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Melanie Cole (Host): According to the American Heart Association, heart disease is the number one killer in the United States but preventing heart disease means making smart choices now that will pay off for the rest of your life. You’re never too young or too old to take care of your heart. My guest today is Dr. Samuel Kojoglanian. He’s an interventional cardiologist and a member of the medical staff at Henry Mayo Newhall Hospital. Welcome to the show, Dr. Kojoglanian. Tell us about our heart and what you’re seeing with heart disease today and heart disease awareness.

Dr. Samuel Kojoglanian (Guest): Well, the heart is an amazing machine. I love the heart. Well, part of the reason why I chose cardiology is because it’s one of the smallest fields where you can literally make a difference in peoples’ lives, not only the quality of life, but the length of life, and so the heart is so very important. We only have one heart and we make choices on a daily basis that are so crucial to our heart health. That’s why I love not only opening up heart arteries, if you will, to save somebody’s life, but even better than that, let’s just go in and prevent all this from happening in the first place.

Melanie: Who’s at risk for heart disease?

Dr. Kojoglanian: You know, there are so many risks for heart disease. One is people will have high blood pressure and that’s called a “silent killer” in America. It’s silent because you’re not aware of it. It’s a killer because it’s going to cause a stroke or a major heart attack. So, people who are not aware of their blood pressure and they have high blood pressure are at an increased risk. People who smoke are at an increased risk. Smoking is like, Melanie, I tell people it’s like taking a jackhammer, going to your street, just jackhammering the whole thing, and then inviting all the kids to skateboard on it. They’re going to crack and fall and bleed. That’s what smoking does to our heart arteries and all the arteries of the body. So, people who smoke, people who are not active and they’re overweight, and bless their souls, a lot of my patients say, “I know, doc. I know, doc. I’m just overweight,” and I want to hug them and love them and I do and I say, “Hey, let’s talk about the truth.” We’re talking about obesity. People are not aware of their weight. People who have a family history; that, we may not be able to do anything about but we can do a lot of things about the other things: taking care of our blood pressure, walking, taking care of our cholesterol. Those people who are oblivious to it or they don’t know about it are at a high, high risk of heart disease.

Melanie: So, let’s talk about prevention of heart disease and you have seven S’s that you like to go over with your patients to help prevent heart disease in the first place.

Dr. Kojoglanian: Yes, prevention is such a crucial thing, Melanie, and the seven S’s, if you will, is the seven ways of living longer and stronger and happier. One is “stretch” and you’re like, “What? Stretching? What in the world is that? We don’t even have time to take a time out.” I tell my patients, “Look, if your blood pressure is really high sit down or lie down on the ground and then take some deep breaths through your nose and blow it out of your mouth ten times. Do it slowly, and that in itself will lower the blood pressure.” When you’re sitting down on a computer stretch your neck, stretch your back, stretch your arms, stretch your legs. It just relaxes the muscles, it decreases tension, and it also decreases the blood pressure; stretch. Salt: we’re supposed to eat 1,500 milligrams of salt on a given day. That’s kind of difficult because one teaspoon has about 2,300 milligrams and if one teriyaki sauce bag, the little one, has up to 1,000 milligrams so we’ve got to be very careful with salt because if we’re careful with salt our blood pressure goes down. Sugar is the third S, if you will, and a lot of my patients are becoming diabetic because they’re not watching out for their sugar. We’re supposed to have six to nine teaspoons of sugar a day and you’re like, “What in the world is that?” Well, one teaspoon is like four grams it equals one white sugar cube--one little white sugar cube. A soda pop has about 10 to 11 sugar cubes in it - just one of them. We’re only supposed to-- women are supposed to have six teaspoons or sugar cubes, if you will, and men nine. So, we’ve got to be very careful with sugar because that’s turning into diabetes, if you will. The fourth is smile--maybe just smile. People are so depressed and I’m finding out that a lot of people are just angry and then that turns into bitterness and that turns into unforgiveness and that turns into depression. Yes, we’ve got chemical problems but I had like a 46-year-old man with a major attack. He had no risks, no risks, and I found out when he was a kid, bless his heart, his parents when they were getting a divorce they said, “What are we going to do with this problem child?” and he always remembered that. It hurt him so terribly and he became so depressed, so angry, that we believed together that that anger caused his heart attack. So, smile, we have so many things to be thankful for and instead of thinking about what we don’t have, we can be thankful for what we do have. Depression is very critical and light therapy, going under the light is so important. Stimulating your frontal lobe is important. Getting away from the television is important. The other S, if you will, is salmon. This is my power food and people are like, “Oh, I don’t like salmon.” Well, it has high Omega-3s. You have other great foods: strawberries, blueberries, almonds, sweet potatoes, spinach, dark chocolate. Yum! That’s one of my favorites - dark chocolate has flavonoids which is so good for the heart. Water! Don’t forget water! It is so healthy for your heart. The other is sweat. Walk ten minutes a day. “Come on and sweat,” the song says. Ten minutes a day walking briskly and if you’re talking on the phone you’re like short of breath, that’s how much. Sweat a little bit. It decreases your depression, it decreases osteoporosis, it decreases heart attacks, it decreases colon cancer. Come on, baby, let’s go, let’s walk, let’s sweat. And then, the other one is, we’ve talked about is smoking. The best way to stop smoking I’ve found out with my patients is either cold turkey--you choose a day that’s so, so important for you like a birthday, an anniversary, Christmas - whatever it might be. Just pick a day that’s important for you and stop on that day cold turkey; or, put the Nicotine patches on with the lozenges but get rid of that smoking. It’s so crucial. And my extra bonus, bonus is serve. Serve people, you’ll forget-- we will forget about ourselves when we serve people. It’s so lovely. I have 28 little orphans in Myanmar that I take care of and they don’t have shoes, they don’t have mattresses, but they are so, so happy and when I’m there with them I’m so blessed and I forget about myself and my sorrows and my problems. Serve people. It’ll bring joy to your heart. Your heart will explode with happiness and those are the ways you can live longer and stronger and happier, Melanie.

Melanie: What an amazing summary, Dr. Kojoglanian. That was excellent and so important for people to hear. When somebody asks you about their annual physicals and what tests for their heart that you think are the most important things for them to be their own best health advocate for them to advocate for themselves, do you want everybody to have a CRP, a cholesterol test, get their blood pressure? What do you want them to do?

Dr. Kojoglanian: Absolutely. Let’s do the essentials. We don’t have to radiate people. We don’t have to take people to an angiogram. We just like the essentials. Number one: you mentioned it, the blood pressure. It’s such a simple exam and people must know what their blood pressure is like. I even encourage my patients to get these machines, anywhere has them - they’re like 30 bucks, 40 bucks, whatever it might be - and write down your numbers. Bring them to me. Let’s see how you’re doing with the blood pressure; very critical, very important. I do believe cholesterol is important for most of my patients--all of my patients, actually--and I check that on a yearly basis. It tells us, “Hey, maybe there’s too much fatty foods in the diet,” “Hey, maybe there’s too much cheese in a diet,” “Hey, maybe there’s too much wine in your diet.” So, it helps me gauge and it helps us curve their diet, if you will. And CRP I think is critical. I personally get it on a yearly basis on my patients and it stands for “C-reactive protein” and it tells us how much inflammation, if you will, the heart has or the body has. The higher the number the worse it is; the lower the number the better it is. And that’s why I tell people simple, simple things. Drink a lot of water. It’s an antitoxin, if you will. It’ll take out the toxins. And these simple things can bring down the inflammation of the body. Exercise--it brings down the inflammation of the body. So, yes, I believe those three things are crucial and I do it religiously on my patients.

Melanie: You brought up the word “inflammation”. I would like to ask you because more and more we’re seeing interventional cardiologists such as yourself using and saying that inflammation is more the cause than, say, cholesterol. Can you at least touch on this subject, because it’s a bit controversial right now. People want to know if cholesterol is still the danger that it always was linked to be or if it’s truly inflammation which could be from stress or from all of these other factors.

Dr. Kojoglanian: Yes, I think they all add up together, Melanie, and I think they cause problems. Inflammation is very critical and if you force me to say what is the most highest inflammatory product that I can place in my body? How am I harming myself? I would have to say sugar. Sugar is causing immense inflammation and why does it taste so darn good? I don’t know, but it is-- we have to say, “I’m going to have a little and I’m not going to have all of it.” But sugar, when we put it in our mouth, it turns to an inflammatory agent, if you will. Like Aspartame that’s hidden in a lot of drinks, sugar-free products, I’m going to let our audience know: stay away from these sugar-free things. I think they’re even worse because the Fowlering colleagues had a study and it was the San Antonio Heart Study examining over 3,000 adults and they were looking at people who were using artificial sweeteners. If you, Melanie, decide to drink two Coca-Colas, let’s say on a day, and it’s regular, you’ll have a 33% chance of becoming obese. If I, on the other hand, decide to drink two Coca-Colas a day and I go diet, sugar-free Coca-Cola or any soda, I have a 55% chance of becoming obese. So, people are saying, “Okay, well I won’t do sugar but I’ll do sugar-free.” I’m here to tell you I think sugar-free is even worse. So, that’s one thing that causes enormous inflammation. I think cholesterol is thrown under the bus. It is very important. We should check it but we became “fat-free America” and we became more obese and the reason why that happened is because we increased our sugar. I think we ought to check all points and be careful at all segments.

Melanie: So, wrap it up for us with your best advice, what you tell your patients every day about preventing heart disease at any age.

Dr. Kojoglanian: Well, I think it’s-- you know, we did the seven S’s. If you take the three W’s I can wrap it up for you. W, W, W, and it’s not a website, it’s just W, W, W. Walk: walk every day, please. People are like, “Well, it’s too rainy and it’s too windy.” Baby, just go to the mall. Walk! Just walk because walking is going to decrease all this inflammation in your body. And if they say, “I can’t walk,” well, when you’re sitting down and watching TV, well, then rise up or kick your leg or kick your arms up and down. Just move, movement is a good thing for the body. The other thing - we talked about walking - the other thing is weighing yourself daily. Do not lie. When my patients lie to me and they say, “Doctor, I’m only eating lettuce,” I’m like, “Baby, what you got in your lettuce? You must be putting chocolate chip cookies in your lettuce.” So, weigh yourself. Tell the truth to yourself, don’t lie to yourself. Maybe log down what you’re doing. And the third “W” is water. Drink water, I beg you. It might not taste as good as the soda pop or the sugar drinks but it is so essential to your health and to your heart and to your body. So, that’s how I sum it up and that’s how we rock the planet.

Melanie: Thank you so much, Dr. K, for being with us today. Absolutely amazing interview and amazing information. Thanks so much for being with us today. You're listening to It’s Your Health Radio with Henry Mayo Newhall Hospital. For more information, you can go to www.HenryMayo.com. That's www.HenryMayo.com. This is Melanie Cole. Thanks so much for listening.