Heart Attacks are Preventable!

EP378: Keto and Other Tricky Cardiovascular Situations

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 helping people understand cardiovascular health management. In this episode, Dr. Bishop addresses several specialized and less commonly discussed topics in cholesterol and heart health management, including ketogenic diets, cholesterol management in women, and treatment considerations for specific patient populations. Key Takeaways Ketogenic and very low-carbohydrate diets can effectively flatten blood sugar levels, reduce appetite, promote weight loss, lower blood pressure, and improve insulin control, leading to better overall health outcomes and improved mood stability. A major concern with ketogenic diets is that they often involve replacing carbohydrates with saturated fats, which can significantly elevate LDL cholesterol levels—particularly in "hyper responders"—and potentially increase cardiovascular risk despite other positive health improvements. Even though some patients on keto diets show large, fluffy LDL particles (considered less harmful), high LDL particle numbers can still lead to arterial plaque buildup, as evidenced by young people with familial hypercholesterolemia developing plaque despite favorable particle characteristics. Dr. Bishop recommends a cautious approach for high-risk or secondary prevention patients on keto diets: maintain reduced carbohydrate intake but minimize saturated fat consumption and aim for the lowest possible LDL cholesterol targets. Substantial research confirms that women benefit significantly from statin therapy for both all-cause mortality and cardiovascular-related mortality, contrary to historical uncertainty in this area. Women also benefit from non-statin cholesterol-lowering medications, and hormone replacement therapy is considered potentially beneficial for perimenopausal women without increasing cardiovascular disease risk. Pregnant women should avoid cholesterol-lowering medications due to insufficient safety data, requiring careful planning when young women with familial hypercholesterolemia wish to become pregnant. Older populations (beyond age 65-70) represent the highest cardiovascular risk group and are suitable candidates for cholesterol-lowering therapy when patients are willing and in either primary or secondary prevention settings. Chronic renal disease is a very high cardiovascular risk indicator, and while statin use is unclear for dialysis patients, those awaiting transplants should receive cholesterol-lowering therapy to protect their vasculature. Transplant patients (heart, lung, or kidney) generally require specialist-directed LDL cholesterol-lowering therapy, with careful attention to drug interactions between transplant medications and statins that may be metabolized through similar pathways. Read more

EP377: Podcasthon Interview With Adam Weir from Surf Life Saving Australia

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 hosts Adam Weir, CEO of Surf Life Saving Australia, during the Podcastathon—an international charity awareness event. The episode explores the organization's massive impact on coastal safety, highlighting its century-long history and current operations across the country. Key Takeaways: Surf Life Saving Australia operates 315 clubs nationwide with nearly 200,000 members, conducting approximately 10,000 rescues annually and providing 1.6 million volunteer hours worth approximately $6-7 billion to the Australian economy. The organization performs far more than water rescues, including 50,000 first aid treatments yearly for coastal injuries ranging from cuts to cardiac events, with an additional 14 million behind-the-scenes volunteer hours supporting service delivery. Coastal visitation has dramatically increased from 450 million to 700 million annual visits since COVID-19, creating significant service demands while the organization aims to reduce Australia's 150 annual coastal drowning deaths to zero preventable deaths. Surf Life Saving welcomes diverse volunteer roles beyond lifeguard patrols, including administrative, financial, equipment, and drone operator positions, ensuring participation opportunities for people with varying abilities and skill sets. The organization experiences consistent 2-3% annual growth in volunteer numbers despite broader community challenges around volunteer availability, indicating strong resonance with its mission and community values. Unlike traditional emergency services, Surf Life Saving receives limited government funding and relies heavily on community donations and fundraising, with each dollar donated generating approximately $20 in community benefit. The organization is adopting innovative technologies including AI-powered cameras for identifying water hazards, drone surveillance for emergency response, and equipment tracking devices to enhance rescue capabilities. Surf Life Saving is transitioning to evidence-based "high-performance CPR" techniques that optimize chest compression effectiveness and hand recoil, with pilot studies showing significant efficiency improvements after single-day training sessions. Read more

EP376: Dr. Foo and Cardiovascular Risk For Women—Really Important Episode

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 with Dr. Fiona Fu, an interventional cardiologist specializing in women's heart health at Sydney Cardiology and Macquarie University. The episode focuses on cardiovascular disease risk factors specific to women, addressing the underrecognized but significant threat that coronary heart disease poses to women's health in Australia. Key Takeaways: Coronary heart disease is the second leading cause of death in women in Australia and kills more women than all cancers combined, yet remains underrecognized by both patients and medical professionals. Several traditional cardiovascular risk factors—including smoking, diabetes, hypertension, and obesity—pose a greater risk to women than to men. Pregnancy complications including gestational hypertension, preeclampsia, eclampsia, gestational diabetes, preterm delivery, and small-for-gestational-age babies are sex-specific risk factors that significantly increase women's future cardiovascular disease risk. Women who experience pregnancy complications should be monitored closely throughout their lives with regular GP check-ups, blood sugar and blood pressure monitoring, and maintenance of healthy lifestyle habits including exercise, healthy weight, and good diet. Autoimmune and inflammatory conditions such as systemic lupus erythematosus (SLE) and rheumatoid arthritis affect women more frequently and substantially increase their risk of early heart attacks and myocardial infarction, sometimes before menopause. The severity of autoimmune disease correlates with cardiovascular risk, and traditional risk factors amplify the danger when combined with autoimmune conditions. Breast cancer treatments, particularly radiation therapy to the left chest, can cause delayed coronary artery disease, while chemotherapy may impair heart function. Early identification and proactive management of cardiovascular disease through regular screening and risk factor control can prevent deaths, as modern medicine can manage identified heart disease effectively. Read more

EP375: What is the Glycocalyx?

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 Dr. Rick Bishop hosts this educational podcast episode discussing the glycocalyx, a microscopic protective lining within the endothelium of blood vessels. This often-overlooked layer plays a crucial role in cardiovascular health and may be implicated in the early stages of plaque formation and atherosclerosis development. The episode explores the structure and function of the glycocalyx, how it becomes damaged, and practical recommendations for protecting it. Key Takeaways: The glycocalyx is a thin, microscopic "slippery" protective layer that lines the inside of arteries, comparable to the slime coating on a fish's skin. The glycocalyx protects endothelial cells (which line blood vessels) and helps them produce nitric oxide and maintain strong cell-to-cell connections. When the glycocalyx is damaged or removed, endothelial cells become more exposed to blood contents and more susceptible to wear and tear, potentially initiating plaque formation. Turbulent blood flow at artery branch points and bends creates shear forces that can damage the glycocalyx, while laminar (smooth) flow protects it. The patchy nature of glycocalyx damage at turbulent flow sites may explain why plaque formation in arteries occurs in specific, scattered locations rather than uniformly. The glycocalyx is composed of complex proteins including integrins, immunoglobulins, albumin, and hyaluronic acid that work together to create a protective environment. Currently, there are no established medical treatments for glycocalyx damage, though some proprietary products exist with limited supporting data. Maintaining lower blood pressure (systolic below 110 mmHg when tolerable) reduces turbulent flow and helps protect the glycocalyx from damage. Arterial imaging in primary prevention settings may help identify areas of glycocalyx damage and early plaque formation before cardiovascular events occur. The glycocalyx represents an important emerging area of cardiovascular research that warrants continued scientific investigation and public awareness. Read more

EP374: If It's Not My Genes, Then What Is Putting Up My Cholesterol?

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. Oreck Bishop hosts this informative episode discussing the various medical conditions and medications that can elevate cholesterol levels beyond genetic factors. Rather than focusing on familial hypercholesterolemia (the monogenic form), Dr. Bishop explores the numerous secondary causes of raised cholesterol that doctors should investigate when managing patients with elevated lipid profiles. The episode concludes with an interesting note about coffee's impact on cholesterol levels. Key Takeaways: Hypothyroidism reduces the effectiveness of LDL receptors, preventing them from pulling cholesterol into the liver, resulting in elevated LDL levels; it's easily detected with a simple thyroid stimulating hormone blood test. Diabetes significantly alters lipid profiles by raising triglycerides, lowering HDL ("good cholesterol"), and creating smaller, denser LDL particles that pose greater cardiovascular risk. Chronic kidney disease with nephrotic syndrome causes significant cholesterol elevation because the liver compensates for protein loss by producing more cholesterol-carrying proteins. Metabolic-associated fatty liver disease (formerly non-alcoholic fatty liver disease) increases both triglycerides and LDL cholesterol, though paradoxically these levels drop at advanced stages near cirrhosis. Cushing's syndrome, caused by elevated cortisol levels, raises triglycerides and LDL particles similar to steroid medications and typically presents with muscle loss, central obesity, and increased cardiovascular risk. Menopause reduces estrogen levels, causing LDL cholesterol to increase while HDL cholesterol decreases during this life transition. Steroid medications are significant cholesterol elevators and should be avoided long-term when possible, as they raise both LDL and triglycerides while increasing risk of obesity, diabetes, and osteoporosis. HIV protease inhibitor drugs directly increase LDL cholesterol and triglycerides, creating compounded cardiovascular risk for patients already dealing with an inflammatory condition. Some antipsychotic medications increase cholesterol and triglycerides, creating a concerning paradox where drugs necessary for mental health treatment also elevate cardiovascular disease risk. Cafestol, a compound in unfiltered coffee (French press, espresso, Turkish coffee), can increase cholesterol levels by 5-10% when consumed at high volumes, nearly equivalent to the effect of doubling a statin dose in reverse. Read more

EP373: Coffee CACs and Questions

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. Coffee, CAC and Questions Podcast Summary Introduction Dr. Warrick Bishop hosts this podcast and videocast station, welcoming listener questions and feedback on health and cardiovascular topics. In this episode, Dr. Bishop addresses questions from listeners about atrial fibrillation treatment options, cholesterol-lowering medications and their metabolic effects, coronary artery calcium scoring, and the cardiovascular effects of coffee consumption. Key Takeaways: Drugs are generally preferred over AV nodal ablation for atrial fibrillation rate control, with ablation reserved as a last resort when medications fail to adequately slow the ventricle. Recent muscle biopsy studies suggest that statin use does not significantly alter coenzyme Q10 levels in muscles, contrary to some previous assumptions about statin side effects. The relationship between statins and vitamin K2 levels remains unclear and requires further research, though Dr. Bishop raised it as a theoretical concern rather than established fact. Bembedoic acid works upstream in the same metabolic pathway as statins, meaning it would have similar potential pleiotropic effects, though these effects are not yet well-studied. Coronary artery calcium scores of 1-10, while still low-risk, represent a three-fold increase in cardiovascular event risk compared to a score of zero, demonstrating that plaque accumulation begins affecting risk even at minimal levels. Coffee consumption shows a J-curve (or U-shaped) relationship with cardiovascular risk, with an optimal sweet spot at approximately three cups per day or 250 milligrams of caffeine. A comprehensive study of over a million participants found that regular coffee consumption is associated with reduced cardiovascular disease risk, supporting multiple previous meta-analyses on this topic. Dr. Bishop encourages listeners to submit questions and topic suggestions via email at info@drwarrickbishop.online or through his webpage to help guide future podcast content. Read more

EP372: Magnets and Health with Mark Fox (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. Podcast Summary Introduction Dr. Warrick Bishop, a cardiologist, author, and CEO of the Healthy Heart Network, interviews Mark Fox, an entrepreneur, rocket scientist, and CEO of Rezona Health, about pulsed electromagnetic field (PEMF) therapy and its health applications. This is part two of their conversation, building on previous discussions about how electromagnetic energy can help cells function better and potentially prevent or reverse disease. Key Takeaways Rezona Health's VIBE device is a pocket-sized wearable (designed to resemble an iPod) that uses electromagnetic field therapy by playing "songs" through a coil that create therapeutic magnetic fields for various health conditions. The device works through three theorized mechanisms: resonating with water in the body, creating ultra-low electrical currents (1,000 times less than TENS units), and potentially interacting with magnetite crystals recently discovered in human cells. A fourth potential mechanism involves blood cells becoming "charged" as they pass through the device's magnetic field near the neck, then distributing that energy throughout the body to improve healing and reduce inflammation. An upcoming pendant device launching in early 2024 will specifically target the vagus nerve, based on research showing that vagus nerve toning at the right frequency can address numerous health conditions. Clinical and anecdotal evidence shows PEMF therapy can significantly reduce fracture healing time (documented in double-blind randomized trials) and improve wound healing in both humans and animals. For PTSD treatment, heart rate variability—not cortisol levels—is the appropriate measurement of success, according to the Veterans Administration and recent research findings. The device can be worn around the neck, in a pocket, or even placed in a bra, and can be infused into water (effective for ~6 hours) or creams (effective for ~30 days) for treating wounds on zoo animals and other applications. VIBE devices retail for $399 but are available to Dr. Bishop's listeners for $249 with a special discount, and Rezona Health ships worldwide for free. Dr. Bishop recommends exploring PEMF therapy for those with chronic pain, anxiety, PTSD, arthritis, multiple sclerosis, and other inflammatory conditions, emphasizing results matter even when full scientific understanding is still developing. Read more

EP371: Magnets and Health with Mark Fox (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. Podcast Summary Introduction Dr. Auric Bishop, a cardiologist, author, and CEO of the Healthy Heart Network, hosts this episode featuring Mark Fox, an entrepreneur, inventor, and CEO of Rezona Health based in Florida. The episode explores pulsed electromagnetic field (PEMF) therapy, a non-invasive energy-based technology that both the host and guest have become passionate about after initially being skeptical of its efficacy for treating various health conditions. Key Takeaways: PEMF therapy works as an energy exchange that recharges cellular "batteries" (voltage) and increases ATP (adenosine triphosphate) production by up to 500%, enabling the body's natural healing mechanisms. Mark Fox developed his PEMF device after witnessing its potential effects on his aging dog with arthritis and later became deeply committed after discovering a 98% success rate treating PTSD in military veterans and first responders. The Rezona Health device is a pocket-sized, portable PEMF device with coils that delivers frequencies without wires, designed as a "music player for your body" with protocols that change every 1-4 minutes like musical chords. Rezona Health has developed 59+ different therapeutic protocols addressing PTSD, anxiety, back pain, blood sugar regulation, vagus nerve toning, and pet health, with rigorous clinical studies underway to meet medical evidence standards (p-values below 0.05). PEMF therapy is far more therapeutically effective than static magnetic therapy (used since 3500 BC) and has been extensively researched and refined by over 8,000 practitioners over 35 years. The United States lags behind other countries in energy-based medical research due to 1934 pharmaceutical industry dominance, when the oil and pharmaceutical industries successfully suppressed electrical stimulation and energy transfer research in favor of drug and surgical approaches. PEMF technology is already widely recognized and used in the equine industry, with veterinarians using large MagnaWave machines, and Rezona's neck-band device delivers similar results for horses by targeting the vagus nerve. Unlike drugs whose mechanisms aren't fully understood (even aspirin), PEMF therapy has established scientific explanations involving cellular voltage restoration and improved cellular energy production. Read more

EP370: Looking at Plaque in the Arteries - IVUS and OCT

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 advanced imaging technologies used to visualize arterial plaque. With heart disease claiming a life every 20 minutes in Australia, Bishop aims to educate listeners on how modern medical imaging can detect and understand plaque characteristics before cardiac events occur. Key Takeaways: Cardiac CT imaging is a non-invasive, external technology that effectively visualizes plaque in arteries before a person experiences a heart attack or cardiac event. Intravascular ultrasound (IVUS) uses high-frequency sound waves advanced down a thin wire to obtain detailed images of plaque from inside the artery. Optical coherence tomography (OCT) is an alternative technology that uses light instead of ultrasound to examine arteries and plaque characteristics with similar precision. Both IVUS and OCT allow cardiologists to visualize plaque composition, fibrous caps, calcification, and stability features to determine rupture risk. The "magic number" for LDL cholesterol is 1.4 millimoles per litre—achieving this level triggers plaque regression in over 50% of patients, as demonstrated by landmark studies (ASTEROID and Glargov). These invasive imaging technologies are primarily used clinically to guide stent placement and in research settings, not for routine screening of healthy individuals. Artificial intelligence (AI) is increasingly being integrated with IVUS and OCT to improve interpretation and analysis of arterial imaging data. Most heart attacks in Australia could be prevented with proper knowledge and prevention strategies regarding blood pressure, weight, and cholesterol management. Read more

EP369: More on PEMF With Candice

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 hosts the Healthy Heart Network podcast and welcomes back Candice Grove, founder and CEO of Best Self Cell, to discuss pulsed electromagnetic field (PEMF) therapy and infrared light therapy. In this episode, they explore how PEMF therapy can address various health concerns and examine the integration of these technologies in therapeutic devices, while also discussing safety considerations and real-world applications. Key Takeaways PEMF therapy works across a broad spectrum of cells and has shown significant benefits for sleep, anxiety, stress, cognitive issues, bone health, joint and cartilage healing, and nerve pain recovery. Research from the Cochrane Review Library demonstrates that PEMF therapy can reduce fracture healing time by nearly 50%—a therapeutic outcome comparable to or exceeding many pharmaceutical interventions. Absolute contraindications for PEMF therapy include electrical implants like pacemakers; pregnant women should avoid it as a precaution due to lack of research, while epilepsy cases require professional consultation. PEMF devices are generally safe with standard metal implants (such as stents) at typical intensities, though very high-intensity devices (10,000 Gauss) should be avoided with metal implants. The Earth's natural electromagnetic field (7.83 Hz) creates a healthy living environment, and PEMF mats mimic this frequency, making them safe for extended use including overnight sleeping. Red light and near-infrared therapy enhance mitochondrial function and ATP production, promoting cellular healing, skin rejuvenation, inflammation reduction, and pain relief in targeted areas. PEMF electromagnetic fields penetrate completely through the body regardless of bone, tissue, or other materials, so users don't need to alternate positions to treat different sides. Best Self Cell pioneered the combination of PEMF and infrared therapies in a single mat in Australia, making this technology accessible locally rather than requiring expensive overseas purchases. Customer success stories demonstrate significant life improvements, including elimination of chronic pain, restored mobility, resolution of brain fog and migraines, and reduced dependence on ongoing therapeutic appointments. Read more