Heart Attacks are Preventable!

EP444: Father and Son Chiropractics - Drs Crean

Welcome to my podcast. I am Doctor Warrick Bishop, and I want to help you to live as well as possible for as long as possible. I’m a practising cardiologist, best-selling author, keynote speaker, and the creator of The Healthy Heart Network. I have over 20 years as a specialist cardiologist and a private practice of over 10,000 patients. Father-Son Chiropractors on Spinal Health, Mobility, and Whole-Body Wellness Dr. Warrick Bishop, cardiologist and host of the Healthy Heart Network podcast, welcomes Stephen and Sam Crean — a father-and-son chiropractic duo from Hobart and Kingston Chiropractic in Tasmania — in what he describes as his first-ever father-son podcast. The conversation explores the broader scope of chiropractic care beyond back pain, its role in healthy aging, and how it complements other health disciplines. Key Takeaways: Chiropractic care extends well beyond treating back pain — it addresses any issue involving muscles, ligaments, tendons, joints, bones, and nerves throughout the entire body Approximately 60% of the Creans' practice consists of patients over 50, reflecting chiropractic's significant role in supporting healthy aging Improving spinal mobility and neurological function helps older patients maintain independence, manage muscle mass, support cardiovascular health, and reduce fall risk The spine's ability to move and function as designed is central to overall health, as spinal nerves connect to muscles, proprioceptors, and organs throughout the body Chiropractic care works best as part of a complementary healthcare approach, integrating with services like strength training and bone density programs Patient empowerment is a core goal — practitioners send patients home with exercises and ergonomic guidance so they can actively participate in their own recovery Some therapeutic discomfort is a normal and necessary part of chiropractic treatment, distinguishing productive adaptation from harmful pain Preventive and performance-focused chiropractic care — starting early in life — can be more impactful than waiting until pain or dysfunction develops The Creans have worked collaboratively with local football clubs for over a decade, training multidisciplinary sports teams in chiropractic principles within their respective scopes Read more

EP443: I don't want to take more tablets - Medication Apprehension

Welcome to my podcast. I am Doctor Warrick Bishop, and I want to help you to live as well as possible for as long as possible. I’m a practising cardiologist, best-selling author, keynote speaker, and the creator of The Healthy Heart Network. I have over 20 years as a specialist cardiologist and a private practice of over 10,000 patients. Episode Overview Dr. Warrick Bishop, a cardiologist, author, keynote speaker, and CEO of the Healthy Heart Network, hosts this solo episode focused on practical lessons from recent patient consultations. Using two anonymized patient cases, he explores the psychological and emotional dimensions of managing chronic conditions and medication adherence. Key Takeaways: A reframe from frustration to gratitude can transform a patient's relationship with their medications — Dr. Bishop shares his own experience with glaucoma eye drops as a personal example of this mindset shift. Modern medical treatments, whether tablets or eye drops, represent remarkable advances that deserve appreciation rather than resentment. There are only three types of medication side effects: anaphylactic reactions, idiosyncratic reactions, and dose-related intolerances — and only the third is typically negotiable. Anaphylactic and idiosyncratic reactions are absolute contraindications to restarting a medication, while dose-related intolerances can often be managed by adjusting the amount taken. When managing dose-related intolerances, starting at an extremely low dose is a valid and sensible medical strategy, not a compromise. Excessive anxiety about a medication can block productive clinical conversations and prevent patients from receiving beneficial treatment. Patients sometimes invest disproportionate emotional energy into manageable medical decisions, energy better reserved for truly serious life challenges. Doctors should meet patients where they are emotionally before attempting to problem-solve or prescribe. Staying on even partial therapy (such as ezetimibe alone) during a medication dispute is better than stopping treatment entirely. Calm, collaborative problem-solving between doctor and patient leads to better outcomes than fear-driven decision-making. Read more

EP442: Best bang for buck in prevention

Welcome to my podcast. I am Doctor Warrick Bishop, and I want to help you to live as well as possible for as long as possible. I’m a practising cardiologist, best-selling author, keynote speaker, and the creator of The Healthy Heart Network. I have over 20 years as a specialist cardiologist and a private practice of over 10,000 patients. Episode Introduction Dr. Warrick Bishop, a cardiologist, author, keynote speaker, and CEO of the Healthy Heart Network, hosts this solo episode focused on cardiovascular and general health prevention. Drawing on a recent paper from the University of Chicago, Dr. Bishop explores how primary care physicians can best prioritize preventative interventions to save the most lives. The episode aims to help patients and their loved ones understand which preventative strategies deliver the greatest health benefits. Key Takeaways: A University of Chicago study identified 42 different preventative interventions and ranked them by their ability to reduce mortality and morbidity, highlighting the challenge of covering all of them in a single medical consultation. Pre-exposure prevention for HIV in high-risk individuals ranks as the single most impactful intervention for gaining future life-years, yet it remains significantly underused in primary care settings. Breast cancer reduction medication (anti-estrogen and anti-aromatase drugs) for high-risk individuals ranks second in preventative value, a fact that surprises many, including Dr. Bishop himself. Pre-exposure prevention counseling for intravenous drug use ranks third, requiring primary care physicians to engage in sensitive but critically important conversations. Statin therapy for primary prevention ranks fourth overall and is considered underappreciated and underused, despite strong evidence supporting its benefits. Alcohol counseling and weight loss/dietician referral round out the top six patient-centered interventions, reflecting the ongoing importance of lifestyle modification. When ranked by efficient use of doctor's time rather than pure patient benefit, the list shifts slightly, with hepatitis B screening and hypertension screening entering the top six. For a practical real-world example, a 65-year-old overweight woman would be prioritized for statins, weight loss counseling (potentially including GLP-1 medications), and colorectal cancer screening, followed by reassessment. Not all preventative screenings are equally valuable — cervical screening ranks lower than commonly assumed, while breast cancer risk-reduction medication ranks far higher than most patients or doctors expect. Patients are encouraged to arrive at medical appointments informed and prepared, knowing their personal risk factors so they can make the most of limited consultation time. Read more

EP441: I know V02, but what's lactate?

Welcome to my podcast. I am Doctor Warrick Bishop, and I want to help you to live as well as possible for as long as possible. I’m a practising cardiologist, best-selling author, keynote speaker, and the creator of The Healthy Heart Network. I have over 20 years as a specialist cardiologist and a private practice of over 10,000 patients. Episode Summary Dr. Warrick Bishop, a cardiologist, author, and CEO of the Healthy Heart Network, hosts this solo episode focused on fitness and longevity. He explores the differences between two key performance and health metrics — VO2max and lactate threshold — and explains why both matter for long-term health and aging. Key Takeaways: VO2max measures the maximum amount of oxygen your body can use during intense exercise, essentially reflecting the strength and efficiency of your cardiovascular delivery system. A useful analogy is comparing VO2max to engine size — a high VO2max is like having a V8 engine that delivers plenty of fuel to the muscles. Two athletes can have identical VO2max scores yet perform very differently, which is what led elite coaches to investigate lactate as an additional metric decades ago. Lactate threshold reflects mitochondrial efficiency — how well the body's cells actually use the oxygen delivered to them, not just how much oxygen arrives. When lactate levels begin to rise during exercise, it signals that the mitochondria are being overwhelmed and the body is switching to a less efficient energy pathway. Lactate threshold is considered the most powerful predictor of endurance performance and long-term metabolic health. VO2max and lactate threshold measure different things: cardiovascular fitness versus cellular and mitochondrial fitness, respectively. Elite athletes and their coaches have long used both metrics together to design more targeted and effective training protocols. Knowing your lactate threshold allows you to tailor training to raise that threshold, improving cellular efficiency at higher exercise intensities. Lactate testing is beginning to enter the longevity science space, complementing the already well-established use of VO2max as a marker for healthy aging. Read more

EP440: How Long Will You Live? Check Your VO2 Max!

Welcome to my podcast. I am Doctor Warrick Bishop, and I want to help you to live as well as possible for as long as possible. I’m a practising cardiologist, best-selling author, keynote speaker, and the creator of The Healthy Heart Network. I have over 20 years as a specialist cardiologist and a private practice of over 10,000 patients. Introduction Dr. Warrick Bishop, a cardiologist, author, keynote speaker, and CEO of the Healthy Heart Network, hosts this solo episode focused on VO2max and its critical role in longevity and overall health. He explains the science behind VO2max in accessible terms, drawing on clinical data and his own plans to undergo VO2max testing and training at his new wellness centre in Hobart, Australia. Key Takeaways: VO2max measures the maximum rate at which your body can deliver oxygen to muscles during intense exercise, functioning like an engine's ability to deliver fuel to its pistons. VO2max is considered the single best predictor of longevity, surpassing traditional risk factors like smoking, blood pressure, and cholesterol. Moving from a low to a below-average VO2max can reduce mortality risk by over 50%, and each incremental improvement (one MET increase) is associated with approximately a 15% reduction in mortality risk. VO2max naturally declines roughly 10% per decade starting around age 30, meaning sedentary individuals could face a 60–70% decline by their 80s or 90s. Key contributors to age-related VO2max decline include reduced cardiac stroke volume (up to 40% of decline), decreased hemoglobin levels, and loss of muscle mass and mitochondrial density (up to 30% of decline). The gold standard for measuring VO2max is metabolic cart assessment, which directly measures inspired and expired gases, though validated field tests and wearables like Apple Watch and Garmin offer useful estimates for tracking trends. VO2max scores below the teens correlate with an inability to live independently, highlighting the real-world functional stakes of maintaining a healthy score. Improving VO2max involves a structured exercise pyramid: a foundation of Zone 2 aerobic exercise (70–80% of training), followed by lactate threshold work, and high-intensity interval training (HIIT) at up to 90% of maximum heart rate. HIIT is one of the most effective methods for boosting VO2max, with one to two sessions per week sufficient to begin seeing measurable improvements. Wearable devices can serve as practical tracking tools for VO2max trends, especially when initially calibrated against a formal gold-standard test. Read more

EP439: Does Stress Cause Cancer?

Welcome to my podcast. I am Doctor Warrick Bishop, and I want to help you to live as well as possible for as long as possible. I’m a practising cardiologist, best-selling author, keynote speaker, and the creator of The Healthy Heart Network. I have over 20 years as a specialist cardiologist and a private practice of over 10,000 patients. Episode Introduction Dr. Warrick Bishop, a cardiologist, author, keynote speaker, and CEO of the Healthy Heart Network, hosts this solo episode focused on the relationship between stress and cancer. Drawing on a large-scale meta-analysis, Dr. Bishop explores the widely held belief that chronic stress directly causes cancer and what the science actually reveals. The episode aims to both inform and reassure listeners who may be carrying unnecessary guilt around a cancer diagnosis. Key Takeaways: Approximately 50% of people believe chronic stress directly causes cancer, a belief reinforced by powerful anecdotes and the fact that cancer and major life stressors often peak at similar life stages. A large meta-analysis pooling data from 22 cohorts across over 400,000 people and 35,000+ cancer cases found no direct link between stress and cancer. Five stress domains were studied — relationship status, perceived social support, bereavement, general distress, and neuroticism — and none showed a clear connection to any cancer type. Even high levels of anxiety and neuroticism showed no measurable link to increased cancer risk across any cancer type. Some associations between stress factors (e.g., bereavement, social isolation) and lung cancer largely disappeared once smoking was accounted for, suggesting stress-driven behaviors — not stress itself — were the real risk factor. Stress can indirectly raise cancer risk by driving unhealthy coping behaviors such as smoking, excessive alcohol consumption, poor sleep, and poor diet. People who have experienced cancer should not blame themselves for past stress, as the evidence does not support stress as a direct cause. Social connection is a powerful protective factor, while isolation is a meaningful risk factor across multiple health outcomes, including cancer. Stress management remains important not because stress causes cancer, but because it affects quality of life and can lead to harmful behavioral choices. Cardiovascular health is a separate concern — depression and anxiety are still associated with increased cardiovascular disease risk, even if the cancer link is unsupported. Read more

EP438: What on Earth is EECP and how can it help?

Welcome to my podcast. I am Doctor Warrick Bishop, and I want to help you to live as well as possible for as long as possible. I’m a practising cardiologist, best-selling author, keynote speaker, and the creator of The Healthy Heart Network. I have over 20 years as a specialist cardiologist and a private practice of over 10,000 patients. Episode Introduction In this episode, Dr. Warrick Bishop, a cardiologist and CEO of the Healthy Heart Network, speaks with Jack Clifford, a 52-year-old former military professional from Florida. Jack suffered a severe heart attack in 2020 with three blocked coronary arteries and, facing emergency bypass surgery, chose to explore an alternative therapy called Enhanced External Counterpulsation (EECP). The conversation centers on Jack's personal journey with EECP and the broader potential of this lesser-known medical technology. Key Takeaways: EECP (Enhanced External Counterpulsation) uses compression cuffs on the legs to push blood upward toward the heart during diastole (the heart's rest phase), improving coronary blood flow without surgery. Jack had three coronary arteries blocked to a degree deemed unsuitable for stenting, making bypass surgery the standard recommendation — a route he ultimately declined. Concerns about cognitive decline following bypass surgery, witnessed through his mother's experience, motivated Jack to seek an alternative treatment path. EECP stimulates the release of vascular endothelial growth factor (VEGF) and hematopoietic stem cells, encouraging the body to grow its own new blood vessels over time. The therapy is described as functioning like cardiovascular exercise at "supra-physiologic" levels — delivering benefits beyond what even a highly fit person could achieve through normal exercise. Benefits of EECP extend well beyond cardiac care, with research suggesting positive effects on erectile dysfunction, kidney function, and cognitive decline, including a 2023 study showing reversal of dementia symptoms. Jack has accumulated approximately 700 hours on EECP — potentially more than any other individual — and reports significant improvements in organ function and visible increases in vascularity throughout his body. Despite being one of the most researched medical devices available, EECP remains largely unknown, even among medical professionals, and access is severely limited in the United States compared to countries like India and China. The standard clinical protocol of 35 hours of EECP treatment, while beneficial, may significantly underestimate the therapy's full potential, as Jack's extended use suggests compounding benefits over hundreds of hours. The mechanism of shear stress on blood vessel walls — triggered by the pressure differentials created by EECP — appears to be a key driver of new blood vessel growth throughout the body. Read more

EP437: The Power of Mitochondria

Welcome to my podcast. I am Doctor Warrick Bishop, and I want to help you to live as well as possible for as long as possible. I’m a practising cardiologist, best-selling author, keynote speaker, and the creator of The Healthy Heart Network. I have over 20 years as a specialist cardiologist and a private practice of over 10,000 patients. Episode Introduction Dr. Warrick Bishop, a cardiologist, author, keynote speaker, and CEO of the Healthy Heart Network, hosts this solo episode focused on mitochondrial health. He explores how mitochondria function far beyond their traditional role as cellular energy producers, examining their connection to aging, inflammation, and chronic disease. The episode aims to help listeners understand how supporting mitochondrial health can be foundational to overall wellbeing and longevity. Key Takeaways: Mitochondria are more than just cellular "power plants" — they also play roles in decision-making, inflammation regulation, and the aging process. Mitochondrial biogenesis (the creation of new mitochondria) is stimulated by exercise, fasting, and hot/cold exposure, all of which work through a master metabolic switch involving molecules like PGC1-alpha and AMP kinase. Greater mitochondrial density in cells is linked to improved endurance, better metabolic health, stronger brain and muscle function, and slower aging. Damaged mitochondria can leak and trigger inflammatory cascades, contributing to low-grade chronic inflammation — a silent driver of heart disease, Alzheimer's, obesity, and bone deterioration. As we age, the body becomes less efficient at clearing damaged mitochondria, allowing inflammation-promoting mitochondria to accumulate throughout the body. Mitochondrial dysfunction may be a common molecular foundation underlying many age-related diseases, including Alzheimer's, Parkinson's, heart disease, cancer, and immune conditions. Exercise is described as the single most impactful intervention for mitochondrial health, with high-intensity interval training and resistance training being especially beneficial. Caloric restriction is the only intervention proven across multiple organisms to extend lifespan, making it a significant tool alongside exercise for longevity. Supplements such as NAD+, its precursors NMN and nicotinamide riboside, resveratrol, and PQQ show promise for mitochondrial support, though outcome data remains limited. Quality sleep, breathwork, and stress management are foundational to mitochondrial and overall health, as recovery during sleep is essential for cellular repair processes. Read more

EP436: The Amazing C15 Story with Danielle Cole

Welcome to my podcast. I am Doctor Warrick Bishop, and I want to help you to live as well as possible for as long as possible. I’m a practising cardiologist, best-selling author, keynote speaker, and the creator of The Healthy Heart Network. I have over 20 years as a specialist cardiologist and a private practice of over 10,000 patients. Introduction Dr. Warrick Bishop, an Australian cardiologist, author, and CEO of the Healthy Heart Network, hosts this episode focused on a newly recognized essential fatty acid called C15 (pentadecanoic acid). His guest is Danielle Cole, Head of Sales for Fatty 15, a supplement company built around this nutrient. Dr. Bishop shares that he and his wife have personally been taking C15 for nearly a year, making this his first public discussion of the supplement. Key Takeaways: C15 (pentadecanoic acid) is only the third essential fatty acid ever discovered, joining omega-3s and omega-6s as nutrients the body cannot produce on its own. Approximately one in three people globally are critically deficient in C15, largely due to changes in modern farming practices and reduced consumption of full-fat dairy. C15 was discovered through a U.S. Navy dolphin health program, where veterinary epidemiologist Dr. Stephanie Venn-Watson identified C15 deficiency as the cause of human-like diseases in aging dolphins. The nutrient's primary role is to strengthen cell walls and improve cell signaling, complementing omega-3s which focus on cellular flexibility. C15 activates AMPK and inhibits mTOR pathways — the same mechanisms targeted by metformin and berberine — supporting insulin sensitivity and metabolic health. A C15 deficiency can contribute to a condition called "cellular fragility syndrome," which is linked to elevated cholesterol, insulin resistance, and accelerated cellular aging. People who are dairy-free face the highest risk of critical C15 deficiency, as full-fat, grass-fed dairy is the primary dietary source. C15 is recommended for all ages, including infants, since babies initially receive this nutrient through breast milk and may start life deficient if the mother is dairy-free or deficient. Testing for C15 levels is available through providers like Genova, with more accessible at-home testing options reportedly in development. No known contraindications or interactions with medications or other supplements have been identified with C15 supplementation. Read more

EP435: Talking Diabetes

Welcome to my podcast. I am Doctor Warrick Bishop, and I want to help you to live as well as possible for as long as possible. I’m a practising cardiologist, best-selling author, keynote speaker, and the creator of The Healthy Heart Network. I have over 20 years as a specialist cardiologist and a private practice of over 10,000 patients. Introduction: Dr. Warrick Bishop, a cardiologist, author, keynote speaker, and CEO of the Healthy Heart Network, hosts this solo episode focused on diabetes. He explores what diabetes is, why it matters, and what individuals can do to prevent or manage it, framing it within the broader context of cardiometabolic disease. Key Takeaways: Diabetes results from either insufficient insulin production (Type 1) or the body's poor response to insulin, known as insulin resistance (Type 2). Type 1 diabetes is an autoimmune condition most common in teenagers, requiring insulin replacement therapy, while Type 2 develops gradually in older, often overweight individuals. Prediabetes represents an early stage before blood sugar reaches clinically diagnostic levels, making it a critical window for intervention. Uncontrolled blood sugar causes widespread organ damage, increasing risk of heart disease, stroke, dementia, kidney disease, and eye conditions. Early detection of insulin resistance using fasting insulin levels and the HOMA equation can help identify risk before blood sugar levels become dangerously elevated. Reducing carbohydrate intake — including seemingly healthy foods like whole grain bread — is essential, as all carbohydrates ultimately break down into sugar. Lifestyle changes including regular exercise, weight loss, improved sleep, and stress management significantly improve insulin resistance. Medications such as GLP-1 agonists (e.g., Ozempic, Wegovy) and SGLT2 inhibitors not only control blood sugar but also improve cardiovascular and kidney outcomes. Abdominal fat is a key warning sign for Type 2 diabetes risk and should prompt medical evaluation and lifestyle changes. Read more