Mapping Heart Attacks with Dr. Warrick Bishop #372
Jan 17, 2023
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Dr. Warrick Bishop, an expert on heart attacks and heart disease, discusses risk factors for coronary artery disease, turning cholesterol risk factors upside down, and understanding heart attacks through a functional lens. Topics covered include changing demographics of heart disease, imaging to understand artery health, the concept of LDL particle size, addressing factors contributing to coronary events, and the importance of routine imaging and blood pressure monitoring.
Coronary artery disease, the primary cause of heart attacks, presents a complex and patchy process that is not yet fully understood, calling for a more comprehensive approach in diagnosing and treating the disease.
Imaging the arteries becomes crucial in primary prevention, as it provides direct insight into the presence and severity of plaque buildup, informing personalized interventions and treatments.
Deep dives
Understanding Heart Attacks
A heart attack, most commonly caused by coronary artery disease, occurs when a major artery is blocked. It is a leading cause of death in the western world. Surprisingly, around 20 to 25 percent of heart attacks occur in people under the age of 65. While the term 'heart attack' is often used colloquially to refer to any ailment involving the heart, in medical terms, it is closely associated with coronary artery disease.
The Complexity of Coronary Artery Disease
Coronary artery disease, the primary cause of heart attacks, presents a complex and patchy process that is not yet fully understood. Factors such as cholesterol, diet, exercise, diabetes, and blood pressure have associations with this disease, but their impact varies from person to person. The development of plaque in the arteries can occur unevenly, with a single plaque causing significant harm, while the rest of the arteries remain unaffected. Recognizing the patchiness of the disease calls for a more comprehensive approach in diagnosing and treating coronary artery disease.
The Role of Imaging and Patient Engagement
Imaging the arteries becomes crucial in primary prevention. Cholesterol levels alone are not reliable predictors of cardiovascular risk, as high cholesterol does not necessarily indicate bad arteries, and low cholesterol does not guarantee clear arteries. By imaging the arteries, clinicians gain direct insight into the presence and severity of plaque build-up, informing personalized interventions and treatments. Patient engagement, trust, and individualized care are essential for impactful interventions, including managing cholesterol, weight, blood pressure, and stress levels. Imaging and managing blood pressure effectively can significantly reduce the risk of heart attacks and related complications.
Dr. Warren Bishop joins me on this episode to discuss the important topic of heart attacks and heart disease. We explore how to assess risk factors for coronary artery disease, turn cholesterol risk factors upside down, and put our understanding of what we do and don’t know about heart attacks through a more functional lens.