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00:00How do cultural and dietary habits in the Gulf region influence cardiovascular health?
00:06Patients will come to the clinic a year after a heart attack for a follow-up,
00:10and the first sentence will start saying,
00:12I did not eat meat for the last year.
00:13This is totally wrong, totally wrong.
00:15A balanced diet is everything.
00:17Definitely, we all know that junk food is bad for your health.
00:21We have to reduce the carbs intake in our diet.
00:24Your cholesterol will not increase from eating cholesterol.
00:27The bad cholesterol will increase when you eat carbs.
00:30This is the bad food.
00:32And again, no zero carbs, no zero protein.
00:36You have to find a balanced diet.
00:38This is the key.
00:39Don't go extreme.
00:40Don't go extreme.
00:41I'm not going to name a special diet, but a balanced diet is enough,
00:45and this will make a huge difference.
00:49Today, we're joined by Dr. Shadi Habush,
00:51consultant interventional cardiologist at the Saudi German Hospital here in Dubai.
00:56With over 14 years of experience and 5,000 coronary cases under his belt,
01:01he's one of the region's leading experts in advanced cardiovascular care.
01:05We'll be talking about the numbers everyone should know,
01:08how to check your cholesterol results,
01:11why prevention matters more than treatment,
01:13and the rising importance of LP little a,
01:16the new genetic marker that's shaping the future of heart health.
01:19If you've ever wondered whether you should check your heart health,
01:22this episode is for you.
01:23Dr. Shadi, thank you so much for joining us today.
01:25So, the first question I have in mind is,
01:28what do you think are the essential heart health metrics
01:32that every adult should do and should monitor,
01:36and how often should they monitor them?
01:38As simple as the basics.
01:41I mean, measure your blood pressure, diabetes,
01:45just check your blood sugar, and your cholesterol.
01:49With a simple three questions,
01:51you will be about 80% of heart disease are actually preventable.
01:55Just know your numbers.
01:58Blood pressure, blood sugar, and cholesterol.
02:00So, how do these recommendations change with age,
02:04with lifestyle, with family history?
02:07When we say heart disease,
02:09we all think of an old guy with a heart attack,
02:14and this is actually not true.
02:15Most of the patients that we see nowadays are 34, 35, 40.
02:20Most of the patients I've seen in the last year with heart attacks are below 40.
02:24And a heart disease needs years.
02:27This means the prevention should start much earlier.
02:32And most of the diseases, the high blood pressure, for example,
02:36is a silent killer.
02:38There is no symptoms.
02:39This means you should start the prevention.
02:42You should start monitoring and checking your numbers way earlier,
02:47years and years earlier.
02:48We used to say, check your blood pressure at 30.
02:53Nowadays, we see in the clinics every day,
02:57young adults, not even 20 years old,
03:01younger than 20 years old, with high blood pressure.
03:03So, the earlier, the better.
03:05The current American recommendations for the blood pressure
03:10is to measure your blood pressure at school,
03:12school times, at least once a year.
03:16Starting from 15, 16,
03:18you should measure your blood pressure at least once.
03:22Again, the same for the blood sugar
03:23and for your cholesterol.
03:26Once you have a positive family history,
03:28means your parents with high blood pressure
03:33or cholesterol or diabetes,
03:35this means you should start even earlier.
03:39All right, speaking of cholesterol,
03:41can you explain why somebody with normal cholesterol level
03:45should still check their numbers
03:46and monitor their numbers?
03:49It's not only the number.
03:51We don't look at the number.
03:53I mean, this is a daily question in all clinics.
03:58This is my number.
03:59What shall I do?
04:00This is not how we look at it from our perspectives.
04:04The number is something,
04:07but the whole risks will play a role.
04:10Someone who has 150 LDL cholesterol,
04:13LDL cholesterol upon 150 is high.
04:16I could send the patient home without medication
04:20with an LDL cholesterol upon 150.
04:22For the same number,
04:24if you have other risks,
04:26family history of coronary artery diseases,
04:30diabetes, high blood pressure,
04:33obesity, other risk factors,
04:35150 is not acceptable.
04:38So it's not only the number.
04:40It's many factors that will lead to our disease.
04:4320% of our patients who have heart attacks
04:46have actually normal numbers.
04:48Those numbers are not normal anymore
04:51once you have a heart disease.
04:53And when we look at it,
04:57I mean, the laboratory value will be normal,
05:01normal curve,
05:02and you will just ignore it.
05:03Right.
05:04If you have other risk factors,
05:05this normal limit,
05:07this normal value is not normal anymore.
05:09It will be affected by the other.
05:11How does diabetes, hypertension,
05:14and obesity interact with each other
05:17with bad cholesterol,
05:19the one that you were talking about, LDL,
05:20in driving the cardiovascular risk?
05:23Let's say you are going to have
05:24a heart disease at the age of 80
05:26if you don't have diabetes,
05:28if you don't have high blood pressure.
05:31Those factors will fast forward
05:34your risk of atherosclerosis
05:36will make it happen faster.
05:38And if you have two risk factors,
05:40you will have the disease,
05:42let's say, 10 years younger
05:45or earlier than expected.
05:47And if you have three risk factors,
05:48bad lifestyle, smoking, and so on,
05:51when we look at cardiovascular risk factors,
05:54we always say there are
05:56modifiable risk factors
05:57and unmodifiable risk factors.
05:59Easier said,
06:00there are factors that we can affect
06:01and we can change
06:03and others that we cannot change.
06:05Now, the genes are the things
06:06that we cannot change.
06:07If you come from a family
06:09that have heart diseases,
06:12there is nothing you can do
06:13about this factor.
06:14But adding to this factor,
06:16obesity, untreated diabetes,
06:18neglected high blood pressure,
06:19then your factors to have
06:20atherosclerosis,
06:22which is the heart disease,
06:23will be faster and quicker.
06:25What can people be doing
06:26in their natural lifestyle habitats
06:29that have the strongest evidence
06:31for reducing the risk
06:32of cardiovascular illness?
06:34Lifestyle and daily habits
06:37are actually the actual medicine,
06:40the strongest medicine.
06:42Now, everyone will know
06:44that smoking is bad
06:45and you have to do sports,
06:47but no one will believe
06:48how effective,
06:50what's the impact
06:51of such small daily habits
06:53on your health
06:55other than how we see it,
06:58how we see it as doctors.
07:00Every day,
07:01we see a patient in the clinic
07:03with a heart attack.
07:04This patient had no previous diseases,
07:07no symptoms,
07:08and suddenly he is the one
07:10with a heart attack
07:10in the hospital.
07:11When you go into details
07:13of his life,
07:14he doesn't do sports,
07:16he's obese,
07:17he's under enormous stress,
07:20and he does not sleep.
07:22Such small factors
07:23will actually make a huge difference.
07:26I don't want to talk about
07:31things that we all know.
07:32I want to just to tell you
07:34about the experience
07:35that we see in the clinics.
07:37Patients in our area
07:38have heart diseases
07:4015 to 20 years
07:42younger than patients
07:44in Europe and in the States.
07:45The only difference
07:47is the lifestyle.
07:49And we have
07:49in the United Arab Emirates
07:51world-class hospitals
07:52with everything possible.
07:55I mean, medically,
07:56we are one of the top countries.
08:00The Gulf area,
08:01we have the best hospitals,
08:03the best doctors,
08:03but I think we still need
08:05world-class prevention.
08:08This is what we are missing.
08:09Right.
08:10If we compare,
08:12I have done my training
08:14in Germany.
08:15If we compare
08:16Western Germany
08:17to Eastern Germany,
08:18in Eastern Germany,
08:19we have less heart diseases
08:21and we have better
08:23heart health in general.
08:25And the only difference
08:26is the society awareness
08:27compared Eastern
08:29to Western Germany,
08:30just as an example.
08:31and simple,
08:33small things.
08:35Measuring your blood pressure
08:37regularly.
08:37Once every year.
08:39Measuring your blood sugar.
08:40Go and check
08:41your cholesterol.
08:43I will talk about it
08:44in details
08:44what is checking
08:45the cholesterol.
08:47And doing sports.
08:49You don't have
08:50to be an athlete.
08:52Yeah.
08:52As simple as
08:5490 to 120 minutes
08:56a week.
08:57This means
08:5720 minutes
08:58three to four times a week.
08:59It has to be cardio
09:00or just any exercise.
09:01Anything that is
09:02going to increase
09:03your heart rate.
09:04Yeah.
09:04Okay.
09:04It's good.
09:05If you swim,
09:06if you go,
09:06if you use the stairs,
09:07I don't mind.
09:09Walking in the mall
09:10is not a sport.
09:11It's not a sport.
09:12It's not a sport.
09:12Everyone is coming
09:13and saying,
09:14I walk for 10 minutes a day
09:15or 20 minutes a day.
09:16This is not considered
09:17a sport.
09:18Your body needs to know
09:19that you are doing sports.
09:20Sports outfit.
09:21Relax.
09:22Turn off your mobile
09:23and move.
09:24And your heart rate
09:25must go up.
09:27This is what we consider.
09:28The resistant training
09:29is what we consider sports.
09:3120 minutes,
09:33three to four times a week
09:34will make a huge difference.
09:36Smoking.
09:37Everyone knows
09:38smoking effect
09:38about vaping.
09:41This effect
09:42on cardiovascular health.
09:45Sleeping.
09:45Getting enough sleep
09:46seven hours a day
09:48is going to make
09:49a huge difference.
09:50We see patients
09:51with sleep apnea,
09:53sleep diseases.
09:55They have more risk
09:57to have diabetes,
09:58high blood pressure
09:58and after all,
10:00heart diseases.
10:03Overweight.
10:04Overweight.
10:05You have to try
10:07to stick to your ideal
10:09body weight.
10:10This makes a huge difference.
10:12Losing five kilograms
10:14from your body weight
10:16will reduce your blood pressure
10:18and reduce your sugar.
10:20everyone in the clinic
10:21is afraid
10:22of taking his medication,
10:24blood pressure medication
10:25forever.
10:26Reduce your weight,
10:27do some sports.
10:29You might also
10:30stop the medications.
10:31Okay,
10:31so there's a chance
10:32that you can stop
10:33those medications
10:33if your lifestyle habits
10:35are in order.
10:36Yes.
10:36Okay,
10:37so you may have already
10:38touched upon this
10:39but I'm going to ask you
10:40how do cultural
10:41and dietary habits
10:43in the Gulf region
10:44influence cardiovascular health?
10:46Patients will come
10:47to the clinic
10:47a year after a heart attack
10:49and for a follow-up
10:50and the first sentence
10:51he will start saying
10:52I did not eat meat
10:53for the last year
10:54and he thinks
10:55he has done a good job
10:56and this is extremely,
10:57this is totally wrong,
10:59totally wrong.
10:59A balanced diet
11:01is everything.
11:02Definitely we all know
11:03that junk food is bad,
11:04is bad for your health.
11:06What I have noticed
11:07in our region,
11:09we eat lots and lots of carbs,
11:11lots of carbs,
11:12rice and bread,
11:13whatever the rice color is,
11:16whatever the bread color is,
11:18brown,
11:19white,
11:20it's all carbs.
11:21We have to reduce
11:23the carbs intake
11:23in our diet.
11:25In my opinion,
11:26this plays a huge role.
11:29Your cholesterol
11:30will not increase
11:31from eating cholesterol.
11:33Your cholesterol,
11:35the bad cholesterol
11:36will increase
11:37and triglycerides
11:38will increase
11:39when you eat carbs.
11:40This is the bad food.
11:42And again,
11:43no zero carbs,
11:44no zero protein.
11:46You have to find
11:47the balanced diet.
11:48This is the key.
11:49Don't go extreme.
11:50Don't go extreme.
11:51I'm not going to name
11:52a special diet,
11:53but a balanced diet
11:54is enough
11:55and this will make
11:55a huge difference.
11:56There is this new
11:57kind of new player
11:59in the cardiovascular space.
12:02It's called lipoprotein A.
12:04You just explain to us
12:05a little bit what it is.
12:05We see a lipid profile
12:07for patients
12:08in their clinic every day.
12:09Someone will go
12:10to the laboratory
12:11to do a lipid profile
12:12and come and ask about
12:13how is my good cholesterol,
12:15bad cholesterol,
12:16and so on.
12:17Now, the only thing
12:18that's really important
12:19is for me
12:20as a cardiologist
12:21to see your risk
12:23is the bad cholesterol,
12:25the low-density lipoprotein.
12:28Now, this low-density
12:30lipoprotein
12:30has many components
12:32and one of them
12:33is the apolipoprotein B,
12:35the lipoprotein A,
12:36and the lipoprotein A
12:37is the tail
12:39that is stick
12:40to the LDL particle
12:42and this lipoprotein A
12:46indicates your genes
12:49to develop atherosclerosis.
12:51So, if I will do
12:52the lipoprotein A,
12:54I would know
12:55that how is your body
12:59is going to react
12:59to the whole cholesterol.
13:01So, let me say it again.
13:05The lipoprotein A
13:06is a test
13:07that everyone
13:08should do
13:08once in a lifetime
13:09and with that test,
13:11I will know
13:11what is your,
13:12how is your genes
13:14affecting your
13:16artery walls,
13:18the atherosclerosis,
13:19which is the key
13:21to developing
13:22heart diseases.
13:24Your diet
13:24is going to affect
13:2510 to 15,
13:26at most,
13:2720% of your
13:29entire cholesterol.
13:30most of it
13:32is coming
13:32from your genes
13:33and the lipoprotein A
13:34is,
13:36for us,
13:37we'll tell our doctor,
13:39we'll tell your cardiologist,
13:40how bad
13:41is your body
13:42going to react
13:43with the whole cholesterol
13:44in your body.
13:45So, basically,
13:45you're saying
13:46your genetics
13:47are influenced
13:48by LP little a.
13:49Yeah.
13:50Your genes,
13:51if you have a bad genes,
13:52if you have the genes
13:53to develop atherosclerosis,
13:55you are going to have
13:56a high lipoprotein A
13:58and this is not going
13:59to be affected
13:59by your diet.
14:00Even if you are
14:00the best athlete,
14:01you don't look,
14:03you have an ideal
14:04body weight,
14:05your total cholesterol
14:06is good,
14:07your lipoprotein A
14:08might be high
14:08because you're
14:09having a bad genes.
14:10Okay, I see.
14:10So, who should be
14:11testing?
14:12Everyone should do
14:13a lipoprotein A
14:14once in a lifetime.
14:15Heart diseases,
14:16with all the development
14:17that we have,
14:18still the number one
14:20killer worldwide
14:20compared to all diseases.
14:22And when we say
14:23heart diseases,
14:23we mean
14:24coronary artery diseases
14:25and everyone should do
14:27once in a lifetime
14:28the lipoprotein A test.
14:29With this test,
14:30I will know
14:31that your body
14:32is going to develop
14:33atherosclerosis
14:34maybe faster than others
14:35and with that
14:36I can prevent
14:37maybe a heart attack
14:38and a heart disease.
14:38Oh, wow.
14:39Okay, so it's very important.
14:40Yes.
14:41Okay, so how can
14:42high LP little a
14:43manage in a left side?
14:45Can it be
14:45if someone's
14:46genetically predisposed to it?
14:47There is no medicine
14:48that's going to affect
14:49the lipoprotein A directly.
14:51We need to know
14:52why the lipoprotein A
14:53is high
14:53and treating
14:55the total cholesterol
14:57or the bad cholesterol,
14:58the LDL cholesterol
14:59is going to affect
15:01your lipoprotein A.
15:02So when we treat
15:04the lipoprotein A,
15:05we are going to
15:07lower your
15:09when we treat
15:11the LDL cholesterol,
15:13the bad cholesterol,
15:14we're going to
15:14lower your lipoprotein A
15:16and with that
15:17we're going to lower
15:17your risk
15:18for having
15:19heart diseases.
15:20So basically,
15:21if you have
15:22a high lipoprotein A
15:24and a bad cholesterol,
15:26your doctor should
15:27start you on
15:28the right medications
15:28and with that
15:29you're going to
15:30lower your risk
15:31of having
15:31heart diseases.
15:33Okay, so you mentioned
15:33that a lot of these
15:34patients who came in
15:35with heart attacks,
15:36you said that there was
15:36no prior symptoms.
15:37Some of them,
15:38you couldn't find
15:38symptoms for their
15:39heart attacks.
15:40What early warning signs
15:42can adults
15:44kind of monitor
15:45to see
15:46that could really
15:47save lives
15:48in terms of
15:49cardiovascular health?
15:50Now, this is exactly
15:51the issue.
15:52We shouldn't wait
15:53until symptoms develop.
15:54Your heart is going
15:55to whisper.
15:56It's not going to
15:57say loudly
15:58that there is an issue.
16:00That's why exactly
16:01prevention is a key
16:02in heart diseases.
16:03We should go
16:04and test
16:05even without symptoms.
16:06If you have
16:07a heart disease
16:08in the family,
16:09you have to go earlier
16:10and generally,
16:11everyone should
16:12test at least once
16:13the lipoprotein A,
16:14your basic
16:16cholesterol values,
16:17your sugar
16:18and your diabetes
16:19even without symptoms.
16:21If we want to wait
16:22until the symptoms
16:23are there,
16:23maybe it's too late
16:25to treat the disease.
16:27And usually,
16:29fatigue,
16:31general weakness,
16:32chest pain
16:33is the typical symptom
16:34when it's too late
16:35and your heart
16:36is already affected.
16:39My target,
16:40my goal,
16:40you should go there
16:42before the symptoms.
16:43Right.
16:44So if you can give
16:45one clear message
16:46to people here
16:47in the UAE,
16:47the UAE community
16:48about heart health,
16:49what would it be?
16:50Heart diseases
16:51are the most common
16:54cause of death worldwide
16:55and especially
16:57in our area.
16:58And I just mentioned
17:00that your heart
17:01whispers
17:01and send messages
17:04for you.
17:05Please listen
17:06to these messages.
17:07Start early
17:08with the prevention.
17:09Move 120 minutes,
17:1190 to 120 minutes
17:13a week.
17:14Check your cholesterol,
17:16check your blood pressure
17:17at least once
17:17every year.
17:19Check your blood sugar
17:21at least one time
17:22a year
17:23before the symptoms
17:24start.
17:25Small changes
17:26will make a huge difference.
17:28With my stents
17:29or me as a cardiologist,
17:30the easiest part
17:31is to put the stent
17:32and to open the artery
17:33that's blocked
17:35with a heart attack.
17:36The hard part
17:38is the prevention,
17:39is to prevent
17:40that from happening
17:41from before
17:43it's too late.
17:44Right.
17:44So proactive,
17:45be proactive
17:45about your heart health,
17:46get checkups
17:48and try to live
17:49as much of a healthy lifestyle
17:51as you can possibly.
17:53From your experience
17:54with thousands
17:54of coronary cases,
17:55what misconceptions
17:57do patients have
17:58about?
18:00The easiest part
18:01for the cardiologist
18:02is to put the stent.
18:03The stent is the metal
18:04that we implant
18:05in the coronary artery
18:06to open the artery.
18:08The stent is a small
18:10metal tube
18:11that we implant
18:12in the coronary artery
18:13when it's blocked.
18:14And this is actually
18:15not true.
18:16Doing the stent
18:17is like
18:18frying the road
18:20from the traffic jam.
18:22But fixing the road
18:23itself
18:23is your job
18:24as a patient.
18:25Taking the pills,
18:27the medication
18:27is actually
18:28what is more important
18:30and what is harder.
18:32Planning a stent
18:33is going to take minutes.
18:36It's really
18:37it's actually
18:37the easiest part.
18:39The hardest part
18:40is to come to the hospital
18:41on the right time
18:43to do the proper tests
18:44and starting
18:45the medications
18:45that you need.
18:47The things that I
18:48hear every day
18:50in the clinic
18:50are which I find
18:52really totally natural.
18:55You have high blood pressure.
18:57I don't want to start
18:59on medication
18:59because if I start
19:01I cannot stop.
19:02You started me
19:03on some medications.
19:04Are they for a lifetime
19:05or I will stop them
19:08one day?
19:09What if I start
19:10the cholesterol medication?
19:11It's for a lifetime.
19:12I don't want to start
19:14because if I start
19:15I will not stop.
19:17This is totally natural.
19:19If you stop
19:20your blood pressure medication
19:21your blood pressure
19:22will go up
19:23back to the number
19:24that we had there
19:25before starting
19:25the medication
19:26and that's it.
19:28I don't
19:28I will not
19:30for me
19:31there is no difference
19:32if you take
19:32the medication
19:33or not.
19:33even for your body.
19:35The difference is
19:36what's important
19:37for me is
19:37I want
19:38normal numbers
19:39for you
19:40cholesterol numbers
19:41and high blood pressure
19:42and I mean
19:43normal blood pressure numbers
19:44for the rest of your life.
19:46If you do that
19:47with medications
19:47then it's okay.
19:49If you do that
19:49with lifestyle changes
19:51then again
19:51it's okay.
19:52In many cases
19:53unfortunately
19:54lifestyle changes
19:55will be
19:56first of all
19:57very slow
19:58and second of all
19:59it will not be
20:00enough
20:01to have
20:03normal values
20:04for the rest
20:04of your life.
20:05So this is what
20:06we hear every day
20:07in the clinic.
20:07If you need
20:08the blood pressure
20:08medication
20:09take it.
20:10Your body
20:10have a list
20:11and it will
20:12never forget
20:13every single time
20:15your blood pressure
20:16is high.
20:16Your body
20:17will never forget
20:18every single day
20:19when your blood
20:20where your blood sugar
20:22is high.
20:22This is what's important.
20:24If you take
20:24one tablet
20:25two or three
20:26your body
20:27will not be sad.
20:27Your body
20:28will be sad
20:28when the numbers
20:29are high.
20:30So what new
20:31treatments
20:31or technologies
20:32excite you the most
20:33now in the
20:33cardiovascular space?
20:35Now the classic
20:36medications
20:37that we use
20:38to treat
20:38the cholesterol
20:39are the
20:40treat the cholesterol
20:41are the statins.
20:43Now many people
20:44will have issues
20:45with the statin.
20:45They will have
20:46side effects
20:46or with the
20:47classic tablets
20:49we will not reach
20:50the values
20:53the goal
20:53that we need.
20:54And nowadays
20:55there are
20:55a simpler
20:57way to treat it
20:58the PCSK9 inhibitors
21:00or the
21:02the injections
21:03that you can take
21:04twice a year
21:05and these
21:07these injections
21:08are gonna
21:08lower your
21:09your cholesterol
21:10and they have
21:11almost no side effects.
21:13So if you
21:14need to lower
21:15your LDL cholesterol
21:15because of
21:17your risk
21:17is high
21:18and your statins
21:19did not
21:21bring you
21:22to the
21:22to the goal
21:23to the LDL cholesterol
21:24level that we need
21:25you can use
21:26the injections
21:27and they will
21:27lower your LDL cholesterol
21:30to the
21:31to the value
21:33that you need
21:34and
21:36people who struggle
21:37to take the medications
21:38every day
21:39the injections
21:40are twice a year
21:41you have to take them
21:43first time
21:44the second one
21:45the loading those
21:45is after
21:46three months
21:47and after that
21:48you're gonna need them
21:49only once
21:50every six months
21:51and things
21:53that are really
21:53important nowadays
21:54are the AI
21:55in interventional cardiology
21:57for us
21:59accuracy
22:00precision
22:01is extremely
22:02important
22:03and time
22:04is important
22:05and
22:06nowadays
22:07it's not like
22:08it's
22:08it's not
22:09it's not
22:10news anymore
22:11we
22:12we actually
22:14use AI
22:14every day
22:15in our practice
22:16we used to
22:17judge with our eyes
22:18the size
22:20where to start
22:21where to
22:22where to
22:22where to stop
22:23and nowadays
22:24with a simple
22:26click
22:27we know
22:27where to start
22:28where to stop
22:29how big
22:30how small
22:30the coronary artery
22:32stent
22:33should be
22:34and
22:35this is actually
22:37extremely nice for us
22:38it's much faster
22:40very accurate
22:41I'm sure
22:42it's hard
22:43to
22:43live without
22:44now
22:44the AI
22:45it has changed
22:46the practice
22:46all over
22:47so you had mentioned
22:48before that
22:49a lot of the patients
22:51who are coming in
22:51with the
22:52cardiovascular problems
22:53are much younger
22:54than they were before
22:55is there a reason
22:56for that
22:57why is this
22:57the case
22:58many are
23:00relating
23:01the young patients
23:02nowadays
23:02to the
23:03vaccines
23:04that we have
23:05and this is actually
23:05not true
23:06I mean
23:07we have
23:08seen
23:08more
23:11myocarditis
23:12the heart muscle
23:13inflammation
23:13after the
23:14vaccines
23:16this is true
23:17but coronary artery
23:18diseases
23:18young patients
23:19with heart attacks
23:20are more nowadays
23:21for other reasons
23:22in my opinion
23:23the first one is
23:24we
23:25we know now
23:26more
23:27why do actually
23:28people will
23:30die
23:31or will have
23:31a disease
23:32we used to say
23:33someone just died
23:35and we don't know
23:35the cause
23:36so we have
23:36we understand more
23:38and we do more
23:39screening
23:39this is one
23:39one part
23:40the second part
23:41is our lifestyle
23:42I mean
23:42we don't eat well
23:44we don't move
23:45we
23:46people are
23:48obese nowadays
23:49compared to before
23:50and
23:51lifestyle
23:52in the last
23:53studies that
23:54I read
23:56the most
23:57common risk factor
23:58modifier risk factor
23:59in the gulf
24:00that we
24:01as a reason
24:02why do we have
24:03heart attacks
24:04younger than
24:05Europe and other countries
24:06is actually
24:08because we are
24:09lazy
24:09we don't move
24:10stuck to the
24:10computer
24:11because we are
24:12lazy
24:12we don't move
24:13enough
24:13compared to
24:14before
24:14that's why
24:15we have
24:15more heart
24:16diseases
24:16nowadays
24:17vaping
24:18and smoking
24:20stress that we
24:20have nowadays
24:21in our
24:22new
24:23lifestyle
24:24plays a rule
24:25and that's why
24:25we have
24:26heart disease
24:26younger
24:27in my opinion
24:27someone said
24:28once I heard
24:29that most
24:29heart attacks
24:30happen on a
24:30Monday
24:31is that true
24:31it's not true
24:32it's not true
24:33heart attack
24:34can happen
24:35anytime
24:35heart attack
24:36can happen
24:36for anyone
24:40heart attacks
24:41in women
24:42are actually
24:42more fatal
24:43than men
24:44we used to
24:44think
24:44or we thought
24:45that
24:46a heart disease
24:47are actually
24:47men diseases
24:48it's not true
24:49the most common
24:50the most common
24:51sign
24:52the first
24:53the first sign
24:54for a heart attack
24:56in women
24:57are actually
24:57unfortunately
24:58is death
24:58they don't
24:59treat the hospital
25:00more than men
25:01and that's
25:02because they
25:02don't have
25:03the actual
25:03symptoms
25:03that we
25:04have
25:04or the lady
25:04will say
25:06it's okay
25:07I will wait
25:08I will wait
25:09and this is
25:11what actually
25:12happens
25:13unfortunately
25:13sadly
25:14is it because
25:15of the maybe
25:15neglecting to
25:16go to the
25:17doctor when
25:17she needs to
25:18go because
25:18she's taking
25:19care of the
25:19family
25:19stuff like
25:20that
25:20it doesn't
25:21I mean
25:22it's hard to
25:23believe
25:23but this is
25:24actually what
25:24happened
25:24great
25:24well I think
25:25we've covered
25:26a lot of
25:26things and
25:27thank you so
25:27much for
25:28joining us
25:31thank you so
25:32to
25:32you
25:32thank you so
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