Heart Disease - Everything You Need to Know

Medically reviewed by John A. Flores M.D., M.S. May 06, 2024| Written by Zenda Nel

Heart Disease - Everything You Need to Know

Cardiovascular disease is the leading cause of death globally, taking anestimated 17.9 million lives annually. More than four out of five deaths occur from heart attacks and strokes, with one-third of that group aged less than 70 years.

Heart disease is included in the group of cardiovascular disease disorders but is limited to the heart and its surrounding blood vessels.

Heart disease can involve any heart structure, including blood vessels, such as coronary blood vessels, the electrical system, heart muscle, heart valves, and chamber walls. 

Conditions that are commonly associated with heart disease typically occur in greater frequency, from coronary heart disease relative to valvular heart disease and congenital heart disease.

1. Coronary Artery Disease (CAD) 

This condition is the most common type of heart disease. It happens when the arteries that supply blood to the heart muscle become narrowed or clogged with atherosclerotic plaque. 

As a result, reduced blood flow to the heart muscle prevents an adequate supply of oxygen and nutrients to the heart and its structures. This situation eventually results in injury and damage to the heart muscle that can cause chest pain (angina), which is often a prelude to a future heart attack. 

2. Valvular Heart Disease (VHD)

 VHD is a disorder involving any heart valves that act as synchronized conduits to direct blood flow through the heart in one direction. The heart comprises dual chambers on the left and right sides. The tricuspid and pulmonary valves are on the right side, directing oxygen-poor blood into the lungs for oxygenation. On the left side are the mitral and aortic valves, which direct oxygen-rich blood from the heart to the rest of the body.  

Disruption of single-directional flow can occur when the valves do not function according to their intended design. This situation can lead to higher internal chamber pressures, which can eventually hamper normal heart muscle activity and cause heart failure.     

Heart valve malfunction can occur from congenital heart defects, age-related degeneration, heart attacks, and other medical conditions, like high blood pressure and autoimmune disease. 

Infections can also damage heart valves, such as streptococcal upper airway infections, as seen in rheumatic fever, and by direct infection of the valves, as seen in endocarditis. Connective tissue disorders like Marfan syndrome or Ehlers-Danlos syndrome are also known to cause heart valve damage.

3. Congenital Heart Disease (CHD)

  • CHD commonly presents as heart defects at birth and typically includes:
  • Valves that don't open properly or leak blood.
  • Absence of a heart valve.
  • Holes in the heart wall between chambers.
  • Structural issues, like missing ventricles or abnormal artery connections.

Some defects won’t offer telltale symptoms until later in life or when discovered during routine medical checks.

Congenital heart defects can occur in the fetus during its development in the uterus during pregnancy. 

Certain medical conditions experienced by the mother during pregnancy can increase the risk of congenital heart defects in the baby, such as poorly controlled diabetes, which carries a fivefold risk.

Somemedications taken during pregnancy are associated with an increased risk of congenital heart defects. 

Small changes in genes can contribute to congenital heart disease. These changes involve variations in the genetic code and alterations in the number of copies of specific genes.

4. Conditions Commonly Associated with Heart Disease

a) Myocardial Ischemia 

Significant narrowing of the coronary artery's internal diameter occurs when there is extensive buildup of atheromatous plaque along the inner arterial wall. Progressive narrowing of the artery can eventually lead to ischemia, which is the critical point where the reduced blood flow cannot adequately deliver enough vital nutrients and oxygen to meet the metabolic needs of the heart muscle (myocardium). This critical juncture results in the injury and damage of myocardial cells that trigger the sudden onset of chest pain.

b) Myocardial infarction or heart attack

Atheromatous plaquing of a coronary artery promotes local tissue inflammation. The irritated tissue cells will release cell byproducts that can provoke the forming of a blood clot. The blood clot will block the upstream flow of blood to the myocardium, damaging local or regional sections of the heart. With prolonged blockage of the artery, the myocardial cell damage becomes irreversible. This infarction of the myocardial wall can be partial or full-thickness, and the extent of wall damage will determine the remaining heart muscle activity. Extensive myocardial damage can result in heart failure and death.

Conditions or Risk Factors Leading to Heart Disease

Risk factors are typically medical conditions and lifestyle elements that are known or suspected to contribute to the development of heart disease.

1. Medical Conditions Associated With Heart Disease

  • End-stage renal disease—primarily individuals on dialysis
  • Chronic inflammatory diseases—which include lupus erythematosus, rheumatoid arthritis, etc.
  • Human immunodeficiency virus
  • Familial hypercholesterolemia

   The best way to examine risk factors is to divide them into conventional, modifiable, and nontraditional risks.

2. Conventional Risk Factors

  • Older age—over 45 years age in men and over 55 years age in women.
  • Family history of early heart disease
  • Race—individuals of African American or Asian heritage appear to have a higher independent risk
  1. Modifiable Risk Factors
  • High blood cholesterol levels
  • High blood pressure
  • Cigarette smoking
  • Diabetes mellitus
  • Obesity
  • Lack of physical exercise
  • Metabolic syndrome
  • Mental stress and depression
  • Sleep disorders
  1. Nontraditional Risk Factors

The following markers will have high serum levels.

  • High-sensitivity C-reactive protein
  • Lipoprotein (a)
  • Small, dense LDL-C particles

Modifiable risk factors bear the most focus as these are elements where individuals can initiate proactive measures to prevent or reduce their influence on heart disease. 

Can Diet and Lifestyle Changes Prevent Heart Disease?

Diet and lifestyle changes are integral in addressing modifiable risk factors contributing to heart disease. 

1. Healthy Diet

To support your heart health and reduce the risk of heart disease, scientists suggest following a diet that provides plenty of fruits and vegetables, whole grains, nuts, fish, poultry, and vegetable oils.

Red and processed meats, refined carbohydrates, sweetened foods and beverages, sodium, and transfats are among the foods that contribute to poor heart health.

2. Staying Physically Active

A sedentary lifestyle is terrible for your general health, increasing your heart disease risk. Lack of exercise contributes to weight gain and increases the risk of developing many chronic diseases.

Research supports a more active lifestyle. A study of healthy women with no heart disease found that sitting for prolonged periods increases the risk of cardiovascular disease.

3. No Smoking

Smoking is a significant heart disease risk factor. One out of every five smoking-related deaths isattributable to heart disease. 

According to Johns Hopkins Medicine, smoking contributes to heart disease by: 

  • Causing a long-term rise in blood pressure and heart rate.
  • Reducing blood flow from the heart.
  • Reducing the amount of oxygen in the blood damages all the organs and tissues in the body, including the heart. 
  • Increasing the risk of blood clots.
  • Damaging blood vessels. 
  • Increasing the risk of stroke due to reduced blood flow to the brain.

So it’s only sensible not to smoke or at least consider quitting if you are a smoker.

4. Alcohol is Not Your Friend

The jury is still out on whether moderate drinking is good for your heart (the red wine controversy). According to the Centers for Disease Control, one drink per day for women and two drinks per day for men is moderate alcohol use. It is best not to use alcohol at all, but if you do, do so in moderation.

Drinking that exceeds the limits of moderate alcohol use is linked to high blood pressure, heart failure, stroke, and cardiomyopathy.

As a source of empty calories, alcohol leads to weight gain, which brings with it a whole list of health problems.

5. Getting Enough Sleep

The American Heart Association (AHA) hasadded sleep to its heart health checklist as part of an 8-item list to improve lifestyle habits.  

The new sleep metric suggests 7-9 hours daily for optimal cardiovascular health in adults and more for children, depending on age.

Research has shown a link between too little sleep and hypertension, coronary heart disease, and diabetes. Sleeping fortoo long or too short a time promotes an association with heart disease and also affects heart-related risk factors, including weight and blood pressure.

Research at Columbia University found that poor sleep can indirectly affect the heart by increasingfood cravings and pushing preferences for foods high in saturated fat and sugar. 

What are the Preferred Dietary Programs?

The Cardiac Diet

The Cardiac Diet, also known as the Heart-Healthy Diet, is based on recommendations from healthcare professionals and organizations like the American Heart Association (AHA) and the National Institutes of Health (NIH).

The recommendedevidence-based guidelines are:

  • Eat a wide variety and plenty of fruits and vegetables
  • Choose whole grains rather than refined grains
  • Choose minimally processed foods instead ofultra-processed foods
  • Choose plant-based protein (legumes, nuts and seeds)
  • If you desire animal protein, choose fish, other seafood, low-fat or fat-free dairy products, lean meats, and poultry.
  • Cook with liquid plant oils like olive oil, avoiding tropical oils like coconut or palm oil.
  • Choose food that contains little salt or sugar, and prepare food with little salt.
  • Limit intake of sweet beverages
  • Maintain a healthy body weight
  • Limit alcohol intake or avoid it altogether

What Makes the Cardiac Diet Healthy? 

According to a2019 scientific review, nutrition science has shown that a healthy diet adopts high consumption of non-starchy vegetables, fruits, whole grains, and legumes in addition to moderate consumption of nuts, seafood, lean meats, low-fat dairy products, and vegetable oil.

Trans fats, saturated fats, sodium, red meat, refined carbohydrates, and sugar-sweetened beverages are minimized or avoided altogether.

The researchers found the three diets that closely resemble this ideal are DASH, the Mediterranean, and vegetarian.

  • TheMediterranean diet focuses on fruits, vegetables, whole grains, legumes, and olive oil.
  • TheDASH diet promotes eating plant-based, whole foods while avoiding salt, sugar, and most fats.
  • Vegetarian whole-food dietsinclude fruits and vegetables and replace animal proteins with plant-based sources such as legumes, nuts, seeds, and whole grains.
  • If you follow one of the cardiac diets, your diet naturally includes a host of fruits, nuts, seeds, and vegetables that support heart health.

How do the Composed Food Groups of the Cardiac Diet Promote Health?

1. Fruits

Fresh fruits are all good for your health and your heart. Berries, in particular, have been found to support heart health. Berries like raspberries, blackberries, strawberries, and blueberries are high in antioxidants, which protect against oxidative stress and inflammation that can otherwise contribute to the development of heart disease. 

Fresh is best, but frozen or dried fruit without added sugar is also good if unavailable. Refrain from buying canned fruit in syrup.

2. Vegetables 

Here, we are talking about leafy greens like kale, cabbage, spinach, and bok choy, which are overflowing with vitamins, minerals, and antioxidants. These can lower blood pressure, reducing the risk of heart disease. 

These vegetables contain nitrates, which can help relax and widen blood vessels,reducing blood pressure and lowering the risk of cardiovascular disease.

3. Whole Grain Provides Fiber

Whole grains are good sources of dietary fiber, which can help improve blood cholesterol levels and lower the risk of heart disease, stroke, and obesity. A diet high in fiber helps to control cholesterol levels in the bloodstream. Cholesterol can clog up the arteries and is a risk factor for coronary heart disease.

  • Whole Grains Include Whole wheat, whole rye, brown or wild rice, quinoa, barley, corn, and farro.
  • Foods made from whole grains include whole-grain bread, bagels, English muffins, tortillas, whole-grain crackers, and pancakes. Whole-grain breakfast cereals, including sorghum and rolled or steel-cut oats. Whole wheat pasta and couscous. Unsalted, air-popped popcorn. 

Fiber is so crucial for health that even if, for some reason, you’re cutting down on carbs, you should try adding supplementaryfiber powder to fulfill your daily fiber needs. 

4. Healthy Plant Protein Sources 

Plant-based proteins such as legumes, nuts, whole grains, and seeds are healthy protein choices that lower the risk of cardiovascular disease. Fatty fish is also an excellent choice for a heart-healthy diet.

  • Legumes like soybeans (including edamame), lentils, chickpeas, and peas protect against cardiovascular disease. 

Eating one serving a day of beans, peas, chickpeas, or lentils can significantly lower LDL “bad” cholesterol and, therefore, the risk of cardiovascular disease. Eating these foods can reduce the risk of cardiovascular disease by 6%.

  • Lentils are perfect for you. Their relatively low vitamin K content protects against heart disease, making themsafe for CVD patients on anticoagulant (blood thinner) treatment.

  • Nuts are super healthy. They contain healthy oils, fiber, protein, and loads of minerals. One Brazil nut provides all the necessary selenium – almost twice the daily requirement.

Numerous studies have revealed that nuts protect against a range of diseases. A study conducted at Maastricht University in the Netherlands found that consuming nuts may protect against diseases, including cancer,heart disease, and diabetes.

Another study found that people who regularly eat nuts of all kinds are less likely todevelop cardiovascular disease or coronary heart disease than those who never or seldom eat nuts.

  • Seeds are underestimated as a valuable nutrient-dense member of a healthy plant-based diet. Seeds are a good source of polyunsaturated fatty acids (PUFA), vitamin E, micronutrients, minerals, dietary fiber, and phytochemicals.

Chia seedsare therichest plant source of omega-3 fatty acids. These acids help increase HDL cholesterol levels, which protect against heart attack and stroke. Chia seeds are also an excellent source of protein. They are complete proteins, which is rare for plant sources of protein.

Another heart-healthy seed isflaxseed. Research has shown that flaxseed might helplower high blood pressure, which plays a role in heart disease.Flaxseed-enriched diets have induced 0% to 18% decreases in LDL (low-density lipoproteins) and 0% to 11% decreases in total cholesterol.

5. Healthy Animal Protein Sources. 

These include oily fish, lean meat and poultry, and low-fat dairy. Salmon, mackerel, tuna, and sardines are rich in omega-3 fatty acids, which protect against heart disease. 

Research has shown that consuming two to three servings of fish per week reduces the risk of cardiovascular diseaseby approximately 10%.

What Foods and Beverages Should We Avoid for a Healthy Heart?

For a heart-healthy diet, avoid the following foods, some of which may currently be your favorite.

  • Sweetened carbonated drinks like Coca-Cola and other sodas.
  • Fruit juices, if they are sweetened.
  • Fruit-flavored drinks—these are just flavored to taste like fruit. They contain flavorings and sugar, none benefiting your health or your heart.
  • Breads and pastries baked with refined white flour.
  • Crackers, pretzels, and similar snacks. 
  • White rice. 
  • Regular pasta and pizza are not made with whole wheat flour. 
  • Processed meats
  • Processed foods 
  • Margarine
  • Packaged soups
  • Flavored potato chips


Okay, as a recap…heart disease is part of the group that makes up cardiovascular disease (CVD), where CVD is the leading cause of global death. 

Heart disease comprises three distinct structural anomalies: coronary artery disease (CAD), valvular heart disease, and congenital heart disease, whereby CAD is the most commonly encountered.

CAD can be associated with ischemia of the myocardium, resulting in episodes of chest pain or heart attack.

There are known elements that increase an individual's risk of heart disease. Still, only the modifiable risk factors can be addressed individually by proactive measures that reduce their impact.

Dietary and lifestyle changes are essential to nullifying the negative influence of modifiable risk factors.

Eating healthy meals is the stalwart solution to reducing or preventing heart disease, along with exercise, avoiding tobacco and alcohol, and getting better sleep.