Coronary artery disease develops slowly, usually over a period of decades. Plaque, which is composed of fat, cholesterol, calcium and other substances, builds up on the artery walls over time.
Coronary artery disease can be hereditary, or it can develop over time from a poor diet and lack of exercise.
Heart disease is the #1 killer of women in the U.S. In fact, American women are 4 to 6 times more likely to die of heart disease than of breast cancer and it kills more women than all cancers combined.
Charles R. Lambert, MD is here to discuss what you can do to help prevent heart disease.
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Can You Prevent Heart Disease?
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Learn more about Charles R. Lambert, MD
Learn more about FloridaHeartExperts.org
Charles R. Lambert, MD
Charles R. Lambert, MD specializes in Cardiovascular Disease, Internal Medicine and Interventional Cardiology.Learn more about Charles R. Lambert, MD
Learn more about FloridaHeartExperts.org
Transcription:
Can You Prevent Heart Disease?
Melanie Cole (Host): Coronary artery disease is the most common type of heart disease. It’s the leading cause of death in the United States for both men and women. My guest today is Dr. Charles Lambert. He’s an interventional cardiologist with Florida Hospital. Welcome to the show, Dr. Lambert. Tell us about coronary artery disease and heart disease and why people don’t realize it’s the threat that it is.
Dr. Charles Lambert (Guest): Well, it’s very, very interesting. Coronary disease and heart disease, in general, is the number one killer in the U.S. and most of the world, all of the industrialized world in both men and women. It outshines the next five leading causes of death all together. So, one of your two closest friends is going to die of coronary artery disease, regardless. There are some simple things that people can do to dramatically lower their risk from coronary disease.
Melanie: First, let’s talk about the risk before we get into the prevention. What are some risk factors? Is there a genetic component? What are some risk factors that would let somebody know they are subject to this?
Dr. Lambert: Well, there are two kind of general classes of risk factors. There are things you can do something about and things that you can’t do anything about. As you just eluded to, you can’t do anything about who your parents are, so genetics and family history are a huge thing. You can’t do anything about that. There’s a whole category of risk factors that you can do something about. Those are things like activity and knowing your numbers – your blood pressure, your cholesterol, your body mass index, basically, if you’re at an appropriate weight and your glucose level.
Melanie: Your glucose level. People always here cholesterol level, Dr. Lambert, and they worry so much about cholesterol. It seems that we’re worrying less about that and more about inflammation. Tell us about the glucose level and why that’s involved in coronary artery disease.
Dr. Lambert: Well, a lot of people don’t know that they are what we used to call “pre-diabetic”. There’s an epidemic of obesity in the U.S., not only for adults but for kids as well. One of the things that comes along with that in the so-called “metabolic syndrome” is early diabetes. You don’t know it. It’s completely asymptomatic, so the only way you can find out is to measure fasting glucose. We use that as a screening factor these days. We didn’t used to do it. We just waited, but it’s just as important as know if you have high cholesterol.
Melanie: What glucose numbers are in the normal range?
Dr. Lambert: If you really want to screen somebody who is at high risk, you want to get a hemoglobin A1-C but a fasting glucose meaning, you haven’t eaten anything after midnight the night before you get the test, of less than 120 depending upon your age, your size, your weight, etc., is generally okay.
Melanie: So now, on to prevention. What do you tell people is the most important information--you’re a cardiologist--when people say to you, “Dr. Lambert, what can I do to reduce my risk, I’m nervous about heart disease?” What do you tell them?
Dr. Lambert: The most important thing, if you could do three things for the population of the United States, it would probably do more to alter risk than what we do in hospitals where we just sort of wait for people to get sick and come in, are very, very simple. They are all lifestyle things. Number one is physical activity. I know you’re an exercise physiologist. American College of Sports Medicine and other professional societies have long had recommendations for aerobic activity and the recent lifestyle guidelines from the American College of Cardiology echo those. Bottom line, without getting too scientific, if you get off the couch 3 to 4 to 5 times a week and exercise for 30 or 40 minutes, huge reduction in cardiovascular risk but it has to be a lifestyle thing. It has to be for the rest of your life. Even if you miss a few years, if you go back, you regain the benefit not only from risk factor reduction even from mortality reduction. So, that’s number one. Number two, which is sort of hand in hand with that is to control your diet and secondarily your weight. Everyone has heard about dietary recommendations, that DASH diet, this diet, that diet, it’s basically a diet that’s sort of Mediterranean. It’s high in non-animal products, high in vegetables, legumes, fiber and low in fats, in general--especially trans fats. So, those two things just diet and exercise and knowing the risk factors, just knowing the risk factors. If you do all those, your risk of cardiovascular disease goes down precipitously.
Melanie: Are there some screenings for cardiovascular disease, Dr. Lambert, that you like to tell people at a certain age? We get our colonoscopies, we get our mammograms. Are there certain screening tests for cardiovascular disease?
Dr. Lambert: We have so many tests you couldn’t list them all on this podcast but the bottom line is that testing needs to be done based upon risk. Our guidelines recently have changed to focus on risk. So, if you’re a high risk individual, if you’ve got a family history, if you’re overweight, if you’ve got a bad diet and you don’t exercise you need to be screened. There’s no set age but, for sure, when you’re into adulthood. So, if you’re 40 years old and high risk, you need to have a good physical examination and the numbers that I just suggested measured, especially cholesterol and glucose. If you’re in completely excellent health and running marathons and have no family history of cardiovascular disease, screening can be relaxed a little bit because the probability that you have that is low. It needs to be individualized but a good history and physical and screening exam at least by age 45 or 50 is what I recommend.
Melanie: What role does stress play in cardiovascular disease?
Dr. Lambert: Well, stress has made it into the recommendations for lifestyle change. So, it’s easy to say take stress out of your life. Unfortunately, most of us cannot do that. But, stress definitely has a role in cardiovascular disease. In garden variety prevention as well as just precipitation of acute events. Even heart attack--everybody’s probably heard of the broken heart syndrome or Takotsubo’s cardiomyopathy. Acute really high levels of stress can even cause or contribute to heart attacks. From a prevention point of view, avoiding stress, however you want to do that – exercise is a great way to lower stress levels. Some people meditate, people have all sorts of mechanisms to lower stress but very, very important.
Melanie: So, we’ve spoken about the dietary insight into its risk with cardiovascular disease. Some people don’t eat healthy, they don’t eat fish and they don’t eat the things that we know are good for us. What about vitamins and supplements? If you take Omega 3 or Vitamin D have any of these been shown to help reduce your risk?
Dr. Lambert: You know, there’s a lot of information out there and, obviously, people that make vitamins want you to take vitamins. Vitamins have been removed—as you know, there are different classes of recommendations for prevention of cardiovascular disease. If you’re in a Class 1 indication, that means that there are really high levels of scientific evidence meaning placebo controlled prospective randomized trials that whatever that intervention is indeed does do something scientifically. Big doses of vitamins for somebody that’s at low risk are really not in the guidelines now; however, there have been studies that have been shown that Omega 3’s help. There have really not been a lot of studies that are of high scientific evidence that high doses of vitamins should be taken by anybody. I would recommend against that. I basically have my own patients on a multi-vitamin, especially if they don’t eat right and I give them information about Omega 3’s and other supplements. In general, stay away from high dose supplements of any kind. Some of those can cause harm to not only cardiovascular issues but other organ systems. Common sense is the rule.
Melanie: It certainly is and how beautifully put. What a great speaker you are, Dr. Lambert. In just the last few minutes give your best advice for listeners on preventing heart disease and why they should come to Florida Hospital for their care.
Dr. Lambert: The best advice--I was just on a panel with Michael Strahan up in New York, and they asked exactly the same question. The best advice is don’t eat that thing in front of you, whatever it is because I got a feeling it’s going to be bad. Get off the couch and go out and exercise. I don’t really have any medical pill or anything like that as far as recommendations. Exercise, eat healthy, know your numbers. That’s the best advice I can give you. In terms of Florida Hospital, this is an organization that values wellness. It’s within and embedded in the culture here in the mission statement and, actually, in the whole Advantage Health system. We try to practice what we preach and, for people that interact with us, I think they will feel that.
Melanie: Thank you so much. It’s great information. You’re listening to Health Chats by Florida Hospital. For more information you can go to floridaheartexperts.org. That’s floridaheartexperts.org. This is Melanie Cole. Thanks so much for listening.
Can You Prevent Heart Disease?
Melanie Cole (Host): Coronary artery disease is the most common type of heart disease. It’s the leading cause of death in the United States for both men and women. My guest today is Dr. Charles Lambert. He’s an interventional cardiologist with Florida Hospital. Welcome to the show, Dr. Lambert. Tell us about coronary artery disease and heart disease and why people don’t realize it’s the threat that it is.
Dr. Charles Lambert (Guest): Well, it’s very, very interesting. Coronary disease and heart disease, in general, is the number one killer in the U.S. and most of the world, all of the industrialized world in both men and women. It outshines the next five leading causes of death all together. So, one of your two closest friends is going to die of coronary artery disease, regardless. There are some simple things that people can do to dramatically lower their risk from coronary disease.
Melanie: First, let’s talk about the risk before we get into the prevention. What are some risk factors? Is there a genetic component? What are some risk factors that would let somebody know they are subject to this?
Dr. Lambert: Well, there are two kind of general classes of risk factors. There are things you can do something about and things that you can’t do anything about. As you just eluded to, you can’t do anything about who your parents are, so genetics and family history are a huge thing. You can’t do anything about that. There’s a whole category of risk factors that you can do something about. Those are things like activity and knowing your numbers – your blood pressure, your cholesterol, your body mass index, basically, if you’re at an appropriate weight and your glucose level.
Melanie: Your glucose level. People always here cholesterol level, Dr. Lambert, and they worry so much about cholesterol. It seems that we’re worrying less about that and more about inflammation. Tell us about the glucose level and why that’s involved in coronary artery disease.
Dr. Lambert: Well, a lot of people don’t know that they are what we used to call “pre-diabetic”. There’s an epidemic of obesity in the U.S., not only for adults but for kids as well. One of the things that comes along with that in the so-called “metabolic syndrome” is early diabetes. You don’t know it. It’s completely asymptomatic, so the only way you can find out is to measure fasting glucose. We use that as a screening factor these days. We didn’t used to do it. We just waited, but it’s just as important as know if you have high cholesterol.
Melanie: What glucose numbers are in the normal range?
Dr. Lambert: If you really want to screen somebody who is at high risk, you want to get a hemoglobin A1-C but a fasting glucose meaning, you haven’t eaten anything after midnight the night before you get the test, of less than 120 depending upon your age, your size, your weight, etc., is generally okay.
Melanie: So now, on to prevention. What do you tell people is the most important information--you’re a cardiologist--when people say to you, “Dr. Lambert, what can I do to reduce my risk, I’m nervous about heart disease?” What do you tell them?
Dr. Lambert: The most important thing, if you could do three things for the population of the United States, it would probably do more to alter risk than what we do in hospitals where we just sort of wait for people to get sick and come in, are very, very simple. They are all lifestyle things. Number one is physical activity. I know you’re an exercise physiologist. American College of Sports Medicine and other professional societies have long had recommendations for aerobic activity and the recent lifestyle guidelines from the American College of Cardiology echo those. Bottom line, without getting too scientific, if you get off the couch 3 to 4 to 5 times a week and exercise for 30 or 40 minutes, huge reduction in cardiovascular risk but it has to be a lifestyle thing. It has to be for the rest of your life. Even if you miss a few years, if you go back, you regain the benefit not only from risk factor reduction even from mortality reduction. So, that’s number one. Number two, which is sort of hand in hand with that is to control your diet and secondarily your weight. Everyone has heard about dietary recommendations, that DASH diet, this diet, that diet, it’s basically a diet that’s sort of Mediterranean. It’s high in non-animal products, high in vegetables, legumes, fiber and low in fats, in general--especially trans fats. So, those two things just diet and exercise and knowing the risk factors, just knowing the risk factors. If you do all those, your risk of cardiovascular disease goes down precipitously.
Melanie: Are there some screenings for cardiovascular disease, Dr. Lambert, that you like to tell people at a certain age? We get our colonoscopies, we get our mammograms. Are there certain screening tests for cardiovascular disease?
Dr. Lambert: We have so many tests you couldn’t list them all on this podcast but the bottom line is that testing needs to be done based upon risk. Our guidelines recently have changed to focus on risk. So, if you’re a high risk individual, if you’ve got a family history, if you’re overweight, if you’ve got a bad diet and you don’t exercise you need to be screened. There’s no set age but, for sure, when you’re into adulthood. So, if you’re 40 years old and high risk, you need to have a good physical examination and the numbers that I just suggested measured, especially cholesterol and glucose. If you’re in completely excellent health and running marathons and have no family history of cardiovascular disease, screening can be relaxed a little bit because the probability that you have that is low. It needs to be individualized but a good history and physical and screening exam at least by age 45 or 50 is what I recommend.
Melanie: What role does stress play in cardiovascular disease?
Dr. Lambert: Well, stress has made it into the recommendations for lifestyle change. So, it’s easy to say take stress out of your life. Unfortunately, most of us cannot do that. But, stress definitely has a role in cardiovascular disease. In garden variety prevention as well as just precipitation of acute events. Even heart attack--everybody’s probably heard of the broken heart syndrome or Takotsubo’s cardiomyopathy. Acute really high levels of stress can even cause or contribute to heart attacks. From a prevention point of view, avoiding stress, however you want to do that – exercise is a great way to lower stress levels. Some people meditate, people have all sorts of mechanisms to lower stress but very, very important.
Melanie: So, we’ve spoken about the dietary insight into its risk with cardiovascular disease. Some people don’t eat healthy, they don’t eat fish and they don’t eat the things that we know are good for us. What about vitamins and supplements? If you take Omega 3 or Vitamin D have any of these been shown to help reduce your risk?
Dr. Lambert: You know, there’s a lot of information out there and, obviously, people that make vitamins want you to take vitamins. Vitamins have been removed—as you know, there are different classes of recommendations for prevention of cardiovascular disease. If you’re in a Class 1 indication, that means that there are really high levels of scientific evidence meaning placebo controlled prospective randomized trials that whatever that intervention is indeed does do something scientifically. Big doses of vitamins for somebody that’s at low risk are really not in the guidelines now; however, there have been studies that have been shown that Omega 3’s help. There have really not been a lot of studies that are of high scientific evidence that high doses of vitamins should be taken by anybody. I would recommend against that. I basically have my own patients on a multi-vitamin, especially if they don’t eat right and I give them information about Omega 3’s and other supplements. In general, stay away from high dose supplements of any kind. Some of those can cause harm to not only cardiovascular issues but other organ systems. Common sense is the rule.
Melanie: It certainly is and how beautifully put. What a great speaker you are, Dr. Lambert. In just the last few minutes give your best advice for listeners on preventing heart disease and why they should come to Florida Hospital for their care.
Dr. Lambert: The best advice--I was just on a panel with Michael Strahan up in New York, and they asked exactly the same question. The best advice is don’t eat that thing in front of you, whatever it is because I got a feeling it’s going to be bad. Get off the couch and go out and exercise. I don’t really have any medical pill or anything like that as far as recommendations. Exercise, eat healthy, know your numbers. That’s the best advice I can give you. In terms of Florida Hospital, this is an organization that values wellness. It’s within and embedded in the culture here in the mission statement and, actually, in the whole Advantage Health system. We try to practice what we preach and, for people that interact with us, I think they will feel that.
Melanie: Thank you so much. It’s great information. You’re listening to Health Chats by Florida Hospital. For more information you can go to floridaheartexperts.org. That’s floridaheartexperts.org. This is Melanie Cole. Thanks so much for listening.