Heart Disease, Menopause, Dr Stephen Kobetski discussed on Mayo Clinic Radio
Range of conditions that affect your heart, including blood vessel diseases such as coronary artery disease, heart rhythm, problems and problems with the heart valves or heart muscle, it self among others, the term heart disease is often used interchangeably with the term cardiovascular disease. Fancy cardiovascular disease, generally refers to both heart problems and blood vessel disease that can occur anywhere in the body in an ongoing effort to raise awareness and promote prevention of heart disease, each February is recognized as American heart month and here to discuss is our favorite mayo clinic cardiologist, no one else is in the room. Right. Welcome back to the program. Dr kobetski, thank you very much. I wonder if even thought the difference between heart disease and cardiovascular disease, right it, we use them. Interchangeably? It gets confusing. I agree. What are the risks the risks? Unfortunately, are many the number one risk factor now for heart disease that has passed up cholesterol, passed up blood pressure passed up smoking is diet the food pattern that we'd is that something that you think is going to be easy to swing back the other way, or is it are we here to stay for a while. It is it's taking off. It's going to be a problem and a couple of reasons one is our kids one hundred percent of kids underage four overeat. It's not their fault. If their parents is us, it's me, you know, we get to patients or folks that eat too much of the wrong foods, addictive foods added on calorie foods. There's a lot of that six percent of our calories. Come from these things, we really don't think we can control. But we really do like the automatic foods. We eat that. We don't even think about it. You sit down the order your food restaurant. They bring you some bread and some butter all sudden the bread and butter all gone, what happened to so it's very very common. This issue with the diet throughout kids adults. Everybody tells a little bit about some of the connection between high blood pressure and heart disease. Yes. Even a small amounts of high blood pressure rise can cause real trouble with your heart. Why is that patients will say gee stock? My blood pressure is only a couple of points over where it should be. I'll say, yeah. But your heart. Pumps one hundred thousand times a day. So think of that hurt thousand times a day multiply that by whatever percent or numbers? Your blood pressure's too high. It takes too high of a toll on your little heart. Then you gain a few pounds every pound of fat. We gain is extra five miles of blood vessels. So if your heart pumps one hundred thousand times a day times five that's an extra half a million miles per pound, a million miles per two pounds. You get the math. So this all adds up. And it really does where your heart, and what we eat really affects our blood pressure to right? Oh, exactly. Lots of salt. A lot of sodium. We're not active enough physically which opens up our blood vessels, the bigger the blood vessel. The lower the pressure. You'll the bigger the pipe the lower the pressure. So we really are working against ourselves. I'm afraid I just heard a piece on the mayo news network recently about the menopause and how menopause can affect your blood pressure. Because is your hormones change than you gain a little bit of weight? And sends you kinda down the same pathway. I didn't think of menopause is being a risk though. Yes. And the earlier menopause is more of a risk. So that's one thing. We asked women you. When did you have menopause in your forties versus your late fifties? That's the difference for your risk and pregnancy pregnancy, I admire any woman this cutting through pregnancy. But if they're blood pressure was high butcher was high during their pregnancy. That's a risk for more problems later in life. Yeah. And that's definitely something. We don't want to forget about is to remember to ask women about those issues during pregnancy and thinking is that go on in life. What about you know, my mom or dad's history? How does that affect me? Yeah. You're you're. They corn does not far to fall from the far from the tree is, you know. And if it happened early with your mom or dad early being early for a woman before sixty five early for a man before each fifty five his men tend to get their disease about ten years before woman. So it's early, and it's not just your mom or dad could be a grandparent or a brother certainly something like that thousand things we need to pay attention to. Let's talk about the cholesterol numbers because there's the LDL and HDL and what they really mean. Yes. The way I remember, my simple mind is is LDL. We want to keep low HDL you wanna keep high. Uh-huh. LDL is lousy in HD is healthy. Okay. So we can raise the HDL with fiscal activity. That's the best way we found. Stopping smoking. Your HDL will go up within six weeks. Eating lower fat foods is helpful to LDL is more medicines. Unfortunately, but it's also diet. Recent studies have shown that diet can affect our LDL for eating a lot of high saturated fats animal fats, specifically fell raise our LDL. Is there one that's more important than the other? If you get where you're LDL is too high and your HDL is too low. Should you try to raise the HDL? Yeah. The that's a very good question. And I think we have two little bit everything. Yeah. You can't just fix one thing things. Go off the we do encourage folks to be physically active and interval activity where you go hard for thirty seconds, sixty seconds. That'll raise your HDL more. We during courage him to eat a less amble saturated fat, eat more oil avocado oil nut oil as which. Is a very healthy oil. Eat more, fruits and vegetables, less red meat. Those things really do add up call the Mediterranean diet, which helps many diseases not just the heart. How do you ultimately diagnose heart disease? How do you figure it out when we say heart disease, we usually mean, there's something that's gone wrong? Artery has gotten plugged up in the in the heart. The valve doesn't work the way it should anymore. The heart rhythm is abnormal member. The heart has plumbing has like, Christy. It has all these different parts to endorse it open and close. So we have to diagnose each individually. It starts with a good history. Talking to the patient saying, what do you feel when you're doing the electricity can you lay down flat your feet, swell, etc. Also talking about family, he knows your mom or dad have similar problems like this because this can run in families. Then listen to the patient. There's this ancient thing we have called a stethoscope. We know that we use sound waves tests echocardiogram stress test. It depends on the disease. But usually start with a history, in fact, one of my mentors here, tell me if you don't know what's going on when you finish the history of the patient. Don't even bother do anything else because you should get all you need to know from talking to the patient and taking a good history. So during the month of February right at Samarkand, heart disease awareness. Yes, toss a little bit about that. Is there something that we could not here to educate people a little bit more will the is. I don't know why the shortest month is the month killer. When you eat a lot of candy doesn't make any sense, right? That doesn't work, but we the opportunity is just to raise awareness. You'll woman as you mentioned earlier as the intro that women at any age is more likely to die of heart disease than of breast cancer to that age. What's the number one killer women with breast cancer, heart disease? So we really do need to raise awareness, and it's all of that permission. Now, we really need to prevent the disease. We cannot wait until it occurs. Intrigue it, well, what are some treatment options? If someone does get diagnosed with heart disease. Do you start off with the medication right away? Or do you try to attack it with diet, boss? Well, it's pretty much both. I mean, everybody needs a little better diet. He's a little bit more physical activity. That's good for everybody in almost all cases. But in general medications are very helpful. If you have arteries that are narrowed you're getting some discomfort in your chest or shortness of breath. When you search yourself, your nitroglycerine long acting nitro-glycerine type pills pills that make it. So the heart doesn't have to need as much blood. When it pumps can be very helpful. If it's a blood pressure problem. You're pressure's too high the heart's working too hard the valvular leaking. Whatever treat the blood pressure that usually died obviously in lifestyle plus medications, we've been talking about heart disease with cardiologists Dr Stephen kobetski, we're gonna take a short break when we come back. We'll turn our attention to the cholesterol lowering medications known as Stanton's. We'll also talk about how to prevent heart disease. We'll have a method matter of fact, if I have diabetes, I can't take a statin medication..