A Cardiologist Answers Your Burning Heart Health Questions

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23-04-2025

Body and Soul readers stuffed our inbox with questions about heart health, and we're bringing you answers from a trusted expert.
We've invited a cardiologist from the American Heart Association to tell all, and she's discussing everything from cholesterol to calcium scans. Dr. Suzanne Steinbaum has practiced cardiology for the past 20 years, leading several heart-health programs throughout New York City. She's also written a book about how women can protect themselves from cardiovascular disease, founded the wellness program Heart-Tech Health, and is a spokesperson for the American Heart Association's Go Red for Women campaign. Here's her well-researched advice.
Dr. Steinbaum: Men typically describe it feeling like an elephant sitting on their chest, with symptoms like sweating and pain that radiates down the left arm. Women, however, have more subtle symptoms. They do often experience chest pressure and pain, but they also get shortness of breath, along with jaw pain, back pain, nausea, flu-like symptoms, and even sleep disorders.
As women go through menopause and their estrogen decreases, the way they metabolize lipids changes. Often that results in an increase in LDL cholesterol. Hormone replacement can help, but typically there's a more profound effect if the treatment is administered transdermally rather than orally.
First and foremost, 'knowing your numbers,' which means getting an assessment of your cardiovascular risk, is the most critical step. This includes tracking your blood pressure, body mass index, fasting blood sugar, and total cholesterol.
For those who are at intermediate risk or with a strong family history, a coronary artery calcium scan, which looks for calcified plaque in the arteries, can help determine the best preventive strategies.
A calcium score is recommended for those people who have multiple risk factors — like high blood pressure or cholesterol — or a strong family history and have no symptoms or have no evidence of coronary artery disease. The coronary artery calcium (CAC) score can help guide how aggressively to treat the cholesterol and what lifestyle interventions to consider. A score of up to 100 is considered mild, with greater than 100 being at moderate risk, and a score over 400 placing someone at high risk.
Several lifestyle changes can help reduce cholesterol, like becoming more active, eating healthier, managing your stress, getting an adequate amount of sleep, maintaining a healthy weight, lowering your alcohol consumption, and not smoking.
When it comes to diet, focus on increasing your fiber intake and eating more vegetables and less sugar. Also, swapping saturated fats (animal fats) for healthy fats such as omega-3 fatty acids (like those found in fish, olive oil, flax seeds, nuts, and avocado) can have a significant impact.
For exercise, the best cardioprotective regimen is five days a week of moderate intensity training for 30 minutes, and two days of strength training.
Lipoprotein(a), or Lp(a), is a genetic marker that's not affected by diet or exercise. It leads to an increase in clotting and the development of plaque formation in the arteries. For those with elevated Lp(a), early screening for coronary artery disease is recommended.
Although there's no direct treatment that's currently available, lowering your cholesterol through a healthy diet, regular exercise, and medications like statins, is considered first-line therapy.
Too much of a calcium supplement is not good and can lead to calcium in the arteries. Taking one that's 1,200 mg per day, along with vitamin D and magnesium to ensure absorption, should benefit for osteoporosis prevention and be safe.
The information provided in this article isn't intended as medical advice, and shouldn't replace professional medical treatment. Consult your doctor with any serious health concerns.
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