Located in Buda, Dr. Ravi is a board-certified lipidologist, a doctor who specializes in diagnosing and treating conditions related to lipids, or fatty substances, in the blood.
Dr. Ravi said his focus and passion is on preventative heart disease, and he helps patients manage and treat high cholesterol and maintain various diet and lifestyle approaches to prevent heart disease.
“Despite having great progress in the last few decades in managing heart disease, heart disease still remains the number one cause of death in the Western world,” Dr. Ravi said. “Unfortunately, about 800,000 people every year have a heart attack in the USA, according to [the Centers for Disease Control and Prevention].”
How can I avoid a heart attack?
The first step in preventing a heart attack would be for everyone to understand what their risk of heart disease is. Everyone should have that conversation with their medical provider because we now have very well-validated clinical estimators, [and] risk calculators that can estimate [potential risk] for any given person. Based on their history, their symptoms and a simple blood test, we can estimate where somebody falls in terms of [the] spectrum of the heart disease, and that's quite useful in how to prevent heart disease.
How can I manage my cholesterol without medications?
The most recent estimates show one in four people have high cholesterol. ... Cholesterol, for the majority of people, can be managed with what we call TLC, or therapeutic lifestyle change. This is a very nuanced topic, but the 30,000-foot overview is having a healthy diet. There are two particular diet patterns that have been studied. One is the DASH Diet and the other one is the Portfolio Diet. Both diets emphasize on having more plant-based proteins, such as legumes, beans [and] lentils. Having things that are rich in healthy fats, such as seeds and nuts, that would not only provide healthy fats, but also reduces the oxidation, which is a big factor in having heart disease. Other things would be like avoiding red meat and having more lean meat and having at least three servings of fruit a day.
There are now things like Step One Foods, which is essentially a company started by a cardiologist ... so this company makes products that include all the things that have evidence of reducing cholesterol, and they sell breakfast bars and those kinds of things.
I have a family history of heart disease, what can I do?
If there is a family history, have that evaluation to see if is that something that we need to be concerned about that is running in the family, and if that's the case. Yes, they would need perhaps more frequent follow-ups, but at the first visit, if it turns out that there are other factors that this individual may not have, that would be a reassurance, and may not necessarily need to go through that emotionally draining frequent checks.
How much salt is too much in a day? Can it impact my heart?
On average, Americans get about 3,400 milligrams of sodium a day. ... The 2015 Dietary Guidelines recommend limiting sodium intake to less than 2,300 milligrams of sodium [per day]. In other words, that is a teaspoon of salt. ... [The] American Heart Association actually goes even further, saying the recommended sodium intake is limiting it to less than 1,500 milligrams a day, but I think it is tough to have like one size fits all. In my opinion, I think general guidance should be less than 2,300 milligrams [per day], which is what I tell my patients.
What are signs of a heart disease? When should I be worried?
... 90% of heart disease manifests in three conditions: one is heart attack, blockages and reduced circulation issues. A second thing is having heart failure. And lastly, arrhythmia, the majority of it being a rhythm issue called atrial fibrillation. ... So the important thing is, in addition to looking for symptoms of shortness of breath, chest pain or waking up at night not being able to breathe compared to what was normal for them a few months ago, if there is a change that should be taken seriously.
How does smoking affect heart health?
The most important thing for anybody to do to live long and not have heart disease I always say is not to smoke. And the second thing would be to exercise. Smoking shortens the lifespan by 10 to 20 years, depending on which study you look at. ... In general, there is three to 10 times the risk of heart attack in people who smoke and people who do not smoke, and that is mainly thought to be due to damage to the blood vessels.
What is the role of exercise and how much and what type of exercise is ideal for heart health?
It is very important for everybody to exercise 150 minutes of aerobic exercise a week or 75 minutes of more vigorous exercise. In fact, I tell patients to have a habit of 30 minutes of daily exercise. ... People who play sports seem to have a much lower risk of cardiovascular disease. ... The Copenhagen study showed that those things are much better than doing, cycling, running, swimming, whatever, and it is thought [that] having some social component certainly is protective of heart disease.
What can someone do to live long and live well?
In terms of longevity and living well, the most important thing is getting 30 minutes of exercise, maintaining ideal body weight, good quality sleep and managing stress. If those four facets of things are well done, that should really significantly extend somebody's life by several years, if not a couple of decades.
What are the common tests done to evaluate heart health and screening of heart disease?
Everybody should have screening cholesterol tests, that includes the wider panel of cholesterol and have a test to rule out diabetes because managing those things would go a long way in preventing heart disease. ... Anybody age over 40 should have a [calculated globulin test] at least one time in their lifetime.
What is a common misconception or misunderstanding about heart health you often find patients have?
One in five people have silent heart attacks. So even among the four out of five people who have heart attacks, symptoms can range quite a bit, depending on the factors. People may have chest pain, chest pressure [or] heart burning. Some people even have just pain in their teeth or jaw or left arm pain. So it can be a big spectrum of symptoms, and it is much more prevalent in women, having atypical symptoms, and also people who have a long history of diabetes.
