Cheryl Martin (Host): Heart disease is the leading cause of death for men and women here in the United States, according to the Centers for Disease Control and Prevention, CDC. But in many cases, heart disease can be prevented. Coming up, you'll learn ways to achieve long-term heart health and more from Dr. Sara Tabtabai. She's the Regional Director of Heart Failure and Population Health at Hoffman Heart and Vascular Institute.

Host: This is Transforming Your Health, the podcast from Trinity Health of New England. I'm Cheryl Martin. Dr. Tabtabai, thanks for being on.

Dr. Sara Tabtabai: Thank you so much for having me.

Host: So, the first question, what are the common risks for cardiovascular disease?

Dr. Sara Tabtabai: So when we think about someone's risk for developing heart disease over the lifetime, the common things that you'll hear us thinking about as physicians are high blood pressure, diabetes, genetics, so if a person has an early family history of heart disease. And those are sort of the main things that we look for when we're trying to assess someone's risk for developing heart disease down the line.

Host: So, how can we prevent cardiovascular disease?

Dr. Sara Tabtabai: So when we are counseling our patients to decrease their risk of developing heart disease over their lifetime, we ask them to focus on some of those risk factors that I had mentioned. So, for example, knowing your blood pressure and working to make sure that it is normal or treating high blood pressure, knowing whether or not you are developing diabetes or have diabetes and keeping your blood sugar numbers controlled, thinking about things like your family history and whether or not you are at higher risk and then paying more focus to some of these other ways that we can minimize our risk.

The other one to think about is cholesterol. So as our cholesterol increases, we have a higher risk for developing heart disease. So, really knowing those numbers meaning your blood pressure, cholesterol, diabetes numbers, or blood sugar, and trying to minimize those or keep them in the normal range as much as possible or, if you have those issues, managing them and keeping them as best controlled as possible will decrease your risk for developing heart disease.

Host: And how do you do that?

Dr. Sara Tabtabai: So, seeing your doctor regularly, and what we say is this phrase of know your numbers. So, know what your blood pressure is and know if you have high blood pressure. If your blood pressure is high, talk with your doctor about how you can decrease your blood pressure or keep it well controlled. Do you need diet changes? Do you need exercise? Medications are often prescribed. Similarly for something like diabetes. So know if you have diabetes. Many folks are walking around with diabetes, they've never had their numbers checked, so know that number. Know your blood sugar number or your hemoglobin A1c and ask your doctor to help you interpret that. If it's high, often initially, we can think about dietary or lifestyle changes or medications to help keep those blood sugar numbers well controlled. And same goes for cholesterol. So again, know your numbers when it comes to cholesterol. Get your blood checked, talk with your doctor about what those cholesterol numbers mean for you, and do you need to make any changes or start on any medications that can help keep those controlled.

Host: That's great advice. So, what then are the signs or symptoms of cardiovascular disease and are they different for men versus women?

Dr. Sara Tabtabai: So, the signs and symptoms of cardiovascular disease that we often counsel folks on are the more clear ones or things that people will often think of when they think of heart disease. So, chest pain or chest pressure shortness of breath. Be aware, sometimes chest pain or pressure can happen with activity and then improve or go away when someone's resting. So, that's an important thing to tune into. Also, you can have chest pain or pressure just at rest, and that could signal something like a heart attack occurring. So, those are the the common or classically better known symptoms. Other symptoms to be aware of are things like racing heart or palpitations, dizziness, passing out, pain that is radiating or moving from the chest down the arm or up into the jaw as well.

And when we think about potential gender differences between males and females, that may present a little bit differently with their heart disease symptoms. Commonly, what's been described is that women may have more of what we call non-specific symptoms. So, not the classic chest pressure, something sitting on your chest sensation, but more stomach concerns, nausea, abdominal discomfort or gastrointestinal reflux-type of symptoms that can also be thought to be more from something like reflux, but can actually indicate cardiovascular disease in women. I have seen men present that way as well, so it's not completely exclusive to women, but just something be aware of that women may present more often with some of those less specific signs or symptoms.

Host: So if someone is experiencing these symptoms, what should they do?

Dr. Sara Tabtabai: So if you are experiencing symptoms of chest pain or pressure, that is a reason to present to the emergency room or to your doctor to be evaluated, especially if that is brand new, that is not going away or it's happening at rest or when I say you're just kind of minding your own business. Some people do have what we call chronic chest pain or angina where they're walking and exerting themselves. They may feel chest pressure that goes away with resting. That, if that's something new for you, still needs to be evaluated but may be less of an emergency. And some people do live with that issue, but it needs to be checked out by your physician. Certainly ,things like racing, heart, dizziness, passing out, those are other reasons to present either to your primary doctor to get evaluated or depending on the urgency to the emergency room.

Host: So in all of these cases, do you call 911 immediately? And how do you determine that if this is something new for you?

Dr. Sara Tabtabai: Right. It can be very scary. It can be hard to know. I will say most of the time, if you are calling your doctor's office with chest pain that's new, they are going to divert you to the emergency room, which is very much appropriate, so that if you are having a heart attack, you can get the care that you need right away. Same goes for things like passing out, that is possible, that they may direct you to the emergency room. But something like having a sensation of racing heart that you're not feeling dizzy, not passing out with that is something that you can contact your primary doctor with. But often, chest pain, pressure, that's going to be directed towards the emergency room, again so you can get the carry you need right away.

Host: Now, talk to us please about what patients can expect from their experience if they choose Trinity Health of New England's Hoffman Heart and Vascular Institute.

Dr. Sara Tabtabai: What patients can expect from their experience with us at Trinity Health is a what we call multidisciplinary approach to care. So, we have very highly skilled physicians as well as physician assistants, nurse practitioners and other affiliated health members that work together as a team to help take care of our patients. We have multiple different facets of cardiovascular care that we can offer to our patients. So, I am the director of the Heart Failure Program where we offer advanced heart failure care. We have a very high level interventional and structural cardiac program. We have a women's heart program. We have a rehab center. We have high level imaging. So, we really have aspects of all the type of cardiovascular care that a patient may need. And we really focus on taking care of the patient's needs and interacting to help them feel safe, comfortable, and well cared for.

Host: Sounds like a really comprehensive program. So, what's the best way to get more information?

Dr. Sara Tabtabai: So, folks can go online at trinityhealthofne.org/heart to get more information about our multidisciplinary cardiovascular program and what might be right for them.

Host: All right, Dr. Sara Tabtabai, thanks so much for educating us on the risk factors for heart disease, as well as on the ways to prevent it as well as your program. Thanks so much.

Dr. Sara Tabtabai: Thank you so much for having me.

Host: To learn more, just go online to trinityhealthofne.org/heart. That's trinityhealthofne.org/heart. And if you found this information helpful, please share it with others, especially on your social media. Thanks for listening to the Transforming Your Health Podcast.