What Heart Disease Means and How You Can Lower Your Risk

As a physician, I want to help patients understand what we mean when we talk about "heart disease." This term refers to a range of conditions that directly affect how the heart works. Common forms of heart disease include:

• Irregular heart rhythms (arrhythmias)
• Coronary artery disease (blocked or narrowed heart arteries)
• Cardiomyopathy (weakened or stiff heart muscles)
• Heart valve disease
• Congenital heart defects (present at birth)
• Heart infections
• Heart failure
• Heart attacks

Sometimes people use "heart disease" and "cardiovascular disease" interchangeably, but they’re not quite the same. Cardiovascular disease is a broader term that includes all diseases of the heart and blood vessels, including stroke and peripheral artery disease.

Each year, more than 800,000 people in the United States die from cardiovascular disease, which includes heart disease, stroke and other vascular conditions. It remains one of the most significant health challenges we face.

Your cardiovascular system is vast. It includes about 60,000 to 70,000 miles of arteries, veins and capillaries that transport blood to every part of your body. In the brain alone, there’s a capillary network spanning roughly 400 miles. This system is essential for keeping your organs nourished and functioning properly.

When any part of this system is damaged (whether in the heart or elsewhere) the impact can be serious. Blocked arteries may lead to heart attacks, heart failure or sudden cardiac death. If blood flow to the brain is reduced, it may result in a stroke.

Heart screenings help us evaluate how well your heart is functioning, even before any symptoms appear. Early detection allows us to catch potential issues, guide treatment plans and reduce the risk of more serious problems in the future.

When we talk about heart screening, we’re referring to tests that focus on how your heart beats, how it pumps and whether there are signs of blockage or structural issues. Based on your symptoms, family history or risk factors, your doctor may recommend one or more of the following:

Heart-focused screening tests may include:

• Electrocardiogram (ECG or EKG): Records the heart’s electrical signals to detect irregular rhythms or signs of strain.
• Echocardiogram: Uses ultrasound to create images of the heart and assess its size, shape and how well it is pumping.
• Exercise stress test: Measures how the heart performs under physical activity by monitoring changes in rhythm and blood pressure.
• Dobutamine stress test with imaging: For those unable to exercise, this test uses medication to mimic activity and checks heart function with imaging.
• Transesophageal echocardiogram (TEE): Offers detailed images of the heart by using a probe placed in the esophagus.
• Holter monitor (24 to 48 hours): A wearable device that continuously tracks your heart rhythm during your usual daily activities.
• Event recorder (up to 30 days): A small device that you activate when you feel symptoms, capturing heart activity at those moments.
• Lexiscan stress test: Uses a medication to widen the coronary arteries, helping identify potential blockages when traditional exercise testing isn't possible.

In addition to heart-specific tests, we may also evaluate blood flow in other parts of the body to get a fuller picture of your vascular health. These broader cardiovascular screenings may include:

• Arterial vascular studies to assess circulation in the legs
• Carotid ultrasound to look for plaque in arteries leading to the brain
• CT calcium scoring to check for calcium buildup in the coronary arteries

These tests help us not only diagnose but also personalize your care. Whether you have symptoms or simply want to be proactive, heart screenings are a smart step in protecting your long-term health.

If heart disease runs in your family, it's best not to wait. We’re seeing more people experiencing heart issues in their 30s and 40s, especially those with risk factors like diabetes or high blood pressure. You may benefit from a heart screening if you have any of the following:

• Family history of heart disease
• High blood pressure or high cholesterol
• Diabetes or insulin resistance
• Obesity
• Smoking
• Physical inactivity
• Excessive alcohol use
• Chronic stress or depression
• Unhealthy diet

Even without symptoms, a heart screening can help detect problems early and guide steps to protect your health. If you're unsure when to start, a conversation with your doctor is a good first step.

How does smoking affect my heart? 

Smoking puts a serious strain on your heart. With every puff, you're inhaling a mix of thousands of chemicals, over 60 of which are known to cause cancer. But even beyond cancer risk, smoking damages your blood vessels, reduces oxygen in your blood and forces your heart to work harder than it should.

y develop microvascular disease, which involves the smaller vessels.

As a result, symptoms in women (such as shortness of breath, nausea, fatigue or pain in the back, jaw or neck) may be more subtle and easier to overlook. Women may also be more prone to soft plaque buildup that increases the risk of heart attack. Because of these differences, heart disease in women is sometimes underdiagnosed or treated later, making awareness and early screening especially important.

Is exercise really important for maintaining heart health?

Yes, regular physical activity may help support heart health. It helps your heart pump more efficiently, lowers blood pressure and cholesterol and improves how your body uses oxygen. The goal isn’t extreme workouts. It’s about finding a balance that works for your body. Even small, consistent movements like walking, stretching or light cardio may go a long way in strengthening your heart and improving your overall well-being.

Does alcohol consumption affect my heart health? <H3>

Alcohol may impact heart health in several ways. While moderate drinking might seem harmless, excessive or frequent alcohol use can raise blood pressure, increase triglycerides, contribute to irregular heart rhythms and raise the risk of heart failure or stroke.

If you don’t already drink, there’s no need to start for health reasons. If you do, keep it in moderation, which is generally no more than one drink a day for women and two for men.

What foods are good or bad for my heart? 

Eating for heart health means choosing more foods like vegetables, fruits, whole grains, lean proteins and healthy oils, while cutting back on saturated fat, sodium, added sugars and alcohol. These choices can help lower blood pressure, manage cholesterol and support a healthier weight.

The DASH eating plan is often recommended because it’s been shown to reduce risk factors for heart disease. Understanding food labels, cooking at home more often and staying mindful of portion sizes are all helpful ways to take better care of your heart through nutrition.