Tim's Stent: How to Protect Your Heart from Disease

Carolyn Pitts
Jan 4
8 min read

"I'm All Good Now"

Last month, my friend Tim had a stent inserted into a coronary artery—a vessel that supplies oxygen-rich blood to the heart. A stent is a tiny wire tube that props the artery open by squeezing fatty deposits, or plaque, against the vessel wall thereby increasing blood flow.

A stent is typically recommended when blood flow is reduced by 70 percent or more. Tim's coronary artery was 80 percent blocked.

How a stent is inserted into a blood vessel

After the procedure, Tim’s doctor prescribed a blood thinner to reduce the risk of clots forming around the stent. Unfortunately, the new medication required changes to his existing prescriptions, leading to two emergency room visits so far. Still, Tim remains grateful.

“Thank goodness my doctor found the blockage in time to prevent a heart attack,” he told me. “I’m all good now.”

“I hate to break it to you,” I replied, “but unless you embrace meaningful lifestyle changes, fatty deposits will continue to build up in your arteries. There could be additional stents in your future.” I didn’t mention that was only if the doctor found the next blockage in time.

Tim shrugged. “My father had heart disease too. It’s in my genes—there’s not much I can do. And once the doctor gets my meds straightened out, everything will be fine.”

What Is Heart Disease?

Heart disease is the leading cause of death worldwide, accounting for nearly 18 million deaths each year. It’s an umbrella term that includes several conditions affecting how efficiently the heart functions.

Tim has coronary heart disease (CHD), which involves blockages in the arteries that nourish the heart.
Cardiomyopathy results from a weak heart muscle with reduced ability to pump blood.
Arrhythmias, such as atrial fibrillation (AFib), occur when electrical signals cause the heart to beat erratically.
Disorders affecting the valves inside the heart include regurgitation (valves that don’t close completely, allowing blood to pool in the heart), or stenosis (valves that have become stiff and narrowed forcing the heart to work harder).

Doctors closely monitor patients’ blood pressure and cholesterol levels because elevated values increase the risk of heart disease. And, since cholesterol-related plaque can form in blood vessels throughout the body (including your brain), it also raises your risk of stroke.

But Heart Disease is Genetic...Isn't It?

Because heart disease often runs in families, people assume their long-term health is as predetermined as inheriting their father’s aquiline nose or their mother’s hazel eyes. While genetics do play a role, their influence is often overestimated.

The Centers for Disease Control (CDC) explains it this way: “Your genes play an important role in your health, but so do your behaviors and environment, such as what you eat and how physically active you are.”

So, another reason that heart disease runs in families is that in addition to genes, we often inherit lifestyle habits—such as how we eat, cope with stress, and move our bodies (or not).

A large study of more than 10,000 adults published in Circulation in 2022 found that individuals with a high genetic risk for CHD could reduce their lifetime risk by up to 50 percent by following lifestyle recommendations from the American Heart Association. The authors concluded that healthy habits could delay the onset of heart disease by as much as twenty years.

Although our genetic code provides the blueprint for every cell in the body, many factors influence how that blueprint is used. Imagine a neighborhood where all the houses share the same basic design, yet look quite different. Some have garages or basements; others don’t. The builder followed the same blueprint but adapted each home to the size and terrain of its lot.

This is how epigenetics works.

diagram showing how lifestyle affects gene expression — Source: **Epigenetic modulation by life–style: advances in diet, exercise, and mindfulness for disease prevention and health optimization**

Research shows that factors such as diet, physical activity, stress, and mental health influence which genes are turned on or off. This is why a woman can carry the BRCA1 gene mutation for breast cancer and never develop the disease—or why identical twins can experience dramatically different health outcomes.

Lifestyle choices don’t change our DNA, but they significantly affect how genes are expressed. Healthy habits may suppress disease-promoting genes, while poor lifestyle choices can silence protective ones.

“All I Need Are Drugs”

Tim’s perspective reflects a widespread belief: that lifestyle changes are either ineffective or unnecessary once medication has been prescribed. As a Health Coach, I encounter this mindset frequently.

Tim readily admits he’s not prepared to give up his beloved French fries and milkshakes. He is comforted by his doctor's reassurances that any food is safe “in moderation,” so for now, Tim is betting that medication alone will protect him from another procedure—or worse.

Yet, healthy individuals experience temporary vascular impairment after a single fast-food meal. The impact could be serious for someone already battling blood flow issues.

In his book How Not to Die, Michael Greger, M.D., FACLM notes that physicians often hesitate to offer nutritional guidance because of patient pushback. Like Tim, many people would rather rely on medication to protect them than relinquish foods they love (even if those foods are slowly killing them).

In addition, doctors are not trained to fight disease with nutrition. A 2010 review found that only 27 percent of medical schools in the U.S. provide the level of nutrition education recommended by the National Academy of Sciences.

It's interesting to note that there was a time when doctors, many of whom were themselves addicted to nicotine, told their patients that cigarettes were safe "in moderation" until the mountains of research to the contrary became too powerful to ignore.

One of many cigarette ads featuring doctors — "More Doctors Smoke Camels" was one of many cigarette ad campaigns featuring doctors.

Kaiser Permanente cautions that, “Too often, physicians ignore the potential benefits of good nutrition and quickly prescribe medications instead of giving patients a chance to correct their disease through healthy eating and active living.”

A systematic review published in Cureus concluded that combining medication with lifestyle changes offers the greatest benefit. Heart-healthy eating and regular exercise enhance the cholesterol-lowering effects of statins, while mindfulness and relaxation practices reduce stress more effectively than medication alone.

Adherence can be a challenge for both approaches, however. Medications can cause side effects or financial strain (or as in Tim's case, visits to the emergency room). Lifestyle changes require sustained motivation and support.

For people not ready to overhaul their habits, a complementary approach may be a reasonable starting point. Still, study after study shows that those who fully embrace lifestyle changes can sometimes eliminate the need for medication altogether—along with concerns about cost and side effects.

I share Kaiser Permanente’s vision that “The future of health care will involve a paradigm shift—one where the prevention and treatment of disease is centered not on a pill or procedure, but on another serving of fruits and vegetables.”

Heart Disease Is Reversible

As I share in my book, Eight Intentions for Self-Healing, the body has a remarkable capacity to heal itself—if given the opportunity. Lifestyle changes don’t just slow the progression of heart disease; they give our body a chance to undo the damage. Even if you haven’t been diagnosed with heart disease (yet), lifestyle changes reduce risk factors by lowering blood pressure, improving cholesterol levels, and even shrinking fatty deposits in the lining of blood vessels.

Lifestyle change requires intentional effort, however. In chapter two I state, “The difference between those who achieve their wellness goals and those who don’t is their readiness for change.” That’s why the book includes a Readiness Self-Assessment to clarify your Why (motivation), your Who (support system), and your Sacrifices (what you’re willing to release to make space for healing).

As you learned in the last issue, I used to be captivated by sugary foods. Resisting soda, ice cream, and cinnamon rolls was challenging at first—but over time, my tastes changed. What once felt like deprivation became liberation as my craving for sweets melted away. It's because lifestyle changes are difficult that achieving them is so empowering.

In the years since kicking my sugar habit, I have eliminated meat, dairy, eggs, and alcohol from my diet. Because I no longer enjoy the foods I ate growing up, I have to take my own dishes to family gatherings. But it's worth it. Although heart disease runs in my family, my risk of suffering a heart attack or stroke in the next ten years is four percent. (You can calculate your risk using the link below.)

How to Protect Your Heart

If you’re wondering where to begin, Cardio Smart, a website sponsored by the American College of Cardiology, has a wealth of information about the care and treatment of heart disease. The site includes a Heart Disease Risk Calculator so you can self-assess your likelihood of experiencing a heart attack or stroke.

The American Heart Association’s Life’s Essential 8 offers a clear, science-backed roadmap to heart health. It emphasizes healthy eating, regular physical activity, restorative sleep, smoking cessation, and the management of weight, cholesterol, blood pressure, and blood sugar. As noted above, a large study concluded that following the AHA recommendations could reduce lifetime risk by 50 percent in people with a high genetic predisposition for heart disease.

Life's Essential 8 from the American Heart Association — https://www.heart.org/en/healthy-living/healthy-lifestyle/lifes-essential-8

Remember that you don’t need to change everything at once. Small, intentional steps can lead to profound change over time.

It took me years to clean up my diet, learn to manage stress, and make exercise a daily habit. And, I continue to make incremental lifestyle improvements...such as my intention to consume Dr. Gregor's Daily Dozen every day.

Consider reviewing the eight areas of the AHA program and asking yourself: Which one feels most achievable for me right now? Identify a WHY strong enough to power you through inevitable setbacks. Consider finding an accountability partner or hiring a coach. Then, take the first step knowing your journey will get easier in time.

Some risk factors for heart disease—such as genetics, pollution, and socioeconomic conditions—are outside our control. Lifestyle factors, however, largely fall within it.

And that’s where our power lies.

References

Hasbani, Natalie R et al. “American Heart Association's Life's Simple 7: Lifestyle Recommendations, Polygenic Risk, and Lifetime Risk of Coronary Heart Disease.” Circulation vol. 145,11 (2022): 808-818. doi:10.1161/CIRCULATIONAHA.121.053730. https://pmc.ncbi.nlm.nih.gov/articles/PMC8912968/

"Epigenetics, Health, and Disease." U. S. Centers for Disease Control. January 31, 2025. https://www.cdc.gov/genomics-and-health/epigenetics/index.html#:~:text=While%20changes%20to%20the%20genes,of%20protein%20a%20cell%20makes.

"Twin research sheds light on how lifestyle, environment impact health." WSU Insider. Oct 31, 2022. https://news.wsu.edu/news/2022/10/31/twin-research-sheds-light-on-how-lifestyle-environment-impact-health/#:~:text=Based%20on%20data%20collected%20at,Registry%2C%20visit%20wstwinregistry.org

Kolanu, Nikhil Deep et al. “The Differential Impact of Medical Therapy and Lifestyle Modification on Cardiovascular Health and Risk of Adverse Cardiovascular Events: A Narrative Review.” Cureus vol. 16,4 e57742. 6 Apr. 2024, doi:10.7759/cureus.57742. https://pmc.ncbi.nlm.nih.gov/articles/PMC11075795/

Tuso PJ, Ismail MH, Ha BP, Bartolotto C. "Nutritional update for physicians: plant-based diets." Perm J. 2013 Spring;17(2):61-6. doi: 10.7812/TPP/12-085. PMID: 23704846; PMCID: PMC3662288. https://pmc.ncbi.nlm.nih.gov/articles/PMC3662288/

Ostaiza-Cardenas, José et al. “Epigenetic modulation by life-style: advances in diet, exercise, and mindfulness for disease prevention and health optimization.” Frontiers in Nutrition, vol. 12 1632999. 21 Aug. 2025, doi:10.3389/fnut.2025.1632999. https://www.frontiersin.org/journals/nutrition/articles/10.3389/fnut.2025.1632999/full

Fabijana Jakulj, Kristin Zernicke, Simon L. Bacon, Laura E. van Wielingen, Brenda L. Key, Sheila G. West, Tavis S. Campbell, "A High-Fat Meal Increases Cardiovascular Reactivity to Psychological Stress in Healthy Young Adults." The Journal of Nutrition, Volume 137, Issue 4, 2007. https://doi.org/10.1093/jn/137.4.935.

Jackler, R. K., and Ayoub, N. F. (2018) ‘Addressed to you not as a smoker… but as a doctor’: doctor-targeted cigarette advertisements in JAMA. Addiction, 113: 1345–1363. doi: 10.1111/add.14151.