The Western Kentucky Heart and Lung Research Foundation and Educational Trust hosted the fourth annual Cardiovascular Symposium on Friday at Knicely Conference Center in Bowling Green, attracting about 200 medical professionals from Atlanta, New York, Indianapolis and more.

The heart experts discussed equipment, medications and complications of heart attacks.

In addition, two fellows from the Medical Center at Bowling Green and a panel of cardiologists discussed the current medical guidelines to managing several cardiovascular issues.

“We are fortunate in cardiology to have so many guidelines, and we’re also unfortunate to have so many guidelines,” said Dr. Aniruddha Singh, the director of preventive cardiology and vascular medicine at the WKHL Research Foundation and Educational Trust.

Dr. Vivak Patel, a cardiovascular fellow at The Medical Center at Bowling Green, discussed the current guidelines for the treatment of hyperlipidemia, or high cholesterol.

High cholesterol means that an individual has extra fats in the bloodstream. This often stems from diets high in dairy, meat and processed foods, physical inactivity, extra weight or obesity, tobacco use and age – which increase someone’s risk for heart disease, heart attack and stroke.

About one in three American adults has high cholesterol, according to the Centers for Disease Control and Prevention.

Treatment frequently leads to the use of statins, medications that can lower cholesterol levels. But hyperlipidemia is a largely preventable disease.

“The guidelines that we have start with heart healthy habits,” Patel said. “That’s the baseline.”

A heart healthy diet includes an abundance of fresh fruits and vegetables, nuts, whole grains, fish and low-fat dairy. And a heart healthy lifestyle includes “consistent cardiovascular exercise,” and the avoidance of tobacco and excess alcohol, Patel said.

Next, Dr. Rich Pham, another cardiovascular fellow at The Medical Center at Bowling Green, reviewed the current guidelines on the treatment of hypertension, or high blood pressure.

When a physician checks a patient’s blood pressure, he or she is measuring the force of blood pushing against blood vessel walls.

High blood pressure indicates that the heart is working harder to pump blood, and contributes to hardening of the arteries, stroke, kidney disease and heart failure, according to the CDC.

Controllable risk factors include smoking, alcohol, diabetes, high cholesterol, obesity, inactivity and unhealthy diets. There are also a few “relatively fixed” risk factors such as sleep apnea, chronic kidney disease, physiological stress and family history, according to Pham.

The 2017 guideline crafted by the American Heart Association and the American College of Cardiology – which is 481 pages of “light reading” – possesses several significant changes, according to Pham.

The first is that there is no longer a classification of “pre-hypertension.” Instead, the early levels of high blood pressure are classified as either “elevated risk” or “stage one.”

“One of the things to take away from here is that there’s a continuous association between elevated blood pressure and increased cardiovascular risks,” said Dr. Jacqueline Dawson Dowe, director of heart failure and cardiac transplant and women’s heart health and vice president of the WKHL Research Foundation and Education Trust. “So whether you’re elevated or stage one, the risk is still there.”

The updated guideline is also significant because it communicates a shift from inevitability to (often) preventability.

“We have to start with lifestyle modification first,” Dowe said. She highlighted the effectiveness of weight loss in reducing cardiovascular risks.

Also new to the guidelines is a recommendation for a high-potassium diet. Essentially, eating potassium-rich foods such as bok choy, mangoes, Brussels sprouts, lentils and kale can counteract hypertension by helping to excrete excess sodium from the body, according to Pham.

In summary, the cardiology experts seem to agree that healthy lifestyles should be prioritized when managing both hypertension and hyperlipidemia before turning to pharmaceutical intervention.