Speaker 2: 01:20 Well, I graduated from Wake Forest Cardiology fellowship in 2010 and signed on in Lexington and I've been here ever since as a community cardiologist and I've very much enjoyed my time. So I chose cardiology as profession for a few reasons. First, I was attracted by how lifestyle can influence disease onset and outcomes in cardiovascular disease. And I enjoy talking to patients about positive lifestyle changes. Second, cardiology has massive amounts of research driving treatments that are effective. So death and disability from cardiovascular disease has declined significantly over the past decades due to these medical advances.
Speaker 1: 01:57 Did you go to wake forest as well? I did go Deacs.
Speaker 2: 02:00 I graduated from wake forest fellowship and then started working as a community cardiologist in 2010 in Lexington.
Speaker 1: 02:06 Very cool. Yeah, so that's the fun part. It'd be about being part of a, the wake forest baptist health family is we're very fortunate to have medical centers in locations all across northwest North Carolina. We are taking a field trip this month to Lexington where we're hanging out with Dr Tom Lee, so you'll might hear that from time to time on the best health podcasts that we're, we're visiting some of our different locations all across north western, North Carolina. So we're excited about that. Dr Tom Lee. It's a, and I'm, I w I'm the one of the marketing guys, so I'm not a clinician or a medical expert, but you know, just kinda thinking about your heart. It's, it's this, uh, obviously very important organ in our lives that we can't live without and it's working every second of every day of our whole life, but at the same time, because of that, it kind of gets put in the back of our minds and maybe not at the forefront of, I don't think, eight times a day about my heart.
Speaker 1: 03:06 Uh, so I think a lot of consumers in patients or potential patients might think the same way. Um, so how do we, uh, help raise awareness about, um, some of the risk factors that people might need to keep an eye out for, um, for them to say, hey, maybe I should visit my primary care or make an appointment. Um, what are the, some, some of the main risk factors or, or important pieces of information or numbers that, that us as as consumers and patients should, should pay attention to? Um, since we're not thinking about our heart?
Speaker 2: 03:43 Well, I feel like awareness has improved greatly over time. Um, most Americans will be able to tell you that heart disease is still the number one killer of Americans as well as most developed countries. It's the number one cause for death and disability. I think that the problem we still have is that people aren't keeping it in the forefront of their minds when they're talking about or thinking about their health from day to day. Sure. Um, so we all want to live long, enjoyable lives. And what we need to realize is that while it's an effort to keep your heart health up, that's going to allow you the best chances to do that. In terms of what we need to think about for risk factors for heart disease, certainly your lifestyle when you're young in terms of how much you exercise and your diet and your keeping a lean weight are important. But other risk factors as you age, like diabetes and hypertension, high cholesterol, whether or not you smoke are all very important also. And all these things are modifiable. So we have treatments that work very well to help prevent cardiovascular disease if you should take those on.
Speaker 1: 04:57 Right. So that's a, that's a great point that talking about some of the pieces that are modifiable and, and sometimes we'll hear questions of well, you know, it's partly genetics or versus environmental or lifestyle. So maybe can you talk about that a little bit about, you know, how much of it is genetics versus how much of it do we have in our control in, in, um, w should be aware of and keep up on a more regular basis.
Speaker 2: 05:22 There's certainly as a genetic component to this, I see a lot of patients who have done everything they could with their lifestyle, but because of their strong family history, they end up with some cardiovascular event or cardiovascular disease. That is something to keep in mind because those people who know about their family medical history, maybe you want to establish with a cardiologist earlier, they might want to get a stress test even if they're not having really significant symptoms. And they have to be really careful to look for symptoms early earlier than their colleagues who may not meet without a strong family history.
Speaker 1: 05:58 Gotcha. So if we're going through our days and um, and I'm busy and I'm working and I got to pick the kids up and I gotta do this and that. So, uh, this thing called stress enters our lives and stress ebbs and flows with different life experiences in life situations. Uh, maybe speak to that a particular topic of stress and how it could impact our, our cardiovascular health in some ways to help keep that in check for us.
Speaker 2: 06:27 Well. That's interesting that you say that cause that's one of my topics that I discuss with my patients all the time. There are three lifestyle modifications that I feel are important in terms of cardiovascular health. The first is exercise and exercise has the best data in terms of its ability to lower your cardiovascular risk. Now the Aha guidelines for exercise are 30 minutes of moderate intensity aerobic activity most days of the week. Okay. And 30 minutes isn't that long of a time to carve out of your schedule each day. Not this one TV show on Netflix. Exactly. The second thing I talk about is a heart healthy diet, which is essentially a Mediterranean style diet. Okay. So this focuses on low saturated fat consumption. So avoiding fried foods, avoiding fatty meats and high fat dairy, but focusing on a set unsaturated fat. So olive oil, nuts, fish, avocados. Also focusing on fruits, vegetables, and whole grains. Okay. Third is distress [inaudible] but you can't just remove the stress from your life, so you have to figure out ways to cope better with stress. What we know about stress is that it causes inflammation in the body and inflammation then leads to arterial damage and arterial damage leads to plaque formation, which is cardiovascular disease. So the less inflammation in your body, the better. Gotcha. Stress being one of those things that causes inflammation. Gotcha.
Speaker 1: 07:58 So I obviously there's a correlation with, you know, exercising helps reduce stress and, and all that fun stuff. Correct. Exactly. Yeah. Yeah. Well, uh, so the heart is an extremely complex organ. It's connected to an, uh, pretty complex cardiovascular system. And like I was saying earlier, we don't, um, I think some people might think, ah, I don't have to worry about my heart unless I have a heart attack. Something major happens otherwise, you know, Kinda does this thing in the background. Um, so why would someone need to pay attention to their, their heart condition, to their numbers, um, before they have a heart attack? I guess what, what are some of the important numbers they need to just be aware of if they're looking through, obviously, but it probably cholesterol is one of them. What are some, some others,
Speaker 2: 08:49 if we're going to talk prevention, you want that to start as early as possible. If you have really high cholesterol until you're 50 and have a heart attack and then you change your lifestyle, that's not going to be as good as if you started at 20 and prevented the heart attack in the first place, obviously. Yeah. So the numbers that we look at, certainly blood pressure and cholesterol for blood pressure. Right now the current guidelines want people 45 and less to be generally in the one 30, over 80 and less range. The guidelines now say that as you age, we can allow a bit higher blood pressure. So 45 to 75, our goal is to be about one 40, uh, less, less than one 40 in less than 85 on the bottom number. [inaudible]. Um, and then for people over 75, you can go a little bit above one 40. Permissively okay. For cholesterol, uh, really we're talking about, um, total cholesterol and your HDL cholesterol, which is your good cholesterol. Um, those numbers should be checked and your doctor knows the ratio that you should have for your total to HDL cholesterol.
Speaker 1: 09:57 Sure. Now tell us again which one's the good one. Cause I always get those mixed up.
Speaker 2: 10:01 So HDL is your good cholesterol and for men you want that to be greater than 40, but for women you want that to be greater than 50 because women's just tend to run higher in general. Um, the bad player in cholesterol is the LDL cholesterol. Okay. We've gotten out of favor of focusing on the LDL cholesterol numbers as a goal. But I'll tell you that I still do in my clinic cause there is a lot of data behind it. So an LDL cholesterol of greater than one 30 is considered high.
Speaker 1: 10:30 Sure. Now when you have, um, patients come in and see you in clinic, um, how do they come to see a cardiovascular specialist or a cardiologist? Uh, cause you know, maybe some people are like, well I don't, I, I just need to see my regular doctor sometimes if I get real sick or I wouldn't really need to ever see a cardiologist. And let's have a heart attack, then they'll send me to the cardiologist. So maybe talk about just kind of the different types of patients that you, that you see in your clinic and um, some of the, uh, the wide range of, of issues that you see in your clinic. And it's always not just right after a heart attack. [inaudible]
Speaker 2: 11:09 right. There's lots of reasons to see a cardiologist. Symptoms wise. Of course chest pain is the first thing we think of, but often shortness of breath is the first symptom of heart disease, even of impending heart attack, dizziness, passing out, leg swelling, all those things are reasons to see a cardiologist. I see patients from 20 years old who are having, you know, too fast of a heart rate for certain reasons, mostly young women. I then of course, valve disease in the elderly is a normal, uh, is a normal process of aging. And so I see elderly with heart murmurs.
Speaker 1: 11:49 Okay. So it's a, it's a wide range of patients, a wide range of, of different issues that affect the heart I guess is what we're looking at. Correct, correct. Yeah. So looking at, um, I think for some patients out there or some consumers, um, the idea of going to see a cardiologist means something, something serious is happening. Yes. It's, it's not, uh, maybe I'm trying to delay that or put that off because then I have to admit to myself that maybe something more serious is happening and that's a little scary. So, um, if you see that in your clinic or when you, when some of your patients, how do you, how do you address that or what's, what's, what's some advice you could give to listeners out there that's, you know, seeing a cardiologist isn't, isn't the last resort. It's, it's, it's better to be proactive.
Speaker 2: 12:43 Absolutely. I had that discussion today with someone. It's better to know what we're dealing with in cardiology because there are such great treatments. Generally, we're not a big gloom and doom kind of profession because we have terrific interventions for coronary artery disease, for valve, EULAR disease, for heart failure. Our treatment plans actually work for people. So I feel like people worry too much. That going to a cardiologist is going to mean, you know, a death sentence or perhaps just a really bad news. Right. We're in fact, we have lots of terrific treatments. And so getting ahead of it and knowing about it ahead of time before it becomes a real problem is the best plan.
Speaker 1: 13:25 Sure. And I guess the follow up on that, you know, we, when you see, you know, watch, uh, some sort of, um, you know, medical show on TV, it's, they're trying to make it as dramatic as possible, right? So they're like, oh, we need to do a heart transplant right now. And then they, they cart the heart in. And so, and so we have that end of the spectrum where our experts like forest baptist health providers, um, can, uh, perform really complex procedures like a heart transplant or, you know, a bypass that requires open heart surgery. Uh, but then there's lots of other, uh, procedures and treatments that are available to patients, um, that, uh, we might not think of after watching the TV drama. Correct?
Speaker 2: 14:12 Correct. Most of cardiology is medicines. So we can do a lot just by giving you a set of guideline suggested pills to take. And I think that people have the wrong idea that we're going to cut on you or we're going to do surgery, right. If you come to a cardiologist, which is not necessarily true.
Speaker 1: 14:31 Right? Sure. So we have a, the wide breadth of, of different treatments available for our providers that y'all is different tools in your tool box, if you will. Right?
Speaker 2: 14:40 Absolutely. So I work really closely with the people at main campus. Um, does you read Arrhythmia to do Hardcast to treat blockages, the seat, the Cardiothoracic to do surgery when it is necessary. Um, but most of my patients don't have to go there. And most of my patients I manage with medications and with the kind of simple tests that I can do in my community.
Speaker 1: 15:01 Sure. So we're, like I said, we're here in Lexington. I'm talking with Dr Tom Lee and, uh, we're very fortunate to have locations all across, uh, northwest, North Carolina and the triad. So I'm not mistaken. We have the most heart and vascular specialists in the region. And there's about 16 different locations across the triad and northwest, North Carolina that you can come and see one of our heart specialists or cardiologist. So I do want to invite people to, um, pick up the phone and give us a call, try and be proactive. Uh, three, three, six, seven one six, w f h. V. That's our special heart heartline that we have right now. Three, three, six, seven, one six w. F. H. V. That's nine three, four, eight. So, uh, that's, uh, that's my, one of my shameless marketing plugs. I do every few minutes I have to insert those in to the podcast.
Speaker 1: 16:00 Dr Tommy King, you're work with me on that. Right, right. Okay. So, uh, going forward, uh, being an academic medical center here at Wake Forest Baptist health research is a big component of, of what we do and looking at difference, um, the next thing coming out in, in different fields of, of healthcare that we service patients here at wake forest. So I guess if you want to talk a little bit about, um, what are some of the more recent um, procedures or breakthroughs in, in cardiology or cardiovascular? Um, that is, um, helping the patients either, um, what they traditionally would be going through a major surgery is now more minimally invasive or the recovery time is quicker. I heard a great story a few weeks ago from a lady, her husband, um, over the course of his life he ended up having I think three different procedures. And so the first one, he was in the hospital for several weeks and that was years and years and years ago. So then the last one, he was in the hospital for like 48 hours and then he was often running, I'm not running but walking and getting brisk s exercise. So I guess if you want to talk about just as being an academic medical center and how that benefits us from a research side of things and how we can bring that back into the clinic for, for the providers such as yourself.
Speaker 2: 17:26 Right. As I mentioned earlier, we have made leaps and bounds improvement in our treatments. So people are living through heart attacks. I don't remember this cause I wasn't in medicine then and probably not even alive, but we used to just watch people have heart attacks. That was all we could do. So we put them in the hospital. We saw how bad it was once they completed their heart attack and that was the only option we had. Oh Wow. Now we have catheter catheters that we can put stents through. We have medications that stop heart attacks and make the outcome much better. We have all sorts of new technology for treating a arrhythmia, heart rhythm problems. We also have, as you mentioned, minimally invasive surgeries for replacing valves and also doing bypass. So where we used to just watch someone have a heart attack and then figure out how bad they were going to end up. Now we can do things and you're right. If someone can be recovered in two weeks back to what they were normally doing by four, that's a tremendous improvement.
Speaker 1: 18:27 Great. So we're getting close to the end of our time with the February pop podcast with Dr Tom Lee and I just really appreciate you taking the time. I know you're really busy and this is so beneficial to the best health community and our listeners out there. Um, so if you, if you could give one last piece of advice to someone out there who's, you know, running the the everyday gauntlet of, of life and has lots of things going on and you know, maybe they don't make the best diet choices all the time, maybe they're not getting their annual checkup with their primary care physician or, um, what's some just, I guess good takeaway advice you could give them to help reduce the risk of disease and maybe, you know, put them at ease about coming to see a cardiologist if they, if they're on the fence of, maybe I need to make this appointment, but I kind of don't want to say closing piece of advice. You could give us [inaudible]
Speaker 2: 19:21 I think remember that early diagnosis is your friend. Don't be scared to ask the questions about your heart health risk. Don't be scared to get that risk assessment. And if you're having a symptom, don't be afraid to see a cardiologist go over the symptoms. It may be nothing, but if there's something that can be done, it's better than waiting until a bad outcome.
Speaker 1: 19:41 Sure. That makes total sense. I'm really glad you mentioned assessments because we have a online heart risk assessment that you can take. If you go to wakehealth.edu/allheart, that's wakehealth.edu/allheart. There's an initial online assessment that you can take and it'll ask you basic questions related to, um, your, your habits and your, um, heart history. And then from there it's pretty easy to get connected with one of our, our fine, uh, either primary care physicians or, um, heart specialists such as Dr Tom Lee. Um, once again, Dr Tom Lee, this has been great. I really appreciate you taking the time. And um, we will be back in March, best health community fam. So be on the lookout for our next podcast coming, uh, in a few weeks. If you have any questions, feel free to go on the website. There's a lot of different resources on there on the heart and vascular page, or you can shoot us an email at email@example.com and we'll catch you next time. Thanks
Speaker 3: 20:48 for listening to this episode of the best health podcast brought to you by wake forest baptist health. For more wellness info, check out wakehealth.edu and follow us on social media, wake forest baptist health, the gold standard of healthcare.