35 Burst results for "Hypertension"
Food Addiction, the Problem and the Solution
Dr. Robert Lustig Exposes Truth Behind Sugar and Obesity
"Dr. Robert Lustig is professor emeritus of pediatrics, division of endocrinology at the University of California, San Francisco. He specializes in the field of neuroendocrinology with an emphasis on the regulation of energy balance by the central nervous system. His research in clinical practice has focused on childhood obesity and diabetes. Dr. Lustig holds a bachelor's in science degree from MIT, a doctorate in medicine from Cornell Medical College and a master's of studies in law from UC Hastings College of Law. Dr. Lustig has fostered a global discussion of metabolic health and nutrition exposing some of the leading myths that underlie the current pandemic of diet -related disease. He believes the food business by pushing processed food loaded with sugar has hacked our bodies and minds to pursue pleasure instead of happiness, fostering today's epidemics of addiction and depression. By focusing on real food, we can beat the odds against sugar, processed food, obesity and disease. And you wrote a couple of books. One is Fat Chance and it's a New York Times and the bestsellers list and the latest one Metabolical, I have read and formed my questions and I have a lot of quotes for you and ask you to address them. Actually it's not really a... You might you might also mention the third book and the reason is because we're talking about addiction and I wrote a book that's pretty much all about addiction and depression and that is The Hacking of the American Mind which really is about diet and mental health and so this is a book that your audience may very much appreciate. Good, wonderful and I would love to have you back and maybe talk about that one and Fat Chance. So yeah we'd love to have you back. I know Esther would agree. You explain that the book Metabolic, it's not really a word Metabolical but but it's a combination of Metabolic and Diabolical and what is going on is Metabolical. Your YouTube video, Sugar the Bitter Truth, has gone viral with over 24 million views and this is the truth. This is, these are the studies that back it up. I'm a believer. We're gonna talk about big food, big pharma, medical industry and the government which are all contributing to this and I told Esther when we decided who to invite I said I want to invite Rob. I've followed you, I've listened to your your videos, you're brilliant and you're bold. You speak the truth and which is based on science and data. Yeah let's start by talking about your work and why you decided to write this book. First of all, you know I didn't come at this with an agenda. I'm a pediatric neuroendocrinologist. I started out taking care of kids with brain tumors and it turns out that a lot of kids with brain tumors become massively obese and I had to deal with the obesity. As I researched that phenomenon which is called hypothalamic obesity, I realized that the same physiology that was causing patients these obesity was actually important in general obesity not related to brain tumors. The hormone insulin, okay, is you know the diabetes hormone. Everybody knows that you know you have to take insulin if you have diabetes to lower your blood sugar. Well where does the blood sugar go with because of the insulin? The answer is it goes to your fat. Insulin is the energy storage hormone and we started realizing that pretty much everybody with obesity had an insulin problem and actually those with the highest insulin problems also had all of these other diseases like for instance polycystic ovarian disease, fatty liver disease, cancer, dementia, gout, hypertension. It turned out we realized that insulin was the bad guy in the story and so then the question was what makes insulin go up in people that don't have brain tumors and the answer was sugar and so you know that's how I got into this and you know basically I've been trying to explain you know the vicissitudes of the American diet you know to the public ever since and explaining that you know there is no pill for this. You know the only way to get insulin down is get rid of the refined carbohydrate and sugar.
Valley Green Vegan
Podcast Highlight: Veganism Transformed My Health in Just Two Weeks
"So one evening, after finishing a huge dinner of filet mignon with a baked potato soaked with butter and sour cream, I told my husband, I'm done. And he was like, what? And I said, I am done eating things that are killing me. I'm turning vegan as of tomorrow morning. And he was like, okay, great, I'll do it with you. So the next morning, when we got up, I had to skip my coffee because I can't drink coffee without creamer in it. So we went to the refrigerator and the pantry, we cleaned out every type of food that was not plant based, we got rid of everything. We took it all to the food bank, and we donated it. And then we made a 40 minute drive to Wegmans, which is a store where we knew we could buy lots of good vegan friendly choices. And we bought about $400 worth of food. Now suffice it to say that we really didn't know better at first, we bought, you know, the good green leafy stuff and lots of fruits and vegetables. But we also bought the processed vegan cheeses, the vegan sandwich meats, the impossible burger patties, you know, all that processed stuff. And we really don't eat those things anymore. But I will admit, they filled a niche during that first couple of weeks of transitioning. So they do serve a purpose for sure for people who are coming off of the crazy diet that I used to be on, and you know, switching overnight to vegan. So here's a little more background on my health that I haven't really shared much about on previous episodes. In addition to having fought bladder cancer for the past six years, I was also overweight with a BMI of 28 .4. So that's the high end of the overweight category right before you hit the obese stage. Now I'm really tall at 5 '9", and so it's a little easier for people my height to kind of hide their weight, but I was at a very unhealthy weight. I had also been taking medicine for high blood pressure for many years. Hypertension ran in my family, so I just assumed that it was something I was going to have to deal with for the rest of my life. And to make matters worse, the last time my cholesterol was checked a couple of years ago, it was a whopping 220. I didn't tell anyone that at the time because I didn't want to hear from my family and friends, oh my God, you need to do something about that. So yeah, even though I knew that, I still had not made any changes to my diet to bring that down. So after watching those documentaries and getting a full understanding of what high cholesterol does to one's arteries, I was really kind of scared to think about what kind of blockages I had already been building in my body over time from just eating a very poor and unhealthy diet. The good news that I gleaned from those shows that I watched and everything that I read was that these problems can be reversed at virtually any age. It was never too late to start. And that was a great motivator, as great a motivator, as reducing the joint pain that I had from the cancer treatments. So here's what happened on day five of my first week on a solely plant -based diet. I woke up and got out of bed without any pain. I am serious, no pain. And that was an absolute miracle for me. I even asked my husband if he thought maybe it was psychosomatic. You know, I just didn't feel the pain because I had convinced myself it was gone. But that really seemed like a reach. I mean, there was no wishing away that kind of pain that I had suffered for so many months. So that was the first thing I noticed. And then as days passed, I felt better and better. Then at the end of week two, I took my blood pressure. Now, this was back when I was still on medication. So before turning to a vegan diet on a good day with meds, my blood pressure was still elevated, usually with a systolic number being, you know, like high 120s and or low 130s. And I had kind of come to accept that as the norm for myself. That morning, I took my blood pressure that second week after transition. It was 117 over 70. I was like, what? I took it again several times throughout the day, and it remained low. And that is crazy. I mean, I thought that's nuts. That's never been it's never been that low. But there it was.
Mark Levin
Tina Turner's Shocking Health Confession Before Death
"From the New York Post Tina Turner admitted that her health was in great danger just two months before her death The legendary singer who passed away today at the age of 83 after a long illness opened up about the battle with kidney disease on March 9th So look even up to that point She was you know still communicative and so forth She said my kidneys are victims of my not realizing That my high blood pressure should have been treated with conventional medicine She told her Instagram followers just two months ago I had myself in great danger I put myself in great danger by refusing to face the reality that I need daily lifelong therapy with medication For far too long I believe that my body was an untouchable and indestructible bastion And it accompanying blog posts for show your kidney love dot com She explained that should diagnose with hypertension in 1978 And at the time she admitted she didn't care much about it and didn't really try to control it 1985 she was prescribed pills that she was supposed to take daily To control it she said after suffering a stroke in 2009 because of my poorly controlled hypertension I struggled to get back up on my feet This is when I first learned that my kidneys didn't work that well anymore They had already lost 35% of their function The Turner eventually developed a fatal dislike she said of her prescription pills and even convinced herself that they made her feel worse So that consulting with her doctors she replaced her conventional medication with homeopathic remedies
WTOP
"hypertension" Discussed on WTOP
". Everything you need every time you listen. WTO news. It's 1145, I'm Ian Crawford, thank you for wrapping up your weekend with us with swimsuit season just around the corner. Some people are starting diets. With varying amounts of success, but some popular diets carry with them a new warning from the American Heart Association. Keto and paleo diets are popular, especially on social media, but the Heart Association says they're two of the worst because they tend to restrict a lot of heart healthy foods. The diet that earns top ranking for cardiovascular health is the dash diet. Dash stands for dietary approaches to stop hypertension. The dash diet prioritizes vegetables, fruits, beans, whole grains, nuts, seeds, and low fat dairy. It also encourages limiting salty foods, fatty meats, and foods rich in sugar. Particularly on WTO P news. The Census Bureau is taking the American economic pulse. The Census Bureau has started collecting data for the 2023 economic census. The bureau requires information from every business location, points like sales or revenue, employment, and payroll. It's collected from about 3.7 million businesses across the U.S.. As for the overall census, the next one is in 2030, and it could include changes how the U.S. government asks about your race or ethnicity. The Biden administration is currently considering adjusting how the questions are phrased, possibly combining two questions into one. Wendy Gillette, CBS News. It's 1147. Car dealers have a bad rap. So not one of them is trying to clear the air. I'm Brian banned Miller on business. Two years ago, Whitney Yates Woods became dealer principal at her father's dealership. She says there are many things customers get wrong about the industry. So she talked to Business Insider to set the record straight. For example, finding car parts became very difficult during the pandemic, and it's still a problem. This leads people to think they're getting bad customer service. But according to Whitney, that's not the case. If they don't know when the part is going to come in, then they just don't know. It's not a trick to get you to pay more or force you to wait longer just for fun. Another misconception buyers paying cash will get a better deal. But Whitney says to the dealer, it's all the same. Everything is cash. If you finance a car, it's still cash to them so it doesn't matter how you pay. She is one of the biggest changes in how transparent things have become thanks to the Internet, translation, research before you buy. Brian banned Miller, CBS News. Now to the top stories we're working on tonight at WTO P, Holmes and businesses damaged in Virginia Beach for a tornado that touched down around 6 this evening thousands still without power we are told
WTOP
"hypertension" Discussed on WTOP
"Dot com. Everything you need every time you listen. WTO P news. It's 9 45. I'm ridiculous Thanks for being with us. With swimsuit season around the corner, some people are beginning to diet. But the American Heart Association is warning people to steer clear of some popular ones. Keto and paleo diets are popular, especially on social media, and paleo diets are foundational for the foods that humans ate around the paleontology period. But the Heart Association says, these are two of the worst diets because they tend to restrict a lot of heart healthy foods, including beans, whole grains, and some fruits. The diet that top ranking for cardiovascular health is the dash diet, dash stands for dietary approaches to stop hypertension. It prioritizes vegetables, fruits, beans, whole grains, nuts, seeds, and low fat dairy. It also encourages limiting salty foods, fatty meats, and foods rich in sugar. Car dealers have a bad rap, so not one of them is trying to clear the air. And Brian van Miller on business. Two years ago, Whitney Yates Woods became dealer principal at her father's dealership. She says there are many things customers get wrong about the industry. So she talked to Business Insider to set the record straight. For example, finding car parts became very difficult during the pandemic, and it's still a problem. This leads people to think they're getting bad customer service. But according to Whitney, that's not the case. If they don't know when the party is going to come in, then they just don't know. It's not a trick to get you to pay more or force you to wait longer just for fun. Another misconception buyers paying cash will get a better deal. But Whitney says to the dealer, it's all the same. Everything is cash. If you finance a car, it's still cash to them. So it doesn't matter how you pay. She is one of the biggest changes in how transparent things have become thanks to the Internet, translation, research before you buy. Brian banned Miller, CBS News. Now to the top stories we're working on here at WTO P. Holmes and businesses have been damaged in
The Trish Regan Show
Consumer Reports Finds Heavy Metals in Hershey's Chocolate
"So Hershey's getting sued because there's this research from consumer reports showing that the dark chocolate they were putting out had very high levels of cadmium and lead. These are two heavy metals that have been linked to a whole host of problems health problems. In children and in adults. So apparently, according to the report consistent long-term exposure to these heavy metals, can actually result in a variety of health problems. I'm going to quote here from consumer reports. The danger is greatest for pregnant people, pregnant people, you heard that. Consumer reports is being politically correct and young children because it can cause developmental problems. It can affect brain development and lead to lower IQ. Then they go on to say that for kids anyway, it would actually result in brain development and neurological issues. And that's a problem. For adults, nervous system problems, hypertension, immune system problems, suppression, immune system suppression, kidney damage, and reproductive issues. So those pregnant people may not be able to deliver as many babies because of these reproductive
Texas Titans Podcast
"hypertension" Discussed on Texas Titans Podcast
"Now we have food on every corner the tencent calorie while it is an absolute modern day. Marvel it is also one of the things that is leading to obesity hypertension cardiac arrest all these other problems right. We're going through a global pandemic a great reason. Why those who are dying of this disease or having the hardest time surviving. Kobe is because they are fat. They are over there overweight in there especially in their gut. Well we live in a habitat that was made to be in the wild that was made to hunt our food. That was made you exert tons of energy and our bodies were made to store that it was made because whenever you ate the wildebeest you had no idea when you're next mill would come. You just didn't know again. Your body doesn't know it doesn't know that we live in this modern day society so for all it knows every time you eat. It's going to tell you we've got a store this unless you take the precautions to let to keep the same move in the west supposed to to keep everything circulating to manage your blood sugar. A lot went off. I'm going to pick this up in our. I lost my life there for minute. And gotta have m- alive because i need this. This forty six year old face needs all the help it can get. So here's the bottomline. Our bodies were not made to live and habitat that we currently is comfortable. We don't exert that much energy. We were made to store energy because we didn't know win. Our next mill was going to be in. So joel talks about aligning. You're eating the things you eat. That perfect precise timing of your eating in such a way that it is in sync with our ancestral body. It's really remarkable. It has a profound impact. And here's the thing. Okay so i know some of you. Whenever i say that eating at the right time. You're thinking oh my gosh. Does that mean you have to set a timer and eating like when you used to do like the five mills at the perfect time. That's just obnoxious. No this is very easy to follow it. Anyone like to say follow because i. It's really such an efficient program. If you want to call it a program you want to call it. A program is just an efficient way of eating of feeding and thinking about how are eating worse. How our body works how we fuel our body. It all starts with feeding the gut properly so that can properly manage most importantly so they can properly manage your blood sugar so as part of this whole improve always always and those of you who have been on this channel before that you listen to the podcast. You know that. I geek out on health and wellness and biohacking the whole thing.
Discover Music Channel (Discover Music Channel)
"hypertension" Discussed on Discover Music Channel (Discover Music Channel)
"I no but seriously though. Yes we on. We've all had someone that Got really ill from covert and some of us. That have lost people from kobe. But i just. I also want to Big up those of us. That survive kovin in arkansas kansas vibrant ovid and that we definitely During this time we see me. Were able to see like the underlining thing so to my understanding. You don't necessarily die or get gravely ill. from povich. itself is the underlining ambitions that kovin Help to exact hurry it up in in your system so The same way that we always you know we want to stress. We wanna have a party one time. We don't want to me spread but we don't meet also don't want you out there with diabetes. You not i mean. We don't want you out there with excessive obesity. We don't want you out there with with hypertension and things of that sort. So like i think this also examines our culture in our community on in health disparities within that. Because yeah these these things are these things are real and i think over hope unfortunately put another shining light on it. Like hey late we need. We need better healthy bodies. You're listening of our people to continue to to play mass to to dance to saying into to enjoy life. So let's let's be healthy for the other days that you know mass is not happening. You know the whole simple play. Massive spire freedom freedom. You know when you put on put on a constable if your feet hit.
Ben Greenfield Fitness
Study Reveals the Secret to Longevity in Japanese Centenarians
"To ancient things. A new study is pop. The is a japanese study and his japanese study was looking at a group of japanese centenarians. Who seem to have these seemingly magical powers. They have an average age of one hundred seven amongst the healthiest longest living humans on earth protected from chronic diseases that that inevitably haunt a lot of the rest of us as we age like obesity and diabetes hypertension and cancer. But what they found these people that really stood out was the trillions of microbes that lived in their gut It wasn't the amount of the microbes but it was. It was the composition of those gut bugs. The composition of those gut bugs basically. They had a bacterial signature. Those similar to the strains of bacteria in in each and every single one of the centenarians but a lot of them had a very similar microbiome in one strain in particular stood out and it was type of bile acid. Okay or is it a bacteria that synthesizes bile acid now bile acids what you might know. Is this kind of boring bodily fluid that's commonly known for digesting fats. But it's now being called as a class of entering hormones hormones that go beyond their classic role in fat digestion and absorption. So what they found. Is that these bile. Acids helped to protect sensitive gets infection and other environmental stressors. So it's really interesting because we know that that the gut bile acid content to decrease a little bit as one ages in the secondary by lasts a really powerful so they've done studies in mice before they looked at the these these microbiomes humans and they found that the gut bile acids to regulate immune cells and prevent some dangerous microbes from taking over the gut. And what a what they looked at in the seniors a particular group of gut bugs called or owed oral back to rasaie adora backdoor and that turned out this little bile acid called eyeso- aloe lithocholic acid or eyeso- aloe
One Life Radio Podcast
"hypertension" Discussed on One Life Radio Podcast
"As this. That even if you if you are dehydrated your blood pressure can go up. Is that true for sure. Yeah i mean those would be some acute changes and absolutely some people are more dehydrated chronically but when we think of the big modifiable risk factors especially for something like you know hypertension. So when you're vessels get A little bit narrower and if bit stiffer that's not good for your vascular health so for your heart and all the vessels and then that's when the pressure goes up a little bit now. The good news is though if we if we for most of us losing some weight improving your blood sugars You know reducing things like belly. They're all great ways of reducing blood pressure yet. No those are great ways reducing You said reducing Blood sugar levels right. Is that what you said. i'm sorry. I'm i'm concentrating on my lunch. I'm joking sorta for sure. We know that people who are even at the high end of normal even if you're in the normal range if you're at the higher end of normal you're still at a significantly higher risk of heart disease and that's actually augmented winner in our late forties and fifties and so people always ask. Where do i start well. Breakfast is a great place to start. I think last time we were on the show. We talked breakfast. But you're getting off to a good start trying to cut back on all the processed stuff that things that bring on board a lot of energy and a lot of calories trying to increase the protein intake so you know things like eggs and yogurt and you know. Put some protein powering. You're smoothie that kind of thing. Yeah no protein is huge. I used the sun warrior plant. Based and sometimes i'll occasionally i'll eat. I'll eat some eggs or something like that. I'm typically mostly vegetarian Which a lot of people disagree with even to be fit. But i just. I don't know because i'm such an animal activists. It's just it's counterintuitive to for my brain. My emotions and so apple are great..
Daily Tech Headlines
Google and Apple Shake up Health Initiatives
"Insider sources say apple will scale back. Its internal app. called health. Habit used by employees to track fitness calls talk to clinicians and manage hypertension health. Habit is part of apple's larger apple health organization and reportedly was seen as a potential model for a consumer product if successful internally. It's unclear if health habit. We'll continue with the smaller team or just be shut down in a memo to employees. Google knows it intends to break up. It's health division planning to split its various projects across other parts of the company. Insiders sources say google health. Chief dr david feinberg will leave the company to be the ceo at the electronic medical records firm. Turner
The Exam Room by the Physicians Committee
Dr. Neal Barnard: The Effect of a Plant-Based Diet on COVID-19
"Barr. Thank you so very much for being here. Jeff these are some really interesting studies and it kind of goes back to what it is that we've been talking about throughout this pandemic and and that is the healthier. You are the less at risk you seem to be. So if you wouldn't mind can you talk to us a little bit about these two studies and what it is. Researchers have discovered yeah. Let me preface this really by saying we've kind of suspect. The diet ought to be a big actor here because when people are overweight when you of diabetes hypertension particularly when these things are really out of control. Kobe just becomes so serious and often fatal but when people have these things under better control they do better. That suggests that if your diet is really good these conditions are going to be better but the question really was well. What if you actually are following a mostly plant-based diet will that help you and the answer seems to yes The first of these studies was involving. Healthcare workers were healthcare workers in six different countries. They tracked they ate and they rated them for more plant based or based or less plant based in other words. If you were less plant based at your eating chicken fish beef and cheese and kinda neglecting your vegetables and fruits and then if you were more plant based at mentor vegan or closer to it and the people who are more plant-based had a seventy three percent reduced risk of severe cove. It but i got to tell you the flip side of this was they looked to people who were doing kito or low carb diets and they did substantially worse a forty eight percent increased risk of severe. So don't go there.
Sadhguru's Podcast
"hypertension" Discussed on Sadhguru's Podcast
"The risk for heart disease or any. Anything like diabetes hypertension alcohol liver disease etc. So we know that. I talked to victor of vico. Victory was so excited to on with us. i want to leave him revealing. I know that you've done youth into programs all over the world are you will ask allow you to ask any questions. They want so go. Go ahead victor. You ask anything you want. Wonderful victor to. Bela maya though How duck european nielsen johnny. Who is trump It's really an honor to be here with everyone. It's it's it warms..
Nature Podcast
How Deadly Heat Waves Are Affecting Our Cities
"Is absolutely an underappreciated. Whether related natural disaster it's really easy to understand flooding when like a big hurricane comes in. It's really easy to understand. Wildfires threatening your house they to get out of the way but heat is. It's a killer. It's it's steady and people don't really recognize that. This often lack of information on heat related deaths a lot of times a medical examiner on a death certificate will just say this person died of exhaustion. This person died of hypertension. This person died of cardiovascular disease but the death certificate notice that that person was an apartment with no air conditioning and it was one hundred and five degrees for five days in a row. If you're older if you're younger if you have pre existing conditions like heart conditions or asthma you are much more likely to be affected by heat. People don't think about he as being a keller but it is. An event of this magnitude really sends shockwaves through society. This is action this our infrastructure system. Our ecosystems and society at large are not well equipped to be able to handle this level of intensity feedback is a professor of climate adaptation at portland state. University and part of his research has involved monitoring heat in different places in cities such as portland oregon and looking at how heatwave effects people and which people are most affected. We've been talking several folks who live in multifamily residential apartments these are low income social housing and the windows aren't applicable or they just opened a few centimetres. The sun solar radiation is hitting those apartment buildings it's being pushed in often through the materials at the apartment. Buildings were built with and then temperatures in there. We were noticing from some informal stations. We have set up. It was getting up to fifty seven sixty degrees in doors. In some of these apartment complexes in that's very very dangerous for human health
Physical Activity Researcher
Blaming Patients for not Doing Enough Is a Waste of Time with Dr. Matti Peura
"Capacious health physician and in the past. He has worked as a plastic surgeon. Dr motti pera helps people overcome their medical issues and achieve their best health. In the second part we will discuss the role of physical activity in our mental and physical wellbeing. And we'll also talk about behavioral chains and about the tools that may help making a change. Easier we are living in a time of sedentary behavior and obesity pandemic in the world. Many of us are thinking about making change towards better. We know what we're supposed to but still quite often. We fail in fulfilling the expectations of others and ourselves as efficient. Do you consider patients about these topics. I mean physical activity obesity so quite a lot of faces. The of this deal with the problems related to obesity obesity and current conquering disease just as diabetes hypertension So that's like an everyday topic for you to talk about it. It's quite it's it's very common. It's well to be honest to to continue from the previous topic the idea of them the value definition. I i have i have. I have applied this same method of thinking. we written helping a faces with obesity. Because like you said that we know what we're supposed to do it's everywhere so it would be kind of like actually a waste of time for me to work as a authority again for a patient to blame them for not doing the right thing. Not trying enough. That really really helps so we have to dig with obesity. We have to go behind to the actual calls. What causes
The Bio Report
Using a Digital Cognitive Behavior Therapy to Treat Diabetes
"David thanks for joining us. I'm happy to be here. Thanks for having me dating. We're gonna talk about better therapeutics. Its efforts to improve outcomes for patients with cardio metabolic conditions through what you call your nutritional cognitive behavior therapy and your prescription digital health products. Let's start with the diseases. you're targeting. how big healthcare problem do they represented a over half of. Us adults have one or more major cardio metabolic disease including diabetes hypertension in hybrid. Dania maids a yard. It's a we use the word epidemic for a lot of things. But i think it applies. Here it's a it's a massive problem to what extent are cardiovascular diseases and diabetes and related conditions driven by behaviors opposed to biology and perhaps more to the point. To what extent. Can these be treated by behavioral therapy rather than pharmacologic interventions so You know a fascinating a fascinating topic. So if you if you think about our evolutionary history i you know we didn't we didn't really have ancestors with cardio metabolic disease yup in in order to in order to survive and thrive and reproduce You know people were lean and fit. And and those are things that seem tend to reduce or eliminate cardio metabolic disease
Cardionerds
"hypertension" Discussed on Cardionerds
"Arterial hypertension lead to complications so they can to maternal complications the most serious being maternal deaths by you can also see a right heart failure homeowner hypertensive crisis and arrhythmias including sudden death and pulmonary. Embolism you can also have. Maternal complications like bleeding complications. That can occur in this population of those abnormal maternal human dynamics and in addition to other factors. We probably don't understand all that well lead to adverse fetal and neonatal complications including neonatal deaths. Poor growth of the baby and also a preterm birth. So there's lots of complications that can occur because of the inability to tolerate those dynamic changes of pregnancy while dr silverside. That was an incredibly helpful review. I feel like i could just picture all of that and my head. So thank you for that. I can imagine patients with severe pulmonary. Hypertension are very high risk of pregnancy related complications as you mentioned given their inability to appropriately augment their cardiac output but what about patients with mild to moderate increase pulmonary pressures or pulmonary vascular reds distance. Do they still have the same high risk. Yeah so there's a number of variables that will determine the risk of pregnancy and how women can accommodate to those human dynamic changes in cartridge based on the severity of the pulmonary arterial hypertension. But it's also based on the women's diagnosis so the ideology of their pulmonary hypertension. It's based on whether or not the patient is stable or not stable. They're functional class. Whether or not they require supplemental old. Chew whether or not. They're needing hominy arterial medications to be stable and also whether or not there rv size and function or normal. So i think we can think of pulmonary. Hypertension is mild water severe but the variables that predict their outcome in pregnancy are more complex than that. What i would say is clearly if you have more severe disease. You're more at high risk however even women with mild or moderate pulmonary hypertension can be stabilized from the human dynamics stresa pregnancy. And so in general. We say that there's really no truly safe cut point in the setting of pregnancy for women who have pulmonary hypertension. I would want to add one comment though. I think what will happen in your career is that we will start to understand more right now. Most of what we understand his on small series retrospective series knicks populations. Some women are using pulmonary as die leaders summer. Not but i think what will happen as we start to acquire more data prospectively in a more refined way we will someday identify the women who maternal morbidity and mortality is perhaps lower and will be able to give a better risk assessments. But we're not quite there yet and so currently any woman who has ominously hypertension trump pulmonary hypertension and particular pulmonary. Hypertension should be advised to avoid pregnancy. Thank you very helpful overview. And i think as you highlighted There's clearly still a lot of work that needs to be done in the fields in cardi obstetrics and the overlap with pulmonary hypertension..
Cardionerds
"hypertension" Discussed on Cardionerds
"She's contributed to a number of international practice guidelines consensus statements and she's also helped develop the car pro to cardiovascular risk prediction score. It's great to have you join us sector sites. Oh thank you very much. I'm so pleased to be here that you're sliver sites. It is such an honor to learn from you today before we dive in. Though we'd love to hear from you how you got interested in cardi obstetrics well when i finished my cardiology fellowship. I then went. On to specialize in adult heart disease which was also linked to cardio obstetrics and that really was because so many of the young women with congenital heart disease who are surviving with their pediatric surgeries were hitting childbearing age and people were trying to figure out what was the risk of pregnancy and how to best get them through a pregnancy. So when i was training those questions were just starting to be answered in the field was evolving and it was really exciting. It's obviously changed since i started doing it. There's much more diverse cardiac population. So now. it's not just congenital heart disease it's women with cardiomyopathy with acquired heart. Disease is now becoming more prevalent because women are getting pregnant older and having more cardiovascular risk factors in general and we're also learning more about genetic in your top facilities and genetic charisma's and how to manage them in pregnancy so the fields really evolved. It's continued to remain exciting. But i started back in the day win. Adult congenital heart disease was really fundamental. Part of cardi obstetrics. Thank you so much darker silver sides for highlighting this overlap between adult congenital heart disease and cardiovascular risk pregnancy on the cardinal's platform. We're really excited to be circling back to that particular topic as part of our upcoming act series but today we're talking about pregnancy and pulmonary hypertension. So why don't we jump right into that. We wanted to start by talking a little bit about why. This is such an important topic primarily because pulmonary hypertension has been associated with such high mobility immortality in pregnancy but thankfully the prevalence of pulmonary hypertension in pregnancy is quite low somewhere between point. Oh one two point zero two percent. I think that's one to two in every ten thousand births although this is rare if this has been rising due to the number of congenital patients like you've mentioned Oversights were living to childbearing age and the development and implementation of effective is therapy. Yeah as you mentioned the prevalence is low but the mortality with pulmonary hypertension is quite high. There have been two major systematic reviews covering a timespan of thirty years. nearly two hundred pregnancies. The total mortality of women in the first review was thirty. Eight percent and twenty five percent in the second review. Most of these women died within the first month after delivery and the major cause of death in these cases was heart failure sudden cardiac death and pulmonary embolism and sonia. In addition to high mortality. There's also a very high morbidity associated with pulmonary hypertension a recent study looking at approximately fifteen hundred pregnant women with pulmonary hypertension from the national inpatient sample found that the rate of major adverse cardiovascular events was around twenty four point eight percent with the majority of these complications including heart failure arrhythmia and pulmonary. Embolism bright so pulmonary. Hypertension is not common in pregnancy. But when it is there it's bad news so before we jump into a case. I thought it might be helpful to review the definition and classifications of pulmonary hypertension as they can run quite. The spectrum have different management and implications for pregnancy doctor silver sides. Do you think you could give esa refresher on the definition of pulmonary hypertension and the who group classifications sure..
What's On Your Mind - Encore
Derek Chauvin's Murder Trial Heads to Jury Deliberations
"The murder case against former Minneapolis police officer Direct showman in the death of George Floyd has now gone to the jury and Ed Donahue has this report. In closing statements, Defense attorney Eric Nelson said It wasn't a lack of oxygen that killed Floyd Drug ingestion. Huh? A bad heart. Diseased heart. Hypertension. Prosecutor Steve Slater told the jury showman had to have known what he was doing to Floyd. He heard him but he just didn't listen. Continued to push him down. Slater also pointed out it's all on video that force for nine minutes and 29 seconds that killed George Ploy. He betrayed the badge tape from court TV show Bin showed little expression. He took off his mask as his attorney, presented his closing statement.
Solvable
Interview With Paul Farmer on Global Health Inequity
"Paul farmers it professor at harvard medical school chief of global health equity at brigham and women's hospital in boston and the co founder of the organization partners in health began by asking him to describe the global health care situation in his own words. Well right now. We could focus almost entirely on the setbacks. You know one of the biggest problems we faced all over. The world is that with a shutdown. Obviously people aren't able to readily accessed their their care. What if they have cancer. Whatever they have diabetes have severe hypertension. So those are ranking problems. I think to anybody who's involved in global health. But that's just the tip of the iceberg. A lot of the efforts that we have engaged in to address. Social determinants of health are also being set back economic educational programs cultural endeavors employment opportunities There's been a major contraction. An anti poverty efforts overall. so it's going to be Troubling reflection on what's happened this past year and a lhasa worried it's gonna be projected poured into a futures. Will
Women's Health By Heather Hirsch
How To Work Through Pregnancy And Menopause.
"Hi and welcome to help each other hurt a podcast dedicated to uncovering many of the women's health issues many of us are wondering about but few of us are talking about my mission is to expose the current gaps in knowledge and Care on all things Women's Health. Enjoy. Welcome back to the show. So today's episode is going to be all about pregnancy and how conditions may may have affected your pregnancy can come back to play a role in perimenopause and menopause. So you may think these two are completely unrelated and I am here to let you know. There's actually some really interesting themes that we may be able to gleam from our pregnancy that we can use when we look forward to or as we're entering into perimenopause and menopause. Before we get into that let's hear a word from our sponsor from Pharma. Thank you so much for sponsoring. Today's episode film Pharma is a woman's health care company the focuses on putting women first off then Farm was established to help women who are often forgotten about the pharmaceutical industry their products address vaginal and Volvo dryness itching and pain. We're always told how important it is to moisturize our face, but our intimate areas just as important many women have trouble talking about dryness with their doctors and do not know where to turn them far. My mom is here for you. This company feels women should feel comfortable making intimate skin hydration a part of their daily skincare routine try their products today for relief from vaginal and Volvo, dryness wage and pain check them out at fem pharma.com. That's, you are not going to be disappointed. All right, so here comes a fun job. Moment of Truth one of the reasons I wanted to do this episode today is because I am expecting and I've been hiding this fact for a pretty long time. I am in my third trimester and so far pregnancy has gone just fine. I'm not one of those people who really enjoys being a pregnant. I know many women who do simply not one of them. So I have been trying to hide it and I guess that's my way of not focusing so much on it. Thankfully. I'm lucky to be pretty healthy during this pregnancy. And this will be my third child is a surprise. We don't know yet if it's going to be a boy or a girl so it'd be really fun if you want to stick around and see I'm due in early June and not anything like my last baby. This baby might be a little early. So if there is a little break in podcast episodes, it's probably because I just had a baby now you also log I love working and I love what I do is I'll probably be back pretty quickly. And at this point I've gotten really efficient at getting podcast episode out to you. So I wanted to let you know because I do not feel like I was being honest hiding this any longer and I am really excited but it really led me to think about let's talk about how pregnancy relates to. Pause and menopause now. I just said I'm one of those people who loves being pregnant. That's mostly because I'm uncomfortable a lot. However, I have been really blessed to have healthy pregnancies, but every single pregnancy can be thought of as a stress test. So do you know what a stress test is if you don't we typically think about cardiovascular stress tests where they put the little leads you and you have to walk or run on the treadmill and they're looking at the EKG to see when you're under stress what happens to your body and this is gleaming information about future cardiovascular or current call log. Vascular risks that you may have and pregnancy is a very similar. It's a, you know, forty weeks stress test to see when we put your body under a little bit of stress or conditions that arise that may play a role in your health as we go down the line and we're starting to clean so much more information about what we can take from our state and as pregnant women into our health as we go forward, for example, if you had gestational diabetes or gestational hypertension preeclampsia, a preterm birth postpartum depression off or any of these other complications, and I'm going to talk to you about what all those could mean and we're still Gathering a lot of this data. So more and more is to come now what you've never had a baby or you haven't had a pregnancy in your lifetime. I think this episode will still be really interesting because we're learning so much about maternal health and female birth. Factors that are completely independent or different from the traditional and I'm saying those are question. You can't see me risk factors, which is based on the mail system. So thinking about these is also really interesting as well as if you have a friend or a daughter or a niece who's going to be pregnant. This is such a really interesting information to know about first. I'm going to walk you through some soft findings and soft findings means. This is just what I see clinically and I don't really know how it's going to go on to apply but one of the things that I do see a very common basis is women who have had a postpartum depression seemed to have an increased risk for either pmdd, which is severe PMS or mood symptoms in perimenopause and into
San Diego's Morning News with Ted and LaDona
More Californians Are Now Eligible for COVID-19 Vaccine
"If you are 16 or older and you have certain health conditions you actually qualify for a vaccine Doctor. Robert Schooley is a professor of medicine in the infectious disease division at UC San Diego. He tells KOGO news. It's complicated to decide who's in the category. Some are wondering why Type Two diabetes is included, but not Type One. The reason for that is the Type two diabetes is adult onset diabetes. It's often associated with obesity and can be associated with heart disease. These patients with diabetes being in it Get her disease, the one to get into trouble with covert type One diabetes is juvenile onset diabetes, often with younger, skinnier people. Dr. Scully also says, Well, some heart issues qualify. Hypertension does not know the county says that is the number one condition among most hospitalized covert patients. Marilyn Haider KOGO News, the
KDWN 720AM
"hypertension" Discussed on KDWN 720AM
"Age 55 older are at risk for hypertension or high blood pressure and 90% of people that have pre diabetes. Don't even know it. And this is astounding. Get this recent reports project that in less than 15 years, 50% of all adults in the U. S will be obese. Now Here's the good news. The World Health Organization says 60% of deaths can be prevented. 60% and these diseases such as cancer, cardiovascular disease and diabetes equate to 35 million deaths each year. And these diseases have common risk factors such as inappropriate diet and physical activity. So by avoiding these risk factors in the first place by improving our lifestyle Now we can prevent the majority of deaths due to those diseases. So, prevention is the key and it starts with healthy aging. Although we can't stop the aging process. You know what you can do. You can stop getting old. If you're middle aged, you've lost nearly 80% of your human growth hormone. Also known is H g H and has heard on Dr Oz and all over the media. The injections of HGH are making people feel and look 10 to 20 years younger, but new advances show that you can naturally and safely increase your own youth hormone. What's the secret? Well, the doctor has some shocking news to share with you and you can't afford to miss it. So we're looking forward to all that. But first, of course we're talking with Dr West are God fearing physician, You've been practicing preventative medicine and making people younger and fitter for over 30 Years a member of the American Academy of anti Aging where thousands of doctors and scientists are on the cutting edge of medical technology. From stem cell research, biotechnology disease prevention hormone replacement therapy. He's been saving lives, which has recently won him most valuable Physician of the Year award for the state of California. That's awesome. So for over 10 years Now you've been developing groundbreaking, all natural age, reversing supplements that have changed thousands of lives. And today you're going to be revealing something new. What is that? I am so happy to announce that we just released the world's first natural H G H supplement specifically formulated for.
All Things Considered
Mexican president tests positive for COVID-19, symptoms mild
"Of consistently downplaying the pandemic. Mexico's president contracted the virus, making him the latest world leader to fall ill from covert 19. His government says he has mild symptoms and is running the country's affairs from the National Palace. As NPR's Carrie Kahn reports, the Mexican leader is sick at a time when the country is witnessing a record number of coronavirus deaths. For many, it was just a matter of time before president and dress Manuel Lopez Obrador would contract the virus. He's rarely seen in public, using a mask and throughout the pandemic has kept up a grueling schedule, touring the country, flying commercial airlines and interacting with many people like he did just this past weekend. The military band played the national anthem, Lopez Obrador inaugurated new basis for his National Guard troops. He told a small crowd that the pandemic yes has been rough on Mexico. But it needs to be put into perspective. Lack is masking a panda Mia. There's been a basically, corruption has done more damage to Mexico. It's worse than a pandemic. It's a plague, he said. On Saturday, Lopez Obrador's underplayed the spread of covert in the country even as the death toll is approaching 150,000, the fourth highest in the world. More than 1.7 million people have tested positive for the virus. But officials admit that is an undercount since only the sickest are tested, and his ambitious vaccination plan is stalled recently after Fizer temporarily halted shipments of its vaccine to the country, do the logistics problems. Critics of the president's handling of the pandemic say they're not surprised. He himself has now fallen ill. Let's face it, The odds were increasingly against him Kindness. Bravo is a political analyst and teaches at sea. They in Mexico City University does not even try to be a social model. In terms of basically taking precautions. Early on in the pandemic, Lopez Obrador famously held up religious ambulance declaring that they along with his good morals. Would protect him from the virus and the cool protector. It is. Alone 80 that the best shield against the virus is to be honest, not to steal and not to betray. His comments, made back in March, are now being rebroadcast continually on TV and social media. For now, Officials say. President Lopez Obrador is isolating in his quarters at the national Palace and has only mild symptoms at 67, though he suffers from hypertension, and he had a heart attack in 2013. His Interior minister, Olga Sanchez, oversized morning press conference today, but kept it far under the two hours the president usually takes sink winter studly, pronto pronto Sirica Pereira, especially the president is stable and will recuperate very soon. I'm sure of it, she said. Soon after the morning conference, the president's office sent out pictures of Lopez over door in a suit behind his desk, taking a call with Vladimir Putin. Russia will reportedly send 24 million doses of its but make the vaccine over the next two months to Mexico.
Cardionerds
"hypertension" Discussed on Cardionerds
"The original com first in man trial which was published in the lancet a a few years ago. And what it is. It's this device that sits within the crowded artery And it's it's like a scaffold. Essentially that is pliable and moves with with sicily and aslam deforms crowded barrel receptor in really tricks the brain into thinking that a blood pressure's higher than it actually is and then technically should bring down blood pressure This is in its fda pivotal clinical trial still recruiting for that. But that's another interventional therapy. That's on the horizon may have to be careful may prove to be effective in terms of blood pressure. Lowering long term particularly resistant hypertension individual. He i think is going to be really interesting to see over the next few years where we land in terms of this perkiness options for blood pressure. Control duck laffin. Thank you so much for all the great information provided to us today. I'm really excited and feel comfortable tackling patients who have uncontrolled hypertension and also being able to address patients who come in with newly diagnosed hypertension as well. I also think it'd be great opportunity to briefly touch on your role as director of the cardiac rehabilitation center. Here at the cleveland clinic. One of the star patients of the series in actually on the most touching stories. I've been able to here on this. Podcast is about mr kennecott. Mean the head of the nuclear lab. Here at the cleveland clinic. He actually gave us his perspective as a heart patient. In episode thirty nine of podcast he told us at cardiac rehab following his semi hospitalizations more than the most helpful aspects of his care on one of the most touching things he said was. I think cardiac rehab is one of the greatest things people can do. Dr laffin would you like to say anything with regard so it goes on the credit rehab and how it helps. Our patients have that sun ice to that yes. I'm medical director of cardiac rehabilitation at the main campus. Cleveland clinic and really cardiac rehabilitation is a great resource for patients following. Any type of her. Katina's intervention. am i cabbage valve repair or replacement. The other indications for angina as well as heart failure with reduced ejection fraction that symptomatic with the f. of less than thirty five percent cardiac rehabilitation oftentimes alive and a lot of doctors and cardiologists thing. Oh it's just getting on a treadmill. It's more than that. It's a supervised and educational program of that takes place over a three month period. Typically thirty successions k. He do about three sessions a week for fifty minutes to an hour and your monitored by our by wonderful team typically nurses exercise physiologists to really maximize your exercise tolerance and really try to improve that and also to educate regarding common risk factors for the progression of cardi messes educator. Hypertension diet blood glucose control..
Cardionerds
"hypertension" Discussed on Cardionerds
"Okay if they have target organ damage out of proportion to what we would expect with their degree of blood pressure elevation which is prominent in primate. Astra's well that's when he wanted to do a little bit more digging as well now the way i like to think about. It is ninety percent of hypertension. That we're going to see is a primary hypertension. Then we have this. Subset of a ten percent is secondary hypertension and but amongst that ten percent. The vast majority is going to be undiagnosed either primarily austrian ism or at least excess aldo strom secretion. We're all taught in med school that you need to use the all-austrian ratio and that will give you the answer. We know that's really not the case really nice. Paper published pretty recently was thousand patients for academic medical centers. They looked at a variety of patients. Normal tens of stage one stage two. I've pretension resistant attention. They sodium loaded them okay to try and suppress all da strong which sodium will do and then they measured arena donald austrian and what they saw which is what makes sense is it's a spectrum of disease. It's not like pregnancy okay. It's not binary you are aren't there's a spectrum of disease and once we reach a certain threshold. We call it primarily southeastern as we think those patients we should be a little bit more aggressive about screening for potential interventions surgical intervention etc. But it's definitely a spectrum of disease. That's why bernie mac tone. The component of it wise from elected was so effective in the treatment of resistant..
WJR 760
"hypertension" Discussed on WJR 760
"Is not covering prevention. You have to take it upon yourself. Make a decision for yourself to get someone who's going to guide you through a process of healing. So if you've got like a family members who have heart disease or hypertension, I guess what I'm I want to know is Go to your regular PCP, and maybe you're gonna get a stress test. Or maybe you're going to get a cardio cardio gram. That's not really going to identify anything. It's not that's for once you're already a diagnosis. Is that right? Well, a stress test is a blood flow test that on Lee identifies people who have narrowing of the artery. And that doesn't affect everybody. So ah lot of people die from a heart attack or stroke before they get a narrowing so you could have a very active plaque. That is going to cause you serious harm very soon yet Pastor stress test with flying colors, so blood flow, which is really how health care is being managed right now in terms of vascular disease. Does not prevent anybody from having death or a debilitating stroke it all So at least the end, or the beginning of the answer is that they need to get identified as to whether they make plank and then what to do after that's been identified. Exactly. So that's what I want to know from all my patients. Do you have plaque and then I want to know. And we'll talk about this next segment. I want to know what's the quality of your plaque? Because that makes a big deal. What's the quality of their park? Is it soft meeting is at risk for rupture is that Hard or safer. Is there a mixture so knowing about the quality of plaque and also knowing about the plaque activity with the blood work? You put that all together and then you can start playing people on the right path? Okay, let's come back and talk some more about the testing that people need in order to prevent disease. In the meantime, we're taking a quick break. You're listening to the colander Medical radio show. If.
Cardionerds
"hypertension" Discussed on Cardionerds
"And the true goal is somewhere with a solid blood pressure. One twenty s which gives us the greatest bang for cardiovascular risk reduction and avoid side effects caused by hypertension. Now we did. Just get a call from the. Ob clinic next door. They're sending over a patient for your review who she saito is a thirty six year old g..
Cardionerds
"hypertension" Discussed on Cardionerds
"Use of home. blood pressure cuffs enrolled ambulatory. Blood pressure monitoring. Greg definitely a we can talk about it. That's a really big deal in a real big push recently in. The hypertension community is make sure measuring blood pressure correctly. Okay i'll i'll touch on it in a sack of the sensor on your iphone se can measure blood pressure through your thumbprint. That's going to be not helpful. So it's really important that we take the time in clinic to measure blood pressure correctly. The standard recommendations are patients can't have had any coffee rector cise or anything like that significant for thirty minutes before we check the blood pressure. Want them to sit alone. Not new chatting with the medical assistant nurse are getting on the phone for at least five minutes before we check blood pressure in that applies to checking at home as well when you do it. You wanna make sure that feet flat on the floor. Legs crossed arm has to be resting heart height. He can't be holding it up. And and you wanna make your make sure. Your back is supported in street. You have to make sure the bladder is empty because a full bladder will raise blood pressure by ten to fifteen millimeters of mercury and most patients. And then what we recommend is then checking blood pressure. Newer statement put out by the american heart association. Talking about should we be doing Or metric in really the push has been more towards oslo metric blood pressure measurement because we we eliminate the human error associated with listening to the cough sounds and so we got him sit there we check the blood pressure. Typically when you're seeing clinic for a new patient appointment you wanna be checking blood pressure.
Cardionerds
"hypertension" Discussed on Cardionerds
"Journal of medicine in twenty fifteen sprint bloodpressure. Trial the spread blood pressure. Trial got a lot of publicity at that. Time and trial is perfect. And i don't think sprint was perfect. But it provides a lot of evidence for clinicians about how aggressively to treat hypertension. So i think it's helpful to go briefly through what it actually showed was. It was comparing lowering systolic blood pressure to one. Twenty or lower versus is less than one forty for the systolic pressure in what it alternately showed was that those patients that we use more aggressive blood pressure treatment strategies some typically more medications ultimately they died less and they had less the composite primary endpoint which was major adverse cardiovascular events as well as inclusion of heart failure events not surprisingly as i think a lot of us would would've thought when they announced the trial at stopped early. Was that a lot of this. Primary endpoint little. The primary point was predominantly driven by changes in heart failure k. There's a lot less heart failure in the group that was more aggressively treated and so that really drove a lot of clinical decision making from the end of twenty fifteen forward and then the discussions about changelings thresholds for four blood pressure management. Because it seems like people do better when we treat them a little bit lower in one of the criticisms to sprint is. How representative is it of the general population that we see a main certain respects. It is in certain respects. It isn't you gotta remember. They weren't enrolling people with really wide pulse pressures or quite low diastolic blood pressures. So you want dealing with those isolated systolic hypertension where diastolic are starting out in the fifties. You know one forties over fifty for examples didn't earn all those people important to note that the enrolled people with high risk of cardiovascular disease so it wasn't individuals walking around at thirty years of age okay with with elevated blood pressure. Because it just weren't going to see the number of clinical events that they would need to and then the way that they measured blood pressure in the way that they titrate medications was also interesting. They did automated unattended office. Blood pressure measurement which typically tends to be a little bit lower than what we see in a typical office setting for measuring blood pressure and then they were pretty aggressive in the control arm so the less than one forty arm about deep prescribing and ultimately their goal was to get people for that systolic blood pressure between one thirty five and one thirty nine. Now that that's where some of the controversy comes from as well because if someone's doing fine and their blood pressure's one twenty nine thirty. Are we really going to prescribe for them. Certain people in their criticism of sprint would say no. We're not but but that's what they didn't a trial so that was the sprint trial in that really drove a lot of these changes in the blood pressure guidelines the following year. The european society of cardiology brought out some guidelines as well. They didn't change the definition of hypertension. They kept it at one forty over ninety but the important thing to note about these guidelines is that oath make a point that if someone's high party vascular risk so similar to the sprint trial population we should consider leasing the european guidelines the languages. We should consider getting them to one thirty over eighty or below and obviously the american guidelines. That's really the goal in anyone with secondary prevention for cardiovascular disease or those individuals at high risk for for cardiovascular disease but are still a primary prevention patient and what they typically use..
Cardionerds
"hypertension" Discussed on Cardionerds
"Not meant to be used for medical advice. The views expressed hey do not necessarily reflect the opinions or policies of our employers. The goal is to enjoy learning cardiology directly from expert cardio nerds hey cardio nerds craig and i are here to learn all about hypertension from a true expert. I have the distinct pleasure of introducing docker. Luke laffin cardiology faculty in the division of preventive cardiology and medical director of cardiac rehabilitation. Here at the cleveland clinic dr laughing at medical school at vanderbilt university school of medicine. He trained in internal medicine and cardiology at the university of chicago where he also completed a dedicated fellowship in hypertensive diseases. He is a clinical specialist in hypertension designated by the american society of hypertension which is now merged with the american heart association. Daca laughing only recently joined the cleveland clinic. And it's been so incredible to work with you and learn from you dhakal. It is such a pleasure to welcome you to the show. Thanks very much for having me looking forward to chatting with you has done a great job with the podcast. Daca laffin russo. Glad you joined us today. We have a very busy schedule for the cardio. Narrates hypertension clinic. Could sure use your help. That's can start with our first patient dilemma as the fifty eight year. old woman. With the history of hyper libya -demia return for follow up. She's asymmetric imports. No major issues until last visit on november twelfth. Two thousand seventeen her blood pressure. Today is one thirty. Five or eighty five is same as her last visit. She's prized when told she may have stage one hypertension. Why didn't they tell me last time she says that laffin. There's a lot to unpack here. Do you mind reviewing the old versus new office. Based blood pressure thresholds for defining hypertension. Sure yeah greg happy. Happy to so really what. The difference is a two thousand seventeen. American blood pressure guidelines came out in november in those endorsed by a variety of organizations most prominently the american heart association and the american college of cardiology and probably the most controversial aspect was really redefining. At what levels of office blood pressure hypertension is defined and so whereas previously stage one hypertension had been defined at one forty above for the systolic blood pressure. Ninety or above for the diastolic blood pressure. The shifted that definition down to stage one hypertension was one thirty to one. Thirty nine mill. News-mercury systolic over eighty to eighty nine millimeters of mercury systolic. And this. You know there's a lot of different opinions out there but there's also reasons behind why they made this change to actually call systolic blood pressures in the one thirties. Hypertension probably the most significant reason was clinical inertia whereas we tell someone you have pre hypertension orange some term. That really mean a whole lot. There are a little bit less likely to change their lifestyle and their patterns and we may not be treating people as aggressively as we need to and that really comes down to understanding what the evidence was behind that change from one forty to one thirty and that was driven predominantly by the publication in the new england.
Cardionerds
"hypertension" Discussed on Cardionerds
"Affects the lives of hundreds of millions dedicated cardio nerds everywhere are working hard to fight this global epidemic. These are their stories. Hey everyone it's amid. Thanks for joining us for today's visit to the cartoon hypertension clinic in this part of our prevention series. We get to learn all about hypertension from becker. Luke laffin preventative cardiologist and hypertension experts. We are also so excited to be joined by dr greg. Ogono a brand new first year cardiology fellow here. At the cleveland clinic. Gray completed medical school at the university of south carolina school of medicine and internal medicine residency training at washington university in st. louis. He served as an academic hospitals there before moving to cleveland to dive into cardiology. Greg enjoys traveling exercising and experiencing new cultures through their food. Greg thank you so much for joining this episode and it's been an absolute pleasure has an avid listener. I feel extremely fortunate to be able to take part in the car owners. Podcast and also be able to learn from dr luke. Laugh in this afternoon. Great when i met you you recognize that i was one of the co host partners right away knowing that that you listen to the show was just so special for really all of us and even after an episode comes out you. You're right there. The next day to give me feedback about the episode. And so it's just it's so special for us to hear that that we're having impact and thank you for listening. And i told the team that we just we have to get great on the show so really appreciate it. Wow yeah i mean i mean..
This Week with George Stephanopoulos
Fauci: Up to 90% of population needs vaccine for herd immunity
"The cdc is now requiring a negative test for any travelers coming from the uk but officials had been downplaying the threat of these of these new strains that we are seeing these variations in the uk. I think you had said earlier this week. That a mutation doesn't mean the virus more dangerous or more deadly. Dr fauci said that these these these variations may already be here in the united states. So why why this new step. Why this new restriction important for people to know that we're layering protection on top of protection on top of protection. No individual protection is going to be one hundred percent. A lot of americans don't know that back in march through the presidential To twelve f authority we restricted. The ability of people to come to the united states from the uk and travel is down ninety percent even pre knowledge about this new variant from the uk. So we've already had severe travel restrictions from the uk. testing within seventy. Two hours isn't one hundred percent. It's not perfect but it does. Further decreased the number of people who will come in and then what we recommend to people according to the. Cdc is that once you get here you still isolate for seven days if you've had a negative test or for further longer than that if you don't get a test on this end ten to fourteen days so those things layer together. We'll significantly decrease chance of exposure to a new variant. But here's what the american people most need to know. Mitigation works the shows that it works. So if you're worried about a new potentially more contagious variant. It that much more important that we follow the four ws. Where a mask wash your hands. Watch your distanced and the fourth one is weight on gatherings especially with one last holiday coming up new year's we need to be very careful. You said that you understand the skepticism. From many african americans about the vaccine obviously given the history of medical racism in this country and you of course got vaccinated on camera to to to to send a message. What else needs to be done to convince people including some of those most vulnerable that this vaccine is not only safe but it's effective and necessary. Well we need to continue to acknowledge what's happened in the past. And i've talked about ski. Talked about henrietta lacks but they were real issues going on today right now in this country when you look at seven hundred women dying pregnancy related complications. Most of them black and brown in the united states. When you look at not just cova hypertension and cancer disparities. We need to acknowledge these things. And we need to show people meaningfully in a real sense what we're doing to improve on these measures and that's why a surgeon general before covid health equity was a critical part of everything that i did. And then we need to engage with trusted influencers. We need to make sure our pastors in e moms in rabbis. All of whom. I'm working with. Have the facts so that they can spread it to to their congregants and we need to walk the talk and that's why i got vaccinated on live tv. I want people to know that as a scientist at the doctor. I've looked at the data. I know the protections that are in place. I know an african american female helped. Develop this vaccine and tony foul. She and i made sure that the trials were were enrolled with diverse participants. And i got vaccinated because i trusted and how we end this pandemic
Fat Mascara
How to Improve Cultural Competence in Dermatology and Skincare with Dr. Susan Taylor
"Okay. So we're here with Dr Taylor, don't worry we gave a nice bio on you before you came on the line do truly one of the most amazing dermatologist in the United States like I'm so excited you're here we want to hear about your career little bit before we start talking about the issues of the day that we brought you on to talk about. So first off what made you want to become dermatologist well, you know. When I went to medical school, I. wanted to be an interest and I wanted to treat people from the inner city with hypertension and diabetes and cardiovascular disease. But then during my fourth year medical school did my very first dermatology rotation and I loved everything about the specialty The fact that he could range from Piatra patients to you know those in their eighties and nineties the fact that there was a little bit of surgery. Pediatrics was cosmetic. Dermatology in general dermatology. The fact that you could actually see in feel in touch the pathology as opposed to like pretending, you can hear it you know through the stethoscope so that really changed my whole focus. Now when I graduated I decided nonetheless to do a internal medicine residency. But halfway through I said, you know you've got to remain true to yourself and what are you gonna be happy you know thirty years from now practicing so I went back and did another residency in dermatology in here we are. Also, that added a little bit of time onto your career. It did. Yes it was so worth it. Yeah, and so you I know you're the founder of many amazing things that I've gotten many resources from one of the things that you're known for is. Working at the skin of Color Center can you and you co-founded that ready did yes. So I'm back with that is when that started back in nineteen ninety eight I did my dermatology residency at Columbia. Presbyterian. Medical Center in about ten years after I had finished I got a call from one of my professors who said you know here in New York, there's the need for a center that specializes in skin disorders for people with darker skin tones, and he said, this was my my mentor. Dr Deleo. He says, you know they say to me you're a nice guy but I want someone who looks like made and so he called me one day and said, would you be interested in coming to New York in creating some type of center and for me it was an incredible challenge an incredible need. This type of center didn't exist anywhere in the world and my mandate was to name it started to figure out what the mission was and that was a wonderful wonderful challenge. So what I decided was. This would be a center for. Instance in clinical dermatology, we would also perform clinical trials, research trials, and at that point, many dermatologists were very afraid of doing any types of cosmetic procedures on people with darker skin tones. So we wanted to really gorge path that. So that's Why we created the skin of Color Center, I am delighted to report it still in existence. Now, it's now affiliated with Mount Sinai and there's a new wonderful director WHO's there? Can, I just ask Dr Leo was he a White Guy? Dr Dalil I didn't know you. Know can Dr till now goes bad. You know I'm a tall white guy and they don't want to see a tall white guy. They want someone who looks like you and you know he's just been a wonderful inspiration over all of these years I'm very fortunate to have had him as a mentor Academic Sense. So when you let your medical residency, did you feel like you were prepared to treat all the patients that you were about to say is at the level of care that they are. Yeah. So I had the distinct honor and privilege of a doing my dermatology residency New York City in Manhattan like one of the most diverse places on earth. So from the time I was the first year. Dermatology residents I saw people with all skin tones. And all ethnicities and racial groups. So when I completed three years of residency, I did indeed the very prepared in diagnosing and treating disorders in people with darker skin tones. Then I opened up a private practice in Philadelphia, which is my hometown and I found that over time many women and men of color sought me out because you know it's not just the skin tone, but it's also the customs habits. Women did not have to explain to me what they do with their hair because I have the same hair and so there is a cultural competence and we wanted to create a center were all the doctors no matter what their race or ethnicity was culturally competent.
UN News
COVID-19: ‘little or no’ benefit from remdesivir: WHO
"Results from a UN coordinated international trial looking at four cave nineteen therapeutics have shown little or no positive impact on preventing death in patients infected with new corona virus, the Solidarity Therapeutics Trial, overseen by the world. Health Organization who found that REMM disappear hydroxy chloroquine, Lapenne Aveer. Rootin- and Interferon. appeared to have little or no effect on twenty eight day mortality or the hospital course of covid nineteen among hospitalized patients. The study involved more than thirty countries and investigated the effects of the treatments on mortality ventilation and length of stay in hospital. It did not examine other uses of the drugs such as preventive treatment, which would. Require further trials in a related announcement. The WHO said that Covid nineteen had also highlighted the increased vulnerability of people with high blood pressure to the coronavirus. The warning is based on data for more than one hundred twenty countries showing significant caveat related disruption to treatment for people suffering from chronic health conditions with findings showing these patients make up fifty to sixty percent of all deaths through covid. Dr Bent Mickelson director of WHO's Department of noncommunicable diseases said that more than one point one, billion people around the world suffer from hypertension mainly in low and middle income countries when it comes to call it nine, thousand, nine, hundred, hypertension, one, hundred and twenty two countries that has reported. US that in over fifty percent of the country's the healthcare services disrupted fully or partially fifty percent of the country's, and in addition we see a high number of is we don't have global figures yet, but we see in the rain show fifty, sixty percent of the people that are severely ill and died in hospitals from code have hypertension diabetes, and so forth and the working on the global targets.