Heart Attacks are Preventable!

EP251: mRNA and Amyloid

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 Episode Summary Introduction Dr. Warrick Bishop, a cardiologist, author, and CEO of the Healthy Heart Network, hosts this episode focused on emerging medical technologies discussed at the 2022 Cardiac Society conference. The episode explores two groundbreaking areas—mRNA applications and amyloid accumulation—and their significant implications for preventing heart disease and improving global health outcomes. Key Takeaways: mRNA serves as a transcription factor that carries genetic blueprints from DNA to cells, enabling the production of specific proteins and offering vast therapeutic potential beyond COVID vaccines. mRNA technology allows doctors to insert information into cells to trigger immune responses, demonstrated effectively by Pfizer and Moderna COVID vaccines using spike protein sequences. Small interfering RNA particles can block the production of harmful proteins like PCSK9 in the liver, potentially replacing current antibody-based cholesterol treatments with more efficient prevention methods. Over 50 Nobel Prizes in Medicine have been awarded for mRNA research, with more than 2,500 mRNA proteins identified, representing an enormous body of scientific work and future medical opportunities. Elevated mRNA proteins can serve as biomarkers to detect cellular stress and strain, particularly in cardiac failure, allowing for earlier diagnosis and intervention. Amyloid is a protein that accumulates in organs like the heart and brain instead of being cleared, contributing to heart stiffness and potentially Alzheimer's disease. Amyloid accumulation can result from plasma cell tumors (myeloma), age-related factors, or genetic predisposition from liver production, making it a complex but increasingly manageable condition. mRNA-based therapies show promise for targeting and blocking amyloid protein production, representing a convergence of these two emerging medical technologies for better treatment outcomes. Read more

EP250: Micro-Awakening Throughout The Night

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. Warrick Bishop, a cardiologist, author, and CEO of the Healthy Heart Network, hosts this episode to explore the counterintuitive relationship between sleep interruptions and sleep quality. With heart attacks occurring nearly every 10 minutes in Australia and affecting over 9 million people globally, Dr. Bishop is on a mission to improve health literacy and prevent cardiovascular disease through education on various health factors, including sleep. Key Takeaways: Brief awakenings during the night may actually indicate good sleep quality, contrary to the common belief that uninterrupted sleep is ideal. Noradrenaline, a stress neurotransmitter previously thought to be inactive during sleep, actively controls the microarchitecture of sleep and rises and falls in waves every 30 seconds. Microarousals (mini-wakes) triggered by noradrenaline peaks are linked to memory consolidation, helping the brain retain information from the previous day's experiences. The higher the noradrenaline peak during sleep, the longer the brief awakening, and the more noticeable it becomes to the sleeper. Sleep spindles—short bursts of brain activity occurring when noradrenaline drops—are directly linked to memory consolidation and learning. Mice with the deepest "valleys" (prolonged noradrenaline drops) followed by extended awakenings demonstrated the best memory retention in research studies. Humans naturally experience over 100 brief awakenings per night during non-REM stage two sleep, which is spindle-rich and essential for memory consolidation. Short awakenings during sleep may play a crucial role in the brain's glymphatic system, which cleans up waste products through a rinsing fluid system that's particularly active during sleep. While restless sleep is not beneficial, occasional brief awakenings appear to be a natural and necessary component of healthy sleep architecture and cognitive function. Read more

EP249: More About Sugar

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. Warrick Bishop is a cardiologist, author, keynote speaker, and CEO of the Healthy Heart Network dedicated to helping people live well for as long as possible. In this episode, Dr. Bishop explores inflammatory bowel disease (IBD), particularly focusing on the connection between sugar consumption and Crohn's disease development. While not strictly cardiological, the topic is relevant because understanding dietary impacts on gut health contributes to overall health literacy and disease prevention. Key Takeaways: Inflammatory bowel disease comprises two main types: Crohn's disease and ulcerative colitis, both debilitating conditions that typically affect younger people and require long-term immune-modifying medications and steroids. A UK Biobank study of over 120,000 subjects found that increased consumption of sugary beverages doubled the likelihood of developing Crohn's disease, representing a 100% increase in cases. Sugar consumption showed no significant association with ulcerative colitis, indicating the impact on IBD is disease-specific rather than affecting all inflammatory bowel conditions equally. The mechanism behind sugar's link to Crohn's disease likely involves alteration of the gut microbiome, which affects intestinal wall integrity and permeability, allowing inflammatory particles to cross the intestinal barrier. Sugar (sucrose and fructose) specifically—not artificial sweeteners or fruit juice—showed a direct link to increased Crohn's disease risk through microbiome disruption. Protecting gut health requires consuming adequate fiber (both soluble and insoluble), incorporating fermented foods, eating a variety of healthy foods including greens, and following a Mediterranean-style diet. Most cases of heart disease and many inflammatory bowel diseases could likely be prevented with proper knowledge and lifestyle modifications. Read more

EP248: About Cholesterol with Mining HQ

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. Warrick Bishop is a practicing cardiologist, bestselling author, keynote speaker, and CEO of the Healthy Heart Network who is on a mission to prevent heart attacks and improve global health literacy. In this episode, Dr. Bishop discusses cholesterol management and heart disease prevention, emphasizing that nearly half of all heart attacks occur without prior warning signs. The conversation explores practical strategies for assessing heart risk and taking proactive steps to avoid becoming a heart attack statistic. Key Takeaways: Cholesterol is a naturally occurring compound essential for cell walls, vitamin transport, and hormone production, but can accumulate dangerously in coronary arteries. Approximately 40% of heart attacks occur in arteries that were not narrowed before plaque rupture, meaning many people have no prior warning signs of arterial buildup. It's crucial to distinguish between association and causation in heart disease risk factors—people who do everything right can still have heart attacks, and vice versa. Regular monitoring of cholesterol, blood pressure, diet, exercise, and smoking status are important preventive measures, though they don't guarantee protection. The coronary artery calcium score scan is a non-invasive diagnostic tool that removes guesswork from personal heart risk assessment. The Virtual Heart Check online platform allows Australians to answer screening questions and access affordable coronary calcium scans ($300) at major centers without multiple doctor visits. Individuals with clear calcium scans should repeat the test every five years while maintaining healthy lifestyle habits. Those with positive scan results gain actionable information to work with their GP and implement risk-mitigation strategies. Dr. Bishop's Healthy Heart Network offers affordable lifetime access ($5) to heart health education and risk assessment resources. Dr. Bishop produces over 200 podcasts covering diverse health topics and is available on all major platforms including Spotify and Apple Podcasts. Read more

EP247: Future Directions With Valves and the Aorta

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. Warrick Bishop, a cardiologist, author, and CEO of the Healthy Heart Network, hosts this episode focused on newer management strategies for heart valves. With heart disease affecting over 9 million people globally and claiming over 20 lives per day in Australia, Dr. Bishop emphasizes that most cases could be prevented with proper knowledge and early intervention. This episode explores cutting-edge approaches to valve disease and aortic management that represent a significant shift toward earlier, preventative treatment. Key Takeaways: Echocardiograms (heart ultrasounds) should be performed on new patients who've never had one to detect valve problems early, as they reveal issues that might otherwise go unnoticed. Approximately 1% of people have bicuspid aortic valves (two leaflets instead of three), which can wear out, require replacement, and are associated with aortic dilation. The medical field is shifting toward treating aortic stenosis earlier than historically practiced, as data shows patients with moderate to severe stenosis experience poor outcomes due to prolonged left ventricle stress and deconditioning. Transcutaneous (through-the-leg) approaches for valve repair, particularly for the tricuspid valve, offer less invasive alternatives to traditional cardiac surgery and represent a growing frontier in cardiology. Early intervention for tricuspid valve problems prevents right heart deconditioning, which causes dangerous liver damage and overall bodily deconditioning from blood congestion. The PEARS procedure (Personalized External Aortic Root Support) wraps a Dacron mesh around the aorta without bypass surgery, enabling preventative surgery at 45mm diameter rather than waiting until dangerous dilation reaches 50-55mm. Bicuspid aortic valves and connective tissue conditions like Marfan's and Ehlers-Danlos syndrome are associated with aortic dilation and require monitoring. The "Goldilocks spot" for valve intervention is shifting earlier, meaning optimal timing for surgery now occurs before severe decompensation, improving patient outcomes significantly. Patients with any valve abnormality must maintain consistent cardiology follow-ups, as treatment strategies and available technologies are rapidly evolving. Read more

EP246: Beta Blockers, Asprin, Hot Days, and Risk of Heart Attack

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. Warrick Bishop, a cardiologist, author, keynote speaker, and CEO of the Healthy Heart Network, hosts this episode focused on an important health intersection: the potential risks of taking cardiovascular medications (antiplatelet drugs and beta blockers) during hot weather. The episode discusses research findings from Germany showing elevated heart attack risk in patients on these medications during extreme heat days, while emphasizing that stopping medications is not the solution. Key Takeaways Heart attacks claim approximately one life every 10 minutes in Australia and over 20 deaths daily, with many cases being preventable through proper knowledge and risk reduction strategies. Research from a 10-15 year German study of nearly 2,500 patients found that people taking antiplatelet medications (aspirin, clopidogrel) or beta blockers faced increased heart attack risk on days exceeding the 95th percentile temperature for that time of year. Beta blockers work by inhibiting the sympathetic nervous system (fight-or-flight response), which may impair the body's natural heat dissipation mechanisms, including skin vasodilation needed to cool the body effectively. The study's key message was not to stop taking these medications, but rather to exercise caution and heightened awareness on extremely hot days if you are at cardiovascular risk. Patients on cardiovascular medications should avoid strenuous outdoor activity during particularly hot weather and instead break up activities with shade, rest, and adequate hydration. The research controlled for multiple confounding variables to establish that the increased risk was related to the medications themselves, not simply as a marker of sicker patients. Individuals can assess their personal heart attack risk through virtual heart checks at www.virtualheartcheck.com.au to understand their specific cardiovascular vulnerability. Read more

EP245: What's The Deal With Grass-fed Beef and Butter?

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. Warrick Bishop, a cardiologist, author, and CEO of the Healthy Heart Network, hosts this episode to explore the health benefits of grass-fed beef and butter compared to their grain-fed counterparts. With nearly one heart attack occurring every 10 minutes in Australia and many being preventable, Dr. Bishop's mission is to help people understand nutritional choices that can reduce cardiovascular risk and improve overall health on a global scale. Key Takeaways: Grass-fed beef contains approximately two-thirds the fat of grain-fed beef, which could reduce annual caloric intake by about 17,000 calories (equivalent to nearly a week's worth of food) for someone eating 65 pounds of beef yearly. Switching from grain-fed to grass-fed beef could result in approximately 6 pounds of weight loss per year without other dietary changes. Grass-fed beef has a superior omega-6 to omega-3 ratio of 0.16:1 (more omega-3 than omega-6), compared to grain-fed beef at over 20:1, which better aligns with the ideal 2-4:1 ratio needed for cardiovascular health. Grass-fed beef contains higher levels of conjugated linoleic acid (CLA), which may be associated with reduced cancer risk, though evidence is more theoretical than conclusive. Grass-fed beef offers superior nutritional profiles with greater concentrations of vitamins B and D, iron, and carotenoids (which convert to vitamin A). Grass-fed butter contains less saturated fat, more omega-3, higher vitamin K2 (beneficial for bone health), and greater beta-carotene levels compared to conventional butter. Grass-fed beef is less likely to be contaminated with antibiotics or hormones used in feedlot operations, reducing exposure to pharmaceutical residues. Blind taste tests by publications like the Huffington Post showed 100% preference for grass-fed beef, citing better earthy flavors and superior muscle texture. Choosing grass-fed products provides environmental and ethical benefits, giving consumers a "feel-good" factor about their food choices in addition to health advantages. Read more

EP244: Warfarin and Risks

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, a cardiologist, author, and CEO of the Healthy Heart Network, hosts this episode dedicated to educating listeners about warfarin and its dangerous drug interactions. With heart disease claiming one life every 20 minutes in Australia and affecting over 9 million people globally, Dr. Bishop emphasizes that most cases are preventable through proper health literacy and understanding medications like warfarin that require careful management. Key Takeaways Warfarin is a blood-thinning medication originally developed as a rat poison in the 1950s and approved for human use by the FDA in the mid-1950s, remaining a critical anticoagulant for decades. Warfarin is still essential for patients with mechanical heart valves, as newer anticoagulants (Xarelto, Eliquis, Pradaxa) have not yet been proven as safe or effective for this specific application. Warfarin works by blocking vitamin K1, which is necessary for the liver to synthesize clotting factors (2, 7, 9, and 10) in the body's coagulation cascade. The drug is metabolized through the liver's P450 system, and many medications including antifungals and antibiotics can interfere with this system, causing warfarin to accumulate dangerously in the body. Warfarin dosing is carefully monitored using the INR (International Normalised Ratio) test, which measures how long blood takes to clot; the target is typically 2.5, meaning blood clots 2.5 times slower than normal. Warfarin interactions can cause INR levels to spike dangerously to 6, 7, 8 or higher, creating risk of spontaneous internal bleeding in the brain, gastrointestinal system, or urinary system—a medical emergency. Patients on warfarin must always inform their doctors about any new medications and ask specifically if they interact with warfarin before taking them. Maintaining a current list of all medications and carrying it with you is essential for quality medical care and preventing dangerous drug interactions. Read more

EP243: Is There a Best Time to 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. Episode Summary: EP243: Is There a Best Time to Exercise? Dr. Warwick Bishop, a cardiologist, author, and CEO of the Healthy Heart Network, hosts this episode featuring Dr. Eric Bishop discussing research on optimal exercise timing. The episode explores a 12-week cardiovascular fitness study that unexpectedly discovered sex-based differences in how the human body responds to exercise performed at different times of day. The discussion aims to help listeners maximize their fitness results by aligning their exercise routines with their biological responses. Key Takeaways: Women who exercised in the morning showed greater fat loss and muscle gain compared to women who exercised later in the day, though the differences were modest. Men showed no significant difference in fat loss or muscle gain whether they exercised in the morning or evening. Men who exercised in the evening experienced better blood pressure reduction compared to morning exercise. Men who exercised in the evening showed improved cholesterol levels and reported less fatigue than those exercising at other times. Exercising at the same time each day helps regulate circadian rhythm and improves sleep quality. Combining exercise with sun exposure enhances circadian rhythm regulation by influencing melatonin production from the pineal gland, further improving sleep quality. Any consistent exercise routine is beneficial; the key is establishing a regular habit rather than sporadic activity. Women seeking to maximize fat loss and muscle gain may benefit from morning exercise sessions. Men aiming to improve cardiovascular markers (blood pressure and cholesterol) and energy levels may benefit from afternoon or early evening exercise. Read more

EP242: Hangry!

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: "EP242: Hangry!" Dr. Rick Bishop, a cardiologist, author, and CEO of the Healthy Heart Network, explores the scientific reality of being "hangry"—the phenomenon where hunger triggers anger and irritability. Drawing on recent research and personal clinical experiences, Dr. Bishop examines whether the foods we consume influence the intensity of hangry episodes, particularly focusing on the role of carbohydrates and blood sugar stability in mood regulation. Key Takeaways: Hangry is now scientifically validated, with a 21-day study of 64 participants showing a 35% association between hunger and increased anger/irritability. The type of food consumed may significantly influence whether hunger leads to anger, with low-carbohydrate diets potentially preventing mood swings by stabilizing blood sugar levels. Dr. Bishop's personal experience with extended fasting (16-20 hours) on a reduced-carb diet shows minimal irritability, suggesting that stable insulin and glucose levels may buffer against hangry responses. A patient case study demonstrated that switching to a low-carbohydrate diet eliminated the patient's road rage, suggesting dietary changes can have profound effects on mood and emotional regulation. Black butter coffee and minimal food intake (cheese) can sustain focus and energy through extended periods without triggering irritability, challenging the assumption that hunger automatically causes anger. The existing hangry research may not account for dietary composition, leaving an important variable unexplored in understanding the full picture of hunger-related mood changes. Stable blood sugar levels appear to be key to maintaining emotional equilibrium during periods of restricted eating or fasting. Read more