Bob Harper, personal trainer and host of the NBC show “The Biggest Loser,” recently suffered a heart attack.  He reportedly collapsed while working out at the gym and a doctor who was there performed CPR on him.  News of his heart attack came as a great surprise to viewers and fans since he is just 51 years old and appeared to be extremely fit and healthy. (Harper told People magazine that heart problems run in his family, and that his mother died of a heart attack.)

People have a lot of questions about how someone like Bob Harper could have a heart attack and Einstein cardiologist Leandro Slipczuk, MD, PhD, (right) addresses some of the questions:

How does someone who is relatively young and extremely fit have a heart attack?

Data indicates that healthy behaviors such as physical activity, non-smoking, healthy diet and lack of abdominal adiposity (belly fat) could prevent four out of five heart attacks. Nevertheless, other factors such as family history of heart disease, hypertension and high cholesterol provide a significant risk. Sometimes a heart attack can happen even without risk factors and this is why screening is important. 

What is a heart attack?

A heart attack occurs when lack of adequate blood supply from the coronary arteries produces damage to the heart muscle. This is usually caused by coronary atherosclerosis that occurs when cholesterol plaque builds up in the walls of these vessels.

Bob Harper

We understand there are different types of a heart attack and that Bob Harper’s attack happened without warning.  Can you explain the different presentations of a heart attack?  

The typical symptoms of a heart attack are oppressive chest pain that radiates to the arms and/or neck. This presentation is, however, not always present and could show up as shortness of breath or atypical chest pain. 

Can you explain what a coronary calcium scan is?  Which patients would benefit from this scan?

A coronary calcium score is obtained from a CT scan of your heart without contrast material. It takes only a few minutes and shows the effects on your coronary arteries of the lifetime accumulation of risk factors in combination with your genetic background. This outperforms traditional risk factors to indicate the risk of having a heart attack. This is very useful as a tool to intensify prevention medications and change lifestyle behaviors.

Every male older than 45 years old and female older than 55 years old who is not experiencing symptoms and does not have a history of a heart attack, could be a good candidate for the test. 

When it comes to heart health, what are the main risk factors people should be aware of?

The major risk factors for heart disease that can be improved, include: high cholesterol levels, high blood pressure, physical inactivity, unhealthy diet, being overweight and smoking. 

What role does genetics play in heart disease? Can people overcome their genetic risk? 

A strong family history such as heart disease in a father before age 50 or a mother before age 60 is a good reason to ask your doctor about screening tests.

Knowing your risk and the presence of disease can help to be on the right medications and modify your risk factors and prevent a heart attack. 

What role does exercise play in heart health?

Aerobic exercise helps to prevent the development of coronary artery disease. The American Heart Association recommends at least 150 minutes per week of moderate exercise or 75 minutes per week of vigorous exercise (or a combination of moderate and vigorous activity) to improve cardiovascular health. 

How can people know if their fitness regimen is right for them?   

They should visit their doctor to screen for cardiovascular risk factors or coronary artery disease and discuss starting an exercise program.