Ep. 46: From Blockages to Big Data: Redefining Cardiovascular Prevention with AI and Policy — with Dr. Yele Aluko, Interventional Cardiologist

What if our healthcare system isn’t broken — but is performing exactly as it was designed? In this episode, Dr. Regina Druz sits down with Dr. Yele Aluko, an interventional and structural-heart cardiologist who spent years opening blocked arteries and implanting heart valves before stepping back from the bedside to work “upstream” on health policy and population health. Together they trace how a heart attack is really the end stage of a decades-long metabolic storm that crosses every medical specialty, why health literacy and personal advocacy matter so much, and how artificial intelligence could either close the health-equity gap or blow it wide open. They also explore the often-overlooked environmental drivers of chronic disease — air pollution, allergies, indoor air quality, light, and social deprivation — and where the most transformative progress in prevention may come from over the next five years. This conversation is educational only and is not medical advice.

Watch on YouTube: A video version of this episode is available on the Own Your Heart Health YouTube channel. Subscribe to be notified of new episodes.

Episode Chapters

[00:00] Introduction & Welcome
[01:30] A Death at Fifteen: Why He Became a Doctor
[03:39] From the Cath Lab to Health Policy
[07:47] Why the System Is Built for Sickness, Not Prevention
[10:41] The Metabolic Storm That Crosses Every Specialty
[13:26] What a Young Person Should Do Now
[17:11] Health Literacy & Advocating for Yourself
[19:23] The Top Three: Diet, Movement & Risk Personalization
[23:05] Personalized Risk & HeartWell.ai
[25:28] Can AI Close the Health-Equity Gap — or Widen It?
[29:13] AI as a Surrogate Medical Advisor: The Dangers
[32:41] Using AI Wisely: Prompts, Guardrails & Your Doctor Visit
[37:55] Environmental Drivers: Pollution, Allergies & Indoor Air
[40:47] Light, Social Deprivation & the PREVENT Score
[44:45] Predictions for the Next Five Years
[48:20] Prevention at Scale — Built Outside the Industry
[50:17] Personal Health Agents & Closing Thoughts

Transcript

[00:00] Introduction & Welcome

Dr. Regina Druz (00:02): Welcome to Own Your Heart Health. I’m Dr. Regina Druz, your holistic cardiologist. This week we’ll dive into common heart health concerns, uncovering root causes and unpacking scientific discoveries and controversies. The information provided does not constitute medical advice. Please contact your healthcare practitioner before making any changes that may impact your health.

Dr. Regina Druz (00:40): Good morning, everyone. I’m super excited today to have Dr. Yele Aluko with me — and I’ll give him a chance to introduce himself in a moment. Dr. Aluko is a renowned cardiologist who, like me, walks in the lane of integrative cardiology, but he brings his view from a different vantage point: health equity, and how it relates to the epidemic of chronic disease we’re seeing right now. That frames the discussion in very different terms — not just for our patients, but for our practitioners. So, Dr. Aluko, I’m going to ask you the question I ask every guest on my show: how did you grow up to be who you are today?

[01:30] A Death at Fifteen: Why He Became a Doctor

Dr. Yele Aluko (01:30): That’s a very interesting question, and I want to first thank you for having me on your podcast. I was fifteen years old when I made the decision to become a doctor. My mother and I had gone to visit a family member at a hospital in my home country of Nigeria, and a patient was wheeled through the emergency room in cardiac arrest. She died right there in the emergency room. Her husband was there — I remember his piercing wailing and all the chaos around us. That was the day I decided I was going to become a doctor. Why? I was a young teenager — altruistic, naive — and I thought that if I became a doctor I’d be able to prevent any family member of mine from suffering that fate. One thing led to another, I did become a doctor, and I’m also a cardiologist, like you.

[03:39] From the Cath Lab to Health Policy

Dr. Regina Druz (02:41): So what happened during your cardiology journey? For me it was an evolution that started maybe ten to twelve years into my career. I walked into my hospital one day — I was a section chief for nuclear stress testing at the time — and I saw these patients lined up, and some of them were so young. I thought, there must be something we’re doing wrong. We were doing a lot of things right, but there were also a lot of things we were doing wrong, and I decided to figure out what. That’s how I emerged as an integrative cardiologist. But what about your journey — how did you evolve?

Dr. Yele Aluko (03:39): You and I actually trained at the same institution — what’s called Weill Cornell today. When I was there it was New York Hospital. I did general cardiology, then interventional cardiology, and after I started practice I became a structural-heart cardiologist. So I was the doctor opening blocked arteries with stents and balloons, and also the doctor who could put a new heart valve into a patient without opening the chest. What I realized along the way was that in the catheterization lab I could most often save the life of the patient in front of me — that was real, tangible, concrete value. But over time a frustration built up, because I kept seeing similar patients coming back with the same kind of preventable disease, and those recurrences were shaped by forces no procedure could fix.

Dr. Yele Aluko (05:00): Later in my career I went to business school, and sitting in an organizational-strategy class I realized something fundamental: the way healthcare is administered — the strategy behind the industry — is not positioning it to be successful in preventive health. It doesn’t support what we call population health. Our health system isn’t poorly run; it’s performing exactly as it was built to perform. It was just built for the wrong thing. It’s designed to be a sickness industry, an illness industry. Once you realize that’s the design problem, you can’t get away from the fact that the fundamental issue isn’t at the bedside. So I began a quest to address the design flaws that led to the patients who came to me. That was my aha moment, and two years later I made the very difficult decision to retire from the bedside and move upstream — to Big Four health-industry consulting. I became a health consultant so I could bring my knowledge upstream and impact the industry itself in a more transformative way.

[07:47] Why the System Is Built for Sickness, Not Prevention

Dr. Regina Druz (06:47): Give us an example, because this is such a common issue. Patients come in and say, “My doctor isn’t listening to me. I have all these questions, and all they want to do is drop a prescription.” The patients who see me say, “My doctor told me I must be on a statin, I must be on this, I must be on that — but I want to understand what’s going to work for me. How should I manage myself?” And that shouldn’t be just drugs — it has to be diet and exercise and everything else. So on that bigger consulting stage, did you manage to shift the focus and reframe the problem? Were you able to change the course?

Dr. Yele Aluko (07:47): No — the course will not change until we have health policy, execution, and accountability for health policy. Specifically, if we don’t have a policy around population health that prioritizes prevention and prioritizes eliminating the adverse social determinants of health — the risky environments or behaviors that cause illness — we can’t fix the problem. It won’t be solved until we address advocacy issues like universal health insurance that provides access to care, improvements in health literacy, and accountability for care, rather than a fee-for-service model where the whole industry is centered around profit. But you bring up a good point: you have patients asking how they can empower themselves. As a cardiologist, you’ll relate to the fact that a lot of what we see in cardiovascular medicine is driven by cholesterol, yes, but also by inflammation. Very few cardiologists connect their day-to-day work with where the disease actually starts — and it starts way before people end up in your clinic or my cath lab. In my world I was treating blockages in the arteries, but that blockage is the end stage of a long metabolic process that probably took twenty years: obesity, insulin resistance, type 2 diabetes — what we call the metabolic syndrome. The audience may have heard of polycystic ovarian syndrome; it got renamed just about a month ago to polyendocrine metabolic ovarian syndrome.

Dr. Regina Druz (10:20): Named recently, right?

[10:41] The Metabolic Storm That Crosses Every Specialty

Dr. Yele Aluko (10:41): Right. So a gynecologist treating a woman with polyendocrine metabolic ovarian syndrome most often isn’t thinking about the cardiovascular risk that’s already happening. The hepatologist treating someone with fatty liver disease isn’t focused on the fact that the problem is beyond the liver — that the liver disease is because of something else. The kidney doctor managing early kidney disease, and even the ophthalmologist seeing diabetic changes in the retina — the specialization of medicine is built such that each of us is looking at our own organ. There was a running joke when I was a fellow: “I’m a doctor below the neck, above the waist, on the left side of the chest.”

Dr. Regina Druz (11:40): In my fellowship we’d ask our fellows, “Are you a plumber or an electrician?” You’d have been in the plumber category, because you were in the cath lab, and the electrophysiology doctors were the electricians. They didn’t really have a moniker for us cardiac-imaging doctors, so they just called us non-invasive — we were the photographers, taking pretty pictures.

Dr. Yele Aluko (12:13): The point I’m making is that this metabolic storm — this insulin resistance — doesn’t respect specialty boundaries. It creates devastation throughout the body: it damages the liver, the kidneys, the blood vessels, the eyes, the heart. It starts very silently and builds up for decades. The fragmentation with which we approach our patients isn’t a clinical accident; it’s the way the system was designed. I’m a super-specialist — my job was to open blockages and put in valves without giving much regard to what happened before. Like I said, I had my aha moment, and I’ve shifted my focus to understanding the health-policy decisions that are made: Why do we not have universal health coverage in America? Why do we have health disparities? Why do we not prioritize population health?

[13:26] What a Young Person Should Do Now

Dr. Regina Druz (13:26): This is so important, because a lot of the time patients are focused on measures of end-stage disease — for example, a calcium score or identifying plaque composition in the coronary arteries. Not that those aren’t important; they’re profoundly important. But they’re the late stage of disease. So let’s say a young person is listening — late teens, early-to-mid twenties. What would you tell them to do right now so that thirty or forty years later they’re not on the table in your cath lab? What should they be doing, or not doing?

Dr. Yele Aluko (14:29): Fundamentally, individuals need to take ownership of their health. A twenty-year-old man or woman should understand what kinds of illnesses their population is exposed to. If we talk about a twenty-year-old man whose father or grandfather had a heart attack — what causes a heart attack? We need to start with the fundamentals: What is a heart attack? Health literacy is very important, and I emphasize that because only about 11% of the American population is proficient in health literacy. We need to know the risk factors for common diseases so we can avoid them. People have to learn to make responsible personal choices about diet and lifestyle, such as physical activity. You need to understand the consequences of not being physically active, of smoking, of drinking alcohol in excess — and the consequences of things outside your control, like exposure to environmental pollution or living in neighborhoods without access to healthy food, where you’re buying ultra-processed food from grocery stores. And a 50-year-old man needs to understand that prostate cancer may be diagnosed as early as fifty. When you go to your doctor, there should be a checklist of what you need to get out of that appointment: you need to know your vital signs, your blood pressure, your BMI, your PSA — the metrics you should ask for, and you need to track them longitudinally over time.

[17:11] Health Literacy & Advocating for Yourself

Dr. Regina Druz (17:11): So a lot of the work falls on the patient to advocate for themselves, and I see that as a big issue in our healthcare system, because, as you said, health literacy is low. Young people feel young — it’s difficult for them to envision what will happen twenty or thirty years down the road — and the discussion gets framed within specialty bounds. It’s very frustrating to me: you mentioned the gynecologist managing polyendocrine metabolic ovarian syndrome, or managing hormones for women, and rarely, if ever, do they look at the most significant driver of mortality in women, which is cardiovascular. We suffer from this tunnel vision consistently. So let’s go to a top three — let’s compare yours to mine. What do you consider the top three must-do lifestyle interventions for any individual, at any age, to overcome environmental disturbances and insulin resistance — to change the landscape in which the metabolic storm arises? Because we’re all going to have some metabolic disturbance as we get older. We know tissue-level insulin resistance is associated with aging — impaired nutrient sensing is one of the hallmarks of aging. So what are the top three you’d say everyone must do?

[19:23] The Top Three: Diet, Movement & Risk Personalization

Dr. Yele Aluko (19:23): We should understand that we are products of what we put inside our bodies — and by that I mean diet and lifestyle choices. If you’re eating a heavily ultra-processed diet, or diets laden with calories, you’re creating a substrate where the metabolic storm can thrive. So number one: know your diet, eat healthy, and control what you put in your body — smoking, excessive alcohol — because in combination these things create the environment where your body becomes vulnerable to metabolic disease, which can damage multiple organs. Number two: the body should not be sedentary. Regular exercise of some form is important. I’m not saying you have to go to the gym seven days a week, but develop the discipline of having some kind of schedule.

Dr. Regina Druz (20:55): Consistency.

Dr. Yele Aluko (20:58): Consistency — that word is perfect, because it’s consistency, not intensity. If you work out like a fiend for one hour on a Monday and don’t come back for a month, you’re not doing yourself any justice. And third: try to be more aware of what your personal medical risks are.

Dr. Regina Druz (21:25): Personalization — risk personalization.

Dr. Yele Aluko (21:27): Precisely. Risk personalization helps you understand your individual risk. Do you have high blood pressure? Is it controlled? Having it is one thing; whether it’s controlled is another — and it must be controlled. If you have abnormal lipids and you don’t like taking medications — understood — then give dietary modification a good, honest try, one to two months maximum. Because if it doesn’t work, we have to be honest with ourselves: some people are genetically predisposed to high cholesterol, and for them diet alone may not work. If you’ve given it a real shot for two to three months and it’s still high, you’re at a crossroads and you must make a decision. A high cholesterol is linked with heart disease, and the way to avoid that risk is to lower it. If dietary intervention hasn’t worked, it’s a good idea to go on a cholesterol medication and bring it down to normal. Then you have another option: you can go off it and see if it stays down with disciplined dietary regimens — but if it goes back up, then you happen to be a person who needs medication.

[23:05] Personalized Risk & HeartWell.ai

Dr. Regina Druz (23:05): This is a great approach, and in many ways it parallels what we do here at Holistic Heart Centers. We run an app called HeartWell.ai that models a person’s risk in real time and lets us pick appropriate nutritional, medical, and supplement interventions to show a patient how they can reduce their cardiovascular risk. What you’re bringing up is so important: cardiovascular risk is a composite, and it’s not the greatest composite, because most of it is derived from population-level data — and the person in front of us may or may not be a good fit for the populations that were studied. That’s where personalization comes in. Being able to model the impact of various interventions before they happen is an opportunity for patients to be proactive and take control, because even within your top three there’s so much variability — in nutritional approaches, in exercise approaches. We know what works in different populations, but once we have a person’s genetic data, biomarker data, and even where they’re coming from in terms of their zip code, we can model something more specific to them. Now, I know you also use artificial intelligence in your work. I use it daily — that whole HeartWell.ai platform is an agentic AI platform, and, full disclosure, I’m the one who built it, so hopefully others will use it too. How do you see the role of this new technology? Do you believe AI is going to open the doors to better population health and even resolve some healthcare inequities, or is it going to do the opposite?

[25:28] Can AI Close the Health-Equity Gap — or Widen It?

Dr. Yele Aluko (25:28): Very important question. I think artificial intelligence is by far the most disruptive technology in the history of humankind. Is it going to make health better or worse? Is it going to close health-equity gaps? AI can do both. It can close gaps or blow them wide open; it can improve health or make care less accessible. It all depends entirely on us — not the technology. By “us” I mean industry leaders and health consumers. Let me start with a fundamental principle: technology in and of itself enables an organization’s strategy; it doesn’t create the strategy. AI is a multiplier of good things and bad things. If you drop it into a system, it amplifies whatever the system is already built to do. So if you have a system that doesn’t prioritize population health and you drop AI into it, it’s not going to improve population health. Our system tends to produce point solutions, and left to that logic AI will do the same — faster, cheaper, at scale. It can produce a thousand brilliant point solutions. That’s the industry perspective. From the person’s perspective, AI is going to help people understand, more quickly and efficiently, what’s happening to their bodies. With all the wearables and devices, you can understand in real time what’s happening to you, what therapies are out there, and how to interpret clinical trials you ordinarily wouldn’t understand — including the statistical variances you mentioned.

Dr. Yele Aluko (28:22): What’s being said about a medication working for a particular disease because of a clinical trial — does that actually reflect your own personal biology? So the outcome from AI is going to depend on exactly how it’s deployed within the industry and how individuals use it. The current industry is optimized for fee-for-service, for transactions, and AI will make that quicker — but it isn’t solving the problem of the lack of universal healthcare.

[29:13] AI as a Surrogate Medical Advisor: The Dangers

Dr. Regina Druz (29:13): That’s very true. Like every physician, I have patients who come in having already uploaded their labs into one of the AI chatbots, with a whole printout. But I recently gave a presentation at the annual conference for the Institute for Functional Medicine, and as I was preparing I found some troubling research: investigators from Stanford documented that as AI models advanced in their capabilities, they dropped medical disclaimers from their answers. So someone going into an AI chatbot now, putting in whatever information they have — and potentially opening the door to hallucinations — often doesn’t get a warning that this is a machine, not a medical professional. That creates a situation where patients, trying to make themselves better and to personalize their care because of the lack of universal healthcare and access, turn to AI as a surrogate medical advisor. But that advisor may take them down the wrong path. At the conference I gave a real-life example from a physician Facebook group I belong to: a patient handed their physician a very long prompt advising them to upload their real labs into an AI chatbot — which of course isn’t HIPAA-protected — and come up with a “cardiovascular wellness score.” I asked the audience, “Have you ever heard of a cardiovascular wellness score?” Because there really isn’t one. We have our population metrics, but this patient was asking AI to take their labs and invent a score — and they’re going to trust it, because it sounds convincing and personalized, even though it basically doesn’t exist. So it can make things more efficient, but it can also compound the problems. How are you using it in your work? What’s your take — what should cardiology do? We obviously use a lot of AI, mostly for ECG and echocardiogram interpretation. But for any person listening right now who wants to implement lifestyle, exercise, nutrition, and avoidance of toxins — should they feed those desires into ChatGPT and see what it produces?

[32:41] Using AI Wisely: Prompts, Guardrails & Your Doctor Visit

Dr. Yele Aluko (32:41): I have a TikTok platform that I use to address health-literacy issues, and this is a question I’ve posed and answered there. The truth is that when people have problems, doctors often aren’t available — AI is available 24 hours a day. It’s good to understand how AI helps, but also why you should be wary of what it says. A lot depends on the prompt you put in. If you say, “I’ve had severe headaches for a month, what could it be?” a brain tumor is going to come out of AI — and it might even be at the top. Even if it’s at the bottom, a patient who sees “brain tumor” is going to freak out. So you have to be fairly explicit in what you put in: “I’m a 56-year-old Caucasian woman, this is my medical history, these are the medicines I’m on, I’m having new symptoms of XYZ. I’m going to see my doctor, but I want to be informed before I go.” That narrows it down — AI is pretty good when you give it the right information.

Dr. Regina Druz (34:26): When you give it guardrails — when you say, “You’re not my doctor, but I want to be prepared when I see my doctor.”

Dr. Yele Aluko (34:34): Whatever it sends back to you, digest it — don’t take it as gospel truth. But at least it’s educating you to some degree. Some people use two or three AI platforms, and I’d do the same — run it in a second one and see what happens. AI is also valuable when a patient is going to see their doctor. Generally you may have fifteen minutes with the doctor — and sometimes the clock starts ticking before you even sit down — so it’s important to understand what you want to get out of that visit and to write it down. Why do I need to change my medications? Explain why. What are the side effects? How and when will we check whether they’re working? AI can help you draw up the top three questions you need to ask. You can’t have a list of ten questions, because the appointment will be over before you get through them.

Dr. Regina Druz (35:53): In traditional appointments — not an integrative cardiology appointment, but a traditional one.

Dr. Yele Aluko (35:58): I’d agree with that. But AI also has value in integrative medicine and integrative cardiology — it makes you a more informed and responsible healthcare consumer.

Dr. Regina Druz (36:14): A hundred percent. At Holistic Heart Centers we have a patient-education community called Holistic Heart University, with some free resources and more in-depth resources with a paid membership. Patients regularly get education on various medications, supplements, and nutritional plans, because there’s so much information out there and so much new research. People are struggling to understand it — and we know that even the guidelines we produce as cardiologists take years to be implemented into practice, and when they are, it’s far from a hundred percent. Let’s pivot a little, because something you said earlier is a very interesting area to me: the effect of environmental impacts on this sea of metabolic disease. When you think about how the environment shapes our chronic-disease trajectory, what do you look for first? Let’s go back to the top-three analogy — what are the most impactful environmental things we need to address to start putting the brakes on this metabolic storm?

[37:55] Environmental Drivers: Pollution, Allergies & Indoor Air

Dr. Yele Aluko (37:55): I’ll speak to three. The first is understanding whether you’re being consistently exposed to environmental pollution. How do you get to work? Are you exposed to a toxic environment by way of fumes, depending on the kind of work you do? Are you living close to a nuclear plant or other facilities that spew out environmental toxicity? And, speaking of AI, it’s become known that AI infrastructure is creating a significant amount of environmental pollution. The second is allergies: what does your allergy profile look like? Many people don’t know they’re allergic to things, and getting an allergy profile — I wouldn’t be surprised if you do these in your office — may yield startling results. People are walking around with a host of allergens they’re exposed to, and they’ve quietly developed a metabolic environment that’s just waiting to become a storm. And the third is indoor air. Where you live and work has an impact on your health — the quality of indoor air, your ventilation, the particles swirling around in the places you spend eight to ten hours a day, inhaling with every breath. I’m currently co-chair of the Global Commission for Healthy Indoor Air, where we’re looking at how to systematize, across countries, regulations about indoor construction — so that construction is held accountable to ensure indoor air is as clean as it can be. So, oblivious to many of us, just walking outside and staying indoors can be exposing us to environmental toxins.

[40:47] Light, Social Deprivation & the PREVENT Score

Dr. Regina Druz (40:47): Very interesting. I also read recently that because so many people work indoors — or work from home — if they don’t step outside even for ten to twenty minutes a day, they may develop a kind of red-light deficiency, because the natural light spectrum includes all wavelengths, including red light. The lights we have indoors — LED and energy-saving lights, which seemed like the right thing to do to save energy — are essentially blue-light devices, so they can make us red-light deficient. This red-light deficiency potentially affects our mitochondrial health and our ability to derive energy from our mitochondria, which could open the door to some chronic diseases. So we are very much under-evaluating the impact of the environment — not only exposure to chemicals, but social deprivation. I worked quite a bit in inner-city neighborhoods here in New York, and I learned firsthand what social deprivation can do to patients. There’s one risk-assessment tool I know of — the PREVENT score, recently endorsed in the lipid guidelines — that has an area for the zip code to calculate the social deprivation index. We run PREVENT as part of HeartWell.ai because it computes all the risk scores, and I’m yet to see a zip code that comes up as low social deprivation. I’m beginning to think it doesn’t exist, because everything comes up at least moderate or high — even for patients from areas one would consider very well-to-do. So this is a whole body of literature that needs to give us data and studies to understand how to find these root causes pushing people into metabolic disease and insulin resistance — because that’s what we can control, in our neighborhoods and in our indoor environments. So I’m curious that you mentioned the Global Commission. Is it that some countries have building regulations and some don’t? How does that work?

Dr. Yele Aluko (43:35): That’s exactly what it is. The regulations are inconsistent — depending on the country there might be none — and the feasibility of executing on these things, developing the infrastructure and the governance structures and platforms, requires government leadership, alignment, and financing. Even in the industrialized world there’s a lack of standardization. What the Commission is seeking to do is develop a global platform for education and to opine on best practices and how current best practices can be further optimized — leading with the fact that indoor air impacts human health. That’s the reason this is being done.

[44:45] Predictions for the Next Five Years

Dr. Regina Druz (44:45): We’ve had a wonderful discussion and touched on a lot of areas. Let’s hear your predictions. In the next five years in cardiovascular and metabolic health, where are we likely to see the most life-changing discoveries or progress? What would you want those areas to be, and what do you think they’ll actually be — because what we want and what we get aren’t always the same. So predict the future, Dr. Aluko. Tell us what it holds.

Dr. Yele Aluko (45:37): If you go with the trajectory of American health, innovation has yielded significant transformation — transcatheter aortic valve implantation is one example, drug-coated stenting another. There’s no question we’ll continue to do those kinds of laser-focused, individualized interventions, and with AI we’ll do them even better; we’ve been doing it already. I also believe health systems will become more efficient at what they do, so the marquee institutions — a Mayo Clinic, a Cleveland Clinic, a Johns Hopkins, a New York Hospital/Weill Cornell, a Mass General — will become even better at managing within the bricks and mortar.

Dr. Regina Druz (46:46): Managing those complex, end-stage conditions.

Dr. Yele Aluko (46:51): Managing within the bricks and mortar. But I don’t look at health as episodic — I’m sure you don’t either. The current model is: people are born, they navigate life, they get sick, they go into a health facility where a lot of activity happens, they get treated, and then they’re sent back out. We should be looking at health from when a child is born and matures, collecting data along the way — so that when they do get sick and go into the hospital, there’s longitudinal data collection both in and outside the hospital. Right now most of the data collection happens episodically.

Dr. Regina Druz (47:41): And siloed. Part of what we do with new patients is spend a lot of time collecting their medical information. They may get a thirty- or sixty-minute visit, but the time to collect their information is at least three to five times longer, so we can understand what’s been happening with them. Something as basic as having access to medical records is still a huge issue.

[48:20] Prevention at Scale — Built Outside the Industry

Dr. Yele Aluko (48:20): That’s very true. Having said all that, I do believe there are going to be technology companies — AI-focused — that evolve. There are many already, but a few will be positioned to really make a difference, and they’re probably going to sit outside the health industry. They’ll require venture-capital funding and private equity to sustain them through the first five to ten years. These companies will be able to do three things: predict illness; prevent it because of that prediction; and, when they predict illness that can’t be prevented, personalize the approach to treatment. All three of those are outside the health industry — because I don’t believe the health industry itself can make a 360-degree turnaround without a change in health policy, since health policy is supporting illness and hospitalization.

Dr. Regina Druz (49:53): Because illness pays the bills.

Dr. Yele Aluko (49:57): That’s correct. When we start talking about prevention at scale, it needs to be developed outside the industry, with a business case built around it — which will happen. And I think that’s going to be the most transformative aspect of AI.

[50:17] Personal Health Agents & Closing Thoughts

Dr. Regina Druz (50:17): I’m with you. I’m seeing Perplexity Health and Claude for health, and recently I spotted that Amazon has a health AI agent — I played around with it, and it pulled my medical records within minutes, something I have trouble even doing myself. So I do think we’re entering an era where a private, personal health agent will be something every person can have, to serve as a guide that shapes the trajectory of their health. And I completely agree it will be outside the healthcare systems — even though those systems are extraordinarily valuable, and we do need procedural physicians like you putting in valves that save people’s hearts. But we have a unique opportunity right now to build a truly personalized, preventive approach that didn’t exist before, if we do it right. The future is very exciting. Dr. Aluko, thank you for speaking with me and sharing your wisdom and your perspective. I wish there were more cardiologists like you — and if you’re a cardiologist listening, please give me a ping so you can be on the show and we can discuss what the future holds for cardiology.

Dr. Yele Aluko (51:46): Thank you very much, and congratulations on the work you’re doing.

Dr. Regina Druz (51:50): Thank you, thank you. Thank you for tuning in to Own Your Heart Health with Dr. Regina Druz. This podcast is powered by Holistic Heart Centers. If you enjoyed the show, please rate and review us on your favorite podcast platform. To learn more about our services, visit holisticheartcenters.com and subscribe to our YouTube channel — the link is in the show notes. See you next week.

Frequently Asked Questions

What did Dr. Aluko mean by saying the healthcare system is “built for the wrong thing”?

His point is that the U.S. healthcare system isn’t poorly run — it’s performing exactly as it was designed to perform. In his view it was built as a “sickness” or “illness” industry, organized around fee-for-service transactions and the treatment of advanced disease, rather than around prevention and population health. As a result, he argues, the system won’t shift toward prevention until health policy, execution, and accountability change — including steps like universal access to care, better health literacy, and tackling the social determinants of health. This reflects his professional opinion as discussed on the episode and is shared for educational context, not as a political or medical recommendation.

What is the “metabolic storm,” and why does it cross medical specialties?

Both physicians describe a heart attack as the end stage of a metabolic process that often unfolds silently over about twenty years — obesity, insulin resistance, type 2 diabetes, and what’s called metabolic syndrome. Because this process damages many organs at once — the blood vessels, heart, liver, kidneys, and eyes — it doesn’t respect specialty boundaries. Yet medicine is organized so that each specialist tends to focus on a single organ, which can mean the shared upstream driver is missed. This is a general explanation of how metabolic disease develops, not a diagnosis; talk with your own clinician about your individual risk.

What are the top three things anyone can do to protect their heart at any age?

Dr. Aluko’s three are: (1) be mindful of what you put into your body — eat a healthy, less ultra-processed diet and limit smoking and excess alcohol; (2) avoid being sedentary, emphasizing consistency, not intensity in regular exercise; and (3) personalize your risk — know and control your blood pressure, lipids, and other metrics over time. On cholesterol specifically, he suggests giving dietary change an honest try for a couple of months, while recognizing that some people are genetically predisposed to high cholesterol and may need medication to bring it to a safe level. These are general wellness principles, not personalized medical advice — decisions about medication should be made with your own physician.

Can AI help close health-equity gaps in cardiovascular care — or could it make them worse?

Dr. Aluko’s view is that AI can do both: it can close gaps or “blow them wide open,” improve health or make care less accessible. His key principle is that technology enables a strategy but doesn’t create one — AI is a multiplier that amplifies whatever a system is already built to do. Dropped into a system that doesn’t prioritize population health, it will simply produce point solutions faster, cheaper, and at scale. For individuals, though, he sees real promise: AI can help people understand their bodies, their wearable data, available therapies, and even how to interpret clinical trials. The outcome, he stresses, depends on how the industry deploys it and how individuals use it.

How can patients use AI tools like ChatGPT safely when researching their health?

Both physicians urge caution. Dr. Druz notes that researchers from Stanford documented AI models dropping medical disclaimers as they became more capable, and warns against tools that “invent” metrics that don’t exist (her example: a made-up “cardiovascular wellness score”) — and against uploading real labs into chatbots that are not HIPAA-protected. Dr. Aluko’s practical advice is to be explicit in your prompt (age, medical history, medications, specific new symptoms), to treat the answer as education rather than gospel, to cross-check across two or three platforms, and to use AI to prepare the top three questions for your doctor — not to replace your doctor. Always give it the guardrail that it is not your physician. This is educational information, not a substitute for professional medical care.

How does your environment — air, light, and neighborhood — affect heart and metabolic health?

Dr. Aluko highlights three environmental drivers: outdoor pollution and workplace fumes; your personal allergy profile, which many people are unaware of; and indoor air quality — the ventilation and particles in the places where you spend eight to ten hours a day (he co-chairs a Global Commission for Healthy Indoor Air working toward construction standards). Dr. Druz adds the possible role of “red-light deficiency” from spending all day under blue-spectrum LED lighting, and the impact of social deprivation — noting that the PREVENT risk score incorporates a zip-code-based social deprivation index. Several of these are emerging or evolving areas of research; they’re shared for general awareness and are not medical advice.

Show Notes & Resources

Guest: Dr. Yele Aluko, Interventional Cardiologist

Dr. Yele Aluko is an interventional and structural-heart cardiologist who trained at what is today Weill Cornell (then New York Hospital). After years in the catheterization lab — opening blocked arteries with stents and balloons and implanting heart valves without open-chest surgery — he earned an MBA and made the decision to step back from the bedside to work “upstream” on health policy and population health, joining a Big Four health-industry consultancy. He is co-chair of the Global Commission for Healthy Indoor Air and uses a TikTok platform to address health-literacy issues for the public. On this episode he speaks to health equity, the social determinants of health, and the promise and pitfalls of artificial intelligence in cardiovascular prevention. (The views shared are his own, offered for educational purposes.)

Topics & References Mentioned in This Episode

Global Commission for Healthy Indoor Air — the international effort Dr. Aluko co-chairs, working toward standardized indoor-air and construction practices
Health literacy — Dr. Aluko cites that only about 11% of the U.S. population is proficient in health literacy (figure as stated on the episode; verify before citing)
Stanford research on AI medical disclaimers — Dr. Druz references findings that AI models dropped medical disclaimers as they became more capable (as discussed; verify before citing)
The PREVENT risk score — an American Heart Association cardiovascular-risk tool that incorporates a zip-code-based social deprivation index
Metabolic syndrome, insulin resistance & “polyendocrine metabolic ovarian syndrome” — the recently discussed renaming of PCOS noted by Dr. Aluko (verify before citing)
HeartWell.ai (heartwell.ai) — Holistic Heart Centers’ agentic-AI personalized cardiovascular-risk tool, built by Dr. Druz
Holistic Heart University — Holistic Heart Centers’ patient-education community (free and paid resources)

Holistic Heart Centers

holisticheartcenters.com
HeartWell.ai — AI-powered cardiovascular risk assessment
Address: 55 Bryant Avenue, Suite #6, Roslyn, NY 11576
Phone: 877-511-5166
YouTube: @reginadruzmd
Instagram: @dr.reginadruz
Podcast: Own Your Heart Health — available on Apple Podcasts, Spotify, and all major platforms

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