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Heart disease is the leading cause of death. Why don't more U.S. adults know that?

A colorful image of a heart inside a chest, replete with arteries
The American Heart Association says some common myths can lead people to believe that heart disease is no big deal or that they aren’t at risk. (iStock/Getty Images Plus)

Despite being the nation’s biggest killer for 100 years, more than half of adult Americans don’t know that heart disease is the leading cause of death in the U.S., according to a new survey published on Wednesday by the American Heart Association (AHA).

In a 2023 Harris Poll survey conducted on behalf of the AHA, 51% of U.S. adults failed to identify heart disease as the leading cause of death nationwide. The survey also found that 18% of people erroneously named cancer as the leading cause of death, while 16% said they didn’t know, and 49% correctly identified heart disease.

“Heart disease” can refer to several types of heart conditions, but the most common in the U.S. is coronary artery disease, which affects blood flow and can lead to a heart attack. The AHA says there are about 1,905 deaths from heart disease each day in the United States, including heart attacks, and someone in the U.S. will have a heart attack about every 40 seconds.

Why the misconception?

Dr. Wayne Rosamond, a professor with the UNC Gillings School of Global Public Health's department of epidemiology, tells Yahoo Life he can see why some people might not know that heart disease is the leading cause of death.

"People are exposed to such a large volume of health related information from so many sources," he says. "The important message that heart disease is still a big risk in our communities and that there are things we can do to prevent and treat it sometimes gets lost."

The AHA says there are some common myths that can lead people to believe that heart disease is no big deal or that they aren’t at risk. For example, many Americans don’t realize that heart disease isn’t just for older adults; young and middle-aged adults can also develop heart problems, and plaque can start building up in the arteries as early as childhood and adolescence.

Dr. Abha Khandelwal, an associate professor of cardiovascular medicine at Stanford University, says education around heart disease needs to start much earlier.

"Our current healthcare infrastructure finances and supports individuals once they are already sick or manifest disease," she tells Yahoo Life. "This is the phase where most of the dollars are spent, and education happens towards secondary prevention. I believe awareness must start much earlier in fact. Awareness campaigns should start as early as childhood even kindergarten."

Some people may also be in danger of a deadly heart-related incident and not even know it. High blood pressure, aka “the silent killer,” may not present any symptoms and can lead to heart attack, stroke or kidney damage if left untreated. And a heart attack doesn’t necessarily present itself as a dramatic incident with severe chest pain; it can also involve some seemingly harmless symptoms like shortness of breath or lightheadedness.

Dr. Sanjiv Shah, a professor of cardiology at Northwestern University Feinberg School of Medicine, tells Yahoo Life he isn't surprised by the AHA survey's findings. "Death due to heart disease often happens quickly," he says, "so it may not come to mind like death due to cancer." While treatments for heart disease have come a long way in recent decades, Shah says many cancers are still difficult to treat, which "may result in the misperceptions about the leading causes of death."

Dr. William Borden, interim chair of medicine at the George Washington University School of Medicine and Health Sciences tells Yahoo Life: "It’s disappointing to learn that so much more education is needed about the threat of heart disease in this country. That’s the bad news." He adds: "The good news is that we know the causes of heart disease, and we have really effective ways to prevent heart attacks and strokes. … As we near February, American Heart Month, hopefully this survey will be a wake-up call to further spread the word about the great tools we all have to fight heart disease."

What puts you at risk for heart disease?

There are several factors that can increase the likelihood of having heart disease.

  • Preexisting conditions. Having diabetes, high blood pressure or unhealthy blood cholesterol levels or being overweight can up your chances of developing heart disease.

  • Lifestyle. Smoking, excess drinking, not getting enough exercise or eating an unhealthy diet can put you at greater risk of heart disease.

  • Age. Your risk of heart disease increases as you get older — though it can develop at any time.

  • Family history. Having a male relative under 55 with heart disease or a female relative under 65 with heart disease can also increase your risk.

What can you do about it?

Some things like age and family history, including a propensity for things like high blood pressure or high cholesterol, are out of your control. However, there are still several steps you can take to reduce your risk.

  • Stop smoking. Fortunately, you don’t need to wait long to start seeing the benefits of quitting tobacco; the risk of heart disease begins to drop as soon as a day after you stop smoking.

  • Prioritize sleep. Not getting at least seven hours of sleep each night can increase your risk of high blood pressure and heart attack.

  • Eat healthy. Consume plenty of fresh fruits and vegetables, fish and lean meats, whole grains and healthy fats, and steer clear of foods that are highly processed or high in salt or sugar.

  • Exercise. You should aim for 30 to 60 minutes of physical activity a day, which can include anything from full-on workouts to simple acts like walking and taking the stairs.

You should also be on the lookout for signs of heart disease. Some common symptoms include arrhythmia (a fluttering feeling in the chest), chest pain, shortness of breath or fatigue or swelling of the feet, ankles, legs, abdomen or neck.