Austin doctor weighs in on how to reduce your risk of heart disease

AUSTIN, Texas - As we wrap up American Heart Month, we want to focus on screenings for heart disease. 

Most cases can be prevented by maintaining a healthy weight along with a healthy diet and exercise. Having normal blood pressure and cholesterol levels can greatly reduce your risk of heart disease, but that doesn't get rid of the risk, and that is when early detection becomes so important. 

Dr. Vivek Goswami, a cardiologist with Heart Hospital of Austin and Austin Hart, joined FOX 7 Austin's Rebecca Thomas to discuss.

Local perspective:

Rebecca Thomas: Dr. Goswami, let's start off by busting a myth. If a person has normal blood pressure and blood cholesterol levels, many people might think they're in the clear. But cholesterol isn't the only thing that clogs arteries. Let's talk about that.

Dr. Vivek Goswami: That's true. Certainly it's true. Why? The higher your cholesterol, the higher the risk. It's not necessarily a 1-to-1 correlate. So what's more important is what's happening is a balance of the cholesterol and the person sitting in front of us. So the days of old where we used to see a certain number saying, hey, your cholesterol is high, we need to treat that number. We really need to be zooming out. And why? Cholesterol and blood pressure are very important pieces of the puzzle. Collectively, we're building a picture to figure out what the risk is and the person sitting in front of us. So, as someone who is board-certified in lipids, I can't tell you if someone needs your cholesterol treated just by their lab test. Three people can have the exact same lab, and we may do three different things depending on what's happening as a balance of the cholesterol and the person in front of us. And that's a much more personalized, specific way of treating people.

Rebecca Thomas: Talk about calcium, the buildup of calcium in the arteries. And is there anything that can prevent that? 

Dr. Vivek Goswami: Yeah, absolutely. So, you know, when this cholesterol plaque in our arteries, the same thing that leads to heart attacks and stents and bypass passing all those things we're trying to avoid, when that plaque becomes old or chronic, it calcifies and with very low contrast, low radiation, non-contrasted Cat scans, we can identify the presence or absence of this calcification. So that is a good tool to screen for the actual disease. I call it a mammogram of the heart, almost like a colonoscopy of the heart. So, if men are say 45, or women or 45, or if you have specific risk factors, maybe even earlier to get a screening CT calcium score to identify the absence or presence of early calcified plaque, I think that's much more specific to the individual sitting in front of us. And remember, when people have heart attacks later on in life, 5565 it's not because of the plaque that starts later on a life that that plaque starts decades before. So we really should be screening for when it starts, not when it becomes clinically apparent. 

Rebecca Thomas: In addition to the calcium score, when it comes to screenings, where do you start? What is the first step?

Dr. Vivek Goswami: I think number one is knowing your risk. We know heart disease is the leading cause of death in the United States. We know there are established risk factors. You mentioned a couple of them high cholesterol, high blood pressure, high sugars, family history, smoking, poor diet, poor exercise. Sometimes, independent of these risk factors, we can still have vascular disease. So, in addition to keeping our conventional risk factors under control, we really want to make sure we're maintaining a heart-healthy diet. We want to think about things like exercise, like a prescription, not just a recommendation. If there's a day that we're not exercising aerobically, that should be analogous to not taking our medication that day, not just something that we do if we have free time or it's elective. And on top of that, you really want to get ahead of things and screen for the actual process. And it's amazing to me how when women turn 40, there's routine recommendations for mammograms to catch disease early. We routinely perform screening colonoscopies when people turn 45, if not earlier. But we oftentimes don't do anything to screen for heart disease, even though it's much more likely to take us off this Earth than breast cancer and colon cancer combined. Right? So in addition to knowing our risk and maintaining our risk factors, actually screening for the disease, I think is very, very important. 

Rebecca Thomas: All right. Dr. Vivek Goswami, cardiologist with Heart Hospital of Austin and Austin Hart, thank you so much for sharing your time and your expertise with us tonight.