Selected Podcast
Risk Factors of Coronary Artery Disease
Dr. Ahmad Hadid discusses Coronary Artery Disease, the risk factors involved, and possible ways to prevent it.
Featured Speaker:
Dr. Hadid completed a fellowship in Cardiology and a fellowship in Interventional Cardiology at Westchester Medical Center, where he was also the Chief of Cardiology Fellows. Dr. Hadid is Board Certified in Interventional Cardiology, Nuclear Cardiology, Cardiology and Internal Medicine.
Ahmad Hadid, MD
Dr. Ahmad B. Hadid is an interventional cardiologist. He graduated from Damascus University in Damascus, Syria where he achieved the academic excellence award. He completed his internal medicine residency at Our Lady of Mercy Medical Center in the Bronx, NY and was awarded the most Outstanding Resident of the Year award, the Best Teaching Award of the Year and the Best Leadership Award of the Year.Dr. Hadid completed a fellowship in Cardiology and a fellowship in Interventional Cardiology at Westchester Medical Center, where he was also the Chief of Cardiology Fellows. Dr. Hadid is Board Certified in Interventional Cardiology, Nuclear Cardiology, Cardiology and Internal Medicine.
Transcription:
Risk Factors of Coronary Artery Disease
Alyne Ellis (Host): Coronary artery disease, for some, it may come as a surprise when the serious symptoms emerge, but the truth is the problems that caused this have been building inside us for years. Welcome to Doc Talk presented by Montefiore St. Luke's Cornwall. I'm Alyne Ellis. Here to tell us about the risk factors that set up heart problems and what we can do about them is Interventional Cardiologist, Dr. Ahmad Hadid. Welcome.
Ahmad Hadid, MD (Guest): Thank you.
Host: Let's begin with an explanation please of what is coronary artery disease.
Dr. Hadid: So, coronary artery disease is what's known as hardening of the arteries. A normal heart have arteries that sit on top of the heart, provide enough of blood for the muscle to work regularly. When a plaque build up inside those arteries causes what's called hardening of the arteries, at one point, can lead to lack of a blood coming to this muscle. It led to some symptoms, what we called angina, or heart attack.
Host: And let's go over some of the risk factors for this beginning with both having high LDL and low HDL. And that surprised me that both of those might cause problems. Is that correct?
Dr. Hadid: That's absolutely right. So, as we know, there are several health conditions and risk factors can lead to, what we call hardening of the artery or coronary artery disease. One of the major risk factors, which we called high cholesterol or hyperlipidemia. The cholesterol is a waxy fat like substance made by the liver or found in certain food.
So, the liver make enough for our body needs and the other source that the cholesterol come from is from the food that we eat. When that is imbalance and there's extra cholesterol, this cholesterol can build up in the walls of the artery, including those of the heart. And this will lead to narrowing of the arteries and decrease the blood flow to the heart. And some other major organs like the brain, kidney and other parts of the body. There is two main types of the blood cholesterol. LDL, or what's known as low density lipoprotein. It's considered the bad cholesterol because that's the one that causes the built up plaque in the arteries. HDL is called high density lipoprotein considered to be the good cholesterol. As a matter of fact, it's a protection against heart disease. So, what we will need, we need to lower the LDL and make the HDL higher.
Host: Could you go over the numbers for me of when we get our blood tests on that, what is considered the right number for LDL and the right number for HDL?
Dr. Hadid: Again, high cholesterol usually have no sign or symptoms. And the only way to know whether you have high cholesterol is to get your cholesterol checked. We do fasting blood work called lipid profile, fasting lipid profile. And when we get these lab work, there is no one number fit everybody because depending on the patient risk factors, this is where we have to see what's our optimum number. In general, our total cholesterol numbers should be below 200. LDL, preferably to be below 100. Patient who had higher risk factor or they are diabetic, or have heart disease, we really strive to get their LDL lower as low as below 70. And we like the HDL above 40. And if it's higher, definitely it's better.
Host: Now you mentioned other risk factors, and I assume one of those might be high blood pressure.
Dr. Hadid: So, high blood pressure is a major risk factor for heart disease. Basically it's a medical condition that happens when the pressure of the blood in your arteries and other vessels is too high. If the blood pressure is not well controlled, that can lead to major damage in the organs. Again, the major organs like the heart, the kidney and the brain. High blood pressure is often called the silent killer because it usually has no symptoms. And the only way to know whether you have high blood pressure is to measure your blood pressure during your yearly physical exam, or on your own. A normal blood pressure we like it to be below 140/80. 140 is the systolic blood pressure, 80 is the diastolic blood pressure and definitely lower blood pressure, lots of other committees like to have the blood pressure lower than that, preferably to be below 130/80.
Host: And let's move on to some of the other risk factors like diabetes and obesity.
Dr. Hadid: Diabetes is a major risk factor for heart disease. Diabetes is when the blood sugar starts to build up in the blood and can lead to more plaque in the arteries and more blockages. As a matter of fact, we know now that the risk of having complications from heart disease and death is higher in patients who are diabetic. So, we consider diabetes a major risk of heart disease. Usually we do a fasting blood sugar to make sure that the blood sugar is normal. The normal value is around 100. The other important number what's called hemoglobin A1C. That's an average blood sugar number for 90 days, preferrably to be below 6.5%,
Host: And as far as obesity is concerned, I've always heard that if you have a fat around the middle in particular, that that's not good.
Dr. Hadid: That's absolutely right. So, obesity is the excess body fat. It's linked to higher bad cholesterol that we talked about earlier, the LDL and the triglyceride level. And also it will lead to lower good cholesterol, the HDL. So, obesity can lead also to high blood pressure, diabetes, and that's how it will increase the chance of having heart disease. So, it's very important to have a healthy lifestyle, a regular exercise program, and talk to your doctor about the best way to treat your obesity.
Host: And finally, I guess the most common one that really can set things off in addition to everything else is smoking.
Dr. Hadid: You're absolutely right. So, tobacco use is one of the major risk factor for having heart disease. We know that cigarette smoking can damage the heart and the blood vessels and increase the risk of atherosclerosis or hardening of the arteries what we call coronary artery disease and heart attacks. Also nicotine can increase the blood pressure. Not only smokers have increased risk of heart disease. We know now that even secondhand smoker, they have increased risk of having heart disease. So, definitely quit smoking is very important in preventing heart disease.
Host: So, our risk also just increases with age, like for example, post-menopausal women or men who are getting older. If you could talk a little about that.
Dr. Hadid: So, heart disease can happen definitely at any age. But definitely the risk of developing coronary artery disease or atherosclerosis goes up with the age.
Host: And it's interesting to talk to you because then we've got this sort of silent problem in a way, which is the family history. And you could be, if I understand this correctly, many of these factors could be in pretty good shape, but if your family history is there, then need to know about that.
Dr. Hadid: It's pretty important. So, definitely when you talk to your physician and especially if you have a what we call a strong family history of premature heart disease, that's a significant risk factor. So, as you mentioned, I always sometimes see some patients who are in very good shape. They do everything the right way. They're very concerned because they have a strong family history of heart disease, somebody in their family developed heart disease or blockage in their arteries in young age. This particular area requires definitely more research. In general, we know that our genes pass from one generation to the other and genetic factors likely play some role in high blood pressure, heart disease. So, if any patient has a strong family history of heart disease, a brother or a sister who have heart disease in a mid-age, that definitely will increase his risk of having heart disease.
Host: So, how often do you recommend that a patient who doesn't have a family history, get these tests that you've talked about for cholesterol and blood pressure and diabetes?
Dr. Hadid: At least once a year during yearly exam, should have fasting lipid profile, fasting glucose test, check the blood pressure and discuss their risk factor for disease and try to prevent any further problem. We know now that the promoting healthy lifestyle, healthy diet, exercise, losing weight, no smoking, all this will decrease the chance of having coronary artery disease significantly.
Host: And for somebody who, for whatever reason, isn't as motivated as, they might be on their own. What's your advice?
Dr. Hadid: Definitely. I will always remind them an ounce of prevention is worth a pound of cure. And they should explore their risk of heart disease. At least what's recommended by the American Heart Association, walking 15 to 20 minutes, normal walk every day. That's a good way of starting.
Host: And is that fairly fast walking?
Dr. Hadid: A brisk walk.
Host: And how does that help since we're talking about our arteries and I know that it helps the heart as the heart muscle, but it also does that help to clear out our arteries when we walk faster?
Dr. Hadid: It's really the way just we know that exercise, it will help to decrease the chance of developing the risk factors of heart disease. So, it will help us to lose weight. It will help our cholesterol to go down. It helps the blood sugar to go down. So it will, will control this risk factor more than fixing the blockage itself.
Host: Anything else you'd like to add, sir.
Dr. Hadid: Again, I cannot emphasize more that an ounce of prevention is worth a pound of cure. And it's the time now to explore all your risks of heart disease and work on it and good luck.
Host: Well, thank you very much for all the information. You've described these tests, in a way that makes it very understandable. And I really appreciate it.
Dr. Hadid: Thank you very much.
Host: Dr. Ahmad Hadid is an Interventional Cardiologist at Montefiore St. Luke's Cornwall Hospital. I'm Alyne Ellis. Thanks for listening to this episode of our Doc Talk podcast. Head on over to our website at Montefioresic.org for more information and to get connected to one of our providers. And if you found this podcast helpful, please share it on your social channels and be sure to check back in soon for the next podcast. Thank you for listening.
Risk Factors of Coronary Artery Disease
Alyne Ellis (Host): Coronary artery disease, for some, it may come as a surprise when the serious symptoms emerge, but the truth is the problems that caused this have been building inside us for years. Welcome to Doc Talk presented by Montefiore St. Luke's Cornwall. I'm Alyne Ellis. Here to tell us about the risk factors that set up heart problems and what we can do about them is Interventional Cardiologist, Dr. Ahmad Hadid. Welcome.
Ahmad Hadid, MD (Guest): Thank you.
Host: Let's begin with an explanation please of what is coronary artery disease.
Dr. Hadid: So, coronary artery disease is what's known as hardening of the arteries. A normal heart have arteries that sit on top of the heart, provide enough of blood for the muscle to work regularly. When a plaque build up inside those arteries causes what's called hardening of the arteries, at one point, can lead to lack of a blood coming to this muscle. It led to some symptoms, what we called angina, or heart attack.
Host: And let's go over some of the risk factors for this beginning with both having high LDL and low HDL. And that surprised me that both of those might cause problems. Is that correct?
Dr. Hadid: That's absolutely right. So, as we know, there are several health conditions and risk factors can lead to, what we call hardening of the artery or coronary artery disease. One of the major risk factors, which we called high cholesterol or hyperlipidemia. The cholesterol is a waxy fat like substance made by the liver or found in certain food.
So, the liver make enough for our body needs and the other source that the cholesterol come from is from the food that we eat. When that is imbalance and there's extra cholesterol, this cholesterol can build up in the walls of the artery, including those of the heart. And this will lead to narrowing of the arteries and decrease the blood flow to the heart. And some other major organs like the brain, kidney and other parts of the body. There is two main types of the blood cholesterol. LDL, or what's known as low density lipoprotein. It's considered the bad cholesterol because that's the one that causes the built up plaque in the arteries. HDL is called high density lipoprotein considered to be the good cholesterol. As a matter of fact, it's a protection against heart disease. So, what we will need, we need to lower the LDL and make the HDL higher.
Host: Could you go over the numbers for me of when we get our blood tests on that, what is considered the right number for LDL and the right number for HDL?
Dr. Hadid: Again, high cholesterol usually have no sign or symptoms. And the only way to know whether you have high cholesterol is to get your cholesterol checked. We do fasting blood work called lipid profile, fasting lipid profile. And when we get these lab work, there is no one number fit everybody because depending on the patient risk factors, this is where we have to see what's our optimum number. In general, our total cholesterol numbers should be below 200. LDL, preferably to be below 100. Patient who had higher risk factor or they are diabetic, or have heart disease, we really strive to get their LDL lower as low as below 70. And we like the HDL above 40. And if it's higher, definitely it's better.
Host: Now you mentioned other risk factors, and I assume one of those might be high blood pressure.
Dr. Hadid: So, high blood pressure is a major risk factor for heart disease. Basically it's a medical condition that happens when the pressure of the blood in your arteries and other vessels is too high. If the blood pressure is not well controlled, that can lead to major damage in the organs. Again, the major organs like the heart, the kidney and the brain. High blood pressure is often called the silent killer because it usually has no symptoms. And the only way to know whether you have high blood pressure is to measure your blood pressure during your yearly physical exam, or on your own. A normal blood pressure we like it to be below 140/80. 140 is the systolic blood pressure, 80 is the diastolic blood pressure and definitely lower blood pressure, lots of other committees like to have the blood pressure lower than that, preferably to be below 130/80.
Host: And let's move on to some of the other risk factors like diabetes and obesity.
Dr. Hadid: Diabetes is a major risk factor for heart disease. Diabetes is when the blood sugar starts to build up in the blood and can lead to more plaque in the arteries and more blockages. As a matter of fact, we know now that the risk of having complications from heart disease and death is higher in patients who are diabetic. So, we consider diabetes a major risk of heart disease. Usually we do a fasting blood sugar to make sure that the blood sugar is normal. The normal value is around 100. The other important number what's called hemoglobin A1C. That's an average blood sugar number for 90 days, preferrably to be below 6.5%,
Host: And as far as obesity is concerned, I've always heard that if you have a fat around the middle in particular, that that's not good.
Dr. Hadid: That's absolutely right. So, obesity is the excess body fat. It's linked to higher bad cholesterol that we talked about earlier, the LDL and the triglyceride level. And also it will lead to lower good cholesterol, the HDL. So, obesity can lead also to high blood pressure, diabetes, and that's how it will increase the chance of having heart disease. So, it's very important to have a healthy lifestyle, a regular exercise program, and talk to your doctor about the best way to treat your obesity.
Host: And finally, I guess the most common one that really can set things off in addition to everything else is smoking.
Dr. Hadid: You're absolutely right. So, tobacco use is one of the major risk factor for having heart disease. We know that cigarette smoking can damage the heart and the blood vessels and increase the risk of atherosclerosis or hardening of the arteries what we call coronary artery disease and heart attacks. Also nicotine can increase the blood pressure. Not only smokers have increased risk of heart disease. We know now that even secondhand smoker, they have increased risk of having heart disease. So, definitely quit smoking is very important in preventing heart disease.
Host: So, our risk also just increases with age, like for example, post-menopausal women or men who are getting older. If you could talk a little about that.
Dr. Hadid: So, heart disease can happen definitely at any age. But definitely the risk of developing coronary artery disease or atherosclerosis goes up with the age.
Host: And it's interesting to talk to you because then we've got this sort of silent problem in a way, which is the family history. And you could be, if I understand this correctly, many of these factors could be in pretty good shape, but if your family history is there, then need to know about that.
Dr. Hadid: It's pretty important. So, definitely when you talk to your physician and especially if you have a what we call a strong family history of premature heart disease, that's a significant risk factor. So, as you mentioned, I always sometimes see some patients who are in very good shape. They do everything the right way. They're very concerned because they have a strong family history of heart disease, somebody in their family developed heart disease or blockage in their arteries in young age. This particular area requires definitely more research. In general, we know that our genes pass from one generation to the other and genetic factors likely play some role in high blood pressure, heart disease. So, if any patient has a strong family history of heart disease, a brother or a sister who have heart disease in a mid-age, that definitely will increase his risk of having heart disease.
Host: So, how often do you recommend that a patient who doesn't have a family history, get these tests that you've talked about for cholesterol and blood pressure and diabetes?
Dr. Hadid: At least once a year during yearly exam, should have fasting lipid profile, fasting glucose test, check the blood pressure and discuss their risk factor for disease and try to prevent any further problem. We know now that the promoting healthy lifestyle, healthy diet, exercise, losing weight, no smoking, all this will decrease the chance of having coronary artery disease significantly.
Host: And for somebody who, for whatever reason, isn't as motivated as, they might be on their own. What's your advice?
Dr. Hadid: Definitely. I will always remind them an ounce of prevention is worth a pound of cure. And they should explore their risk of heart disease. At least what's recommended by the American Heart Association, walking 15 to 20 minutes, normal walk every day. That's a good way of starting.
Host: And is that fairly fast walking?
Dr. Hadid: A brisk walk.
Host: And how does that help since we're talking about our arteries and I know that it helps the heart as the heart muscle, but it also does that help to clear out our arteries when we walk faster?
Dr. Hadid: It's really the way just we know that exercise, it will help to decrease the chance of developing the risk factors of heart disease. So, it will help us to lose weight. It will help our cholesterol to go down. It helps the blood sugar to go down. So it will, will control this risk factor more than fixing the blockage itself.
Host: Anything else you'd like to add, sir.
Dr. Hadid: Again, I cannot emphasize more that an ounce of prevention is worth a pound of cure. And it's the time now to explore all your risks of heart disease and work on it and good luck.
Host: Well, thank you very much for all the information. You've described these tests, in a way that makes it very understandable. And I really appreciate it.
Dr. Hadid: Thank you very much.
Host: Dr. Ahmad Hadid is an Interventional Cardiologist at Montefiore St. Luke's Cornwall Hospital. I'm Alyne Ellis. Thanks for listening to this episode of our Doc Talk podcast. Head on over to our website at Montefioresic.org for more information and to get connected to one of our providers. And if you found this podcast helpful, please share it on your social channels and be sure to check back in soon for the next podcast. Thank you for listening.