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CNN Saturday Morning News

"Weekend House Call"

Aired September 06, 2003 - 08:29   ET

THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.

THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.


SEAN CALLEBS, CNN CORRESPONDENT: "Weekend House Call" with the good doctor, Sanjay Gupta, begins right now.
DR. SANJAY GUPTA, CNN CORRESPONDENT: All right, good morning and welcome to "Weekend House Call".

Let me ask you something. If you knew what the number one killer in America was and you knew that you could prevent it, what would you do?

Well, we think you would do everything possible to battle this killer and to stay healthy. So here's what you need to know.

Heart disease is the number one cause of death in both men and women. For years, the medical community thought that 50 percent of heart attacks were the result of bad genes or just simple bad luck. But now two reports based on many years of research found out that most cases of heart disease are, in fact, preventable.

And as CNN's Elizabeth Cohen reports, there are key risk factors that you and your doctor should be looking for early on.

(BEGIN VIDEOTAPE)

ELIZABETH COHEN, CNN CORRESPONDENT (voice-over): The reports, involving more than half a million patients, show that about 85 percent of all heart attacks occur in people with at least one of four major warning signs -- high cholesterol, high blood pressure, diabetes and smoking. It's big news to doctors, because many believed in the 50 percent rule, which holds that half of all heart attacks strike without warning.

Dr. Philip Greenland (ph) was one of the group of researchers who came up with the startling findings.

DR. PHILIP GREENLAND, NORTHWESTERN UNIVERSITY: Heart disease is more predictable than a lot of people have believed that it is. This work is telling us that these risk factors are present in most people who will get a heart attack.

COHEN: The studies show warning signs may appear long before a heart attack occurs.

GREENLAND: The average time from the measurement of the risk factor to the development of the heart disease was about 15 to 20 years. So what this is telling us is that we need to be looking earlier in life for these risk factors. COHEN: The key phrase is early prevention. Quitting smoking, reducing cholesterol and controlling hypertension and diabetes could prevent or delay a heart attack by years. Another clear message from these studies, you need to find out where you stand, which means you need to have your blood pressure, cholesterol and blood sugar checked, and if there's a problem, a change in lifestyle and possibly medication may help.

Elizabeth Cohen, CNN, Atlanta.

(END VIDEOTAPE)

GUPTA: All right, well, there are some risk factors you just can't control. Your age and gender, obviously, you can't change. But if you have a family history of early heart disease, you can't do anything to change that either. But you can do something about hypertension, cholesterol, smoking and being overweight, as Elizabeth mentioned.

You should start checking your numbers now, even if you're only 20 years old. Find out what your blood pressure and cholesterol levees are. You can do that by seeing your doctor. Normal blood pressure is below 120/80 and a cholesterol level below 200 is what you should shoot for.

Now, there's a really neat Web site that will calculate your heart risk for you. We've put a link to that, actually, on our own Web site. That's our health Web site at cnn.com. You can go to this Web site, plug in your numbers and find out what your risk is for a heart attack. This Web site can be a real motivator. I did it myself.

We know you have a lot of questions about heart health, so call us. That's at 1-800-807-2620. Or e-mail us. That's at housecall@cnn.com.

And to help us wade through a lot of these important questions, we are joined today by Dr. Stuart Seides. He joins us from Washington. He's the associate director of cardiology at Washington Hospital Center.

Thank you very much for joining us, doctor.

DR. STUART SEIDES, ASSOCIATE DIRECTOR OF CARDIOLOGY, WASHINGTON HOSPITAL CENTER: Good morning.

It's nice to be here.

GUPTA: Yes, good morning to you.

A lot of people very curious about this topic, as you can imagine, and you're a cardiologist. A lot of people phoning in and e- mailing in and we're going to -- our phone lines are open. But let's get started with one of our e-mails.

This one comes to us from Jeff in Kentucky. And he asks, "If a partial clogging of the arteries is discovered, will diet and exercise reverse this condition or is an operation the only option?"

And, Dr. Seides, this is an interesting point. You know, can you actually reverse this process or is it going to really require the knife and an operation to do that?

SEIDES: Well, surgery or surgical like procedures are required if a person has such severe acute risk, that is, risk in the very short-term, that such that opening the artery is required to preserve their life over the short run.

But it is true that whether or not one has surgery, it is important to attend to risk factors for what we would call secondary prevention.

We've talked a little bit, or you've mentioned some of the issues around primary prevention in young people who've never had a heart problem. But secondary prevention in those who do is very important.

You can always slow the process of heart disease, in everybody. You can stop the process in some people. You can reverse it in a few. So the take away message is that risk factor modification is important both in primary and secondary prevention and is a big issue in those who already have heart or vascular disease.

GUPTA: OK, yes, and lots of people falling into these different categories. We are going to go through these various risk modifying behaviors over the next half hour.

We've got a phone call coming in now, as well. Dean from Tampa.

Welcome to House Call, Dean.

DEAN: Yes, good morning, gentlemen.

SEIDES: Good morning.

DEAN: When it comes to prevention as far as young people, with the lack of physical education and also the planning of our school menus, what can parents do and perhaps even schools do as far as planning menus to prevent heart disease in young people from getting it later?

GUPTA: People are thinking about this younger and younger, Dr. Seides, I mean even in the school cafeterias. Are you getting those questions, as well?

SEIDES: Well, we are. Of course, those are big public policy issues and have to do with lots of things that are non-medical, including school budgets and the like. But clearly, getting the message to young people as to the importance of regular exercise as part of their lives, inclusiveness in physical education, as well as encouraging school districts and parents to provide at least the option for healthy eating, is terribly important for our young people.

GUPTA: Really quick, Dr. Seides. How young is too young to start getting your cholesterol and your blood pressure checked? SEIDES: Well, it's probably too young among, I would say, school age children up to and including high school, unless a person has a very, very extraordinary family history. There are some youngsters who have extraordinarily high cholesterols as a manifestation of a familial genetic cholesterol disorder.

GUPTA: OK.

SEIDES: But for most young people, it's really simply important to develop those right kind of habits and then have their blood work done and their blood pressure done as they get into young adulthood.

GUPTA: OK. And staying on the children's theme now, going from Tampa to Michigan, Carol from Michigan has a question.

Welcome to House Call, Carol.

CAROL: Good morning, gentlemen.

I have afib and I was wondering what, at this early age, I could do to tell my children to prevent this. Is it preventable and what causes it?

GUPTA: Atrial fibrillation is a heart arrhythmia, we should mention, as well.

Dr. Seides, what do you say to someone like Carol?

SEIDES: Well, atrial fibrillation is an important heart arrhythmia. It's an alteration, as you said, in the cardiac rhythm. It is not directly related to heart and vascular disease of the nature that we're talking about today. It sometimes does run in families. It tends not to be preventable in the same way that coronary heart disease is preventable. But, again, good habits, maintenance of good body weight, maintenance of good exercise habits will tend to reduce the frequency of the arrhythmia and perhaps delay the age at which it might occur in family members.

GUPTA: Great. And Dr. Seides, one of the things that strikes me is that a lot of the things we're talking about really effect so many people. In fact, nearly all of us will have to deal with high blood pressure at some time in our lives.

And when we come back, we're going to take a closer look at hypertension, how can you keep it low and how is the stress in your life adding to your risk of high blood pressure and heart attack?

The answers to those questions when CNN's House Call continues.

Call us with your questions, 1-800-807-2620. Or e-mail us, housecall@cnn.com.

COMMERCIAL

GUPTA: All right, this is "Weekend House Call" and we're talking about preventing heart attacks and stroke. We want to hear from you. Call us with your questions, 1-800-807-2620. Or e-mail us, housecall@cnn.com.

While we get all these phone calls lined up, let's check our health quiz now. For years, normal pressure was considered 120/80. In May, a new normal blood pressure goal was issued. Do you know what it is? We'll give you that answer in 30 seconds.

Stay with us.

COMMERCIAL

GUPTA: All right, checking the daily dose health quiz. We asked, "For years, normal blood pressure was considered 120/80. In May, a new normal blood pressure was issued. Do you know what it is?"

The answer is the new normal is actually below 120/80. In fact, according to some data, you should shoot for 115/75. Specifically, you're considered to have pre-hypertension if your systolic blood pressure is 120-139 or your diastolic pressure is 80-89. Anything over 140 is considered high blood pressure.

Some people only have high blood pressure when they visit the doctor's office. They call that white coat hypertension. Here are some good tips for having your blood pressure taken when you go to the doctor's office. Don't drink coffee or smoke cigarettes 30 minutes before having your blood pressure measured. Go to the bathroom prior to the reading. A full bladder can change your reading. Before the test, sit for five minutes with your back supported and your feet flat on the ground. Rest your arm on a table at the level of your heart. Wear short sleeves so your arm is exposed. Get two readings taken at least two minutes apart and then average the results. Also, ask the doctor to tell you your blood pressure readings in numbers and write those things down.

There's a new study that shows 60 to 90 minutes of exercise a week can actually lower your blood pressure. That amount of aerobic exercise spread out over a week reduced systolic blood pressure, the top number on a blood pressure reading, an average of 12 points, and the lower, or diastolic reading, by an average number of eight points.

That, along with maintaining a healthy weight and diet, and limiting your salt intake, can make a difference. Also, limit your drinking and remember to take your prescribed medications, as well.

Dr. Stuart Seides is joining us today on "Weekend House Call". He is in Washington.

We have lots of calls and e-mails coming in.

Let's take another one right away, doctor.

This is from Steven in Indianapolis. He asks, "Do cholesterol and blood pressure levels affect each other? Should both or one be controlled to influence the other?"

SEIDES: That's a good question. They don't affect each other in a direct way, but their adverse effects are synergistic. That is, the presence of both high blood pressure and an elevated cholesterol magnify the effect of one and the other on one's risk of heart disease. So in a sense one plus one equals three and certainly in a person who's got high blood pressure, the grocery of treating both the high blood pressure and the elevated cholesterol is that much greater.

So multiple risk factors are more than additive in terms of the person's risk of developing heart disease. And so that kind of an individual, with both high blood pressure and an elevated cholesterol, has a particular urgency in getting good treatment for both conditions.

GUPTA: OK. And one of the things that strikes me, as well, doctor, is a lot of people are starting to think about this younger and younger. We've already gotten a couple of questions about young people. And now Olga from North Carolina also has a question about blood pressure in her teenager.

Olga, welcome to House Call.

OLGA:

GUPTA: Hi.

Do you have a question for us?

OLGA: Yes. I think a couple of minutes ago you just answered it. I hope you answered it. But my son is 16 years old and he's a high school student. Every time we go to the doctor's office, his blood pressure is like 140 or 144/70 or 80. And my question is should I be concerned about it, because the doctors apparently are not concerned about it.

GUPTA: You know, it's sort of a more complicated problem, isn't it, Dr. Seides, because that's usually where you get your blood pressure checked is at the doctor's office, and 144, that would be considered hypertensive, right Dr. Seides?

SEIDES: It would, although the numbers that our caller has given us suggest that the systolic, or upper number, is elevated. The lower number really is not. And that phenomenon of what we would call a wide pulse pressure, that is, a high systolic pressure, a normal or a low diastolic pressure, number one, can be due to a number of other medical conditions -- thyroid disease, valvular heart disease and so forth. And I would think that in a young person who has this type of phenomenon consistently, she might want to have her son checked by a cardiologist to be sure that this is not simply the early manifestation of hypertension.

GUPTA: Good advice there for Olga.

Let's go straight to our next e-mail, as well.

Lisa from St. Louis asking, "Can stress alone, without the other risk factors, cause arthrosclerosis or heart disease?"

So many people, Dr. Seides, sort of associate the two. I'm stressed out and therefore I'm going to have a problem with my heart. How strong is that link?

SEIDES: Well, of course, it's a very difficult link to establish because stress, psychological stress is a very difficult parameter to quantify. You know, what is stressful for one person is not stressful for another. But certainly there is some data out there that suggests that psychological stress or dissatisfaction with one's life or occupation can accelerate heart disease, or at least make the manifestations of heart disease more severe.

However, psychological factors, at least in the initial genesis of heart disease, play a much more modest role than the traditional risk factors that you emphasized earlier in the program -- elevated cholesterol, diabetes, hypertension and tobacco abuse.

GUPTA: That's smoking. That keeps coming up. And we're going to talk about that, as well. We're also going to talk -- we've been getting a lot of e-mails about cholesterol. We want to answer your questions about that. How do you keep your numbers down and what drugs are best?

We're going to cut into cholesterol questions when "Weekend House Call" continues.

Stay with us.

COMMERCIAL

GUPTA: Welcome back to "Weekend House Call".

We're talking about being heart healthy.

One in five Americans has high cholesterol. Lowering your numbers can lower your risk for heart disease. Where high blood pressure is a problem for older people, cholesterol really doesn't care what age you are and for some people, they can eat right and they can exercise and they can still have high cholesterol.

Knowing your numbers, that can be a good start. That can tell you a lot about your health and about your heart. You want to try and have a cholesterol of less than 200.

We'll talk to Dr. Seides about that, as well. Your bad cholesterol is called LDL. That's what you want to look for. If it's high, it could indicate a risk for heart disease.

Now, if you've had a heart attack or have diabetes, your goal for your LDL should be less than 100. If you're healthy and have no risk factors, shoot for under 160.

Lots of questions about this, and Dr. Seides is going to help us wade through it. We've got an e-mail question now from Alex in Florida.

He asks, "Is it possible to reduce bad cholesterol by only exercising and eating healthier or should I start taking the medicines like statens that may have side effects?" Dr. Seides, the statens medication, that's just amazing how popular these medications have become. Lipitor, for example, is almost a $10 billion industry around the world. How aggressive are doctors being with these staten medications?

SEIDES: Well, I think the reason for their success is no accident and I think in relative terms they are extraordinarily effective and have an extraordinarily safe profile relative to other drugs. There are no dugs that have no side effects, but the side effect profile of statens relative to the number of people who take them is very, very low.

It may be extraordinarily difficult for a person to lower their LDL cholesterol even with the most aggressive dietary and exercise habits. Remember that most cholesterol is not consumed by the individual. Most of it is manufactured by the liver. Cholesterol is an important and natural substance that is key to the functioning of cells in the human body. And so it's important to remember that cholesterol is not a poison, but rather a biological substance when -- that when it occurs in a high concentration can have ill effects.

And for those individuals who manufacture a lot of cholesterol, primarily due to genetic reasons, they just can't get down to healthy levels with diet and exercise. And for those people, staten therapy is both effective and generally quite safe.

GUPTA: And I think that's a point worth repeating, as well, that most cholesterol, a good majority of it actually being produced by the body, probably won't be affected as much by diet.

Let's get to a phone caller now. A lot of phone calls coming in, as well.

Janet from Pennsylvania, welcome to House Call.

JANET: Thank you.

Dr. Seides, I'd like to know what role cholesterol -- what role triglycerides play in cholesterol and why cardiologists watch this area, and if niacin is helpful in its treatment.

Thank you.

GUPTA: That's a good question, as well.

Go ahead, Dr. Seides.

SEIDES: Indeed, it is. Triglycerides are another type of fat that circulate. Triglycerides are much more affected, acutely, by diet than cholesterol is. For example, if you have a fatty meal this morning, your triglycerides will go up very high in the short run. Cholesterol tends to be a phenomenon that is more affected by cumulative dietary habits.

The association between triglycerides and heart and vascular disease is not as strong for triglycerides as they are with -- as it is with cholesterol, and triglycerides are also much more affected by the presence of diabetes and the presence, for example, of alcohol consumption than cholesterol is on an acute basis.

Niacin, as everybody knows, or may know, is a vitamin supplement and niacin can be helpful both in driving down the triglycerides, but it also plays a very important role in elevating good cholesterol, that is the HDL cholesterol that may only be modestly elevated by statens. So niacin is a very important part of our armamentarium in both lowering triglycerides and elevating HDL cholesterol.

GUPTA: OK, Dr. Seides, good advice there. Good tips.

Final thoughts and final tips right after this break.

Stay with us.

COMMERCIAL

GUPTA: Well, that's all the time we have for today.

Dr. Seides joined us from Washington.

I want to thank you very much for joining us, waking up with us on "Weekend House Call". I think a lot of good tips were given today. And if I may give one...

SEIDES: Thank you.

GUPTA: Thank you, Dr. Seides.

And if I may give one final tip, as well. Smoking, we didn't get a chance to talk about it enough. If you stop smoking today, anybody who's a smoker, you'll decrease your risk of heart disease by about 30 percent.

Make sure to join me tomorrow when we delve into the mystery of autism. More and more children are being diagnosed with the disorder. We'll tell you the warning signs and cover the newest research on autism, as well.

That's tomorrow at 8:30 Eastern. I hope you join me.

Thanks for watching.

I'm Dr. Sanjay Gupta.

TO ORDER A VIDEO OF THIS TRANSCRIPT, PLEASE CALL 800-CNN-NEWS OR USE OUR SECURE ONLINE ORDER FORM LOCATED AT www.fdch.com







Aired September 6, 2003 - 08:29   ET
THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.
SEAN CALLEBS, CNN CORRESPONDENT: "Weekend House Call" with the good doctor, Sanjay Gupta, begins right now.
DR. SANJAY GUPTA, CNN CORRESPONDENT: All right, good morning and welcome to "Weekend House Call".

Let me ask you something. If you knew what the number one killer in America was and you knew that you could prevent it, what would you do?

Well, we think you would do everything possible to battle this killer and to stay healthy. So here's what you need to know.

Heart disease is the number one cause of death in both men and women. For years, the medical community thought that 50 percent of heart attacks were the result of bad genes or just simple bad luck. But now two reports based on many years of research found out that most cases of heart disease are, in fact, preventable.

And as CNN's Elizabeth Cohen reports, there are key risk factors that you and your doctor should be looking for early on.

(BEGIN VIDEOTAPE)

ELIZABETH COHEN, CNN CORRESPONDENT (voice-over): The reports, involving more than half a million patients, show that about 85 percent of all heart attacks occur in people with at least one of four major warning signs -- high cholesterol, high blood pressure, diabetes and smoking. It's big news to doctors, because many believed in the 50 percent rule, which holds that half of all heart attacks strike without warning.

Dr. Philip Greenland (ph) was one of the group of researchers who came up with the startling findings.

DR. PHILIP GREENLAND, NORTHWESTERN UNIVERSITY: Heart disease is more predictable than a lot of people have believed that it is. This work is telling us that these risk factors are present in most people who will get a heart attack.

COHEN: The studies show warning signs may appear long before a heart attack occurs.

GREENLAND: The average time from the measurement of the risk factor to the development of the heart disease was about 15 to 20 years. So what this is telling us is that we need to be looking earlier in life for these risk factors. COHEN: The key phrase is early prevention. Quitting smoking, reducing cholesterol and controlling hypertension and diabetes could prevent or delay a heart attack by years. Another clear message from these studies, you need to find out where you stand, which means you need to have your blood pressure, cholesterol and blood sugar checked, and if there's a problem, a change in lifestyle and possibly medication may help.

Elizabeth Cohen, CNN, Atlanta.

(END VIDEOTAPE)

GUPTA: All right, well, there are some risk factors you just can't control. Your age and gender, obviously, you can't change. But if you have a family history of early heart disease, you can't do anything to change that either. But you can do something about hypertension, cholesterol, smoking and being overweight, as Elizabeth mentioned.

You should start checking your numbers now, even if you're only 20 years old. Find out what your blood pressure and cholesterol levees are. You can do that by seeing your doctor. Normal blood pressure is below 120/80 and a cholesterol level below 200 is what you should shoot for.

Now, there's a really neat Web site that will calculate your heart risk for you. We've put a link to that, actually, on our own Web site. That's our health Web site at cnn.com. You can go to this Web site, plug in your numbers and find out what your risk is for a heart attack. This Web site can be a real motivator. I did it myself.

We know you have a lot of questions about heart health, so call us. That's at 1-800-807-2620. Or e-mail us. That's at housecall@cnn.com.

And to help us wade through a lot of these important questions, we are joined today by Dr. Stuart Seides. He joins us from Washington. He's the associate director of cardiology at Washington Hospital Center.

Thank you very much for joining us, doctor.

DR. STUART SEIDES, ASSOCIATE DIRECTOR OF CARDIOLOGY, WASHINGTON HOSPITAL CENTER: Good morning.

It's nice to be here.

GUPTA: Yes, good morning to you.

A lot of people very curious about this topic, as you can imagine, and you're a cardiologist. A lot of people phoning in and e- mailing in and we're going to -- our phone lines are open. But let's get started with one of our e-mails.

This one comes to us from Jeff in Kentucky. And he asks, "If a partial clogging of the arteries is discovered, will diet and exercise reverse this condition or is an operation the only option?"

And, Dr. Seides, this is an interesting point. You know, can you actually reverse this process or is it going to really require the knife and an operation to do that?

SEIDES: Well, surgery or surgical like procedures are required if a person has such severe acute risk, that is, risk in the very short-term, that such that opening the artery is required to preserve their life over the short run.

But it is true that whether or not one has surgery, it is important to attend to risk factors for what we would call secondary prevention.

We've talked a little bit, or you've mentioned some of the issues around primary prevention in young people who've never had a heart problem. But secondary prevention in those who do is very important.

You can always slow the process of heart disease, in everybody. You can stop the process in some people. You can reverse it in a few. So the take away message is that risk factor modification is important both in primary and secondary prevention and is a big issue in those who already have heart or vascular disease.

GUPTA: OK, yes, and lots of people falling into these different categories. We are going to go through these various risk modifying behaviors over the next half hour.

We've got a phone call coming in now, as well. Dean from Tampa.

Welcome to House Call, Dean.

DEAN: Yes, good morning, gentlemen.

SEIDES: Good morning.

DEAN: When it comes to prevention as far as young people, with the lack of physical education and also the planning of our school menus, what can parents do and perhaps even schools do as far as planning menus to prevent heart disease in young people from getting it later?

GUPTA: People are thinking about this younger and younger, Dr. Seides, I mean even in the school cafeterias. Are you getting those questions, as well?

SEIDES: Well, we are. Of course, those are big public policy issues and have to do with lots of things that are non-medical, including school budgets and the like. But clearly, getting the message to young people as to the importance of regular exercise as part of their lives, inclusiveness in physical education, as well as encouraging school districts and parents to provide at least the option for healthy eating, is terribly important for our young people.

GUPTA: Really quick, Dr. Seides. How young is too young to start getting your cholesterol and your blood pressure checked? SEIDES: Well, it's probably too young among, I would say, school age children up to and including high school, unless a person has a very, very extraordinary family history. There are some youngsters who have extraordinarily high cholesterols as a manifestation of a familial genetic cholesterol disorder.

GUPTA: OK.

SEIDES: But for most young people, it's really simply important to develop those right kind of habits and then have their blood work done and their blood pressure done as they get into young adulthood.

GUPTA: OK. And staying on the children's theme now, going from Tampa to Michigan, Carol from Michigan has a question.

Welcome to House Call, Carol.

CAROL: Good morning, gentlemen.

I have afib and I was wondering what, at this early age, I could do to tell my children to prevent this. Is it preventable and what causes it?

GUPTA: Atrial fibrillation is a heart arrhythmia, we should mention, as well.

Dr. Seides, what do you say to someone like Carol?

SEIDES: Well, atrial fibrillation is an important heart arrhythmia. It's an alteration, as you said, in the cardiac rhythm. It is not directly related to heart and vascular disease of the nature that we're talking about today. It sometimes does run in families. It tends not to be preventable in the same way that coronary heart disease is preventable. But, again, good habits, maintenance of good body weight, maintenance of good exercise habits will tend to reduce the frequency of the arrhythmia and perhaps delay the age at which it might occur in family members.

GUPTA: Great. And Dr. Seides, one of the things that strikes me is that a lot of the things we're talking about really effect so many people. In fact, nearly all of us will have to deal with high blood pressure at some time in our lives.

And when we come back, we're going to take a closer look at hypertension, how can you keep it low and how is the stress in your life adding to your risk of high blood pressure and heart attack?

The answers to those questions when CNN's House Call continues.

Call us with your questions, 1-800-807-2620. Or e-mail us, housecall@cnn.com.

COMMERCIAL

GUPTA: All right, this is "Weekend House Call" and we're talking about preventing heart attacks and stroke. We want to hear from you. Call us with your questions, 1-800-807-2620. Or e-mail us, housecall@cnn.com.

While we get all these phone calls lined up, let's check our health quiz now. For years, normal pressure was considered 120/80. In May, a new normal blood pressure goal was issued. Do you know what it is? We'll give you that answer in 30 seconds.

Stay with us.

COMMERCIAL

GUPTA: All right, checking the daily dose health quiz. We asked, "For years, normal blood pressure was considered 120/80. In May, a new normal blood pressure was issued. Do you know what it is?"

The answer is the new normal is actually below 120/80. In fact, according to some data, you should shoot for 115/75. Specifically, you're considered to have pre-hypertension if your systolic blood pressure is 120-139 or your diastolic pressure is 80-89. Anything over 140 is considered high blood pressure.

Some people only have high blood pressure when they visit the doctor's office. They call that white coat hypertension. Here are some good tips for having your blood pressure taken when you go to the doctor's office. Don't drink coffee or smoke cigarettes 30 minutes before having your blood pressure measured. Go to the bathroom prior to the reading. A full bladder can change your reading. Before the test, sit for five minutes with your back supported and your feet flat on the ground. Rest your arm on a table at the level of your heart. Wear short sleeves so your arm is exposed. Get two readings taken at least two minutes apart and then average the results. Also, ask the doctor to tell you your blood pressure readings in numbers and write those things down.

There's a new study that shows 60 to 90 minutes of exercise a week can actually lower your blood pressure. That amount of aerobic exercise spread out over a week reduced systolic blood pressure, the top number on a blood pressure reading, an average of 12 points, and the lower, or diastolic reading, by an average number of eight points.

That, along with maintaining a healthy weight and diet, and limiting your salt intake, can make a difference. Also, limit your drinking and remember to take your prescribed medications, as well.

Dr. Stuart Seides is joining us today on "Weekend House Call". He is in Washington.

We have lots of calls and e-mails coming in.

Let's take another one right away, doctor.

This is from Steven in Indianapolis. He asks, "Do cholesterol and blood pressure levels affect each other? Should both or one be controlled to influence the other?"

SEIDES: That's a good question. They don't affect each other in a direct way, but their adverse effects are synergistic. That is, the presence of both high blood pressure and an elevated cholesterol magnify the effect of one and the other on one's risk of heart disease. So in a sense one plus one equals three and certainly in a person who's got high blood pressure, the grocery of treating both the high blood pressure and the elevated cholesterol is that much greater.

So multiple risk factors are more than additive in terms of the person's risk of developing heart disease. And so that kind of an individual, with both high blood pressure and an elevated cholesterol, has a particular urgency in getting good treatment for both conditions.

GUPTA: OK. And one of the things that strikes me, as well, doctor, is a lot of people are starting to think about this younger and younger. We've already gotten a couple of questions about young people. And now Olga from North Carolina also has a question about blood pressure in her teenager.

Olga, welcome to House Call.

OLGA:

GUPTA: Hi.

Do you have a question for us?

OLGA: Yes. I think a couple of minutes ago you just answered it. I hope you answered it. But my son is 16 years old and he's a high school student. Every time we go to the doctor's office, his blood pressure is like 140 or 144/70 or 80. And my question is should I be concerned about it, because the doctors apparently are not concerned about it.

GUPTA: You know, it's sort of a more complicated problem, isn't it, Dr. Seides, because that's usually where you get your blood pressure checked is at the doctor's office, and 144, that would be considered hypertensive, right Dr. Seides?

SEIDES: It would, although the numbers that our caller has given us suggest that the systolic, or upper number, is elevated. The lower number really is not. And that phenomenon of what we would call a wide pulse pressure, that is, a high systolic pressure, a normal or a low diastolic pressure, number one, can be due to a number of other medical conditions -- thyroid disease, valvular heart disease and so forth. And I would think that in a young person who has this type of phenomenon consistently, she might want to have her son checked by a cardiologist to be sure that this is not simply the early manifestation of hypertension.

GUPTA: Good advice there for Olga.

Let's go straight to our next e-mail, as well.

Lisa from St. Louis asking, "Can stress alone, without the other risk factors, cause arthrosclerosis or heart disease?"

So many people, Dr. Seides, sort of associate the two. I'm stressed out and therefore I'm going to have a problem with my heart. How strong is that link?

SEIDES: Well, of course, it's a very difficult link to establish because stress, psychological stress is a very difficult parameter to quantify. You know, what is stressful for one person is not stressful for another. But certainly there is some data out there that suggests that psychological stress or dissatisfaction with one's life or occupation can accelerate heart disease, or at least make the manifestations of heart disease more severe.

However, psychological factors, at least in the initial genesis of heart disease, play a much more modest role than the traditional risk factors that you emphasized earlier in the program -- elevated cholesterol, diabetes, hypertension and tobacco abuse.

GUPTA: That's smoking. That keeps coming up. And we're going to talk about that, as well. We're also going to talk -- we've been getting a lot of e-mails about cholesterol. We want to answer your questions about that. How do you keep your numbers down and what drugs are best?

We're going to cut into cholesterol questions when "Weekend House Call" continues.

Stay with us.

COMMERCIAL

GUPTA: Welcome back to "Weekend House Call".

We're talking about being heart healthy.

One in five Americans has high cholesterol. Lowering your numbers can lower your risk for heart disease. Where high blood pressure is a problem for older people, cholesterol really doesn't care what age you are and for some people, they can eat right and they can exercise and they can still have high cholesterol.

Knowing your numbers, that can be a good start. That can tell you a lot about your health and about your heart. You want to try and have a cholesterol of less than 200.

We'll talk to Dr. Seides about that, as well. Your bad cholesterol is called LDL. That's what you want to look for. If it's high, it could indicate a risk for heart disease.

Now, if you've had a heart attack or have diabetes, your goal for your LDL should be less than 100. If you're healthy and have no risk factors, shoot for under 160.

Lots of questions about this, and Dr. Seides is going to help us wade through it. We've got an e-mail question now from Alex in Florida.

He asks, "Is it possible to reduce bad cholesterol by only exercising and eating healthier or should I start taking the medicines like statens that may have side effects?" Dr. Seides, the statens medication, that's just amazing how popular these medications have become. Lipitor, for example, is almost a $10 billion industry around the world. How aggressive are doctors being with these staten medications?

SEIDES: Well, I think the reason for their success is no accident and I think in relative terms they are extraordinarily effective and have an extraordinarily safe profile relative to other drugs. There are no dugs that have no side effects, but the side effect profile of statens relative to the number of people who take them is very, very low.

It may be extraordinarily difficult for a person to lower their LDL cholesterol even with the most aggressive dietary and exercise habits. Remember that most cholesterol is not consumed by the individual. Most of it is manufactured by the liver. Cholesterol is an important and natural substance that is key to the functioning of cells in the human body. And so it's important to remember that cholesterol is not a poison, but rather a biological substance when -- that when it occurs in a high concentration can have ill effects.

And for those individuals who manufacture a lot of cholesterol, primarily due to genetic reasons, they just can't get down to healthy levels with diet and exercise. And for those people, staten therapy is both effective and generally quite safe.

GUPTA: And I think that's a point worth repeating, as well, that most cholesterol, a good majority of it actually being produced by the body, probably won't be affected as much by diet.

Let's get to a phone caller now. A lot of phone calls coming in, as well.

Janet from Pennsylvania, welcome to House Call.

JANET: Thank you.

Dr. Seides, I'd like to know what role cholesterol -- what role triglycerides play in cholesterol and why cardiologists watch this area, and if niacin is helpful in its treatment.

Thank you.

GUPTA: That's a good question, as well.

Go ahead, Dr. Seides.

SEIDES: Indeed, it is. Triglycerides are another type of fat that circulate. Triglycerides are much more affected, acutely, by diet than cholesterol is. For example, if you have a fatty meal this morning, your triglycerides will go up very high in the short run. Cholesterol tends to be a phenomenon that is more affected by cumulative dietary habits.

The association between triglycerides and heart and vascular disease is not as strong for triglycerides as they are with -- as it is with cholesterol, and triglycerides are also much more affected by the presence of diabetes and the presence, for example, of alcohol consumption than cholesterol is on an acute basis.

Niacin, as everybody knows, or may know, is a vitamin supplement and niacin can be helpful both in driving down the triglycerides, but it also plays a very important role in elevating good cholesterol, that is the HDL cholesterol that may only be modestly elevated by statens. So niacin is a very important part of our armamentarium in both lowering triglycerides and elevating HDL cholesterol.

GUPTA: OK, Dr. Seides, good advice there. Good tips.

Final thoughts and final tips right after this break.

Stay with us.

COMMERCIAL

GUPTA: Well, that's all the time we have for today.

Dr. Seides joined us from Washington.

I want to thank you very much for joining us, waking up with us on "Weekend House Call". I think a lot of good tips were given today. And if I may give one...

SEIDES: Thank you.

GUPTA: Thank you, Dr. Seides.

And if I may give one final tip, as well. Smoking, we didn't get a chance to talk about it enough. If you stop smoking today, anybody who's a smoker, you'll decrease your risk of heart disease by about 30 percent.

Make sure to join me tomorrow when we delve into the mystery of autism. More and more children are being diagnosed with the disorder. We'll tell you the warning signs and cover the newest research on autism, as well.

That's tomorrow at 8:30 Eastern. I hope you join me.

Thanks for watching.

I'm Dr. Sanjay Gupta.

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