Melanie Cole, MS (Host): The latest 2025 American Heart Association data states cardiovascular diseases includi heart disease and stroke claim more lives in the U.S. than all forms of cancer and accidental deaths combined. In the U.S., someone dies of cardiovascular disease every 34 seconds, and nearly 47% of U.S. adults have high blood pressure, and more than 72% of U.S. adults have unhealthy weight. Those statistics are incredible.

Welcome to Back to Health, your source for the latest in health, wellness, and medical care, keeping you informed so you can make informed healthcare choices for yourself and your whole family. Back to Health features conversations about trending health topics and medical breakthroughs from our team of world-renowned physicians at Weill Cornell Medicine.

I'm Melanie Cole. And today, we're talking about heart healthy living and joining me is Dr. Robert Harrington. He's a cardiologist and serves as the Stephen and Suzanne Weiss Dean of Weill Cornell Medicine and Provost for Medical Affairs of Cornell University,

Dr. Harrington, it is such a pleasure to have you with us today. And as I said in that intro, that's a big wow. Cardiovascular disease, people don't really think of it as being that number one killer. They think of cancer, they think of all these other things. So before we get into this amazing topic, how did you get involved in Cardiology and why is it so important to you?

Dr. Robert Harrington: Well, first off, thank you for having me. And indeed, as you point out here in the middle of Heart Month, that those statistics are in some ways jarring, in some ways maybe not telling the whole story. We've made tremendous progress over the last 50, 60 years in how we think about heart disease, how we treat it, how we prevent it. But we have a ways to go. And I think that's the point of those statistics. We got a lot of work ahead of us.

How did I get interested in Cardiology? Well, I trained in Internal Medicine. And during my Internal Medicine training, I particularly became interested in why blood clot happens and how do you treat that, how do you prevent it. I became interested in that because of heart attacks. And I became interested in that for both personal and professional reasons, but it was really my ideas of studying blood clotting that led me into the field of Cardiology. And it's one of the things that keeps me interested about cardiology today.

Melanie Cole, MS: It's such a fascinating, fast-moving field that you're in. It would have been my choice had I gone on to medical school as well. And so, I'd like you to speak about some of the latest exciting advancements in cardiovascular disease as we're moving so quickly, and technology, and wearable monitors, and all of these things are coming into the picture. How is Weill Cornell Medicine leveraging that technology and innovation?

Dr. Robert Harrington: Oh, we have a great group of professionals working in cardiovascular medicine, whether you're talking about treatment, prevention, Interventional procedures, surgical procedures. At Weill Cornell Medicine, we really have it all. We have people focusing on prevention. And you mentioned wearables. We're clearly using wearables as a way to help with prevention and heart health. What do I mean by that? Think about the apps that you wear, that you can measure how many steps you take. We know from work through the American Heart Association that 30 minutes of brisk walking a day, five days a week, translates into positive benefits for heart health. So, we can use wearables for that.

With regard to treatment, we have world-class physicians who are working on replacing heart valves percutaneously, meaning without surgery. But we also have outstanding surgeons if there's something in the heart that needs correcting. So at Weill Cornell, we really think about the spectrum from prevention to the most advanced forms of treatment. We have people doing research in all these areas. We have people training, young people training to become cardiovascular specialists. I would say that here at Weill Cornell Medicine focus on cardiology and cardiovascular health is one of our key priorities.

Melanie Cole, MS: Such an exciting time in your field, as you say, Dr. Harrington. Now, one of the things I noticed when I was working in cardiac rehab many years ago was that everything we were doing was based on the studies of men. All the studies, Framingham, everything was men. But now, we have learned so much more about heart disease in women and how it differs. Our symptoms, our symptoms of event, cardiac event. All of these things are different in women than they are in men. Tell us a little bit about some of those differences, what women specifically should know, and how are you helping to raise that awareness of women's heart health, aside from this podcast today.

Dr. Robert Harrington: Well, you mentioned at the outset the 2025 Heart and Stroke Statistics that the American Heart Association puts out every winter to really drive awareness to the importance and the widespread prevalence of the diseases in cardiovascular medicine. And in part of that, you'll see a lot of the data broken down by men and women, and it should be noted you made the case that in cardiovascular disease writ large, it's the leading cause of death and disability in the United States. I'd also point out it's the leading cause of death and disability everywhere in the globe, with the exception of sub-Sahara Africa, where it's also increasing in its prevalence and importance in public health.

And if you look at women, we've long thought that men have more cardiovascular disease than women. But in fact, when you look at women, it's the leading cause of death and disability. For women in the United States, it's not breast cancer. It's not lung cancer. It's cardiovascular disease. And I think that we've not done as good a job as we can in the public health awareness campaigns.

We've had a long-standing campaign with the American Heart Association called Go Red for Women. If you were looking at me on camera today, you'd see my red dress on the lapel of my coat. And that's really to draw attention during heart month to heart disease in women.

Women have many of the same features of heart disease as men. They get coronary disease, they get heart failure, they get arrhythmias. But some of those symptoms present differently. Let's take coronary disease, blockages in the arteries. We think of the classic picture of a man, middle-aged businessman, smoker perhaps, clutching at his chest because of pain in the middle of the chest.

With women, that pain might not be quite so clear cut. It may be an ache in the arm. It may be a sense of nausea. It may be symptoms that are occurring in the abdomen and not in the middle of the chest. Women have symptoms that are referable to the heart that may differ from men. And so, part of the awareness campaign is making sure that women understand that they indeed are at risk for heart disease, and they should take symptoms seriously, particularly if they have risk factors.

Melanie Cole, MS: Dr. Harrington, we're going to discuss that, but why do you think the trends are moving upward as we learn more about smoking and exercise is medicine, and all of the things that we're learning about? All of it. Why do you think the trends are going up?

Dr. Robert Harrington: Well, part of it is we have made great progress. Smoking is at an all time low in the United States. Smoking is at an all time low in both men and women in the United States. But the challenge that we have is that there are other things that are increasing. Obesity is increasing. Obesity carries with it high blood pressure. It carries with it diabetes. It carries with it high cholesterol. So, there's a lot of things that go along with obesity that portend an increased risk of heart disease.

We're an aging population, and this plays into women as well. Women on average get their heart disease about 10 years later than men. Women live longer than men. Women are likely to experience their heart disease later than men. And so, the aging of the population, the rising epidemic of obesity, diabetes, hypertension, are all contributing to the increased burden of heart disease that we see.

Melanie Cole, MS: It's such a complex problem, too, this obesity epidemic, and that we're seeing it even in our kids. And so, we're seeing high blood pressure, and it's really so complex when you think of all of the built environment, plus the lifestyle factors, plus everything you've mentioned. It really is overwhelming when you think of ways that we can try and reverse some of that trend. But when you give people your best advice as the expert that you are, what do you tell people to do?

Dr. Robert Harrington: Well, what I first try to tell people to do is that much, if not most, of cardiovascular disease can in fact be prevented. And we also have some great treatments. We talk about things like weight control, diabetes, glucose control, cholesterol. Know your cholesterol. Treat it when appropriate. You've mentioned exercise, critical as a foundation for cardiovascular health. Weight control, all critical. Cholesterol, know what your cholesterol is. Treat it when appropriate.

And something that's recently been added to the list of things that increase the risk of cardiovascular disease is our sleep. Poor sleep, including things like sleep apnea, can lead to an increased risk of cardiovascular disease. And of course, you've mentioned at the beginning, and I would be remiss if I didn't say it over and over, get rid of tobacco. Tobacco does nothing good, and it leads to an increased risk of heart disease.

Melanie Cole, MS: Well, we certainly are learning more and more about sleep as well. Now, Dr. Harrington, you know, you're so great on the air, and is there a patient story that you can share? Because I can hear the compassion and the passion in your voice for what you do. Tell us something really exciting about a patient that really made you feel good about what you do for a living.

Dr. Robert Harrington: A few years ago, I was seeing a patient who was referred to me by my wife, actually, because she knew his wife, and he had been treated for shortness of breath, wasn't feeling good, was not able to walk up a long driveway. It was very, very frustrating to him. He had not had much offered to him in terms of how he might combat this.

I saw him in the office, physical examination. He clearly had some excess fluid on board. He was in an abnormal heart rhythm. So, what did we do? We embarked upon a multi-month strategy of let's get his heart pumping stronger through the use of medications. Let's get rid of some of the fluid that he has. Let's try to slow his heart rate down so that his heart wasn't going so fast. And as we begin to do all of that, he's able to exercise a bit more. He's able to drop a little weight because he's able to exercise.

And within three to six months, this man was a different man. I would meet him at events. He and his wife were both equestrians, my wife and his wife, and I would meet them outside while they were doing their activities. I would see him. He would be able to walk around the barn and enjoy the activities of the day. It was a great example of paying attention to what I'll call the essentials, making sure that he was on the right medicines, making sure that his heart rhythm was controlled, making sure that he was getting some exercise. It just gave him a whole new outlook. It was really rewarding to see. And he's just one of many examples that I could give you.

Melanie Cole, MS: I've seen stories like that as well as an exercise physiologist for 35 years. I see patients, Dr. Harrington, that I've had for 30 years as my personal training clients. And I see what they've been able to maintain that their peers necessarily that didn't do these things weren't able to. So, it really is remarkable, isn't it?

Now, it's not just a silo, right? It's a multidisciplinary approach. I'd love you to speak about what makes Weill Cornell Medicine's approach to heart health unique, and that there's so many people involved when you're caring for a patient, that coordinated care, that shared decision-making. Speak about that for us.

Dr. Robert Harrington: Oh, I'm so glad that you brought this question up because, for me, one of the hallmarks of great medical care is making sure that it's team-based care, bringing all the different levels of expertise, whether it's from our nursing colleagues, our physician assistants, our NPs, our exercise physiologists, our social workers, our pharmacists, it all has to come together to give somebody a great team approach to their care.

And one of the things we really take pride on here at Weill Cornell is our ability to both assemble great teams and make sure that everybody on the team feels recognized for what they're doing. I spend a great deal of my time talking about the importance of team-based care, and we try from the very beginnings of our medical students to make sure that they understand the importance of team-based care. I think you've asked the right question, how do people get better care? They get better care when it's team-based, and it's integrated team-based.

Melanie Cole, MS: So important. This is a great conversation we're having, Dr. Harrington. And I know that you and I could really talk about this and the nuances for a very long time. But as we get ready to wrap up now, if you had to give one takeaway for listeners, what you want them to know about heart health, when you're speaking in front of community and groups, and you have one best piece of advice, what is that for us?

Dr. Robert Harrington: Take control of your heart health. Eat right, exercise, eat healthy. Take the medications that have been prescribed. Keep your blood pressure under control, don't smoke, get good sleep, take control of it yourself. So much of what you can do for your heart health is in your hands. And so, take it on.

Melanie Cole, MS: That is great advice. And as women, we have to put our own masks on before we put the mask of our loved ones. So, being our own best health advocate is really the best advice, Dr. Harrington. And thank you so much for giving that to us and sharing your incredible expertise with us today.

And Weill Cornell Medicine continues to see our patients in person, as well as through video visits. And you can be confident of the safety of your appointments at Weill Cornell Medicine. That concludes today's episode of Back to Health. We'd like to invite our audience to download, subscribe, rate, and review Back to Health on Apple Podcasts, Spotify, iHeart, and Pandora. And for more health tips, go to weillcornell.org and search podcasts. And parents, don't forget to check out our kids healthcast. We have so many great podcasts there as well. I'm Melanie Cole. Thanks so much for being with us today.

Promo: Every parent wants what's best for their children, but in the age of the internet, it can be difficult to navigate what is actually fact-based or pure speculation. Cut through the noise with Kids Health Cast, featuring Weill Cornell Medicine's expert physicians and researchers, discussing a wide range of health topics, providing information on the latest medical science.

Finally, a podcast to help you make informed choices for your family's health and wellness. Subscribe wherever you listen to podcasts. Also, don't forget to rate us five stars.

disclaimer: All information contained in this podcast is intended for informational and educational purposes. The information is not intended nor suited to be a replacement or substitute for professional medical treatment or for professional medical advice relative to a specific medical question or condition. We urge you to always seek the advice of your physician or medical professional with respect to your medical condition or questions. Weill Cornell Medicine makes no warranty, guarantee, or representation as to the accuracy or sufficiency of the information featured in this podcast. And any reliance on such information is done at your own risk.

Participants may have consulting, equity, board membership, or other relationships with pharmaceutical, biotech, or device companies unrelated to their role in this podcast. No payments have been made by any company to endorse any treatments, devices, or procedures. And Weill Cornell Medicine does not endorse, approve, or recommend any product, service, or entity mentioned in this podcast.

Opinions expressed in this podcast are those of the speaker and do not represent the perspectives of Weill Cornell Medicine as an institution.