Here’s an excerpt from the transcript of this webinar – “Just Say NO to Heart Disease!”

Elizabeth Owings, MD

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Job Title / Position: Board Certified General Surgery (Additional training in Critical Care Medicine and Pediatric Surgery)

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When we talk about heart disease, we’re also talking about strokes, peripheral artery disease, erectile dysfunction, and all the other things that involve blood flow that may be keeping you awake at night. The deal is, it’s not a pill deficiency. You don’t have a heart attack because you failed to take your cholesterol pill that morning. These are lifestyle issues, but there are things we can do to help. We know it’s primarily lifestyle issues because wherever we’ve opened a McDonald’s, anywhere on the planet, heart disease rapidly becomes the number one killer. To me, heart disease is a terminal event in atherosclerosis. It’s the number one killer of Americans, and in any industrialized nation, it’s going to be vascular disease. I just finished looking at the statistics in the Baltics and the Slavic nations; it’s still these vascular diseases. Sometimes, it’s misleading, if you look at causes of death and they separate heart diseases from strokes, but I don’t separate them; it’s still a vascular problem. The first sign will be death in 1/3 to ½ of them. Friendly reminder: we’re looking at heart disease, we’re looking at carotid disease, which may cause strokes; peripheral vascular disease, which may lead to amputations; peripheral bypasses; chronic wounds; erectile dysfunction; all of these things.

How does this happen? How does someone with healthy blood vessels end up with a heart attack? It doesn’t happen overnight, it usually happens over decades. When we’re born, our blood vessels are smooth and clean. But by the age of ten, most of us have already developed fatty streaks, definitely the case in this younger generation. In fact, they’re telling us that this generation of children is going to be the first that has a shorter lifespan than their parents. It comes down to these risk factors for vascular disease. Over time, things progress. We build up plaque, the muscle walls get thicker, and this plaque may actually rupture, which is what happens in most heart attacks and about 80% of strokes. Immediate plaque rupture causes blood to clot right around the thick, gooey mess. Blood flow is completely blocked, and that’s when you have ischemia, loss of blood flow, downstream. This leads to a heart attack or a stroke, and people with peripheral vascular disease may have their toes turn black. All of these things can be associated with plaque rupture.

If it doesn’t rupture, what happens over time is what I call chronic limitation of blood flow: a thick vessel that’s been filled with plaque, and a tiny bit of room for the blood to flow. If that person runs up some stairs, is that person going to feel symptoms at the top? Very likely they’re going to be out of breath, they may feel heaviness in their chest…