Dr. Miller: Can coronary heart disease be cured? We're going to talk about that next on Scope Radio.
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Dr. Miller: Hi, I'm Dr. Tom Miller on Scope Radio. And I'm here with Dr. Jim Fang. Jim Fang is the Chief of the Division of Cardiology here at the University of Utah, and also the Executive Medical Director of the cardiovascular service line. Jim, can coronary disease be cured?
Dr. Fang: Coronary artery disease is a disease, but I think of it as a condition akin to diabetes, hypertension and/or arthritis. And none of those conditions are per se curable.
Dr. Miller: They can be managed.
Dr. Fang: They can be effectively managed.
CAD Risk Factors
Dr. Miller: And what are the top three risk factors that predispose you to coronary disease?
Dr. Fang: Well, smoking I'm going to put absolutely number one. The good news is here in Salt Lake City in the University of Utah, as opposed to other parts of this country, we see far less of it. The other risk factors include diabetes, hypertension, and that rounds out three.
But I'm going to go on and talk about family history, because certainly if you have a family history of heart disease at an early age, that's very, very powerful, and then of cholesterol. And cholesterol of course is the one that we talk about a lot in the press and the doctor's office.
Modifiable Risk Factors for Heart Disease
Dr. Miller: Now, family history is not necessarily modifiable because we're born with the good and bad traits that our parents give us. What are the modifiable risk factors? You've mentioned smoking. What are the others?
Dr. Fang: Well, the other risk factors are arguably modifiable. So diabetes and hypertension, once you have them it's important that they are under the most rigorous control that you can achieve. Then of course there is cholesterol, and cholesterol we can manage through lifestyle changes. Activity, diet, weight loss and exercise.
Cholesterol and Heart Disease
Dr. Miller: And if those aren't exactly perfect in terms of getting cholesterol down we have medication.
Dr. Fang: We do. We do. You've already alluded to it. The first strategy, of course, is lifestyle changes. They are cheap but maybe not so easy to implement, but from a health care and health economics standpoint, we all have to always start there.
Once an adequate trial of lifestyle changes has been employed, we absolutely then look at cholesterol. Cholesterol management of course starts with dietary management. And dietary management, again, is inexpensive and should always be done. After that, we're talking about drugs.
High Blood Pressure and Heart Disease
Dr. Miller: Now, just to put it all in the same hat, high blood pressure and diabetes are also managed with aggressive lifestyle changes. And one can be very effective in terms of controlling those problems as well through lifestyle.
Dr. Fang: Absolutely. Absolutely. We certainly know that weight loss, watching alcohol and salt intake will absolutely affect hypertension control.
Dr. Miller: So having coronary disease is something that can be managed. You don't necessarily get rid of it but the top four things that you mentioned would be smoking, diabetes, high blood pressure and elevated cholesterol. And then finally, family history is quite important, but we're born with that, so we can manage the four former risk factors that I just mentioned.
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