The Tribune

By DR ANTONIO LEWIS CAMARGO, MD

Specialist in Cardiology, Heart Failure and Transplantation Cardiology, Cleveland Clinic

This week is Chronic Disease Awareness Day - but what are chronic diseases and how should you be making sure you are ready to deal with them if you or your family are affected? Dr Antonio Lewis Camargo, of the Cleveland Clinic, answers your questions.

1. What are chronic diseases, and where does heart disease fit among the most common chronic conditions affecting adults today?

Chronic diseases are conditions that persist for a year or longer, require ongoing medical care, or limit daily activities, think diabetes, arthritis, chronic lung disease, and heart disease.

Heart disease sits at the very top of that list. It's not one condition but a family of them: coronary artery disease, heart failure, arrhythmias, valve disease. Together, they make cardiovascular disease the single leading cause of death worldwide, and in the US it kills more people every year than cancer and accidents combined.

2. What characteristics make heart disease a chronic condition, and how does it differ from an acute cardiovascular event such as a heart attack?

Heart disease usually builds quietly for decades, plaque accumulating in an artery wall, heart muscle gradually stiffening, long before anyone feels a symptom. A heart attack is the acute moment when that slow process erupts: a plaque ruptures, a clot forms, and blood flow to part of the heart muscle is suddenly cut off. The heart attack is the headline; the chronic disease is the story that was writing itself for years beforehand.

3. Why is cardiovascular disease considered one of the greatest public health challenges worldwide?

The scale is staggering. In the US, someone dies of cardiovascular disease roughly every 34 seconds, close to a million Americans a year. And it's not just a disease of old age anymore: roughly 1 in 6 cardiovascular deaths now occur in adults younger than 65. Add in the cost, hundreds of billions of dollars annually in care and lost productivity, and you have a condition that reshapes families, workplaces, and health systems all at once.

4. What are the major risk factors for developing heart disease and other cardiovascular conditions?

Some risks are fixed, age, family history, and genetics. But most of the burden comes from factors you can influence high blood pressure, high cholesterol, diabetes, smoking, excess weight, inactivity, poor sleep, and chronic stress. High blood pressure alone affects nearly half of US adults, making it the single most common driver of cardiovascular risk in the country. Risk factors don't just add up, they multiply each other's damage, so tackling even one meaningfully lowers overall risk.

5. What role do healthy eating, regular physical activity, stress management, quality sleep, and other lifestyle habits play in preventing heart disease?

The American Heart Association groups the core protective habits into what it calls "Life's Essential 8": eating well, staying active, not smoking, sleeping enough, and controlling weight, cholesterol, blood pressure, and blood sugar. Diet patterns like Mediterranean or DASH remain the best-studied for heart protection, not because of any single "superfood," but because of the overall pattern: vegetables, whole grains, fish, olive oil, and less processed food and added sugar. None of these habits work in isolation; they reinforce each other.

6. What warning signs or symptoms may indicate an underlying heart condition, and when should someone seek medical attention?

Chest pain or pressure is the classic warning sign, but heart disease doesn't always announce itself that way, especially in women, who more often present with fatigue, shortness of breath, nausea, or jaw or back discomfort instead of textbook chest pain. Palpitations, unexplained swelling in the legs, and fainting are also worth a call to your doctor. Sudden or severe symptoms, crushing chest pain, difficulty breathing, one-sided weakness, mean call 911, not "wait and see."

7. How does early detection and diagnosis of heart disease influence treatment options, long-term outcomes, and quality of life?

Catching heart disease early is the difference between managing risk and managing damage. A person identified with high blood pressure or early plaque buildup has dozens of tools available, lifestyle change, medication, closer monitoring, that can stop progression in its tracks. Wait until symptoms force the issue, and the options narrow to procedures and higher-risk interventions. Early detection isn't just about living longer; it's about staying active and independent longer.

8. What are some of the most common myths or misconceptions about heart disease that people should be aware of?

The biggest one: that heart disease is an "old person's disease." The biological process plaque quietly building in artery walls, can begin in the teens and twenties, decades before any diagnosis. A close second is the myth that it's mainly a man's disease; cardiovascular disease kills roughly as many women as men, and it's still the leading cause of death for women in the US. And because conditions like high blood pressure and high cholesterol rarely cause symptoms, "I feel fine" is one of the least reliable ways to judge your heart health, numbers matter more than how you feel.

9. Many heart conditions can be managed but not cured. What strategies help patients successfully live with chronic cardiovascular disease and reduce their risk of complications?

Consistency beats intensity. Take medications as prescribed, keep follow-up appointments, and treat blood pressure, cholesterol, and blood sugar as numbers to track, not abstractions. Layer on the same lifestyle habits that prevent heart disease in the first place, diet, movement, sleep, stress management, no tobacco, and learn your own early warning signs so you can act on changes quickly rather than waiting for a crisis. Living well with heart disease is less about heroic effort and more about steady maintenance.

10. In recognition of Chronic Disease Awareness Month, what recommendations would you give to help people reduce their risk of heart disease and maintain a healthy heart throughout their lives?

Know your numbers, blood pressure, cholesterol, blood sugar, weight, the way you'd know your bank balance, and review them with your doctor regularly rather than waiting for a wake-up call. Build a heart-healthy plate most days, move your body most days, protect your sleep, and keep stress and tobacco use in check. None of this requires perfection. The evidence is consistent that small, sustained changes, a daily walk, one fewer processed meal a week, a blood pressure check you actually schedule, compound into real protection over a lifetime.