Heart disease: myths and facts.

The three major risk factors of heart disease are smoking, an elevated blood cholesterol level, and high blood pressure. Because there are so many myths floating around concerning these risk factors, heart disease remains as the leading cause of death in the United States. Controlling the risk factors takes knowledge and determination, and one of the first steps is separating myths from facts.

MYTH: Cigarettes are hazardous to your heart only if you smoke.

FACT: The truth is, living or working with a smoker may also place your heart at risk. New data suggests that passive smoking, or inhaling someone else's smoke, may potentially lead to heart disease. Even if you are not personally bothered by inhaling smoke, it may be healthier for you to sit in nonsmoking sections. If you do not have designated "no smoking" areas at work, lobby to create some.

MYTH: If people have smoked for up to 20 years or more, it's too late to quit.

FACT: Actually, as soon as you stop smoking you start to reverse some of the changes that have occurred in your lungs. Doctors say that if you quit smoking for one year, you reduce your risk of developing heart disease by 50 percent. After 10 years you can reduce your risk to that of a nonsmoker.

MYTH: If a food product is labeled "no cholesterol," it's healthy for your heart.

FACT: Just because an item is marked "no cholesterol" doesn't necessarily mean that the item is fat-free. The key to watch for is the cholesterol and fat content of foods. Avoid fried foods. Cook with unsaturated vegetable oils instead of butter. Substitute skim-milk products for whole-milk counterparts. When recipes call for eggs, replace one egg with two egg whites to cut out the cholesterol.

MYTH: If you have a cholesterol level of 230 or higher, you will definitely have heart disease.

FACT: A cholesterol level greater than 200 does not necessarily mean you will have heart disease. If your cholesterol level is above 200, you should see a physician and have a complete cholesterol screening. The test will provide information on the breakdown of the HDL to LDL cholesterol. The HDL cholesterol, or high-density lipoprotein, is protective to the heart, while the LDL cholesterol, or low-density lipoprotein, may be responsible for increasing your risk for heart disease. Exercising often, following a low-fat diet, and maintaining proper weight are ways to increase the HDL or good cholesterol.

MYTH: A person with hypertension will be tense or stressed out.

FACT: It's true that fear and anger, for example, can raise blood pressure, but it drops back to its prior level in most people. And some studies indicate that psychological and social stress may contribute to chronic hypertension. But hypertension is seen in people who have no problem whatsoever with stress. Most cases are related to family history.

MYTH: If I feel fine, I shouldn't have to worry about having my blood pressure checked.

FACT: Hypertension is called the silent killer because in most cases the person affected experiences no symptoms at all. It's important for you to get annual screenings, either at your doctor's office or at a local blood pressure screening program. If your blood pressure level is more than 140/90, you should see a physician for advice. Your treatment may include medication and/or a low-fat diet, a low-salt diet, or other changes, such as quitting smoking, losing weight, and getting more exercise.