A Cardiologist Answers Your Most Pressing Questions About Preventing Heart Disease
Heart disease remains the leading cause of death worldwide, yet many cases are preventable through lifestyle changes, awareness, and timely medical care.
To help break down the most common concerns about heart health, we spoke with Dr. Haider, an interventional cardiologist at NewYork-Presbyterian Medical Group Queens. Known online as @yourheartdoc, Dr. Haider is dedicated to educating the public on heart disease prevention.
In this detailed Q&A, Dr. Haider shares expert advice on diet, exercise, medications, screening, and common myths, providing a clear guide to keeping your heart healthy at every age.
Building a heart-healthy lifestyle
Q: What are the most important lifestyle changes people can make to prevent heart disease?
Dr. Haider is clear: consistent lifestyle choices form the foundation of heart disease prevention.
Movement
'Staying active is key, even if it's just walking,' he says.
'Multiple studies have shown that taking 7,000 to 8,000 steps a day is associated with lower cardiovascular mortality.'
For structured activity, he recommends either 150 minutes of moderate exercise, such as walking, cycling, or gardening, or 75 minutes of vigorous exercise like jogging, swimming, or tennis each week.
Diet
Movement alone, however, isn't enough. What you eat matters just as much. 'The Mediterranean diet is the most heart-healthy diet supported by data, ' he explains.
This way of eating focuses on whole foods, including fruits, vegetables, legumes, nuts, olive oil, lean proteins, and whole grains. It limits processed foods, red meat, sugar, and saturated fats.
'A diet low in saturated fats and processed foods, with lots of fiber and healthy fats, can significantly reduce your risk of cardiac events.'
Habits to avoid
Other essential habits include not smoking, limiting alcohol, and managing weight. 'Smoking is one of the most dangerous things you can do for your heart, and there's no safe level,' Dr. Haider warns.
As for alcohol, moderation is key: 'If you drink, keep it to a minimum. Alcohol doesn't protect your heart, no matter what old headlines might suggest.'
Q: How does stress affect heart health, and what can people do about it?
' Chronic stress, whether emotional, mental, or physical, has been repeatedly linked to heart disease,' Dr. Haider says.
'There's also a strong connection between mental health and cardiovascular outcomes.' While stress alone doesn't cause clogged arteries, it can increase inflammation, elevate blood pressure, and lead to maladaptive habits, such as overeating, smoking, or skipping exercise.
That makes stress management a vital part of prevention. Techniques like mindfulness, therapy, exercise, and prioritizing sleep and connection can all help. 'Mental health isn't separate from heart health. It's part of the same conversation,' he adds.
Q: At what age should someone start paying attention to their heart disease risk, even if they feel healthy?
'It's never too early,' Dr. Haider stresses. By the time someone reaches their 20s, they should already be having conversations with their doctor about heart health.
'You should have your cholesterol, blood sugar, blood pressure, weight, and waist circumference checked,' he adds. 'These numbers provide a foundation for understanding and managing your risk.'
Knowing your numbers
Q: What are the key health numbers people should track, and how often should they get checked?
Dr. Haider emphasizes that monitoring one's health stats can make all the difference. ' Cholesterol should be checked at least once a year, or more frequently if treatment is being adjusted,' he says.
He also recommends taking blood pressure at every physical. If it's high, patients may need to start tracking it at home with a monitor.
Additionally, blood sugar, often measured by fasting glucose or HbA1c, is another critical number, especially for those with risk factors like obesity, family history of diabetes, or high blood pressure.
'We also monitor weight, BMI, and waist circumference,' he explains. 'These are all pieces of the puzzle.'
Q: Can someone have heart disease without any symptoms?
'Yes, absolutely,' Dr. Haider says. 'By the time someone experiences symptoms like chest pain or shortness of breath, the disease is often advanced enough to have caused a blockage.' This is why early and consistent monitoring matters so much.
In some cases, imaging tools like a coronary artery calcium (CAC) score or CT angiography may be used to screen for silent heart disease. 'Depending on the individual's risk profile, we might recommend these tests to detect early plaque buildup before symptoms appear.'
Incorporating medication and supplements
Q: When is it appropriate to start medications like statins, even if you haven't had a heart attack?
Statins, which help lower cholesterol, can be used both for people who've already had cardiac events and for those at risk. 'If someone has any evidence of coronary artery disease or atherosclerosis, like on an imaging test, they should be on a statin,' Dr. Haider explains.
Even in people without signs of existing disease, statins may still be appropriate based on calculated risk. 'We use the ASCVD risk calculator to estimate a person's 10-year likelihood of a cardiac event. That helps us decide when to start treatment,' he says.
'If LDL cholesterol is very high (over 190 mg/dL) even after lifestyle changes, then statins are usually recommended.'
Q: Do heart health supplements like fish oil or CoQ10 actually help?
Dr. Haider is cautious about over-the-counter heart supplements. ' Fish oil supplements can lower triglycerides, but they haven't consistently been shown to reduce heart attacks or strokes in the general population,' he explains.
'And while CoQ10 is sometimes taken alongside statins to help with muscle symptoms, the data doesn't support its effectiveness.'
He recommends focusing on proven strategies, including lifestyle, medications when appropriate, and routine monitoring, rather than relying on supplements.
Addressing common misconceptions
Q: What are some of the biggest myths people still believe about heart disease?
'There's a lot of misinformation out there,' Dr. Haider says. One persistent myth is that high cholesterol doesn't cause heart disease, or that saturated fats are harmless. 'Those claims are simply false,' he asserts.
'There is overwhelming evidence that high LDL cholesterol and diets rich in saturated fats increase the risk of heart disease.'
Another false belief is that once you develop coronary artery disease, it can be completely reversed. 'We can stabilize the condition. We can slow its progression. But full reversal is not realistic, even with a perfect diet or supplements,' he says.
Finally, Dr. Haider warns against thinking that heart disease only affects older men. 'Young people and women are at risk, too. Heart disease doesn't discriminate, and that's why prevention matters for everyone.'
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