Guest: Dr. Jason Kaplan
Presenter: Patrick Reyes
Guest Bio: Dr Jason Kaplan is a specialist adult cardiologist and physician. He studied Medicine at UNSW and graduated with Honours in 1999. He then completed his Internal Medicine Training at St George and Prince of Wales hospitals and Adult Cardiology training at Royal Prince Alfred Hospital. Currently, Dr. Kaplan is the Clinical Lead of Cardiovascular and Respiratory Medicine at Macquarie University and is a clinical lecturer in Medicine and Cardiology in the Faculty of Medicine and Health Sciences teaching undergraduate and postgraduate students.
Segment overview: Heart and cardiovascular disease are amongst Australia’s largest health issues. Each year, an estimate of one in every six Australians are affected, resulting in 480,000 hospitalisations and 45,000 deaths Dr. Jason Kaplan joins Health Professional Radio to talk about the lifestyle choices and common kitchen ingredients that can help stop the spread of heart diseases without taking drugs. He will be discussing the benefits of Aged Garlic Extract as a natural therapy to support heart health.
Health Professional Radio – Halt Cardiovascular Diseases Naturally
Patrick Reyes: Hello and Welcome to Health Professional Radio, I’m your host Patrick Reyes. Now given that a heart a cardio vascular disease are most Australia’s largest health issues, we’ve decided to invite Dr. Jason Kaplan onto the show. He’s an Australian trained Adult Cardiologist with a sub specialty training in Cardiac Imaging and he’s currently the Clinical Lead of Cardiovascular and Respiratory Medicine at Macquarie University and a Clinical Lecturer in a Medicine and Cardiology in the Faculty of Medicine and Health Scientist teaching in Undergraduate and Post Graduate students. Welcome to the show Jason.
Dr. Jason Kaplan: Thank you very much for having me.
P: Thank you. And now can you tell us the rate of heart attacks in Australia?
K: Look, every 10 minutes one person in Australia has a heart attack and misses data from the Heart Foundation with heart disease probably bleeping the number one killer in Australia and also the number killer of people worldwide. What’s so really interesting is that most people think it’s a disease killing of men but actually women who actually aged of 55 or 60 the risk for heart attack also increases too significantly. So it affects both sexes equally after the age of 60 as well.
P: And why is Cardiovascular disease is so prevalent in Australia?
K: I think the majority of it is because of our lifestyle change. We are becoming more sentry, in fact sitting down is almost the new smoking and a lot of us are seated on our desk, we don’t move a lot. Our way of eating has become slightly more Americanized that there are strip malls with fast foods outlets and when I practice in the Western Suburbs to Sydney, I see a McDonalds, a Pizza Hut or Kentucky Fried Chicken all in a row. And this is where people eat this really bad food and increases the risk of heart disease, also we’re not walking, we’re not spending enough time for outdoors. Children start from very early playing video games instead of going out and exercising. So our rate of heart disease is increasing because of lifestyle factors and it’s lifestyle factors we’ll be able to change and reduce our risk of getting heart disease in the future.
P: Speaking of lifestyle choice, what lifestyles risk that can people make to stop heart disease without drugs or medication?
K: So this is a fascinating area in Cardiology where intuitively we’ve known of that making a positive lifestyle choices will make a big difference to your outcome but we never really had the data or the large studies to show this. And to make any meaningful sense of information in Cardiovascular trials, usually you need about 10,000 patients. And traditionally pharmaceutical companies have done large trials to show defects of drugs and Pharmaceuticals, they’re very difficult to show this in large clinical trials for lifestyle intervention. But that has really changed over the last few years and there was this amazing study published in 2013 in one of the biggest Medical journals and the most popular in the world called The New England Journal of Medicine based out of Boston and it’s called the Predimed Study. And the predimed study show the effect of the Mediterranean style diet that reducing heart attacks and strokes over quite a few years and the amazing thing they found was compared to traditional way of eating, people eating Mediterranean style diet which was lots of whole foods, lots of nuts, lots of fresh food and vegetables and interestingly a large amount of extra virgin olive oil incorporated in a day to day cooking and eating habits, reduced the risk of having a heart attack or stroke by 40%. And to give you an idea about how powerful that is, that’s like taking the most popular cholesterol drug called Atorvastatin, that’s like taking 20mg of Atorvastatin, the effects of lifestyle. Which is pretty amazing then if you add to that the compound and effects of doing regular aerobic exercise, people just need to get moving. I tell my patients that you should get one of those fitness trackers on the wrist and make sure you’re doing at least 10,000 steps of that in a day. And if you’re getting to run 10,000 steps a day you have a very good idea that you are moving and you’re getting enough movement that you need to reduce your cardiovascular risk. And it’s always lots about the type of exercise to do, for me the advice I give to my patients you have to get moving and make sure that your heart is speeding to level where you know makes a little bit difficult to talk comfortably and you’re doing quite a few times a week. You just have to do something that you enjoy but that something that you do more and more often. So lifestyle choices have becoming paramount, in a way that people can do that on a consistent basis by making choices in terms of the food that they eat and exercise.
P: Is heart disease hereditary?
K: Heart disease is hereditary and I can’t overestimate the effects of having a first degree family member with heart disease has on your cardiovascular risk. And so for people that don’t know their family history it’s important to speak to relatives and find out exactly what sort of heart condition that they have. And the majority of heart diseases we’ve seen in Australia … is Coronary Artery disease and that is the buildup of plaque in people coronary arteries that supply blood to the heart and that definitely has a hereditary component to cause of that is often a very high level cholesterol and high levels of bad cholesterol which is often a heredity as well and often high blood pressure which is also a component is affected by hereditary components. What we’ve now known is that despite having a hereditary pre disposition to heart disease, if people make simple lifestyle changes such as having a healthy weight, regular exercises, having a normal blood pressure and choosing a more Mediterranean style diet and also interestingly having low levels of stress, you can reduce your underlying genetic risk for heart disease by over 50% and this is from a very powerful study that will published in just a few months ago at the American Heart Association in New Orleans. So in a way your genes, your genetic make up loads the gun but the environment that pulls the trigger and we really can change your genetic pre disposition to heart disease.
P: You did mention high blood pressure, what does it mean to have high blood pressure and what can it do to your body?
K: So high blood pressure commonly is when the pressure in our arteries that supply blood to all of our organs in our body is elevated above 140 which is a top number to the systolic number or 90 which is a diastolic number … which the heart pumps. Now blood pressure is one in a way of these very insidious diseases because it doesn’t really cause any symptoms, until you start to see the end effect of blood pressure and when I talked to patients about having high blood pressure I liken it like the way feeling rocks on the ocean coast that for many, many years they’re subjected to these waves of high blood pressure in the arteries. And it’s only after many, many years you start to see erosion on the rocks, you start to see changes in your blood vessels, so high blood pressure is the effect on the blood vessels by making them harder and stiffer which increases your risk of stroke. It has the same effect on your heart muscles as a heart has to pump out against the high blood pressure, the heart muscle becomes stiffer and an actual fact it’s one of the main causes of heart failure going for. High blood pressure is also the major epidemiological cause of disease equals to stroke which is called atrial fibrillation which is in an irregular heart beat and also can affect our kidneys as well, so it’s really important to get your blood pressure checked. And also to get on top of it early and because you don’t feel the effect, you don’t feel actually start the effect the high blood pressure on your body until a lot of damage has been done.
P: And what are some of the signs and symptoms of high blood pressure and how can we control it?
K: A lot of people will feel that their blood pressure is very high. They’ll often feel a pulsation in their head or their neck. Some people might feel that they might get headaches, blood pressure can affect the eyes as well and the eyes are really interesting gateway into our blood vessels and for anyone who’s interested they should really go to see an Optometrist and Ophthalmologist and get them take a picture at the back of the eye, because you can really see the changes of high blood pressure and often it’s called Silver Wiring. And using the eyes you can actually see what’s a marker on what’s happening to blood vessels, also on my Clinical practice I use something called pulse wave analysis which is the measuring of the stiffness of people’s arteries and this measures something called Pre-hypertension. So people who have high blood pressure and very stiff arteries and almost certainly they’re gone to set up high blood pressure, high blood pressure down the line. Now over a quarter of all men at the age of 50 in Australia are on high blood pressure medication, there are a lot of lifestyle things we can do to lower high blood pressure. One of the most important things is having a diet in high food in vegetables to lower your salt intake, do regular exercise, alcohol restriction, even things like meditation and exercises to reduce our stress and anxiety are very helpful. And in some cases supplements can very helpful as well, there’s been some recent studies recently published about the effects of aged garlic extract on blood pressure and there’s actually some very promising results when aged garlic is used then people that you don’t have very high blood pressure, or is in adjunct to medication to try to limit the amount of drugs people may use to lower their blood pressure and can sometimes lower high blood pressure to 10-15 mm of mercury, which is an often an effect of a single drug, so it can be more effective.
P: Before we get more into aged garlic extract, what are the some common kitchen ingredients for a healthy heart?
K: So I always tell my patients and said it’s better from the plate than the bottle. And it’s not often that I tell patients that I’ll recommend taking too many supplements because I think the best nutrition comes from the food that we eat. I tell all patients that’s it’s really more important that we have a quite a few servings of fatty fish, so that their quantity of Omega 3 fish oils, so Salmon Mackerel Sardines or plenty of fish three times a week. If you’re not getting it, think about taking in a fish oil supplements from a good quality supplement. I think extra virgin olive oil used … on raw foods is a great supplement to have, diet that’s high in fruit and vegetables, the other really important thing to include is fiber. So fiber is great at lowering our cholesterol and so the most effective ways we can lower cholesterol by simple dietary means, things like psyllium husks, a very helpful … that’s in oats or plenty of fiber containing vegetables is a great way to low cholesterol over the long term.
P: You did mention aged garlic extract, can you tell more about the benefits of it?
K: So what’s really interesting is when I spoke earlier about the Mediterranean style diet, what we’re trying to see is that dietary eating patterns instead of single food make the biggest difference in people’s out comes. And while the Mediterranean style diet is done well for all these people live around Mediterranean … that included food like garlic as part of their regular eating patterns for hundreds if not thousands of years. Now aged garlic extract is a special form of garlic to optimize the beneficial effects of garlic without some of the smell or effect on people’s breath and also it is very standardized form of the compound. And it has been shown in quite a few clinical studies to both lower blood pressure and also really interestingly to slow the effects of coronary artery calcification. Now coronary artery calcification is the build-up of plaque in people’s coronary arteries which is what we call coronary artery disease or arteriosclerosis. There has been some very early studies that show that aged garlic extract can slow the progression of this in certain people and it’s useful as an adjunct to regular recommended treatment programs in people with coronary artery disease.
P: Now for our final question, what is the biggest misconception about heart disease that you would like to clear up?
K: Well I think that from the latest study that I mentioned from the American Heart Association that despite your genetics, we have the power to change our risk of developing heart disease going forward by making positive lifestyle changes. And we never think of we are a product of our genes and lifestyle change even though it may not be that people may not feel it as powerful as drugs and it’s often harder to do than simply popping a pill, but the effects of making lifestyle choices far outweigh way the more beneficial on people’s overall health than just purely relying on medication to make those changes. So I think one of the misconceptions is that people often think “Well I’ve tried lifestyle, it’s not going to make a difference.” But all the data now suggests that how we live our life and the food and the eating patterns that we use and the exercise choices that we make, make a major difference to our cardiovascular outcomes reducing our risk of stroke, reducing the chance of high blood pressure. And in all the major guidelines it still remains the cornerstone of cardiovascular disease prevention. So I think people must not underestimate the powerful effects that lifestyle can make at reducing heart disease.
P: Alright, it’s been a real pleasure having you on the show Jason.
P: Thank you very much for having with me, I appreciate it.
P: Yes, thank you. Now you’ve been listening to Health Professional Radio, I’m your host Patrick Reyes and we’ve been in conversation with Dr. Jason Kaplan as we talked about heart and cardiovascular disease and also what having high blood pressure means for your body and how you can control it. If you’ve missed our conversation or if you would like to listen to this interview again, transcripts and audio of this program are available at healthprofessionalradio.com.au and also at hpr.fm and you can subscribe to this podcast on iTunes.