How to beat heart disease: 8 habits you must fix | Dr. Nour Makarem

**ZOE** (0:00)
Welcome to ZOE Science and Nutrition, where world leading scientists explain how their research can improve your health.
Heart disease is still the number one killer globally, responsible for around one in five deaths in the US. While these figures are deeply worrying, heart disease is not inevitable. Science has shown that there are simple, achievable lifestyle changes that you can make now that will significantly reduce your long-term risk. Today, I'm joined by Dr. Nour Makarem, a cardiovascular epidemiologist at Columbia University, whose research focuses on how lifestyle factors impact heart disease risk. Her work is helping reshape prevention science and shows that daily rhythms play a surprisingly important role in keeping your heart young. It's not just what you eat, it's when you eat it. She also explains how sleep can be your secret weapon against heart disease. By the end of this episode, you'll understand exactly what you need to do to protect your heart. Nour, thank you so much for joining me today.

**Dr. Nour Makarem** (1:18)
It's great to be here. Thank you so much for having me.

**ZOE** (1:21)
So we always like to kick off the show at ZOE with listener questions. And we have a rapid fire Q&A, and we have one strict rule.

**Dr. Nour Makarem** (1:29)
Okay.

**ZOE** (1:30)
Designed for scientists to be hard. You can say yes or no, or if you have to, a one sentence answer.

**Dr. Nour Makarem** (1:36)
Okay.

**ZOE** (1:38)
Can poor sleep make you age faster?

**Dr. Nour Makarem** (1:41)
Yes.

**ZOE** (1:43)
Do heart disease risk factors affect men and women in the same way? No. Does your ethnic background play a part in your risk of heart disease?

**Dr. Nour Makarem** (1:55)
Yes.

**ZOE** (1:56)
Does when you eat impact heart health?

**Dr. Nour Makarem** (1:59)
Of course, yes.

**ZOE** (2:00)
And finally, what's one thing that most people do wrong when trying to look after their heart?

**Dr. Nour Makarem** (2:06)
People sleep on sleep. People don't prioritize their sleep and don't realize that sleep is a really important way to prevent heart disease.

**ZOE** (2:14)
My grandfather died of a heart attack. And it's also true, as my family tells me, I'm a bit of a hyperchondriac, so I can worry about my health. And so I've definitely had chest pains in my life and wondered if this is the first sign of a heart attack. And I'm pleased to say, Nour, it never has been. It's been indigestion, or like some sort of minor muscle twinge after being at the gym. And despite all of that, I really want to keep my heart healthy. It's definitely something that I feel is really important. Now, I know you've got a lot of great advice and that the heart health essential eight that you were involved in creating is something that we will definitely get to. But before we go there, I'd like to sort of provide some context because every time someone talks about heart disease, like I find it quite complicated. So firstly, just that word heart disease, like I think everyone is like, oh, I'd like to avoid a heart attack. But what is heart disease?

**Dr. Nour Makarem** (3:14)
Basically, it's the narrowing of the arteries or the vessels in our body that supply blood to our heart, which of course is necessary for pumping blood to all of our organs so that we can function. And heart disease begins with the narrowing of those arteries, the decrease or eventually even the abrupt stop to that supply of blood to our heart, that can lead us to having a heart attack. And this is a process that happens for a lot of people over multiple decades of life before we get to that bad outcome of having a heart attack or a stroke in the case of the brain.

**ZOE** (3:47)
I've also heard doctors often talk to me about high blood pressure. Has that got anything to do with this heart disease you're talking about?

**Dr. Nour Makarem** (3:55)
Yes. So high blood pressure or what we call hypertension is actually the number one cause of heart disease. It's the number one cause of dying from heart disease. Making sure that our blood pressure stays in the normal range is one of the best things that we can do to prevent developing cardiovascular disease or having a heart attack or a stroke.

**ZOE** (4:13)
I'm actually really shocked to hear you say that high blood pressure is the number one cause of heart disease and heart attacks. Could you help me to understand what it is?

**Dr. Nour Makarem** (4:21)
Yes. Blood pressure refers to the pressure on the walls of those blood vessels when our heart pumps and also when our heart is not pumping. So that's what those measures correspond to. We have an upper reading when we measure our blood pressure, which is the systolic blood pressure, and then we have this lower reading, which is the diastolic blood pressure. Both of them have been linked to future risk of heart disease and to heart disease outcomes. But generally, the measure on the top, the upper reading is the one that I would say is more strongly related to our future risk of heart disease.