The World Heart Organization asserts that cardiovascular diseases (CVDs) are the number one cause of death worldwide, and it is estimated that every year, 17.9 million people die due to CVDs. Cardiovascular diseases refer to conditions that affect the heart and blood vessels, of which coronary heart disease is a type of CVD.

In this episode of ExpertsConnect, a Clinical Fellow in Interventional Cardiology, at the University of Toronto,  Dr. Tahira Redwood, explains the condition known as coronary heart disease, its causes, and risk factors. In addition, she describes the signs and symptoms of the disease and provides an overview of the short-term and long-term effects of the disease. Finally, Dr. Redwood explains how we can prevent coronary heart disease and shares her tips to live a heart-healthy lifestyle. 

SHOW NOTES:

 What exactly is coronary heart disease? [1:25] | Dr. Redwood explains that coronary artery disease is a very common disease. In fact, it is the leading cause of death in first-world countries and in the Caribbean, it can affect anyone, usually over the age of 35. But as one gets older, their risk increases. And there are other risk factors that contribute to this disease, including diabetes, hypertension, obesity, sleep apnea, and end-stage renal disease or kidney failure. So, basically what happens is there is a buildup of lipid cholesterol within the blood vessels in around the body, but more specifically, in the heart. And this can decrease blood flow to the heart causing things like heart attacks or heart failure.

What are the modifiable and non-modifiable risk factors of this coronary heart disease? [2:21] | Dr. Redwood explains that the modifiable risk factors are things that one can change. In essence, one is not born with these risk factors. She states that it's an amalgamation of various habits that one has picked up over the course of life. For example,  smoking, which is a significant modifiable risk factor. Dr. Redwood also states that medical personnel always encourage people to discontinue smoking when possible. Another modifiable risk factor she mentions is diet. Therefore, she recommends a well-balanced diet, high in vegetables and fruits, but also balanced within the other food groups. She also lists obesity as a significant modifiable risk factor, as such she recommends daily exercise of at least 30 minutes per day, most days of the week, which she states is usually enough to modify one's risk factor in terms of obesity. In addition, she stated that keeping a normal body mass index, also known as BMI, and trying to keep one's waist basically smaller than their hips is ideal for obesity control. Dr. Redwood further explains that non-modifiable risk factors include hypertension, which could be genetic or induced by increased salt intake or kidney problems, or other diseases. She also lists diabetes as a very common non-modifiable risk factor, especially in first-world countries with a Westernized diet. She also highlights that one could become diabetic from being obese. Therefore, she advocates that weight control is very important. Dr. Redwood discusses other non-modifiable risk factors such as race e.g., the Southeast Asian and Black race, have an increased risk for getting coronary artery disease.

What's the link between cholesterol and coronary heart disease? [5:38] | Dr. Redwood explains that high cholesterol is pretty common, especially because we have the Westernized diet, which is well adopted by people in the Caribbean. She states that the Westernized diet includes really high protein, high fatty foods, high fatty acids, containing foods, and fewer vegetables and fruits. She further states that the link between high cholesterol and coronary artery disease is because cholesterol gets deposited in the walls of the blood vessels, which further causes atherosclerosis or plaque. Eventually, this builds up over time, which can completely occlude vessels, and they can break off and cause heart attacks, or they can occlude vessels causing heart failure in the long term.

What Exactly is Atherosclerosis? [8:08] | Dr. Redwood explains that atherosclerosis is basically the build-up of cholesterol and lipid within the blood vessels of the arteries in one's body. In essence, they're just little small molecules that over time, just build up and build up. Dr. Redwood mentioned that some persons even at a very young age have high atherosclerosis in their body, from things like familial hypercholesterolemia, which is basically when one has levels of cholesterol and it runs in their family. She defines atherosclerosis as the build-up of cholesterol, lipids, and other substances e.g., LDL, or vldls, causing a massive plaque in the arteries, which can eventually block it. 

What are the long-term and short-term effects of coronary heart disease? [10:53] | Dr. Redwood mentions that if one has very severe coronary artery disease, and one could have a heart attack, or the worst thing that could happen is that one dies, or otherwise, once could have significant damage to the muscles of the heart, which is called heart failure. In this case, Dr. Redwood states that one is unable to pump blood around the body like it's supposed to, which can affect one's kidneys, causing kidney disease eventually leading to hemodialysis. She also stated that this can cause strokes and heart failure symptoms. Therefore, one can have a buildup of fluid because the body is unable to get rid of the fluid in the way the body is designed to. As such, one can get leg swelling, significant shortness of breath, one is able to do the things that they are used to doing, and one would have to be on medications e.g., water tablets to try and get that water off. She mentions that heart failure is one of the biggest complications that medical personnel try to avoid, which can decrease life expectancy by five to 10 years. 

How can we prevent coronary heart disease [13:11] | Dr. Redwood argues that there are many ways to prevent coronary artery disease. If it runs in one's family, then one should ensure they go to screen early at their general practitioner. In addition, she mentioned that a certified herbal medical doctor could assist with lifestyle balance because lifestyle is going to be the first and key and primary prevention of coronary artery disease. She also emphasized that exercising at least four days of the week, for at least 30 minutes, could be useful to reduce blood pressure, prevent diabetes, and obesity. She describes other preventative methods including balancing one's diet and consuming food in moderation. She also mentioned getting help from a dietitian and quitting smoking as preventative measures among others. Dr. Redwood stressed that all these measures were also applicable to people who were already diagnosed with coronary heart disease.

How can we live a heart-healthy lifestyle? [19:06] | Dr. Redwood shares the following tips to live a heart-healthy lifestyle. 1) Make a list when going grocery shopping. Be sure not to buy things you don't need. 2) Choose healthier options like fruits instead of ice-cream or zucchini noodles for pasta or cauliflower rice as a rice substitute. 3) Exercise when you're free. 4) Quit smoking. 5) Check for diabetes and monitor your blood pressure at least once per year. 

Notable Quotes from Dr. Tahira Redwood

"[…] Coronary artery disease is a very common disease. In fact, it is the leading cause of death in first-world countries and in the Caribbean, it can affect anyone, usually over the age of 35." [1:30]

“[…] keeping a normal body mass index, also known as BMI and trying to keep your waist basically smaller than your hips is really the goal of obesity control.” [3:17]

“I don't strongly believe in diets, I strongly believe in eating the right amount of food. And one of the biggest issues is humans have adapted to eating larger amounts of food than they actually need. So the aim is to eat smaller quantities of the food that you like, and try to balance it so that you can be consistent with a normal diet, […] because when you do crash diets, not eating and ketogenic and things that your body is not used to, it's very hard to maintain those kinds of things. So even though you know what you say, avoid fatty foods, […], and fried food. I say that if this is what you like, then you should be able to eat small quantities of it. It's when you eat three pieces of you know, […] that's above and beyond, but you know, the one-piece is okay.” [7:09]

“[…]   There are many ways to prevent coronary artery disease. If it runs in your family, especially on you know that you have brothers, sisters, your mother or father, aunts or uncles that have had heart attacks, heart failure, heart disease,  you should ensure to screen early at your doctor or your general practitioner.” [13:15]

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