Welcome And The Big Question

Hi, and welcome back to another episode of Fell The Mind, Healthy Life. I'm your host, Cyan, and this is the space where we slow down the conversation and have some real talk that quietly shape how we live. Today, I'm joined by Dr. Jeffrey L. Boone to talk about something that most of us have accepted as inevitable: heart disease and stroke. And we are going to look at why these conditions still take so many lives, what we have been missing in how we approach prevention, and what it would actually take to build a world where the next generation doesn't have to carry the same fear that we did. So I invite you all to join me on this very informative conversation. And Dr. Jeffrey, I think it's a pleasure to have you here with us today and really hoping to learn something new, something more informative about how we see heart diseases and heart attacks. So welcome to the show. Thank you very much. Great to be here. Likewise, Dr. Jeffrey. So just a little disclaimer for all the listeners who have just tuned in right now, some statements might reflect personal belief and experiences and are presented as individual views and not medical advice. Listeners should consult qualified professionals for medical conditions. So

Why Dr Boone Chose Prevention

with that being said, Dr. Jeffrey, uh, before we dive in, uh Doctor, I would love to um start with your story. So out of all the directions that medicine could have taken you, and it's a vast field, I think, what really made you commit uh to your work to a future without heart attacks? You know, was there a moment that uh lit that fire in you? What was it an instance or instances, a series of instances? What would you like to say?

Yes, very good question. Uh, because my field is very unique. Uh medicine is a vast field with a thousand different subspecialties that you could go into. Uh so I was uh in the middle of America in Kansas, uh uh just a typical young man growing up. Uh fortunately, I'm I had a good work ethic. And as we begin to uh take courses, study, I always just tried to do my best at everything I did. And so I got good grades, which is important um in America. And then as I I uh went through college, did a lot of sports, tennis, uh, basketball, football, all those, played those sports in college, and I majored in uh physical education, meaning the the science of exercise. And then I got a master's degree in uh uh exercise physiology. So it was in the 70s when exercise was changing from just playing ball to the the actual science behind fitness and and the heart and weight to weight control and health. Uh so that interested me. And then uh we're still now in the early 70s, so over, you know, 50 years ago. Um physicians hadn't really adopted much leadership in that world. You know, uh doctors were taking care of people, but the disease of heart disease was very much a disease of uh lifestyle, yet there weren't any doctors that were uh that were uh uh supporting that very much. And so I began to think about that. I had met my uh uh my future wife, Colette, and we were dreaming about our future. I was thinking about a PhD in exercise physiology. Um, and then she said, well, why don't you go to med school? So I thought you could just go down and sign up almost I didn't know it was hard to get in medical school. But it was also about the time in the last decade that uh Dwight Eisenhower, who was the president of the United States, had had a heart attack. And his physician was Paul Dudley White, who told him he should exercise after a heart attack. And that was fairly revolutionary. And then as I was employed as a physical fitness specialist, uh I was leading the training of post-heart attack patients in the uh exercise to rehabilitate after their heart attack. And again, I began to notice that everybody was kind of beginning to get on board with that, but MDs were not. And so I thought that I would try to go to medical school strictly to prevent heart attacks. And so that was very unique in those days. And so that was kind of the progression there. And I got in and was able to craft my training to always look at preventive cardiology. And the disease in those days, they were just learning how to fix it, you know, not how to prevent it. Uh and it looked like our fix-it approach was way too much, way too late. Bypasses, stance, heart attack, sudden death was very common. So my career kind of spanned the development of tests and medications to stop that process. Uh, the problem with the disease is the first time you ever know you have trouble, you die or have a heart attack about 50% of the time. So the first symptom is you just die. And that's a problem. You don't get warning signs as much as you might think. And so the other thing about heart disease that really bothered me is that we never measured the disease. You know, usually you have x-rays or some imaging of the disease, whether it's pneumonia or broken leg, but in heart disease, we treated what we call risk factors, cholesterol, blood pressure. Yeah. And th those are important, but they're not really diseases. They're just numbers that are predictors of the disease. So we pioneered starting in the even in the late 80s, 90s, the imaging of the heart, which isn't still common in America. Most the other thing in uh financers drive things, and most of the money, at least in America, is in the hospitals and the, you know, everything is getting paid well to fix it. But if you wait long enough to know you've got it by symptoms, you know, half the people are dead or disabled by that point. And so that was our whole pro approach to begin pioneering strategies to image and find the disease early with ultrasounds and CAT scans, and then to treat it aggressively with, you know, dozens of medicines we have now that can do that. And then still, uh, even on the subcontinent of Asia, you know, who to treat is unknown. You've got to image it to treat. Now we need the urgent people to take people to the hospital and try to fix them, but the best news would be to find it earlier and stop it aggressively and reverse it.

Okay. So that's really uh interesting and I would say an inspiring story as well. And uh I'm sure uh since you have spent uh nearly, I mean uh multiple decades into this field, um, I I wanna make this uh much more practical for the listeners listening to

Risk Factors Versus Measuring Disease

this today. So Dr. Jeffrey, I'm gonna ask a couple of questions. Um the first being um are there any early signs that are specific to heart attacks? Uh I'm gonna say. And you know, like you said, uh the the numbers are obviously there, which uh work like a risk factor. Um like you can only predict, and you know, I mean, uh you can say you can you can tell the probability that this is gonna happen, but are there any you know hundred percent accurate early symptoms, uh, you know, an early stage that uh one should look out for, perhaps.

Yeah. I um

How To Find Plaque Early

my main approach would be that if you wait for symptoms, you're in trouble, but still, you know, recon recognize those symptoms. I think people need to look for ways to uh measure do they have plaque or atherosclerosis, which is the biggest killer. One way you can do that is look at your relatives. If you have any relative, mother, father, uncle, brother that ever had any heart attack, stroke, TIA, stent, bypass surgery before the age of 40, 50, 60 even, then you need to subtract 10 to 15 years from that and begin looking at yourself. Why did my grandfather die at 50 of a heart attack? Or why did my my uh my brother have a heart attack at 45? You know, you've got the disease, most likely. You need to marry it mm mm measure it. And if you can't measure it with simple ultrasound of the neck looking for plaque or CAT scans of the heart looking for calcium, or even uh what we're calling in America uh opportunistic imaging. Like if you if you have a car wreck and they image your stomach, if there's calcium in the aorta, you have plaque. Uh if you get uh dental work done and you look at the uh dental x-rays, sometimes those will have calcium in the carotid artery or here. Uh if you bump your head and get an MRI and they see minor plaques there, that's the time to treat it. We treat plaque, atherosclerosis like we treat cancer. Now, the treatment sometimes is lifestyle, but uh uh an aspirin a day, a baby aspirin, very inexpensive. There are drugs called statins that you people should take, and those are getting pretty inexpensive and available around the world. Um and and then I think uh ultimately there are more medications along those lines. But look at your family history and subtract a decade from that to know. Look for opportunities to find plaque, especially if you have relatives that have had trouble. Um and then you find it and then treat it. So embrace the possibility and then treat it aggressively. And the medicines now so that so then if you don't know if you've got plaque, then embrace your cholesterol. You want your cholesterol to be as low as possible, and if it needs a drug, that should be fine. You want your blood pressure to be as low as possible, and if it requires a drug, that's okay. Blood sugar, you want your blood sugar to be very well managed as well. And those are the three things that if I didn't know plaque status, I'd want to manage those. So a drug like, you know, uh a torvostatin for cholesterol, aspirin 81, uh uh a drug called lofsartin uh for blood pressure, and a drug called metformin for cholesterol. Those would be the basics that almost every American needs by age 40 to be perfect. We're always looking for perfect. Every Asian, everyone in your continent, from Pakistan to Bangladesh to India, that there's a genetic inertia, and then the the populations are beginning to live like America has lived for 50 to 100 years, which has made heart disease the biggest disease in the history of the world. And uh we are eliminating other causes of death, and so cancer and heart disease emerge. Cancers are complicated, but heart disease is easy to stop if you know it. And it's hard to fix later on. Like in India doesn't need more bypass surgeons. It needs more early detection and medication. Uh if you it's almost like you're you're on the edge of a cliff and everybody's being shoved off the cliff, and all of our resources go to the ambulances at the bottom of the cliff, as opposed to building a fence so you don't fall off the cliff. And you know, that's where the aggressive approach is. And they're quite sophisticated as well. Uh, you know, on on your continent, the development of CT scans, you know, high-speed CT scans for the heart are, you know, depending on economics and insurance, but you know, you could actually do those to get a very, very elegant version of what's inside your arteries. But I think what we like to look at is redefining two words. What is significant disease? In America for a long time, significant disease has been chest pain, ambulances, stents, bypasses, hospitals. But uh to us, significant disease is even a tiny bit of plaque, treating it like cancer. In the cancer world, they don't tell you, oh, wait till it gets bigger, then we'll treat it. They go after it. But in the heart disease world, if we find that you're not having chest pain, you only have a 30% blockage, don't worry about it, it's not going to hurt you. It's wrong, totally wrong. And we're trying to change that. And then aggressive care is aggressively optimizing your uh genetic risk, your anatomic risk, your physiologic and biochemical risk, which is really blood work. And there's some fancy genetics that you can take that cost a few hundred dollars here, and but uh but they'll tell you, do you have a certain genetic inertia? But there's something about your your ethnic subgroups that are that are having more trouble. Uh and that that needs to be further worked out and investigated because people are dying way too much of this as they're developing very successful lives.

Agreed. I think uh that was spot on, Dr. Jeffrey. So uh, you know, we we uh tend to look at um things like cholesterol or high blood pressure, and uh you have already named a few of the medicines. So I want to take this a little further and ask you. So someone who knows that you know they have these symptoms, say they they have uh detected these symptoms early on. So, what are those few medicines that you know they should always carry with themselves? Uh, because uh I I'm not sure if you have heard about uh this drug called uh sorbitrate. So it's very common in India. Um, and you know that's something that people here uh carry with them all the time, especially specifically those who are uh uh struggling with any kind of uh high cholesterol or blood pressure. Um so uh maybe a few and and also um uh Dr. Jeffrey, I think you would be the best person to ask you uh ask uh this that you know what are the some very rare symptoms, okay? Uh in the sense rare in the sense uh that you're in the middle of a heart attack. You know, what would you really like to say? Uh like you know, in that moment, uh what you should do and you know, what are the few medicines that maybe you should always keep by yourself? So I think uh that would really help our listeners listening to this today.

Symptoms People Miss Too Often

Yes, I think uh while I'm very much wanting people to find the disease before they have symptoms, on the other hand, most people they're going to be assessed by symptoms. So in your typical physical activity during the day, whether it's walking or working hard, if you ever start feeling some heaviness in your chest area, or some shortness of breath, or a little more intolerance to the exercise, or walking the stairs, you're feeling more trouble, especially if you've had a family history of heart attack and stroke, or you have a personal history of high cholesterol, high blood pressure, things like that. Take that very seriously. That could be reduced blood flow down the arteries of the heart. Uh then, uh, especially in women, the pain of heart disease often expresses itself differently. Uh, jaw pain, uh, belching, other things can mimic that. So any change that seems to be brought out by exertion uh is a very good hint that you might have something wrong. I was on a podcast from a guy in New York City the other day, and he was talking about uh uh, you know, he was kind of a skeptic of what I was talking about, but it was funny. His name was Mind Dog. What a name. And he goes, he goes, you know, I don't know if this is a spiritual thing, and he's, you know, talking like New Yorkers do. But he said, the last week, every time I carry luggage around my house, I get check, I get pain in my chest and shortness of breath. And so we have a good long talk, but I kept saying, Mind dog, you need to go to the hospital. Uh and then uh I said, I told him he was in New York, I'm in Denver. I said, You could even fly to Denver. I'll do a free evaluation on you because I think you got heart disease. And I I remember we finished the interview and I could hear him talking to his audience, and he goes, ah, he probably doesn't know what he's talking about. Well, a week later he called me up and he was in the hospital. And they were putting a stant in it. He had taken our advice, gone to the hospital, and he had a severe blockage, and he was probably on his way to a heart attack. And the more the more we had the um the more we had the uh discussion, the more I kept bringing it back to his own health because all of a sudden, yeah, all of his brothers had died in their 50s and now he's 60s. I mean, it would didn't take a genius to say that he's he's in trouble. So anyway, that was uh uh so we saved the podcaster. But uh but yeah, so I think looking for those symptoms, um, and then I think being aggressive, like I tell uh to to let your doctors be the ones that decide things for you. You know, you decide yourself. You know, I got two, I'm worried about this. I want to, what can I do? Ask your doctors. A lot of doctors like it when their patient really is engaged. You know, they're they're actually pushing the doctor. Well, what kind of tests could I do to see if I got anything in my heart? And these high-speed CAT scans now are very inexpensive to look for calcium because as the plaque grows, it turns to calcium in the coronaries. And that's kind of a good way to uh um, you know, to to pick up the early plaque and then realize then to me that puts into guidance what I should do with my cholesterol, blood pressure, uh, blood sugar, things like that. And then the medicines are getting better than ever. So I I'm not seeing much in the way of side effects with things. But uh and then with women, odd, you know, people never expect women having heart attacks, but a woman should take seriously any sort of new, just like indigestion, you know, aches or pain, shoulder pain can sometimes be a heart attack, uh, jaw pain, uh, gastrointestinal distress. Uh for men, it's a little more classic, something's kind of heavy on your chest. But but still take those seriously. Uh sometimes if they even occur during mental stress, even if you're out walking around, that can be important as well. So check that out. How how are the doctors' situations in in uh uh in India? Does everybody have a doctor they can go to and talk to for the most part?

Yeah, I mean, uh for heart disease, I think it's another very common here. And um, I mean, uh I mean definitely I agree with the CT scans that you talked about earlier. I think uh the drugs as well, um uh I mean uh certain advancements in some of the drugs have really reduced the side effects. So I can say that uh, you know, um I would say that from reducing the heart disease standpoint, I would say that the main challenge still remains early detection because you know, once that's detected and that's ignored for uh uh you know a prolonged duration and when it adds up, I think that is when uh the trouble happens. So I think we are focused way too much on the cure rather than prevention. So I think this conversation uh is gonna be extremely important for anyone who's listening to this perhaps, and you know, perhaps uh looking at their science and you know their numbers uh this week. So I think this this is really extremely useful, Dr. Jeffrey. So I really appreciate it. So, what are the some of the drugs uh I mean uh that you know they could carry with themselves, which are proofs to uh stop heart diseases almost instantly, you know, open up that artery, open up that wall so that uh blood could blood flow could improve uh during during that kind of uh failure.

Aspirin Statins And Emergency Moves

There seems to be a benefit from carrying aspirin. Aspirin, uh generally a small aspirin, we call it a baby aspirin here in America. 80 milligrams of aspirin is is a pretty good idea to take daily. Now, what happens is the plaques that kill are growing inside the artery wall, and the plaque will crack and a clot will form. So the aspirin doesn't get rid of the heart disease, but it prevents a clot that might cause heart attack stroke. Um, generally, I recommend to my patients that are getting older or we know they have atherosclerosis or heart disease, I'll recommend that they take one 81 milligram a day, and it might be 80 milligrams. I think in Europe or uh Asia it might be 75 milligrams. Sometimes it's in a packet or chewable form. That's good. Now, if you find yourself in the middle of some event, like, oh man, I'm feeling bad, I've got shoulder pain, my chest hurts, got jaw pain, then chew five of those all at once. So people could carry that around, and that actually begins to dislodge the clot that has probably formed on top of a plaque in the brain or the heart. So those five aspirins, you know, uh bear in America makes these white aspirins, they're kind of crummy to chew up, but chew a couple of those up, that's a good thing on your way to the emergency room, is a good idea. Now you mentioned this drug that started with an S sober trait, or what was it called?

Yeah, I think it's the same drug that you're mentioning. So here it's uh mentioned as uh sobitrate, I believe. That's right, because it's chew it up as well. Yes.

So that's probably the your version of the aspirin, and that's a very smart one. Now, the um the other thing is a nitroglycerin, but that one has that's usually given only to people that know they've got serious blockages and that are having chest pains. And so I don't know that that would be for everyone to carry around. And then I think embracing, like even all my children are in their 30s and they're already on the statin drugs, which are now worldwide ubiquitous, inexpensive. And I have found a lot of our patients, we've had patients from Dubai to Vietnam come visit us. And uh the the the access to drugs, it's actually often much cheaper than in America to get to get good drugs. Uh and so I would I would look very aggressively if your blood pressure is even slightly above normal, then a a drug that ends in ARTAN, low sartan, valsartin, those are very nice low symptom drugs. We work with a lot of professional sports teams here in America, and those are good blood pressure drugs for athletes because they have no limitation on your athletes. And you're uh World, what is it, cricket and uh rugby and uh tennis and uh b uh uh squash and all kinds of great athletic games. Uh um so anyway, the athlete wants to not hurt his performance, but we want to protect the athlete. So the these uh uh and then other drugs in America that end in P-R-I-L, uh accupril, quinpril. So those two drugs are almost for everyone because they've been found that even if you don't have tr typically described hypertension, the guidelines for blood pressure drop five or ten points every year. So really the best blood pressure to have is one that barely keeps you standing, you know, so as low as possible. And then the more stressful your life or stressful your job, blood pressure will surge in that regard. And so I think I think if you don't have bleeding or bruising, taking one of those tiny little aspirin every day is a good period, and then two, four, or five. And if you don't have uh if you have a little high blood pressure, then taking the uh uh uh ACE inhibitor or the ARB, which are those two drugs. And then I think the bias is to over-treat with a statin. So if your doctor or you have just borderline cholesterol, that's enough for me to say just take a statin, because I think they're very inexpensive, and they all end up uh rosuvastatin, the torvostatin, symvostatin. Those are all the generic names of those drugs, and they're fantastic. And they they tend to not just lower cholesterol, but they stabilize plaque in the body. Um and then the that cornerstone of of aspirin, arten, statin is just fantastic. And if you have really high cholesterol, you add something called ezetomide. Now, there's a guy in Australia named Nichols who's been pioneering a triple drug formula with a little bit of statin, a little bit of ezetomide, and a little bit of bempadoic acid. So, you know, there are ways where we're looking at treating the whole world with this. And I think we're we're also pioneering, we got very sophisticated ultrasounds and CAT scans. But if you just did an ultrasound of this carotid artery of the neck in all of Nigeria, you would find 50% of the people that need the drug. Same thing you could do with all of uh South India. Uh you could you could find the people that need the drug and and those machines are available. We had a a group the other day was even talking to us about opening Boon Hart uh, which our name, uh the name of our clinic is called the Boon Hart Institute, opening Boon Hart Rwanda in the middle of Africa, you know, because the rest of the world is now developing this as the biggest cause of death.

Wow, I think that's uh very, very informative for all the listeners listening to this right now. And um uh it's quite interesting to know the different uh I mean magnitude of the effects and side effects that you all to describe uh with these drugs, Jeffrey. So I I think uh that's gonna be really, really helpful for the listeners listening to this today. Um and and yeah, so folks, uh something that uh I would like to also uh share across before we wrap this off is that always focus on uh getting these things diagnosed, you know, you know, focus more on the prevention rather than cure because it's always good to have that cure. I mean, with with the advancements in uh drugs specifically, uh, you know, we I think uh Dr. Jeffrey, we are really doing good, but uh from an individualistic standpoint, I think it's always good to have those checkups being done. And sp like you said, uh, you know, specifically if if um you recognize that you know you are uh I mean you have a family or relatives who have these kind of diseases and you know uh previous uh mortality. Um so I I I think that is what uh today's message uh would really be, Dr. Jeffrey. And of course, uh the drugs that you mentioned, I think that that's gonna be really helpful for all the listeners listening to this right now.

Resources The Book And Final Takeaway

So, Dr. Jeffrey, for people who actually resonated with this conversation, found this helpful, and uh wants to connect with you and learn more about your work, perhaps takes your guidance uh as well. Where's the best place for them to find you at?

Yes, they uh uh boonheart.com is our website. And it would give you an example of the very aggressive work. We think we're uh you know the best in the world at trying to prevent heart disease. Now the next step is to not just get it to our patients, to the whole world. And then a fourth drug that I didn't mention, but there's a drug called metformin that is a prediabetic drug, and that would be another good one for your listeners. So the uh metformin, lo sartin, rosuvastatin, and aspirin. And if you got everybody aged 30 in uh 30 to 40 in India on that combination, you'd eliminate about half of all heart attacks, probably if you got it going early enough. Uh but yeah, I'd love to talk to people there through that website. Uh uh also on Barnes and Noble and Amazon, our new book, uh A World Without Heart Attack, kind of g goes over the history and why things happen. And here we've got one of the richest countries in the world, yet all the money often goes the wrong place. In America, insurance companies, hospitals, everybody's gr scrambling for the money. We're one of the few clinics that talk about just stopping a disease and not about like even insurance is mostly in America interested in the cost of your health, not your health. And then I just listened to that book, Everything is Tuberculosis. And, you know, we've got the cure for tuberculosis, yet almost a million and a half people die of tuberculosis. And much of that is because of greed and lack of things. So I think there's a lot of things that could happen with podcasts like yours to get the word out that if we can get more, we hopefully we're moving into the next 20 years of doing the right thing. You know, too much of my half of the world has been uh just greedy and you know, and and hoarding as opposed to helping. And I think the whole world is starting to realize that just doesn't make you happy. You know, make you happy is helping other people. Um and I think even in the tuberculosis world we could stop that as well. But ultimately, even all across the world, the biggest cause of death is heart disease, and we can now prevent it with the appropriate strategies.

Wonderful. That's a very strong message indeed. And yeah, I think uh uh after all, I think uh from your standpoint as well, uh Dr. Jeffrey, I totally agree because I think helping uh another individual should be uh I mean, um as you as you you know age, I think you realize that maybe that is the purpose of life at all, you know, how you can help another soul uh reach their goals. And and so I think uh that is again um something very philosophical to perhaps end this uh on as well. So for the people who actually resonated with this conversation, folks, I'll link the book and the website so that you could easily find Dr. Jeffrey. So, folks, if you stayed with us throughout this conversation today, I want to thank you because I think this episode reached you for a reason. So you need to hear uh that you're not just at mercy of your genes or your past. Take care of your heart and listen to the symptoms, listen to your body. And folks, with that, this has been Healthy Mind, Healthy Life. I'm Cyan, and yeah, take care of your mind tonight, and we'll see you in the next one again.