 staying young at heart. My name is Maria Mera and I'm your host as well as a financial advisor with Edward Jones. And you're in for a treat today. We have the best person to talk about how to stay young at heart. And he's a cardiologist, Miguel Vazquez. Miguel, thank you very much for joining us today. How are you doing? I'm doing great. Thank you for inviting me. Oh, well, of course, my pleasure. Please tell us what is a cardiologist? A cardiologist nowadays is a very complex definition because there are several types of cardiologists. There are the general cardiologists, non-invasive cardiologists, interventional cardiologists, and electrophysiology cardiologists. There is a group now that we also have like a preventive cardiology that is a kind of significant. What type of cardiologist do you fall into? I was the interventional cardiologist. That means putting a stance, pacemakers, defibrillators, and other things, doing active things. Nowadays, the interventional cardiologists also put valves to replace the rocking ones to catheters. Is that the intervention that we do in interventional cardiology? So what made you be a cardiologist? The alternative were not so good. One was to be a priest and the other was to be a military. I decided to study very hard to become a cardiologist. It takes too many years, but that's fine. I didn't know that. That's a good one. So did you study? And again, before we continue, let's let this close here from Peru. I'm from Spain. We are speaking Spanish and we are in Hawaii, which is so funny. So what made you come to the US? Mainly because my professors in Peru said I should go further in my education and improve whatever I had and they recommended. However, my choices were like we don't know in Peru. I chose Cleveland, that is in the Midwest, cold, but the best cardiology at that time, I even nowadays was there. That's where I went to Cleveland. And then from there I can move. So did you like Cleveland after living there? I was excited because I never have seen snow and cold weather, but I was mostly living in the hospital, therefore I was not even out. Just as an anecdote, I got a scholarship in the College of Worcester, who that happens to be also in Ohio. And I went back to Spain during Christmas and when I came back in January, it was like when I arrived and they opened the door of the gate of the plane. I thought they were opening like the fridge and I was just jumping in the fridge. That's true, it's very cold. Go ahead please. You see we are in Hawaii. I always say a sign of intelligence is to move west. I moved from Cleveland to Wisconsin to Chicago, California, now I am in Hawaii. I'm proving my theory anyway. Little by little. Do you think that the weather, I have my own opinion here, but do you think the weather is good for your heart? Like the warmer the weather, the healthier your heart is? At this factor especially, yes, not only because the warmer, because the weather we have in Hawaii, invites you to be out doing things. Compared with the Lissy Cleveland in Chicago. In the winter, you don't go out. You are in the bars and place closed. You have a lot of conferences talking, but you don't exercise. The weather in Hawaii invites you to go out. More outdoor activities versus being with a blanket and having a hot chocolate. And full disclosure, I'm outside. So my apologies if there is noise or it is beautiful and in the spirit of being healthy. I'm outside today. So Miguel, we hear the news about this vaccine, Johnson & Johnson or AstraZeneca, creating thrombosis or clots. Tell us the concern about that and what your experience should be concerned about. Well, as you know, I'm a cardiologist not there. Indirectly I got from my fellow infectious disease and from the articles that we, our organization published. But as Johnson & Johnson and AstraZeneca had an usual number of cases of plotting some problems with the blood with what will they then produce side effects. And they are pausing the usage until this is clarified. And I think it's a good reason. Unfortunately, that will diminish the number of vaccines available to the population. They delay our protection at the low range. However, it will eventually happen. How dangerous for those who already got the vaccine and they might be concerned of what is going to happen. If something happens, they are fine. It's just the early phase when they got it. And it seems like it's more women of a certain age, which brings me back to our hearts, right? Are there gender or an age specific that we should be more concerned about taking care of our health, specifically our hearts? Well, as you know, we are different, Venus and Mars in many ways. And there are certain studies shows more problems in women, depends on the age group. But as the women get older, I think the things level because the hormonal protection is not there. And they get the same kind of risk factors like men in some way. But in spite of that, women tend to live longer than men. Lucky us. Yes. Therefore, if you see in the nursing homes, there's more women than men. And that tells us that in some way, the women either follow recommendations better before they have some kind of inner protection that lasts longer. What are important things for us too that we can prevent and take care of? That's very important thing. There are things that we can change. One thing we cannot change at this moment in the future probably your genes, your parents have heart disease at the age of 50. You are in bad situation because you probably have high level of high risks of developing something at that age. Therefore, the only thing we can change is some things that we can change. For example, lifestyle is the basis of prevention. A lifestyle, something should start early. You will start when you already have blockages and you have surgery. It's less possible that you will get benefit. You will prevent progression, but you already got the disease. Give us more specific examples. Like exercise, what would be a good exercise for? Because we also hear athletes in the top of their careers who have high issues. So what would be a good average recommendation that we should all follow? Okay, I'll give you the basic knowledge. For example, the cholesterol levels at this point, we know the cause of causing blockages in your arteries in the neck, the heart, the brain. And one factor is the bad cholesterol, they call LDL. The LDL is high, the chance of having problems is higher. And now we have medicines that make it lower, but this is the thing. If you have the LDL high, the long-distance, you start to have high LDL when you were 20, 22. By the time you get 60, it has caused a lot of damage. And that was proven in the soldiers of Vietnam that they were 25, 20, that died. And they cut their arteries, they found a lot of cholesterol already. But in those days, they will eat, like many of us, a lot of hamburgers and spam and that in those days. Therefore, when I say to change things, it's with intention to decrease these bad levels. And what make those changes is, for example, like you say, exercise. It has to be a regular exercise because it triggers some metabolic changes that make this LDL go down, but the opposite of LDL is the HDL. We don't have too many medicines to make the good cholesterol HDL to go up, but exercise that. We need to look at the LDL, but also the ratio between the LDL and the HDL. Well, the HDL is one factor that you need to consider. Yeah, the ratio. And like I said, the HDL is more difficult to treat with medicines, we don't have too many medicines. What about, you were saying exercise, what about our eating habits? Is it, should we be vegetarians or? That is the basics. They just did a study in the United Kingdom, comparing like 9,000 people. They're comparing vegetarians, fish and chicken and meat eaters. Although the study was having more number of people eating meat, therefore it's kind of in some question about the study. But at the end, the people that has been eating meat at higher percentage of cardiac events, stroke, heart attacks, high blood pressure. Vegetarians were at the low, they still have it, but lower level. Before that proves you that. And in relation to meat, there are variations. There's another study that shows that we compare different meats. It process, process meat, the sausages, the spam and all those things that are processed are much worse than regular meat. But there are some variations on that. But the vegetarians for sure, they have advantage. The one that they talk more about is the Mediterranean diet. It has to have nuts, nuts are very important for the manufacturers. And fruits, good. Unless you're diabetic and you diabetes, you have to avoid certain sweet fruits. Olive oil, very important. Should replace all the other oils. Well, some of the other vegetable oils. Here in Hawaii, sometimes they use a lot of coconut oil. And it's not very good because the oils are bad depending on the length of the chain, the oil change. The longest change in oils is palm oil. That is part of many products. The second is coconut oil. And as you go down like sesame oil is less and olive oil is less. It's a shorter chain. That's why it's less harmful. Okay. Well, those are great advice and I'm really glad that you said the olive oil. People told me olive oil runs through my veins, not blood. Also make your hair looking good. Yeah, yeah, it goes. It was a lot of vitamin D. That must be the wind also. Well, talking about wine, that's very important. There are many, many advices about using a drink. White wine or white wine or it doesn't really matter. It really doesn't matter much, but there is a little more studies about red wine because there are some components. But any liquid would do or alcohol. But it's a curve. If you drink more than two glasses a day. That sounds like more than what I drink. That's more than what I drink a year. But yeah, that's a good just measure to have. Miguel, so let's say I never had an issue with my heart. I don't have any issues with and I live a healthy lifestyle. Do I need to go to the cardiologist? That's a good question because we have a lot of arguments. Like, sometimes you get in the mail. Some companies saying we're going to do screening for you free. And they check your heart to your neck. Check your heart. And those people are without symptoms. And some of the arguments is that we should not treat things unless there is something symptomatic. And the other is the economy. We will, if we want every person go to cardiologists to prevent things, we will have not enough cardiologists. There's no money that the society will spend in cardiologists to be checked. There's too much compared with the benefits. But like I say, your parents have heart disease. And you ate or you smoke and you have obesity. Those cases really should check cardiologists to get advice how to modify those things. Not everybody. We're going to take a very quick break here. And then we will be right back with Miguel Vázquez, our favorite cardiologist. Okay. Welcome back to our show. And we have our best cardiologist here, Miguel Vázquez. Miguel, thank you for joining us. What makes a person or a doctor a good cardiologist? What are the qualities that we should be looking for? One that keeps up with the progression of medicine. Cardiologists that doesn't study, keep studying. No good because cardiologists changing so much. You have to be sure that he's going to conferences. He deals with universities. And the other one that I think is very important in cardiologists to be honest. You cannot sometimes lie about what the person has. You have the abilities to express the concern you have about somebody without hurting the people. But you should be more honest telling them what you think. That is important for the person to know what they have. So I assume like these days, right back to COVID-19 and how we are being challenged with social distancing and going to hospitals. How bad do you think it's been for people to not have their conditions treated? I didn't get that. So do you think people are being affected or not being treated by their heart condition if during COVID-19 or things have been normal? No, COVID-19 we discovered that the ones that die, we found that the heart has evidence of inflammation by the virus. And other changes are interesting new concepts. Therefore, the person that has already a pre-existing cardiac problem will suffer more and end up dying. Because on top of the pre-COVID condition comes the COVID affecting the heart more and then that's why they don't survive many of them. Fortunately it's not a high percentage but they do suffer more than ones that have a pre-existing hypertension, people that have heart attacks, people with pulmonary problems also end up with heart troubles. So my question is more like cardiologists having an issue just trying to treat patients via Zoom or not even being able to see their patients. Yeah, that's very difficult. My brother just retired because he couldn't take it. He was used to see people. And the same with cardiology. I mean many times you get more information seeing them. But you have to adapt. It's nothing that we can change for a while and you just have to make up all those things. So how long have you been retired? Two years now, practically. Do you feel like you're healthier? I'm healthier because I am playing golf. I'm walking four hours, five hours there. And I'm doing more active things. The only thing is with COVID I had to be eating more because, you know, I don't cook. I got to restaurants. But restaurants, I only have trouble with restaurants in Hawaii because many of them have salty food. Oh yes. And it's not because the other, because some of the dishes are salty like udon or ramen or something like that. Even just the soy, right? It's very, very salty. And that is one of the problems. But in reality, the stress of getting up at two in the morning and four in the morning and what's sleeping many hours is. Another thing in prevention is sleeping good number of hours is very good. So nothing new. Nothing new. You're not breaking news. Exercise, diet, sleeping habits, no stress. I could be a cardiologist. Exactly. That's it. I'm charged for that. I'm sure you can give better advice about food that I can do. I'm not sure about that. But what are the conditions that if I feel something, I should just run to my physician or my cardiologist? Well, the young age is not too many, but when you get over 45, you have a pressure feeling like heaviness and you don't know what it is. Don't think like many people say is my indigestion or my thing, my chest wall, kind of check with somebody before discarding it. The young people, the main problem is rapid heartbeat, irregular heartbeat, kind of more or less. So one more question for you regarding medicine in the US. How do you see it moving forward or what's your take on medicine in the US? Medicine? Yes, in general, medicine in the US. Oh, I think it's the best. I'm really very proud of the medical community because like nowadays they have responded to this COVID very well. Some of them have died from it, more in other countries, but the United States in medicine is really the best, I would say. Not the cheapest. No, that is different issue. But the other thing is you go to an emergency room here in the United States and they will treat you before asking you what is your great car or what is your... That's true. And then they will send you a couple of dollars. Later on you pay for it, but at least they treat you. Yeah, well, that's how it should be. Isn't it like that in Peru? No, like my wife had symptoms or appendicitis. My friend, a friend always saw her and said, okay, I'm calling the surgeon. I'm taking you by ambulance to the clinic, a private clinic. They would not let her out of the ambulance until I put my great car and deposit $5,000. Oh, wow. Okay. That's very interesting. Okay, then let's stay in the US. Well, any further advice that you can give our viewers and that you want to share with our audience? Yeah, the one that I'm still very surprised that people still smoke. I think that's something you should avoid. Like a local, maybe it's not as bad as smoking, but smoking is bad. That's funny because we've had a specialist in ventilators. I think that was our previous episode, if anyone wants to see it. And I asked for his advice and he said the same. He said, don't smoke and don't vape because maybe it's also don't vape. I think he's knew the cigarettes. Yeah, that's not good either. Well, Miguel, we hope to be as healthy as you and we'll keep your advice and thank you so much for joining us. I'll see you in the Boulevard running. I'll see you in Alamoana probably. Thank you. Thank you so much. Thank you to all our viewers for joining us and we'll see you in a couple of weeks. Aloha everyone.