a heart attack. Luckily, a trusted coworker found her and helped her get the care she needed. This fictional scenario highlights exactly what living with heart conditions can be like – misunderstood and unpredictable. That episode also highlighted how disparities exist that can put women of color at higher risk .7
What final message do you have for people to prioritize their heart health this American Heart Month?
Dr. Gibson: Please know that if you have cardiovascular disease, you are not alone. Rather than emphasizing heart disease, embrace an overarching commitment to improving your heart health with diet and exercise, stress level management, and setting a target with your doctor to ensure you're reaching your cholesterol goals. Heart health awareness is more than a just a month out of every year – it's a lifetime commitment to a healthy lifestyle to reduce the risk of potentially harmful cardiovascular events.
Angelica: It may not be revolutionary, but the importance of prioritizing your own well-being cannot be overstated. As airline safety says, "put on your own oxygen mask first before assisting others." By taking care of yourself, you will be able to better care for your loved ones. I mention this because if you can't do it for yourself, do it for them. They depend on you, just as you depend on them.
References
- Centers for Disease Control and Prevention. Heart Disease Facts. Accessed January 2024. https://www.cdc.gov/heartdisease/facts.htm.
- Mark McClellan, Nancy Brown, Robert M. Califf and John J. Warner. Call to Action: Urgent Challenges in Cardiovascular Disease: A Presidential Advisory From the American Heart Association. Circulation. 2019;139:e44–e54. https://doi.org/10.1161/CIR.0000000000000652. 24 Jan. 2019.
- National Heart, Lung, and Blood Institute. Heart disease risks among younger adults on the rise. Accessed January 2024. https://www.nhlbi.nih.gov/news/2023/heart-disease-risks-among-younger-adults-rise.
- Centers for Disease Control and Prevention. Cholesterol. Accessed January 2024. https://www.cdc.gov/cholesterol/.
- Centers for Disease Control and Prevention. LDL and HDL Cholesterol and Triglycerides. Accessed January 2024. https://www.cdc.gov/cholesterol/ldl_hdl.htm.
- Rosenthal RL. Effectiveness of altering serum cholesterol levels without drugs. Proc (Bayl Univ Med Cent). 2000 Oct;13(4):351-5. doi: 10.1080/08998280.2000.11927704.
- Mehta LS, Velarde GP, Lewey J, et al. Cardiovascular Disease Risk Factors in Women: The Impact of Race and Ethnicity: A Scientific Statement From the American Heart Association. Circulation. 2023;147:1471–1487. https://doi.org/10.1161/CIR.0000000000001139
