Vascular Screening Can Save Your Life
From the Show: Highland Medical P.C.
Summary:
Air Date: 9/3/20
Duration: 10 Minutes
Dr. Jared Corriel discusses best practices for vascular health.
Transcription:
Prakash Chandran: Cardiovascular disease is the leading cause of death for both men and women in America. Every year, more than 600,000 people die of heart disease. That's one out of every four deaths. Unfortunately, the majority of people with this disease are living unaware of their risks. If vascular diseases are detected early, the more likely they can be managed with lifestyle interventions and medications instead of invasive surgery. We're going to talk about it today with Dr. Jared Corriel, Director of Echocardiography and Cardiac CT at Montefiore Nyack Hospital. This is Sound Advice, the podcast from Highland Medical PC I'm Prakash Chandran. So first of all, Dr. Corriel, great to have you here today. What exactly is vascular screening and why is it so important?
Dr. Corriel: Vascular screening is essentially a pretty straightforward and easy testing methodology that we do at Nyack Hospital for free, where we utilize both blood pressure of the arms and legs, as well as ultrasounding the dominal aorta and carotid arteries, where we can really define the flow to the various organs and to make sure there is no carotid arterial disease or peripheral arterial disease, which is pretty important. It's almost, I equate it with patients to the plumbing. So if there's clogged arteries and clogged pipes, the flow doesn't get to where it needs to be. And so then it can't work effectively.
Host: I see. And yet you alluded to this a little bit, but can you maybe talk about some of the examples of what vascular diseases this screens for?
Dr. Corriel: Yeah, sure, absolutely. It's basically screening for carotid artery disease, which puts people at risk for having strokes. It also screens for aortic aneurysms in the abdomen, and it also screens for peripheral arterial disease, which are blockages in the arteries, supplying the feet and the legs.
Host: Okay. Understood. So who exactly should get screened and how often should they be screened?
Dr. Corriel: So, we're essentially doing a onetime screen for the most part at this point for people with any risk factors for cardiovascular disease. So that could include people with hypertension, hyperlipidemia, people with a tobacco history, those who have a family history of cardiovascular disease and diabetic patients.
Host: I see. So for example, if there's someone with a family history, when exactly should they come in to get screened.
Dr. Corriel: So, oftentimes we're screening them as early as 10 years before their family member had been diagnosed with the disease. Many times we will start at the age of 50 in people with multiple risk factors for cardiovascular disease.
Host: Maybe talk a little bit about the importance of coming in early and the risk of not actually having the screening done.
Dr. Corriel: What's so important about learning and screening for peripheral arterial disease is the fact that there are really some tremendous implications to someone having the disease and not knowing about it. So peripheral arterial disease is linked with an increased risk of cardiovascular event rates like strokes, heart attacks, and death on the order of 70% greater than the normal population. So those that you can detect early, you can start on these measures such as lifestyle modifications, medications to limit progression of plaque buildup in the arteries, utilizing medicines like aspirin to reduce event rates by sending the blood a bit. So it's really important to screen people early. So we can really intervene early in a noninvasive way in many events. And there are long-term benefits when we do really diagnose early.
Host: Yeah, that makes a lot of sense. One of the things that you alluded to was a plaque buildup and that causing a lot of these diseases, I'll just ask a more basic question. What causes this plaque buildup and then these vascular diseases in the first place? Is it the things that we eat? Is it from lack of exercising? Just talk about that at a high level.
Dr. Corriel: Yeah. That's a great question. So specific to peripheral arterial disease, the two biggest risk factors that I see are typically those patients with longstanding, especially poorly controlled diabetes, and also smoking history tobacco use. These two are probably the biggest risk factors for peripheral arterial disease. On top of those with known coronary artery disease, those who have had heart attacks or stents or bypass surgery. So those are really very highly, some of the major risk factors for peripheral arterial disease. And we're much more aggressive in terms of screening early on.
Host: I think one of the things that you mentioned is those with hypertension or potential family history coming in, you know, maybe around the age of 50, let's say they get screened and nothing is found afterwards, is it, are they safe or do you feel like it's something where they should get screened every couple of years, maybe talk a little bit about that.
Dr. Corriel: Oftentimes with these screening exams, we will follow up testing in say three to five years, especially people with strong family history or multiple risk factors for cardiovascular disease. And especially, and again, this is in people who are without symptoms. Obviously if someone develops symptoms, it completely changes the landscape, but in someone who's asymptomatic and you're just screening, I think a three to five year window is very realistic, especially because there's really no side effects. There's no downside to the screening, it's all noninvasive. And it just makes sense for many of these patients.
Host: Yeah. You know, as I close each one of these conversations, I always like to talk about prevention. So we touched upon this earlier. I'm assuming don't smoke, exercise a lot, eat healthy, maybe dive into that a little bit and maybe give your best recommendations for people that are listening.
Dr. Corriel: Absolutely aside from obviously controlling those risk factors. So say controlling blood pressure to the best of our abilities, keeping our glucose levels at bay in people who are diabetic and obviously treating the lipid levels and people with high cholesterol levels. I think that the lifestyles that we generally recommend people subscribe to is one that is those that are going to exercise three days, three to five days a week, essentially 30 minutes at a time moderate intensity exercise is linked with lower rates of cardiovascular events. Obviously tobacco cessation is important, a diet that's rich in plant based items and limiting our processed foods, plenty of vegetables and fruits throughout the day. And I'm also a big proponent of those eating a non shellfish on a regular basis, plenty of nuts for protein. And generally speaking, a plant based diet has been shown to really reduce cardiovascular event rates, reduce cholesterol levels almost by half in many patients.
Host: And when you say plant-based diet, are you saying completely plant-based or are you just saying I lot of plants in your diet?
Dr. Corriel: So, it's really hard to convince the population to go completely plant based and make everyone a bunch of vegans. It's really, I think if that's you're setting the bar a little too high. So what I usually tell my patients is to really incorporate the plant based diet into your diet as much as you can. So sure you can, if you're going to go to a barbecue and you're going to have a burger or chicken, that's fine, but that shouldn't be on a daily basis and try to make that more on the special occasion as opposed to on a consistent basis. And just your diet, when you look at your plate, it should have so much, much more vegetables on it, salads, and that should be the bulk of your diet as opposed to going, having to have the meat at all times.
Host: Totally makes sense. My dad actually went through a cardiac incident and he has since gone 100% plant based, but I know that's not possible for everyone. But one thing that he does make sure to do is to take vitamins and supplements, to get some of the things that a hundred percent plant-based may not necessarily have easily accessible. So I think no matter what we do, we have to make sure we're getting the right supplements, the right balanced nutrition, wouldn't you say?
Dr. Corriel: Absolutely. I think that's so important. I think that having all of the necessary vitamins and it's something that the Western diet, unfortunately, it's not subscribed to as much as some other cultures, unfortunately. And I think it shows in the fact that, you know, cardiovascular disease is in fact the number one killer in Western countries. So if we could sort of bring the Western medicine and incorporate it with other cultural lifestyles, and I think that would be the best mixture of the two worlds together.
Host: Absolutely agree. Before we close here, Dr. Corriel, is there anything else you wanted to share around vascular screening preventing or just heart health in general?
Dr. Corriel: I think in general, that Montefiore Nyack Hospital, a screening program has been a tremendous success. It's been open to the entire community. I think we are actually have the screening programs that we're utilizing Montefiore Nyack has actually had the fastest ramp up of any other hospital system. So we're really excited about that. It's been a tremendous success. We've been able to really diagnose people early on in the disease. Those that have really been asymptomatic and we can really plug them into the system, get them on the appropriate medicines and lifestyle measures. And it's really been a tremendous success. And I really welcome everyone to the program and really encourage everyone to participate in it from the community because it's going to have some long lasting beneficial effects.
Host: Well, Dr. Corriel, I think that is a perfect place to end. Thank you so much for your time today. Truly informative. That's Dr. Jared Corriel, director of echocardiography and cardiac CT at Montefiore Nyack Hospital. The Vascular Institute at Montefiore Nyack Hospital aims to raise awareness of the hidden risks associated with vascular disease and encourages early intervention to prevent serious complications or disabilities. Any adults who are older than 60 years of age or younger, if other risk factors are present, is eligible for a free screening at Montefiore Nyack Hospital. Thanks for checking out this episode of Sound Advice. Call 833-32 Heart or (833) 324-3278. If you have the risk factors for vascular disease or visit Montefiorenyack.org/vascular to make an appointment for screening. If you found this podcast helpful, please share it on your social channels and be sure to check out the entire podcast library for topics of interest to you. Thanks, and we'll talk next time.
Prakash Chandran: Cardiovascular disease is the leading cause of death for both men and women in America. Every year, more than 600,000 people die of heart disease. That's one out of every four deaths. Unfortunately, the majority of people with this disease are living unaware of their risks. If vascular diseases are detected early, the more likely they can be managed with lifestyle interventions and medications instead of invasive surgery. We're going to talk about it today with Dr. Jared Corriel, Director of Echocardiography and Cardiac CT at Montefiore Nyack Hospital. This is Sound Advice, the podcast from Highland Medical PC I'm Prakash Chandran. So first of all, Dr. Corriel, great to have you here today. What exactly is vascular screening and why is it so important?
Dr. Corriel: Vascular screening is essentially a pretty straightforward and easy testing methodology that we do at Nyack Hospital for free, where we utilize both blood pressure of the arms and legs, as well as ultrasounding the dominal aorta and carotid arteries, where we can really define the flow to the various organs and to make sure there is no carotid arterial disease or peripheral arterial disease, which is pretty important. It's almost, I equate it with patients to the plumbing. So if there's clogged arteries and clogged pipes, the flow doesn't get to where it needs to be. And so then it can't work effectively.
Host: I see. And yet you alluded to this a little bit, but can you maybe talk about some of the examples of what vascular diseases this screens for?
Dr. Corriel: Yeah, sure, absolutely. It's basically screening for carotid artery disease, which puts people at risk for having strokes. It also screens for aortic aneurysms in the abdomen, and it also screens for peripheral arterial disease, which are blockages in the arteries, supplying the feet and the legs.
Host: Okay. Understood. So who exactly should get screened and how often should they be screened?
Dr. Corriel: So, we're essentially doing a onetime screen for the most part at this point for people with any risk factors for cardiovascular disease. So that could include people with hypertension, hyperlipidemia, people with a tobacco history, those who have a family history of cardiovascular disease and diabetic patients.
Host: I see. So for example, if there's someone with a family history, when exactly should they come in to get screened.
Dr. Corriel: So, oftentimes we're screening them as early as 10 years before their family member had been diagnosed with the disease. Many times we will start at the age of 50 in people with multiple risk factors for cardiovascular disease.
Host: Maybe talk a little bit about the importance of coming in early and the risk of not actually having the screening done.
Dr. Corriel: What's so important about learning and screening for peripheral arterial disease is the fact that there are really some tremendous implications to someone having the disease and not knowing about it. So peripheral arterial disease is linked with an increased risk of cardiovascular event rates like strokes, heart attacks, and death on the order of 70% greater than the normal population. So those that you can detect early, you can start on these measures such as lifestyle modifications, medications to limit progression of plaque buildup in the arteries, utilizing medicines like aspirin to reduce event rates by sending the blood a bit. So it's really important to screen people early. So we can really intervene early in a noninvasive way in many events. And there are long-term benefits when we do really diagnose early.
Host: Yeah, that makes a lot of sense. One of the things that you alluded to was a plaque buildup and that causing a lot of these diseases, I'll just ask a more basic question. What causes this plaque buildup and then these vascular diseases in the first place? Is it the things that we eat? Is it from lack of exercising? Just talk about that at a high level.
Dr. Corriel: Yeah. That's a great question. So specific to peripheral arterial disease, the two biggest risk factors that I see are typically those patients with longstanding, especially poorly controlled diabetes, and also smoking history tobacco use. These two are probably the biggest risk factors for peripheral arterial disease. On top of those with known coronary artery disease, those who have had heart attacks or stents or bypass surgery. So those are really very highly, some of the major risk factors for peripheral arterial disease. And we're much more aggressive in terms of screening early on.
Host: I think one of the things that you mentioned is those with hypertension or potential family history coming in, you know, maybe around the age of 50, let's say they get screened and nothing is found afterwards, is it, are they safe or do you feel like it's something where they should get screened every couple of years, maybe talk a little bit about that.
Dr. Corriel: Oftentimes with these screening exams, we will follow up testing in say three to five years, especially people with strong family history or multiple risk factors for cardiovascular disease. And especially, and again, this is in people who are without symptoms. Obviously if someone develops symptoms, it completely changes the landscape, but in someone who's asymptomatic and you're just screening, I think a three to five year window is very realistic, especially because there's really no side effects. There's no downside to the screening, it's all noninvasive. And it just makes sense for many of these patients.
Host: Yeah. You know, as I close each one of these conversations, I always like to talk about prevention. So we touched upon this earlier. I'm assuming don't smoke, exercise a lot, eat healthy, maybe dive into that a little bit and maybe give your best recommendations for people that are listening.
Dr. Corriel: Absolutely aside from obviously controlling those risk factors. So say controlling blood pressure to the best of our abilities, keeping our glucose levels at bay in people who are diabetic and obviously treating the lipid levels and people with high cholesterol levels. I think that the lifestyles that we generally recommend people subscribe to is one that is those that are going to exercise three days, three to five days a week, essentially 30 minutes at a time moderate intensity exercise is linked with lower rates of cardiovascular events. Obviously tobacco cessation is important, a diet that's rich in plant based items and limiting our processed foods, plenty of vegetables and fruits throughout the day. And I'm also a big proponent of those eating a non shellfish on a regular basis, plenty of nuts for protein. And generally speaking, a plant based diet has been shown to really reduce cardiovascular event rates, reduce cholesterol levels almost by half in many patients.
Host: And when you say plant-based diet, are you saying completely plant-based or are you just saying I lot of plants in your diet?
Dr. Corriel: So, it's really hard to convince the population to go completely plant based and make everyone a bunch of vegans. It's really, I think if that's you're setting the bar a little too high. So what I usually tell my patients is to really incorporate the plant based diet into your diet as much as you can. So sure you can, if you're going to go to a barbecue and you're going to have a burger or chicken, that's fine, but that shouldn't be on a daily basis and try to make that more on the special occasion as opposed to on a consistent basis. And just your diet, when you look at your plate, it should have so much, much more vegetables on it, salads, and that should be the bulk of your diet as opposed to going, having to have the meat at all times.
Host: Totally makes sense. My dad actually went through a cardiac incident and he has since gone 100% plant based, but I know that's not possible for everyone. But one thing that he does make sure to do is to take vitamins and supplements, to get some of the things that a hundred percent plant-based may not necessarily have easily accessible. So I think no matter what we do, we have to make sure we're getting the right supplements, the right balanced nutrition, wouldn't you say?
Dr. Corriel: Absolutely. I think that's so important. I think that having all of the necessary vitamins and it's something that the Western diet, unfortunately, it's not subscribed to as much as some other cultures, unfortunately. And I think it shows in the fact that, you know, cardiovascular disease is in fact the number one killer in Western countries. So if we could sort of bring the Western medicine and incorporate it with other cultural lifestyles, and I think that would be the best mixture of the two worlds together.
Host: Absolutely agree. Before we close here, Dr. Corriel, is there anything else you wanted to share around vascular screening preventing or just heart health in general?
Dr. Corriel: I think in general, that Montefiore Nyack Hospital, a screening program has been a tremendous success. It's been open to the entire community. I think we are actually have the screening programs that we're utilizing Montefiore Nyack has actually had the fastest ramp up of any other hospital system. So we're really excited about that. It's been a tremendous success. We've been able to really diagnose people early on in the disease. Those that have really been asymptomatic and we can really plug them into the system, get them on the appropriate medicines and lifestyle measures. And it's really been a tremendous success. And I really welcome everyone to the program and really encourage everyone to participate in it from the community because it's going to have some long lasting beneficial effects.
Host: Well, Dr. Corriel, I think that is a perfect place to end. Thank you so much for your time today. Truly informative. That's Dr. Jared Corriel, director of echocardiography and cardiac CT at Montefiore Nyack Hospital. The Vascular Institute at Montefiore Nyack Hospital aims to raise awareness of the hidden risks associated with vascular disease and encourages early intervention to prevent serious complications or disabilities. Any adults who are older than 60 years of age or younger, if other risk factors are present, is eligible for a free screening at Montefiore Nyack Hospital. Thanks for checking out this episode of Sound Advice. Call 833-32 Heart or (833) 324-3278. If you have the risk factors for vascular disease or visit Montefiorenyack.org/vascular to make an appointment for screening. If you found this podcast helpful, please share it on your social channels and be sure to check out the entire podcast library for topics of interest to you. Thanks, and we'll talk next time.
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