Heart Health, Personalized Heart Testing, Wegovy, and More with Dr. Tracy Paeschke
Did you know that heart disease is the leading cause of death for both men and women?
According to the American Heart Association, 80 to 90 percent of cardiovascular disease is preventable. This prevention can be achieved through healthy food choices, an active lifestyle, regular health check-ups, stress reduction, and other proactive measures.
In this episode, I’ve invited Dr. Tracy Paeschke, a double board-certified cardiologist and health coach with over 25 years of experience in caring for people with heart disease. After many years of diagnosing and treating heart disease, Dr. Paeschke now focuses solely on prevention at Heart Health Prevention and Wellness.
She sheds light on what heart disease is, how to manage it, the role of medications, recognizing symptoms, and the relationship and positive effects of GLP-1 medications like Wegovy on heart health.
A Comprehensive Breakdown of Heart Disease
Heart disease—ever wonder what that really means?
Think of it like a big umbrella term that covers anything that can go wrong with your ticker. To break it down, I like to compare it to a house. Just like a house can have issues with plumbing, structure, and electricity, so can your heart.
First off, we’ve got the ‘plumbing problems.' These are all about the blood vessels and circulation. Picture the pipes in your house getting clogged; well, your heart’s arteries can get clogged too. That’s when things like heart attacks and strokes can happen—they’re some of the most common types of heart disease. Basically, anything messing with your blood vessels fits here.
Next up is structural heart disease. This is like when your house has problems with its walls and roof. In your heart, it’s about the muscle and those all-important valves. Stuff like congestive heart failure comes into play here—when your heart muscle isn’t pumping blood like it should. And then there’s valvular heart disease, where those valves either don’t open and close properly or start leaking.
And last but not least, we’ve got the 'electrical problems' of the heart. Just like your house has an electrical system keeping things humming, your heart’s got its own system making sure it beats in a nice, steady rhythm. Issues here can include things like atrial fibrillation, which messes with your heartbeat’s regularity, or SVT (supraventricular tachycardia), where there’s an extra electrical loop making your heart race.
Now, when we talk about common heart diseases, a few come to mind right away. We often think of heart attacks, strokes, and heart failure, especially when there’s a family history involved. These are the ones that tend to pop up most often in conversations about heart health.
So, heart disease isn’t just one thing—it’s a whole mix of different problems that can crop up in different parts of your heart. Whether it’s plumbing issues, structural concerns, or electrical quirks, knowing these categories can really help us understand what heart disease is all about. It’s good to know these different types so we can take smart steps to prevent and manage them
The Preventability of Heart Disease
Heart disease stands as the leading cause of death for both men and women, surpassing even all types of cancer combined when it comes to women. But here’s the truly empowering part – according to the American Heart Association, we have the potential to prevent 80 to 90 percent of cases. Yes, you read that right – 80 to 90 percent!
This statistic shines like a beacon of hope. Dr. Paschke frequently encounters patients burdened by a family history of heart disease. Whether it's parents lost to heart attacks or siblings facing similar challenges, it can feel like a looming threat. Yet, the knowledge that such a significant portion of heart disease can be prevented instills genuine optimism.
It’s empowering because it shifts the narrative from helplessness to action. Just because heart disease runs in your family doesn’t mean you’re destined to follow suit. There are many steps you can take to significantly lower your risk. Start with the basics: maintain a healthy diet, stay active, quit smoking, and effectively manage stress.
It’s not solely about genetics; it’s about the daily decisions you make.
Heart Disease in Women
Heart disease, often perceived as a male issue, is actually the leading cause of death for women. This misconception stems partly from historical biases in medicine, including the exclusion of women from drug trials following incidents like the thalidomide tragedy (do look it up, but to warn you, it’s heartbreaking). Despite its prevalence among women, heart disease can show up differently, with symptoms like nausea and fatigue often overshadowing more traditionally expected signs like chest pain.
Women's symptoms are frequently overlooked or misdiagnosed, attributed to stress rather than considered as potential heart issues. Treatments tested primarily on men may not be as effective for women, highlighting the gap in medical research and healthcare.
The key message for women is to advocate for their health, trust their instincts, and find doctors who listen and take their concerns seriously. Addressing broader issues like the underrepresentation of women in clinical trials and being aware of gender-specific symptoms are crucial in achieving equitable care.
Foundations of Heart Disease Prevention
Prevention is a powerful tool, and there's a well-established roadmap to follow: the six pillars of lifestyle medicine. These pillars form a solid foundation not just for heart health, but for overall well-being. Let's dive into what these pillars are and how they can help lower the risk of heart disease, diabetes, Alzheimer's, obesity, and even cancer.
The Six Pillars of Lifestyle Medicine
1. Whole Food Plant-Based Diet
A diet rich in whole foods and plant-based ingredients is key. This means focusing on fruits, vegetables, whole grains, legumes, nuts, and seeds. These foods are packed with nutrients that support heart health and help reduce the risk of cardiovascular diseases.
2. Exercise
Moving more is crucial. Regular physical activity helps maintain a healthy weight, lowers blood pressure, improves cholesterol levels, and boosts overall cardiovascular health. As a cardiologist, we can’t stress enough how vital exercise is for keeping the heart strong and healthy.
3. Restorative Sleep
Getting enough restorative sleep is essential. Poor sleep can lead to a range of health issues, including increased risk of heart disease. Aim for 7-9 hours of quality sleep each night to help your body repair and rejuvenate.
4.Stress Management
Managing stress is another important pillar. Chronic stress can negatively impact heart health, leading to high blood pressure and other cardiovascular issues. Techniques like meditation, yoga, and deep-breathing exercises can be incredibly beneficial.
5. Social Connection
Social connections play a significant role in our health. Strong relationships and a good support system can reduce stress and promote a sense of well-being. Loneliness and social isolation are linked to higher risks of heart disease.
6. Avoiding Risky Substances
Avoiding risky substances such as tobacco, excessive alcohol, and drugs is critical. These substances can have detrimental effects on the heart and overall health. Smoking, in particular, is a major risk factor for cardiovascular disease.
It's interesting to note how many of these pillars resemble lifestyles from 50 years ago. Back then, diets were less processed, physical activity was a daily norm, and social connections were stronger. However, modern conveniences like processed foods, sedentary lifestyles, and social isolation have unfortunately become more of the norm.
By embracing these foundational principles, we can significantly improve our well-being. Adopting a whole food / plant-focused diet, regularly exercising, ensuring adequate sleep, managing stress, fostering social connections, and avoiding harmful substances can make a world of difference.
The Best Type of Exercise for Heart Health
When it comes to exercise and heart health, the debate about the "best" type of exercise is ongoing. However, there are some general guidelines and principles that can help us understand what works best for cardiovascular health.
The Basics of Exercise for Heart Health
The American Heart Association (AHA) recommends at least 150 minutes of moderate-intensity aerobic exercise per week for optimal cardiovascular health. This could be as simple as a brisk walk for about 30 minutes a day, five days a week. It's a manageable goal for most people and can significantly benefit heart health.
The Role of Cardiovascular Fitness
Cardiovascular fitness, often measured by VO2 max (the maximum amount of oxygen your body can utilize during exercise), is a critical factor in heart health. People with a higher VO2 max tend to have better heart outcomes. While activities like CrossFit or jogging can boost VO2 max, it’s important to remember that not everyone needs or wants to engage in high-intensity exercise. The key is to find an activity that you enjoy and can stick with long-term.
The Importance of Movement
The focus should really be on movement. Many of us have sedentary jobs and spend large portions of our day sitting. Even those who exercise regularly can benefit from incorporating more movement into their daily routines. Simple activities like standing up, stretching, and walking can have significant health benefits.
Learning from the Blue Zones
Consider the lifestyles of people in the Blue Zones—regions where people live the longest, healthiest lives. These individuals don't necessarily go to the gym or follow structured exercise routines. Instead, they incorporate natural movement into their daily lives. Gardening, cleaning, and other forms of physical activity are part of their everyday routines. This continuous, low-intensity movement is highly beneficial for cardiovascular health.
Exercise Snacks
"Exercise snacks" is a buzzword that emphasizes short bursts of physical activity throughout the day. Setting an alarm to remind you to move every 45 minutes, whether it’s doing jumping jacks, lunges, or a quick walk, can break up long periods of sitting and boost your overall activity level. This approach aligns well with modern lifestyles and can easily be integrated into a busy schedule.
Practical Tips for Incorporating More Movement
Many of us now commonly rock athleisure wear, so taking a quick workout break between calls or tasks is quite feasible. These little bursts of activity not only improve physical health but also boost mental clarity and productivity. Encouraging people to take short walks or stretch between meetings can lead to a more productive and enjoyable workday.
In conclusion, while structured exercise like running or CrossFit can be beneficial, the most important thing is to move more throughout the day. Embrace natural movement, incorporate exercise snacks, and aim for consistency. By doing so, you can significantly improve your heart health and overall well-being even in our modern, convenience-driven society.
Linking Stress to Inflammation and Cardiovascular Health
Stress, in moderation, is actually beneficial. It triggers a response that helps us react to immediate danger. For example, if a car swerves in front of you on the road, your body releases hormones like adrenaline and cortisol, which help you react quickly to avoid an accident. This stress response is an evolutionary survival mechanism.
However, in our modern society, stress has become chronic. We constantly worry about work, finances, family, and even global events that we can see on our phones 24/7. This chronic stress keeps our stress hormones elevated longer than they should be, leading to increased inflammation in the body.
Chronic inflammation is a significant factor in cardiovascular disease. So here me out - high cholesterol has long been recognized as a cause of plaque build-up in arteries, leading to heart attacks and strokes. However, not everyone with high cholesterol develops plaque, and some people with normal cholesterol levels still have heart attacks. This discrepancy has led researchers to focus on inflammation as a key factor.
Inflammation irritates the arteries, making it easier for plaque to stick and build up. Understanding this can highlight how important it is to manage stress, which is a major contributor to chronic inflammation.
Reducing Stress in Daily Life
So, how do we lower stress? It involves addressing the sources of stress and incorporating stress-reducing activities into our daily lives. Easy to talk about, but hard to put into action, right? Here are some strategies:
1. Limit Exposure to Stressors
Limit your social media and news consumption to specific time periods each day to minimize exposure to stressful content. Be mindful of the amount of television you watch, particularly news and other programs that may induce stress.
2. Mindfulness and Relaxation Techniques
Regular meditation, yoga, and journaling are effective ways to reduce stress and enhance mental well-being. Meditation for 10-15 minutes daily, yoga's blend of movement and breathing exercises, and journaling for emotional clarity offer practical tools for managing stress in daily life.
3. Physical Activities
Walking in nature can release stress-reducing chemicals in the body. Engaging in regular physical activity, whether through structured workouts or daily movements,can greatly reduce stress levels.
4. Therapeutic Techniques
Emotional Freedom Techniques (EFT) or ‘tapping’ on certain points on the body can be highly effective for stress relief; try it consistently for a week to gauge its impact. Relaxing in a sauna or hot tub can also effectively alleviate stress by calming the body. For those who find it invigorating, cold water plunges can provide stress relief as well.
The key is to experiment with different stress-relief techniques to see what works best for you. Just like encouraging a child to try a new food several times, you might need to try these techniques consistently to see the benefits. Give each method a week, practice it daily, and then evaluate how you feel. This approach can help you find the best stress-relief strategies to incorporate into your daily routine.
Advanced Cardiovascular Testing
Understanding your heart health goes beyond basic screenings, especially when standard tests might miss critical details. Despite heart disease being a top killer, insurance often sticks to only covering basics like cholesterol levels. That's where advanced markers like ApoB, Lp(a), Myeloperoxidase, PLAC2, and hsCRP come in—they reveal genetic risks and inflammation that could slip under the radar.
Alongside blood tests, high-tech imaging like carotid intimal thickness and CT calcium scores give a deeper look. They spot plaque and blockages that could cause trouble down the line. Even if insurance doesn't cover them, these tests are surprisingly affordable, like snagging a good deal on something you know will pay off in the long run.
Sometimes, you've got to nudge your doc to think beyond the basics. If they don't go for it, services like Any Lab Test Now or Rupa Health let you take the reins. Getting these tests done means you're not just guessing about your heart—you're armed with solid info to steer your health in the right direction.
Personalizing Statin Therapy
Statin therapy can be great for managing cholesterol levels and reducing heart disease and stroke risk. These meds work by curbing liver enzymes that produce cholesterol, making them a cornerstone in heart health. Yet while statins are widely used after heart issues, their role in preventing first-time problems, especially for women missed in earlier trials, is still up for debate.
In practice, docs often use calculators based on age and cholesterol levels to suggest statins, but these may miss key risks like family history or inflammation. That’s where advanced tests like other lab tests and CT calcium scores come in—they paint a clearer picture of heart risk. This tailored approach ensures statins are used wisely, avoiding unnecessary meds for folks with high cholesterol but low overall risk.
Patients often worry about starting statins and their side effects. Yet, for those with high cholesterol or a strong heart disease history, statins can be a game-changer.
Dr. Paschke stresses how important it is to monitor each patient. Even with a healthy lifestyle, some people, like those after menopause, may face heart risk and muscle aches with statins.
To really tackle heart health, statins should be considered one piece of the puzzle. Plan for better eating, less stress, good sleep, and a solid support circle. They're all part of a whole-health approach that's all about fitting care to you.
Breakthrough in Heart Health: Wegovy Redefine Cardiovascular Care
GLP-1 receptor agonists like Wegovy (semaglutide) have sparked excitement in the cardiovascular world. As seen in the SELECT trials of Fall 2023, they have shown to have a 20% reduced risk of heart disease including heart attacks and strokes in at-risk individuals!
Wegovy has even been shown to be so effective, it prompted FDA updates to include these heart health benefits in drug labels. This shift marks a super exciting advancement in preventive medicine, offering hope for better heart health outcomes across diverse patient populations.
In summary, GLP-1 agonists like Wegovy represent a pivotal advancement in modern cardiology, combining diabetes management with substantial heart health benefits.
By adopting preventive measures such as maintaining a healthy lifestyle, regular check-ups, stress management, and using GLP-1 agonists where appropriate, individuals can significantly reduce their risk of cardiovascular disease. Let’s pave the way for healthier hearts so we can live longer and live better.
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