Top Docs Q&A: Gary Balady

This post is part of our Top Docs Q&A series where we ask a physician who was selected as one of our Top Docs questions about their field, life as a doctor, and practicing in the Greater Boston area. 

Name: Gary Balady

Hospital Affiliation: Boston Medical Center

Title: Director of non-invasive cardiovascular labs and preventive cardiology at Boston Medical Center; Professor of medicine and assistant dean of admissions at Boston University School of Medicine

Field: Cardiology

Specialty: Preventative Cardiology

In 1985, Gary Balady founded the cardiac rehab and prevention program at Boston Medical Center, which has since served nearly 4,000 patients. Currently, he is an active leader of the American Heart Association and has been on many of their committees. This May, Balady will be presented with the American Heart Association’s Paul Dudley White Award, named after the association’s founder.

How did you first choose cardiology?

In my family there’s a long-standing history of high blood pressure, which peaked my early interest in that. Then as I began studying physiology in college, I really became enamored by cardiovascular physiology.

What do you love most about practicing in Boston?

I still remember the day, in 1979, where I found out that I would be going to Boston Medical Center to do my residency. I was just so excited to be coming up to Boston, a place that is so renown for medicine and biotechnology. When I was placed up here I didn’t think I’d stay very long, and here I am now, 34 years later, still a part of the Boston community.

What do you love most about the field?

Preventative cardiology is really a partnership with your patients, and I really enjoy that interaction. I love working along with them as I watch them make lifestyles changes that hopefully prevent any future heart events. Cardiology is also a very dynamic field. Every five years there’s something major that happens which allows us to do an even better job than we were doing before.

How has cardiology changed in that last 30 years that you’ve been practicing?

When I was a young intern all we could do is treat the subsequent bad outcomes from a heart attack, but now we can actually intervene and stop a heart attack in its progress before it causes any potential damage. Also the development of Statin drugs has really revolutionized the treatment of heart and vascular disease. Statin drugs are very powerful agents that work to prevent and reduce plague build up in the coronary arteries and other vessels.

What are the latest achievements happening in the field?

I run a cardiac rehabilitation program, which is a program where patients with known heart disease are referred. We provide patients with really comprehensive assessments and interventions to reduce future heart events and help improve their overall cardiovascular health. We now have good evidence that shows that people who participate in such programs tend to have a significant reduction in cardiovascular events and tend to live longer. Now we are taking the program to the patient by developing a hybrid program where patients are able to do both work within the facility and also at home through web-based support.

You established this cardiac rehab program at Boston Medical Center in 1985, what made you decide to do this?

The cardiac rehab program was a very attractive and comprehensive way for me to address both my interests in exercise and treating high blood pressure, along with other issues. Our program was pretty cutting edge because in the late 70s these programs were primarily focused on exercise only, whereas we felt that it was more important to create a program that used exercise to help prevent disease in addition to many other treatment and prevention methods.

What discoveries have you made through your research on exercise and cardiovascular health? 

We, and others, have demonstrated that individuals who exercise regularly have improved blood flow in their vessels in their heart and also other parts in the body. There are also a number of studies that demonstrate that exercise reduces inflammation, which is probably the precursor of the development of blockages in the blood vessels. Also there is a lot of good science that demonstrates that people who exercise regularly have a lower future risk of developing heart disease. This is because exercise helps condition the body to be better suited to a particular level of stress.

As an active member of the American Heart Association you’ve been involved in a lot of political advocacy work, what has that experience been like for you?

Over the years I’ve had opportunities to meet with Ted Kennedy, John Kerry, Barney frank, and Scott Brown. It’s been really exciting to be able to walk with my colleagues down the Senate and have the opportunity to help foster bills that could help improve the cardiovascular health of our nation. For example, earlier this year, we helped foster a bill that allowed for cardiac rehab programs to be a covered benefit for people with heart failure.

What is your hope for the future of cardiology?

My hope is that we continue to develop interventions to help prevent heart attacks and strokes. Research continues to provide us with information that we can actually prevent disease before it occurs, and that’s where a lot of research focus is taking place now. I think there’s tremendous promise that we can eventually eliminate many of the problems that cause heart disease.

You were just named this year’s honoree of the American Heart Association’s Paul Dudley White Award. When did you find out and what was your reaction? 

I think I found out in early December. My colleague set up an appointment with me, and I just thought it was a regular meeting. When the time came, I opened the door and there was a whole group of wonderful people from the Heart Association in there to tell me that I had won the award. So that was a total surprise, and the first thing I wanted to do was just sit down and take it all in. I was really overwhelmed and very humbled. It’s really it’s a phenomenal honor.