People's ideas about causes

The causes of heart failure are complex (see 'What causes it' and 'Other causes'). Those who have a family history of heart disease, those who smoke, are overweight or have diabetes are more likely to develop heart disease than those who do not. Many of the men and women we talked to were aware that diet and smoking were possible causes, but put forward many other theories including stress (see 'Stress and heart failure'), shift work, pollution, viruses, too much exercise, growing old, getting angry, and also bad luck. A doctor with heart failure said he found it unhelpful to dwell on the question “why”?

Finds it unhelpful to speculate about causes of heart failure.

Many had mixed feelings about whether smoking should be blamed for their heart failure, for instance some said that though they had smoked in the past, they had stopped years before their heart failure started. Others, though smoking at the time of diagnosis, thought other things like stress and shift work were more important. Several said that some doctors blamed smoking for everything, and one man thought he was misdiagnosed with emphysema because he was a smoker. Others said that they had connected smoking with cancer rather than heart disease until they became ill.

How smoking and working shifts affected his heart.

Describes how smoking affected doctors trying to make a diagnosis.

He gave up smoking after his heart attack.

High levels of cholesterol in the blood may mean that you have a greater chance of developing heart disease. Cholesterol levels may be reduced to some extent by eating less fat and exercising more regularly, and also by cholesterol-lowering drugs called statins. Many people knew that having a high cholesterol level in the blood was a risk and had taken steps to change their diet. Some found it difficult to give up fatty foods, for instance one man said that he had been in the habit of eating a lot of animal fat since his childhood, and another said that it was hard to avoid a high fat diet because of his cultural background. He also thought he should be have been prescribed statins earlier on in his treatment. Another person said that knowing your cholesterol level could be unhelpful unless it could be changed, and that it might cause more worry than reassurance.

Reflects on his childhood eating and smoking habits.

His cultural background makes it difficult to alter his diet and lower his cholesterol levels.

Many people said they were told that their heart failure could be the result of a virus, and several thought that other factors were also involved. For instance one woman had been told that a virus may have caused her heart failure, but she thought she and her mother might have had the same pattern of illness. Several were confused about inheriting heart disease and couldn't explain it. Some people thought that if you had inherited heart disease there was very little you could do to combat it.

Thinks her heart failure may have been caused by a virus or her genetic inheritance.