January / February 2016
By Dr. Pablo Lozano
Q: What are the greatest risk factors for heart disease?
A: There are 5 risk factors for heart disease. Hypertension, Diabetes, High Cholesterol, Smoking and Family Background.
Q: Is it possible for any of these risk factors to be reversed? If so, how?
A: Yes. The first 4 factors can be controlled. Hypertension: eat a low salt diet, weight control, exercise, and use blood pressure medications. Diabetes: Watch diet, exercise, and strict compliance with medications. High Cholesterol: Eat a low cholesterol diet and use medications. Smoking: Cessation.
Q: If heredity/genes is a risk factor, how is that reversed or prevented?
A: Genetic risk factors are not reversible or preventable, however, if the individual has a family history of premature coronary artery disease, risk factor management at an early age, even as a teenager, is recommended.
Q: H ow reliable are stress tests to indicate heart issues? When should a nuclear stress test be done versus a regular stress test?
A: Stress tests are helpful for evaluating a potential cardiac complaint, such as chest pain, shortness of breath or unusual exertional fatigue. In the absence of these symptoms, the stress test is rarely helpful and may lead to further diagnostic testing in an individual who is asymptomatic, thereby resulting in increased anxiety and medical expense. Nuclear stress testing may be necessary when the individual is unable to exercise or the routine treadmill test is equivocal or if previous coronary artery disease has been identified and treated and reassessment is needed.
Q: Can heart disease be disguised as other issues?
A: Yes, the common mistake is to attribute “heart burn” from stomach issues when it is really due to heart disease.
Q: A “stent” procedure for heart issues is often referenced. What is the expert standard on stent vs. bypass and expected outcomes of each?
A: Most studies suggest that triple vessel coronary artery disease is better treated with surgery. Whereas single vessel disease can often be stented with a good long term result, but many times diabetic patients will do better with coronary artery bypass, even in the setting of single vessel disease.
Q: What diet do you recommend?
A: A whole foods plant-based diet is preferred as coronary artery disease is a lifestyle problem. Poor exercise habits and the standard American diet are often the chief culprits behind its development.
Q: Is exercise important?
A: Yes, the benefits from exercise often will appear within just 10 to 20 minutes of daily exertion. The feeling that a whole hour of exercise is necessary is a common mistake that may intimidate a person into maintaining a sedentary lifestyle.
Q: What books can help?
A: A newly released guide to a long healthy life is entitled “How Not To Die” by Michael Greger, MD.