Q&A With Dr. Alan Golston
By Maria Dolan
Cardiologist Alan Golston, MD, reflects on what's changed and what hasn't with heart health.
You've been a cardiologist for many years. What big changes have you seen?
There's been a very rapid acceleration of advances over the last 35-45 years, including the first heart transplant and the first bypass in the late 60s. Since I began medical school in 1977, it was confirmed that clot formations cause heart attacks, and clot dissolving drugs were developed to treat them. The first coronary angioplasty was performed in 1979, which led to coronary stenting, now the preferred treatment of heart attacks. The development of implantable defibrillators has saved many lives as well.
What do you think is the most significant change?
The development of statin medications for treating elevated cholesterol and preventing heart disease. Millions of people have benefited from these drugs.
What are some common misconceptions about heart disease?
Patients often believe that removing blockages with stents or bypass surgery will cure them. Unfortunately, this just isn't the case. The underlying condition that led to the blockages is still there and more are likely to occur — especially if patients don't change the habits and patterns that helped bring it on in the first place. The solution isn't to fix one or two "plumbing" problems, but to change the habits that caused the disease in the first place.
What type of habits would you like to see changed to improve or protect heart health?
Start active prevention strategies with good lifestyle habits. Consuming a healthy diet and avoiding saturated fats is essential. Getting "good fats" in your diet, like olive oil, canola oil, and fish oils — especially from salmon — is important. And establishing habits, such as getting regular exercise, not smoking, and maintaining an appropriate weight are also important.
When should patients start paying attention to their heart health?
As soon as they can. Atherosclerosis — the build up of plaque in the arteries — can begin very early in life. The earlier we develop healthy habits, the easier it is to sustain a healthy lifestyle. Probably the best early intervention is to avoid ever smoking.
What do you enjoy most about this specialty?
The patients. Cardiologists don't often cure their patients since many of them have a chronic disease like atherosclerotic cardiovascular disease or congestive heart failure. However, our treatments help patients live with their disease. It's very gratifying to see patients' lives improved as a result of our treatments.
What do you enjoy doing in your free time?
Family is my first priority. I enjoy photography, golf, kayaking, and skiing. I'd like to do more bicycling. I need to exercise more, and practice what I preach.
Do you see any big advancements on the horizon in the next decade or two?
There are many areas that hold promise. The advancement of surgical and catheter-based techniques used to treat some heart conditions will make these procedures less invasive and safer. The area of genetics will allow patients at risk for certain cardiac conditions to be identified so they can receive directed therapy. Cell-based therapies may lead to restoration of cardiac function and other treatments.