The Silent Build – A Conversation with Dr. Hayes

Tell us about yourself.

Well, hello, everyone. My name is Dolphurs Hayes, and I’m originally from Albany, Georgia, so I’m a Southern Georgia boy at heart.

I grew up as a student-athlete. I played football since I was eight years old because my dad wanted me to be tough, and I stayed with that sport all the way through high school until I did a pretty unique thing.

I actually started pole vaulting!

And as you can imagine, being in the South, having a Black kid pole vaulting was a very rare thing. But I ended up doing very well, and it pretty much changed my life.

I went from just an average pole vaulter to the second-highest pole vaulter in the state of Georgia by the time I graduated high school. And that led to me getting a full scholarship to attend Savannah State University.

While there, I continued pole vaulting, but I knew deep down I wanted to become a doctor. I was a biology major, kept my grades up high, did research, and did all those things in the background to set me up if the athletic stuff didn’t work out.

By my senior year, I kind of burnt out from sports, and that’s when I went full throttle on becoming a doctor.

Of course, this wasn’t an easy journey for me. I was the first in my family to take this path, so navigating this process was all me—doing research and trying to get mentorship from somebody ahead of me.

Then, after applying to medical school two times, I was able to get accepted to Morehouse School of Medicine, and that’s where I fell in love with the field of cardiology.

And now, as of today, I’m in my last year of cardiology training, and I’m serving as a chief fellow of the Emory program.

So, major blessings. It’s been a humbling process.

Outside of work, I’m a family-oriented guy. I have two little sons, a four-year-old and a one-year-old. They keep us busy. I’m married to the woman of my dreams, and we’ve been married now for four years.

And I just love being around people. I love spending time with my friends and connecting. I still have some of the same friends from third grade, actually. So, that kind of speaks volumes on how I value friendship.

So, that’s me in a nutshell, and hopefully you all can learn something from what we talk about today.

Why did you choose this topic, and why should people care?

My experience with my patients and listening to their stories. And it’s typically always the same.

They have a heart attack, and they’ll say, “I don’t know where this came from! It came out of nowhere!”

And usually, in that moment, I think back on all the years and decades leading up to this that they didn’t see. They didn’t notice those small lifestyle changes that they weren’t paying attention to, not getting labs done, not doing preventive screening.

So, that’s why this topic is meaningful to me. I want us to share awareness so people can do something about it on the earlier side.

Then we can be more in a preventive state versus trying to deal with a heart attack after it happens.

What are the most important things everyone should know?

The main point today is understanding the timetable of atherosclerosis.

And that term is just when you build up plaque on the inside of your arteries.

Since I’m in the field of cardiology, we’ll mainly focus on coronary artery disease.

This is when you have plaque buildup in the blood vessels supplying your heart, and over time that can lead to heart attacks.

So, think back to your early twenties when you were fit and had nothing going on. You just went to school or work, worked out occasionally, kind of ate what you wanted, but you still felt great the next day. You could probably even run off a few hours of sleep.

Nobody during those years thinks that they may already be developing early plaque changes on the inside of their vessels because you don’t feel it. You know, that “silent killer,” as people would call it.

And the key point I want to make is that this can actually be the beginning of when those risk factors and plaque development start.

Atherosclerosis can begin developing when you’re young. In your twenties, you may already have early plaque changes even though you still feel completely normal.

Over the years, especially if you have risk factors such as smoking or high cholesterol that aren’t being controlled, that plaque can continue to progress. And as you get older, your risk of eventually having a heart attack can continue to increase.

What can people do today?

First, staying physically active. Right now, our guidelines recommend we do at least 150 minutes of moderate-intensity activity a week.

And to think about moderate intensity, think about working out at a level where you can still have a conversation, but you’re breathing hard enough that singing would be difficult. That’s usually your moderate intensity.

Try to aim for that 150 minutes however you want to break it up in a week. I know we all have very busy lives.

I have a family at home, and it can get too busy to get to the gym, so I walk super fast through the hospital. Some people think I’m crazy, but that’s me getting some of my cardio in!

The other thing is weight management. Keeping an eye on your weight every so often is important, so you know when it may be slipping out of a normal range.

And that brings us to BMI, or body mass index. I know some people look at BMI and say, “Well, everybody in my family is big-boned. It’s just meant for me to be big.”

I want you to know that is a myth. That is 100% not true.

Unless you are a bodybuilder, or you’re standing tall like LeBron James and you’re a star athlete, BMI can still be a pretty useful screening tool for most people.

And once you get to a BMI of 30 or above, that falls into the obesity range, which is associated with a higher risk of cardiovascular disease and other health problems.

So, big picture: stay physically active, keep an eye on your weight, and try to get that 150 minutes a week of moderate-intensity activity.

Then, beyond those lifestyle factors, go to your primary care appointment and look at your lab profile.

Sometimes you can have a genetic cause to high cholesterol that you did not know. You may have had an uncle that had a heart attack at 45, but it seemed like it wasn’t related to you.

So, one thing I want you all to walk away knowing is to get a lipid panel. Specifically, you want to know your bad cholesterol, called the LDL.

The next one I want you to pay attention to is called lipoprotein(a), or Lp(a).

This is a separate blood test that has gotten a lot of attention in the cardiology world, even in the preventive space. Your Lp(a) level is largely determined by genetics, and if it’s elevated, it can increase your cardiovascular risk.

Having those two pieces of information—your LDL and your Lp(a)—can help you have that shared discussion with your provider about what you need to do next.

What gives you hope about the future?

The research that’s coming out now is truly incredible. We’re getting more and more advanced, and we’re getting answers faster than ever.

And when you pair some of these advances with AI, I think there’s a lot of potential to identify risk and disease earlier.

And on the topic of this conversation, we’ve had new guidelines and new parameters come out that can help us identify cardiovascular risk earlier and intervene sooner.

So, I’m very excited about what the future may bring with that.

And from a personal standpoint, I’m always asking, “How can I improve myself?”

So, one of my things now is the fitness piece. I was a track-and-field athlete, as I mentioned earlier, and I’m trying to get back in shape.

I want to do a 5K within the next two months. Hopefully, ideally, like three in a year. So, trying to get slowly back into that.

And the biggest thing I’m excited about is this is my last year of training. It’s been a long road since undergrad, and now I have only 10 months left before I get my first big-boy job.

So, super stoked about that.

If readers remember only one thing from your article, what should it be?

Don’t look at life as just one snapshot in time. Always think about all the preceding things that lead up to it.

Think about atherosclerosis. Remember, it’s that disease process that can take decades to build up before you ever have that big moment.

What if we catch it on the earlier side by starting healthier habits?

And I want you to envision that same thing with your health. If you are overweight, you won’t get to that normal body mass index overnight. It’s going to take slow, consistent habits.

You don’t wake up one day and run a marathon. There’s a large amount of training beforehand that gets you to that moment.

So, again, just not focusing on the right now and the big moments. Think about those small moments every single day that lead you up to the big changes.

How can we connect with you?

You can visit my Instagram, which is @dhayes_ent. That’s a quick way to get me.

And I’m also on Facebook under my name, Dolphurs Hayes. And that’s D-O-L-P-H-U-R-S.

You can message me on there, and I’d be glad to connect with you all and give you any advice.

Each One Health Evidence Review

Heart attacks may seem like they happen suddenly, but the disease process that leads to them can begin many years earlier. Research examining the arteries of children and young adults has found evidence of early atherosclerosis long before symptoms develop, with more extensive disease seen in people with multiple cardiovascular risk factors.

This is why prevention matters even when you feel healthy. Staying physically active, maintaining a healthy weight, knowing your cholesterol levels, and understanding inherited risk factors such as lipoprotein(a) can help identify cardiovascular risk earlier—before it has decades to progress.

Berenson GS, Srinivasan SR, Bao W, Newman WP, Tracy RE, Wattigney WA. Association Between Multiple Cardiovascular Risk Factors and Atherosclerosis in Children and Young Adults. New England Journal of Medicine. 1998;338:1650–1656.
- What it showed: Researchers examined the arteries of young people ages 2–39 and found that fatty streaks and fibrous plaques were already present in the aorta and coronary arteries. The extent of atherosclerosis increased with age and was strongly associated with cardiovascular risk factors including higher BMI, blood pressure, LDL cholesterol, triglycerides, and smoking. The more risk factors a person had, the more extensive their atherosclerosis tended to be—supporting the idea that the process leading to cardiovascular disease can begin long before symptoms appear.
- Read the study: New England Journal of Medicine
Blumenthal RS, Morris PB, Gaudino M, et al. 2026 ACC/AHA/AACVPR/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA Guideline on the Management of Dyslipidemia. Circulation. 2026.
- What it showed: The updated ACC/AHA guideline emphasizes identifying and treating cardiovascular risk earlier to reduce lifelong exposure to cholesterol-containing particles that contribute to atherosclerosis. LDL cholesterol remains a central measure of risk, while additional tests can help identify risk that may not be obvious from a standard lipid profile. The guideline now recommends that all adults have lipoprotein(a), or Lp(a), measured at least once to help identify inherited cardiovascular risk.
- Read the full study: Circulation
Kronenberg F, Mora S, Stroes ESG, et al. Lipoprotein(a) in Atherosclerotic Cardiovascular Disease and Aortic Stenosis: A European Atherosclerosis Society Consensus Statement. European Heart Journal. 2022;43(39):3925–3946.
- What it showed: Evidence from large epidemiologic and genetic studies strongly supports Lp(a) as an independent cause of atherosclerotic cardiovascular disease. Lp(a) levels are largely determined by genetics, remain relatively stable throughout life, and can increase cardiovascular risk even when LDL cholesterol is low. This is why knowing your Lp(a) can provide information about inherited cardiovascular risk that may not be apparent from lifestyle or a standard cholesterol panel alone.
- Read the full study: European Heart Journal