Understanding Heart Health: Insights from Dr. John M. Pargulski of Mahaska Health Part 2

John Pargulski, DO is Board certified by the Cardiovascular Disease Board and has earned certifications in Echocardiography, Nuclear Cardiology, Vascular Ultrasound interpretation, and Angiography.
Oskaloosa, IA – Cardiovascular disease (CVD) remains one of the leading causes of death globally, and recent insights into the connection between mental health and heart disease are changing the way healthcare professionals approach patient care. Dr. John M. Pargulski of Mahaska Health shared his perspective with Oskaloosa News on the emerging research and global initiatives that are shaping the future of cardiovascular health.
The Overlooked Link Between Mental Health and Heart Disease
Emerging studies indicate a strong link between mental health and cardiovascular disease, highlighting a critical gap in heart health treatment. According to Dr. Pargulski, approximately 40% of cardiac patients experience symptoms of clinical depression. Mental health issues, such as depression, anxiety, and stress, not only increase the risk of developing cardiovascular disease but also worsen outcomes for those already diagnosed.
“Mental health factors are deeply intertwined with heart disease,” Dr. Pargulski explained. “It’s not just the behaviors that people often associate with mental health struggles—like inactivity or poor diet—that contribute to heart issues. Biological and chemical changes triggered by mental health problems directly impact cardiovascular function.”
To bridge this gap, Dr. Pargulski emphasized the importance of integrating mental health support into cardiovascular care. He recommended incorporating routine mental health screenings into cardiovascular treatment, utilizing psychotherapy and pharmacotherapy, and promoting lifestyle modifications as part of cardiac rehabilitation. Wearable devices could also play a role in the early detection of both cardiovascular and mental health issues, enabling timely interventions.
The Role of Global Initiatives and Policies
Globally, initiatives such as the World Health Organization’s “25 by 25” campaign, which aims to reduce cardiovascular mortality by 25% by 2025, have helped raise awareness about cardiovascular disease. While these efforts have achieved some success, Dr. Pargulski noted that they are likely to fall short of reaching their ambitious goals.
“Despite improvements in therapies and treatments, cardiovascular death rates in the U.S. have changed very little over the last decade or two,” Dr. Pargulski said. “This is likely a reflection of the obesity and diabetes epidemic.”
Dr. Pargulski suggests that to make meaningful progress, it is crucial to focus on improving the management of cardiovascular risk factors such as obesity, diabetes, hypertension, smoking, physical inactivity, and unhealthy diets. He also called for investments in health systems, particularly in low- and middle-income regions and rural areas, to more effectively manage CVDs.
“We need to focus on primary and secondary prevention,” Dr. Pargulski urged. “This includes the optimal management of risk factors and launching targeted health education campaigns, especially for younger populations.”
Personalized Medicine and Genetics: A New Frontier
Advances in genetics are also transforming cardiovascular care. Personalized medicine offers the potential to identify individuals at higher risk for cardiovascular diseases before symptoms appear, allowing for earlier intervention.
“We’re at the point where genetic information can help us predict how patients will respond to specific medications, which allows us to create more precise treatment plans,” said Dr. Pargulski.
However, Dr. Pargulski also acknowledged the ethical concerns that accompany genetic testing, including privacy issues and the risk of discrimination in employment or insurance. Additionally, learning about genetic predispositions could lead to anxiety for some patients.
For individuals with a family history of heart disease, Dr. Pargulski recommended beginning cardiovascular health screenings at a younger age and placing a stronger emphasis on heart-healthy lifestyles. “Earlier and more aggressive treatment of risk factors like high blood pressure, high cholesterol, and diabetes may be reasonable,” he added.
Tailoring Public Health Campaigns to Cultural Needs
Cultural factors can significantly influence lifestyle choices, such as diet and physical activity. Dr. Pargulski believes that effective public health campaigns must take these cultural factors into account.
“If we want to be effective, we need to develop our campaigns with input from the communities we’re trying to help,” Dr. Pargulski explained. This approach might involve adapting nutritional advice to incorporate traditional foods in healthier ways or suggesting culturally acceptable forms of physical activity.
Dr. Pargulski also pointed to the impact of urbanization and increasingly sedentary lifestyles on the future of heart disease, particularly in low- and middle-income regions. “The trend towards sedentary lifestyles is leading to higher rates of obesity, hypertension, and metabolic diseases like type 2 diabetes and hyperlipidemia,” he noted. To address these challenges, Dr. Pargulski recommended prioritizing access to physical activity, especially in socioeconomically disadvantaged areas.
Looking Forward
“Cardiovascular health isn’t just about treating the heart—it’s about addressing the whole person,” Dr. Pargulski said. As awareness of the mental and genetic components of cardiovascular health grows, he is hopeful that healthcare providers will increasingly adopt a more integrated approach.
“We need to think holistically about how we care for our patients,” he concluded. “Incorporating mental health screenings, genetic insights, and cultural sensitivity into cardiovascular care will be key to reducing the burden of heart disease in the years to come.”