Welcome to iHeartRadio Communities, a public affairs special focusing on the biggest issues in facting you this week.
Here's Many Munio's.
And welcome to another edition of Iheartradios Communities. As you heard, I am Manny Munyo's. February is American Heart Month, and heart disease happens to be the number one cause of death for Americans. Yet more than half of us don't even really know what it is. So how about we get some clarity on it, why it's so deadly in our country, and what we should all know about being able to take better health, better care of ourselves and our loved ones. Let's bring in doctor Clyde Yancey. He's
chief of Cardiology, Northwestern Medicine Blum Cardiovascular Institute. Doctor Yancey, I appreciate the time.
Happy to be here, Manny, Thank you so much.
Bill.
Let me start off with this, what exactly is heart disease and what are the different types?
Manny. Let's think about the way you framed this begin with you talked about this being in deadly condition. Let's let the first takeaway for the audience be this, it doesn't have to be a deadly condition. Let me tell you what heart disease is, so we can start from the same point. Anytime the heart are blood vessels, and particularly the two together are functioning abnormally, we are at
risk for heart conditions. What does that mean. It means heart attacks, It means strokes, it means heart failure, it means a regular heart rhythms. You can see that there are any number of ways in which heart disease can be experienced, but it all starts from a floor a floor of any scenario, any circumstance where the heart our blood vessels are the two together are no longer healthy.
Why is heart disease the number one cause of death here in our country?
What makes it so widespread?
So that definition allows us to really address what's important. When the vessels become unhealthy, when the heart becomes unhealthy, we start to have these conditions. And because of our lifestyle, in particular, because of the way in which we engage with our community, our society, it means that we have these burdens of risk. It also means that these burdens are risk and modifiable. What are those risk factors? Thinking about how we engage in life. Smoking definitely a risk factor,
high blood pressure, obesity. Our dietary choice is physical inactivity. We need to understand all of them, taken together put us at risk. In add family history to that, and now you can begin to understand that is this whole assortment of different exposures that puts us at risk for these heart conditions. But they all are modifiable. And that's the really good messaging we want to share.
Is this a uniquely American problem? Do they have the same levels of heart disease in other countries for example?
Yeah, heart conditions vary across the world. It turns out that high blood pressure is the number one heart condition worldwide, but in all communities, particularly in westernized communities Northern Europe, for example, the Pacific Rim, we see the same kind of profile of heart disease. But this is not just innically resource countries. Low and middle income countries are having more and more awareness of heart disease in their communities
as well. So let's think about this. Heart disease is ubiquitous, it doesn't vary according to geography, and any great extent, we should all hear these messages.
I'm guessing one of the problems is that so many of us, and especially men in our country try to avoid visiting the doctor at every turn, and there's early warning signs and symptoms that people often probably overlook as well.
No, so there are three things embedded in what you just said, Manny. The first is that because we're so intimidate about the deadliness of heart disease, then we kind of de select, we kind of step away. That's part of the hesitancy. I wouldn't just drop that on the back of men. The other thing is that we don't elevate the risk of women nearly enough. We need to do that because the risk factors apply for both sexists.
So that's yet again another very important thing if we're talking about how do we address this condition.
You mentioned men and women there, but I do know heart disease is a different between the two.
So let's get to this issue of signs and symptoms and the way it becomes we might say manifest or the way you might say it becomes experienced. It is experienced differently in men versus women. That is correct. That's why we need to have these conversations and so that women recognize that anytime they feel not at ease, not well, particularly in the central chest, we should think immediately about
heart conditions, whether it's typical or not. For healthcare providers and particularly for doctors like myself, we should realize that women can have different presentations than men can have, So that's important across the board, though. What are the signs
and symptoms, Well, the symptoms of which you experience. If you're experiencing justice comfort of any sort, If you're experiencing inexplicable, uncertain amounts of weakness, that requires a conversation, if you have any shortness of breath that requires a conversation, palpitations that requires a conversation. The conversation is with your healthcare provider, your doctor, your family practitioner, the people that help you restore your health and improve your health. Those are the symptoms.
The signs are things that we identify at the bedside. What's your blood pressure, what's your clusterol level, what does your heart examination sound like? We put the two together and then we'll be able to understand who's at risk and what can we do about it.
What are the biggest misconceptions about heart disease?
Doctor, There are several misconceptions that we just have to eliminate right now. Women are at risk for disease. That's incredibly important. But the second misconception is two people. Too many times people feel as if there's nothing you can do about it. That's wrong. Eighty percent of heart disease is preventable. The third thing people think, well, they're just going to prescribe a pill a dual procedure. No, so much can be done with lifestyle so that you can
control this on your own. So those are three very immediate mess that I want to dismiss. Women do have heart disease. There is something we can do about it. Eighty percent of it is preventable, and it doesn't always require a drug guard procedure. Lifestyle coaching, lifestyle changes can make a difference.
I want to get back to that lifestyle thing in just a moment. Here we're speaking with doctor Clyde Yancey, Chief of Cardiology, Northwestern Medicine, Blum Cardiovascular Institute. Why is American Heart Month so important in drawing attention to heart disease? And what has been the impact of heart disease awareness?
So two important things in your question, and the key word was attention. One of the unique things about having a designated window like February as Heart Month is because it gets all of us to centralize our conversations first about the heart, yes, but more broadly about our health. That's incredibly important because health is our most precious asset. When we have health, we can do anything. If we don't have our health, there's nothing we can do. So
that's the first thing. But the second part of the question is really quite insightful. What can we do about it? What's been the result of this awareness. It turns out that over the last three decades we've seen a fifty percent decrease in deaths due to heart disease. We should celebrate that, we should applaud that, but we also see a worrisome increase in the burden of risk, and those curves are going to begin to change. So that's why Heart Month is great because it's allowed us to get
the message out and we've seen this reduction. But Heart Month is also necessary because we see more risk factors coming along.
One of those reasons I imagine that we've made such great strides, as you mentioned over the last three decades, is not only the diagnosis.
But treatment exactly. We've been able to do more for heart disease than ever before. The therapies we have. The procedures are incredibly effective, again than ever before, but also for prevention. But we also know this that reduction in depths due to heart disease, over half of that has come from heart healthy messaging. Taking subs to prevent heart disease are terrific today, better than they've ever been. But prevention is powerful as well.
Let's go back and talk about something you've already mentioned, but I want to re reiterated the biggest risk factors for heart disease that we can control.
We need to be more active because physical inactivity, centary lifestyle sitting puts us at risk for heart disease. We need to think about our diet. I want to articulate the things you've heard before. You know about fresh fruits and vegetables and low fat, but I want to give you something simple. Think about just eating less. If we can just think about eating less, that gets the journey started to what's becoming healthier. If we can completely avoid tobacco,
that's incredibly important. Weight management is incredibly important. Medical obesity is a risk factor for disease. So to be very clear, smoking, physical activity a heart unhealthy diet. Diabetes particularly hypertension and your family history. All those are risk factors, and like you, let's just focus. So one thing, high blood pressure. If you don't know your blood pressure today, you should go and have it checked. It's just that important.
Some of the best things in life are the things that are bad for you, right red meat, I love to drink, my wine, love fried foods. You're not suggesting that we completely deny ourselves those things, but everything in moderation.
So some of the best things in life are health and happiness, healthche But what I'm also suggesting is that it's all about moderation. No one is. You don't hear me telling you don't do things with the exception tobacco. Everything else is moderation. Everything else is about eating less about doing more about positive things we can do to gain our health.
A little bit of movement more better than no movement at all.
We've talked about diet and exercise are the most significant impacts on preventing heart disease. I want to ask you something that is still kind of taboo to discuss in our society, but I think we're making great strides stress and mental health because both of those things do have an effect on heart health as well.
There's nothing taboo about talking about a risk factor that we know is important for heart disease, and that's particularly stress. It used to be a vague sort of consideration, but now we understand this stress when it becomes manifest as inflammation, is in fact a risk factor for heart disease. Now what does inflammation mean. It's a big fancy word. Imagine getting an insect bite, looking at your hand and seeing
a red circle around that bite. That's inflammation. When that happens in your blood vessels, that puts your risk of disease. That's a visual that everyone can understand. Stress does in fact cause heart disease working through inflammation, and so we can find ways to manage stress. Well. It adds to our understanding of what we can do to reduce this burden. But one other thing adds to our understanding, and that's knowledge.
We have to know our numbers. We can't measure stress, but we can measure blood pressure, we can measure closterol, we can measure humanglobmin a ONEC, we can know our weight. All of the things we're talking about, All of these things can reduce this exposure to heart conditions.
How effective are medications these days? Cholesterol, blood pressure? We hear a lot about it these days. Lowering your A one C maybe.
Losing weight incredibly effective. I want to be very clear. All of the things we know to do are based on evidence, not storytelling matt antidotes, but based on evidence. Lowering the blood pressure those at risk a thirty percent reduction in death. We know that lowering the cholesterol, lowering the LDL fraction in particularly, the lower the better, the lower the better, the lower the better. There's no mystery there.
We know that reducing the burden of weight. Now, with all of the brilliant work going on to help us understand medical obesity, we know that that makes a difference. We know that this trio of our metabolism, our kidney, and our heart work together. When we treat that trio, call it cardio kidney metabolic conditions. We know that two works. We're no longer guessing. We know that they're effective therapies that change our exposure to heart conditions.
I asked you a moment ago about stress and mental health and what role that can play in heart disease. We're so different in the United States than many other countries, fast pace of life, we don't take time to take care of ourselves. How important is sleep in maintaining a healthy heart?
So you're bringing up a good question because we know that despite our resources, we are unhappy, we are unhealthy, and we're not well rested, and that's a bad trio. But we understand that if we are able to get seven hours of sleep per night, that's equivalent to preventing heart disease almost in total. It's just that beneficial target seven hours of sleep as a major step to reduce
heart disease. If you put it in an entire portfolio being more active, eating less, knowing our numbers, and getting more sleep, that's seven hour threshold. That's the big stuff forward towards reducing our exposure at heart disease.
Final couple things for you, because someone in our country does die from heart disease every thirty four seconds. And there's a reason it's called the silent killer, right. I think it's in forty percent of heart attacks. The first symptom is sudden death and there's no treatment for that. So what are the symptoms that people other obviously going to the doctor getting a check up, knowing their numbers, what are the things people should.
Look out for.
So the first thing is, don't wait for the symptom. We know that all of us should risk. No one is protected, no one is privileged. All of us are at risk. So understand early on what's my exposure. It's very simple in the beginning. Measure your cholesterol, know you wait, knowing your blood pressure. Let's start it there. But if we are thinking about symptoms, anytime you feel not well, anytime you have chest die comfort, shortness of breath, skipped heartbeats, palpitations,
you can fill them almost as hiccups. Anytime you have these conditions, speak up. It's much easier to speak up and be reassured than to dismiss this and then have something much more worrisome occur. Don't fear this condition. It's more treatable now than it's ever been before. Let's get the idea of deadly out of our vernacular, and let's think about the opportunity to have ideal heart health going forward.
It's all on us, I guess Doctor Clyde Yancey, Chief of Cardiology, Northwestern Medicine, Blum Cardiovascular Institute for American Heart Month, thank you so much, for the time and all the wonderful information.
I appreciate it.
I appreciate you, Thank you.
There are many angles that we can and will take in discussing heart related issues this month, but I found this one to be fascinating. We all know what CPR is, but how exactly does it work and how has it developed? Why should all of us know how to save a life. Let's bringing an expert to discuss it. Doctor Lawrence Phillips is director of Nuclear Cardiology at ny u's Lango and Medical Center. Doctor Phillips, I appreciate the time, thanks for joining.
Us, Thanks for the invitation to talk today.
Let's start off with the basics. What does CPR stand for.
So CPR is called cardiopulmonary resuscitation, and the idea of CPR is to essentially help support what's been a failing part, to allow oxygenation to the body when that body is not able to do it by itself. There are two major things we think about. First is oxygen and the second is essentially transportation throughout the body.
How do we know when someone is in need of cardioc arrest?
So classically, what we think about, especially when we're thinking about the community is somebody suddenly collapsing and becoming non responsive or unresponsive, and it's important that as bystanders we immediately jump into help because the amount of time that the body, especially the brain, is about oxygen, is completely related to the likelihood of having a poor outcome.
Can CBR be performed or should it be support performed on someone who is breathing but unconscious or is it only on somebody who's breathing has stopped?
If they not, if they're not breathing, that's when you would start CPR. And if we broaden it, what we want to think about is when somebody collapses unresponsive, they're not moving, they're not breathing, their heart is likely stopped or is it really a fatal rhythm that's not able to sustain life, And so a bystander who's there is able to help them by providing CPR is actually increasing
the chance of their survival. Without bystander CPR in these situations, death is rare than ninety percent, and so's it's really important that first people learn how to do it. It's very simple to do, and they also be willing to step up to help when they see somebody underneath it yeah, I.
Guess both of those are equally important, aren't they.
It's one thing to know how to do it, but then refuse to step in when you need to. And I want to get into how somebody trains and learns how to do this properly. I guess all of us are familiar with CPR from you know, watching movies, TV shows and things like that, and I know it's changed a little bit.
You've got chess compressions and you've got assisted breathing, is that right?
Yeah, so in classic CPR, and this is you know, if we think about the history of CPR, different components of this was looked at over centuries, but really in the last century where the greatest developments made up until the point of nineteen sixty when it was all put together for what we classically think of a CPR, so
assisted breathing and chess compressions. Now, what was found is that when you combine those two, even with people that are learning, they often are uncomfortable for many reasons and doing it when the situation arises. And so in the late two thousands, two thousand and eightish, the American Heart Association said, based on good scientific data that if you're
a bystander and you're going to help that. Hands only CPR can be as effective, meaning removing the resuscitation part with the breathing from it and using the hands only component of it, so the chest compressions. And so the way I look at it is in the medical community, when we're involved in resuscitation, clearly we're using ventilations as
well as chess compressions. But for a bystander, so somebody in the community, for family member, even doing chess compressions alone can increase a likel their survival by two or three times. And so there's a big push on the community level to train everybody in hands only CPR so that it can increase the response of this.
And I guess the reason for that was people just didn't want to give what is known as mouth to mouth exactly.
I think one of the big things is that they were afraid to give mount to mouth for any number of reasons, especially if it's a stranger or the environment that they're in. And then what happens is if they don't give mouth to mouth. They found that people wouldn't do anything at all, Right, So by removing that barrier, we've found that more and more people are willing to get in and help. That makes a big difference.
Yeah, it's one of those things.
And I mentioned I want to ask you we'll close it out in just a couple of minutes here talking about the easy ways to get information and actually train for this. But I guess it's the difference between what you know different people. Some of us will run towards danger to try and be the hero, and some of us will run away from the danger. And that's an important thing when you're talking about a life or death situation at that moment where somebody needs medical.
Assistance, absolutely, and things to think about. And I'm always struck by this fact that when we think about cardiac arrest for the heart stopping someone who would benefit from CPR, almost over seventy percent of them occur in the home, right, The great majority occur in the place of work or at home. So the fear of it being a stranger is much less than it being somebody either a loved
one or a colleague. And so learning the skill is really important because we kind of think about it the movie version, right, It's that it's out in public, that you don't know the person, but much more likely, right, somebody.
You know differences obviously between performing CPR in an adult, in a child, or in an infant.
Yeah, so there are different components of it. When we think about CPR, including the assistant breathing. There are different ratios that you use for the breathing and the compressions. Those are specific to the age of the person or really the size of the person. When we think about other components of it. For the reason someone's having a cardiac arrest, it changes from a child to an adult.
Adult is more likely going to be related to the heart as the primary problem, where an invent or a child, it might be more related to breathing or related to choking or other things that we think about when we think globally about arresting. You know, a lot of the traditional mouth to mouth resuscitation was over a century ago when thinking about people that were drowning, and that's where
there was a lot of progress that was made. So if we think about that evolution that's occurred, the age of the person involved makes a big difference.
And the training is important because how hard, how fast those chest compressions are given, I imagine can determine life or death.
It does. But I think the key take home is going to be that for bystanders CPR, if you're doing hands only CPR, it's very easy to learn. And because that the person's had a cardiac arrest, you're not hurting them, right not, you shouldn't worry that you're going to hurt them more and taking that and I've taught people in a few minutes how to do it, and so learning
how to do it is very easy. And if you have the opportunity to be an environment where you can practice it, and you know, with a mannequin for example, there are medicans and frequently that that's great, But even just watching a video online is enough to have the basic skill set to be able to help.
Have a few more minutes here with doctor Lawrence Phillips, he's director of Nuclear Cardiology at NYU's land Gone Medical Center, on this American Hard Month talking about CPR.
It feels like just.
About everywhere we go these days, we see those boxes on the walls, right aed the automated external defibrillator. Is that something that is used in place of CPR, something that it used in conjunction with CPR.
How do we use.
So AEDs are extremely important to try and reset the heart's rhythm. So when somebody has a cardiac arrest, what we're doing with CPR is we're trying to maintain blood supply to the rest of the body, but that alone is frequently not enough, and what the AED does is an electrical shock that will put the heart rhythm back into a normal rhythm, hopefully giving them back their pulse and their breathing. And the key is that they are
simple instructions on these AEDs. Often they have verbal cues of where to put the pads and what buttons the press, similar to what I was talking about about hands only CPR when someone's having cardiac arrest. The AEDs will not give a shock to someone if they don't need a shock, and therefore you should not be worried you're going to hurt somebody by using them. Extremely important community initiatives to have as many of these around, especially in high risk areas.
How did somebody first come up with CPR? What was the thinking behind it? Do you know the history of how it was first thought of and developed?
Yeah, so it's really fascinating. It's been again over centuries. In early on it was the individual components of it. It was a discussion about how to for the for the breathing part of it, how to get air in you know, hundreds of years ago, it had to do with position the body in certain ways and moving the
arms around others. It was inhaling or pushing air into the lung, but really it went to the mouth to mouth and realizing that expired air, so air coming out of somebody's mouth, even though they've breathed themselves already, can be sufficient to help oxygenate somebody. For the compression part of it, early on it had to do with actually pushing on the heart when surgical surgically to opening up
the chest. But they found quite accidentally at times that external pressure on the chest could artificially give a pulse or the feeling of the blood going through the body. And then it kind of want to stepwise fashion and bringing it all together, and that was that was only sixty five years ago or so where they realized that they could all be put together into what we now think of a CPR.
And obviously it's been moderate and modernized. You've kind of alluded to that throughout our conversation, and it's changed now to realize that the compressions might be enough. You don't need to perform quote unquote mouth to mouth exactly.
And I think that then that's what's going to allow us to really expand it as broadly as we can. Right the medical professionals and you know, in the hospital environment, we're still using the full components of cardiopomet resuscitation when we're thinking about you know, training, when people do actual
training programs like lifeguards, they're using the full training. But as we think about the best impact we can have on the community at large, it's more and more people getting training, and that's by using hands only CPR for bystander.
I imagine it depends, so it depends on how well it's performed, how quickly it's performed. Do you have any numbers on survival rates on someone who does receive CPR when they've lost consciousness.
Yeah, it you know, some people talk about twenty to thirty percent survival. A lot of has to do with community and the environment that it's in. I think it's important as a reminder we talk about CPR, but one of the most important things is that somebody calls nine to one one immediately and that you get ems as quickly as possible, because really a lot of what you're trying to do is stabilize while you get to the advanced care and the underlying cause, especially if you don't
have an AD. So the key take comes really are active the emergency services as quickly as you can start hand only CPR if that's what you know or comfortable with CPR, if you're able to, and if there's AD using that to try and fix the rhythm of that's how long.
Should someone continue to receive CPR or if you're able to. If we're trying to save a life, you continue doing it until you know first date arrives at, the ambulance gets.
There, or whatever exactly. You try to keep going as long as you can, hoping to be able to continue until more advanced care is about.
I know parents are often offered or advised to get CPR classes, you know, when when they give birth and things like that. I've seen you point out that usually you're going to need to use CPR because somebody is in distress, and you mentioned it earlier. Usually it's somebody.
That you know.
It is. And I think when you ask about parents, I think it's an important skill to have a CPR in first daid when you have children, to understand more about what's going on, to learn that foundation. Get it that those skills hopefully are very rarely needed, but to have them if if you happen to unfortunately be in that situation, it's gonna be key.
You mentioned, even just knowing the basics YouTube video sometimes would suffice and help save a life. What are the easiest places to get the information and actually sign up for classes to do it properly.
Yeah, The American Heart Association have great resources online on their website that's heart dot org and that shows even sixty second videos on how you can learn hands on the CPR, and that's great for everybody in the public to learn. If you're looking for more complete courses and to sit for several hours. For example, the Red Cross the Heart Association both have excellent courses that you can take and the sign ups with the on their website.
How young a kid do you do you suggest should learn something like this and it could be beneficial to them?
Well, I think it's the biggest push that I've seen has to do. A high school student and a requirement as part of their high school education to get CPR training and that they need it for graduation. So there, I think maybe over two dozen states now require it, And I think that that's a great skill to kind of just incorporate it into general education so you can
do it younger. But I think that the having certain stages where we just want our entire community to know it, because I said, you never know when you're gonna need the skill, and understanding it and being able to jump into action really makes a difference.
Doctor Lawrence Phillips, director of Nuclear Cardiology at NYU's Langone Medical Center, Really appreciate your time, Really appreciate the explanation and the information.
Thank you so much.
Be well, thank you, and that'll do it for another edition of Iheartradios Communities.
I'm Manny Muno's until next time.
M