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Cardiologist warns even some heart healthy preventive measures can backfire
Many habits labelled as “heart healthy” are often adopted with the best intentions - but without a full understanding of the medical context, some preventive practices can quietly backfire. From self-prescribing medications to obsessing over isolated test results, doing the right thing for the wrong reasons can sometimes cause more harm than good.
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Drawing on years of frontline experience, Dmitry Yaranov, a cardiologist and heart-transplant specialist with expertise in advanced heart failure and mechanical circulatory support, breaks down the common cardiovascular practices he has personally stopped following, explaining why evidence, individual risk and medical nuance matter far more than one-size-fits-all prevention. In an Instagram video shared on January 13, the cardiologist reflects on 10 things his years in cardiology have taught him and explains why he has consciously stopped following these habits.
A post shared by Dmitry Yaranov, MD | Cardiologist 🫀 (@heart_transplant_doc)
Dr Yaranov highlights that relying on a single blood pressure reading is not ideal, as blood pressure can fluctuate throughout the day and vary depending on circumstances, stress levels and activity at the time of measurement. He explains, “Blood pressure is highly variable - sleep, stress, caffeine, pain, and even walking into the clinic can spike it. Trends tell the truth, not single readings.”
The cardiologist highlights that chasing “perfect” LDL numbers is not an accurate marker of cardiovascular health, as overall heart health is influenced by several other, more meaningful parameters beyond test results alone. He highlights, “Absolute LDL numbers matter less than plaque burden, inflammation, metabolic profile, and age. Risk-based therapy beats “perfect” lab targets.”
Many people begin taking aspirin as a preventive measure as they get older, but Dr Yaranov cautions that for most individuals, the risk of bleeding associated with regular aspirin use outweighs any potential preventive cardiovascular benefits. He explains, “For most people, the bleeding risk outweighs the preventive benefit. Modern guidance focuses on real cardiovascular risk, not birthdays.”
Palpitations can often be a result of several cardiovascular issues, and dismissing them as merely stress or anxiety can prove to be life threatening. Dr Yaranov emphasises, “Palpitations often come from PVCs, PACs, SVT, Afib, anaemia, thyroid issues, dehydration, or sleep disorders - all missed if we label it ‘anxiety'.”
The cardiologist points out that stress tests do not take soft plaque into account, which is one of the major causes of heart attacks. He explains, “Stress tests miss soft plaque - the unstable plaque that actually causes heart attacks. A normal test doesn't mean arteries are clean.”
Salt is often considered public enemy number one when it comes to heart health, but Dr Yaranov stresses that it is actually essential for normal bodily function, and need not be avoided by metabolically healthy individuals. He explains, “Salt restriction matters for heart failure and some hypertension, but metabolically healthy people don't need aggressive low-sodium diets. Too little can even raise stress hormones.”
The cardiologist highlights that statins are among the most powerful medications for cardiovascular prevention, adding that many commonly reported side effects are largely nocebo-driven rather than true drug-related effects. He states, “Most statin muscle complaints are nocebo-driven, not true intolerance. Statins remain the strongest, most proven drug in cardiovascular prevention.”
Not understanding how GLP-1 drugs work can lead some people to stop taking them once they reach their goal weight, but the cardiologist explains that abruptly discontinuing GLP-1 therapy often results in regaining most - if not all - of the lost weight. Dr Yaranov explains, “Obesity is a chronic, relapsing metabolic disease. Stopping GLP-1 therapy almost always leads to rebound weight and returning cardiometabolic risk.”
Dr Yaranov highlights that many supplements, even natural ones, can interfere with heart medicines and even make certain heart conditions worse. He explains, “‘Natural' doesn't mean safe - many supplements interact with rhythm meds, blood thinners, BP meds, and statins. Some worsen arrhythmias or fluid retention.”
The cardiologist points out that calcium scoring does not take into account soft plaque, hence it is not an ideal diagnostic tool to investigate chest pain or other cardiovascular symptoms. He states, “Calcium scoring can't see soft plaque. It's a risk tool, not a diagnostic test for chest pain or symptoms. Score zero lowers risk but doesn't make you disease or symptom proof.”
Note to readers: This article is for informational purposes only and not a substitute for professional medical advice. It is based on user-generated content from social media. HT.com has not independently verified the claims and does not endorse them.
Source: HindustanTimes
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