Heart Disease: Causes and Prevention

• A. Cancer
• B. Cardiovascular disease ✓
• C. Respiratory infections
• D. Diabetes

Why: Cardiovascular disease, including heart attacks and strokes, is the leading cause of death globally, responsible for roughly a third of all deaths according to the World Health Organization.

• A. Arrhythmia
• B. Atherosclerosis ✓
• C. Angina
• D. Myocarditis

Why: Atherosclerosis is the progressive buildup of plaque made of cholesterol, fat, and other substances within artery walls, which narrows the arteries and restricts blood flow.

• A. Age over 40
• B. Family history of heart disease
• C. Smoking tobacco ✓
• D. Being male

Why: Smoking damages the blood vessels, raises blood pressure, and promotes plaque formation. Unlike age, sex, or family history, smoking is a modifiable risk factor that can be eliminated.

• A. Hormones
• B. Oxygen and nutrients ✓
• C. Electrolytes only
• D. Insulin

Why: The coronary arteries supply the heart muscle itself with oxygen-rich blood and nutrients. When these arteries are blocked, the heart muscle can be starved of oxygen, causing chest pain or a heart attack.

• A. Eating large meals less often
• B. Regular physical activity ✓
• C. Drinking more coffee
• D. Sleeping fewer hours each night

Why: Regular physical activity strengthens the heart, helps control weight, blood pressure, and cholesterol, and improves blood sugar regulation, all of which reduce the risk of heart disease.

• A. Age
• B. Cigarette smoking ✓
• C. Family history of heart disease
• D. Male sex

Why: Cigarette smoking is a major modifiable risk factor because individuals can choose to quit. Age, family history, and sex are non-modifiable risk factors that cannot be changed.

• A. Increasing blood oxygen levels
• B. Thinning the walls of the heart chambers
• C. Promoting plaque buildup in the arteries ✓
• D. Lowering blood pressure directly

Why: LDL, often called 'bad' cholesterol, deposits in artery walls and contributes to atherosclerosis, the buildup of plaque that narrows and hardens arteries.

• A. Physical inactivity
• B. High dietary sodium intake
• C. Being over 65 years old ✓
• D. Excess body weight

Why: Advancing age is a non-modifiable risk factor because it cannot be changed. Physical inactivity, high sodium intake, and excess body weight are all modifiable through lifestyle changes.

• A. Reducing the heart's need for oxygen
• B. Causing the arteries to become more elastic
• C. Placing excessive force on artery walls, causing injury over time ✓
• D. Eliminating plaque from artery walls

Why: Sustained high pressure stresses artery walls, causing small injuries that promote plaque formation and stiffening, and it forces the heart to work harder.

• A. Iron deficiency
• B. Metabolic syndrome ✓
• C. Vitamin D sufficiency
• D. Low resting heart rate

Why: Metabolic syndrome, a cluster of conditions including abdominal obesity, high blood pressure, high blood sugar, and abnormal cholesterol levels, significantly raises the risk of both type 2 diabetes and cardiovascular disease.

• A. Monounsaturated fat
• B. Saturated fat ✓
• C. Polyunsaturated fat
• D. Omega-3 fatty acids

Why: Saturated fats, commonly found in red meat, butter, and full-fat dairy, tend to raise LDL cholesterol. Replacing them with unsaturated fats is a key dietary strategy for heart health.

• A. White bread
• B. Oats ✓
• C. Fried chicken
• D. Potato chips

Why: Oats contain beta-glucan, a soluble fiber that binds cholesterol in the digestive tract and helps reduce its absorption into the bloodstream.

• A. Eat as much salt as you like since it does not affect the heart
• B. Keep sodium intake below about 2,300 mg per day and ideally lower ✓
• C. Consume at least 5,000 mg of sodium daily
• D. Only limit sodium if you already have a diagnosed condition

Why: Major health guidelines recommend limiting sodium to under about 2,300 mg daily, with lower targets beneficial for many adults, because excess sodium raises blood pressure, a major heart disease risk factor.

• A. A diet high in refined sugars and processed meats
• B. The Mediterranean diet, rich in vegetables, fruits, whole grains, legumes, nuts, and olive oil ✓
• C. A diet consisting mainly of fried foods and sugary drinks
• D. A diet that eliminates all fats and carbohydrates

Why: The Mediterranean diet emphasizes whole plant foods and healthy fats, and it has substantial research support for reducing cardiovascular events.

• A. They raise HDL cholesterol and lower LDL cholesterol
• B. They raise LDL cholesterol and lower HDL cholesterol, increasing heart disease risk ✓
• C. They have no effect on cholesterol but add calories
• D. They strengthen blood vessel walls

Why: Trans fats raise harmful LDL cholesterol while lowering protective HDL cholesterol, a combination that significantly increases the risk of coronary heart disease. They are often found in partially hydrogenated oils and some baked or fried foods.

• A. No more than 30 minutes of activity per week
• B. At least 150 minutes of moderate-intensity aerobic activity ✓
• C. Only strength training, with no aerobic exercise
• D. Exercise only on weekends, for at least 8 hours total

Why: Major health guidelines recommend at least 150 minutes per week of moderate-intensity aerobic activity (or 75 minutes of vigorous activity), spread across several days, to support cardiovascular health.

• A. Sleeping while lying in bed
• B. Brisk walking, where you can talk but not sing ✓
• C. Sitting at a desk all day
• D. Standing still while waiting in line

Why: Moderate-intensity activity raises your heart rate and breathing noticeably while still allowing you to hold a conversation. Brisk walking is a classic example.

• A. It raises resting blood pressure permanently
• B. It strengthens the heart muscle and improves its efficiency ✓
• C. It causes the arteries to narrow
• D. It decreases the body's ability to use oxygen

Why: Regular aerobic exercise strengthens the heart muscle, allowing it to pump more blood per beat, and helps lower resting heart rate and blood pressure, while improving cholesterol profiles.

• A. Feeling slightly out of breath while climbing stairs
• B. Mild muscle soreness the next day
• C. Chest pain, pressure, or tightness during activity ✓
• D. A slightly elevated heart rate during a brisk walk

Why: Chest pain, pressure, or tightness during exercise can signal reduced blood flow to the heart and requires stopping activity and seeking prompt medical evaluation. Mild breathlessness and soreness are typically normal responses to exercise.

• A. It burns the most calories of any part of a workout
• B. It gradually raises heart rate and blood flow, reducing strain on the heart ✓
• C. It eliminates the need for cooling down afterward
• D. It permanently increases maximum heart rate

Why: A warm-up gradually increases heart rate, blood pressure, and blood flow to working muscles, allowing the cardiovascular system to adjust safely before higher-intensity exertion.

• A. Less than 120/80 mm Hg ✓
• B. 130/85 mm Hg
• C. 140/90 mm Hg
• D. 160/100 mm Hg

Why: Normal blood pressure is less than 120 systolic and less than 80 diastolic. Readings from 130/80 upward are classified as hypertension under current guidelines, so 130/85 and above are not normal.

• A. Oxygen to body tissues
• B. Cholesterol from the liver to body cells ✓
• C. Cholesterol from body cells back to the liver
• D. Digestive enzymes to the intestines

Why: LDL (low-density lipoprotein) carries cholesterol from the liver to cells throughout the body. High LDL levels can lead to plaque buildup in artery walls, which is why it is often called 'bad' cholesterol.

• A. Eating more sodium-rich foods
• B. Reducing sodium intake and increasing physical activity ✓
• C. Drinking more caffeinated beverages
• D. Avoiding all forms of exercise

Why: Reducing salt intake and getting regular physical activity both help lower blood pressure. Excess sodium causes the body to retain fluid, raising pressure in the blood vessels, while exercise strengthens the heart and improves vessel flexibility.

• A. Bad cholesterol
• B. Good cholesterol ✓
• C. Dietary cholesterol
• D. Triglyceride cholesterol

Why: HDL (high-density lipoprotein) is called 'good' cholesterol because it carries cholesterol from the arteries back to the liver for removal. Higher HDL levels are generally associated with lower heart disease risk.

• A. They have no connection to each other
• B. High levels of both increase the risk of atherosclerosis and heart disease ✓
• C. Only cholesterol affects the heart
• D. Only blood pressure affects the heart

Why: High blood pressure damages artery walls, and high cholesterol contributes to plaque buildup in those damaged areas. Together they greatly accelerate atherosclerosis, raising the risk of heart attack and stroke, so managing both reduces overall risk more effectively.

• A. Nicotine
• B. Carbon monoxide ✓
• C. Tar
• D. Ammonia

Why: Carbon monoxide binds to hemoglobin far more strongly than oxygen does, forming carboxyhemoglobin. This reduces the oxygen delivered to the heart and other tissues and makes the heart work harder.

• A. It thickens the lining and makes vessels more flexible.
• B. It damages the endothelium, promoting plaque buildup and narrowing of arteries. ✓
• C. It has no effect on the endothelium.
• D. It only affects veins, not arteries.

Why: Smoking damages the endothelium, the inner lining of blood vessels. This damage makes it easier for cholesterol and inflammatory cells to build up as plaque, which narrows and stiffens the arteries.

• A. Binge drinking several times a week
• B. Up to one drink per day for women and up to two drinks per day for men ✓
• C. Four or more drinks daily
• D. Drinking only on weekends in large amounts

Why: Guidelines define moderate drinking as up to one drink per day for women and up to two for men. Heavy drinking and binge drinking are linked to high blood pressure, arrhythmias, and cardiomyopathy, so exceeding these limits raises heart risk.

• A. It lowers blood pressure permanently.
• B. It causes repeated release of stress hormones like cortisol and adrenaline, which can raise blood pressure and heart rate and promote unhealthy behaviors. ✓
• C. It has no link to cardiovascular health.
• D. It only affects mental health, not the heart.

Why: Chronic stress repeatedly activates the body's stress response, raising blood pressure, heart rate, and inflammation. Stress is also linked to behaviors such as poor eating, smoking, and inactivity, all of which increase cardiovascular risk.

• A. Switching to light cigarettes
• B. Cutting back gradually without quitting completely
• C. Quitting smoking completely ✓
• D. Smoking only outdoors

Why: Quitting smoking completely is one of the most effective ways to lower heart disease risk. Risk begins to drop within a few years of quitting and continues to decline over time, while partial measures like light cigarettes provide little real protection.

• A. Sudden improvement in appetite
• B. Chest discomfort or pressure that lasts more than a few minutes or goes away and returns ✓
• C. Increased energy levels during exercise
• D. Persistent itching of the skin on the hands

Why: Chest discomfort described as pressure, squeezing, or fullness that lasts several minutes or comes and goes is one of the most common warning signs of a heart attack. Anyone experiencing it should seek emergency care promptly.

• A. Ringing in the ears only when lying down
• B. Shortness of breath, nausea, or unusual fatigue ✓
• C. Dry, flaky skin on the elbows
• D. Frequent sneezing in the morning

Why: Women and some older adults may experience shortness of breath, nausea, vomiting, back or jaw pain, and extreme fatigue rather than classic chest pain. Recognizing these atypical symptoms can lead to faster treatment.

• A. Eating large meals less frequently
• B. Avoiding all forms of physical activity to reduce strain
• C. Regular aerobic exercise, such as brisk walking for at least 150 minutes per week ✓
• D. Drinking several cups of energy drinks daily

Why: Regular moderate aerobic activity strengthens the heart, helps control blood pressure and cholesterol, and reduces the risk of heart disease. Health guidelines commonly recommend about 150 minutes of moderate activity per week.

• A. Blood type only
• B. LDL ("bad") cholesterol level ✓
• C. Platelet color
• D. Body temperature after meals

Why: High levels of LDL cholesterol contribute to plaque buildup in the arteries, a major cause of coronary artery disease. Regular lipid testing helps guide prevention and treatment decisions.

• A. Switch to chewing tobacco instead
• B. Reduce smoking to only on weekends
• C. Quit smoking completely, and seek support if needed ✓
• D. Smoke only after meals

Why: Smoking damages blood vessels, raises blood pressure, and promotes clot formation. Quitting completely offers the greatest and fastest reduction in heart disease risk, and support programs or medications can help.