coming up next on being well our topic is something that most can relate to and that's heart health everything from heart disease prevention treatment and more our guest today is cardiologist dr. Sanjay maeda dr. Matta will tell us what we can do now to keep our hearts healthy he'll also talk about the signs and symptoms of heart problems and the treatment options that are now available that's coming up next on being well you dr. beta thanks for coming in today let's talk about heart disease it's a big topic and it seems to be coming more rampant how big of a problem is this and what how did it get this bad well heart disease is a is a global problem it's been growing every day and it's affecting most of the country most of the world affects men women affects all ages there are no exceptions and the mortality is going on it caused the big socio-economic impact on the day-to-day life it and if steps are not taken to control it it is going to go out of control what age should people start thinking about heart health do you think well nowadays the most of the literature says it starts right from childhood days if you have a strong family history at some point in your life due to various stress factors it starts getting in a faster pace but there are so many literature that even the younger kids those are obese they start having fatty plaque formation in there are trees so the disease is there it starts very early but if you take care of yourselves an early precaution you are able to slow it down so essentially I would say it really starts from a very early age but when do most adults start seeing problems like high cholesterol well usually if if they are feeling well if they are not going to their doctors office most of them are in denial they could be having that sitting it's like an iceberg we just are seeing the tips of it for example blood pressure cholesterol all these things are there but until unless you have not had any symptoms a young person on board board or doctors office and say oh I need this check and that check until unless he has a strong family history so it's like early screening we usually recommend 35 years to 40 years when you are if you have family history start checking it early but if you had no history and still once you go to a primary care we should we always encourage them to once you're 14 go and meet your primary it see what he has to tell you because things like you don't really know if you have high cholesterol there's really not absolutely it's not like by the time you start getting symptoms he was already late yeah let's talk about some of the things that lead to heart disease and heart issues all right so how do these obviously family history is sitting in the background a few most common factors which have been strongly proven number one with diabetes number two is high cholesterol high blood pressure and smoking these are the four big real real big risk factors and plus with family history in the background it is really going to occur it an early age there are a lot of other factors which we take into consideration depending on what kind of minor particles you have in your bloodstream are you having home assistant deficiency are you having some federal risk for stresses day-to-day life stresses your job what you are there are certain jobs like for example bank tellers and those who work on the stock markets those people are at extremely stressful life and they are going to get the disease at an earlier age and why is that like when you talk about stress why is that even if maybe you eat okay right eat right why does stress which is that really do physically I mean it it sets you it's your hormones see we have stress hormones in the body and when you are in a lifestyle where there are plenty of stress the hormones are there in the body which starts triggering the atheros chlorosis the process by which the black starts building up and because of those hormones at times you have your blood pressure fluctuates that indirectly affects your plaque formation stress is obviously if you have a family history of diabetes that also can trigger you to get into diabetes so it's all really nicely interconnected that is none one on other one what about if someone you know is eating you know okay regularly but they exercise what effects does exercise have on the heart and heart disease and helping exercises there's a big importance of exercise exercise can help you reduce weight number one you bone more calories you improve your body's own insulin so there by the response of the same insulin is better so you get lesser insulin resistance these are the few important things which are known to cause plaque formation obviously exercise as a separate roll it improves your metabolism of the body it improves the exercise over a period of time you can improve your capacity you're able to do more activity and obviously it improves your morale it improves your body is image and it also helps to reduce the blood pressure when you start exercising there is razor dilation of course the blood pressure tends to come down diabetes comes under control so X and obviously along with weight loss it has significant role in day-to-day life we used to say that high blood pressure started at 140 over 90 and I understand that that's actually gone down that you like the blood pressures to be a lot lower than that right the important point over there is depending on the age recent guidelines which are go to come out next year there was an article saying that person who is between 30 to 40 his blood pressure we try to keep around one below 130 the upper number in the lower number arm below 80 but once somebody comes to you in the office who is really more than 65 or 70 one should not target to bring it down to way below 130 140 is their cut off so not only the numbers but at what age somebody's coming is important for example those were 80 85 we see a lot of population more than 85 you try to drop down their blood pressure to 120 s if they start present even lightheadedness sometimes they can get into stroke so sometimes too low is not good too right so it really for a young population which we call usually between the age of 30 to 60 that population the targets usually we try to keep around once 130 of the upper numbers and lower numbers we try to keep below 80 that's an ideal guideline okay so we know that there's really not a lot of symptoms for cholesterol or high blood pressure but if you do have a blockage of some sort what are some symptoms that that you may have something going on maybe a heart attack or something well it's very interesting question once again the common things what we know are even from the television network and all education that if you start having chest pain which is one of the most common symptom not everybody gets chest pain chest pain is classic symptom but people can have shortness of that somebody gets tightness in the chest somebody gets Justin left arm pain somebody gets shoulder pain somebody says that oh I was walking and now I have neck pain going to the left side of the jaw and I think I should go to the dentist these are all some abnormal or symptom which if you never had before you should focus on them and get yourself checked out and especially in women they don't get all this classic symptoms they might just come to you and say I don't feel good that's the only thing they say and it's the job of the doctor to find out what all things she has it is factor so lot of a typical presentations are there but the common ones are chest tightness shortness of breath and in this season you will hear they start doing lawn mowing they start getting tightness they have to stop so I usually tell my patients that if you have new symptom which you never had before and it worsens with doing activity and it stops or goes away when you stop doing that activity think it is your heart go and make a trip to the emergency room or to your physician and get it investigated that's why it's important if you understand your own body and what's going on if something's not right then probably a pretty good indicator yeah you stopped a little bit about women's and heart disease why is why is it so different than men well most of the time women would never go to the doctor they are usually hesitant to go because they don't have real symptoms they feel that if they go to the doctor's office the doctor is going to say oh this is nothing going on but once after these are 45 they should be more careful women have hormones which protect them the storage and progesterone hormone this it protects them it tries to control them lipids it has endothelial dilatation activity so they are usually they start late compared to male population but they do catch up with the males in getting heart disease so women should have an extra focus if they have a family history they should be questioned more detailed way because they may not have classic symptoms let's talk about some of the screening tests that doctors do for heart disease right usually I mean if you have no respect or we start off with the regular clinical testing that is this most important rather than doing a series of laboratory tests obviously blood pressure measurement and clinical examination trying to find out signs for heart disease on examination and then we do a basic blood test to see the cholesterol and lipid profile because lipids is not only cholesterol what we say are there are four common things there is a bad cholesterol affair there is a good cholesterol triglycerides these are all factors we said you should get a blood sugar check because you could be having subclinical debate is going on or you might be pre-diabetic obviously blood pressure and there are variety of other testing which helps us pick up disease and obviously the newer tests which you will hear on educational channels that CT scan just come out it helps to detect your calcium in the arteries calcium is an indirect marker to say that you have some inflammation in the body and if you have it that means you could have some plaque formation socal calcium scoring is a big nowadays and we also do a see siri siri RP test by blood test which is nothing but it tells you the inflammatory process of your body it is not only specific for only for heart disease but it can tell that if you have high you have some kind of inflammatory response maybe it is diabetes maybe the heart disease going on maybe this high cholesterol which is causing that obviously people with rheumatoid arthritis and other inflammatory bowel disease can also have but once you correlate with symptoms the stress it really helps to pick up things early we had spoke earlier about it's obviously a lot easier to fix a small problem early on a stint or something like that can you talk about some of the procedures that can be done for heart disease that don't involve you know open-heart surgery right so standing has been going for quite some time and the balloon angioplasty started very early basically when somebody gets into gets to you with a blockage you can put a while and put a balloon over it which usually compresses the block and it opens up the artery the whole period of time the research showed that stenting is better because in standing acts as a scaffold and prevents the plug from dropping inside however nothing is foolproof if the if it keeps coming back they developed a new kind of stent which has got a medication over it so that's the medicated stent and now they are developing newer techniques where because tent is made up of different metals after some time is going to be permanently inside so they are coming out with newer technologies now that after a few months the stent dissolves and disappears so you don't have any foreign body sitting inside because after opening a blockage the initial period is more important to open up the artery after that the body tries to heal itself there are other methods where you can remove the plaque and you can cut the block with a rotor blade or what we call it drills a hole to the calcified plaque in opens up but the final thing is stenting video variety of standing but when somebody has multiple blockages they are better treated because the long-term results will be better with a bypass surgery okay well let's talk about we talked about some ways to prevent it and obviously one of them is through what we put in our mouth what are some foods to we'll talk about foods to avoid things that are bad for the heart well obviously fast foods are bad there is a big drive going on right now in the country that each fast-food chain should come out with the heart-healthy foods which would be obviously they are tried to cut down most of them don't contain trans fats nowadays but the saturated fats are also important so they are trying to cut that down now along with it low salt in the diet excessive calories if you see nowadays childhood obesity has started going on rampantly basically it should the children should be also educated and there is a big drive going on right now to cut the portion size you can eat but control your portions and roll your calories most of the literature shows that compared to 20 years ago each and every individual is taking ten to twenty percent extra calories then there are earlier generation so that's why we did not see heart disease that rampant which we are seeing now excessive calories less exercise causes heart disease and so what are some of the good foods that we can eat that can help right so the rarity of diets which have been recommended but I would really recommend a balanced diet which has got fruits which has got vegetables lean meats everything available now in the store is ninety-eight percent fat free you can select and pick fish is obviously very good it has got proteins it has got fish oils inside and you can also eat chicken the skin off after the skin is removed grilled portion red meats little less because it has got more fat inside so you can eat most of the foods if you eat in moderation along with vegetables and obviously the Mediterranean diet there is a big focus because it got olive inside and vegetable saw olives are very good because olive oil is one of the best oils so these are few dietary changes if people do it would help them to go further talk about a lot of people use take omega-3 Brightheart how does that right does that help or why is that see though the omega-3 oil first started you know along maybe thirty years ago there was a research and then fish oils fish has got plenty of omega-3 and Eskimos who live in Greenland areas and all they did not get blockage in the harder it was in spite of eating oil every day they found out that it is omega-3 oil which has protective effect opens up your arteries decreases the plaque formation it decreases your triglycerides it prevents your particles of the blood which stick to each other it prevents that from occurring it thins the blood there are variety of actions how it works so fish oil is predominately omega-3 there are other plant sources from algae and there are also green oil they call there are grapeseed oil which have got some amount of this and obviously flexi these are vegetarian vegetable parts which gives you omega-3 oils so omega-3 oils is a big big important role along with the regular which has omega-6 predominantly so does it make a difference if you're taking those in supplement form or if you're just eating we usually we usually recommend I most of the people eat fish twice a day when twice a week but if somebody who is a start vegetarian I mean then we usually recommend them flex seal oil and omega-3 fish oil captions are available and usually we start of them with one grams and then go to to graham to grammys supposedly ideal but once again it's not a variety of them available but it's a content inside the epa and DHA the higher the content the better it is but usual recommendation around two grams if you take and it should be it should be pretty good are there other things in our diet that our diet supplements that can help right so obviously olives which we spoke of olive has got excellent amount of polyunsaturated and monounsaturated fats so it is considered one of the best oils that's it there are other oils canola oil then soya bean we call and corn oil they come after that but olive oil supersedes everything obviously coconut oil is really bad which is predominantly saturated oils then there are other than knowledge we recommend nuts especially almonds and walnuts which have got good poly saturated and monounsaturated cashew nuts are not the best because they have got a lot of saturated and facts which is not good for us okay it's funny you bring up coconut oil because we're starting to see more coconut milk and right it's turning this it and it was always thought of as a bad thing right so no but if you see if the markets and grocery aisle there are all of them they mention fat-free 98% light also those are both at once in a while good but there are certain population here the coastal areas they make everything from coconut oil that's that's really bad yeah but I know a lot of products now are labeled with no trans fat that's only so I'm kind of it's not fat free right so that's what we always tell people to read the labels trans fat does not mean fat free right so amount you have to read the labels ninety-eight percent at free because trans-fat obviously the the FD has taken a big step and try to cut that out and even the fast-food chains to nowadays have stopped that so but still there are fat inside so you need to just read the label need almost a you know a extra hour at the grocery store to sit and read all the labels give us some advice doctor on when we as patients come and see the doctor and we may have some symptoms how can we be better as patients and sort of talking about heart disease and describing some of our symptoms so you can do a better job at helping us well most of the time we tell people don't be in denial if you feel different you know your body best if you have anything which is new discomfort which makes you stop doing any activity just go to the doctrine tell him this is what your feel feeling it's it's you who is going to guide the doctor and we always tell even our junior doctors were starting that always listen to the patient the patient is complaining which he has never complained before take it seriously especially the chest pain shortness of breath some people have filled palpitations irregular heartbeat they might say they are feeling light-headed which they've never felt before at any given time after age of 45 40 45 you start feeling those symptoms always approach and doctrine tell the doctor the right thing there's no need to hide no need to fail a shame that this is what I am feeling doc I am too young it can affect it and occur at any age do you find that denial maybe happens if it's someone that you know tries to take care of themselves and still has high cholesterol right and nothing you can owe me think anybody I mean I speak it a custom health care professionals also you may be a nurse you may be a physician yourself but you will owe that can never occurred to me we see many times health care industry professional coming to us with heart attacks and they say oh I had this going on for some time but I never thought that would occur to me well let's talk about cardiac rehab if someone's had a cardiac incident what can they do to get back to their regular exercise we have nice programs now correct rehab recall where people are assessed depending on how much damage they have to heart muscle depending on how much exercise they should start off and we have seen significant response and we are able to make the first person more functional than earlier rather than he would do by himself and olden day there was a saying that we need to wait for a month nowadays most of the recent paper which came out last month only said that even within five to seven days after a heart attack you can start rehab after three to four weeks of kind of open heart surgery you can start rehab and rehab is usually for four to six weeks depending on how the person is progressing for two to three times a week and really does wonders it is monitored if you get any irregular heartbeats is all taken care the nurse is always there supervising is so rehab is a really really a strong role and improves your vital capacity it improves your exercise tolerance for a period of time so we always recommend before you go and start doing exercise on your own if you had a heart attack if you had any procedure for the heart if you had an open heart surgery please talk to a doctor and get yourself and roll in cardiac rehab and is that is that mandatory after any type of heart if you had if you had a heart attack or a bypass surgery not for just regular stress tests on all if you had a real event for which you are in the hospital for even two to three days rehab really does work give us just the last little bit of advice let's talk about prevention what are the things that we can do right now to hopefully if you're younger person prevent heart disease in the first place right while watch your diet portion control low fat low calorie diet low sugar diet low salt that these are the most common things which you need to do and everyday exercise the recommendation right now is 30 minutes of exercise every day that would work best to keep you fit and visit your primary care doctor if you have a strong family history prevention is always better than making up for a secondary prevention primary prevention is the goal but if you do have heart disease it's not there's a lot of treatments and things available absolutely especially if it's caught early oh yeah it is called a variety of medications and in the medication has evolution and it has progressed so much in the last 10 years that you are almost you get predictive results just with medications also with the new cholesterol-lowering medications the Staten group which has done wonders it can bring your cholesterol down by 50 60 points in just two to three weeks time and I'd imagine there's new medications and new things coming out all there are plenty of new medications in the next one or two years we'll have variety of other medications for patients are not able to tolerate the regular Staten which is one of the Wonder drugs but some cannot tolerate so there are so many new in the pipeline getting ready all right it's been an interesting discussion thank you for coming on and sharing information with us we'll be right back with more being well after this thank you don't forget you can watch full episodes and demonstration segments from the being well series visit us at youtube.com / w EIU TV in this week's demonstration segment dr. Robert good explains blood pressure what the top number means and what the bottom number means and what are the recommended blood pressure levels morning Kim check your blood pressure here this morning it's important when we check your blood pressure it's your blood pressure cuff fits you adequately so when you do home blood pressures make sure that the cuff it's about two-thirds of the other partier of your arm in order to get an accurate blood pressure so let's just check and see what your cut your pressure is this morning well your blood pressure is 106 over 60 that's very good the top number of your blood pressure indicates when your heart squeezes from called systole and that usually is related to your high blood pressure which is at into heart disease so that's good and your bottom number 60 is also very good so that's a time when your heart is relaxed and when your coronary artery is actually filled just to let you know the top number 44 blood pressure should be less than 1 30 actually the national committee considers anything lesson from 120 to 130 to be normal rather than 130 to be abnormal and certainly greater than 140 without risk factors is considered to be high blood pressure so for you know risk factors the blood pressure should be kept less than 130 or starts increasing the risk in years past high blood pressure was oftentimes consider be much higher in the 160s but as we've now brought that number down the incidence of coronary disease has decreased in the incidence of heart attack has decreased thanks for watching being well I hope the information in today's program is helpful to you in your quest for living a more healthy lifestyle if you have questions or comments about the show you can email them to w/e I you at wiU net we hope you'll join us again for another edition of being well you