Cleveland Clinic Heart Surgeon & Cardiologist Tackle Misconceptions About Heart Health

Heart 411 - The Only Guide to Heart Health You'll Ever Need by Cleveland Clinic Doctors Marc Gillinov & Steven NissenIn their new book entitled, Heart 411: The Only Guide to Heart Health You’ll Ever Need, two renowned heart experts, heart surgeon Marc Gillinov and cardiologist Steven Nissen, both of the Cleveland Clinic, tackle some prominent misconceptions about heart health, and answer questions that their patients have raised over their decades of practice.

“While consumers have access to more information about heart disease than ever before, much of it is incorrect or even dangerous,” the authors told USA Today in an interview about the book.

Among the questions addressed in the book are the following: “Can the stress of my job really lead to a heart attack? How does exercise help my heart, and what is the right amount and type of exercise? What are the most important tests for my heart, and when do I need them? How do symptoms and treatments differ among men, women, and children?”

The book draws upon the authors’ decades of clinical experience and the latest scientific research. It is, however, written in accessible prose for patients and health care consumers. The book’s primary focus is on prevention and providing the knowledge and tools needed to live a heart-healthy life.

The new book Heart 411, was published January 31, 2012, by Three Rivers Press. It is available from in paperback or Kindle editions: Heart 411: The Only Guide to Heart Health You’ll Ever Need

Tips on Tests and Procedures

In a Q and A interview about their book with USA Today, when asked, “Your book mentions that some tests are more useful than others. Which do people really need?” Doctors Gillinov and Nissen gave the following answer:

“You need these tests in order to ‘know your numbers:’

  • Blood pressure: Check every year.
  • Weight check (body mass index): Check every year.
  • Cholesterol test (lipid profile): Get your first check by age 20. If results are normal, check again every five years.
  • Fasting blood sugar: Check this annually if you are overweight.”

When asked “Which tests should people avoid,” the Doctors responded:

“The problem with overtesting is that ‘the more you test, the more you find.’ We suggest avoiding these tests:

  • Heart calcium scans. These tests expose patients to excessive radiation and have not been demonstrated to save lives.
  • Total body CT scans. These scans, which examine the heart and other organs throughout the body, involve huge doses of radiation and have not been shown to improve outcomes. The Food and Drug Administration has warned the public about this procedure.
  • Exercise stress tests, or treadmill tests, in patients without symptoms. The chances of a false positive test are high and an abnormal often leads to unnecessary heart catheterization, an invasive procedure in which long tubes are inserted through the blood vessels.
  • Some ultrasound examinations (echo tests). These should not be performed in healthy individuals and should be used only for those with other signs of heart disease, such as a heart murmur or heart failure. An echocardiogram, or ultrasound of the heart, should be used only for those with other signs of heart disease, such as a heart murmur or heart failure. Carotid ultrasounds, for example, are sometimes ordered in healthy people to determine if they have thickened walls of the artery. The problem with this type of screening test is that it can lead to unintended consequences. We strongly prefer to get a medical history, then measure the well-validated risk factors such as cholesterol and blood pressure.
  • Fancy cholesterol tests. Well-meaning physicians frequently order special cholesterol tests that measure cholesterol “particle size,” sometimes known as VAP or NMR cholesterol tests. These tests are expensive and do not improve outcomes. They are unnecessary.”

Ask Questions and Get Second Opinions

Each patient is different and should be guided by doctors’ advice in determining whether to have a test or procedure. However, the authors advise patients not to be afraid to ask your doctor questions. They suggest bringing a list of questions to ask along with you to doctors’ appointments, so that you do not forget what you intended to ask.

As to recommended tests or procedures, they suggest you ask how will the test or procedure help you, what are the risks, what would happen if you do not have the test or procedure, what are the side effects, and will it cause pain.

As to prescribed medications, the authors suggest you ask how long the medication has been on the market. They make the point that newer medications that may not have been as thoroughly tested and tried may not necessarily be better than older ones that have been on the market longer.

The doctors recommend that every patient should bring with you to the doctor a list of all medications you are taking, including any diet supplements you take, along with your complete medical history. And, be sure to ask about any potential interactions between medications you are prescribed and other medications or dietary supplements you may be taking.

Drs. Gillinov and Nissen also advise patients to get second opinions. In fact, the authors told USA Today that the one thing they wish more patients knew about heart health, hospitals and heart surgery, is that “Not all doctors and hospitals are the same.” They advised:

“Your health is too important not to do some research. Most people spend more time researching a new car than they do a heart surgeon. Ask questions. Get second opinions. Make sure that you get the best for your health. And don’t be worried about offending a doctor by going elsewhere for a second opinion. If the doctor becomes angry, he was the wrong doctor for you in the first place.”

What are the biggest mistakes that people make about their heart health?

The authors emphasize that dietary supplements are no substitutes for prescription medications prescribed by doctors. They told USA Today that, “Too many patients are seduced by unsubstantiated claims for diets and dietary supplements.” “The dietary supplement industry is completely out of control. An ill-advised federal law bars the Food and Drug Administration from regulating these supplements, which often make outlandish claims for improving heart health. It’s a national scandal,” said Drs. Gillinov and Nissen.

What One Lifestyle Change is Most Important for Heart Health?

When asked what one change they would most like to see in their patients, the Doctors said, “One change: Exercise. We’d like to see everybody make the time to exercise for 30 minutes a day. It’s simple. Find a friend and go for a walk. You can even split it up into 10- or 15-minute increments.”

They advocate that people should ask “How do I stay healthy?” ahead of time and make the necessary lifestyle changes to prevent unnecessary heart disease, rather than waiting until they are sick and then asking the doctor only, “How can you fix my problem?”

The authors emphasize that it is never too late to make healthy lifestyle changes. “It is absolutely never too late. Even patients with advanced heart disease can benefit from lifestyle changes,” they say. “For example, studies show that heart failure patients improve when they get regular exercise. Smoking cessation brings benefits within days to weeks. Some studies show that stopping smoking shortly before surgery can reduce the likelihood of lung complications after surgery.”

The new book entitled, Heart 411: The Only Guide to Heart Health You’ll Ever Need, by heart surgeon Marc Gillinov and cardiologist Steven Nissen, both of the Cleveland Clinic, is available from in paperback or Kindle editions: Heart 411: The Only Guide to Heart Health You’ll Ever Need

More Information

See the HelpingYouCare™ resource pages on Heart Disease & Stroke, including

See also the HelpingYouCare™ resource pages on High Blood Pressure.

And see, the HelpingYouCare™ resource pages on Wellness/ Healthy Living for Seniors & Caregivers, including:


Copyright © 2012 Care-Help LLC, publisher of HelpingYouCare™.


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