What Is the Stigma of Heart Disease?

Reviewed by: HU Medical Review Board | Last reviewed: November 2019

Do you smoke? Are you overweight? Physically inactive? Eat a lot of fast food? If the answer is yes to one or more of these questions you may have felt pressure from friends or family to make some lifestyle changes.1 These characteristics are associated with poor health, heart disease, and the development of heart failure (HF). Some risk factors are easy to spot and others, like acute stress, high blood pressure, and high cholesterol may be present but invisible to family and friends. But they all can increase your chance of developing or exacerbating heart failure.1-3 In fact, HF can develop even if you are physically fit and eat a healthy diet.

Managing heart failure

Heart disease is the leading cause of death in the United States.4 Some kinds of heart failure can be prevented or at least well-managed. Medical problems associated with bad habits can be a source of personal concern and public ridicule.

People may feel anxious or afraid to tell their doctors, their family, or friends that they might have or do experience symptoms that could be related to heart failure.1 These early symptoms could include heart palpitations, shortness of breath, or swelling in their feet and ankles.1-2

Social stigma

Western society often creates an environment of social stigma that affects people who are obese, smokers, or perhaps perceived to be lazy. It can affect your social life, create prejudice at work, and lead to unfair treatment and discrimination.3-4

People who feel embarrassed about their physical state may delay treatment because they are fearful of what a doctor will say to them or just too uncomfortable to go in and have an open discussion. This cycle can result in stigmatized groups to be more susceptible to chronic diseases, including heart failure.3

Another area of stigma is that heart disease only affects old people. Although more common in our aging population, heart disease can affect anyone of any age. Some people are born with it. Heart failure is not just a condition that affects overweight people. You can develop HF even if you are physically fit and eat a healthy diet. Family history, genetics can also play a role in having HF. Even environmental factors can influence the onset of HF.4

Stigma influences care

The social stigma of obesity and smoking have influenced changing health habits in some people and increased isolation for others. For those with a good support system, a diagnosis of HF can help them set out to change their lifestyle; adjusting their diet resulting in weight loss, lowering cholesterol, increasing physical activity, and even quitting smoking if they were a smoker.

For others, a diagnosis of heart failure can leave them feeling that life is unfair, a sense of helplessness and concern for the future. Studies have shown that treatment adherence is more difficult for people with social limitations and unstable health.2

Managing the stigma related to heart failure

It’s hard enough to cope with your own diagnosis of heart failure but to have people blame you for the condition can make you feel worse and lead you to delay treatment. Self-blame is common, people know what kinds of decisions they could have made differently. But, having your friends and family tell you “I told you so” about what you eat, drink, or smoke can increase stress and make a difficult situation worse.2-4

Stigma can lead to increased stress, feelings of anger and shame - all of which can exacerbate heart failure. Self-blame can make it harder to practice good self-care. A key to heart failure management involves lifestyle changes. Support rather than blame may yield more effective results.2

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