The Q&A
Take Heart

Your Guide to Cardiac Wellness with Dr. Atul R. Chugh of Franciscan Health​

This month, we spoke with Dr. Atul Chugh, MD, FACC, RPVI, a board-certified cardiologist at Franciscan Health, about the evolving landscape of heart disease prevention. From wearable technology to groundbreaking screening methods, Dr. Chugh shares how small lifestyle changes and modern preventative approaches can significantly impact heart health in 2025. Discover why it's never too late to make positive changes and how working with a compassionate physician can help create sustainable, heart-healthy habits.

---

Q: What are the key lifestyle changes people can make for better heart health?
A: First and foremost is adhering to a heart-healthy diet. We now have strong data supporting diets rich in plants and antioxidants. Look for foods with vibrant colors in nature, as color usually indicates antioxidant content. Even following this diet six days a week with one cheat day can be beneficial.

Exercise is another crucial component. The best approach is 30 minutes of moderate exercise most days of the week. You should break a sweat by the end of thirty minutes but still be able to speak in complete sentences. The goal should be 150 minutes per week. If you can maintain this for 40 days, it typically becomes a habit.

Weight loss is also critical. Even a modest 5-10% reduction in body weight can reduce cardiovascular risk by about 25%. Additionally, maintaining proper blood pressure control through lifestyle changes like following a low-sodium diet, and taking medications when necessary, is essential.

Q: What are your thoughts on wearable devices for heart health monitoring?
A: I'm actually quite enthusiastic about them. While consumer-level wearables aren't always the most accurate, they can provide valuable early signals that we can then confirm with medical-grade devices. They're also excellent motivators for maintaining exercise goals and tracking sleep quality. The ability to monitor sleep is particularly important as getting seven to nine hours of quality sleep per night is crucial for heart health. These devices can even help identify conditions like sleep apnea, which is a risk factor for arrhythmias and hypertension.

Q: What diets have the strongest evidence for supporting heart health?
A: The two diets with the most robust data are the DASH diet (Dietary Approaches to Stop Hypertension) and the Mediterranean diet. The DASH diet focuses on high potassium and low sodium intake, which helps control blood pressure. The Mediterranean diet is rich in vegetables, fruits, grains, fish, nuts and healthy oils, particularly olive oil. Studies like the Lyon Diet Heart Study have shown impressive results, reporting up to a 70% reduction in cardiovascular events and death with the Mediterranean diet. Plant-based diets are also showing promising data, though research is still ongoing.

Q: How can people better manage stress for heart health?
A: Stress management is highly individual, but we have good data supporting certain approaches. Transcendental Meditation has shown remarkable results in reducing blood pressure, almost equivalent to the effect of medication. Deep breathing exercises, particularly slowing breathing to 4-5 breaths per minute for 10-15 minutes daily, have also demonstrated significant benefits for blood pressure reduction.

Exercise can be an excellent stress management tool, and proper sleep is crucial. When we're under stress and not sleeping well, our stress hormones (catecholamines) remain elevated, which can increase inflammation and blood pressure. While some people turn to alcohol for stress relief, it can disrupt sleep architecture and often causes more harm than good.

Q: Is there a healthy level of alcohol consumption for heart health? 
A: If we strictly adhere to one unit of alcohol per day for women and two for men, there might be some minor heart health benefits, primarily through a marginal increase in good cholesterol. However, these measurements need to be precise. We're talking about a 12-ounce beer, 6-ounce portion of wine, or 0.5 ounce of liquor. Once you exceed these amounts, you risk increasing blood pressure. The good news is that reducing alcohol consumption to these levels or below can help lower blood pressure.

Q: What are some warning signs people shouldn't ignore?
A: While we often talk about classic symptoms like chest pain radiating to the left arm, shortness of breath, or swelling in the legs, heart warning signs can be quite subtle. This is especially true for two groups: diabetics and women. About 20% of diabetics may have "silent ischemia," experiencing heart attacks without feeling any pain. Women often have more atypical symptoms, which can include unexplained nausea or sweating.

One key warning sign is a decrease in your normal functional capacity. If activities that were easy for you two months ago, like climbing stairs, suddenly become difficult, that's a major red flag that warrants medical evaluation. In general, if something feels wrong, see a healthcare provider. It's better to identify these issues early rather than too late.

Q: Beyond annual check-ups, what screenings should people consider?
A: In 2025, our approach to preventative cardiology has really evolved. Given that cardiovascular disease remains the number one killer in the country, we clearly need to do more than just routine check-ups. I recommend a fasting lipid profile to check cholesterol levels, and once patients reach age 45, I strongly advocate for a heart scan—a CT scan of the heart that takes less than five minutes and usually costs around $49.

This scan is particularly valuable because it can identify calcium in the heart's blood vessels, which is a component of plaque architecture. Finding calcium gives us the opportunity to be more aggressive with preventive measures, such as blood pressure control and managing LDL cholesterol. You don't need a prescription for this scan—you can simply call and schedule it at most major healthcare centers.

This screening is especially important if you have a family history of heart disease, particularly in first-degree relatives (parents, siblings).

Q: Any final thoughts on heart health? 
A: While discussing heart health can be scary, we're in a great era of medicine where almost everything is solvable, and the risks involved with fixing problems are very low. It's never too late to make lifestyle changes. The key is working with a compassionate physician who understands your lifestyle and can help you make sustainable changes.

Remember that every positive change you make has an incremental effect. Think of it like managing expenses—small changes in multiple areas add up to significant improvements. These small changes in aggregate can make a huge difference, and that should be reassuring for most people. You don't have to do everything perfectly, but each step in the right direction counts toward improving your heart health.

Take the first step toward better heart health today. Schedule a same-day cardiology appointment at Franciscan Physician Network Indiana Heart Physicians at 317-893-1900 or visit FranciscanHealth.org/HeartCare for more information.