Heart disease: what physicians say, in their own words

Last updated September 20, 2026.

Read together, the 449 KevinMD posts on heart disease say one thing consistently: the fights are about prevention, not treatment. Nobody on the site argues about stenting a heart attack; they argue about statins for people who have never had one, about pills for mild hypertension, about CPR on a ninety-year-old, and about whether a cardiologist’s income shaped the test. Posts mentioning statins or cholesterol have never fallen below 12 percent of the record in any period, and the statin argument that began in 2013 is being reargued in 2025 by a lipidologist who calls the drugs “the gospel.” Where physicians disagree, on primary prevention, on blood pressure thresholds, on the value of a coronary calcium score, and on what CPR is for, both sides are on this page under their own names.

This page is a maintained record of what physicians, cardiologists, and patients have written about heart disease and its prevention on KevinMD.com, a physician-authored publication founded in 2004 by Kevin Pho, MD, a board-certified internal medicine physician in Nashua, New Hampshire. It draws on 449 essays and podcast transcripts with a cardiovascular term in the title, published between May 2004 and September 2026 by 202 named contributors, 229 of the posts bylined by physicians and 19 of them podcast episodes with transcripts. Of the 449, 104 were published from 2023 onward and 36 in 2026 alone, the most since 2010. Every claim is attributed to a named author with the month it was published, quoted in the author’s own words, and linked to the original.

This record covers coronary disease, blood pressure, stroke, cardiac arrest, atrial fibrillation, heart failure, prevention, and cardiology as a specialty. Old age and its care are on the Aging and dementia: what physicians say, in their own words record; CPR at the end of life is argued here and on the End of life: what physicians say, in their own words record; the weight-loss drugs now marketed for the heart are on the GLP-1 drugs: what physicians say about Ozempic and its successors, in their own words record. Each section opens with a direct answer, then what named authors have said, in the order they said it. Where authors cite studies or figures, the source is named alongside the author and the figures are theirs as of the date they wrote. Patients are cited at the same weight as physicians and identified as such. Contributors who sell services into this subject are identified where they are cited. This is physician opinion and experience, not clinical guidance.

What do physicians say about statins and cholesterol?

The statin argument on KevinMD has run in two rounds. The first, in 2013 to 2016, was about the guideline that replaced cholesterol targets with risk scores and would have put most people over sixty on a statin; the second, in 2025, is a lipidologist re-examining the hypothesis itself. Physicians agree the drugs work after a heart attack and disagree about everyone else. Statins or cholesterol appear in 27 percent of posts in 2014 to 2018 and 41 percent since 2025.

Eric Van De Graaff, MD, a cardiologist, wrote in August 2010 that “The theoretical benefit of widespread statin use has translated into a real effect,” in “Statins for heart disease and stroke, and debunking statin myths.” John Mandrola, MD, a cardiologist, wrote in December 2011 that “As one of the world’s most effective and commonly used medications, statins provide great writing topics,” in “Let’s close the chapter on statin safety.” Kevin Pho, MD, wrote in November 2013 of the 2013 guideline that “It represents a fundamental shift in how we prescribe statin drugs,” in “New cholesterol guidelines: The statin decision lies with patients.” Janice Boughton, MD, an internist, wrote in April 2014 that “not everyone with high cholesterol or other cardiac risks will actually have a heart attack or stroke,” in “What do European doctors say about our guidelines for statins?” Richard Young, MD, a family physician, wrote in March 2015 of the 2013 guideline that “this would result in a large increase in the number of Americans taking statins,” in “We are overprescribing statin medications for high cholesterol. Here’s why.” Dr. Saurabh Jha, a radiologist, wrote in April 2016 that “Statins enjoy the metaphysical carapace, the immunity from falsification, which not even God enjoys,” in “God is in the statins.” Dr. Saurabh Jha, a radiologist, wrote in September 2016 that “The latest fight between orthodoxy and free inquiry is about the benefits and harms of statins for primary prevention,” in “The statin wars expose 2 factions in medicine.” Robert Centor, MD, an internist, wrote in October 2016 that “I would not encourage statins for true primary prevention,” in “Statins as primary prevention: Helpful or harmful?” Henry H. Ting, MD, MBA and Victor M. Montori, MD, wrote in November 2016 asking of a healthy 55-year-old “Should you take a statin for the rest of your life,” in “Should I take a statin to lower my risk of a heart attack?” James B. Rebitzer, PhD and Robert S. Rebitzer, MBA, economists, wrote in July 2023 that “Subsequent clinical trials have established that statins decrease heart attacks and prolong life,” in “The evolution of lighting vs. cholesterol treatments: a tale of innovation and value.” Larry Kaskel, MD, an internist and lipidologist, wrote in August 2025 that statins opened an era of “Drugs that treat risk more than illness, and surrogate markers more than suffering,” in “Are we repeating the statin playbook with lipoprotein(a)?” Larry Kaskel, MD, an internist and lipidologist, wrote in September 2025 that “Statins were not just recommended; they were the gospel,” in “The ignored clinical trials on statins and mortality.” Larry Kaskel, MD, an internist and lipidologist, wrote in October 2025 that “the ‘LDL-C hypothesis’ continues to dominate our guidelines, our CME, and our prescribing habits,” in “Re-examining the lipid hypothesis and statin use.” Cliff Dominy, PhD, a scientist, wrote in March 2026 that “Cholesterol-lowering drugs like statins will, on average, extend your life,” in “Statin safety and efficacy: What recent studies reveal.”

What do physicians say about blood pressure?

Physicians on KevinMD do not dispute that untreated hypertension kills; they dispute where treatment should start, and the same author has been calling the mild-hypertension guidelines unproven since 2014. Since 2023 the posts are about who has it, Black Americans first, and whether the cuff at home is accurate. Blood pressure or hypertension appears in 31 percent of posts in 2010 to 2013 and 41 percent since 2025.

Erin Marcus, MD, an internist, wrote in April 2010 that “When her gynecologist told her she had high blood pressure, Marie had a simple solution: switch doctors,” in “High blood pressure treatment that patients need to know.” David K. Cundiff, MD, an internist and Cochrane reviewer, wrote in January 2014 that “the evidence basis for the drug treatment recommendations for mild hypertension in this report is in dispute,” in “A call to retract the JNC-8 hypertension guidelines.” Pamela Wible, MD, a family physician, wrote in January 2014 citing Harrison’s textbook that “urban blacks have twice the prevalence of hypertension as whites,” in “The unidentified cause of one man’s hypertension: Racism.” Kenneth Lin, MD, a family physician, wrote in January 2015 that “the few randomized trials of antihypertensive medications in this population did not show improvements in cardiovascular outcomes or mortality,” in “Treating mild hypertension: The benefits are being questioned.” Janice Boughton, MD, an internist, wrote in April 2015 that “10 to 15 percent of patients with high blood pressure will have resistant hypertension,” in “Resistant hypertension? Or failure to take blood pressure correctly?” Steven Reznick, MD, an internist, wrote in July 2016 of patients over eighty, that the old thought was “maybe we need to keep their blood pressure a bit higher,” in “Blood pressure in the elderly: How low is too low?” Peter Ubel, MD, wrote in January 2020 that “it is good to make sure you have earned the diagnosis,” in “How do you know if you have hypertension and need medication?” Jie Shi Yan, MD, wrote in April 2023 that “hypertension disproportionately affects Black Americans, with 56 percent of this population affected,” in “How do we reduce hypertension in Black Americans?” Jordana Cohen, MD, a nephrologist and hypertension specialist, wrote in June 2023 citing the Journal of Hypertension that “out of the 100 best-selling blood pressure devices on Amazon, 81 percent had not undergone adequate clinical validation testing,” in “How the U.S. blood pressure validated device listing (VDL) ensures accurate readings and revolutionizes hypertension control.” Jeremy Bock, MD, a cardiologist who performs the procedure, wrote in August 2024 that “Hypertension, known as high blood pressure (HBP), is a global epidemic,” in “Renal denervation: a solution for hypertension patients worldwide.” David K. Cundiff, MD, an internist, wrote in January 2026 that his 2012 Cochrane review concluded “there was no evidence that blood pressure-lowering medications for mild hypertension reduced heart attack strokes or any other important outcome,” in “Are mild hypertension guidelines driven by pharma ties?”

What do physicians say about stroke?

On stroke the physicians writing are emergency physicians, neurologists, and, increasingly, the survivors and the children of people who died: an internist who had one, a physician whose father had his inside a certified stroke center. The clinical posts are about the clock; the recent ones are about what comes after. Stroke appears in 36 percent of posts in 2010 to 2013 and 43 percent since 2025.

ER Stories, MD, an emergency physician writing under a pen name, wrote in September 2010 that “this time limit (and the data for TPA’s efficacy is only OK at best) causes mass chaos and annoyance,” in “The TPA time limit for acute stroke causes mass chaos in the ER.” Harlan M. Krumholz, MD, a cardiologist, wrote in February 2011 of New York’s certification program that “mortality rates were modestly better at the stroke centers than at the other centers,” in “Do stroke centers improve patient outcomes?” Charles A. Pilcher, MD, an emergency physician, wrote in October 2011 of the sixty-minute door-to-needle goal that “that leaves only 35 minutes for the rest of the process,” in “tPA is the standard of care for stroke but with significant risks.” Natasha Burgert, MD, a pediatrician, wrote in October 2013 that “Despite its seeming rarity, pediatric stroke is not uncommon,” in “Pediatric stroke is not uncommon.” Steven H. Rudolph, MD, a neurologist, wrote in August 2015 that “The most important factor in successful stroke treatment is time,” in “How this neurologist used Twitter to help treat a stroke.” Michael Brant-Zawadzki, MD, a neuroradiologist, wrote in March 2019 that stroke remains common “striking someone in the United States every 40 seconds,” in “After Luke Perry: a greater awareness of stroke symptoms.” Joanne Loethen, MD, an internist, wrote in February 2021 that “Confusion was replaced by the realization: I was having a stroke,” in “After a stroke, a physician experiences true vulnerability.” Hoag Memorial Hospital Presbyterian wrote in May 2021 of the pandemic that “stroke death rates increased as people elected to stay home with stroke symptoms rather than seek immediate help,” in “Suspect a stroke? Act F.A.S.T.” Rida Ghani wrote in February 2026 that “Post-stroke cognitive impairment (PSCI) is common, persistent, and one of the strongest predictors of long-term disability,” in “Post-stroke cognitive impairment: the hidden challenge of recovery.” Lori Nelson, MD, a physician, wrote in June 2026 that “My father had his stroke inside a stroke center,” in “Anchoring bias killed my father inside a stroke center.” Kayvan Haddadan, MD, a pain physician, wrote in September 2026 that after stroke that “pain is common, often under-recognized, and can significantly hinder rehabilitation,” in “Post-stroke pain management: what the 2026 guidelines say.”

What do physicians say about cardiac arrest and CPR?

Physicians on KevinMD write about CPR from both ends: the bystander version they want every citizen trained in, and the hospital version they say is performed on people it cannot help. The public’s estimate of CPR survival is several times the real figure, and physicians say that gap is what makes the end-of-life conversation hard. Cardiac arrest, CPR, or defibrillator appears in 12 percent of posts in 2010 to 2013 and 35 percent in 2023 and 2024, the year of Damar Hamlin’s collapse.

Monica Williams-Murphy, MD, an emergency physician, wrote in June 2012 that “it’s morally wrong to do CPR on 90-year old great grandmas,” in “Burdening families with CPR decisions in the face of futility is cruel.” Maria Yang, MD, a psychiatrist, wrote in February 2013 that “The experience of performing CPR and attending to patients who are critically ill contribute to physician preferences against CPR,” in “Why physicians tend to decline CPR and other heroic measures.” Christopher Johnson, MD, a pediatric intensivist, wrote in May 2013 that “Family observation of CPR is a hot topic among critical care and emergency physicians,” in “Should families be allowed to witness CPR?” Jim deMaine, MD, a pulmonologist, wrote in June 2014 of a woman with a signed DNR who collapsed in a store that “Shoppers at the store immediately started CPR and 911 summoned the medics,” in “CPR without informed consent in the elderly.” Caroline Tredway, MD, wrote in September 2015 after watching a medical drama that “All actors should have to take at least one CPR class,” in “All actors should have to take a CPR class.” Janice Boughton, MD, an internist, wrote in May 2017 that “Denmark has been quite aggressive in training and encouraging citizens to perform CPR,” in “Bystander CPR makes a difference.” Skeptical Scalpel, MD, a surgeon writing under a pen name, wrote in March 2018 that “the public’s unrealistic expectations about CPR make it difficult for physicians to discuss end-of-life issues,” in “The public’s unrealistic expectations about CPR.” Mick Connors, MD, a pediatric emergency physician, wrote in January 2023 that “America got a real glimpse of the horrors of CPR on national TV,” in “The emotional side of CPR: Reflecting on the challenges of resuscitation in the wake of Damar Hamlin’s collapse.” Carolyn Boscia, MD, a hospitalist, wrote in January 2023 of Damar Hamlin that “No doubt, timely and effective CPR and defibrillation saved his life,” in “The reality of CPR: a powerful tool with serious consequences.” Ketan Tamirisa, Jonathan Jose, and Ronak Patel, MD, wrote in January 2023 citing the Sudden Cardiac Arrest Foundation that “there are over 356,000 out-of-hospital SCA annually in the United States,” in “The urgent need for widespread CPR and AED access.” Jon Marinaro, MD, a critical care physician who runs an ECPR program, wrote in September 2024 that “the limitations of CPR are becoming increasingly apparent, particularly in cases of out-of-hospital cardiac arrest,” in “The hidden flaws of traditional CPR: Why we need a new approach to save lives.” Alisa Berger, MD, wrote in February 2025 asking of CPR “should we be doing this in such a knee-jerk fashion,” in “Why doctors must talk about death: the truth about CPR and end-of-life care.”

What do physicians say about stents, blood thinners, and atrial fibrillation?

On procedures, cardiologists on KevinMD have said since 2010 what the trials later confirmed: a stent in stable disease does not fix the patient, and a specialty that became procedural over two decades is being asked to think again. On atrial fibrillation the questions are newer, whether to screen for it with a watch and whether anticoagulation must be for life. Stent, angioplasty, or bypass appears in 22 percent of posts in 2010 to 2013 and 17 percent since 2025; atrial fibrillation in 11 percent since 2025.

Larry Husten, PhD, a cardiology journalist, wrote in February 2010 of a live-televised ablation that “The TV producers pulled every trick in the book,” in “Treating atrial fibrillation with catheter ablation on TV may not be ethical.” John Mandrola, MD, a cardiologist, wrote in July 2010 that “After a stent is placed the words, ‘you are fixed,’ is often said,” in “Stents to treat blocked heart arteries are not an easy fix.” Carolyn Thomas, a heart attack survivor, wrote in December 2010 collecting survivors’ accounts, including her own, that “after the first stent was implanted, an area in my artery near the stent dissected,” in “Heart attack symptoms in women, in their own words.” John Mandrola, MD, a cardiologist, wrote in July 2011 that “warfarin-treated patients are in therapeutic range only two-thirds of the time,” in “How dabigatran is an atrial fibrillation paradigm shift.” Shannon Brownlee, a health journalist, wrote in August 2011 that “Angioplasty and stents, on the other hand, are backed up by more than belief and theory,” in “Decision aids need to be used for angioplasty and stents.” Hans Duvefelt, MD, a family physician, wrote in February 2016 that “Over just two decades, cardiology became a procedural specialty,” in “Will cardiologists become slow and methodical internists again?” Aseem Desai, MD, a cardiac electrophysiologist, wrote in July 2020 that “AFib is the most common heart rhythm disorder worldwide, affecting more than 33 million people across the globe,” in “The connection between atrial fibrillation and burnout.” Aseem Desai, MD, a cardiac electrophysiologist, wrote in January 2021 that “Traditionally AFib was considered a disease of aging,” in “Extreme athleticism and the risk of atrial fibrillation.” Martin C. Young, MD, a physician, wrote in December 2023 of his own episode that “my management never included a proper physical exam,” in “My battle with atrial fibrillation.” Radhesh K. Gupta wrote in February 2026 that “One in five strokes is caused by atrial fibrillation (AF),” in “Why Medicare must cover atrial fibrillation screening to prevent strokes.” Saurabh Gupta, MD, wrote in May 2026 of a trial that asked “Do patients with atrial fibrillation really need to take blood thinners for the rest of their lives to prevent stroke,” in “Rethinking blood thinners for atrial fibrillation patients.” David K. Cundiff, MD, an internist and Cochrane reviewer, wrote in June 2026 estimating that “a substantial number of people per year worldwide may have fatal bleeding associated with anticoagulant treatment,” in “Heparin for acute coronary syndrome: a closer look.”

What do physicians say prevents heart disease?

Physicians on KevinMD agree that diet, exercise, and not smoking prevent heart disease and disagree about almost everything a clinic can add to that: the calcium score, the risk calculator, aspirin, salt, the athlete’s ECG. The pattern since 2011 is a family physician calling a screening test low value and a cardiologist writing that patients need it. Diet, exercise, or lifestyle appears in 25 percent of posts in 2014 to 2018 and 33 percent since 2025; women in 15 to 13 percent across the record.

Erin Marcus, MD, an internist, wrote in March 2010 that “As her doctor handed her the prescriptions for the blood pressure pills, he also gave her some advice,” which was to stop the salt, in “10 salt reducing tips that can lower your blood pressure.” Richard N. Fogoros, MD, a cardiologist, wrote in July 2011 that the debate stems from “our failure to clearly identify what we wish to accomplish in establishing such a screening policy,” in “Should young athletes be screened for heart disease?” Kenneth Lin, MD, a family physician, wrote in August 2011 that “coronary CT screening is low-value health care at best, and wasteful and potentially harmful at worst,” in “Coronary CT screening is low value health care.” Carolyn Thomas, a heart attack survivor, wrote in November 2011 of the patients who do best, that “They take on all the modifiable risk factors at once,” in “What patients with heart disease need to learn from cancer patients.” Albert Fuchs, MD, an internist, wrote in July 2013 that “Lots of evidence shows that eating more salt raises blood pressure,” and much less that it raises the risk of stroke or heart attack, in “A low salt diet for high blood pressure: Where’s the evidence?” Kenneth Lin, MD, a family physician, wrote in March 2015 citing an analysis that “both the ACC/AHA and Framingham-derived risk calculators overestimated cardiovascular risk by 37 to 154 percent in men,” in “Are cardiac risk calculators accurate?” Kevin R. Campbell, MD, a cardiologist, wrote in February 2016 that “Women must understand their individual risk and actively work to take control of their own heart health,” in “4 questions every woman should ask about heart disease.” Heather Shenkman, MD, a cardiologist, wrote in April 2019 that “Poor diet quality has been identified as the leading cause of death and disability in the United States,” in “As a cardiologist, I’m concerned that California isn’t very heart healthy.” Olubadewa A. Fatunde, MD, MPH, a cardiology fellow, wrote in May 2019 that under the 2019 guideline “aspirin is no longer recommended for those without cardiovascular disease,” in “The new aspirin guidelines: The media does a disservice to patients.” Deepti Bhandare, MD, a cardiologist, wrote in November 2019 that “The ketogenic (keto) diet is a high-fat, very low carbohydrate diet,” in “What does a cardiologist think of the keto diet?” Anand Shah, MD, MBA, a cardiology and preventive medicine fellow, wrote in February 2025 that “Prevention relies on three pillars: identifying at-risk individuals,” intervening, and monitoring, in “The role generative AI can play in cardiovascular education for patients.”

What do physicians say about heart failure?

Heart failure is the part of this record physicians say is under-treated by their own profession: a cardiac surgeon who wants it approached like cancer, a hospitalist who says three quarters of admitted patients could be on all four drug classes and are not, and a call to look for amyloid in the older patients everyone has labeled idiopathic. Heart failure appears in 15 percent of posts in 2019 to 2022 and 21 percent since 2025.

Brian Lima, MD, a cardiac surgeon, wrote in May 2019 that “the call to action when heart failure is diagnosed is comparatively subdued and haphazard,” in “It’s time we approach heart failure like cancer.” Marc Semigran, MD, a cardiologist, wrote in March 2022 that “genetic dysfunction also underlies many forms of heart disease and should be more widely considered in the clinic,” in “It’s time to start approaching heart disease like breast cancer.” Radhesh K. Gupta wrote in February 2026 citing a 2024 study that “between 10 percent and 18 percent of older adults with heart failure have unrecognized ATTR-CM,” in “ATTR-CM screening: the missing link in heart failure diagnosis.” Benjamin P. Geisler, MD, Jeffrey L. Greenwald, MD, and Kathy May Tran, MD, hospitalists, wrote in March 2026 that “The results cannot necessarily be generalized to sicker patients presenting with decompensated heart failure,” in “Managing acute heart failure: evidence from the DOSE trial.” Vimal George, MD, an internist, wrote in April 2026 citing studies that “nearly three quarters of patients hospitalized with heart failure could receive all four classes,” in “Why heart failure care requires spaced repetition for doctors.”

What do physicians say about cardiology as a specialty?

Cardiologists on KevinMD have been unusually candid about money: that imaging paid well and was ordered accordingly, that interventional cardiology was a revenue engine for hospitals, and that the specialty became procedural because procedures were paid. The newest posts are about what a fellow learns when volumes fall, who gets into the field, and who signs when the AI reads the echo.

Larry Husten, PhD, a cardiology journalist, wrote in September 2009 that “Interventional cardiology, in particular, has been utilized as a seemingly endless font of revenue for many institutions,” in “Will there really be an impending shortage of cardiologists?” John Mandrola, MD, a cardiologist, wrote in February 2010 that “surely, the historically generous reimbursement of imaging has a role in decision making,” in “Does your cardiologist deserve his salary?” Wes Fisher, MD, a cardiologist, wrote in August 2012 that “cardiology is still a procedural field that pays hospital systems pretty well,” in “In a financial squeeze, a way forward for academic cardiologists.” Sandeep Mangalmurti, MD, JD, a cardiologist and attorney, wrote in February 2015 citing 429 closed claims that “the most common patient allegations against cardiologists and other clinicians were diagnostic errors,” in “What we can learn from cardiology-related malpractice claims.” Hans Duvefelt, MD, a family physician, wrote in February 2016 of 1979, that “Cardiology was a purely cognitive specialty,” in “Will cardiologists become slow and methodical internists again?” Solomon Bienstock, MD, an incoming cardiology fellow, wrote in May 2020 of the pandemic that “The procedural and imaging volumes have declined significantly, and therefore, there is less opportunity to learn cardiology,” in “I will be a cardiologist with a subspecialty in resilience.” Stephen Freiberg, MD, an anesthesiologist, wrote in July 2020 that “a cardiologist’s assessment of anesthetic risk or prediction of perioperative complication, means nothing to me,” in “I don’t care what your cardiologist says.” Adam Tannoukhi wrote in February 2025 that “challenges persist, including concerns about data accuracy, privacy, and regulatory approval,” in “The future of cardiac monitoring: AI-powered wearables in practice.” Tarpan Patel wrote in June 2026 that “There is no Current Procedural Terminology (CPT) code for reviewing patient-generated wearable data,” in “How to use patient wearable data in cardiology visits.” Teddy A. Teddy, MD, a cardiologist, wrote in July 2026 citing estimates that “Black cardiologists comprise only 3 to 5 percent of the cardiology workforce,” in “Diversity in cardiology is a power problem, not a pipeline.” Teddy A. Teddy, MD, a cardiologist, wrote in September 2026 that “Traditional malpractice principles designate the interpreting cardiologist as the primary legal decision-maker,” in “When AI misses a diagnosis, the cardiologist signs alone.”

What do physicians disagree about?

On statins for primary prevention, Eric Van De Graaff, MD, and John Mandrola, MD, defended the drugs in 2010 and 2011, Robert Centor, MD, would not encourage them in 2016, and Larry Kaskel, MD, called them the gospel in 2025; Robert Centor, MD, an internist, wrote in November 2013 that “The controversy rests then on primary prevention,” in “The cholesterol debate: Seeking truth where there is no truth.” David L. Katz, MD, a preventive medicine physician, wrote in December 2013 that as between competing statin criteria “The answer may not matter a lot, because it’s the wrong question,” in “The statin debate ignores the signal of lifestyle as medicine.” On mild hypertension, David K. Cundiff, MD, has argued since 2014 that the drug thresholds are unproven, and Dustyn Williams, MD, in 2018 called the lower 2017 thresholds logical from a patient safety perspective. On CPR, Janice Boughton, MD, wants every citizen trained, and Monica Williams-Murphy, MD, calls it morally wrong on the very old. On what cardiologists owe the climate, Erika Maria Moseson, MD, a pulmonologist, wrote in September 2020 that the evidence reduces to “Don’t light things on fire and breathe them into your lungs,” in “Apocalypse now: climate change, cardiac arrest, and the price of inaction.” Kurt Miceli, MD, MBA, a physician, wrote in April 2026 that “Turning toward planetary-health advocacy raises the question of what cardiologists are being asked to do and should do,” in “Why cardiovascular medicine should focus on patients, not environmental advocacy.” The record does not resolve these; it dates them.

What would fix it? What physicians propose.

Asked what would fix cardiovascular care, physicians on KevinMD propose shared decisions instead of thresholds, screening paid for where the evidence is strong (atrial fibrillation, amyloid) and stopped where it is not (coronary CT in the well), guideline drugs actually prescribed in heart failure, and a payment system that stops rewarding the test over the conversation.

James McCormack, PharmD and Mike Allan, MD, a pharmacist and a family physician, wrote in December 2013 of the 2013 cholesterol guideline, that “the patient is the one who should decide what’s best,” in “The new cholesterol guidelines: Emphasize patient preference.” Michael J. Barry, MD and John B. Wong, MD, internists, wrote in December 2013 that “In many ways, the new guidelines should simplify lipid management,” in “Cholesterol management with patients requires shared decisions.” Robert Pearl, MD, a physician executive, wrote in May 2014 that “Fixing the problem starts with education,” in “How do we fix the high blood pressure problem?” Marc Semigran, MD, a cardiologist, wrote in March 2022 that for definitive answers “we should turn to genetic testing to best advise patients and their families,” in “It’s time to start approaching heart disease like breast cancer.” Jon Marinaro, MD, a critical care physician who runs an ECPR program, wrote in September 2024 that “Extracorporeal cardiopulmonary resuscitation (ECPR) emerges as a natural solution to these limitations,” in “The hidden flaws of traditional CPR: Why we need a new approach to save lives.” Radhesh K. Gupta wrote in February 2026 that “Medicare must add AF screening to its preventive services for beneficiaries aged 65 and older,” in “Why Medicare must cover atrial fibrillation screening to prevent strokes.” Radhesh K. Gupta wrote in February 2026 that “Medicare must establish targeted ATTR-CM screening programs in geriatric and cardiology practices nationwide,” in “ATTR-CM screening: the missing link in heart failure diagnosis.” Vimal George, MD, an internist, wrote in April 2026 that “Heart failure management is not a single decision,” in “Why heart failure care requires spaced repetition for doctors.”

How has the heart disease conversation changed since 2004?

The record starts with Kevin Pho’s short commentaries on news and studies from 2004 to 2011, 101 of them, counted here but not cited, and with 29 board-review case questions, counted but not cited. The 2009 to 2013 posts are cardiologists and journalists writing about money and procedures: Husten, Mandrola, Brownlee, Fisher. The 2013 to 2016 posts are the statin and blood pressure guideline wars. The record thins from 2017 to 2022 to about a dozen posts a year. Since 2023 it has doubled, and the subjects are CPR after Damar Hamlin, atrial fibrillation screening, heart failure drugs, wearables, AI, and the statin argument reopened. Wearables, Apple Watch, or AI appear in 20 percent of the 2025 and 2026 posts against 1 percent in 2014 to 2018.

Two things did not change. The word guideline appears in 12 to 40 percent of posts in every period, because in heart disease the argument is always with a document. And the physicians most skeptical of cardiology’s tests and drugs have been generalists and, since 2025, a lipidologist.

Term 2004 to 2009 (78 posts) 2010 to 2013 (139 posts) 2014 to 2018 (81 posts) 2019 to 2022 (47 posts) 2023 to 2024 (34 posts) 2025 to 2026 (70 posts)
Statins or cholesterol 27 percent 26 percent 27 percent 19 percent 12 percent 41 percent
Blood pressure or hypertension 21 percent 31 percent 54 percent 43 percent 32 percent 41 percent
Stroke 22 percent 36 percent 33 percent 30 percent 35 percent 43 percent
Cardiac arrest, CPR, or defibrillator 8 percent 12 percent 7 percent 9 percent 35 percent 6 percent
Stent, angioplasty, or bypass 13 percent 22 percent 11 percent 11 percent 6 percent 17 percent
Atrial fibrillation 1 percent 11 percent 10 percent 11 percent 6 percent 11 percent
Heart failure 4 percent 11 percent 9 percent 15 percent 6 percent 21 percent
Guideline 12 percent 17 percent 16 percent 28 percent 21 percent 40 percent
Diet, exercise, or lifestyle 12 percent 27 percent 25 percent 30 percent 24 percent 33 percent
Women 18 percent 15 percent 15 percent 17 percent 9 percent 13 percent
Wearable, Apple Watch, or AI 0 percent 0 percent 1 percent 9 percent 26 percent 20 percent

Term frequencies are the share of posts in each period whose text contains the term at least once, computed on the September 20, 2026 corpus of 449 posts with one stored expression per term.

The KevinMD heart disease corpus by the numbers

These figures describe the set of KevinMD posts this page draws on. They are counts of what KevinMD has published, not prevalence or clinical data.

Measure Value
Posts in the corpus 449
Published 2023 or later 104
Published in 2026 (through September) 36
Named contributors 202
Posts bylined by physicians (MD or DO) 229
Podcast episodes with transcripts 19
Kevin Pho’s 2004 to 2011 commentaries, counted but not cited 101
Board-review case questions, counted but not cited 29
Posts not indexed, counted but not cited 87
Most frequent contributors Larry Kaskel, MD (13); John Mandrola, MD (12); Larry Husten, PhD (5); Eric Van De Graaff, MD (5); Janice Boughton, MD (5)
Title matches excluded 181: posts whose text mentioned the subject fewer than three times, and one figurative use of heart

How this page was built and how it is updated

The corpus was assembled from title searches for heart disease, heart attack, heart failure, cardiac, cardiovascular, coronary, myocardial, cardiology, statin, cholesterol, LDL, lipid, blood pressure, hypertension, stroke, atrial fibrillation, arrhythmia, stent, bypass, catheterization, cardiac arrest, CPR, defibrillator, aspirin, calcium score, echocardiography, stress test, sudden cardiac death, pacemaker, and women’s heart disease. Posts whose text mentioned the subject fewer than three times were excluded as false matches, 180 in all, most of them short news links. Term frequencies were computed against the full text of each post. Posts are counted whether or not they are indexed; citations on this page are limited to posts that are indexed and can be verified at the link. 87 posts in the corpus are not indexed, including Kevin Pho’s 2004 to 2011 commentaries and podcast episodes without transcripts; they are counted but not cited. Board-review case questions and a podcast episode sponsored by a drug company are counted but not cited. Quotations are taken verbatim from the original posts and were checked against the source text by script. Author credentials are as they appeared in the byline at publication; where the byline gave none, the credential is the one the post itself states. Patients, journalists, and economists are cited at the same weight as physicians and identified as such. Contributors who sell services into this subject are identified where they are cited: Jeremy Bock, MD, performs renal denervation; Jon Marinaro, MD, runs an extracorporeal CPR program. Every source is linked in the sentence that cites it, and the full list appears at the end of the page. The closest archive is the Cardiology tag. Related records: Aging and dementia: what physicians say, in their own words, End of life: what physicians say, in their own words, Primary care: what physicians say, in their own words, and Artificial intelligence: what physicians say, in their own words.

This page is updated as new essays on heart disease are published on KevinMD. When it is updated, the date at the top changes, the counts in the tables are recomputed, and new named claims are added to the relevant section. Nothing is removed unless the original post is removed. An author who believes a quotation on this page misrepresents them can write to Kevin Pho and the page will be corrected.

To cite this page: Pho K. Heart disease: what physicians say, in their own words. KevinMD.com. Updated September 20, 2026. https://kevinmd.com/heart-disease

The 93 KevinMD posts cited on this page, in order of publication