Heart Smart Living
Heart Smart Living

Cardiologist, author, and heart health expert Dr. Sarah Samaan offers advice on how to live a heart smart life.

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Preventing Heart Disease: The Next Frontier in Cardiology

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When I first began my practice of cardiology in 1994, my ten years of medical training had prepared me exceptionally well for treating heart attacks and saving lives on the front line. At that time, the emergency room was our battleground, and our fight was against the blocked coronary artery. Never mind how that blockage came to be, my mission was to get it open.

Over time, I began to realize that although treating a heart attack was exciting and usually very gratifying, preventing heart disease was the more challenging task. Despite our technological and pharmaceutical progress, cardiovascular disease kills one in three American men and women, and costs the US economy over $300 billion every year. Forty five percent of heart attacks occur in those younger than 65, and one in twenty strikes before the age of 40. Shockingly, the arteries of as many as 15 percent of teenagers show signs of cholesterol buildup.

Any medical student can rattle off the risk factors for heart disease. High blood pressure, diabetes, high cholesterol smoking, obesity, a sedentary lifestyle, and family history head the list. We’re very good at prescribing drugs for the first three, but in many cases, those conditions can be fully prevented or seriously curtailed by a heart healthy lifestyle. In fact, fully 85 percent of heart disease is preventable, and as much as 70 percent can be directly attributed to lifestyle choices.

In the early 1980’s, as I was starting my training, only about 10 percent of Americans were obese. In 2012, more than 33 percent are considered obese, and the numbers continue to rise. At the same time, one in every five kids is obese, a statistic that would have been unthinkable 20 years ago. Less than one third of us exercise regularly, and yet our daily caloric intake has increased by 200 to 300 calories over the past two decades.

The Trust for America’s Health and The Robert Wood Johnson Foundation warn that “obesity threatens America’s future.” This is not an overstatement. A major contributor to cardiovascular disease, diabetes, hypertension, high cholesterol, arthritis, lung disease, and cancer, obesity is a serious threat to both physical and financial wellbeing. Although the biochemical, physiologic, and psychological factors underlying obesity are complex, the fundamental fact is that we are eating more of the wrong things, and exercising less.

Treating heart disease can be complicated, but preventing it is often quite simple. A Mediterranean diet, including plenty of fruit, green vegetables, whole grains, olive oil, nuts and fish, with little to no red meat (and wine in moderation if appropriate), may reduce heart attack risk by half compared to a typical Western diet. The diet also appears to lower the likelihood for cancer, dementia, and even erectile dysfunction. Exercising 30 minutes five days per week will lower heart attack risk by 30 percent; even 15 minutes a few days a week will make a modest difference.

It’s time that we start taking our gift of life to heart, and stop living as if we’re invulnerable. Our body suffers the consequences of the harmful choices and habits that we cultivate every day, yet with good nutrition and a lifestyle that nurtures and sustains health, there is great capacity for healing. That’s the message I share with my patients and my readers, and that’s the simple secret that will help to mitigate the looming healthcare crisis that threatens the economic well-being of our nation.

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Tags: You and Your Doctor

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About the Author


MD, FACC

Dr. Samaan is an acclaimed cardiologist, writer, and heart health educator.

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