February is American Heart Month—a perfect opportunity for members of the George Washington University community to take a closer look at our own cardiovascular care. GW Today spoke to Andrew Choi, director of noninvasive cardiology, clinical lead for the GW Complex Lipid Program and professor of medicine and radiology in the School of Medicine and Health Sciences (and a double GW alumnus) about what our hardworking hearts need this winter.
Q: What do you wish more people knew about heart health?
A: Love your heart! The heart is an amazing organ—it beats 100,000 times per day, 35 million times a year and 2.5 billion times during a lifetime. To quote Confucius: “Wherever you go, go with all your heart.”
Heart disease risk factors are rising in young individuals in the United States. According to a 2025 report by the American Heart Association (AHA), almost half of U.S. adults have some form of cardiovascular disease. Heart disease claimed more lives in 2022 than all forms of cancer and chronic lower respiratory disease combined.
On a personal note, one of my high school classmates died suddenly from early heart disease. Each of us may know a friend, family member or colleague that has suffered the effects of early heart disease. Today is a great day to become better educated and follow a new path to a heart-healthy lifestyle. Starting prevention earlier could mean a substantially longer and healthier life.
Q: What are the most common cardiac health problems that you see? What behaviors or environmental factors are risk factors with those problems?
A: Obesity, high blood pressure and metabolic issues that affect heart health are on the rise in young adults. The good news is that tobacco cigarette smoking has declined significantly over the past two decades, so now just 2% of high school students and 12% of adults are estimated to smoke regularly. But e-cigarette use (vaping) is on the rise and even short-term exposure may lead to adverse effects on the heart like high blood pressure and increased heart rate, leading to early heart failure.
How about alcohol? For both men and women, the most recent research finds that any amount of alcohol consumption is associated with increased heart risks. This effect was most pronounced in young adults engaging in binge drinking. Over time this can lead to the development of heart failure, increased weight gain and early development of plaque in the heart (atherosclerosis)—the precursor to a heart attack. A small amount of red wine may increase good cholesterol and provide an antioxidant effect, but only in the context of an overall heart healthy lifestyle.
Diets high in processed and ultra-processed foods (mass-produced snacks and breads, instant soups and frozen foods) made from oil, fat and refined carbohydrates are also contributing to higher rates of high cholesterol, high blood pressure and high blood sugar. Consuming energy drinks may affect heart health by causing abnormal heart rhythms and blood vessel spasms.
Q: How can people—especially younger people—take control of their cardiac health?
- Eat well, stay active and practice healthy habits. The AHA’s My Life Check – Life’s Essential 8 is an up-to-date, quick and easy way to assess your current heart health. If you are interested in dieting, stick to plans that are proven and evidence based. Plant-based diets and the Mediterranean diet are my favorites.
- Keep it simple. Use a fitness app like MyFitnessPal to keep track of your dietary habits and your smartphone or a fitness watch to keep track of your steps, aiming for 8,000 to 10,000 steps per day.
- Know your numbers. Get your cholesterol (lipids) checked, including LDL (“bad cholesterol”), body mass index (BMI) and blood pressure. Target to guidelines in conjunction with your doctor.
- Check your lipoprotein (a) at least once in your lifetime. Lipoprotein (a), pronounced "little a," is an LDL-like protein that is genetically determined and non-modifiable. This cholesterol molecule has been linked to the development of early atherosclerosis, even in patients with normal top line cholesterol.
- Start today with exercise! According to the AHA, less than half of Americans engaged in recommended levels of moderate intensity exercise. Consider brisk walking, dancing or water aerobics. Several of my D.C. patients love go-go dancing! Today is the best day to get started—exercise a little bit at a time and make it fun. Everything counts!
Exposure to extreme cold can have unpredictable effects on the heart, so if you are an older adult, take your activities indoors during winter—try an exercise bike, indoor pool activities or follow your favorite fitness YouTuber. For individuals with heart disease or risk factors for heart disease, get help with snow shoveling. If you do have to shovel, dress warmly, takes frequent breaks and use smaller loads.
Q: What are the warning signs of an emergency?
A: If you feel any sudden symptoms of chest pain or pressure, heart palpitations or new tingling in your arm, neck or jaw, seek medical care without delay.
