#424 How to Prevent Heart Disease - Dr Paddy Barrett

Paddy Barrett (0:00)

In truth, if you look at over a long enough time horizon, everyone will ultimately likely develop atherosclerosis or plaque in their coronary arteries at some time point. The key is we develop a small amount as late as possible that ultimately doesn't cause a complication leading to an event. Heart disease doesn't kill people, heart attacks kill people.

Siim Land (0:20)

Welcome to the Siim Land Podcast. Our guest today is Dr. Paddy Barrett. Dr. Paddy is a preventive cardiologist from Ireland. He's got 20 years of experience in preventing heart disease and improving metabolic health. This episode is brought to you by Bon Charge, my favorite company for blue blocking glasses, red light therapy devices, and red light light bulbs. These items are essential for keeping your sleep-wake-on-a-cycle aligned in a world that tries to mess them up. Instead of looking at your phone before bed and letting the blue light disrupt your melatonin production, why not wear blue blockers instead that prevent that from happening? Instead of having your bedroom lit up with bright lights, use the more sleep-friendly alternative by opting for flicker-free red light light bulbs that don't disrupt your sleep. BonCharge also has amazing infrared sauna blankets that can give you the same health benefits as the traditional sauna. You also get the unique benefits of infrared light that improves joint and skin health. Head over to bondcharge.com for Seem Land and use the code Seem, S-I-I-M, for a 15% discount.

Dr. Paddy, welcome to the show.

Paddy Barrett (1:24)

Good to be here.

Siim Land (1:25)

Yeah, I'm excited to have you on the show, and we're going to talk about heart disease, which is still the number one killer in the developed countries, the number one cause of death worldwide. So yeah, maybe you as a cardiologist, maybe we can start with some statistics, like what is the situation with heart disease right now? Like is it still the number one killer? And yeah, are we seeing any improvements in the statistics or not?

Paddy Barrett (1:57)

So I think it's always important to put things in context. The way I approach things is, you know, stats and actuarial models. If you look globally, as you said, heart disease is the leading cause of death, and I think roughly kills about 20 million people each year, and that is actually probably close to double what cancer kills on an annual basis, and that's on a global basis. The differences in terms of mortality, in terms of global figures, and also in the developed nations, is actually much closer, and often you get this on par, kind of one-two jockeying for position in terms of all cardiovascular disease, so heart disease, stroke, peripheral arterial disease, and with all cancers.

What is really important to point out is, although it is a leading cause of death, if you look at the differences in terms of mortality at an earlier time point compared to, say, 50 years ago, it has decreased considerably. Now, those differences have been manifest across different socioeconomic classes more dramatically. So if you're in a lower socioeconomic class, you haven't accrued the same amount of benefits. The second thing is that those continued declines really started to plateau out around 2010 and have slowly started to take back up a little bit. But in the context of where we were compared to 50 years ago or the 1950s, there has been an absolute implosion in terms of the annual death rates at an earlier time point.

Siim Land (3:32)

What was the biggest reason why there was such a drastic decrease in heart disease?

Paddy Barrett (3:37)

It's multifactorial, but there is no doubt that you can overlay quite clearly the decreased rates in smoking, as probably one of the biggest drivers in terms of early heart disease presentations, fatal myocardial infarctions. So in terms of, it's even different in terms of the last 10 to 15 years, in terms of how people would present. People obviously still have very serious heart attacks, fatal heart attacks, but you can see a pattern that has changed over the years. People tend to present with less what are called stemmies, or an acute occlusion of the vessel, and more non-stemmies, so subacute occlusions. They tend to present earlier, they tend to present with less mechanical complications. And when you look at the, I suppose the environmental factors as well, people are much more dialed into the cardiovascular risk factor profile, how to manage it, and how to potentially kind of delay the onset of cardiovascular disease. So while I think on a ranked basis that cardiovascular disease still requires a huge amount of our attention, and we have to always look at it on the basis as a leading cause of death, where 80 to 90% of it in its early form is preventable, we always have to hold it in comparison to the unbelievable progress that has been made over the last 50 years.