Atrium Health doesn’t just treat cardiovascular disease. It is one of the few health systems in the country with cardiologists dedicated to preventing cardiovascular disease. To celebrate American Heart Month, we asked Dr. Michael Shapiro, director of the Center for Preventive Cardiology at Atrium Health Wake Forest Baptist Health, to answer some of your frequently asked questions about maintaining heart health and preventing heart attacks.

What do you wish more people knew about maintaining heart health?

As a cardiologist, I felt that lack of awareness was a major problem. It’s that people don’t have enough information about how to keep their heart healthy. However, in recent years, misinformation has taken center stage. Myths circulate very efficiently through social media and other channels. There are a lot of misconceptions out there, especially because of the diet wars, and in some ways that’s even worse than lack of awareness.

How should people get accurate information on how to keep their heart healthy?

Please consult your health care provider. These are very good sources of reliable and good information about heart health. You don’t necessarily need to see a cardiologist to learn how to manage your blood pressure, cholesterol, blood sugar, and weight. You can learn all of this by talking to your primary care provider. If you also want to get information online, I recommend her website at the Mayo Clinic and her WebMD as two good sources for her information.

We hear a lot about cardiovascular disease. What exactly is cardiovascular disease?

In reality, a series of conditions are in place. There are three main classes of cardiovascular disease. There are diseases of the arteries such as coronary artery disease of the heart. There are also diseases of the heart muscle such as heart failure. There are also electrical and conduction system diseases such as arrhythmia.

When people use the term “cardiovascular disease,” they are usually referring to coronary artery disease. This is because coronary artery disease is the most common and deadly condition. It kills more people worldwide than anything else. While we have begun to see improvements over the past 40 years, unfortunately, mortality rates from cardiovascular disease have begun to increase, primarily due to the twin epidemics of obesity and diabetes. Coronary artery disease is the leading cause of heart attacks.

Can I be at risk for a heart attack even if I don’t feel symptoms?

yes. Even if you don’t feel symptoms, you may be at risk for a heart attack. Half of people who have a heart attack initially experience typical symptoms. They say things like, “My chest feels tight every time I go up the stairs or walk four blocks.” Then they visit our office for a stress test. Maybe a stress test is positive, maybe a blockage is found, maybe they get a stent or bypass surgery, maybe they get medication, maybe they change their lifestyle. That sounds unfortunate, but it’s actually the better scenario.

The worst-case scenario is that the other half have a heart attack and show no symptoms. A heart attack, or worse, sudden cardiac death, can occur suddenly and without warning. That’s why it’s important for everyone to learn about heart health and not wait until they think they don’t have to worry about it.

How can people who don’t have symptoms but have concerns about their heart health (perhaps have a family history of heart disease) know their risks?

Your primary care provider may recommend screening tests for coronary artery disease that can detect calcium buildup in your coronary arteries. It’s like a heart mammogram. If testing reveals risks, we can make lifestyle recommendations and consider preventive medications.

The good thing about heart disease is that there are effective strategies to reduce your risk. That’s exactly why we screen for heart disease. There are good things we can do to dramatically lower a person’s risk. And the sooner you start, the more benefits you’ll get.

How can I reduce my risk of cardiovascular disease?

The main categories include quality diet, regular physical activity, weight management, and smoking cessation. But asking people to do everything at once is difficult. What if someone is feeling overwhelmed and wants to start doing something? First, if they smoke, they should start a quit smoking program to help them quit. If you don’t smoke, you should start by adding physical activity.

People may be afraid to see a cardiologist. Because we’re worried that we’re going to tell them all these horrible things, like tell them to run eight miles a day and eat blueberries and leaves and tree branches. Not at all! The truth is, it’s the low to moderate intensity physical exercise that wins at the end of the day. If he can go for a 45-60 minute walk most days of the week, that’s how he stays cardiovascularly healthy.

What message do you want people to understand about cardiovascular disease?

This is a preventable disease. The same cannot be said for most diseases. We know the recipe, so to speak, but it is important to identify those at risk at the right time. The sooner we can find these patients, the more we can do for them. That’s why I love my job. It’s about saving people from heart attacks in the first place. That is wonderful.

How healthy is your heart?

Complete a quick heart health assessment to see if you have an increased risk of developing heart disease.