Heart Attacks are Preventable!

EP328: Discussing Statin Intolerance

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. EP328: Discussing Statin Intolerance Dr. Auric Bishop, a cardiologist, author, and CEO of the Healthy Heart Network, hosts this episode featuring a detailed discussion on statin intolerance with his guest Warwick. The episode explores why patients report difficulties with cholesterol-lowering medications and examines the scientific evidence behind these reported side effects. The core theme challenges the widespread perception that statins are poorly tolerated, presenting research suggesting that psychological factors play a major role in reported adverse effects. Key Takeaways: The Odyssey Alternative Trial found that 78% of patients initially reporting statin intolerance were actually able to tolerate statins when properly tested, compared to the 100% who claimed intolerance at entry. A Cleveland Clinic observational study showed that 72% of self-reported statin-intolerant patients could take statins without problems when blinded to treatment. The Samson Trial demonstrated a "nocebo effect," where approximately 90% of reported statin side effects were attributable to negative expectations rather than the medication itself. In the Samson Trial, symptom scores increased from 8 out of 25 with no treatment to 15.4 on placebo, suggesting that psychological anticipation drives most reported symptoms. Statins are often wrongly blamed for side effects that actually result from other medical conditions, as illustrated by a patient whose leg pain was caused by severe lumbar spine problems, not statins. Alternative therapies like PCSK9 inhibitors (such as elirocumab) provide options for truly statin-intolerant patients, though their high cost limits widespread use. Reducing statin dosing frequency to twice or three times weekly can allow up to 60% or more of patients to achieve therapeutic benefits while minimizing perceived side effects. Almost all medications can cause side effects in some populations, and statin intolerance should be confirmed through rigorous testing rather than accepted based on patient reports alone. Read more

EP327: Statins, Co Enz, Q10, Sams and Metformin

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 Introduction Dr. Warwick Bishop hosts this episode focused on cardiovascular health and metabolic management, exploring the relationships between statins and coenzyme Q10, as well as the broader therapeutic potential of metformin. The episode examines recent research on how these medications affect muscle function, oxidative stress, and metabolic health, while emphasizing evidence-based approaches to disease prevention. Key Takeaways: Coenzyme Q10 (ubiquinone) is found throughout the body and is essential for mitochondrial function, but statin use significantly reduces muscle levels of this compound. A 12-week study found that baseline muscle coenzyme Q10 levels were lower in statin users compared to non-statin users, but these levels did not differ between those who experienced statin-related muscle symptoms and those who didn't. Exercise training increased muscle coenzyme Q10 levels across all groups regardless of statin use, suggesting that the lower coenzyme Q10 levels in statin users may not be the primary cause of muscle side effects. Moderate-intensity exercise is an effective strategy to boost muscle oxidative capacity and counteract oxidative stress associated with statins, benefiting all individuals regardless of medication use. Metformin demonstrates benefits beyond diabetes management, with emerging evidence suggesting potential reductions in cancer risk and Alzheimer's disease through improved insulin and glucose control. The benefits of metformin appear to be most pronounced in overweight individuals with prediabetes or insulin resistance, rather than as a universal preventive medication. Metformin is already established as beneficial for managing obesity, polycystic ovary syndrome, gestational diabetes, and weight gain from antipsychotic medications. The therapeutic effects of metformin likely stem from reducing hyperinsulinemia and elevated glucose levels, which contribute to cellular dysfunction across multiple organ systems. Read more

EP326: Conference Time

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 EP326: Conference Time Dr. Warwick Bishop hosts this episode, sharing his experiences and key learnings from the NCC (National Cardiac) Congress held in Sydney on March 2-3, 2024. The episode features detailed insights from world-renowned cardiologists and specialists who presented on cutting-edge cardiac care, including genetic risk assessment, new cholesterol-lowering therapies, women's cardiovascular health, heart failure management, and innovative approaches to rural healthcare delivery. Key Takeaways: Holistic patient care is essential—specialists must look beyond their particular expertise to address all aspects of a patient's health, including blood pressure, diabetes, weight, mental health, and general well-being. Polygenic risk scores could help stratify patients for earlier screening; rather than using fixed age-based imaging protocols, genetic risk scores could identify which age groups need arterial imaging (e.g., imaging high-risk individuals at 35 versus standard protocols at 50+). Research suggests a potential link between LDL particles and amyloid protein, indicating that cardiovascular health and brain health are interconnected and deserve integrated research and treatment approaches. Small interfering RNA (siRNA) molecules represent an exciting breakthrough in treating dyslipidemia, with potential applications expanding to triglycerides, lipoprotein A, and even hypertension management. siRNA therapies can be administered every 6-12 months with prolonged cellular effects, dramatically improving medication adherence and treatment efficacy compared to daily medications. Women receive better cardiovascular outcomes when treated by female physicians, yet women's heart disease remains under-researched and under-resourced globally, with insufficient female cardiologists in the field. Ventricular assist devices (mechanical pumps) for heart failure have advanced significantly, with the longest recorded use reaching 18 years, and success depends on maximizing guideline-directed medical therapy including beta-blockers and SGLT2 inhibitors. Mobile cardiac clinics (like the Heart of Australia Truck) effectively bring specialized cardiovascular care to remote rural areas, identifying high-risk patients who would otherwise lack access to screening and intervention. Lipoprotein A is approximately six times more atherogenic than standard LDL cholesterol and represents a significant cardiovascular risk factor requiring targeted management strategies. Social media presents a double-edged sword for medical communication—while it enables patient engagement with quality health information, it also exposes clinicians to potential misinformation and malicious attacks. Read more

EP325: Gladiator and Trainer to the Stars: Lourene Bevaart (Part 2)

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 EP325: Gladiator and Trainer to the Stars: Lourene Bevaart (Part 2) Dr. Auric Bishop, a cardiologist and CEO of the Healthy Heart Network, hosts this episode featuring Lourene Bevaart, a world champion karate athlete, former gladiator, and fitness trainer to celebrities like Russell Crowe. In this second part of their conversation, Lourene discusses her career pivot from elite athletic training to helping people improve their health and wellness through education about cellular health and redox signaling molecules. Key Takeaways: Lourene experienced a major life pivot when she became a single mother, prompting her to find flexible work-from-home solutions centered on health and wellness that would allow her to earn income while raising her daughters. Redox signaling molecules are nano-sized molecules inside cells that detect, repair, and replace damaged cells; humans lose approximately 10% of these molecules every decade, which contributes to visible and invisible signs of aging. The analogy of aging cells to an outdated iPhone illustrates how reduced cellular capacity leads to decreased function—similar to how an old phone can't perform like a new model, aging bodies struggle to perform their optimal functions. Protein is critical for satiety and metabolism; Lourene recommends consuming 15-20 grams of protein with each meal or snack, with her personal minimum being 140 grams daily from varied sources including Greek yogurt, eggs, fish, and plant-based options. Chronic dehydration is widespread, and proper hydration with added minerals and electrolytes is essential for optimal health and athletic performance. A comprehensive health approach includes hydration, adequate protein intake, quality sleep, resistance training, and supplementation with redox signaling molecules to accelerate cellular repair and overall health transformation. Redox signaling molecules are unique supplements—not herbs, plants, or synthetic compounds—that are biochemically identical to molecules naturally present in human cells and can be taken as liquid or topical gel formulations. Many people fail to implement simple health steps (hydration, nutrition, exercise) while engaging in counterproductive behaviors like consuming alcohol and junk food, then wonder why they experience weight gain, sluggish metabolism, and persistent cravings. The redox field is relatively new (established in 2010) but growing rapidly with university studies, books, and conferences dedicated to understanding its therapeutic potential for general health and athletic performance. Read more

EP324: Gladiator and Trainer to the Stars - Lourene Bevaart (Part 1)

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 Introduction Dr. Warwick Bishop hosts this podcast episode featuring Lorene Bevaart, a 30-year experienced fitness and wellness trainer, former world karate champion, and original gladiator from the first series of Gladiators. The episode explores Bevaart's remarkable journey from a grade eight student with ambitious dreams to a successful fitness professional who trained celebrities like Shane Warne and Russell Crowe. This is part one of a two-part conversation focusing on her life story and personal journey. Key Takeaways: Childhood dreams matter profoundly—Bevaart articulated specific goals at age 13 (attending university, becoming a physio teacher, achieving world champion status, and having four children) and achieved all of them, demonstrating the power of early goal-setting and belief. Your social circle directly shapes your potential—surrounding yourself with high achievers, supportive peers, and driven individuals creates an environment that naturally elevates your own performance and ambitions. Parental support and modeling of work ethic provide crucial foundational encouragement for children to pursue their goals without fear of judgment or limitation. Willingness to step outside your comfort zone and "give it 100 percent" is essential for personal growth and discovering where your capabilities can take you. The Gladiators audition process was unexpectedly grueling, with a 9-minute fitness routine that challenged even highly trained athletes, demonstrating that physical conditioning and mental resilience under pressure are distinct skills. Major life decisions sometimes require choosing between security and opportunity—Bevaart resigned from a secure head-of-department teaching position to pursue the Gladiators opportunity when her principal wouldn't grant leave. Personal success can evolve through strategic pivots and willingness to take calculated risks, as demonstrated by her transition from teaching to establishing a personal training business at a time when few trainers existed professionally. Toxic friendships and negative influences should be actively removed from your circle, as they unconsciously shape your behaviors and beliefs regardless of awareness. Read more

EP323: Interview With Dr Kaplan Part 2: A Day in the Life of a Cardiologist

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. Podcast Summary Introduction Dr. Warwick Bishop hosts this episode featuring Dr. Jason Kaplan, both cardiologists, as they discuss their personal daily routines and lifestyle habits for maintaining cardiovascular health and longevity. This is part two of their conversation series, following up on their previous discussion about plant-based diets and cardiovascular disease. The episode provides practical insights into how two cardiac specialists integrate evidence-based health practices into their everyday lives. Key Takeaways: Don't aim for perfection in daily health habits; focus on the bigger long-term picture and cumulative effects of healthy behaviors rather than being overly strict about doing everything flawlessly every day. Intermittent fasting and time-restricted eating show promise, with black coffee, green tea, or water acceptable during fasting windows; several mornings per week without breakfast can be beneficial. Incorporate contemplative and meditative practices daily, such as gratitude meditation or yoga, which provide immediate mood and stress-relief benefits while building long-term mental health resilience. Exercise recommendations include either 75 minutes of high-intensity activity once or twice weekly, or 30 minutes of moderate exercise five times per week, ideally combining movement-based exercises like yoga with aerobic activity. A primarily plant-based diet with meals centered on salads, legumes, tofu, tempeh, and vegetables supports cardiovascular health more effectively than animal-heavy diets. Cold showers post-exercise or in the morning may activate brown fat, improve metabolism, and provide cellular benefits including positive effects on DNA methylation and telomerase activity. Relationships and quality time with family and close friends are as critical to cardiovascular health and longevity as exercise and diet, as supported by Harvard's longitudinal lifestyle studies. Prioritize 7+ hours of sleep nightly, with 6 hours as an absolute minimum, as insufficient sleep is associated with worse cardiovascular outcomes. Incorporate walking into your daily routine during commutes, and listen to enriching content like audiobooks or educational podcasts during exercise to maximize time efficiency. A healthy sleep environment with elements like essential oil diffusers with calming oils and red light exposure supports better sleep quality and brain health. Read more

EP322: Interview With Dr Kaplan Part 1: Cardiologist Talking Diet.mp3

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. Auric Bishop hosts Dr. Jason Kaplan, both cardiologists passionate about preventing cardiovascular disease through lifestyle and dietary intervention rather than invasive procedures. This episode explores their personal health practices and the science behind plant-based eating for heart disease prevention, with both doctors sharing their commitment to educating patients with scientifically-backed information. Key Takeaways: Plant-based eating can reduce LDL cholesterol by approximately 25% and improve other cardiovascular biomarkers including C-reactive protein, triglycerides, and lipoprotein(a). Aerobic exercise capacity is one of the strongest predictors of longevity, and both doctors prioritize daily aerobic activity combined with strength-building practices like yoga. Sleep has recently been recognized by the American Heart Association as the eighth principle of cardiovascular health, alongside their original Life Simple 7 recommendations. Transitioning to a plant-based diet doesn't have to be all-or-nothing; starting with meat-free nights a few times per week can be a manageable first step for many people. Dean Ornish's landmark randomized controlled trial demonstrated mild regression of atherosclerotic plaque in patients following a very low saturated fat, plant-based diet. The Mediterranean diet and Blue Zone diets are predominantly plant-based when examined in detail, with meat consumed only occasionally rather than as a daily staple. Having a supportive partner or community helps significantly when adopting dietary changes, and modern resources like Forks Over Knives and Michael Greger's website provide accessible recipes and meal plans. Even high-end restaurants in Sydney now offer plant-based options, making it increasingly feasible to maintain plant-based eating in diverse social and dining situations. Read more

EP321: Aortic Aneurysms, Anxiety and Exercise

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. Podcast Summary: EP321 - Aortic Aneurysms, Anxiety and Exercise Introduction: Dr. Warwick Bishop, a cardiologist and CEO of the Healthy Heart Network, hosts this episode discussing cardiovascular health topics relevant to Australians. The episode covers two main subjects: ascending thoracic aortic aneurysms (with personal insight from Dr. Bishop's own experience with the condition) and the relationship between physical activity and anxiety. Dr. Bishop aims to help listeners understand heart health conditions and prevention strategies. Key Takeaways: An ascending thoracic aortic aneurysm is a dangerous dilation of the aorta (the major blood vessel from the heart) that can result in over 90% mortality if it ruptures, making early detection and surgical intervention critical. The PEARS procedure (Personalized External Aortic Root Support) is an alternative surgical option that uses a 3D-printed custom sleeve to wrap around the aorta, providing structural support without complete aortic replacement. A Yale study found a "silver lining": patients with dilated ascending aortas tend to have clearer coronary arteries and lower rates of coronary artery disease compared to age-matched peers. Normal aortic diameter at the heart's exit is approximately 35mm; intervention is typically considered at 45mm, strongly recommended at 50mm, and essential at 55mm. Aortic aneurysms are often associated with connective tissue disorders like Marfan syndrome and bicuspid aortic valves (having two leaflets instead of three). Just 10 minutes of physical activity daily, 5 days per week, can significantly reduce the risk of developing general anxiety disorder by approximately 23% in older adults. Exercise provides multiple health benefits beyond physical fitness, including improved mood, better blood pressure control, enhanced glucose regulation, and better diabetic management. Regular physical activity is a low-risk intervention with broad mental health benefits and should be incorporated into daily routines for overall wellbeing. Read more

EP320: Blindsided (Almost)

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: EP320 - Blindsided (Almost) Dr. Warwick Bishop, a cardiologist, CEO of the Healthy Heart Network, and author, shares a personal health journey in this episode of his podcast. Rather than discussing heart disease directly, Dr. Bishop recounts his unexpected diagnosis of raised intraocular pressure and the series of eye health issues he discovered over several years. The episode emphasizes the importance of proactive health maintenance and regular screenings across all areas of health, not just cardiac care. Key Takeaways: Early detection of vision problems can prevent serious complications; Dr. Bishop's attentiveness to blurred vision in his right eye led to identification of retinal tears that were successfully treated with laser therapy Retinal tears can occur spontaneously with age as the eye changes shape and size, and the condition is not necessarily linked to family history Raised intraocular pressure (elevated eye pressure) is often called "the silent thief of sight" because it can damage the optic nerve and cause glaucoma without obvious symptoms Intraocular pressure must be measured through tonometry (a puff test on the eye) to be detected, as there are no noticeable warning signs; normal pressure is 15-20 mmHg Laser iridotomy, a procedure creating small holes in the iris, can improve fluid drainage in the eye and help manage elevated intraocular pressure When raised intraocular pressure is detected before causing optic nerve damage, it can be managed effectively with eye drops and regular monitoring Age is a primary risk factor for eye health issues, making regular eye check-ups essential for people approaching 60 and beyond Proactive health maintenance across multiple areas—heart, eyes, bones, gut, and cancer screening—is crucial for long-term wellness Preventive screenings like bowel cancer screening kits are underutilized, with approximately 50% of eligible people not completing the free test Quality of life benefits from early intervention far outweigh the inconvenience of treatment, such as taking daily eye drops Read more

EP319: Buffing Up Your Immune System

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 Introduction Dr. Warwick Bishop, a cardiologist, author, and CEO of the Healthy Heart Network, hosts this episode focused on strengthening the immune system through sustainable lifestyle habits rather than short-term interventions. The episode is timely given current COVID waves and exam-related stress, and emphasizes year-round immune system maintenance as a foundation for overall health and reduced inflammation. Key Takeaways: The immune system consists of body cells that work with the autonomic nervous system to defend against external attacks such as bacterial or viral infections, and maintaining immune balance helps reduce inflammation linked to heart disease and blood pressure issues Dental health and gut health are critical entry points where bacteria and inflammatory proteins can breach the body's defenses; periodontal disease and poor oral hygiene can trigger systemic inflammation Nutrition is foundational—prioritize whole foods rich in vitamins and minerals while avoiding processed, sugary, and overly fatty foods, and be mindful of high salt intake which can increase gut permeability and inflammation Regular moderate exercise (such as walking at a conversational pace) reduces inflammation by clearing excess mitochondrial energy and preventing harmful byproduct buildup in cells A balanced exercise program should include both strength training and endurance work to maintain independence and functional ability in daily living Chronic stress activates the sympathetic nervous system, releasing cortisol and increasing blood pressure, blood sugar, and sleep disruption—managing stress is essential for immune health Quality sleep is foundational to health; establish consistent sleep routines including dim lighting, avoiding late meals, using relaxation techniques like meditation or self-hypnosis, and gentle wake-up methods Targeted supplementation with vitamin D, vitamin A, vitamin E, and occasionally vitamin C and zinc may support immune function, though whole-food nutrition should be the primary source Read more