Chat Transcript: Dr. Oz on Heart Health

Dr. Oz on heart health.

Chat Moderator: We’ll be chatting today with Dr. Mehmet Oz, an attending heart surgeon at NewYork-Presbyterian Hospital and director of the Cardiovascular Institute at Columbia University Medical Center.

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jerrydawson asks: What is the best way to find out the condition of the interior of my arteries?

Dr. Mehmet Oz: There are two parts to figuring out how healthy your arteries are. Part 1 is to actually see the arteries. Part 2 is to see if there’s enough blood passing through the arteries. The best way to see inside the arteries is a CT angiogram, which actually allows us to see great details of the heart. However, it is not as important as finding out if enough blood is passing by whatever blockages we might see. The best way to find that out is a stress test, with the addition of an echocardiogram if you’re a woman.

Danielle asks: A friend of mine said her doctor recommended she floss every day and see the dentist regularly because your teeth tie into your heart health — is this true??

Dr. Mehmet Oz: Absolutely, yes. The teeth sit on gums that can get infected, and that’s called gingivitis. Like any chronic infection of the body like vaginitis or prostatitis, the body’s immune system becomes overstimulated, and overreacts to the small cracks that occur in our arteries, which causes acute closure of blood vessels. When these happen in the heart, they are called heart attacks. They can kill us, because they are so unpredictable. Flossing daily is the best treatment for gingivitis.

vickcha asks: What tests should you take for mitral valve prolapse?

Dr. Mehmet Oz: The best test is an echocardiogram, which shows us the mitral valve, which is like a big floppy sail that billows, and that’s what happens in prolapse.

Danielle asks: What’s the deal with aspirin? Does it really battle heart disease? How much – and how often – should I take it?

Dr. Mehmet Oz: Aspirin absolutely benefits the heart and prevents clots from suddenly closing off an artery. Most men and women over the age of 50 should take 2 baby aspirin a day. The reason we give 2 rather than one is that many Americans are resistant to aspirin. And because the side effects are so minor, it makes sense to give double the dose.

respiterri asks: What is your position on statins in an otherwise healthy 48-year-old woman whose LDL is 161 but HDL is 66 and triglycerides are 67. Seems like a life sentence of unnecessary meds to me.

Dr. Mehmet Oz: Generally speaking, I tend not to treat these lab values too aggressively, because I understand your reluctance to start on medications. Especially if you are a woman, the HDL number appears to be more important than the LDL.

jujuz asks: Would a thickening of the left ventricle cause shortness of breath?

Dr. Mehmet Oz: Yes. Most people think that you have to have a weak heart to get shortness of breath, but too strong a heart that is unable to relax can also cause problems. This is called diastolic dysfunction, and is very common in people with high blood pressure.

eileen999 asks: You recommend a multivitamin daily. I cannot find a vitamin that contains all of the requirements you mention in YOU! The Owner’s Manual. Can you recommend a brand of multivitamin that contains all the nutrients you recommend?

Dr. Mehmet Oz: There is no perfect vitamin combination from our perspective, but there are reputable brands that at least give you in the pills what they say they are giving you. Consumer Reports publishes lists of the reliability of vitamin companies, and is a good place to start.

rdkel asks: Why is high-fructose corn syrup so detrimental?

Dr. Mehmet Oz: Like most simple sugars, high-fructose corn syrup forces our insulin to work overtime. So, our blood sugars are bouncing up and down so rapidly that our body can’t adapt. It also stimulates changes that make us hungry more frequently, so we end up gaining weight.

Danielle asks: What about fish oil capsules? And if I take aspirin, should I also take fish oil?

Dr. Mehmet Oz: I am a big fan of fish oils, because they contain omega-3 fatty acids. I recommend that everyone get 2 grams a day of these important nutrients. I would take aspirin as well, because it is a potent anti-inflammatory, and only stop if you find that you are getting lots of bruises on your body or are having stomach pain.

lindab2 asks: I have mitral valve prolapse and was just diagnosed with arrhythmia and given a beta blocker. I feel much better. Should I be worried or take any cautions?

Dr. Mehmet Oz: A beta blocker is the right treatment if you are feeling symptoms. Often, as you get older you won’t require a beta blocker.

vickcha asks: Can the syndrome mitral valve prolapse actually make you feel so ill even if there is no infection present?

Dr. Mehmet Oz: Mitral valve prolapse can give you panic attacks because it allows the blood to pound against the back of the heart, which irritates nerves that send signals to the brain that something is wrong. Sufferers will often have rapid heartbeats, cold sweats, and claustrophobia.

Danielle asks: How much activity should I be doing each day to reduce my risk of having a heart attack?

Dr. Mehmet Oz: One hour a week of sweating is essential. This means that you will keep your heart rate greater than 75% of your maximum, which is 220 minus your age. Remember that in order to reach this heart rate and sweat, you need to do some exercise. So, the true amount of sports we’re asking for is 1 hour and 20 minutes per week.

dandoun asks: Does the body become immune to blood pressure medication? How does this affect your heart?

Dr. Mehmet Oz: Generally your body does not become immune, but, as you grow older and put on weight, your body will develop naturally high blood pressure, which means you will need more medications.

Danielle asks: Does salt really affect blood pressure? And how important is blood pressure when it comes to risk of heart disease?

Dr. Mehmet Oz: Blood pressure is the #1 predictor of heart disease and aging in this country. Nothing is more important. The salt, for a small percentage of people, is a huge determinant of blood pressure. For most people, it should be minimized in order to maintain low blood pressure.

Danielle asks: What abut sex and heart disease? Can a regular roll in the hay make me healthier?

Dr. Mehmet Oz: Having sex 160 times a year will help promote your longevity, and as far as we can tell, the more the better, at least when it comes to men. For women, it’s not the quantity but the quality that appears to be more important.

vickcha asks: I have been very ill on and off for several years and just found out I have mitral valve prolapse. I have been running fevers as well. I am only 37 and feel 70. What tests can I request to help find what is wrong? I have been to the lab 7 times this month.

Dr. Mehmet Oz: You should have surveillance blood cultures, and if an echocardiogram is not revealing, an MRI might be helpful to ensure that there is no infection of the valve.

JoAnneRB asks: Hi. You were on Good Morning America with Joel Harper and he did some exercises. How can I get his tapes?

Dr. Mehmet Oz: You can google Joel Harper — I believe his workouts are called FitPack. You can also get on a diet workout. I believe they’re on the RD site, but if not, check

Danielle asks: Are there any foods I can eat to reduce my heart attack risk? I’ve heard chocolate and red wine can help!!! And what’s this I hear about pomegranate juice?

Dr. Mehmet Oz: All 3 of these are very helpful because they are rich in antioxidants — especially pomegranate. The chocolate has flavonoids, which relax the heart and allow more blood through, and the resveratrol in red wine is particularly healthy for the heart as demonstrated in several studies. Tree nuts are also wonderful because they have healthy oils, which reduce the chance of fatal irregular heartbeats.

lbisax asks: Do you prefer mechanical valves or tissue valves for replacement?

Dr. Mehmet Oz: If the patient is older than 60 years of age, I generally prefer tissue valves, in order to avoid the blood thinners. Even if I have a younger patient who is very active, I may still prefer tissue valves in order to avoid the risk of thinning their blood.

denisemcavoy asks: Is there anything I can do to increase my HDL? I usually run between 38 and 42. (I am 43 years old — heart disease runs in my family — I’m on Lipitor and my LDLs are at 160.) Are any drugs being worked on to help boost HDLs?

Dr. Mehmet Oz: The best way to raise HDL is exercise and niacin. There’s lots of research in this area, but no drug has been effective yet.

rdkel asks: Is slow deep-breathing especially helpful in lowering blood pressure?

Dr. Mehmet Oz: It is because it stimulates nitric oxide. it can then enter the lungs. It also centers the mind. I use it routinely.

pskumar6 asks: Is it true that unhomogenized milk is better than homogenized milk from a health perspective?

Dr. Mehmet Oz: I believe this to be true, although difficult to prove. I have concerns that homogenizing the milk makes it more difficult for our body to digest. Milk is a wonderful source of vitamin D because it is fortified.

Danielle asks: I’ve heard that eating fish can help protect your heart – is that true?

Dr. Mehmet Oz: Absolutely true. You should have 3 servings of fish per week because it has healthy oils.

respiterri asks: Is it possible for the heart to repair itself after a serious heart attack and to what extent can normal function of daily life return in your experience?

Dr. Mehmet Oz: The heart will naturally wish to repair itself, and is repopulated by adult stem cells soon after the injury. Our hormonal shifts can sometimes help and sometimes hurt this process, so aggressive management by heart failure cardiologists is often worthwhile if the damage is severe. Return to normal activity is often very possible.

Danielle asks: I thought only diabetics had to worry about eating too much sugar. What does sugar have to do with heart disease?

Dr. Mehmet Oz: Sugar is like broken glass on the arterial highways of our heart. It scratches up the “Teflon” lining of those tubes so that they have to be continually repaired by cholesterol, which eventually leads to plaque buildup.

patiw13 asks: Love your books! Here’s my problem… I am allergic to statin drugs. I am currently taking 2000mg Niaspan and Zetia nightly. I am fairly diligent watching my diet. I know I need to exercise more. What other steps can I take to lower my cholesterol?

Dr. Mehmet Oz: There’s a possibility that you may be able to take statin drugs if you combine them with co-enzyme Q10. Otherwise you are doing great!

annbar29 asks: Is 3 grams of fish oil too much?

Dr. Mehmet Oz: It is probably not too much, but also probably not needed.

Guest1 asks: I keep hearing about walnuts for a healthy heart. But I don’t really like raw walnuts. What can I have instead?

Dr. Mehmet Oz: Hazelnuts and almonds are also great. Also, flaxseed oil.

dandoun asks: Heart problems, high blood sugar, high cholesterol and high blood pressure run in my family. I take 20 milligrams of Lipitor every day and Nexium occasionally. What kinds of preventive heart tests should I be asking my doctor about?

Dr. Mehmet Oz: Exercise stress test should be the first step for men, with addition of an echocardiogram for a woman. The key question to ask is whether these risk factors are present because of obesity in the family.

Danielle asks: I have a strong history of heart disease in my family — can I really beat bad genes when it comes to the heart?

Dr. Mehmet Oz: Absolutely. Your genes only control 1/3 of how you age. You control the other 2/3rd.

Guest1 asks: What are the warning signs of heart disease?

Dr. Mehmet Oz: The most important signs are shortness of breath, chest pain, sweating… but often, the heart attack comes up without any warning, so a stress test is essential.

vickcha asks: What is a beta blocker?

Dr. Mehmet Oz: The body has an autopilot system that controls many of its functions. The beta blockers block one part of the system that stimulates you, so that your body can relax. That’s why it is used for so many different problems ranging from high blood pressure to anxiety attacks.

pskumar6 asks: Other than the calorie perspective what are the advantages of sweeteners over white sugar?

Dr. Mehmet Oz: Artificial sweeteners have no advantages over sugar other than the calories, and have not been helpful at helping people lose weight either. So, search for a natural alternative like good old water if possible.

neospyce asks: Is edema, particularly in the left foot, a cause of concern for heart disease?

Dr. Mehmet Oz: Edema in one leg is not concerning, and is probably due to veins not working in that leg. Edema in both legs is a concern. Heart failure might be part of the problem.

Danielle asks: When is it time to see a cardiologist?

Dr. Mehmet Oz: If you have risk factors for heart disease including high cholesterol, high blood pressure, and are having trouble controlling these, or if you have very high blood pressure, you should seek out the help of a cardiologist early in life. In most people, you should have a stress test by a cardiologist by age 50.

Guest1 asks: How much is stress a factor for a bad heart?

Dr. Mehmet Oz: Stress is a major driver of heart disease, especially when it is associated with hostility. It overstimulates the body’s autopilot system, and the heart suffers accordingly.

respiterri asks: Do you think it is more important to limit fat or sugar/carbs in the average diet for heart health?

Dr. Mehmet Oz: I think sugar is a bigger problem. I would strongly encourage that you cut out the trans-fats also.

achampl asks: This is not a question but more a thank you. My daughter is 19 and in college but unfocused until she read your book YOU: The Owner’s Manual. She’s now studying nutrition in college and driving us all crazy but eating healthier.

Dr. Mehmet Oz: Notes like this make all the hard work worthwhile. Thank her for becoming an expert on her own body, and encourage her to spread the word to start a movement to have all Americans recognize that the only way to make our nation healthier is to do it ourselves.

dandoun asks: I am almost 34 and about 5 years ago, I started having pains on the left side of my chest after I gave birth to my daughter. After some tests, my doctor dismissed this. The discomfort is bearable but I worry about what it means for my heart. What should I do?

Dr. Mehmet Oz: If you have ensured that the pain is not from your heart, then at least the most dangerous risk is removed. Now focus on alternative possibilities, including gastroesophageal reflux and musculoskeletal pain.

ellie518 asks: I’m 37, but both my brother and dad died early from heart disease-related problems. My blood pressure and cholesterol levels are great. Should I get a stress test to check my heart?

Dr. Mehmet Oz: You can start around age 45 unless you are having problems, although it never hurts to get a stress test now if only to make you more comfortable emotionally.

yayabain asks: You said blood pressure is so important to heart health, but no one seems to agree on what your BP number should actually be. What number should we aim for? Is lower always better?

Dr. Mehmet Oz: There’s a lot of data that the optimal blood pressure is 115 over 75. You generally do not treat blood pressure with medications once it is below 140 over 90, because there is no evidence that it helps. If you can get it lower with diet and exercise, you are much better off. High blood pressure will strip a decade off your life.

neospyce asks: Why is it that diabetics are more susceptible to heart disease?

Dr. Mehmet Oz: The excess sugar in diabetes strips the teflon lining of the arteries. The answer above about high sugar applies here also.

bymywitz asks: What are your thoughts on low-carb diets when it comes to treating heart disease?

Dr. Mehmet Oz: I have a lot of confidence that these can help because they are feasible ways to lose weight, which is the major driver of heart disease.

[email protected] asks: Doctor, can you actually HEAR your heart thumping loudly? This happens to me in the morning. Please advise.

Dr. Mehmet Oz: You can feel your heart — sometimes it is beating harder and sometimes you are more sensitive to it. It generally is not dangerous if you otherwise feel OK, but you should make sure you’re not having irregular heartbeats.

Thejonnybomb asks: I am a pretty healthy 30-year-old man. I just came off beta blockers. How long will I feel the rebound rapid heart rate and blood pressure?

Dr. Mehmet Oz: It can last up to a week or two. That’s why the drug should be tapered slowly.

jerrydawson asks: What is your opinion on bioidentical hormone replacement?

Dr. Mehmet Oz: Bioidentical hormones are reasonable, but should be used with the guidance of a physician who understands the nuances of the potential dangers of any hormone replacement therapy.

Chat Moderator: We will take one more question…

Thejonnybomb asks: What does a BP of 145/92 in a 16-year-old point to?

Dr. Mehmet Oz: You may have a narrowing of one of your major arteries (coarctation) or in your kidneys, or a hormone tumor, and you must be seen by a physician for a thorough evaluation.

Chat Moderator: Thank you all so much for the great questions! And thanks to Dr. Oz for providing answers.

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