| Misconceptions about cardiovascular diseases -- heart | | | | equally affected by heart attacks and stroke -- a fact |
| attacks, stroke and high blood pressure -- have | | | | that has long been neglected by doctors and health |
| existed for many years and have in effect become | | | | professionals, and by women themselves. Furthermore, |
| myths. Most of them stem from factual observations | | | | pregnancy-associated hypertension is an important |
| during the early phase of the current global epidemic | | | | health problem in the developing world, where it is the |
| and have become deeply rooted in the minds of | | | | major cause of premature birth and perinatal death, |
| policymakers, health professionals and the public alike. | | | | and is also responsible for up to one-third of all |
| Since these misconceptions adversely influence the | | | | maternal deaths. |
| allocation of resources and undermine actions to | | | | Myth 4: Heart disease is a problem of old age |
| prevent and control cardiovascular diseases, they | | | | Atherosclerotic cardiovascular diseases (coronary |
| need to be firmly squashed. | | | | heart disease and stroke) and hypertension increase |
| Myth 1: Heart disease is a problem of developed | | | | with age. But research in industrialized countries shows |
| countries | | | | that about one-third of heart attacks and one-quarter |
| Every year, cardiovascular diseases cause around 15 | | | | of strokes occur in people below the age of 65. Many |
| million deaths in the world (30% of all deaths), and of | | | | of the deaths due to cardiovascular diseases also |
| these about two-thirds occur in developing countries. | | | | occur early, one-quarter of them below the age of 70. |
| So the absolute number of deaths from these causes | | | | In the developing world, the situation is even more |
| is twice as high in developing countries as in the | | | | marked: up to half of all deaths attributable to heart |
| industrialized world. Over twice as many deaths from | | | | diseases occur in persons younger than 70; and a |
| stroke occur in developing countries as in industrialized | | | | great number of working-age adults suffer from these |
| countries; and the numbers of deaths due to heart | | | | diseases. This has an enormous impact on the |
| attacks are equal in poor and rich countries. It is | | | | economic situation of individuals and families as well as |
| estimated that in China and India combined, which | | | | on society as a whole, and hampers efforts to |
| account for half the population of the developing world, | | | | alleviate poverty. |
| between five and six million deaths are caused each | | | | Myth 5: Heart disease is not susceptible to community |
| year by cardiovascular diseases. | | | | action |
| Myth 2: Heart disease is a problem of the rich | | | | The predominant factors contributing to the risk of |
| All societies include "early adopters" and "late | | | | cardiovascular diseases appear to be acquired, and to |
| adopters" of lifestyle changes. Early in the heart | | | | be lifestyle-related rather than genetic. Risk factors |
| disease epidemic, affluent people in developing | | | | can be modified within a "healthy environment" that |
| countries had the means and the opportunity to adopt | | | | supports appropriate lifestyle practices, and most |
| new lifestyles, involving behaviour such as choosing | | | | cardiovascular diseases are preventable. The |
| foods rich in fat and calories, buying cars and using | | | | prevention of heart diseases in individuals calls for the |
| tobacco. Since these goods have become affordable | | | | active promotion of health in populations. |
| for mass consumption "unhealthy" behaviour of this | | | | Programmes that combine community mobilization with |
| kind has become common across all social classes. | | | | governmental regulation through taxation, legislation and |
| Today, affluent people, especially the urban rich, have | | | | pricing policies have proved to be effective in |
| better access to health information concerning risk | | | | controlling tobacco and encouraging healthier diets in |
| factors in the media and they also possess the means | | | | numerous industrialized countries. From these |
| to modify their behaviour in favour of a healthier | | | | experiences, it is clear that community, national and |
| lifestyle (healthy diets, leisure-time physical activity, | | | | even global action are key elements in combating the |
| abstinence from tobacco). They constitute the "early | | | | advancing epidemic of cardiovascular diseases in the |
| adopters", while the urban poor and rural communities | | | | developing world. Community mobilization can best be |
| -- with limited access to information and little time or | | | | attained through educating the public, patients, |
| money for "healthy foods" and "fitness clubs" -- lag | | | | professionals and policymakers, based on the advice |
| behind. As a result, risky behaviour develops, and risk | | | | of health professionals. |
| factors increase. | | | | Myth 6: Heart disease is no longer a public health issue |
| Recent studies from Latin America and South-East | | | | There is a widespread mistaken belief that the total |
| Asia, where coronary heart disease is particularly | | | | burden of cardiovascular diseases is diminishing. |
| common, indicate that many coronary risk factors are | | | | Despite declining mortality, heart disease remains the |
| more prevalent among those with lower | | | | dominant public health problem in industrialized countries. |
| socioeconomic standing and that the poor are, indeed, | | | | Eastern European countries are at present |
| at higher risk of heart attacks. | | | | experiencing the highest mortality rates due to |
| In industrialized countries too, where the epidemic | | | | cardiovascular diseases. A major cause for concern is |
| began among the urban rich, though some decades | | | | the projected rise of these diseases in developing |
| earlier than in the developing world, cardiovascular | | | | countries in the next century. It is predicted that by |
| diseases are now more common in the relatively poor. | | | | 2020 the number of deaths due to heart attacks and |
| When the worldwide heart disease epidemic fully | | | | stroke in the developing world will have doubled as |
| develops, the poorest countries and the poorest | | | | compared with 1990. |
| people within society will be the worst affected. | | | | The reasons for this anticipated acceleration of the |
| Myth 3: Heart disease is mostly a man's disease | | | | epidemic are increasing life expectancy related to a |
| While coronary heart disease is, in general, less | | | | decline in infant mortality, unhealthy lifestyle changes |
| common in pre-menopausal women than in men, in | | | | related to industrialization and urbanization, and longer |
| many parts of the world it is the most common cause | | | | periods of exposure to the risk factors of heart |
| of death in women, even those aged under 65. Heart | | | | disease because of improved socioeconomic |
| disease, as well as its risk factors, varies to a | | | | conditions. |
| surprising degree between populations. For example, | | | | The public health consequences of an uncontrolled |
| women aged 35-64 years in Glasgow, Scotland, and in | | | | epidemic of cardiovascular diseases in the developing |
| Belfast, Northern Ireland, have higher heart attack rates | | | | world would be disastrous. Not only would millions of |
| than men in some parts of southern Europe, according | | | | productive years of life be lost, but the high costs of |
| to a recent WHO study on trends in cardiovascular | | | | technology-intensive management of these diseases |
| diseases (the WHO MONICA Project). | | | | would impose a heavy financial burden on affected |
| Hypertension and stroke are also major problems that | | | | individuals, their families and society as a whole. The |
| affect women. Given the longer life expectancy of | | | | global epidemic needs a global response now, in the |
| women, they contribute increasingly to cardiovascular | | | | form of an international effort to create awareness |
| deaths and disability after the sixth decade. The result | | | | and stimulate action in all countries and all sectors of |
| is that, over their entire lifespan, women and men are | | | | society. |