Heart Health

Welcome to the Ask Dr. V Show. I'm your host, Dr. Valda Crowder, and you can call me Dr. V. I'm a board certified emergency physician for over 30 years now, and I've treated patients across four pandemics, one mass shooting, and a category four hurricane. I've treated almost every medical issue you can imagine. Since the COVID-19 epidemic, I have taken my expertise to the airways to help thousands of families navigate our healthcare system. So today we're getting things started with the heart. Okay, what is cardiovascular disease? It is a general term that is used for conditions that affect the heart, the blood vessels, or the blood vessels that go to the heart. So, as an example, cardiovascular disease is primarily heart attacks and strokes. Heart attacks and strokes are about 85% of cardiovascular disease. But cardiovascular disease can also be aortic aneurysms, uh, aortic dissections, uh, intracranial bleeding related to high blood pressure. So all of this is the category of cardiovascular disease. So your heart is a muscle and it is about the size of your fist. So it is not a very big organ. If you actually are 70 years old, your heart has squeezed and pumped for you 2.5 billion with a B a billion times. So it really needs to actually be strong. So the things that actually weaken or uh cause damage to the heart are things like smoking, diabetes, high cholesterol, high blood pressure, inactivity. So what I want to talk about today is what can we do about it? So the most, the two most important things are your blood pressure and your hemoglobin A1C. So let's start off first with your blood pressure. It is important that you know what is your baseline blood pressure. You can purchase a blood pressure cuff for about$15 to$30 on Amazon. And what you do is you actually take your blood pressure the same time of the day once or twice a day. Your blood pressure varies throughout the day, so that's why it's important not to compare a number that you got at 9 a.m. to a number that you got at 1 p.m. So for a week, you want to take your blood pressure every day at 9 a.m. or every day at 5 p.m. or both if you're deciding to do it twice a day. Then you write those numbers down and take those numbers into your physician's office. Then you can have a conversation with him about are you in a good range? Is there anything that you should be doing differently? Now let's talk about blood pressure and what it actually means. Everybody knows that they see those two numbers. There's a top number and there's a bottom number. A lot of times people don't really know the difference, but there's a very, very dramatic difference between those numbers. The top number is your systolic blood pressure. That is the pressure that your heart experiences in the arteries when your heart beats. So that is when your heart is actually contracting and beating, and that is the pressure that it is experiencing. The second number is your diastolic blood pressure. That is what happens when your heart relaxes. So that is the pressure that your heart feels when it is in relaxation mode. Now, a lot of people ask, is the top number more important, or is the second number, the bottom number more important? Well, I would say this. They're actually both important, and here's why. One is that the top number is actually your heart pumping blood out to your brain, your arms, your legs, your intestines, etc. That is the systolic blood pressure, the top number. The bottom number, when your heart relaxes, that is actually when the blood vessels that go to your heart are filled with blood, and that is when your heart oxygenates itself. What happens is about one-third of the time your heart is beating, and about two-thirds of the time your heart is at rest. So both of these numbers are important. What we define as high blood pressure or hypertension is defined as two blood pressure measurements that are over 140 over 90. So if the first number is over 140, or if the second number is over 90, or it could be that both numbers are over 140 over 90. Most people who have high blood pressure do not have any symptoms. And this is why we call it the silent killer. You begin to get symptoms when the blood pressure gets very, very high. So when the blood pressure gets very high, people may experience headaches, nosebleeds, chest pain, difficulty breathing, shortness of breath, vomiting, confusions, palpitations, change in their in their vision, these types of symptoms when the blood pressure gets very high. So what's most important is that you don't want to actually wait until it gets this far along. What is important is knowing what your baseline blood pressure is and working with your physician to make sure that you have a regimen that is keeping your blood pressure in the safe zone for you. The second number that is very important is your hemoglobin A1C. And this is an indicator of whether or not you have diabetes or you have prediabetes. And prediabetes just means that you are on your way to developing full-scale diabetes. Every adult should know their hemoglobin A1C level. What the hemoglobin A1C shows is what your average blood sugar or glucose level has been over the past two to three months. If you check your glucose level just once, that doesn't tell you what the average has been over a very long period of time. And that average is actually what's more important in predicting whether or not you will develop diabetes or not. If you have a hemoglobin A1C that is less than 5.7, you are considered to be in range. If you have 5.7 to 6.4, you're considered to be prediabetic. And those that have a hemoglobin A1C over 6.4 are in the diabetic range. You are more likely at this point to actually begin to have complications related to diabetes. So one in 11 adults worldwide will actually develop diabetes. Most of those are what we call adult onset or diet-related diabetes. 90% of patients with diabetes have adult onset or diet-related diabetes, which means you can do something about it. Type 1 or juvenile diabetes is 10% of the diabetic population, and the onset of the diabetes occurs when you actually are younger, usually in your teenage years. So why is this so important when it comes to heart health? Adults with diabetes are twice as likely to have a stroke or a heart attack than those that are without diabetes. And if you look at age 60, if you have by the age of 60 diabetes and cardiovascular disease, then what happens is you lower your life expectancy by 12 years. Every 80 seconds in the United States, someone with diabetes is hospitalized for heart disease. So again, high blood pressure and diabetes are very, very, very linked to heart disease. So once you know your blood pressure and once you know your hemoglobin A1C, what else can you do to prevent heart disease and keep your heart beating as strongly as it needs to for all the years of your life? So a couple things is um eating healthy makes a very big difference, limiting processed foods, limiting trans fat and saturated fats. Also, it is really important to be active. And you don't necessarily have to run a marathon. I tell people, you know, sometimes it's just important to do 15 or 20 minutes of walking a day. Try to maintain a healthy weight. If you're if you're overweight, you want to actually lose those extra pounds. You want to speak to your doctor about what should my BMI be. And BMI is your body mass index. And you want to get your body mass index into a healthy range. It is also important to manage stress. We have a lot of things going on today in our work life and our family life. If you feel that you are very stressed, you want to actually look at what sort of things can I do to actually manage the stress or get the help that I need or ask people for help. In general, stress increases your cortisol levels in your body and it turns your whole body into a heightened fight or flight awareness situation, which actually stresses out your heart. Getting enough sleep is very, very important. If you're smoking, you want to quit smoking. You actually want to limit any exposure to secondhand smoke. That, along with maintaining your blood pressure and maintaining your cholesterol, and maintaining your blood sugar in a good range, are all of the things that actually make a difference for keeping your heart healthy. Now it's time to get into the heart of your health questions. So make sure you call in now at 1-800-450-7876, 1-800-450-7876. You can also email me at infotaskdrv.us. That's info at askdrv.us with your name, location, and a question. You never know. You might hear yourself here on the show. Does your business believe in the empowerment of the community? Do you want to be part of advancing their understanding of health and overall well-being? Ready to reach more people while growing your brand and visibility with your audience? Maybe you want to help eliminate racial medical disparities. Advertise on the Ask Dr. V show. 30 seconds and one-minute spots are available. Email our team at info atasdrv.us. That's info ataskdrv.us. And find out how you can advertise on the Ask Dr. V show today. We'd love to see how we can work together to reach and empower our audience. All right, I've got a question from Joanne in Suitland, Maryland. And she wants to know the American Heart Association came out strongly against vaping. What does vaping have to do with heart health? Okay, so a couple of things. With vaping, you are inhaling vapor from an e-cigarette. And there are a lot of liquid solutions that are vaporized, which is why they call it vaping, and stay in your body for six to eight hours. And when you're vaping, that really kind of does a lot of things. So one is that most of us have some cholesterol deposits in our arteries. Those cholesterol deposits with vaping become unstable. They can rupture, they can break, pieces can actually break off and then go downstream. That's significant if you're talking about your heart or your brain. The breakage sometimes causes a clot formation, and the clot formation is bigger than the original cholesterol plaque ever was. So people who vape are 50% more likely to have a heart attack, and they're about 30% more likely to have a stroke. But I want to also deal with smoking as well, because smoking and vaping and chewing tobacco and cigars are all associated with heart unhealthiness. So you really want to make sure if you're doing these things to try to quit. And you're quitting at any age. You know, some people say, Well, yeah, I'm too old to quit. Well, you know, if you quit at 66 and you're a guy, you gain about two years of life. If you quit and you're a woman at 66 years old, you gain like four years of life. So women really get a lot of benefit from quitting, whether or not it's vaping, smoking, or chewing tobacco. So most people want to know how to quit because that's the issue is, you know, I find that when I speak to people that vape or smoke or chew tobacco, they really would like to get freedom from this habit in their life. And so let me just spend a little bit of time on how to quit or tips for quitting. So one is that you need to know why you're quitting. And you I recommend people actually really write it down because you need to be quitting for yourself. Um, you shouldn't be quitting because your, you know, your your your wife or your husband or your friend told you to quit. You need to really be quitting for yourself. The other thing that I think is important is that people get really present to how much are they spending on whatever this habit is, whether or not it's vaping cigars or chewing tobacco. Really write it down. Like, what am I spending on this? And what else could I do with that money? Um, maybe there's something else that you could do with that money, like take a vacation or you know, buy a gift for yourself. Then it's also it's also important to set a date, right? You want, you don't want to get into minana, minana, minana. You want to actually really create, I'm going to quit on this date, uh, whether or not it's today, tomorrow, or the next week. You want to set a date. And during the time between the date coming around, really, really create a plan, right? What am I gonna do when my cravings hit? Am I gonna drink water? Am I gonna chew gum? Am I going to take 10 D breaths? Am I gonna go exercise? What am I gonna do? You also wanna know do I need help from the experts? Have I tried to quit before and it didn't work? There's all sorts of quit lines out there that are actually uh free, and they have them in all different types of languages. Uh the CDC has one that's just 1-800 quit now, and they will send you text messages every day. They'll connect you with experts. They have them in all different languages: Spanish, Mandarin, Korean, Vietnamese, et cetera. There's a lot of workplaces that have uh programs that help you actually quit smoking. Um, and then also reach out to your primary care doctor, see what sort of support and what sort of things he can help you with. Now, the other thing that's important is make sure to share with friends and family that you're planning on quitting and also make sure that they know how best to support you. And you don't always get this on the first time around. So, you know, if you try to quit and you do well for a little while and you slip up and you go back, that's part of the journey of actually quitting these particular habits. So I hope that sort of answers your question. I know there was a little bit more than you asked, you asked specifically about vaping, but I think it is important that we talk about the impact of vaping and also how to quit these habits, whether or not it's vaping, smoking, or tobacco use. Thank you for the question. All right, we have uh Mike from College Park, Maryland, and he sent in a question. He said, Can stress cause high blood pressure or strokes? And Mike, the simple answer to the question is yes. Stress can cause both hypertension and strokes. But here's what's important to know it it's not just experiencing stress in a momentary way. Okay, so if you experience stress for an hour or two, and then that stress goes away, then normally your heart rate and your blood pressure, which go up with stress, um, often go back down to normal. What actually is really the problem is when people have chronic or continued stress. So they may be constantly stressed out over a period of uh months or weeks, and that is the stress that really actually causes a problem. And what that does is it increases your blood pressure, it increases your heart rate, and when you think about it, your heart never really gets a break from it. Again, your heart is this a small muscle, the size of your fist, and if you live until you're 70 years old, it is beating two and a half billion times, two and a half billion with a B times. So if you have chronic stress for six months, then that heart is under a lot of stress and strain and is beating against a higher blood pressure, and it may also be beating faster. So it's really, really important uh that you actually recognize in your life when you have stress that is chronic, that is becoming chronic and is not episodic. If you have episodic stress, we all have episodic stress. It comes and it goes, our heart will respond, the blood pressure will go up, the heart rate will go up, and when that stress goes away, our everything will go back to normal in your heart. So it is the chronic stress that actually causes the problem. Thanks for the question, Mike. We have a question from Tina and Silver Spring, and she wanted to know please explain why heart health seems to be such a silent killer for black people. All right, good question, Tina. Uh, the main reason is most people don't know the two numbers that I discussed that are the most important numbers to know. I challenge everyone who's listening today to ask your friends and family, do you know your baseline blood pressure? Do you know your hemoglobin A1C? And notice how many of them don't know it. Now, what's important is that as a family and as a community, that we all encourage those around us to get those numbers and to actually know those numbers. And when you actually go get and figure out your baseline blood pressure and your hemoglobin A1C, then what happens is you can catch things early. It is really, really important to know these numbers before you're not feeling well. So sometimes in our community, folks don't go to the doctors or don't see anybody until they're feeling unwell. It is really, really important to know these numbers and to check these numbers before you feel unwell. What you do while you're feeling well keeps you well for your entire life. So again, I encourage everyone, ask your family members and friends, what's your baseline blood pressure? Do you know your hemoglobin A1C? And see what they say. Let's encourage everybody around us to actually know the most, the two most important numbers in their life. Thank you for the question. All right, let's get to some more of your questions. Okay, we have a question from Stephanie, and she wants to know are there any lingering heart issues related to the COVID-19 pandemic? Uh Stephanie, great question. Great question. And uh this is kind of a question that we're still researching and uh doing data analysis on. So let me tell you what we actually what we actually know. So one is that COVID affects every single part of the body. Uh people think of COVID as a respiratory disease, and it is a respiratory disease. However, it actually causes inflammation everywhere, including your heart. So what we saw during the pandemic was we saw people who didn't have high blood pressure, who suddenly had high blood pressure. Um I saw children and adults with pericarditis, which is an inflammation of the lining of your lung. Uh, we saw people, the increase of uh heart attacks, MIs or heart attacks increased. Um we also saw a lot of arrhythmias, you know, where your heart is beating irregularly, whether or not it was um atrial fibrillation or other cardiac arrhythmias. So we know that about 4% of the people who had COVID-19 need cardiovascular care after getting the infection. Also, what we know is it really didn't matter whether or not they had a mild infection or a severe infection. So if you just had an infection and it kind of went away, you were not necessarily protected from the cardiovascular effects of COVID-19. So if it's not related to the severity of the infection, what is it related to? And that's actually what we don't know. And so we haven't really determined how you can tell who are the people that were going to have cardiovascular effects from COVID and who were not gonna be the people who have cardiovascular effects of COVID. We are seeing an increased incidence in heart attacks in younger people between 25 and 44 years old. There's been a 30% increase in heart attacks in young people. That's something that we actually know. But we don't actually know why or how to specifically identify who would be impacted by that. So, great question. So there are lingering effects, we're just trying to figure it all out, um, but we are seeing it clinically. Thanks for the question. All right, Mary Ann uh from College Park is asking a question, and her question says I once heard someone say that it's scientifically proven that unforgiveness and loneliness can negatively affect one's heart health. Is that true? Let me take that in two different segments. But essentially, that is true. And let me give you uh what what we know about it. So when we look at things like loneliness and forgiveness, we lump a lot of things together. So we look at how socially isolated is someone versus loneliness versus depression versus anxiety versus unforgiveness. So there was a study done, it looked at 400,000 people, and it looked at loneliness, specifically loneliness and social isolation. Well, when they followed these people over a period of about 12 years, was that people that were socially isolated and lonely had a higher risk for hospitalization and death from heart failure. And what they found was the higher risk was almost 15-20%. So it wasn't really a small amount, it was a pretty significant amount. But what was most interesting about this study was if someone was socially isolated and they didn't particularly feel socially isolated, they were okay with being socially isolated, they didn't really see this increased risk of heart disease. And then there were some people who had lots of people around them, had lots of friends, lots of family around them, but they felt lonely. So they were not socially isolated, but they felt lonely. Those people did have an increased risk of hospitalization and death from heart failure. So loneliness is an increased risk if the person actually feels isolated. Social isolation alone is not an increased risk if the person does not feel lonely. But loneliness, with or without social isolation, is actually an increased risk for hospitalization and death from heart failure. So that does make a difference. Now, the second part of your question was about forgiveness making a difference in heart health. Let me address that. So forgiveness actually reaps huge rewards for your heart. And I'm really glad that this person asked this question because this past weekend I was really mad at somebody, and myself, I was being a little unforgiving. And when I went back and looked up some of the research for this question, I thought to myself, I really need to let this go. So let me let me share with you some of the information. And thanks for asking the question because sometimes we all have to be reminded. You know, people think because I'm in the healthcare field, you know, I remember everything all the time, and I don't do things perfectly in my life either. And so, you know, I really had to kind of remind myself. So a couple of things about forgiveness. So forgiveness lowers your risk of heart attacks, it improves your cholesterol level, it improves your sleeping, it lowers your blood pressure, it also lowers levels of anxiety, depression, stress, loneliness, and social isolation, so social isolation, which, you know, as we just said previously, really make a difference. Um, and it's also important that as you get older, there is an increased connection. The connection's even tighter between uh forgiveness and uh your heart health. So why is this? So chronic anger really kind of sets off your whole adrenaline fight or flight response, right? So that's, you know, adrenaline, cortisol, all your stress hormones, you're gonna, again, increase your heart rate, increase your blood pressure. If you're unforgiving for a little bit of time, that may happen for a little bit of time, um, and then your heart will go back to normal. But as we know, some people are unforgiving for years. And that is the stress, the chronic stress that really, really, really makes a difference. So the other thing that they looked at is, you know, just saying um, I forgive you really is not it. Because a lot of people say, well, I forgive you, but they don't really forgive the person. They're still kind of angry and upset about everything. So, you know, forgiveness is really a conscious decision to let go of negative feelings, whether or not the person deserves it or not, and whether or not that person has actually asked for it or not. What is really important is that you release anger, resentment, hostility. And, you know, sometimes people will say, Oh, I've released it. You haven't released it if you're running around telling everybody the story and telling them why this person still did this bad thing to you and uh should be buried 10 feet under the ground. And so, you know, it's not really released if it's if you're still telling people about it, uh um ruminating about it, all of those things mean that it hasn't really been released. Now, what's also interesting is when they've studied forgiveness, um, they found that some people are just naturally more forgiving than others. And some people really struggle with it. Um, and the people that are naturally more forgiving tend to be more satisfied with life and seem to be happier. Um, so the quicker you can sort of get to forgiveness, it really is uh a blessing and a benefit to yourself, more so than the other person. Um, and when you have gotten to forgiveness, what happens is you can begin then to have some compassion or empathy for the other person. The other thing that uh the studies kind of looked at is why are you forgiving the person? So some people actually forgive people because their religion requires it. Or they'll say, Well, I don't have any other choice. I just have to sort of forgive the person. That may not be enough. Those two reasons are not necessarily enough to bring healing to your heart. One study found that peoples whose forgiveness came in part from understanding that no one is perfect were able to better resume a normal relationship with other with the other person, even if the person never apologized. But some people who forg who forgave in order to salvage the relationship were more likely to end up in a worse relationship. So you really want to actually look at why am I forgiving this person and am I really, really letting this go? It is really important if you have something that has occurred in your life, um, because we all have things that have happened in our lives, and if you have some things that have occurred in your life and you're like, I really, really do not know how in the world I'm ever gonna forgive this person, and you feel like you're throwing up your hands about it, really consider getting professional counseling about it and getting a therapist or somebody to possibly help you get over this. Because at the end of the day, you're the one with the increased risk of heart attacks, you're the one that's gonna have the increased risk of high blood pressure, increased cholesterol levels, increased risk of uh anxiety, depression, et cetera. So you really want to seek out the therapy that you need to really get over whatever moral injury has occurred. And all of us have had moral injury occur to us in our lives. So uh thank you for this question. This was a very good question. All right. Angie from Columbia, Maryland wants to know uh she's saying that her doctor wants her to get a CPAP machine because of her lack of sleep is hard on her heart. She doesn't understand what is the connection between her sleeping problems and her heart. So, uh Angie, so let me let me go over this. So uh you if you're if your doctor is giving you a prescription for a CPAP machine, uh that most likely means that you had a sleep study, a sleep study done and you were diagnosed with sleep apnea. So I want to first tell people what sleep apnea is. So sleep apnea is when you have apneic episodes when you're sleeping, which is basically you stop breathing and you stop breathing, and then suddenly you'll breathe very, very hard, very, very deep. Now, sometimes people that live around you think that you're just like a really big snorer. And so if you have big snores in your life, they may not just be snoring, this may be sleep apnea. And sleep apnea is really, really, really important to diagnose. It can be mild, moderate, or severe. Again, the way you actually diagnose it is by going in and going and getting a sleep study. In addition to loud snoring, people sometimes feel tired when they wake up, they feel sleepy during the day, they're restless and they're getting up and they're going to the bathroom. Um, they also may be overweight. And so, what does all of this have to do with heart health? Well, a couple of things. When you stop breathing and you have these periods where you're apneic, right? Your oxygenation goes down and your carbon dioxide levels go up. And again, this activates the adrenaline fight or flight system in your body. So your blood pressure goes up, your heart rate goes up, your blood vessels constrict, particularly in your lungs. So people begin to get pulmonary hypertension. Pulmonary hypertension is very, very difficult to uh treat. Uh, people with primary pulmonary hypertension often have to get a lung transplant. So what sleep apnea does is it essentially strains your heart. You wind up actually with that little that little fist of a muscle pumping harder against harder blood pressures, against harder heart rates, um, and it is uh and it causes your heart to um have heart failure. You can have left ventricular heart failure or right ventricular heart failure from untreated sleep apnea. So again, you diagnose sleep apnea by getting a sleep study. Once you get a sleep study, what can you do about it? So there's a lot of things you can do about it. The most common treatment is what you've actually, what your physician has actually given you, which is a CPAP machine. And that CPAP machine is basically you put it over your mouth and nose, and it's a positive ventilation machine. So it blows air into your uh into your mouth and nose, so you don't experience that drop in oxygenation. Um, the other thing for some people is um they need to lose weight. So if you can lose 10 or 15% of your body weight, that can make a really big difference with sleep apnea. Um, some people actually need nerve stimuli, um, and other people sometimes need surgery. Sometimes they have excess tissue in their upper airway uh that need to uh be taken out. And so the treatments really vary uh dramatically. So if you have somebody who is a loud snorer or who feels tired during the day, is always sleepy, maybe a little overweight, really recommend that they get in and get a sleep study because left untreated, uh, sleep apnea causes high blood pressure, it causes heart failure, it causes diabetes, causes stroke, it increases the risk for sudden death, and it decreases your life expectancy. So sleep is very, very important. I am going to do an entire hour uh later on uh on sleep and the science of sleep. So thank you for that question. All right, we have a question from Angela in Washington, D.C. She says, When my grandfather died, I truly believe that my grandmother died from a broken heart. Can that medically happen? Is there science behind our emotions and our physical health? So this is a this is an interesting question. So, you know, I've talked a little bit about uh the impact of loneliness and anxiety and depression and social isolation. However, grief also has impact on uh people's heart. Now, I don't know necessarily whether or not this specifically played a role in your grandmother's death, but there is a uh uh there is a uh disease called the broken heart syndrome. And basically what it is is the name of it is called uh takasubu, cardiomyopathy, and it's also called the broken heart syndrome. It occurs when someone experiences very intense emotional or physical stress, such as grief. And what happens is uh the left ventricle of the heart actually temporarily gets very enlarged and changes shape. They call it takasubu because that is what an octopus pot that is used in Japan to sort of catch octopuses, that's actually the x-ray or the image of the heart actually begins to look like that. Similarly, people can actually really experience symptoms from this. They can start to have chest pain, they can start to have uh shortness of breath, um, and it is often caused, again, by a surge of adrenaline or stress hormones, not necessarily by blocked arteries. Now, obviously, if someone is elderly and they already had blocked arteries, that actually makes it worse. Uh, but often we see people with this who their arteries will be completely clean, but they will actually have uh signs and symptoms like uh like they're having a heart attack. And then when they go for cardiac catheterization or stress test, uh they may have a completely clean appearance of their coronary arteries. So, you know, like I said, this was first recognized in the 1990s in Japan, but it's now recognized worldwide. Uh so again, our emotions really, really do have an impact on our heart health, and that is important to remember as you go through the stressors in life. And usually it is the chronic experience or the prolonged experience of these emotions. So you want to make sure to get whatever help you need from your community, from a therapist, or from a pastor to really, as we experience life's challenges, um get over them as quickly as possible and and and move on with the new normal of your life. Thanks for the question. All right, Diane from Capitol Hill wants to know if I've seen the video of Halle Berry saying that hot flashes during menopause are like min mini strokes. And she wants to know, are hot flashes really mini strokes? Is are they that dangerous? Okay, so first of all, I have seen the video uh that you're referring to. It was actually sent to me by someone from this community. So I'm glad you guys uh are sending stuff to my email. Again, if there's anything you ever want me to look at, send it to info ataskdrv.us. Info at askr.us. So thanks to that email address, I did actually see this. I believe it was on Instagram, if I remember correctly. So I I did take a I did take a look at this and look this up in the research, and I don't think that many strokes is really quite the correct description of this. So, first of all, um, the studies that she's actually referring to looked at prolonged menopause and prolonged hot flashes. And specifically, they looked at people who were having hot flashes for four to five years. So this is not, if you've gone through menopause and you had hot flashes for maybe, you know, four or five months, this does not, this does not apply to the research that Hollyberry was speaking of. So the research that she was speaking of, they looked at women that went through prolonged menopause, hot flashes for more than four to five years, and they looked at what was the impact on their brain. I wouldn't necessarily call it mini strokes. I would actually say it was actually more like entanglements almost similar to what we actually see in Alzheimer's disease. So and some women actually had some experience of some uh confusion or disorientation during the actual hot flash. So I think that it's really important, you know, if you are actually experiencing hot flashes and they're particularly bothersome to you, and you are particularly having symptoms associated with it, that you speak with your OBGYN doctor or your primary care doctor, and you find out should you actually get treatment for your hot flashes so that they are not as severe. I think it particularly is a conversation if you are having a prolonged uh episode of menopause or hot flashes that lasts more than a year or two. So we still don't know right now what is the impact of hot flashes on women's brains that only have hot flashes for a year or two. This particular study that she was referencing, or the studies that I have seen that have been more definitive in the literature, are studies where women have had hot prolonged menopause and prolonged hot flashes for more than four to five years. Danny from Hyattesville is asking uh the question: what is CoQ10 and fish oil and how does it improve or impact heart health? Does it really help? I see the commercials on TV and I don't know if it's true or not. All right, Danny, so here's a uh let me go through this. CoQ10, uh, I'm gonna start with Code Q10. CoQ10 is an antioxidant that basically helps with energy production in the cells. So it's naturally occurring in your body, um, but it does decrease with age, and it also decreases with um uh cardiovascular disease and certain medications. So when we look at whether or not a medication helps or not, in the heart literature they use the uh definition of MACE, MACE. And MACE is a major adverse cardiovascular event. So in the cardiovascular literature, it'll say, did this medication or did this supplement make a difference in the occurrence of a major adverse cardiovascular event? So what is a MACE event? So a MACE event is uh a nonfatal heart attack, uh, a non-fatal stroke, uh hospitalization for chest pain, shortness of breath, like unstable angina, and also obviously cardiac death or a sudden death. So when we look at literature to see whether or not something helped or not, in the literature what they talk about is mace. And did this nutrient or supplement or medication decrease the incidence of mace? So there's been several studies on CoQ10, and it found that people who took CoQ10 who had heart failure were able to significantly reduce mace events or major adverse cardiovascular events and improve survival compared to a placebo. So that was for a particular population, that is patients with chronic heart failure. Then there was also a study that actually looked at blood pressure and what was the impact of CoQ10 on reduction of blood pressure. And it found that COQ10 provides a modest reduction in blood pressure. The first number, the systolic blood pressure, decreased by about 10 millimeters of mercury. The second blood pressure decreased by about five. The other thing that they found was important was people who were actually on statin medications. So statin medications are medications like Lipitor, Crestor, Zocar, Lovastatin, Pravastatin. Those are a statin, what we call statin medications. And statin medications are used to actually lower your cholesterol and decrease your risk of heart disease. People that are on statin medications, those medications can deplete CoQ10 levels in their body. They're naturally occurring CoQ10. So what I say about CoQ10 is that it is helpful for some people. It's not helpful for everyone. It would be important to actually speak to your physician about what's going on with your health and find out whether or not a supplement like CoQ10 would actually make a difference. All right, so so next you asked about uh fish oil. Fish oil is rich in omega-3 fatty acids, and these uh chemicals are anti-inflammatory, anti-thrombotic, means that you don't form clots as well, which is great, and they also help with lipid lowering. What in general do the studies show for that? So there was a large-scale study uh looking at the impact of fish oil, and what it found is that it can reduce major adverse cardiac events, particularly in people who already had a heart attack. The other benefit of fish oil that they've found is that it can decrease triglyceride level. So when you get your cholesterol levels checked, you can have normal cholesterol level and elevated triglycerides. You can also have elevated cholesterol and normal triglycerides, and then you can have elevation of both. So fish oil is good for those that have elevated triglyceride levels. And elevated triglyceride levels are a risk factor for heart disease. So it is important to get your triglyceride level down into a normal range as well as getting your cholesterol into a normal range. Lastly, there were a couple of studies looking at heart failure and atrial fibrillation related to fish oil. In patients that are heart failure patients, fish oil can improve heart function and can reduce mortality, although they found that the benefit was relatively modest. Lastly, they looked at atrial fibrillation, uh, which is when your heart beats irregularly and sometimes it can beat irregularly very fast. Um, and they were it was very unclear, there really was no. Significant reduction in risk found with atrial fibrillation. So, you know, I I I understand from the question, you know, the the the concern about all of these particular ads that you see for CoQ10 and fish oil. And I think it's important to really understand where you can get CoQ10 and fish oil naturally in your diet. So foods that are high in CoQ10 are foods like organ meats, which are kidney and liver, also fatty fish, sardines, salmon, trout, mackerel, uh, certain vegetables, spinach, broccoli, cauliflower, soybean oils, uh soybeans, lentils, peanuts, pistachio, sesame seeds, and also certain fruits like strawberry and oranges. As far as foods that naturally provide you fish oil, it's a lot of the same foods as those uh that have the CoQ10. So it is fatty fish, so salmon, mackerel, sardines, herring, anchovies, and tuna, particularly albacore tuna. Um, also your shellfish, shrimp, and oysters. Um, you can also get it from uh flaxseed and seaed seeds and walnuts. And these are the things that have naturally occurring fish oil. So I provide this information because you don't necessarily have to buy supplements. You can also just bolster these things in your diet to actually get them naturally. Thanks for asking the question. Damon from Capitol Hill uh asked a question, and his question is this I'm a big sports fan and I particularly like football and basketball. And I saw Damon Hamlin during the game experience a cardiac arrest, and LeBron James' son also experienced a cardiac arrest while playing. I I can't help but cringe seeing both of these players still play now. How is it possible that they could completely recover from a heart attack and resume being professional athletes? This is a really good question. Both uh Damar and Damar Hamlin and Bronny James had completely different things going on, and they really didn't have what you would typically call a heart attack. So let me start with Damar Hamlin because he was probably the most dramatic and that he had a cardiac arrest. And what happens is there's a thing called commocio cortis. So commocio cortis occurs when a person receives a really strong blow to the chest at a particular point in their cardiac cycle where they're vulnerable, where the the heart the electrical activity of the heart is vulnerable. The blow basically disrupts the normal rhythm of the heart and sends the patient into ventricular fibrillation. So, from everything that I've read about what happened with Damar Hamlin, is that is what actually occurred to him. He actually received a blow to the chest at a particular time, which is very rare, that will then send you into a V fib or a ventricular fibrillation like cardiac arrest. Now, here's how they come to that conclusion is once someone actually has a cardiac arrest, they have to go through a cardiac catheter. They've got to look at their coronary arteries. And my understanding is that he was completely cleared to go back to playing by several cardiologists. So that means he not only had a stress test, but he most likely had a cardiac catheter. Commocio cortis normally occurs in young and healthy players. Um and because it is a very rare event, um, they can be cleared to actually go back to activities. Now, Bronny James, uh son of LeBron James, who suffered a cardiac arrest on July of 2023 during a workout, um, that was a completely different event than what Damar Hamlin had. Uh, Bronny James had a congenital heart defect and didn't know it. So there's a lot of people that have a congenital heart defect and never really know it. And they may know it when they begin to play sports at a very high level. Um, that was a condition that caused his particular cardiac arrest. Um, he had surgical correction of this congenital heart defect, um, and then afterwards was cleared to resume playing basketball. Similar to Damar Hamlin, I'm sure that he had extensive cardiac workup to be cleared to actually play again. Neither one of these players had a heart attack, so they did not have typical clogging of their arteries that you have in older patients and a heart attack. So, but thanks for the question. I I think that that they both of them are very interesting cases, and it's important to look at how um heart health is even important when you're looking at young, healthy, active people. All right, thank you for that question. When we return, we'll hear from comedian Damon Williams to get his take on today's topic. All right, we have Damon, Comedian Damon Williams. So, Damon, what do you think about today's topic? We've been talking about heart health. What do you think? Here's today's edition of Damon Williams That's What I Think.

Hey, Doc, it's Damon Williams, and today we're talking about heart disease. Heart disease is one of the number one killers, not only of women, but African Americans and people in general. When it comes to the heart, you gotta play it smart. You gotta get your screenings and your tests, your stress tests, your EKGs. You wanna be on top of your heart. And if you ever feel any kind of weirdness or strangeness in your heart, you go right away and get that checked out. Even if it's a false alarm, which is the case that I went through. I was in New York once and my hotel had a 25th floor room and the elevators went out. So after walking up and down the 25 flights of stairs, I felt the weirdness in my chest. I decided that it was time to get checked out. I did not hesitate. I jumped in the cab and I went to an emergency room. After a battery of tests, it was determined that nothing was wrong with me, that it was probably that two hits of weed I had just smoked before I went up and down them stairs. Full disclosure, I think I had a panic attack. Doc, I know I can talk about this now because weed is legal. And so I'm telling my story. This is my truth. One of the main reasons why I went to the emergency room right away is because we had just lost one of my good friends, comedian Dave Arnold, suddenly. And you know, heart disease is something that is pervasive in our communities, and it's also some things that can be reversed and preventable when it comes to treatment. If you have a family history or relatives that have had heart issues, you definitely need to be diligent about getting all your screenings and getting yourself checked out. We live in an era of unhealthy food choices, even the healthy food is not as healthy as we think. And we also live in an era of pill poppers. And by pills, I mean male enhancement pills. Fellas, if you're out here trying to take a pill to get your thrill, make sure your doctor says you have a clean bill of health. Same for women. Women carry a lot of burden and stress, not to mention us men getting on your last nerve. That might not be right. It might not be true, but that's what I think. Follow me on Instagram at Damon WilliamsComedy or hit my site, damnwilliamscomedy.com.

All right, that's funny, Damon. Listen, at the end of the day, heart disease is no joke, but luckily for us, a good joke or two is good for your heart, your soul, and your immune system. All right, I just want to uh go over and recap what we learned today. We learned about the importance of CoQ10 and fish oil in certain settings, how to actually really get these things in your diet. And also what has happened to some of the sports figures that we've enjoyed watching as far as their heart health. Thank you for joining me today. We'll be back next week tackling questions and information right here, the show where you can be informed and empowered about your health.