Although he has special expertise in the evaluation and treatment of patients with coronary artery disease, Dr. Brown also treats patients with heart failure, arrhythmias and heart valve disease as well as combinations of these problems. As the team cardiologist for a Division 1 athletic program in New York for 10 years, Dr. Brown also has experience treating cardiac issues in competitive athletes of all ages. He emphasizes the importance of lifestyle changes to preventing heart disease.
The most common risk factors are diabetes, high blood pressure, high cholesterol, smoking, obesity and a lack of physical activity or a sedentary lifestyle. There are also risk factors that cannot be controlled, such as gender, age and family history.
Patients may be referred by their primary care physician, following a hospitalization when they’ve shown signs of heart disease, or they may self refer when they are concerned about their own risk factors. When I first see patients, we take a medical history, perform a physical examination, conduct a baseline electrocardiogram, or EKG, discuss their lifestyle habits such as exercise and diet, and go through a risk assessment. The risk assessment consists of questions about a patient’s age, gender, weight, cholesterol, blood pressure and activity levels. As you connect risk factors, you can see what a patient’s risk may be for heart disease and work from there to reduce that risk.
A healthy diet and exercise have been shown to reduce the risk of heart disease by up to 80 percent. I often recommend a Mediterranean diet because it is one of the most researched diets and has proven successful for those who want to make changes. We have access to dietitians for those who would like additional guidance. I also stress the importance of exercise. People do not have to invest a lot of money in a gym or on electronic tracking devices. They really just need a good pair of walking shoes and to start walking short distances at first that they can build upon over time. Other areas that may pose a risk are stress and even periodontal disease, which leads to inflammation in your mouth and can impact your heart. Finally, if you are serious about taking care of yourself, you have to quit smoking.
Diabetes is a major risk factor for heart disease. If someone comes to me with diabetes, I may treat that patient a little more aggressively to prevent the development of heart disease. Individuals with Type 2 diabetes can also be positively impacted by a change in diet and exercise, which may lead to reducing or eliminating some medications. As diet and exercise reduce weight, lower blood pressure and improve metabolism, medications used to treat blood pressure, cholesterol and blood sugar can often be reduced or sometimes eliminated altogether.