From red wine to cholesterol: the 10 largest heart myths under the magnifying glass

In a world where information spreads faster than ever before, false facts and myths about our health are everywhere—and the heart is no exception. Few topics are as rife with misinformation and fake news as heart disease. From supposed miracle cures to misconceptions about cholesterol and lifestyle—many of these myths can not only be misleading but, in the worst cases, even life-threatening. With one in three people in Germany dying from cardiovascular disease, it is alarming how often dangerous half-truths further increase the risk instead of reducing it. It’s time to take a closer look at the biggest myths about the heart and use scientific facts to clarify what’s really true—because only with the right information can we effectively protect our hearts.

 

Myth: A glass of red wine a day is good for the heart

Positive effects of red wine on heart health with moderate consumption

• Red Wine and Heart Health: Recent studies show that moderate red wine consumption (up to one glass per day) may have positive effects on heart health. In particular, resveratrol and other polyphenols in red wine appear to have a protective effect on the cardiovascular system by exerting antioxidant and anti-inflammatory effects.

Negative effects of alcohol on the heart with excessive consumption

• Increased risk of cardiac arrhythmias: Recent studies show that even light to moderate alcohol consumption can increase the risk of atrial fibrillation. People with pre-existing cardiac arrhythmias should avoid alcohol as much as possible.

• Alcohol and high blood pressure: A systematic review has shown that alcohol consumption, regardless of the amount, is associated with elevated blood pressure and thus a higher risk of cardiovascular disease. This is particularly concerning for people who already have high blood pressure.

Effects of Alcohol on Existing Heart Conditions

• Heart Failure: In people with heart failure, alcohol consumption can lead to a worsening of the condition. Even moderate consumption can impair heart function, and an alcohol-free lifestyle is strongly recommended for patients with heart failure.

• Coronary Heart Disease (CHD): In people with existing CHD, alcohol consumption is a risk factor for sudden cardiac events such as heart attacks. A recent study shows that alcohol consumption in CHD patients should be closely monitored, and in many cases, complete abstinence may be advisable.

• Risks in heart disease: In people with existing heart conditions such as heart failure, atrial fibrillation, or CHD, even low alcohol consumption can increase the risk of further complications. The recommendation is therefore often to avoid alcohol or limit it significantly.
  

Myth: Cholesterol is always bad for the heart

Myth: Heart disease only affects older people

The myth that heart disease affects only older people is widespread but medically inaccurate. Heart disease can affect people of any age, even though the risk increases with age. Here are some scientifically sound reasons why heart disease does not affect only older people:

Lifestyle factors play a major role

Unhealthy habits, often developed at a young age, increase the risk of heart disease. These include:

• Unhealthy diet: A diet high in saturated fats, sugar, and salt can lead to atherosclerosis (narrowing of the arteries) even at a young age, which increases the risk of heart attacks and strokes.
• Lack of exercise: Physical inactivity contributes to obesity, high blood pressure, and high cholesterol—all risk factors for heart disease.
• Smoking: Adolescents who start smoking at an early age expose themselves to a significantly higher risk of heart disease, as nicotine and other harmful substances damage the cardiovascular system.

Rising prevalence of obesity and diabetes among young people

Obesity and type 2 diabetes are increasingly common even among younger people. Both conditions are closely linked to the risk of heart disease:

• Obesity leads to high blood pressure, high cholesterol, and insulin resistance, which strain the heart and increase the risk of heart disease.
• Diabetes damages the blood vessels and the heart, which can lead to heart attacks or strokes even at a young age.

Genetic factors

Heart disease can also be genetic and affect young people, even if they lead a healthy lifestyle. Genetic risk factors include:

• Familial hypercholesterolemia: A genetic disorder that leads to extremely high cholesterol levels can cause atherosclerosis and heart attacks even at a young age.
• Congenital heart defects: Some people are born with heart defects that can lead to serious heart problems over the course of their lives.

Stress and Mental Health

Chronic stress, which is becoming increasingly common even among younger people today, can increase the risk of heart disease. Stress can cause high blood pressure and encourage unhealthy behaviors such as excessive alcohol consumption, smoking, or an unhealthy diet, all of which put a strain on the cardiovascular system.

Heart Disease in Young Athletes

Even seemingly healthy young people, especially athletes, can be affected by heart disease. Some conditions, such as hypertrophic cardiomyopathy (thickening of the heart muscle) or arrhythmias, can lead to heart failure without warning, particularly during physical exertion.

Myth: Men are more affected by heart disease than women

The myth that men are more affected by heart disease than women is widespread but misleading. In fact, both men and women are affected by heart disease, though with different manifestations and risk profiles. The assumption that heart disease is primarily a “male problem” can lead to the risk being underestimated in women—which can have serious consequences. Here are some medical facts that debunk this myth:

Heart disease is the leading cause of death among women

Heart disease is one of the leading causes of death among women worldwide, just as it is among men. Studies show that cardiovascular disease leads to death more frequently in women than, for example, breast cancer. The assumption that women are less frequently affected leads to the risk often being underestimated—both by those affected and by doctors.

Different symptoms in women and men

Heart disease often manifests differently in women than in men. While men frequently experience classic symptoms such as severe chest pain (angina pectoris), women often suffer from less specific symptoms such as:

• Shortness of breath
• Nausea or vomiting
• Back pain or jaw pain
• Fatigue and weakness

These differences in symptoms often lead to heart disease in women being diagnosed later or even overlooked. Delayed diagnosis can increase the risk of serious complications, including heart attack and death.

Protection from hormones—but only up to a certain age

Before menopause, women have a lower risk of heart disease than men due to the protective effects of estrogen. Estrogen helps regulate cholesterol levels and keep blood vessels flexible. After menopause, however, this protection declines rapidly, and the risk of heart disease rises sharply in women, in some cases reaching the same or even higher levels than in men.

Risk factors affect women differently

Certain risk factors, such as high blood pressure, diabetes, and smoking, often have more serious effects on heart health in women than in men. For example, diabetes increases the risk of coronary heart disease more in women than in men. Additionally, women are more susceptible to stress and depression, which further increases their risk of heart disease.

An Underestimated Danger: Microangiopathy

Women are more likely than men to suffer from a specific form of coronary heart disease known as microangiopathy. In this condition, it is not the large coronary arteries but the small blood vessels that are affected. This form of heart disease is often more difficult to diagnose, as it is not always detected during standard examinations such as coronary angiography.

Delayed Treatment in Women

Women tend to ignore their symptoms for longer and seek medical help later than men. This can result in them not receiving timely treatment for heart attacks or other acute heart problems. Additionally, there is evidence that women are sometimes treated less aggressively than men when it comes to the diagnosis and treatment of heart disease.

Myth: A heart attack is always accompanied by severe chest pain

• The myth that a heart attack is always accompanied by severe chest pain is widespread but misleading. While chest pain is a common symptom of a heart attack, heart attacks do not always present this way. Especially in women, older adults, and people with diabetes, the symptoms may be different or less typical. Here are the reasons why this myth is not true:

Atypical Symptoms of a Heart Attack

• Not every heart attack presents with the classic, severe chest pain. Many people—especially women and older adults—experience so-called “atypical” symptoms instead, which can easily be overlooked or misinterpreted. These may include:

  • Shortness of breath: Many people experience shortness of breath without necessarily having chest pain.
  • Nausea and vomiting: These symptoms are often not associated with a heart attack, especially in women.
  • Weakness or extreme fatigue: Some people report sudden, unexplained exhaustion that occurs for no apparent reason.
  • Pain in other parts of the body: Heart attacks can cause pain in the back, neck, jaw, or arms without the chest being directly affected.

"Silent heart attack"

• In some cases, a heart attack can even go completely unnoticed. This so-called “silent heart attack” often occurs without the typical symptoms and is frequently only discovered during subsequent medical examinations, such as an ECG. Such heart attacks occur more frequently in older adults and people with diabetes, as their ability to feel pain may be impaired.

Differences Between Women and Men

Women often experience different symptoms during a heart attack than men. While men often have the classic, intense chest pain, women are more likely to report nonspecific symptoms such as:

• A feeling of pressure or tightness in the chest that isn’t necessarily perceived as pain
• Pain in the upper abdomen, which can be misinterpreted as digestive problems
• Dizziness or sudden nausea

These differences often lead to heart attacks in women being recognized later or misinterpreted, which can delay their treatment.

Myth: People with heart problems should take it easy and avoid exercise

Exercise and physical activity play a central role in the prevention and treatment of heart disease. Regular exercise not only improves heart health but can also help slow the progression of existing heart disease and improve quality of life.

Exercise with Existing Heart Conditions

Even with existing heart disease, you can Physical activity—provided it is performed under medical supervision—can be safe and effective. Exercise helps strengthen the heart, especially in patients with stable heart failure or those who have had a heart attack. Benefits include:

• Improved heart function: The heart becomes more efficient, leading to improved endurance and performance.
• Strengthening of the heart muscle: A stronger heart muscle can pump more effectively and thus supply the body with oxygen more efficiently.
• Better oxygen uptake: The body is better supplied with oxygen, which increases exercise capacity.

Recommended sports

For people with heart disease, moderate endurance activities such as walking, cycling, swimming, or light aerobics are ideal. These sports strengthen the heart without overloading it. Moderate-intensity strength training can also be beneficial for strengthening muscles and improving physical endurance.

Important Precautions

Although exercise is beneficial for many people with heart disease, they should always consult a doctor before starting an exercise program. Some important precautions:

• Watch for warning signs: If you experience symptoms such as chest pain, shortness of breath, dizziness, or an irregular heartbeat, stop exercising immediately and see a doctor.

• Regular checkups: People with heart disease should undergo regular medical examinations to ensure that their exercise program remains safe and effective.

• Overloading the heart: Intense physical exertion can lead to overloading of the heart muscle in people with heart disease. This can trigger dangerous complications such as arrhythmias, heart attacks, or sudden cardiac death. Intense physical exertion poses a particular risk for patients suffering from unstable angina or advanced heart failure (see NYHA classification).

• Inadequate adaptation of the exercise program: Scientific studies show that the exercise program for heart patients must be individually tailored. A “one-size-fits-all” approach does not work here, as exercise tolerance varies from patient to patient. Particularly in cases of heart failure, depending on the NYHA stage, the exercise program must be highly customized and medically supervised.

• Risks of an Insufficient Warm-up: Studies have shown that suddenly starting intense activities without an adequate warm-up places additional strain on the heart. A slow and gradual introduction to physical activity is crucial to avoid overtaxing the cardiovascular system.

Myth: Low-fat diets are the best prevention against heart disease

• The myth that low-fat diets are the best prevention against heart disease has been increasingly debunked in recent years. In the past, it was often recommended to reduce fat intake in general to lower the risk of heart disease. However, modern research shows that the type of fat is more important than the amount.

Good Fats vs. Bad Fats:

• Unsaturated fats, found in nuts, seeds, avocados, olive oil, and fatty fish, are good for the heart. They can lower LDL cholesterol (bad cholesterol) and raise HDL cholesterol (good cholesterol), which reduces the risk of heart disease.
• Saturated fats and trans fats, found in processed foods, fried foods, and fatty meats, increase the risk of cardiovascular disease. These fats can raise LDL cholesterol levels and promote inflammation.
   

Low-fat diets are not always heart-healthy:

Studies have shown that low-fat diets often lead to higher consumption of carbohydrates, particularly refined carbohydrates such as sugar and white flour. These carbohydrates can raise blood sugar levels and lead to insulin resistance, which increases the risk of heart disease and type 2 diabetes​(

The Mediterranean diet as a model:

The Mediterranean diet, which is rich in unsaturated fats from olive oil, nuts, and fish, is now considered one of the healthiest diets for preventing heart disease. Studies have shown that this diet can significantly reduce the risk of heart disease, stroke, and overall mortality

 

Myth: Low blood pressure is always healthy

Contrary to the myth, low blood pressure is not always healthy or beneficial; rather, it can be a health risk. It becomes particularly problematic when accompanied by a serious underlying condition. To monitor your blood pressure and its trends, we recommend owning your own blood pressure monitor . In addition, it is advisable to have your heart rate monitored by a doctor via an ECG to detect cardiac conditions early.

Dizziness and fainting: If blood pressure is too low, not enough blood reaches the brain, which can lead to dizziness, lightheadedness, or even fainting. This often occurs when standing up quickly (orthostatic hypotension) or during sudden changes in position.

• Exhaustion and weakness: The muscles and organs may not be receiving enough oxygen, leading to fatigue, exhaustion, and a general feeling of weakness. The heart also often has to work harder to circulate blood throughout the body.

• Cold sweats and paleness: Peripheral blood flow—that is, blood flow to the outer parts of the body such as the hands and feet—can be restricted when blood pressure is low, leading to cold extremities and pale skin.

• Vision problems: Due to the reduced blood supply to the brain, Symptoms such as blurred vision, seeing "stars," or "blackouts" may occur.

Myth: Only overweight people are at high risk for heart disease

• Even slim people can be at high risk for heart disease, especially if they have other risk factors such as smoking, high blood pressure, or high cholesterol levels.

Statement on the myth: "Only overweight people suffer from heart disease"

This myth is false and misleading. Although being overweight is a known risk factor for heart disease, people with a normal or even low body weight are not automatically protected from heart disease. 

Cardiovascular risk factors independent of weight

There are several risk factors that can cause heart disease, regardless of body weight:

• Genetic predisposition: Family history and genetic factors play a significant role in heart disease. A person may have an increased risk despite being of normal weight if heart disease runs in the family.

• Cholesterol and high blood pressure: People with a normal weight can still have high LDL cholesterol levels (“bad cholesterol”) or high blood pressure, both of which are major risk factors for heart disease.

• Smoking: Smoking damages blood vessels and increases the risk of atherosclerosis and heart attacks, regardless of body weight.

• Diabetes: Diabetes significantly increases the risk of heart disease, and there are many people of normal weight who have type 2 diabetes.

• Stress and lack of exercise: A stressful lifestyle and lack of exercise can lead to heart problems, regardless of weight.

"Metabolically Obese Normal Weight" (MONW)

There is a term called "Metabolically Obese Normal Weight" (MONW) that describes people who, although they have a normal body weight, still exhibit risk factors for heart disease, such as insulin resistance, high blood pressure, high triglyceride levels, and low HDL cholesterol.

These people have an increased risk of cardiovascular disease, even though they appear slim on the outside.

Possible heart conditions in people of normal weight

• Atrial fibrillation: Even people of normal weight are susceptible to cardiac arrhythmias such as atrial fibrillation.
• Heart attacks: Studies show that up to 25% of heart attacks occur in people with a normal BMI.

Heart disease results from a combination of several factors, including genetics, lifestyle, blood pressure, cholesterol levels, diabetes, and smoking. While being overweight increases the risk, even people of normal weight are not protected from heart disease. Therefore, it is important to regularly monitor blood pressure, cholesterol levels, and blood sugar and to maintain a healthy lifestyle, regardless of body weight.

Myth: Heart disease is inevitable if it runs in the family

The myth that heart disease is inevitable if it runs in the family is widespread, but medically incorrect. While genetic predisposition plays a role in the development of heart disease, many other factors also influence an individual’s risk. Here are the main reasons why this myth is false

Genetics is only one piece of the puzzle

• Genetic predisposition can increase the risk of certain heart conditions, such as coronary heart disease or heart attack. However, genetics alone do not determine one’s fate. Factors such as lifestyle, diet, and exercise have a significant influence on whether a genetic predisposition actually manifests as a disease.

Modifiable Risk Factors

Many risk factors for heart disease are modifiable. These include:

• High blood pressure: Lifestyle changes such as exercise, a healthy diet, and stress management can often lower blood pressure.
• High cholesterol: A balanced diet and medications such as statins can help control cholesterol levels.
• Smoking: Quitting smoking significantly reduces the risk.
• Diabetes: Diabetes can be managed or even prevented through weight management, a healthy diet, and physical activity.
• Lack of exercise: Regular exercise strengthens the heart and significantly reduces the risk of heart disease.

Epigenetics and environmental influences

Science shows that lifestyle factors and environmental influences can have an epigenetic effect. This means they influence how genes are turned on or off. A healthy lifestyle can therefore influence the activity of genes that increase the risk of heart disease.

Early Detection and Prevention

Modern medical techniques make it possible to identify risk factors early on. Regular health checkups can help address issues such as high blood pressure or high cholesterol in a timely manner. With appropriate measures, even people with a family history of heart disease can significantly reduce their risk.

Psychosocial Factors

Stress, lack of sleep, and emotional strain can also contribute to heart disease. By consciously addressing these factors—for example, through stress management or a healthy work-life balance—the risk can be further minimized.