Scott Webb (Host): There's never a bad time to talk about heart health with an expert. And I'm joined today by Dr. Elliot Brown, board-certified cardiologist, and he's here today to discuss the most common cardiovascular diseases, the importance of early detection, and more.

Welcome to Conversations Like No Other, Heart Care, presented by the Heart and Vascular Institute of Valley Health System in Paramus, New Jersey. Our podcast goes beyond broad everyday cardiac topics to discuss very real and very specific subjects that impact your heart health. We think you'll enjoy our fresh take. I'm Scott Webb. Thanks for listening.

Doctor, it's so nice to have you here today. We're kind of going to do a heart health 101. We're going to discuss the most common cardiovascular diseases, symptoms, risk factors, importance of early detection, all that good stuff. So, let's just start there. What are the most common cardiovascular diseases and how do they typically present in most patients?

Dr. Elliot Brown: Well, thanks for having me, Scott. And I think that's a great kickoff question. Without being directly related to the heart itself, I think to a general audience, I would say one of the most common cardiovascular diseases would be high blood pressure or hypertension. And I open up with that because it has no symptoms. You would not know it unless you checked and took a blood pressure, and it can do a lot of damage. It's called the silent killer. And so, from a cardiac standpoint, when this goes unchecked, it can lead to a lot of disorders.

But from a primary cardiac standpoint, the number one cause of death of all men and women in this country is cardiovascular disease, and the leader is coronary disease, or blockages that causes heart attacks, require stents, or bypasses.

Many people are familiar with, you know, Cardiomyopathy, that affects athletes or weak heart muscle in adults. common disorder would be electrical or arrhythmia. Most commonly, many people out there know something called AFib or atrial fibrillation. So, these would be a large population of what a cardiologist sees and comes through our office on a daily basis.

Host: Yeah. I've heard experts like yourself kind of break this down that, you know, when it comes to the heart, there's like plumbing issues, there's electrical issues, you know, kind of dumbing it down a little bit for us lay folks out here. Just wondering, like, what are some of the early signs or symptoms of cardiovascular disease that maybe we tend to overlook?

Dr. Elliot Brown: Yeah. So, great question because a lot of adults will experience something in the chest that may not be pain, but it's a discomfort and they may feel that it's gastrointestinal or some type of indigestion. So, any discomfort in the chest, particularly exertional and relieved by rest, would be a yellow flag. Shortness of breath that's exertional, relieved by rest. If someone notices they're retaining fluid, you want to come in and tell us, get it checked up, or any feeling of fluttering, which might represent an electrical or arrhythmia experience in the heart, you'd want to come get an EKG. Put on your Apple watch, nowadays they're very accurate.

Host: Yeah. It does feel like my Apple watch is always trying to share important information with me. It's telling me to breathe, which I assume is maybe literal, but also, you know, sort of figurative in a way. But yeah, there's lots of ways to tell, and we definitely don't want to ignore these things. And I'm assuming things, doctor, like, you know, risk factors, let's say, so genetics, lifestyle, and stress, that they all are contributing factors in heart disease.

Dr. Elliot Brown: Well, thank you for pointing that out, because when most people think of risk factors, they think of the typical cigarette smoking, hypertension, weight. But yes, we know that genetics play a huge role in a lot of heart diseases, including coronary disease and some of the cardiomyopathies. If somebody has had tragedy in their family and early death, that should be brought to the doctor's attention early.

 Lifestyle is extremely important in risk. Sedentary people do not live as longer as active people. A person, an 80-year-old that walks two miles and two hours and a 20-year-old that runs two miles in 20 minutes have both done the same amount of work and burn the same calories. So, it's important to keep that in mind. And we know that depression and anxiety activate the central nervous system. Mental stress does, it increases adrenaline, which translates to high heart rates, high blood pressure, weight gain, poor choice in food. So, we know that emotional stress, lifestyle choices, and genetics have become as potent as sort of the more traditional risk factors from the past.

Host: Definitely. Yeah. And I never have an expert on doctor who says that, "Uh, you know, when it comes to detection of things, cancer, heart disease, we can wait. There's no rush," right? They always seem to stress the same thing, which is that early detection is so key, whether that's in managing or preventing the progression of cardiovascular diseases. Just want to hear from you, why do you believe it's so important that we catch these things early?

Dr. Elliot Brown: Sure. So, one of the most important take-home messages for my listeners in this podcast would be that cardiovascular disease in general is very slow-growing so that if you can detect it before it finds you, you have a great chance of having impact in its prevention or slowing down the progression. And we now have many great ways of defining a person's risk before they come to clinical issues.

And so, seeing your physician and looking into these screening techniques, particularly what we have at Valley, for example, coronary calcium scoring. We typically do CAT scans of the coronary arteries, which are non-invasive to detect early risk and disease, and have really led the forefront in coronary disease detection and prevention.

Host: Yeah. Of course, the ED or ER docs are amazing, but we want to try to catch these things, you know, before someone ends up there, before they have to call 911, of course. So, let's talk about that. Let's talk about those regular checkups and diagnostics and the role that they play in heart health and which of the tests are most critical.

Dr. Elliot Brown: Sure. So, just looking at the beginning of a regular exam, a good history, talking about genetics, lifestyle, and all the things we discussed, their stress level, is a great place to begin. Then, the exam begins with a blood pressure check and vital signs, person's weight. So, weight and blood pressure would be particularly important in the cardiovascular realm in the office setting. Physical exam may give clues to heart murmurs or sounds that may provide us with an inkling we need certain testing.

And then, finally, a good set of lab work to check cholesterol, blood sugar, would be very complementary, and a 12-lead EKG. So, that's all part of a normal well exam. And if a person, you know, gets through that in good order, a once-a-year physical would be more than adequate.

Host: Yeah, I just had my physical not too long ago. You were talking about the risk factors earlier. And of course, smoking's usually at the top of everyone's list, like, "Don't do that. Stop that." But in terms of other proactive steps we can take, like, what else can we do to reduce our risk?

Dr. Elliot Brown: So, using that term risk factor, if I could name one risk factor that to me after 30 years of private practice is truly the most important, it would be body mass index and weight. So, a proactive step patients of mine can take is really get serious about losing that belly and getting the weight down so you won't have the sleep apnea, you won't have the hypertension, you won't have the glucose intolerance and all the traditional risk factors that lead to heart disease.

It's important to move more. Park your car further away from the restaurant. Get 10,000 steps in a few times a week. More is not good for your skeleton, but less is not as optimal for your cardiovascular system. And those of you out there who have lost a family member prematurely, make sure that by age 30, 35, 40 the latest, you're getting screened for the first time to make sure that you're not heading down the same road.

Host: Yeah. Just a great advice from an expert today. I was just thinking myself, I try to do that. I went to Costco yesterday. You know, and I could have parked really close. There was a great spot really close, and it's almost like I had a premonition. I could predict what you were going to say today. And I was like, "No, park way over there and get those extra steps in." So, on the same page for sure, doctor. Just want to give you a chance, I like in these podcasts to sort of debunk, you know, myths if we can. So, what are some misconceptions or at least one about heart disease that you'd love to debunk?

Dr. Elliot Brown: I guess from a preventative standpoint, if I could leave one message for people, it would be you don't need to get an A on your report card when you go to the doctor. The key is you don't want to get an F because it's much harder to pass once you're down that low. Getting a B and making a few adjustments can get you on honor roll the very next marking period.

So, that metaphor is what you should keep in mind because these are slow-growing disorders that when found early and detected, we can have a huge impact on changing the course of the outcomes in such instances. And that would be what I would try to debunk. You don't have to be worried that your doctor is going to tell you you have a problem. It's an opportunity to not have irreversible disease.

Host: Right. We don't want to be afraid to see our doctors, right? We don't want to be afraid to get those labs because the doctors, the nurses, the expertise that you have, you know, a lot of these things are reversible, especially if detected early. And that's kind of our message today. I just want to give you a chance here at the end, doctor, and this has been good stuff, maybe some actionable tips that we can implement like I'm making a little list of things that you said here today. And one of them is just to get up and get moving and get more steps. But from you final words, takeaways, what are some things that we can do to help ourselves?

Dr. Elliot Brown: All right. I'll stick to the three bullet points, and I would say to all of you out there, do whatever you have to do to ensure you're going to get down to the right body weight once and for all in your life. Do it. Set the example for your kids. Even if you need the newer medications, it will help you.

Number two, get a blood pressure cuff for the next Christmas, Father's Day, Mother's Day, birthday, and put it in your kitchen. And monitor it occasionally so you know that you're not running around high and doing damage to your kidneys and your heart. And three, listen to your body and get a physical exam once a year. That would be my advice.

Host: That's perfect. Short and sweet. It's been great to have you here. Great to have your expertise. When we think about these things, you know, I'm 56, so I start to get a little older and I would say I got more of a B plus on my last report card than an A minus or A, you know. But I felt pretty good. 56 B plus, but you know, there's still some things I could do like parking further away and taking the stairs instead of the elevator, all that good stuff. So, thank you so much for your time.

Dr. Elliot Brown: Excellent. Thank you for having me, Scott.

Host: Thanks for joining us on this episode of Conversations Like No Other, Heart Care. We hope today's discussion on cardiovascular health has been helpful. Remember, your heart is at the center of your overall well being, and it's never too early to start taking care of it. Don't forget to subscribe and share this episode with loved ones. For more resources on heart health, visit valleyhealth.com/heart.