Featured Interview: Marc Gillinov and Steven Nissen

Q. What are some of the risk factors of coronary heart disease that we are least likely to know about?

A. Unfortunately most people don't know the simple, basic risk factors--LDL (the "bad" cholesterol), blood pressure, and body mass index (a measure of obesity). Together, these three risk factors plus smoking and diabetes, predict more than 80 percent of the risk for heart disease. We also have a growing list of emerging and sometimes surprising risk factors for heart disease. These include rheumatoid arthritis, sleep apnea, periodontal/gum disease, and even air pollution.

Q. Do 1-2 glasses of wine a day really stave off heart disease?

A. People who drink moderately are less likely to develop coronary artery disease and more likely to live longer than people who abstain from alcohol. This makes biological sense, as alcohol increases HDL cholesterol and reduces blood clotting. The evidence is solid, but we don't have conclusive proof that wine staves off heart disease. Nevertheless, a glass of wine (or a beer or a scotch) a day can be part of a heart healthy lifestyle.

Q. How does stress affect the heart?

A. Today we understand the link between emotional stress and heart attacks. In the patient with coronary artery disease, stress can trigger a heart attack by causing release of hormones and chemicals that increase blood pressure and heart rate and also increase the tendency for blood to clot. Anger is a common heart attack trigger, with up to 3 percent of heart attacks preceded by bouts of intense anger. Managing emotional stress can be life-saving for the patient with coronary artery disease.

Q. Is red meat really that bad for the heart?

A. Red meat contains large quantities of saturated fat, which is linked to increased LDL cholesterol and an increased risk of heart disease. An occasional steak or hamburger is fine, but a diet that includes daily consumption of red meat, especially when compared to a diet rich in fish, is associated with an increased risk of developing coronary heart disease. If you do eat meat, choose less fatty cuts and limit portion sizes.

Q. Why is this book so important? How is it different than other books on heart disease?

A. This book is about proven strategies to achieve and maintain heart health. Today there is simply too much health information on the Web and on the bookshelves. Some of it is accurate, but much of it is completely wrong. Your heart-health is too important for you to get sucked in by ridiculous fads. You can't afford to make critical mistakes based upon incorrect and confusing information. In this book, we detail the evidence, dispel the myths, and distill the truth. Let us guide you to a life of sustained heart health.