Welcome to iHeartRadio Communities, a public affairs special focusing on the biggest issues in facting you this week. Here's many Munios.
And welcome to another edition of Iheartradios Communities. As you heard, I am Manny Muno's. In the US, someone dies from heart disease every thirty three seconds. Men higher at risk, yet we are the ones that are less likely to go visit our doctors.
Let's talk about it.
Get a little bit of clarity on this with doctor Jane Wilcox. She's Associate chief of Cardiology at Northwestern Medicine Cardiovascular Institute. Doctor Wilcox, I appreciate the time.
Well, thanks so much, many, it's the pleasure to be with you.
Explain to me why men are more likely than women to develop heart disease.
Well, to be clear, men, both men and women are at high risk for partiovascular disease. It is the number one killer of both men and women here in the US and globally. However, men reasons you mentioned earlier, maybe the reluctance to go see the doctor. But men have a bit of an earlier risk. Heart disease can present earlier than in women, and that's due to several factors, one of which might be the factor s right, the stubbornness factor of kind of putting our head in the
sand and avoiding symptoms. That's not always the case, So men don't have the benefit of estrogen that women have with through their fourth and fifth decade of life. Now men don't have the hot flashes and everything else that goes along with menopause, but they do. They're at higher risk for atherosclerotic cardiovascular disease, that hardening of the arteries a little bit earlier than women.
As someone who's been married for twenty three years, I always thought it was the women who are were hard headed, but obviously it is the men as well. I always say, I always say, if you can't trust your doctor, who can you trust?
And and there's a reason why men, I guess, are more at.
Risk because they have that aversion to going and getting yearly checkups and things like that, don't they.
Sometimes that's the case, you know, But but like you said, that's not always the case. Men also, I will say, you know, tend to carry weights a little bit differently than women. So men have this the carry weight in their bellies and they're abdomen and that's called visceral fat. That type of fat that surrounds the organs can be particularly inflammatory and that can increase the risk for cardiovascular disease.
Did you not play an influence in a man's likelihood of developing heart disease or anybody's.
A likelihood.
One percent? So there, you know, it's important to talk, especially, you know, Father's Day is coming up. When families get together, it's important that families have these conversations to understand what sort of runs in the family. You know, do we have grandmas and grandpas and aunts and uncles who have had stents, have had bypassed surgery, have had high blood pressure, or diabetes. All of those things have a genetic component
in addition to a lifestyle component. But if those things run in your family, it's important to talk to your doctor about it because your risk is likely higher than an average risk.
And the frightening thing about it. High blood pressure is often called the silent killer, right, because I think it's what it's something like thirty percent of heart attacks, the first symptom is sudden death.
Yeah, so's it's hypertension. High blood pressure is called the silent killer because you really can't feel high blood pressure. And that's why knowing your numbers really I encourage patients to know their numbers because knowledge is really power. And so that one twenty over eighty stolic or the top number should be one twenty, the bottom number should be eighty, and anything higher than that, you really should understand why it's higher, like why do you have high blood pressure?
And then you know, talking with your doctor about ways to lower the blood pressure.
Does that change what your your goal blood pressure is as we age?
It does?
It does? In general, though, we are targeting this one twenty over eighty definitely less than one thirty over eighty, even even in older population, because we know that high blood pressure over the life course is really what, like you said, brings about heart attack and stroke and that's that major risk factor. The no led pressure can also really.
Affect kidneys kidney Yeah go ahead, yeah.
Yeah, well was it. It can really affect the kidneys. It's it's a reason that people end up with progressive kidney disease and end up needing to be on dialysis from years of untreated blood pressure. So it's definitely a definitely important number to know.
You mentioned know your numbers that's obviously been part of a campaign. I would imagine because I've heard about it, but that would require regular screenings, regular checkups, and not everybody goes for that yearly physical every year, do they.
No, it's something that if you're going to make a commitment to yourself this Father's Day, it's really go to that yearly physical.
Right.
We take our cars in for the oil change and to rotate the tires, but we don't take ourselves in to check our numbers.
Have a few more minutes here with doctor Jane Wilcox. That's an excellent assessment. She's Associate chief of Cardiology at Northwestern Medicine's Cardiovascular Institute. I hope you don't mind if I get personal for a moment before we go back into some of the symptoms and signs and treatments and everything else. You cared for your dad through years of heart failure that I influenced your career in medicine.
Talk to me about that.
Yeah, thanks, Nanny. I think you know, like most dads on Father's Day, right, My dad was sort of my hero growing up, but then when I was in college, he was diagnosed he was really really sick with hearts failure. He had a cute heart failure, was actually lifted for heart transplant for a short period of time, and then ended up actually getting better with medical therapy, and over the next ten to fifteen years he had improved quality
of life. And I finished my training and now I direct the heart failure and transplant program here at Northwestern. And then he eventually, you know, got worse and ended up meeting a heart pumped something called in left and tricular assist device, and that was placed in twenty seventeen, and my team here at Northwestern took care of him
and got him five more years of life. And so it's really he really has been a modern almost a modern success story and definitely my motivation for becoming a cardiologist.
That's awesome. That story brought a smile to my face.
Obviously, lifestyle changes, diet and a lack of exercise can all contribute to not only high blood pressure, but all sorts of other cardiovascular issues, I imagine, right.
That's right, that's right. We talk about like life's essential aids and knowing our numbers, and so you know, when we get together on Father's Day, it's talking about our family risk. But then also you know talking about are we exercising, are we moving most days of the week
thirty minutes and sweating? Are we reducing the sugar eat intake that we're taking in reducing our risk for diabetes, eating more fruit or eating more vegetables, leafy greens, these sort of anti inflammatory foods, not smoking, and getting enough sleep. All of those things sound like, you know, sometime I'm really hard to achieve, but it really just takes sort of one step towards those things, you know.
I always like to mention Knowledge is power nm dot org slash heart is the website you could go to for more information nm dot org slash heart.
What role you mentioned getting a good night's sleep?
And I think that's probably something not enough of us think about, not off of us make an effort to do.
What role does stress play in heart disease?
So stress is incredibly important in managing We do know that high levels of stress can cause heart muscle damage over time. There's actually this there's this relatively rare finding of something called stress cardiomiopathy, where you have an acute
stressor and the heart muscle can get acutely worse. And if you think about low levels of stress over the course of your lifetime that actually can lead to high blood pressure, can lead to hardening of the arteries, and so managing stress with things like meditation or yoga or just a good night's sleep in addition to exercise are really really important. And so that mind body connection, all of those hormones are very important to keep in mind.
And so you should be getting close at least seven hours of sleep at night, which sometimes seems hard to do, but that's really the goal for most adults.
What are the signs of heart disease that you think often get missed?
So, you know, I think we were pretty attuned to like oh the elephants crushing my chest or pain down my left arm that I need to go to the doctor for call nine to one one. But it's really those subtle things, like I tell patients and family members, really pay attention to what you're able to do, like your exercise capacity. So if you are getting what we call, you know, short of breath, like a little winded more than you used to going upstairs, right, that's not always conditioning.
We always think, oh, well, maybe we're getting a little bit older, and it's just that's normal.
I'm just out of shape, breath.
Yeah, that's not the case, so that needs to be you need a diagnosis for that.
What screenings should men prioritize them? Other than just knowing their numbers?
So you know, I think going into your primary care physician or seeing a cardiologist just to get that baseline risk assessment, because you know, may not know your entire family history. You may not know that there are other what we call comorbid conditions like pre diabetes or diabetes or other inflammatory conditions that could increase your risk for
heart disease. So I think knowing your numbers and then having a shared decision making conversation with your position are things that you should prioritize.
This Father's say, we're focused on men obviously, because I guess you established that that we're the ones that are that have harder heads when.
It comes to going to get checked out.
Are there are there different warning signs though, seriously, between between men and women and the development of heart disease.
So that's often you know, sort of talked about that men and women can present, you know, they present differently. I will say that that that can be the case, but women can also just get regular, you know, sort of chest pain, and I see women who are like, oh, well I have chest pain. But I know that women present differently, so that's probably not my heart. I'm like, oh no, that's your heart, yeah.
Right now, it's in the same spot.
Yeah, there's the same spot. And they also can have a typical symptoms, so a lot of times indigestion, right, So, oh, maybe I ate something bad. I'm having belly pain, or maybe this is my gallbladder. That actually can be a sneaky sign or symptom of an active heart attack in women. So that's something to keep in mind.
Obviously, the first thing you would do is try to change your diet, work, you know, exercise a little bit more, try to lose weight, things like that.
But it's really easy to treat.
Things like high blood pressure with with with medicine these days, is it not.
It really is, And so I would say that it's not just one thing, right when we you know, nothing is ever that simple in life, right, Yeah. Unfortunately, it's the combination of life, right, it's unfortunately. Yeah, So it's
a combination of lifestyle changes. You know, every five to ten pounds of weight loss can give you maybe close to five ten points of blood pressure, the weight loss into play, as well as reducing particularly the sodium in our diet, so shopping on the outside of the grocery store and avoiding foods that are high in salt, and then sometimes medication and medication can be very well tolerated.
You know a lot of patients tell me I'd rather take this pill in addition to the lifestyle medications that I've made, or lifestyle modifications that I've made in order to prevent heart attack, stroke, going on dialysis, all of those things. So it's often, you know, a multi pronged approach.
Yeah, steak isn't the same without the salt.
Right, What are some heart healthy foods that we might want to increase in our diet while decreasing maybe the ones that are at higher and fat are not as good for us.
Yeah, that's a great question. So thinking about sort of the food the pyramid, right, our tech classical food pyramid is really really focusing on whole grains and leafy green vegetables, you know, avoiding sodium and then those dietary those unsaturate the saturated fat, the athogenic fried foods, really avoiding those foods and things like blueberries, fruits, and lean meat, salmon, chicken,
avoid fried foods. You know, I think it's doable. It takes an adjustment, sure, but those can be delicious as well.
Right, How important is early detection, uh, the impact of the prognosis for not only controlling heart disease, but not dying from it.
Yeah, so I think if you know your numbers and you can manage your risk. They're in addition to the lifestyle changes and sometimes medication changes, we're finding that patients are living you know, people are living so much longer and living so much better. Right, even if you have cardiovascular disease, you know, with the available treatments, we can you know, really move the needle and have more health, relate health, you know, sort of our quality of life.
Father's Day is a great time to remind dads everywhere to know their numbers. Nm dot org slash heart is the website you could go to for more information. Nm dot org slash heart. We've been speaking with doctor Jane Wilcox, Associate Chief of Cardiology, Northwestern Medicine Cardiovascular Institute. Doctor Wilcox, I appreciate the time, Thanks so much for the information.
Thanks Manny, it was a pleasure to be with you.
Moms understandably get all the attention, no debating that every day should be Mother's Day, but as we celebrate Father's Day, we should take a moment to consider the dads too deal with their own set of mental health issues. As a matter of fact, Monday, June sixteenth is International Father's Mental Health Day. That's right, it is a real thing.
So why don't we discuss everything that entails in including some unique areas of men's mental health as we bring in doctor Daniel Singley, San Diego based Board certified psychologist. He is the founder of the Center for Men's Excellent and the advisory council chair of the nonprofit Postpartum Support International.
Doctor Singley, thanks so much for sharing some time with us.
Thanks for having me on.
I wanted to ask.
You about men and mental health because it still feels like it's a little bit taboo for men and fathers to even talk about the fact that they might have all sorts of mental health issues and stressors, even in this day and age.
Yeah, so if we kind of back up, oftentimes it's
the identity piece here. The fatherhood identity tends to sit on a platform of the guy's masculinity and these days, you're right, it's kind of a it's a hot topic, and it's pretty controversial in particular because there's kind of the SoundBite, which is, you know, masculinity means toxic masculinity, right, And I guess the top level point I want to make is that, certainly, according to the research in this area, it's not being a man or maleness or masculinity per
se that is problematic, and problematic means, you know, contributing to negative health outcomes for men and fathers, including depression, including postpartum depression. And we'll get there. The issue is when a guy a father will only be that.
Marlborough Man version of masculinity, so without the flexibility, just being stoic, independent, aggressive, hardcore and so on.
The reality is there are plenty of circumstances where that is very helpful, that that is the kind of masculinity that's called for. However, there are plenty of other context and certainly fatherhood and co parenting or one of them, where the healthiest approach will be able to also show up with empathy, compassion, and the willingness to accept influence. It's not just provide sacrifice but the healthiest men that live the longest and have the best mental health, the
best relationships. You know, if your deaths of despair are also able to allow other people to protect them and to provide for them and to sacrifice for them, when that's what's called for.
We've come a long way since the nineteen fifties, I think, is what you're trying to tell us.
At a time when what it means to be a man is in some ways I think less clear it than what it means to be a father. Sure in that sense, like we can always go back to well established tropes that look like that kind of nineteen fifties mad men routine because that prevents guys and fathers from experiencing shame. Like that's really what that does. Right, When you step out of that eyebox like that, you're running the risk of being perceived as feminine or weak or whatever.
But I really do see early fatherhood as the tip of a spear in sort of the evolution of what it means to be a man, or sort of updating the male operating system to include that traditional guy guy while also adding a caring and caregiving element and normalizing that Yeah, let me.
Talk to you about that, because that's part of one of the things you're here to talk about is men experiencing postpartum depression. And I'm not sure I had ever even heard about that. We all know about, you know, moms going through postpartum depression after birth and everything that mothers deal with after they've given birth.
Talk to me about how men experience it.
Sure, Just a really good friend of mine once said that if you don't believe something exists, you won't look for it, right, And the fact of the matter is that one in ten dads gets postpartum depression. And I don't just mean like you know, they get kind of down. I mean they meet criteria for major depressive disorder with perry partum onset, and even higher percent to nearly twenty
percent will develop an anxiety disorder. And again not just kind of stress, but post traumatic stress, acute stress, obsessive compulsive disorder, specific COVIA, and so on. And part of that we don't look for it because we don't think it's a thing, is reflected in the terminology. So generally speaking, this area of mental health is called maternal mental health.
Whereas my colleagues and I are looking at this as broadly parental mental health, and there are some aspects of it which are maternal specific and others which are paternal specific. But what we're trying to do is is broaden the tent.
And so I work with Postpartum Support International and when our mission is we are the largest provider of able to connect help seekers in the perinatal period conception to about a year or so postpartum and beyond that with the resources, the people, the handouts, the helpline that we have that can help them. And that's as you say,
people don't necessarily connect that with fatherhood. But we absolutely have lots of resources for dads on our website as well as we have every Friday we have breakout groups that are specifically just for the new dads to come together and have some community. It's pretty hard to find.
The website, by the way, is postpartum dot net. Postpartum dot net. We have a few more minutes here with Doctor Daniel Singley's the San Diego based Board certified Psychologists, the founder of the Center for Men's Excellence and part of the Advisory Council. He's the chair of the nonprofit Postpartum Support International, so if I could just interject some of my personal experience when we found we waited a long time before we even tried having children, so I
was an older dad. But I remember the moment we found out that my wife was pregnant. I ran out and bought the book What to Expect, What You're Expecting, went through all of that stuff for nine months, and I remember sitting in a recovery room by myself at two thirty in the morning, crying as they sewed up my wife and cleaned up our son when he was born, And all of a sudden, in those moments, everything about life had changed, right, and then I was ready to
experience the joys of fatherhood. And it seems like we can understand a woman going through postpartum depression because not only of all the hormones that it entails and motherhood and everything else and what they've been through for the last nine months. I think it might be more difficult to understand how a man deals with it.
Can you explain that, Yeah, I hear this one a lot that Hey, you know that can't be a thing. You know, fathers don't carry the baby, they don't have the hormonal changes. The research shows very clearly that it is a mistake to boil perinatal depression, meaning it happen during the pregnancy, it can happen after the pregnancy, to boil down that kind of experience, that mental health issue to just hormones. Hormones are very important, They're a very
important element of it. But other factors that are critically important are what's the nature of the coparental relationship. Do they have a history of mental health trauma? Do they have to work three jobs to keep the lights on and baby formula going? And the list goes on. Now, one thing that most people don't know is that, in fact, bothers who are hands on with their infants also it do experience the same hormonal shifts that moms do, so the magnitude is different, so it's not as much of
a change for the fathers. And several longitudinal programs of research that follow these dads over time have been able to clearly show that there are relationships between fathers. It's dudes. So they always look at testosterone right early postpartum testosterone functioning and then the subsequent development of it. But again I want to repeat my point, Yes, hormones matter, but it is a mistake to boil postpartum depression or anxiety down to just a hormone hormone right.
More to it, I often say that my children are my greatest joy in life, also my greatest.
Stressor in life.
And it strikes me that if the father of an infant, a newborn, is beginning to experience these, you know, postpartum depression symptoms, they miss out on some of the especially the initial joys of fatherhood.
Does that lend itself to the depression worsening?
Yes, so everything writ large. People with postpartum depression think they're terrible. The world is terrible, the future is terrible, and the world thinks they're terrible, including their baby. And what a lot of the dads that that experienced postpartum depression will say is my baby hates me, or I'm not attached to my baby, I'm bad for my baby, my baby loves my partner. And they sort of use
their infant to to cut a back up there. We'll call it their poop covered or colored glasses, but that oftentimes causes the fathers to back off.
The long term effects of dealing with that are what.
So let me let me look at this the other way. So the long term effects of having a highly involved and engaged father in that first year post part arm predicts better emotional regulation on the part of the child. More words, when they start school, higher IQ, greater social agency, less involvement with the juvenile justice system. Like the list goes on, and a lot of people just don't know that. Yeah,
in fact, fathers have something really important to contribute. All these outcomes that we want for our children have been shown to be linked to highly engaged fathers, even in that first year with an infant.
The difference between experiencing the exhaustion and the stress and maybe even in a lot of cases, the disconnect between the father and the mother and actually experiencing these postpartum depression symptoms.
Where's the line.
Yeah, that's tough. I mean reality, what we like to think of is psychopathology is really just an exaggerated, completely normal and functional response. So with this experience of depression, it causes a lot of these dads to sort of pull back, and like for moms, we do the differential diagnosis between just kind of baby blues versus major depressive disorder. With perry partum onset, it's that four weeks postpartum for dad.
Dads tend to spike postpartum depression three to five months postpartum, and so for that reason, a lot of people miss it, and also for the reason that a lot of times fathers will present with depressive symptoms that are a little bit different than what we usually think of in terms of, you know, vegetative, they can't get out of bed, they're not going to work, they're suicidal, they're weeping in the corner,
and so forth. A lot of these dads manifest what we call masked male depression, and it more looks like anger, like anger, frustration, irritation, sometimes all the way up into rage and increased. They talk about substances and other drugs. In the literature of the reality is video gaming, risky sex, gambling, chop lifts, and kind of whatever gets your cerebral joy juice flowing going to an extreme with that where it ends up causing problems. The third is isolation or being withdrawn.
And to clarify, you could be a dad that's at work around other people all day, or in a fit based community or in a multi generational household, so you're around people a lot, but you're not connected, you're not engaging. That's that social withdrawal piece. And then the last really common symptom of this last male depression the dazzle show, is what's called somaticizing, and that means taking a psychological
difficulty and turning it into a physical one. And this tracks with what we know about about shame and stigma, right guys like I can't be the pressed, but I can have migraines, I can have muscle tension, I can have you know, gi problems, like there's a weight on me. And so keeping an eye on some of those samaticized or physical symptoms is another really important piece to this.
If that sounds like you, or it sounds like somebody that you know, a loved one. The website is postpartum dot net postpartum dot net. We've been speaking with doctor Darryl Singley, Board certified Psychologists, founder of the Center for Men's Excellence, and the chair of the Advisory Council of the nonprofit Postpartum Support International. Doctor Single, I really appreciate the time, thanks for the conversation, the information be well.
Thanks so much. Happy Father's Debt.
And that'll do it for another edition of iheartradios, communities.
I'm many Muno's until next time.