NRI Pulse


Dr. Narendra Singh’s insights into holistic cardiology and the future of heart health


In this extensive Q&A, Atlanta cardiologist Dr. Narendra Singh shares valuable insights into holistic cardiology, stress management, and South Asian heart health. He delves into the importance of comprehensive well-being and offers practical advice for individuals looking to improve their heart health. Dr. Singh also sheds light on emerging trends in heart medicine and the significance of clinical research in advancing cardiac care.

Dr. Singh’s extensive career includes significant contributions to cardiovascular research, participation in over 125 trials, and independent research on various critical topics.

He graduated with distinction from Dalhousie Medical School and completed residency and cardiology fellowships at the University of Toronto. Dr. Singh has held prominent roles in the Canadian Cardiovascular Society and co-founded a cardiology organization in Toronto.

He relocated to Atlanta in 2002, partnering with Northside Cardiology and later joining Atlanta Heart Specialists. In 2020, he established NSC Cardiology and NSC Research. Dr. Singh is a councilor on the board of the Georgia Chapter of the American College of Cardiology.

He serves as a Senior Clinician Scientist with the Canadian Collaborative Research Network, and his achievements include being a “Top Doc” in Georgia and receiving the Distinguished Service Award from the Georgia Chapter of the American College of Cardiology.

Q&A below…

What is holistic cardiology and how does it differ from traditional cardiology?

Holistic cardiology, to me, means looking after the whole body, not just focusing on the heart alone. While the heart is crucial, good health requires attention to all aspects of care. This involves maintaining a healthy diet, overall wellness, regular exercise, and recognizing that people have different belief systems and preferences for therapies. For example, in our South Asian background, many patients prefer Ayurvedic or homeopathic medicines. I support complementary therapies as long as they don’t harm. Stress management is also essential because stress can impact heart health.

How do you address stress management and emotional well-being in your practice?

Stress management is crucial for preventative cardiac care. Stress is a part of our lives, but everyone copes with it differently. It’s essential to find what works for you. This could be exercise, hobbies, music, spending time with pets, or having a good listener. Our focus is on helping patients cope with stress without relying on drugs, as long-term drug use can be problematic.

How do you determine what stress management strategies work best for an individual?

It’s essential to communicate and work with patients individually. We don’t overwhelm them with multiple changes at once. We identify one aspect of their health they can tackle first, whether it’s weight loss, exercise, or diet modification. Starting with something achievable is important and provides positive reinforcement to continue on the right path.

What role does diet play in maintaining heart health?

Diet plays a significant role in heart health. We’ve shifted our focus from solely low-cholesterol diets. Instead, we encourage a balanced diet that includes more protein, complex carbohydrates (whole grains), and fresh fruits and vegetables. The Mediterranean diet, rich in these components, is highly recommended.

Is it challenging to convince South Asians to reduce their carb intake, especially rice and roti?

Yes, it can be challenging, but it’s crucial to modify their diet to make it healthier while still enjoying traditional foods. Shifting to whole grains and moderating carb intake can help maintain a South Asian diet that is healthier for the heart.

Is a vegetarian or vegan diet good for heart health?

A vegetarian or vegan diet can be heart-healthy if it includes sufficient protein sources like lentils. Plant-based diets, when balanced, are generally healthier because they reduce inflammation in the body, a significant contributor to heart disease.

What is inflammation, and are there indicators of it in the body?

When you visit us, one of the essential measurements we take is for a marker called CRP, or C-reactive protein. CRP serves as a valuable indicator of inflammation in the body. While there are several markers we use to assess inflammation, one that people often recall is their white blood cell count, commonly known as the white count. Notably, an elevated white count tends to correlate more strongly with bacterial or acute infections.

CRP, on the other hand, provides a broader perspective on the overall level of inflammation in your body. This inflammation can stem from various sources, including conditions like rheumatoid arthritis or even dental issues. That’s why we stress the importance of maintaining good dental health since it can influence your CRP levels.

Now, let’s connect the dots between inflammation and heart disease. The development of atherosclerotic plaques in the arteries plays a significant role in heart health. Think of these plaques as similar to pimples forming on the inner walls of blood vessels. Two key factors can trigger the rupture of these plaques, potentially leading to severe cardiac events: high blood pressure and inflammation.

Inflammation, in particular, can destabilize these plaques, making them more prone to rupture. When a plaque bursts, it can lead to the formation of a blood clot on the surface, which can block an artery and ultimately result in a heart attack. This is where managing inflammation becomes crucial.

Our goal is to help individuals reduce the level of inflammation in their bodies. Exercise is one of the most effective ways to achieve this. Additionally, incorporating foods rich in antioxidants into your diet can also be beneficial. Moreover, certain medications, such as aspirin and statins, have anti-inflammatory properties and can play a role in reducing inflammation throughout the body, thereby promoting heart health.

Is sugar the big enemy it’s made out to be?

Yes, sugar is a significant concern. Excessive sugar consumption leads to abdominal fat, inflammation, and an increased risk of diabetes. Reducing sugar intake, especially refined sugars, is essential for heart health.

What are common misconceptions about heart health?

A common misconception is that severe blockages are the only cause of heart problems. In reality, even minor blockages can cause heart attacks if they rupture. Regular screenings and early intervention are crucial, especially for those with a family history of heart disease or South Asian ethnicity.

If someone’s calcium score is high, should they be worried?

A high calcium score indicates plaque buildup in the arteries. If your score is high, consult a cardiologist to assess your risk and discuss necessary interventions. However, don’t panic; effective treatments are available.

What are some simple lifestyle changes individuals can make for better heart health?

Maintain a healthy diet with fresh foods and vegetables, stay physically active (even walking helps), and prioritize mental health by managing stress. These changes can significantly improve heart health.

Are there emerging trends in cardiology that excite you?

It’s clear that wearable technology like our watches and similar devices are set to become vital tools. They’ll be able to measure blood sugar levels, providing real-time insights into our metabolism.

Additionally, these wearable devices will help monitor parameters like oxygenation, which can dip during sleep, especially in cases of conditions like sleep apnea. Moreover, wearable tech will allow for convenient tracking of blood pressure and body temperature, potentially serving as early warning systems for impending infections.

Another transformative aspect is the shift towards personalized medicine. With advances in genetics, we’re gaining a deeper understanding of individual risk factors and medication responses. Instead of a one-size-fits-all approach, we’re moving towards tailoring treatments to your specific genetic profile. This move towards personalized medicine promises more effective and targeted healthcare.

The third revolution is the impact of the internet and technologies like AI. While this presents a challenge for healthcare professionals, it’s also empowering for patients. You now have the resources to research your conditions extensively, often more focused than your doctor can be, as they deal with numerous conditions. This information empowerment enables you to take a more active role in managing your health.

In essence, the future of healthcare is marked by the convergence of wearable technology, personalized medicine, and the information age. Regardless of your location, you can access a wealth of information about your health, akin to the resources available at a renowned institution like the Smithsonian Library.

Can you talk about your involvement in clinical research?

:My research centers on evaluating the unique healthcare needs of South Asian individuals and how these needs differ from other patient populations. In addition to my research, I also oversee a clinic in Toronto that serves a sizable South Asian community. The rapid growth of the South Asian population here in Atlanta has also led to increased awareness of the risks associated with heart disease in this group.

Collaboratively, we engage with leading medical centers worldwide, including Duke University, Harvard, the Cleveland Clinic, and Oxford. We actively participate in trials involving pharmaceutical therapies and cutting-edge medical devices, representing the next generation of treatments. These trials rely on volunteers from our patient community and others globally to help determine if these innovations represent significant breakthroughs in healthcare.

One aspect I find particularly fulfilling is the intellectual challenge of this research. It allows me to stay at the forefront of medical advances and offer my patients early access to promising therapies before they become available on the market. It’s truly a win-win situation for all parties involved.

Our research efforts often encompass phase three and phase four studies, which involve interventions that have already demonstrated value. These trials are designed to provide the definitive evidence required for FDA approval. Importantly, they are generally considered safe for participants.

I’m immensely proud of our research team. Despite being a relatively small center, we conduct a substantial volume of clinical research, contributing to advancements in healthcare that benefit patients not only in our local community but also on a global scale.

How can individuals participate in clinical trials?

To participate in a clinical trial, individuals can check government websites or our clinic’s site to find ongoing trials related to their condition. Once identified, a screening visit determines eligibility. If eligible, patients can join the trial, where they receive high-quality care and contribute to medical advancement.

Tell us about the HPP lecture series that you host?

The HPP lecture series aims to provide patients with valuable information in an informal setting. It offers short presentations on heart health topics followed by extensive Q&A sessions. This allows patients to get their questions answered and ensures they leave with a better understanding of their heart health.

In conclusion, what message would you like to share with our readers regarding heart health?

I encourage everyone to be proactive about their heart health. Don’t wait for warning signs; take preventive measures. Get screened, maintain a healthy lifestyle, and consider participating in clinical trials to advance heart care. Your health is in your hands, and knowledge is a powerful tool for a healthy heart.

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