by Stefanie Plum, Gather Partner Team
Member since:
February 19, 2008

Preventing Heart Disease Chat TRANSCRIPT – Join the Discussion and Win Gather Points™!

March 31, 2009 10:02 AM EDT (Updated: April 01, 2009 10:11 AM EDT)
views: 203 | rating: 10/10 (11 votes) | comments: 100

Join us for a live chat, tonight at 8pm ET to discuss preventing heart disease. We’ll discuss the following topics:

  • What’s an ideal cholesterol and blood pressure?
  • How much exercise and what types are best?
  • Should every adult take a statin?

We will be joined by Dr. Howard Lewine of Harvard Medical School. During the chat you can ask him questions, share tips and get advice from other members! One Gather member who participates in the live discussion between 8-9pm ET will win 250 Gather Points™.

The chat takes place here, in the comment field below. You must refresh your browser to see new comments.

Howard LeWine, M.D., is chief editor of Internet Publishing at Harvard Health Publications. He is recognized as an outstanding clinician and teacher and is a recipient of the Internal Medicine Teacher of the Year award at Brigham and Women's Hospital. Dr. LeWine continues to practice Internal Medicine; most recently he became a hospitalist after practicing primary care for over 20 years.

 
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Comments: 100

Jennifer aka Jenn B. Mar 31, 2009, 10:05am EDT
7 PM my time...I'll try and make it...
B.B. B. Mar 31, 2009, 10:13am EDT
6pm my time, i will try being here would be interesting
Susan Budig Mar 31, 2009, 10:18am EDT
This is important enough that I'd give you points to participate if required.

My dad has congestive heart disease. He's lost his mother and brother and sister to congestive heart failure :-( otoh, all three were well into their 80s and early 90s upon passing. But the disease still takes a toll on one's quality of life.
I'm looking forward to tonight's chat.

Yesterday, the polypill grabbed media attention. The medical journal Lancet just published a preliminary study suggesting that adults who take this 5-in-1 pill can lower their risk factors for heart disease. Lots more research needs to be done. The concern is people will think they don't need to exercise as much and eat healthy -- a pill might do this instead.

Lot's to discuss -- will check in this evening at 8 PM Eastern Time.
lynn a. Mar 31, 2009, 11:56am EDT
Hoping to be here, if for no other reason, it helps to keep heart health in mind. Sort of helps in walking away from foods that contribute to clogging those arteries.
Desiree T. Mar 31, 2009, 12:21pm EDT
sounds like a good one
Renee (Pres of Baby James Foundation) ~. Mar 31, 2009, 12:30pm EDT
I really need to be here for this one
Jo N. Mar 31, 2009, 1:36pm EDT
Sounds good.
Mary M. Mar 31, 2009, 6:00pm EDT
What’s an ideal cholesterol and blood pressure?
Cholesterol I think under 120, and BP around 120-130/80 is ideal.

How much exercise and what types are best?
Exercise 3-5 times a week for 20-30 minutes. Cardiovascular is best (getting your heart rate up).

Should every adult take a statin?
A statin is for people whose cholesterol is too high. If we ate better and exercised more (and I definitely include myself in that admonition!) we would not need statins at all. It's kinda scary how many people are on these types of meds.
Mary M. Mar 31, 2009, 6:00pm EDT
You also have to consider that many statins cause a reaction in folks like leg pains.
Mary M.– thanks for opening the dialogue on the three questions. From a public health perspective, we do need set goal numbers for cholesterol and blood pressure levels to help lower risk of heart and other cardiovascular disease. But new research is suggesting that other factors may be equally if not more important. Anyone else want to offer some their thoughts about these questions?
golds g. Mar 31, 2009, 7:54pm EDT
I'm here
☀ Aunt Shanny Mar 31, 2009, 7:59pm EDT
* What’s an ideal cholesterol and blood pressure? Cholesterol has several "ideals". Good and bad levels.

BP: 100-150 over 50-100. I always have good BP.

* How much exercise and what types are best? Regular and low impact, like walking several times a week.

* Should every adult take a statin?
Sandy M. Mar 31, 2009, 8:03pm EDT
my husband had high blood pressure and he did not like the meds. they gave him so he lowered it by eating only low sodium foods. he eats low fat foods. he takes fish oil and centrum cardio. his blood pressure is normal now.
Hi everyone and Dr. Lewine! Thanks for having this chat tonight!
The total cholesterol is less important than the LDL and HDL levels. Some experts say the lower the LDL (bad) cholesterol the better. Most recently 70 or less for the LDL is an "ideal" goal. The opposite for HDL, the higher generally the better, with over 60 considered great. Not sure that there is an ideal HDL -- HDL has multiple components and not all of them are "good."
My husband has high cholestreol, any advice to getting a "stubborn man" to keep up with his meds and diet?
Hi to all just joining in. Sandy -- good point about the low sodium and other ways to lower blood pressure without drugs. Loading up on the vegetables, some fruits, and regular exercise can lower blood pressure substantially. And of course maintaining a healthy weight. But it varies -- so don't get discouraged if you are doing all the right things and still need to take your meds.
Which excersise is the best for you in general? Is there one?
Sandy M. Mar 31, 2009, 8:09pm EDT
Thank you Dr. he keeps his weight very thin. eats healthy. fruits, veggies, low sodium, etc. sometimes he is so picky it drives me nuts. lol.
Sandy M. Mar 31, 2009, 8:11pm EDT
on the other hand I need to lose some weight and the diet that works best for me is Dr. Gotts no sugar no flour diet. I was wondering if you can tell me if it is ok to be on that diet. I mean would eating the meats, etc. raise my cholesterol or blood pressure?
Sheli -- my wife would definitely agree about the stubborn "man" syndrome. For me, it was believing that heart disease would be the health issue that would hurt me the most if I didn't do what I need to -- not smoke, get lots of exercise, keep my weight in line, but I really do need the medications for my blood pressure and high LDL cholesterol. Food is my weakness -- I emphasize the positive --lots of salads, other veggies, fruits.
Sandy -- the question of the best diet for weight loss vs. the best diet for overall health. I have to go with the Mediterranean style diet over the long term. But you surely can jump start any weight loss program with a high fat, low carb diet -- even with lots of meats. But I would keep this short term, no more than 3 months. You get ketones that build up and lots of meats increase the risk of certain cancers, especially colon cancer (and prostate cancer in men).
Sandy M. Mar 31, 2009, 8:18pm EDT
thank you. I may have to look into a mediterranean style diet. I think I recall seeing a book on it.
Funny, my husband runs from salads, fruits, and veggies! LOL!! I try my hardest to keep him on track and I don't give up-we have joined a gym and that is helping him with his excersising-he loves his meats and sweets!!
Sheli -- on the best exercise question -- for the longest time, aerobic exercise in a fat burning zone (about 60 - 80 percent of maximal heart rate) has been promoted as the heart healthiest. So newer research suggests that short burst of getting anaerobic mixed with the aerobic might be even better. For example, after a 10 to 15 minute warmup, add in some heavy exertional exercise in 15 to 30 second bursts. HOWEVER -- if you are not already doing at least 20 minutes of moderate intensity exercise now, don't start the anaerobic training right away. BE SAFE and pay attention to any symptom that doesn't seem right.
Mary G. Mar 31, 2009, 8:24pm EDT
I would like to know how many days a week you recommend exercise and how long?
Aerobics....I was hoping you weren't gonna say that!! LOL!! I do like that but it does not like me! I have gotten myself up to 30 mins. on the treadmill at a speed of 3-which is great for me. Jogging will be next...
Mary G. Mar 31, 2009, 8:26pm EDT
Thanks I see my answer now and I am on the right track I see with variety and my warm up and running. Also do some yoga a couple days a week.
Great question Mary!
I think doctors are too quick to pass out pills and settle for positive results, or even slightly positive results as the "solution" to high bp and/or high cholesterol.

My partner had a heart attack in Feb. and he's been under a doctor's "care" for about 8 years for high bp/cholesterol. It was just pills, pills, pills that lead to a false sense of "I'm okay."
Personally, I try to exercise for 60 minutes every day. But in reality, if I do 6 days in a week, that's terrific. Usually, it ends up to be 5 days per week. Spinning is my favorite, and those classes usually last 45 - 60 minutes. The key is finding the types of exercise that you enjoy enough (or at least don't hate) to stick with it. I mix in resistance training and try to do this 2 times per week. I would like to do weights 3 days per week but the weight stuff bores me.
Spinning is good, I like that too!
EM JAY -- absolutely, pills are not the answer. Healthy lifestyle choices are. But realistically, most of us can't lead the kind of life that would naturally prevent us from heart disease, strokes. And indeed is not about the numbers. Any medicine should not just lower a cholesterol or blood pressure level -- it needs to improve well being and prevent disease.
I find too that by me going to do the grocery shopping, I don't buy all the sweet stuff and junk food, I buy low-fat, fat free, whole wheat.....when the bad stuff is not in the house it makes it so much easier to not eat it!!
Angela A. Mar 31, 2009, 8:34pm EDT
What’s an ideal cholesterol and blood pressure?
That's a good question. I think it would vary, depending on the individual.
The man blood pressure that we should all strive for is in the 120/80 range.
Mine is always rather great. About 108/80
Sandy M. Mar 31, 2009, 8:35pm EDT
it sure does Sheli. we try to eat whole grain breads.
If I HAD 60 minutes a day to devote to exercise, I'd probably find something else to do.
Angela A. Mar 31, 2009, 8:35pm EDT
For Cholesterol, I truly don't have much of a clue about that.
I've never measured mine. I probably should though due to the fact that I'm overweight.
Speaking of pills, the polypill called POLYCAP got lots of press over the past 24 hours and reaffirms EM JAY'S point -- the study just showed that it can lower blood pressure, slow the heart rate and lower LDL cholesterol. But does it really make us healthier?
By the way -- here are the ingredients if a Polycap:
Thiazide 12.5 mg (diuretic lowers blood pressure)
Atenolol 50 mg (slows heart rate, lowers blood pressure a little)
Ramipril 5 mg (ACE inhibitor, relaxes blood vessels and lowers blood pressure)
Aspirin 100 mg (platelet inhibitor, dose is a little higher than what’s in a baby aspirin)
Simvastatin 20 mg (statin to lower cholesterol)
Sandy, I bought the whole wheat hamberger buns the other day and I honestly don't even think the boys noticed!! LOL!! I slip in "good foods" all the time and thankfully boys just don't pay attention!! LOL!
Sandy M. Mar 31, 2009, 8:37pm EDT
my husband told me about this poly pill. he seen it on the news recently.
Sandy M. Mar 31, 2009, 8:38pm EDT
great sheli. the whole grain breads are much better. at least that is what I heard.
Mary G. Mar 31, 2009, 8:38pm EDT
I do buy a lot of fruit and vegetables, as I do like to eat 5 times a day. These are small meals, as I'm losing weight. I started the year with 30 pounds that had to go, as been with my husband 30 years and had gained about a pound a year. I'm having trouble taking off the last pounds; however, my doctor stated that the lost weight has really improved my health.
Sheli -- how about a veggie burger cooked in a little olive oil to put on that whole wheat bun? Can you get away with that one?
I went to a nutritionist with my partner after he recovered from his heart attack. (Ten days before the heart attack, he was given a diagnosis of diabetes. That's when his insurance suddenly became interested in education and preventive medicine.) If he had been eating what I cooked all along, he probably would have been better off. He's off the fast food totally now and dropped 20 lbs. in a month.

What is frustrating is his doctors act like the meds for high bp/cholesterol/diabetes control are "for life." I can't believe this! He's taking very positive steps toward better health and I'm sure with more weight loss, the diabetes will not be an issue (it doesn't run in his family at all). Even though his new primary care doctor admits he's "borderline" diabetic and not full on, he thinks the meds have to be a forever thing. I just can't buy that.
That is what I heard too Sandy, I am not a big fan but it really doesn't taste all that bad!
Mary G -- stick with it. Those pounds should come off, especially if you can ramp up the physical activity. And your doctor is absolutely right.
Well, we have gotten as far as a Turkey burger off the grill! LOL!! I have done several things with ground turkey, after I did the tacos, he said no more!! LOL!! What kinda wife would I be if I actually listened to that? LOL!!
Watch the salt in those prepackage "health" foods like veggie burgers!

Congrats, Mary G! Don't give up.
If you can find "ARNOLD" brand breads, they are great! No High Fructose Corn Syrup and many varieties. The whole grain is fantastic.
EM JAY, the Drs. told my Dad he had diabetes and he needed to loose weight-he did big time-he did not wanna take all the meds so he lost weight, he checks his blood-does not run in his family either!
Sandy M. Mar 31, 2009, 8:45pm EDT
I found an organic bread I like called ezekial bread.
"Thomas's" brand English muffins and bagels also have come out with 100 calorie mini bagels and other whole grain varieties that have no high fructose corn syrup.
So weight loss helped your da, Sheli? I've heard other people have had success that way too. Doctors are too hung up on pills.
April H. Mar 31, 2009, 8:47pm EDT
I really like Arnold bread as well!
I really love the Arnold's brand whole grain breads, too. I have a hard time finding the really good ones, but they are worth the extra cost when you can. The taste is far superior to a lot of commercial breads, and if I can't make my own, they are what I look for.
Sandy M. Mar 31, 2009, 8:48pm EDT
sheli, that is good that your dad is listening and losing weight and checking his blood sugar.
Debra C. Mar 31, 2009, 8:48pm EDT
I have found that diet and exercise are the best way to maintain reasonable numbers.

While a "polypill" may be an answer for some, I worry that people are too interested in having a "fix-in-a-pill" rather than exercising self-discipline. My parents were given pills to "maintain ideal numbers" and are reaping the benefits of overmedication and metabolic issues that were not part of family history, but are consistent with side effects of some of the meds. Certainly every choice made has risks, but I hope we don't overdo the pharmaceutical avenue.
Yes EM JAY it did. He was over weight and now he has maintained a healthy weight. He is always watching what he eats, he is limited but he sticks to the diet and he is good. He is not a pill taker in any means, not even a simple Tylenol for a headache.! Good luck to you both.
Have you Arnold fans tried the multi-grain sandwich thins? THE BEST! Only 100 calories, if you are counting those.
And whole grain foods don't raise blood sugars as much as simple carbs.
Sandy M. Mar 31, 2009, 8:51pm EDT
the thing I tried that i did not like was brown rice.
lynn a. Mar 31, 2009, 8:51pm EDT
We have the Thomas brand English muffins here. I keep looking at them and thinking why not. I remember being able to buy crumpets with 0 fats a few years ago.
Happy you shared that info about your da, Sheli. I will continue to argue with doctors as long as Wil keeps doing as fantastic as he's been doing so far. I don't believe pills should be a life sentence!
What are crumpets? Crushed trumpets?
I'm not a fan of polypills. In fact, I dont' like combination pills in general. Although people often have co-existing risk factors like high blood pressure and high cholesterol, I don't generally prescribe a fixed combination of a cholesterol drug and blood pressure drug in one pill. One at a time.
Sandy M. Mar 31, 2009, 8:54pm EDT
I`ve never tried whole grain pasta though.
I don't trust the statin drugs at all. I know sometimes pills are necessary to get a result started, but can't be a lifestyle.
Sandy - whole grain pasta is good. Just check the lable - some of it is not much better than regular pasta.
Sandy M. Mar 31, 2009, 8:59pm EDT
ok. thanks em jay. I see it on the shelf but it does not look good. especially since i tried the brown rice and didn`t like it.
lynn a. Mar 31, 2009, 8:59pm EDT
I'm not sure exactly what a crumpet is, the best I can explain is like a floppy pancake except thicker. They're good though. I really liked them and liked that they had no fat.
I keep saying that I am gonna get whole grain pasta but I am so afraid I won't like it...I am just gonna do it-there was a coupon in the paper too so I am just gonna try it!!
Debra C. Mar 31, 2009, 9:00pm EDT
Do you have any quick comments on Red Yeast Rice?
EM JAY -- I am a statin fan. The evidence for the health benefits continue to mount. And the good news is that several of them are available as generics. I take a generic. Not to say everyone should be taking one. Diet and exercise first, second and third. Then consider a statin not just to treat a number, but based on personal risk factors.
Susan V. Mar 31, 2009, 9:00pm EDT
I recently started drinking 8 to ten glasses of water a day and I have so much energy!
Brown rice is really good Sandy-I love it at Chinese Resturants!!
Thanks for that description, Lynn. Sounds like something I'd put too much jam on.
lynn a. Mar 31, 2009, 9:01pm EDT
Who is it that knows about the wheat products? I've wanted to switch to wheat pasta, which is your favorite? And when I bought brown rice, after reading the info, it didn't seem that much different from white. I will say the taste is fine, at least to us.
Sandy M. Mar 31, 2009, 9:02pm EDT
Sheli, I bought a box of it once and we did not like it. I ended up throwing it away.
lynn a. Mar 31, 2009, 9:02pm EDT
EM Jay, you could. They are thick.
I've read about statins and the way they don't descriminate between good and bad cholesterol. Wil was given statins and THEN a prescription for something to boost his good cholesterol, which I investigated and found was nothing than Niacin!
Gotta find a recipe for crumpets!
That is what I am afraid of happening with whole wheat pasta for me Sandy! LOL!
I meant to say "nothing more than niacin"
Some concern in the past that some brands of Red Yeast Rice contained lovastatin -- and not surprising these brands did lower LDL cholesterol. Not sure if this is still true. Probably best to check out the brand of Red Yeast Rice before using it.
Sandy M. Mar 31, 2009, 9:05pm EDT
me too. I am afraid that I will not like the whole grain pasta. if you do try it let me know how you liked it.
Debra C. Mar 31, 2009, 9:06pm EDT
Interesting. I have a friend who's doctor just took him off Crestor (severe muscle pain) and put him on Red Yeast Rice. The gent is 90 and in otherwise great health.
Don't fear the whole grains!
Ok Sandy I will! Having a coupon helps too because it is a little more then the "good one" LOL!!
Thanks everyone. I am signing off for tonight. I will check this page tomorrow afternoon.
Be well.
LOL EM JAY!! You sound like my Sister yelling at me!! She says the same thing!! LOL!!
Thanks Dr. LeWine for the great chat! Have a great night!
Sandy M. Mar 31, 2009, 9:08pm EDT
yes, those coupons do help. I hope it tastes good. it may surprise us and be really good.
Sandy M. Mar 31, 2009, 9:09pm EDT
Thanks Doctor for having the chat.
I have eaten whole grains for so many years, I don't know what white bread tastes like.
Adios, Doc.
Debra M. Mar 31, 2009, 9:15pm EDT
Oh darn! I missed the chat, but the comments are still useful. I need to find out more about Red Yeast Rice.