♪ Which is the better chance of a good return winning the lottery or doing something to lessen your chance of.

>> Happening in dying from a heart attack.

Stay with us.

As we talk with cardiologist, doctor Ken Williams about preventing deaths from coronary artery disease.

Next, Kentucky health.

>> Kentucky health is funded in part by a grant from the foundation for a healthy Kentucky.

♪ ♪ >> Heart disease remains the number one cause of death in the United States and heart attacks and coronary artery disease are the leading cause of sudden death from cardiac disease.

Every 40 seconds someone in the United States has a heart attack.

Unfortunately, 12% of these people would die.

And those that live may have a compromise quality of life.

This and begs the question since so many of us are having and dying from heart attacks.

Does this mean that there is nothing that we can do to either prevent or mitigate our risks?

To paraphrase the writer, Francis Church from the now defunct New York Sun newspaper.

Yes, Virginia.

We can decrease deaths from coronary heart disease.

But it takes making some simple lifestyle adjustments and less believing in a cure through medicines, the poet and playwright Oscar Wilde said that hearts live by being wounded.

I believe that is the uninjured heart that lives better.

And therefore, this is where we need to put our attention.

To give us a better understanding of the complexities and the development of coronary artery disease and the things that we can do to prevent it or at least decrease the chances of dying from a heart attack.

We have is our guest today.

Doctor Ken Williams.

Doctor Williams is a graduate of the University of Chicago Pritzker School of Medicine.

He completed his internship and residency at Emory University Department of Medicine, followed by a fellowship in cardiology back at the University of Chicago.

He is the past president of both the American College of Cardiology and the American Society of Nuclear Cardiology and is the former chair of the board of directors of the Association of Black Cardiologists.

He is the founder of the Urban Cardiology Initiative in Detroit, Michigan, and is the founding editor in chief of the International Journal of Disease Reversal and Prevention.

But the Williams was named chair of the Department of Medicine at University of Louisville School of Medicine in July of 2022.

And Doctor Williams.

Kim, welcome to Louisville, forced to welcome back.

Thank you so much for having me.

Thank And illustrious career as you ready to turn over.

Just go to bed.

he got in the you know, I made the mistake is >> My incoming speech, you know, the inaugural speech to this President, American College of Cardiology made the mistake of saying I'm not going to retire until heart disease.

Number 2.

>> We were this close.

That was 2015.

Since then.

The curve is gone.

The opposite direction.

It's all about lifestyle.

As you quoted.

And it really if we can get the public to understand the underpinnings of this disease, we can get to number 2 and I could retire.

What is coronary artery disease?

What is it really that coronary artery disease elsewhere?

The things that you actually try to explain this to my patients typically have a heart attack to get a covering the coronary care unit the next morning.

And I said, you know, let me just have silly conversation you've ever had with the doctor.

Just humor me for a couple minutes and say what do you think happened to you and said, well, I had a stent put in it.

And and so why didn't you need a stent put in your artery?

And they said because it was blocked.

And that's right.

And so doing good so far.

What was it blocked with?

Almost everyone that I talked to can answer that question.

No se Okay.

And so and what is plaque made out of >> a fat cholesterol?

That's And where does plakon cholesterol earth the plaque cholesterol?

In fact, what does it come from?

Yeah.

Everyone will will admit it.

I ate And so we've had this difficulty.

You mentioned that has been a leading killer for a long time.

That was 1918.

Was the last time heart disease was not the leading killer of Americans.

It was taken out for one year by the Spanish flu.

In 1919, it was back.

And we have been suffering with it ever since it has to do with diet primarily, but also lifestyle.

But as as everybody knows from ever for from Jim, thanks to the recent guru, exercise guru has a heart attack, you can exercise your way out of a bad diet.

And so what we really need to do is follow the guidelines.

There's guidelines out there that we've that personally written with the American Heart Association, American College of Cardiology.

The talks about lowering the amount of sodium lowering the cholesterol, eliminating would be better.

That would be of completely plant-based diet, having to reduce a refined grains, refined grains are everywhere.

Every piece of white bread, every every bagel impress.

let's make them all out of whole grain.

When you can do that, you lower the risk as opposed to refined grains that increase the risk and then their sugar and short sweet and beverages.

Those create inflammation.

They raise your insulin levels.

They make more plaque.

If we just follow those guidelines, we would actually get rid of heart disease almost completely.

>> My brother just showed me a picture he took when he was up in New York recently.

It was an Abbott has said it's sugar.

It adds nothing.

>> Haha, I love the know.

Put that up.

But but before I get into some of the preventive things, tell me a little bit what really is a heart attack.

So we all understand what's happening.

It's the blocked artery.

And so.

>> You know, like like every organ in your body is fed by your heart through the arterial system.

It's like a highway system with little tiny streets that come off of it and feed every cell in your body.

And if you do not have open arteries.

Places don't get blood flow.

And so the ones that people don't always recognize is you can actually block off are the artery to a kidney.

When you do that, your blood pressure goes sky high because of what's happening to the kidney.

You can block off artery to lake typical.

You're smoking diabetics.

Get this a lot to block off that artery and then you end up with an amputation or stand or before or bypass surgery.

One of our major ethnic health care disparities, amputation and blacks for everybody else getting re Vasquez ation that says that the fancy term for stents and bypass isn't balloons to open up the artery.

Well, then, you know, people get strokes.

Same issue plaque, getting typically in your party, same kind of the same thing and then you get close it off or have a piece of the break off, go up to the brain caused a stroke.

Well, the heart is an organ.

5% of the blood flow from the body goes actually to the heart itself.

And so you end up with coronary disease.

Now people don't may not know it when they when they take off a little piece of their kidney because they, you know, heard a piece of a blood vessel, but they're definitely know what happens in the brain.

And what happens in the heart.

Typically people will get some chest discomfort.

Some shortness of breath and understand and poor function of the heart sand that really if things are going really with that heart attack, it's large enough.

They'll get a rhythm disturbance that.

Can be fatal.

And that's why everyone in who is in even if you're not doing American diet.

And most Americans are do it.

You should know about CPR.

And if you can afford to have an AED that's an automatic external defibrillator in your house.

>> Since you brought those 2 things up, can you differentiate for us then the difference between a heart attack and what happened to the football player Damar him.

That was not a heart attack was it was not exactly people will call a heart attack.

So McGee died of a heart attack when they have sudden death.

Yes, because the sudden death is really a rhythm disturbance where you get a chaotic rhythm.

>> That chaos is really meaning that your heart is is feb relating ventricular fibrillation is what it's called.

And it's just moving in a chaotic fashion, not squeezing in an organized fashion.

So it turns you know, had a lot of insight into what happened to the football player because I was a little league coach back in the 90's when the New England Journal of Medicine first published the condition called Commotio Cordis where if you hit the hardest supposed to beat electrically and that relax us.

And during that relaxation period, there's a little bit of a time period where it's very vulnerable to any kind of external, anything, a pacemaker or an extra beat or in this case.

A a a a baseball and getting the chest right above the heart.

Syncing sending out a little a tiny electrical current at the wrong time and the heart will start the fibrillation is.

And so we learned to protect Little League kids with better chest We probably should still put him on the pictures, not just the catchers there to protect them from line drives.

But, you know, when you make a and not another NFL player and you know, the the the guy playing safety, he actually initiated the contact.

That was his job.

But he got hit right in the chest at the wrong time of the cardiac cycle.

That little fall double period, electrically started so called Commotio Cordis or that ventricular fibrillation or having said that, >> Is it possible that a person that age can have Mike Arnold and farce the plaque or something?

I wish I could say that is not the case, but we're seeing.

>> It was a nice Wall Street, not Nice.

Wall Street Journal about this.

How it's happening, more and younger people and happening more particularly in black folks.

And guess what?

It really is.

Nutrition.

And, you know, this nutrition thing has widespread implications like military readiness.

If you put that in your search engine, you'll find that our young kids are not ready anymore because of the obesity and lack of physical exercise.

Then you get a look at what happens education skills because of poor diet.

And then the incidents of so used to be we actually call it.

Remember the days we called diabetes adult onset in juvenile onset.

Right now you have an adult onset diabetes that is type 2 diabetes occurring in children.

The better 8 years old.

And that is because of the diet.

We've got to rein it in.

Make it healthy.

And, you know, and we have to just realize that our society.

You gain wealth by education and hard when you're not healthy, you'll never be wealthy.

Sensing the dew point is you?

>> I'm sure you wear that when Truman first proposed about having universal health care back in his 1946, addressed.

He points out that over a million Americans were unfit to be drafted because of poor health.

And so you're the same battle that you're talking about.

Well, has been going on for at least back then.

So you said it a couple of times.

You've talked about that.

Make the connection for me between.

My diet and my heart.

So absolutely so.

But let's start with each of the one of those components that I that I mentioned.

Let's start with sodium.

>> People eating too much salt.

That is more than 2300 milligrams a day.

Write that down for the audience.

2300.

What it was like.

And that looks like a quarter teaspoon.

If you're putting that much salt on your food every day or more, it raises your blood pressure, not everybody assault but many people are.

And if you are salt sensitive, your blood pressure is going up.

Everyone should have a blood pressure cuff in their and they should measure it routinely.

If you have high blood pressure taking much pressure medicine, you should measured every day.

But everybody should measure at least every now and then and make sure that you are less than one over 70. people don't do that Adding salt live, really and our restaurants to it.

you can't always figure out how much sodium you're getting in your food when you buy packaged food.

Sometimes they sodium is high, but at least it'll tell you how much.

So the FDA has done a really good job of asking to label the things that I will really want to see people to know about how much sugar, how much salt, how much saturated fat and how much cholesterol so it.

So anyway, that was just one.

That's the sodium raising the blood pressure, raising the blood pressure, traumatize the blood vessels.

How do you heal trauma dies.

Blood vessels delay plaque in it.

Really?

Yeah.

And so that's how hypertension tends to worsen as well as worsening kidney disease, causing strokes.

and it's out also causing heart failure.

So hypertension is a major U.S..

He was a good one to start with because it's so and, you know, the incidence of hypertension by people.

By the time you get 75, it's about 80%.

And this is something that would be very avoidable if people start now with a healthy diet, then go on and on the next one would be saturated fat, which raises your cholesterol and if pizza.

Yeah, we all hear about HDL, LDL, cholesterol.

>> Right.

Straighten this out.

>> So it turns out that we had that wrong for 60 years that HDL being happy cholesterol.

We KET that was the major component of plaque formation in cholesterol.

And when you eat cholesterol, which is in pretty much every every animal tissue has some very few things don't quite Jello.

That's really about it that that don't that animal products that don't have colostrum.

And so, yeah, the issue of people would say that as you're healthy for you because yes, it will raise your LDL cholesterol, the bad one.

But it also raises your HDL and there was a lot of observation, UL data, meaning that you look going to a population of the cholesterol and see what happens to people that would say that the was a marker for risk.

The lower it is the more heart attacks people hat.

And then there was good mechanisms that we worked out also called reverse cholesterol transport.

Sounds really fancy, but it's put some the HBO was supposed to go in and pull the LDL out of your arteries and it sounds so good.

Then you've got a little clue when the big.

>> Billion dollar pharmaceutical industry.

We're doing things.

2 drugs, development and studies to raise your HDL and pretty much all of them failed to improve.

And most of them actually worsen the outgrew it just a hair.

And so people are still taking niacin and, you know, the cetera, pigs and all these drugs to trying raise their HDL.

Well, it turns out 2 large studies published in the last 3 can hard from Canada and the Copenhagen trials.

All show the truth.

That is yeah, there's a sweet spot.

But the higher you raise your HDL, the more heart attacks you get.

So we had the wrong for 60 years.

So do today.

So what I try to do with the HDL is leave it alone.

You know, it's a marker of how well you're exercising, but I'm not going to do specific things to try to raise it.

Now, the opposite is true of LDL.

That is we used to be so afraid because there's cholesterol in your brain.

And if you've got the too low, your brain would fall out or something completely.

Not true.

Having a very, very low LDL cholesterol.

We have people who are genetically preprogrammed to do that and his so-called pcsk 9 deficient people.

Well, that became into a big drug industry.

Try to make pcsk 9 deficient people with injections because if you Kevin LDL of 7 or 14, something really low and your cardiac event rate goes plummeting.

And so yeah, lower the LDL pretty much ignore the HBO except as a market for exercise.

Genetics.

Yeah.

Yeah.

It would roll.

So genetic, you know, people will say it's not your diet.

it's your family history.

And the family history is really a lot about.

Culture and habit.

And you learn to eat from your parents.

And so it unfortunately, there are still plenty of James out there.

And I think United States is starting to catch up Great.

Britain fantastic job of looking for people with genetic LDL problems so called familial Hyperloop a D me.

That's the the technical term and of course and comes in 2 varieties.

One is where you have one bad team out of 2.

And the other one is where both are And so people so 2 doses of the bad gene, they could end up dying before their 30 of heart disease.

The people with one bed Jane, instead of having a heart attack on an American died and 60 65, they'll get it at 45 or or even 50.

And so our job is to identify those people.

If you have an LDL cholesterol of greater than one, 90 there and there's a significant likelihood that you have one of those teams.

Now, the funny part about it is that you can get genetic testing and come out negative because we don't have necessarily identified every single gene that raises it.

And so and even if you don't identified, you don't know how it works, whether but in general, if you have one of those chains, it's going to affect half of your family members.

That is half your brothers and sisters.

Half your parents have 2 So please, everyone should know their numbers.

And if you have one of those high LDL cholesterol get treated and detail, everybody who is related to you to get a check.

What about getting screened?

Looking for corner others?

That's exactly what I do.

You mentioned, you know, in in Detroit to the Urban Cardiac initiative that a lot of that was going to places whether it was inside the hospital, go to a church, go to Belle Isle for the Michiganders.

Are people who are familiar with that right and let everybody know we're going to screen.

You're going to region for We're going to take a blood pressure and we're going to screening for cholesterol.

Now, the nice part about it is that when I got back to Chicago in 2013, want to Rush University that month, it's when the risk calculator came out.

And so I hopefully everybody has heard about the risk calculator.

Please audience could, you know, put it in Find out.

Look for ACC risk calculator.

A CDC risk calculator OK?

And yet American Heart Association work on it too.

But the fact the matter is little you can actually take your phone next time.

You're with your family and we'll show how do you now live to and what, what What was your last blood pressure?

And when you quit smoking, you put all the data into that risk calculator and it will give you a pretty good estimate of your 10 year risk of having heart attack, stroke or death.

Then you take that number.

If it's high, you could your doctor and get those risk factors taken care And if it's low, you know, change to a plant-based diet exercise every day and up essentially cardiac immortal.

But, you know, it's something that is extremely helpful.

And that's what we started doing that at Rush.

We've done several of them here.

We're going to do one this weekend here in Louisville where we go to a church or community group actually to the Department of Medicine, retreat.

Yeah, exactly.

it I have to admit my faculty was a lot healthier than those usual places that I'm going when I'm on the south side of Chicago, for example, or the West side of Louisville, what about the coroner comes from scams?

So talking then about a really good segue because the risk calculator has recommendations in our 2019 guidelines that say if you're above 5%, 10 year risk.

Yeah, we'll have a conversation with someone about whether or not you need a coronary calcium score positive family history.

One of those conditions like lupus or rheumatoid arthritis.

There are several diseases, chronic kidney disease that will increase your cardiac risk more than what the risk calculator will tell you if you have one of those 14 things, you need a corner.

Calcium score.

If you're above 7.5%, 10 year as you need a coronary calcium scores because we're going to try to treat those people, get the cholesterol down.

Okay.

The funny part about it is that if you're above 20%, you know, really the calcium score anymore to tell you the treatment you need to get that those numbers fix right away.

And there's no nothing in the score would tell you different.

But if you're 19%, that sounds really high.

But there are people with a 19% score who have this coronary calcium and that they may not be exactly cardiac and more over the next 10 years.

But awfully close to us.

Would you spend about 3 minutes?

Tell me about the guy that you tell your patients to the war.

>> So I'm always asking people to try to modify and I would say that we have people to a whole food, plant-based iron.

That's not a junk-food vegan diet to the gun with sugar, the the juicing instead of smoothies.

The difference is whether or not there's fiber in the it in to try to follow our whole food plant-based guidelines is not easy for some people.

Other people.

It's really easy.

All the animal rights people really easy.

They can I'm not going to murder a fish to eat.

You know, that kind of And the people who are concerned about the planet, it's really easy.

People had a heart attack after had a little conversation and made many with their own mouth that they caused this bite heating.

I've had a fair amount of success, but for when you try to connect screening and changing diet and you really need a tool like the risk calculator to tell people that there is only what it is, not what it's not.

One of the things that I want you to start eating this distance so glad you said that because people say if I'm a vegan or whole food plant-based, I what am I going to eat?

Yeah.

Well, the Americans, let's be honest, really, even probably about 7 species of animals, maybe 8, 0, k. And I had one of those vegan gurus call Odessa Sun.

He up in Cleveland Clinic.

He said there's 29,000 beans, grains, nuts, seeds, fruits and vegetables on this planet.

I looked it up.

It's only 21,000.

Haha, there's plenty to eat.

Now.

We do have issues our grocery stores the so-called food deserts.

Every label that food deserts put a little extra s and why?

Because it's not their fault.

They're not in the health care business there in the food making try to make a profit, KET the store open business and so they so what people buy.

So we need to do the education of what it is that people should be eating, which is being screens, not seeds, fruits and vegetables.

And if we can get that into integrated into our culture like it was when we were in Africa, for example, are for the for the black population when when we do that, that's what Bill Self they're going to.

So it's not, you know, buying fruits and vegetables and having them right in the store is not in their best interest.

What about you mentioned about the what was going after?

What about just here in Kentucky from the Hollows?

The urban areas.

We're struggling.

We really within a lot of it has to do with That is everybody's got a television.

Everybody sees fast food and it makes it look succulent and juicy and wonderful when it actually is deadly.

Actually, for those of you are interested in you like to go on your search engine, you can search my name in an article called Marketing Mortality and you'll be appalled that the vast majority of food on commercials are things that increase your death rate.

Where can I go to get information on?

Have a plant based diet to make sure I'm getting all the vitamins and other nutrients that need to be absolutely I we have several tools out there.

There are many books probably the most convenient is actually from the Association of Black Cardiologists.

And if you go on the ABC website which be cardio, dot and look under patient resources, you'll find the heart and Soul cookbook and this was my brain child.

But all the hard work was done by an African-American cardiologist in Houston, Baxter Montgomery, who runs a wellness center and I've got a restaurant not got a farm.

So he's really taken seriously, try and changing.

He's and a changing people's outcomes with heart by changing their diet.

So as you say it again, we're a good day.

Be cardio dot org AB cardiology work that just cardio hard.

80 C a R d dot org.

They've got to do given the 10 second how much access they need to do so as much as possible.

So all of our guidelines were wrong.

Even the ones Publix in 2019 saying, you know, moderate exercise a it's 150 minutes per week.

There was data published about 3 weeks ago that said high intensity exercise requests is plaque that you guys so please go for what we're going to have.

You come back again.

Doctor William Jarvis, Kim, just just can't get your shot up Monday.

Target Utah man is so hard to pull the human thanks for being with.

I really appreciate it.

>> All right.

Thank you for being with us today.

Also hope that you found this tragedy discussed by Doctor Williams within your reach.

I think many of them are maybe came to the mall.

But I hope that you will is considered these ideas and implemented many as you can with your family and friends your heart with thank you as If you wish to watch the show again, watch an archived version of past shows go to www that KD Dot Org forward.

Slash help.

You have a question or comment.

>> We'll have something that you like us to address.

Please give us a call or e-mail us at K will help.

That Ktv Dot org.

Would you change your diet?

We'll talk about that.

some more legal approach.

>> Kentucky health is funded in part by a grant from the foundation for a healthy Kentucky.

♪ ♪ ♪ ♪ ♪ ♪