Americans Still Underrate Danger of Heart Disease and What They Can Do About It

American adults are still underestimating the danger of heart disease, according to the 2020 installment of Cleveland Clinic’s annual national heart health survey.

More than a third of U.S. adults (37%) think they won’t develop heart disease in the next 10 years — even though heart disease is still the leading cause of American death. A large majority of Americans (68%) don’t know that heart disease is the No. 1 killer of U.S. women. And Americans are much more likely to binge watch a TV show with their partner (66%) than to exercise with them (46%).

“Physicians still have a lot of work to do to educate their patients about the importance of heart health,” says Samir Kapadia, MD, Chair of Cardiovascular Medicine at Cleveland Clinic. “We may think that patients have heard it all before, but what’s well-known to us is still news to much of the population. Reinforcing the basics — about diet, exercise, risk factors, symptoms — isn’t repetitive, it’s necessary.”

Surprising things Americans believe

The survey of 1,000 U.S. adults, conducted as part of Cleveland Clinic’s “Love Your Heart” consumer education campaign in celebration of American Heart Month, also revealed these findings:

• 9% of Americans think smoking cigarettes is not harmful to their heart.
• 18% believe vaping e-cigarettes is not harmful. This belief is even more widespread among millennials (26%).
• 58% mistakenly believe that taking an aspirin a day is a good way to prevent heart disease.

The finding that may be most surprising also represents a valuable opportunity for clinicians: The vast majority of Americans (92%) don’t know that most heart disease is due to risk factors they can control.

“Too many people still don’t realize that healthy lifestyle choices can help them prevent heart disease,” says Leslie Cho, MD, co-Section Head of Preventive Cardiology and Director of the Women’s Cardiovascular Center at Cleveland Clinic. “This is a huge opportunity for the medical community. Recommending simple changes to more patients can drive significant improvements in heart health.”

“Heart attacks don’t just happen,” adds A. Marc Gillinov, MD, Chair of Thoracic and Cardiovascular Surgery at Cleveland Clinic. “Ninety percent of heart attack risk is attributable to personal choices. Making good lifestyle choices is the best way to love your heart.”

Back to basics

While heart disease accounts for one in every four deaths in the U.S., that number could be reduced by making sure more patients know the following:

• Eating a Mediterranean diet is healthiest for your heart. According to the survey, only 19% of Americans know this. Nearly 30% think a low-fat diet is best.
• Any level of exercise is better than nothing. About one-third of Americans don’t think that moderate jogging, walking the dog or riding a bike are ample exercises for heart health. More than half (58%) say they get less than the recommended three hours of exercise per week, and 14% never exercise at all.
• Cholesterol testing should begin in your 20s. Three-quarters of Americans (77%) believe that cholesterol testing is for people in their 30s or older.
• Symptoms of a heart attack can be different in women. More than half of Americans (55%) don’t know that new or extreme fatigue is a common symptom of heart attack in women. And 60% don’t know that nausea and vomiting can be symptoms, in addition to chest pain, shortness of breath, sweating and pain in the neck or jaw.

Urge patients to partner up

“Enrolling the support of a spouse or partner may help patients stick with lifestyle improvements,” says Dr. Cho. Over half of Americans in a relationship (60%) are more motivated to lead a heart-healthy lifestyle for their partners than for themselves, she notes from the survey.

A full 83% of Americans with partners said they would adopt a heart-healthy diet if their partner did. And more than half (57%) said they are more likely to exercise with their partner than by themselves.

Results reported here are from a Cleveland Clinic online survey of 1,000 U.S. adults conducted in September 2019. The sample was nationally representative by age, gender, ethnicity, region, income and education. It had a margin of error of ±3.1% (95% confidence interval).