American Heart Month Podcast 2 – Learn Ways to Prevent Heart Disease

SUMMARY
As a contractor for Medicare, Kepro serves as the Beneficiary and Family Centered Care Quality Improvement Organization, also referred to as a BFCC-QIO. While Kepro provides BFCC-QIO services in 29 states, the general information is relevant to everyone who has Medicare (including Medicare Advantage) and everyone who works with people who have Medicare. 

This episode is a conversation with our guest, Jessica Whitley, MD, MBA, Chief Medical Officer for Kepro.

In this podcast, Dr. Whitley will share information about things you can do to help prevent heart disease. She shares about lifestyle changes and ways you can monitor the risks that you have.

For more information about Kepro BFCC-QIO, please visit www.keproqio.com.

KEY TOPICS

00:29: Overview of second podcast – heart disease prevention
05:39: Lifestyle and genetic factors
12:46: Blood pressure monitoring

16:17: Cholesterol monitoring
17:37: Blood sugar monitoring

20:44: Final thoughts

 
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RESOURCES

BFCC-QIO Information for stakeholders: www.keproqio.com/partners

BFCC-QIO Information for people who have Medicare: www.keproqio.com/bene

Resources for heart disease: 

www.cdc.gov/heartdisease/prevention.htm

www.heart.org

Music: Motivational Upbeat Corporate by RinkevichMusic 

soundcloud.com/rinkevichmusic

protunes.net/

Video Link: youtube.com/watch?v=ZZH_Dd237EQ

Transcript

Welcome to Aging Health Matters, a podcast from Kepro, a Beneficiary and Family Centered Care Quality Improvement Organization. We plan to cover healthcare topics for the Medicare population. Information in today’s show may help you or someone you know in their healthcare journey. Thanks for joining us. Now let’s get started.

Scott Fortin   

Hello everyone and welcome to Part 2 of our Heart Month podcast with Dr. Jessica Whitley, Chief Medical Officer. Today we will be talking about some of the elements that you can look at to improve your health around your heart. Now that Dr. Whitley has given us some ideas in our previous podcast of things to look for and different disease types. This will be a good action item for us all to take a look at our health and ways that we can improve our heart health each and every day. So without further ado, let’s get back to the conversation with myself and Dr. Whitley with her asking me. “Scott, what else would you like to talk about?”

 Well, thank you. I mean that was really good because a lot of times, doctor, we will hear people use abbreviations, and I heard several of them as you were talking, A-fib, CHF, things of that nature, echo, cardio. So these are things that are really good to learn, and I think also when we're looking at some of the signs that you outlined, I believe that many of us will look at these signs every day and say, well, my stomach is upset, or I've had some light-headedness, and I think what you're trying to drive home here is that that can be a problem, which can be occurring for a long time versus when you think of a heart attack, it's immediate. Something's going to happen, and we definitely shouldn't drive. We should have an ambulance. We should be under professional care as fast as we can get it, to save that heart muscle, to keep the blood pumping as much as we possibly can and get quick treatment. So I think those signs that you outlined are very important. 

Jessica Whitley   
 Scott, just before we go ahead because just like you said, these are signs that we can feel a lot.

Scott Fortin   
 Yes.
 
Jessica Whitley   
 So I don't want people to like ohh, I feel a little short of breath today, having a heart attack. Remember, these signs are going to be persistent. They're going to persist throughout the day. Either they're going to come, and they're going to stay and not go away, or if they come and go away, it's going to keep coming back throughout the day or days. And so that's really what you want to pay attention to. When these symptoms come, how long are they staying? Is anything that I'm doing causing them to come on? Is there anything that I can do that makes them go away, but you really want to follow that timing pattern. You know, if I feel nauseated one, for a little bit one day, and I know that I probably went to a restaurant that I was questioning the food, and you vomit, that's probably not a heart attack. So you really want to kind of put all of this into thinking because, yes, these symptoms can be caused by a lot of other different things. Now if it's a heart attack, it's really going to be persistent.

I mean, it's staying there. If it's just a heart disease, you'll notice it's not as severe, and it could just follow with you over a period of months. And so whenever you're feeling anything like this, if you think it's a heart attack, remember call 911. If you're not sure, contact your primary care physician because you really need a doctor that's going to help you to monitor these symptoms, to do certain testing that you need to figure out to get down to the bottom of what's causing the symptoms. But don't ignore them. Pay attention to the symptoms. OK, go ahead, back in your court, Scott.

Scott Fortin   
Well, absolutely. And as you were saying, Dr. Whitley, we've talked in a previous podcast that we did together where you have to advocate for your own health, and you have to have good communication with your doctors and people that are taking care of you. So I think that that's important too is if you do present with some of these, I'd rather see folks present with gosh, I had dizziness and light-headedness and find out that as you just outlined, a lot of heart issues. I don't want any of them,  and I don't want anybody I know or anybody in our audience to ever have to worry about them.
 But it's great to know about them, and it's good to know how to treat them and how we can move on from them. So now that you've got me concerned about heart disease and all of the things to do with the heart and irregular beats and things like this, what can you tell me and the audience about how we can protect ourselves?
 How can we improve ourselves from a physical standpoint to try and protect against some of these elements that you just discussed with us?

Jessica Whitley   
Now you're getting to a really important point because if anyone has ever heard me on these podcasts before, one of the points that I constantly try to bring to the audience is you really are the best caretaker of yourself. Your doctor is a partner in that, but your doctor alone cannot take care of you. You have to be the captain of your ship. Your body is your ship, and so you want to make sure you're driving that ship properly. We don't want to run it into an iceberg like the poor Titanic. 

And there are things that you can be aware of with your body and that you have to be aware of if you want to keep this body in as good of health as you can. Now what I will say is there are a lot of lifestyle factors. Lifestyle factors means you know the way we live our lives that can help to contribute to our heart disease or that the way that we live our lives can help to prevent heart disease. There are a couple of things that we cannot change. We can't change how old we are, and we're all going to get older. So you can't change that, and with increase in age, and that's what you said at the top of the show for our Medicare beneficiaries, you are at an age that just puts you at a higher risk for these diseases of your heart. There's nothing that you could do about that. The other thing that you can't do anything about is if you have a family condition, what we call genetic factors, and it's something that's just passed down in the family that may give you a higher risk. You can't do anything about that. 

Sometimes depending upon conversations that you may have with the doctor and if you talk to the doctor about certain conditions in your family, that may make the doctor do more tests on you, so that if you're going to get one of these heart conditions, you can catch it early. That is very, very important. That's why we're paying attention to these signs and symptoms because if you catch a disease early, a disease could be controlled, and you can go on to live a healthy life. Heart disease is not necessarily you're going to have all of these symptoms that prevent you from leading this active, healthy life. We want to try to catch it early. Make sure you know if anybody in your family has things like heart attacks or strokes, especially if they've had them at an early age like before 60 years old, and you really want to know about like your parents and your siblings and your children. 

Those are the most important, so make sure you know if those conditions exist in your family, if you can. Some people are adopted, and they may not know that type of thing. So as best as you can try to know this information. Let's focus this on what we can do to protect ourselves from heart disease. A lot of us don't live healthy lifestyles because in our busy society quick is the easiest thing to do. So we often divert to quick. That may be going through a fast food restaurant, and sometimes you will do these things. I don't want to make it seem so overwhelming where you're like, I can't do this, but at least for 80% of the time, try to make sure you're living healthy. What is living healthy? It's choosing healthy food and drinks, fresh fruit and vegetables. This could be frozen too but try to get most of your diet from fruits and vegetables. You can have like seeds and nuts. Just incorporate a lot of these.
 
I'm not saying you can't eat meat, but you should eat the fruits and vegetables if you want to live a healthy life. You want to eat foods high in fiber, and you don't want them to have a lot of fat. You don't want to eat a lot of salt, and you definitely don't want to eat a lot of sugar in your diet. Finally, and these are just some quick things,  lot of fruit, a lot of vegetables, and we want to go low in fat, and we want to go low in sugar, low in salt, and we want to go low in alcohol. So remember, you want to have low alcohol intake.

The second thing we want to do is keep a healthy weight, so let's just get down to what is a healthy weight. The best thing that you can do to know whether or not your weight is healthy is to check what we call the body mass index, the BMI. There are so many calculators online, or there are even apps that you can put on your phone that will calculate your BMI for you. It's based upon your weight and your height, and once you get this number, if it's not what you want, OK. This is where we are, and we can just have goals. I want to start moving in the right direction.
 
Don't feel overwhelmed. You can't change things in a day, but if we start to make small changes, we can start moving in the right direction. When you figure out what your BMI is, and certainly your doctor can give this to you, or you can, if you know your weight and your height, you can calculate it yourself. But I will give you some of the meanings of a BMI. If you're between 18.5 and 24.9, that is a healthy weight. So just think of that, that's where we want to be. Let's keep it between 19 and 25 to be more simple. If your BMI is over 30, this is the level that will increase your risk of heart disease the most, if you're 30 and above. Know those numbers. Know what your BMI is. 

Next, get some regular physical activity. This doesn't mean you have to go to the gym, or you have to do these exercise classes. If you're in a chair, simply lift your legs up and down. Move your arms up and down. Just move your body. If you're in your house, have a time where you get up, time for me to take a lap around my house or around my apartment. Or if you're living in a in a nursing home, maybe I can take a lap around the nursing home. If you're unable to move your body because of certain health conditions, just move what you can. If you're in a cold climate like myself, I do have a treadmill that I walk on in the house to avoid the cold. Or I do a mall walk because that's inside the mall, and it's nice and warm. I just have to make sure I don't do a mall spend when I do that. Just get your body moving. 

The next thing is smoking. I cannot emphasize how smoking is really, really bad for your health. So if you don't smoke, fantastic, don't start smoking. And if you do smoke, don't get overwhelmed. But let's start to try to move in the direction of how do I figure out how to stop smoking. It's going to take a plan. It's going to take a lot of effort, and this is again where you want to talk to your doctor to get some help. There are all kinds of other resources out there. Smoking is very, very addictive. So don't feel bad if you haven't been able to kick the habit. So never give up on trying to stop smoking. 

The next category, aside from kind of this overall lifestyle, is we really need to monitor ourselves to see if we're going to get these health conditions, and if we have these health conditions, then we need to monitor them to see if they're in control. So there are a couple of health conditions that I'm going to highlight that contribute to heart disease. The first one is blood pressure. So we have to try to have a healthy blood pressure. What we want to do to have a healthy blood pressure is to really check our blood pressure at home. If we only get our blood pressure checked when we go to the doctor's office, then it's just taking like this one snapshot, and we don't really know what it is throughout time. Typically, you can get a home blood pressure monitoring device. The American Heart Association recommends a cuff that goes around your arm, and then you just press a button. There are also ones that go around your wrist; There are even ones that go around your finger. The wrist blood pressure cuffs and the finger ones, they're just not as accurate. If you have that, then certainly use it. And the best thing to do is to bring whatever device you have, bring it to the next doctor's appointment and compare what you get on your device to what that doctor gets as a reading in the office to make sure it's good.
 
What you want your blood pressure to be, you want your top number to be kind of 120 to 130. Some docs depending upon your other disease conditions will say they want it less than 130, but typically that's for your top number, the number that's on the top. You want to keep it to around 120 or 130. That's a really good goal, but if you go over 140 at the top, this really increases your risk. That high blood pressure, and over a long term, it can cause a lot of diseases. Over 140 consistently is definitely something that you want to be concerned about. You want to live in that 120 to 130. I will tell you if your top number gets to 180 or above, that's something you need to really call your doctor about because you're really getting into what can be in a danger zone. It takes a lot of other assessments to decide what that's going to be and everything, but 180, you need to talk to your doctor. You don't want to be consistently over 140, and if we're golden, we'd like to live in that 120 to 130 range. 

For the bottom number, you want that number to be less than 90. Typically, we'd like it to be around 80, less than 85, but definitely not higher than 90. So you want to know these numbers about yourself. If you don't know these numbers about yourself, then you don't know what to do and what you need to talk to your doctor about. So make sure you know these numbers. So we've gotten two numbers we need to know: your BMI, your blood pressure. Measure it a couple times a week if you have high blood pressure, if you don't have high blood pressure, maybe you can take it a few times a year just to make sure you don't have high blood pressure.
 
Now the next thing you have to monitor is your cholesterol because your cholesterol is one of those things that can put you at risk of having that narrowing of your arteries. So if you don't have high cholesterol, you usually are going to get this level checked. It's a blood test. Your doctor will order it about every four to six years. If you do have high cholesterol, or if you have a family history of high cholesterol, then your doctor is probably going to monitor that more often. But it's usually the  numbers that you want to look at are your bad cholesterol, which is your LDL cholesterol, and your good cholesterol number, which is your HDL. That I will give you for a little bit of homework. There's so much information that you can find that's going to tell you where you want these target numbers to be at but know these target numbers. So go on the Internet, sites that have a .gov ending or .org ending or sometimes .edu ending. These are the sites that are going to give you the most reliable information. 

In trying to pay attention to time, and I know you're probably running out of listening space in your ears, I want to get to another condition that's really, really important. Diabetes. If you have diabetes, it's so important to control your diabetes, and I'm going to tell you about another number. I talked about your BMI. We talked about your blood pressure. Cholesterol is a number, but I didn't give you targets for that. But I want you to look that up. That's homework, and then the fourth number that I want you to know is something that we call, the medical term for it is glycated hemoglobin. But oftentimes your doctor calls it either your hemoglobin A1C, or they simply refer to it as your A1C.
 
This is another blood test, and it's going to tell you one if you don't have diabetes, it can help diagnose diabetes. And if you do have diabetes, it's going to tell you how well your diabetes is controlled. So I am going to give you some target numbers. If you do not have diabetes, a hemoglobin A1C, that means your hemoglobin A1C is less than 6.5. That means you don't have diabetes. Any hemoglobin A1C of 6.5 or greater, that is a diagnosis of diabetes. That is something that sometimes your doctor will check, maybe with your annual physical, if you don't have diabetes.

If you do have diabetes, your doctor is going to check this A1C more regularly, and the target for somebody with diabetes is to have an A1C 7 or less than 7. Now there's sometimes if you have a problem with your sugars going low, if you're on insulin, and sometimes you're with diabetes and your sugars go low, they will set the goal a little higher for you. But that's usually for people that have a problem detecting when their sugars are going low, or their sugars are often going low, or they have other health conditions that just really complicate certain things, and it makes trying to achieve a lower blood sugar level a little bit dangerous. So sometimes they may set that point a little higher. That would be something for your doctor to discuss with you. If you have diabetes, typically you want your number to be 7 or less. And for those of you that don't have diabetes, that A1C cannot hit 6.5, so if you see your A1C is around 6, if it's in the upper fives, start to know your risk of getting diabetes is increasing, and you want to really do the lifestyle changes that I discussed about trying to prevent heart disease are the same lifestyle changes that you would use to prevent and control diabetes. Those are the high points that I'm going to hit. And I think that maybe I can stop it there, Scott, are there any other points that you think I missed or any other things that you think we should discuss?

Scott Fortin   
No, I think you've hit the high points as far as helping us to recognize the disease and then also taking a look at what we could do to prevent some of these instances.
 I mean, we both are advocates for taking control of your own health. The modern healthcare movement is away from treating things reactively and going towards more proactivity and things that you discussed in here today, such as cholesterol,  blood pressure numbers, blood sugar numbers. These are all important factors that I think people have gotten more intelligent about, and I know our audience hopefully has educated themselves, and if not, I really urge you to do that. It's something that we all should take better care of ourselves with, and to Dr. Whitley's points, to stop and prevent some of these things I think is the biggest thing. How do we protect ourselves and prevent this from getting worse for us? So I'm very appreciative of the explanation on all of our terms that we could hopefully all understand of the different terminology we've heard today. Dr. Whitley, CHF, A-fib, heart attack, heart failure, things of that nature. So I really hope that the audience was as educated as I was with all of this, even working in health care I've learned some new things today, so thank you. I really appreciate the fact that you met with us again today and guided us through some elements of how we can all do better here during Heart Month.

Jessica Whitley   
Right. And just let me leave the audience with don't be overwhelmed. There was a lot of information in here. If you didn’t catch it all, I wouldn’t be surprised. The beauty of a podcast is that you can relisten to it. But also, these facts are not just known by me. They are readily available for you. Remember .org websites, .edu websites, .gov websites. If you have a lot of these health conditions, taking on multiple lifestyle changes at once can be very overwhelming. Sometimes, just start with one thing. Just remember that. You don’t have to be overwhelmed. We gave you a lot of information. You can relisten to this podcast later, or you can browse the web, or you can talk to your doctor and get this information. Try to make changes a little bit at a time. Those are usually the most effective changes, when you just make them gradually. So, I want to leave the audience with don’t be overwhelmed. Just decide what am I going to do, but please try to pick one action that you're going to do to make yourself healthier. This February, the internet will be filled with lots of good information that you can get, and then hopefully, you can talk to your doctor, and I wish you all a happy heart.

Scott Fortin   
Absolutely. Thank you again, Dr. Whitley. And to follow up with the elements that you mentioned, we are going to have some links in the bottom of our podcast intro here in our cover. You can take a look at some of those links here. During Heart Month, we can put those out there for you. We can also provide our information to our website for different ways to reach us. If you need to know more about any of the services that we provide, and then also I would be remiss if I didn't say that I would ask you all to tune in for our next podcast and relisten as Dr. Whitley said to some of our past ones because some of them, including one of Dr. Whitley's past ones about advocating for your own health, are very important. Besides anything that Kepro can do for you in the appeals, review, or Immediate Advocacy area is also you taking control of your own health and being the healthiest that you can. So I too wish you a happy Heart Month, and I'm very glad that we were able to spend some time together educating folks a little bit Dr. Whitley. So thanks once more. I wish all of you a great day and a great Heart Month. Thanks and take care. We'll talk to you next time.