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Tweet Chat with Drs Nissen&Cho (2 7 13)

Thursday, February 7, 2013 – Noon


Dr. Steven Nissen, Chairman of the Robert and Suzanne Tomsich Department of Cardiovascular Medicine and Dr. Leslie Cho, Director of the Cleveland Clinic’s Women’s Cardiovascular Center, Section Head, Preventive Cardiology and Rehabilitation hosts this month’s Tweet-Chat @ClevClinicHeart and @ClevelandClinic #CCHeart

See more webchat and twitter chat transcripts.

Heart Tips for Heart Month

Q1Cleveland Clinic: Why is red wine good for the heart? How much is too much?

Dr. Nissen: There seems to be nothing special about red wine, but moderate alcohol use seems to be beneficial.

Dr. Cho: Alcohol has its own risks. Too much alcohol can cause high triglycerides, heart failure, and car accidents.

Q2 Cleveland Clinic: Are those Valentine’s Day chocolates actually good for me?

Dr. Nissen: The suggestion that chocolate is good for you is not necessarily based on science.

Dr. Cho: Dark chocolate may be an anti-oxidant. Like all things, it should be consumed in moderation. It can increase blood sugar, triglycerides and weight.

Dr. Nissen - Dr. Chocolate is not a health food.

Q3: Cleveland Clinic: Does fish oil lower bad cholesterol?

Dr. Cho – The purified form of fish oil can lower triglycerides (TGs), but increase bad (LDL) cholesterol by 10%.

Dr. Nissen: There is no evidence that lowering TGs improves cardiovascular outcomes.

@lisalivesloves: Is there a connection between epilepsy and chest pain?

Dr. Cho: We are unaware of any connection between epilepsy and coronary artery disease.

Nhanson22: @ClevelandClinic: sounds like the ultimate heart meal would be a glass of wine, fish and dark chocolate... count me in.

Dr. Nissen: We don't agree. A balanced diet makes sense - there are no magic foods.

Q4: Cleveland Clinic: How much exercise should I be giving my heart?

Dr. Cho: The recommendation is to get at least 20 minutes of exercise most days of the week. Any exercise is good but more is better. Incorporate exercise in your daily activity - such as parking farther away or taking stairs.

Dr. Nissen - Don't focus too much on heart rate, it is not really that important.

Nhanson22: Wonder what's better for heart -- exercise or diet? Obviously both are good, but is one better?

Dr. Cho: Healthy lifestyle including exercise and diet are the cornerstones of good heart care. Both exercise and healthy diet are important.

Q5: Cleveland Clinic: Can Vitamin D help prevent a heart attack?

Dr. Nissen: There are no proven heart benefits from vitamin D. This now has a cult like following but the science is not there.

Q6: Cleveland Clinic: Can you eat red meat if you have heart disease?

Dr. Cho: Yes, of course - but all in moderation. Choose lean cuts, limit portion size. Like all meats, meat increases LDL (bad cholesterol).

Blmbmi: is yoyo dieting more heart harmful than maintaining an obese weight?

Dr. Cho: There is some evidence that yoyo dieting is bad for you. In fact, every time you yoyo diet you gain back more weight. Once you lose weight, it is important to exercise because it can help maintain weight loss and - be mindful of calorie intake.

@dianne630: Is it worth considering high blood pressure (BP) meds for BP within 145-150/85-90 with excellent HDL, triglycerides...

Dr. Nissen: It is very controversial whether treatment of borderline BPs in otherwise healthy people is beneficial. We recommend the DASH diet, a high fiber low salt diet that has been shown to lower BP moderately in people with borderline HTN. (Note: you can find information on DASH diet on our website or in more detail at NHLBI)

Q7: Cleveland Clinic: Are there any vitamins or supplements that help your heart?

Dr. Nissen: No. Nearly all vitamins and supplements for heart disease are a scam. Save your money and eat a heart healthy diet.

Jtrowbrid: Is UDO oil good for heart?

Nissen: Nothing special about UDO oil - just another expensive scam.

Askbryan: Do the good Dr.'s place any emphasis/utilize evolutionary principles when prescribing a diet/lifestyle for heart...

Dr. Nissen: In my clinic when I see a Neanderthal, I prescribe a cave man diet.

Dr. Cho: Any diet that is heavily based on meat is probably NOT a good diet. Meat raises LDL (bad cholesterol). The caveman diet, if it includes fruits, vegetables, grains would be ok in moderation. Neanderthals also worked very hard for their food; scavenged for it and often went hungry when they did not have food. That is not the case in modern times.

Sampuzzo: What are the success rates for EECP therapy?

Dr. Nissen: EECP therapy does seem to work for some people with no option for treating coronary blockages. However results for EECP are variable and uncertain.

Sampuzzo: Would EECP help with angina as a result of exertion? I'm 20+ yr. survivor of 7MIs, 2 Triple CABGs.

Dr. Nissen: Yes, it might help.

Q8: Cleveland Clinic: Is excess weight bad for your heart? How overweight is too much weight?

Dr. Cho: If you are a little overweight and fit it is better than being thin and not fit.

Dr. Nissen: Calculate your Body Mass Index (BMI) - go to a BMI calculator: to put in your numbers. If your BMI is less than 25 - Great! if your BMI is 25-30 you are overweight; over 30 you are obese; over 35 very obese; and over 40 morbidly obese.

Dr. Cho: Waist circumference is also important. If you have a waist circumference greater than 35 inches for women and greater than 40 inches for men, you have increased risk for cardiovascular disease (CVD).

Q9: Cleveland Clinic: What tests should people have to check their risk for heart disease? At what age?

Dr. Nissen - too much testing is not a good idea. Know your BP and cholesterol. These numbers should be checked starting in your 20s. Avoid fancy and expensive tests such as calcium scans and lipid subfractionation.

Q10: Cleveland Clinic: What is the most important heart health tip you give your patients?

Dr. Cho: Don't smoke. Follow a healthy diet and lifestyle. Lead an active life and know your numbers.

Dr. Nissen: My favorite tip - get more exercise! It has a huge effect and it is free.

More Information

Reviewed: 02/13

This information is provided by Cleveland Clinic as a convenience service only and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition. Please remember that this information, in the absence of a visit with a health care professional, must be considered as an educational service only and is not designed to replace a physician's independent judgment about the appropriateness or risks of a procedure for a given patient. The views and opinions expressed by an individual in this forum are not necessarily the views of Cleveland Clinic institution or other Cleveland Clinic physicians.

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