Gina DiPietro  0:06  
So you've been diagnosed with heart disease. It is not an immediate death sentence because there are things you can do to turn around your heart health and live a full life. Welcome to Novant Health healthy headlines. I'm Gina dipietro. Heart disease kills more Americans each year about 655,000 than anything else. It's the leading cause of death among women in men. But 80% of heart disease is preventable. In this episode, Kliff. Mertens talks to Dr. Sandy Charles, a Novant, Health cardiologist about the steps you can take if you're facing the task of living with heart disease. Thank you for listening.

Dr. Sandy Charles  0:45  
Once you're diagnosed with coronary disease, is it reversible? Um, yes. So, you know, like you said, coronary disease is so prevalent, that the first thing I kind of tell people when they're diagnosed with it is that they're, you know, not alone. And to not to feel discouraged, but to feel engaged with their physicians and their medical care and empowered that what they can do will make a difference. And so, you know, I don't, it depends on how the coronary disease has manifested itself, and what complications have occurred. So some things that happen due to coronary disease are, in fact reversible. But a lot of things, at the very least, can be prevented from recurring, based on lifestyle changes, and, you know, understanding and adhering to the medical therapy, exercising amongst a variety of things. I imagine it's if you get that diagnosis, it's easy to panic and think, Oh, my arteries are blocked. This is it, the drain is never going to open again. I'm a goner. But that's not the case. Tell me specifically what it will what you can do to reverse some of that damage. And you just touched on lifestyle, exercise, things like that. Yeah. So to take a step back, you know, coronary disease can manifest itself in a variety of ways. And like you touched on essentially, it's, you know, is your plumbing blocked or not. And so there are a variety of ways that our patients learn of their diagnosis. You know, there are a lot of patients who have no symptoms at all, and just based on imaging, find out that they have a little bit of plaque. And these patients are ideal in identifying that the plaque is there. But thankfully, it's minimal enough that it's not causing any problems, but imperative to start therapy to keep it from progressing. So from for this patient groups, so important to start aspirin therapy, and Staton therapy, cholesterol therapy, regardless of what your cholesterol level is, because that actually stabilizes the plaque prevents it from causing heart attacks. And, and helps to keep the plaque from progressing to a lot of different vessels. But, you know, number one thing I tell my patients is if they're feeling well, exercise, exercise, exercise, watching and minimizing how much sugar and carbohydrates they take in and processed foods. And all of that helps to minimizing the complications and progressions from coronary disease. But there are a large subset of people who unfortunately, you know, find out that they have heart disease because they have a heart attack, or they start having chest pain. And these are people who have severe heart blockages. And for them, like their, you know, minimal plaque patients, it's super important to start aspirin and cholesterol medications. And those are things that should be continued for a lifetime, if possible. But these are people who go on to needing stents and other therapies to open up their blockage and, and so thankfully, for these people, they feel better after that is done. And then it's so important for them to, you know, get into the swing of exercising and trusting their bodies again, and knowing how much they can push themselves. And for them, additional medications are are also necessary. How important is it

Cliff Mehrtens  4:29  
for to pay attention to your blood pressure and your cholesterol levels? I know a lot of people might get a diagnosis early on as is high and they brush it off and think okay, no big deal. I'll worry about that. That's an old person's disease. Yeah, so thank you for bringing that up. That's something that's exceedingly exceedingly important. And that's because Heart disease is the number one cause of death for both men and women killing more people than all forms of cancer combined, yet 80% have heart disease.

Dr. Sandy Charles  5:00  
preventable, simply based on risk factor modification. So a lot of these risk factors that you mentioned, having high blood pressure, having high cholesterol, diabetes, these are things that people tend to not feel, and to not know that they even have, unless they're getting screened regularly. And unfortunately, you know, a lot of people just feel like, you know, they have something bad if they have these things, and it's a bad thing to start medications. But, you know, I tell people, you know, number one, a lot of these risk factors can actually be reversed through exercising regularly and consistently through a low sodium diet, and really paying attention to weight and what people are eating. You know, unfortunately, a lot of people just are not aware about how much sodium is in processed foods, and they think, Oh, you know, I don't put a lot of salt in my food. But I say, you know, if you go to chick fil a, and you just get a regular chicken sandwich, a lot of them have upwards of 80% of your whole days recommended amount of salt, in that and including a lot of those salads at fast food places. So it's really important to pay attention to what you're eating and to eat as many Whole Foods and plant based foods on exercise. And those can truly make a difference. And I, I tell people, you know, to really partner with their doctors to understand what medications are important for blood pressure and cholesterol and to really be open and comfortable to save, they're having side effects so that that can be be switched. But to really emphasize that medications don't have to necessarily be a lifelong commitment. Because I have lots of patients who with a commitment to exercise and getting on a healthy diet and cutting back on alcohol intake, which is an important thing to bring up, especially during this pandemic, where you know, a good number of people are actually drinking more than usual, you know, and obviously cutting back on smoking and, and touching based on stress and anxiety, all of these things, if they're modified,

can be can be optimized through lifestyle changes, and not just medications alone.

Cliff Mehrtens  7:27  
They're both important exercise and diet. And a lot of people pick either or it's hard to maintain both, which people have the most trouble doing and maintaining is it exercise? Or is it that low fat, low fat, low salt diet? Yeah, you know, what I, what I what I have seen is a lot of obstacles or hurdles really depend on the way you were raised and what you were exposed to. So, you know, the patients that I have grown up in households where, you know, their parents were always eating healthy and primarily veggies and their parents exercise, you know, they're more likely to engage in these things. And the converse is true for people who aren't as exposed but but I will say you know, it's equally it's equally difficult. But but but very possible to optimize both things. So I tell people that really nothing is more important than your health especially because a good portion of people with heart disease, unfortunately don't get the privilege of of having symptoms or having a chest pain as a as an indicator they that they have heart disease for a lot of people, you know, death is the first sign of heart disease or our cardiac arrest um, and, and and so really taking every opportunity to optimize health so yes, people say that they don't have enough time unfortunately, especially during this pandemic. People are at home working, watching kids during school virtually, but the one thing I emphasize is anything and everything that you can do is helpful for exercise. You don't have to have a peloton, obviously, you don't have to go to the gym. But just being able to you know, take breaks and walk around your home stand in place and and jog while you're watching TV 30 minutes a day, five minutes, five days a week is what is not recommended but it's absolutely necessary to maintain health and you know, I have the privilege of seeing patients who have have done this through their life and I see the 92 year olds who are doing JUMP JUMP jumping jacks and are and are still you know, exercising so so it's there's really something to preservation of health that that's so important. And the same with diet. I have people say you know, Dr. Charles, it's so hard to cook

Dr. Sandy Charles  10:00  
Um, you know, watching the kids and working, I really don't have enough time. And I always say, if you don't make that investment on the front end, you know, you'll end up having to make that investment on the bad the back end, in terms of dealing with poor health and, and having to make the time to go to doctor's appointments or go, you know, going to hospitals. So, so little things I tell people cut back on sugary drinks, you know, 20 ounces of Coca Cola is the same amount of sugar is 18 chocolate chip cookies. So if you can make simple switches like not having sugary drinks, but having water or tea with minimal sugar, I'm cutting back on fast foods and trying to cook primarily at home and trying to have more veggies. That would be great. And you know, it's a process, you got to rewire your tastebuds to not be so used to all that sugar and salt. But in the end, it is certainly worth it.

Cliff Mehrtens  10:55  
Talk about the effect of stress on a person's heart and what that really does affect your health. And what people can do especially now during the pandemic to sort of reduce that stress and make themselves a little less heart damaging. And that double Yes, yes. So stress and anxiety have profound effects on heart health. Unfortunately, unlike diabetes and high blood pressure, it's it's not as it's harder to be objective and to quantify exactly what the contribution is to heart disease. But you know, studies know that when you are more stressed and more anxious, you are frequently less likely to get adequate sleep, you're less likely to have enough time to engage in activities like exercise, you tend to put yourself second and er, are more concerned with the day to day activities. And so it is exceedingly important to for physicians, one to ask about patient's stress level and anxiety level, because these things can lead to bad habits, they can lead to overeating and weight gain, they can lead to increase alcohol intake, a lot of my patients actually have started smoking again when they didn't because of the stress from the pandemic. And so these are exceedingly important things to address. But there are also actual cardiac diagnoses something called stress induced cardiomyopathy, where patients who are so stressed are more likely to have heart failure. So so so while it's hard to quantify what stress, actually how much stress puts you at risk, we know that it does, and it's something that has to be acknowledged and something that has to be addressed. And patients know that just as much as they have to make time for exercise and eating a healthy diet. It's important to focus on a wellness and self care making time to find ways to decrease your stress level.

I'm not trying to pick on the younger crowd here, but isn't health, I'm shooting heartcare a lifelong thing. You shouldn't wait till you're 50 to decide, oh, I need to take care of my heart this you really establish those healthy habits early in your life. Correct? I couldn't say that better. It is so correct. You know, studies that were done on autopsies on young children have found that children as young as age 10 and 11 start developing plaque buildup in their arteries. So it is never too early to start optimizing your heart health and I will say, you know, yes, in the younger population, you know, they are not excluded. I, you know, recently had a 37 year old woman who had a heart attack, a 40 year old man who died of heart disease. So so so knowing that healthy habits should indeed start as early as you start eating and as early as you can start exercising, and knowing in particular your family history, if you have anyone in your family whose man and had heart disease, before and including up to age 55 or a woman 65 and younger, you are particularly at increased risk for heart disease. Even if you exercise five days a week, if you're eating a perfect plant based diet, you still could be at risk. So it's important to you know, collaborate with your doctor and and and really evaluate that risk and see if there are additional things that could optimize and further reduce your risk for heart disease.

What's your overriding message to someone who's been diagnosed with coronary disease? What would you tell them if they're in your office and you you inform them that this was

Dr. Sandy Charles  15:00  
Now something they have to deal with. Yeah, my number one message is that, you know, they should take this not as something discouraging, but as something that is essentially like a new beginning, you know, it's it's frequently a positive thing that it's been diagnosed, and that dangerous complications, you know, haven't occurred or have been taken care of. And, and that now with medications, you know, though a lot of patients, you know, are saddened by the fact that they may need more medications that than they were on before I say, you know, what these medications have been proven to save lives, and that now, they are on a on a beneficial regimen that will reduce their risk for having something dangerous happen in the future. And now, at the very least, this is a massive wake up call that, you know, you can't take your health for granted. And any of the things that you weren't doing before, now is the time to really make those changes. So people who are diagnosed at a young age in their 30s and 40s, I've seen many of them do such positive changes that they essentially never have to worry about their heart health again, because they're in a really good position, you know, so, so I always tell them just, you know, to be positive, to be engaged, to be empowered, and to really partner with their doctor and feel comfortable with their doctor to mention any reservations so that they can fully commit to this this journey.

Gina DiPietro  16:42  
Hello, Gina dipietro. Again, to recap, learning that you have heart disease can give you a second chance of sorts, if you pay attention to diet, exercise, and other helpful changes. modifying your lifestyle isn't always easy, but it will be worth the effort, and your heart will definitely thank you. Thank you for listening to this episode of healthy headlines. If you enjoyed this, please take the time to rate and review us and subscribe to this and all Novant Health podcasts. We post new episodes all the time. Most are just 15 minutes. Thank you for listening

Transcribed by https://otter.ai