S1: It's time for Midday Edition on KPBS. For today's show , we are getting to the heart of cardiac disease. We'll talk about the latest research and where more is needed , plus what it's like to live with a heart condition. I'm Jade Hindman with conversations that keep you informed , inspired , and make you think. About the impact Covid can have on the heart.
S2: More long Covid , more effects , you know , at organ level , like the brain and the heart. And we're just not keeping up our guard and our attention on this.
S1: Plus , why women and heart disease haven't been researched enough and what it's like for one woman living with congenital heart disease. That's ahead on midday Edition. Of. The. World Heart Day raises awareness about cardiovascular disease across the world. One illness that may put your heart health at risk is Covid 19. Research shows the infection can be linked to inflammation of the heart and an irregular heartbeat , known as atrial fibrillation. Here with the latest is Doctor Eric Topol , professor and executive vice president at Scripps Research Translational Institute. Doctor Topol , it's always a pleasure to have you on. Thanks.
S2: Thanks. Great to be with you.
S1: All right. Well , glad to have you , but let's let's start here.
S2: I mean , I think one of the things that we've learned over these four plus years is that there's a propensity after Covid to develop blood clots because the infection can lead to inflammation of the walls of blood vessels. And so that's one issue that that can occur in the days or weeks after a Covid infection. Another one you've mentioned is the heart arrhythmias again here because of inflammation of the heart per se , this can help trigger or increase the risk of various heart arrhythmias , such as atrial fibrillation or more frequently , just lots of extra beats. So people just will have palpitations. And they can have what's known as postural orthostatic tachycardia or Potts , the syndrome where when you stand up , your heart rate raises from 60 or 70 to potentially 130 , 140. And then there's a more rare , the problem of myocarditis , which is inflammation of the heart muscle itself , or the lining sac of the heart , the pericardium. And so these are the kind of the full gamut of the various things that can happen after a Covid infection. Yeah.
S3: Yeah. Well , what.
S1:
S2: So we shouldn't all be overly concerned that this is going to lead to heart issues. But as a cardiologist , I can say that , um , often it's not considered when talking to a patient and asking about their Covid history , which is surprising to me , because basically every patient that comes to see a cardiologist or physician , we should know about their status with respect to have they had Covid ? How many times ? Because the number of times of having Covid increases the risk of these things , um , and also their vaccine history because vaccines are protective against these complications. But the , uh , young men , uh , who get the mRNA vaccines , there's a rare but important complication of a higher rate of myocarditis , the inflammation of the heart muscle. So one of the things that helps is really to understand each person's Covid and vaccine history. And then , of course , the symptoms that we described are everything from , uh , low energy fatigue to palpitations to lightheadedness and dizziness to chest discomfort. Um , you know , just it's quite a large range of complications of , or symptoms that can be linked to Covid and then rarely to Covid vaccines , particularly , you know , in a special group of , of , um , young men afterwards. Yeah.
S3: Yeah.
S1: Now have you had a Covid infection , Doctor Topol.
S2: I've had one. I never want to go there again. Last December , I had the Jan one variant. Um , and , uh , you know , that was not a pleasant experience , so I was able to forestall it for years , but , uh , finally caught up with me.
S1:
S2: Uh , but the key point here , we've been talking about the heart. But the real news is about the brain. Um , there were two big studies published. One was in young people who were volunteers to get a challenge of Covid. This is early on before there were vaccines. So trying to understand in depth what was the consequences of a Covid infection and give these young people credit , healthy people for signing up for this. What was found at one year in this group of , uh , healthy people is that although they didn't pick up on their cognitive deficits. And this is against controls who didn't get the infection. They had objective decline in cognitive and memory scores. Another study of hospitalized people at one year or a year and a half. There was a very marked deficit of cognitive performance , atrophy of the gray matter of the brain and very persistent markers of of injury of the brain. So this actually appears to be a bigger problem even than the things that we've been discussing with the heart. And it's often when the infections don't lead to a hospitalization , we don't have the ability to detect the hit. But under formal testing with controls in a proper , rigorous study is showing up. And that's not a good thing. Hmm.
S3: Hmm. How do you think.
S1: The medical community will respond to that. The results of that study.
S2: Well , usually it's , you know , deny , deny , deny because none of us want to think that , you know , we have these , uh , uh , complications of particularly affecting our brain function , um , no less , or heart and other organs , but , um , there's too many studies now that have reinforced it. So the denialism has to stop. And , you know , we have to really be very serious about protecting from Covid. Uh , we also learned from the patient led group that people who have long Covid , who've done exceptional work , that reinfections , again , are increasing the risk for all these things , brain and heart. And there's not enough attention for people. We've just been through a major wave , um , here in San Diego and throughout the country , uh , attributable to a variant , um , called CP3 and its related descendant , CP 311. And most people did not take this seriously. They didn't do anything to protect themselves. And so they got often reinfections and increase their risk for these complications. So this is a problem in that we try to deny things and we don't take precautions. And here we're , we're getting uh , at least some of us are going to take a , have a toll from getting Covid either for the first time or multiple times.
S3: Well , what are levels.
S1:
S2: But it really you could say it's much more attributable to the evolution of the virus and how it basically finds a way to evade our immune response at the same time that our immunity has waned because not having another booster or , um , remote from a prior infection. And then , of course , the lack of using any of the mitigating measures we know of , like masking and avoidance of indoor crowds and air quality and ventilation , all those sorts of things. So when those all come together , we get a wave , and then now we'll have another wave in the months ahead , when the virus gets to another place that is hard for us to recognize and people , you know , not too many people have gone out and had booster shots , and particularly people at increased risk really should go and do that. Yeah.
S3: Yeah.
S1:
S2: And in fact , the Novavax is just now starting to show up in San Diego. But the two mRNA shots , um , Moderna and Pfizer were the ones that were initially available there directed towards the virus that has evolved , particularly mRNA with the so-called two variants. It's closer to what we're dealing with right now , but as you mentioned , the wave is starting to head down and there is better safety out there , the less circulating virus. But that doesn't mean it's gone away. And I'm sure most listeners know people who have been hit with the recent wave in this region because it really had a big impact for infections. Fortunately , because there's some immunity , not so much in the way of hospitalizations or deaths. But yes , more long Covid , more effects , you know , at organ level , like the brain and the heart. And we're just not keeping up our guard and our attention on this.
S1: Yeah , I want to dig into that more. But , you know , one thing you've always said is that a nasal spray vaccine would be a good weapon against Covid 19.
S2: And they had a nasal vaccine that they tested in about 140 healthcare workers. So they are people who are exposed to. And this is , you know , during high circulating virus , when China had , um , stopped their zero Covid policy. So there was lots of exposure. And what was interesting is when the health care workers got two shots of the nasal vaccine spray , they basically , uh , 87% , uh , did not get any infection. And they even checked for asymptomatic infection. So it looked for the first time we have in people , particularly healthcare workers , that are high risk. We have evidence that a nasal vaccine not only led to a huge increases in antibodies in the mucosa , like the lining and the nose and upper airway. Huge levels of specific to spikes across ten different strains of the virus. And that's one of the big features of the nasal vaccine. You don't have to worry about evolution of the virus because you're getting the virus. You're hitting it and preventing it. Setting up a wall , um , where it enters and it doesn't matter that it evolves. So the nasal vaccine achieves two big things. One is that it's not so sensitive to new strains or evolution of the virus , and two , it prevents infections and transmission , which is what we don't have with shots. Now , it's not 100% , but this lasted for three months , which is really quite good. And I don't think any of us would have a problem of of having a home spray. Um , you know , a nose spray every three months to prevent infections. And then we wouldn't have to worry so much about the kind of complications we've been discussing. Right.
S3: Right.
S1:
S2: In China ? I guess it's just starting to roll out. They're not in the US and it's very frustrating. This is nothing like back in 2020 when we went all out with this Operation Warp Speed. We don't have any operation that's like that now. And so we're going to watch nasal vaccines get commonly used in other countries. And it may take another year or longer before they'll become available here. Wow.
S3: Wow.
S1: Well , you know , I guess testing then is a good tool for us.
S2: So they're , they're they're not , um , become obsolete at all. They're still useful. I recommend ordering those free tests. What have you got to lose ? Right. And , um , even more importantly , you know , if you're a person at risk , whether it's because you're older or you're , uh , have other coexisting conditions , you know , get a booster , um , it's going to help.
S1:
S2: We have no treatment and we have , you know , little in the way of even ongoing clinical trials to test treatments in a rigorous , scaled way. So we're very short on treatments. We're very long on understanding the different ways people get long Covid. But the problem is we have no , you know , biomarker test. So it's a clinical diagnosis based on the patient's , um , symptoms , uh , or some of these complications that we've been discussing. Uh , and the problem is that not enough clinicians take this seriously. And so many people with long Covid , we have very few long Covid clinics that are multidisciplinary to handle the high burden of people that are out there that are suffering. And a lot of , uh , physicians , whether it's primary care or specialists , they don't have this in front of mind. So they don't connect the dots when they see people presenting with some symptoms that could actually represent long Covid , but without a treatment. Um , it's now mostly supportive , and we hope to do some definitive trials in the months ahead to help shed some light on effective treatments.
S1: And to be clear about the vaccines , while they may not be 100% protective against infection. They do offer some protection from long Covid. Absolutely.
S2: Absolutely. So just to be straight on this. There is some protection from infection in the first 4 to 6 weeks after a booster. Um , which is good. It's , you know , maybe 50 or 60% , and then it tails off. So it doesn't last very long. And it's nothing like , you know , 80 , 90 , um , percent. Now , what you brought up is that long Covid , all the studies , including a new one , uh , this week , point to about 40% , perhaps even 50% reduction of getting having the chances of getting long Covid , which is something you don't want to have. And so that's just yet another reason to get , in my view , for even healthy people to consider getting a booster because it's going to give them added protection. Having up to date , um , vaccine immunity really helps reduce the risk of long Covid.
S1:
S2: It's just a matter of when the virus has not stopped its evolutionary arc. And so whether it's November or December , but , you know , it takes a few more months from when it has come down to the next variant to kind of show it's , um , it's capability of inducing infections and transmission spread to others. So we're see , we have a variant that's out there right now that's in the US and many other countries. It's called XC. So it might be that or it could be , you know , a descendant of that virus with more mutations. But in the months ahead we're going to see this pattern. It's just going to keep going. It's going to just keep going until we take this seriously with getting universal vaccines , nasal vaccines , you know , a much more , uh , effort and resources and priority than we're doing right now.
S1: I've been speaking with Doctor Eric Topol , professor and executive vice president at Scripps Research Translational Institute. Doctor Topol , it's always great to have you on the show. Thank you. Thank you. Coming up , finding community and raising awareness about congenital heart disease.
S4: You find ways to cope with the pain and the trauma that you had as a kid. For me , for example , I always try to keep myself busy and be involved with something that like , brings happiness.
S1: Hear more when KPBS Midday Edition returns. Welcome back to KPBS Midday Edition. I'm your host , Jade Hindman. On the heels of World Heart Day , today's show is about cardiovascular health and awareness. Heart disease is the leading cause of death in the United States , and more than half of U.S. adults don't know that statistic , according to a report by the American Heart Association. Well , now , an estimated 1.6 million U.S. adults live with congenital heart disease. That's when someone is born with a birth defect. UC San Diego's Adult Congenital Heart Disease program is the first and only of its kind in the San Diego region. The program's director , Doctor Laith Al-shaabi , is also a professor of cardiology at UC San Diego. He likes to go by Doctor Lathe and he joins me now. Welcome.
S5: Thank you , Jade , for having me.
S1: So glad to have you here. Also here is Jessica Vargas Miranda. She's a co-chair for the Adult Congenital Heart Association's annual walk for 1 in 100 in Southern California. Jessica , welcome to you.
S4: Thanks for having us.
S1: So glad to have you both here. Um , doctor Laith , I'd like to start with you.
S5: And it was once considered a fatal condition. But major advancements in surgical techniques and medical care during the 1970s and 80s dramatically improved survival rates. As a result. Currently , over 90% of infants with complex forms of congenital heart disease now survive into adulthood. This has created a new population of adults who require lifelong specialized care. Because traditional cardiology training and infrastructure are often insufficient for their unique needs. Hmm.
S3: Hmm.
S1:
S5: But eventually they get diagnosed and they get channeled towards the correct care. Hmm.
S3: Hmm.
S1:
S5: Um , a failure to gain weight or what they're called thrive. Um , but in adults , um , it could present in difficulty breathing or inability to perform physical activities that they used to do.
S3: And what does.
S1: Treatment then typically look like. For someone who has congenital heart disease.
S5: Most require open cardiac surgeries to repair or palate the problems , but many will require lifelong repeat operations or minimally invasive transcatheter interventions.
S1: Jessica , I want to hear about your story. You were diagnosed with congenital heart defect at just seven months old.
S4: So basically when I was like around eight months , I started to get sick and I developed bronchitis , and then it complicated to pneumonia. So my parents wanted a second opinion from the medical professionals. And when they took me to another doctor or another pediatrician , they actually told them that I had congenital heart disease. So my parents were devastated because I needed to have , like , a surgery immediately. Uh , so my first surgery was at the age of nine months , and then I had a second one at the age of ten months. And my third heart surgery was at the age of seven. I barely remember , like , you know , when I was in the hospital when I was around seven years old. But I have some memories because for me , the stay in the hospital in Mexico , it felt like it was an eternity. I had to leave my two younger siblings. So that was pretty tough because back in the day , my parents couldn't stay in the hospital with me or none of my family members , so it was just me basically in the floor with other patients with congenital heart disease in 2013. Uh , March of 2013 , I was in L.A. and I collapsed getting into my car. So I thought it was like maybe I was Stay hydrated. So in April of , uh , 24 of 2013 , I had my fourth open heart surgery at sharp. But as an adult , I got to realize that , you know , your life completely changes. Like , you know , when you're a child. Um , I guess the trauma you could call it , or the stress of having a surgery , you kind of really completely block it from your head. But now , as an adult , it was a totally different decision because , um , and an experience I had never taken medication like , you know , on a daily basis to take care of my condition. And now I do , um , I take blood thinners and I take a blood pressure medication. So now I have to have , like , a little bit more of care than I did as I was a child.
S3: You know.
S1: Doctor Laith , one thing Jessica highlighted is how families are affected when loved ones have congenital heart disease. You're also on a patient Family advisory committee to improve patient care.
S5: One would be by engaging in these facts or patient family advisory committees. These are really robust structures that come with mandates and produce specific recommendations for health care systems to enact change that would eventually benefit the family and the patients alike , but also on an individual level. I encourage families to be as engaged as possible with their loved ones , care , and come with them to their appointments. It's important to note that many of our patients live with lifelong PTSD from childhood operations , and it's really critical that they have their health care advocate who's often a family , uh , individual or a loved one with them. Uh , to help them address all the questions and also retain the information that we provide for the patient and their family during the clinical visit.
S1:
S4: Because if my blood is too thick , then my valve might not work properly. Or if my blood is too thin , I might have like some type of , um , hemorrhage or I start bruising. So you have to be , like , more proactive on taking care of yourself. Like , for example , during the Covid and even sometimes today , depending on where I go , I make sure that I wear a mask that I'm up to date to my vaccines , that I'm eating healthy , that I exercise , that I have like an active life. And as the doctor mentioned before , um , many patients , we do have PTSD , but it depends on how you find ways to cope with the pain and the trauma that you had as a kid. And it comes from like many areas of sports , family. It could be your church , it could be your friends , it could be hobbies. So , uh , for me , for example , I always try to keep myself busy and be involved with something that , like , brings happiness. And , um , I try to just have a positive day , even though that it might not be the greatest and shiny day outside. But , you know , I think that has to do a lot on how it has helping me , um , live with KD. Yeah.
S3: Yeah.
S1: And Jessica , you're you are a volunteer for the Adult Congenital Heart Association. You're also on their diversity , Equity and Inclusion committee.
S4: It's to make sure that the Hispanic population and the African American community , they stay in care because unfortunately , I could talk , especially in regards to the Latino communities , that sometimes as a child , they had a procedure , they had a heart operation. And it's maybe because of the lack of education or just because they saw that their kid came out of surgery fine. When they were kids. They don't no longer need care. And , you know , as you age , your body changes , the heart structure changes. And unfortunately , many patients in the Latino community. They delayed that care , and sometimes it complicates their condition when they're older adults. For me , like my purpose now is to educate the Hispanic and African American community that not because you had a surgery as a child , it means that you are fixed and everything. It's going to be fine. I'm trying to make sure that they understand that having congenital heart disease , it's a long , lifelong condition , that it has to be monitored by a professional. Yeah.
S3: Yeah.
S1: Well , doctor Lee , the two of you are working together on the walk for 1 in 100 , coming up on October 13th. Tell me more about what we can expect from that event.
S5: It is hosted by the Adult Congenital Heart Association. There will be stationed at Liberty Station , and it's going to be a physically easy walk , um , around Liberty Station , but also it's an opportunity to learn about congenital heart disease and the impact that the ACA has on the community in the United States at large.
S3: Well , in Jessica.
S1: I want to hear more from you on that , too.
S4: Because when I was a kid , I the only people that I knew that they had the same condition where other kids in the hospitals , but outside the hospital , I didn't feel that I had a community that represented me , used to have the team and having your friends , your family and all of your caregivers , including the doctors and nurses at UCSD , it was like a totally opening experience that I was like , oh my God , like , I really have a purpose. And I , I'm going to keep doing this as much as I can. And since then I've been part of a as a volunteer , not only for the walks but as the I committee. And sometimes I also work as their translator from their English material into the Spanish finding community.
S1: And purpose is just so important.
S5: 1 in 100 people walking amongst us were born with congenital heart disease. So I think that venue is important. The vast majority of our patients are not engaged in care. In fact , there are several studies pointing that up to 80% of patients would be lost to care by the time they're 18. And it's critical that we re-engage with these families and patients and have them back to care so that we can do proper surveillance and not wait for complications or problems to happen in the acute setting. Yeah.
S3: Yeah.
S1: I've been speaking with Doctor Laith Al Shawki. He's director of UC San Diego's Adult congenital heart disease program and professor of cardiology. Doctor Laith , thank you so much for joining us today.
S5: Thank you very much for the opportunity.
S1: Also , Jessica Vargas Miranda , co-chair of the Adult Congenital Heart Association's annual walk for 1 in 100 in Southern California. Jessica , thank you for taking the time.
S4: Thank you for having us. I really appreciate it.
S3: You can find.
S1: More information about their annual walk for Congenital Heart Disease at PBS.org. Still ahead , why early researchers on heart disease overlooked women and how that impact is felt now.
S6: Cardiovascular disease is the leading killer of both women and men. And yet we left out half the population.
S1: Hear more when KPBS Midday Edition returns after the break. Welcome back to KPBS Midday Edition. I'm your host , Jade Hindman. On today's show , we're discussing heart health and disease prevention. Well , now , medical research has come a long way over the past few decades , but gaps in knowledge and diagnosis remain. Some call it the heart disease gender gap. Before the early 1990s , women were rarely included in clinical trials. Today , there's still a lot. The medical field doesn't know about female biology , which means women's heart problems are often under-recognized. Joining me now to discuss this is Doctor Martha Gulati. She is the director of prevention at Cedars-Sinai Heart Institute in Los Angeles. Doctor Gulati , welcome.
S6: Thank you for having me.
S1: So glad to have you here. If you could provide some historical context around the lack of women's representation in clinical trials for heart disease.
S6: Yeah , I think our history dates back to the 1960s. And some people might remember a drug called thalidomide that was used in women to prevent morning sickness. But unfortunately , no studies were really done before that drug was launched , and it ended up harming the offspring of those women that used it in Europe. So almost overnight , you know , the the US and the FDA specifically said that trials will not include women of childbearing ages , but unfortunately that got translated to women should just be excluded in trials. And so for a number of years , you know , women were not included in trials and specifically in the field of cardiovascular disease. And why that matters is that cardiovascular disease is the leading killer of both women and men. And yet we left out half the population. Wow.
S1: Wow. And I mean , the the consequences seem obvious. But if you could talk a bit about what it means to have women excluded from these trials and how their health care is impacted.
S6: Yeah , absolutely. So what I think happens , you know , is that we often look at the trials and when people are not included , specific groups , we sometimes think , well , these trials may not apply to them and therefore we might not give certain therapies to women. And we know that is definitely happened for women. There's also , of course , bias in our care , meaning that we don't think of heart disease as a woman's problem because , you know , we didn't study them , so it must not be a problem for them. And that also creates bias both within the public , meaning that women often don't think that heart disease is their problem. So if they experience crushing chest pain in their chest , they don't often think it's a heart attack because they're told differently , that that is not an issue for them. Or they might be getting public health messages that women present differently than men , even when it's more common that they're going to present similarly rather than differently.
S1: Well , I tell you , as a heart attack survivor , this conversation is of of interest to myself , to me. Um , can you talk about why it's so important to have these trials , uh , for both men and women.
S6: First , you know , the way I always try to break up things is I always ask myself , is it sex or is it gender ? And if it's gender gender's a social construct , how we're seen by people and that people say , oh , I see a woman and I'm going to treat her in this way. So there's , there's , you know , the way that our society will just treat people that look like women. And that's an important issue and actually contributes to our outcomes. Meaning that if a man presents with chest pain , it's more likely that they'll treat a man faster than a woman , because we somehow identify men and heart disease as being an important issue and a less important issue in women , and we often attribute symptoms like chest pain or chest discomfort as being anxiety or stress in a woman. But the sex differences are biological. Meaning if you are x x , which is a woman , or your chromosomes are x y as a man , that there are biological differences. Perhaps how we present with disease we might have different forms of diseases , and we can see that in , um , a type of , uh , ischemic heart disease where , um , blood vessels respond abnormally , but sometimes it's due to blockages in the coronaries. But women , for example , are less likely to have those blockages , and they tend to have a different form of ischemic heart disease , even heart failure , which is a common issue that people live with. Women tend to have a type of heart failure where their heart function looks more normal , and men's heart function when they have heart failure , looks like a failing heart. Another good example that people might recognize is there's an type of disease that is a type of heart attack known as a broken heart syndrome. And people may have heard this , you know , often when somebody either had an emotional event , whether good or bad. But it's often described when somebody has lost a loved one where they could have a heart attack and they have something called broken heart syndrome , also known as Takashi Bo's syndrome , but again occurs much more frequently in women than in men , meaning that that brain and heart connection is much stronger in women than it is in men. And these are just things we're learning about right now.
S1: What is that syndrome that you just mentioned ? The broken heart syndrome.
S6: Physically , the way they present is like a heart attack. But instead of having disease in their coronary arteries , um , blockages where we can go in and put stents. We actually find that their arteries look normal , but the way that their actual heart damage looks , it looks more like heart failure. So when we see these patients , often there's some clues , meaning their heart is dilated and often in a very specific pattern. So there's some features that they present with that gives us the clue that there is something else going on.
S3: What about.
S1:
S6: So meaning that when women , um , go through menopause , we know that change at least is associated with a heightened or increased cardiovascular risk , meaning their blood pressure tends to rise , cholesterol tends to go up , and there can be other changes that occur in the metabolism and the weight gain. So we certainly know that after menopause , women do increase the risk of heart disease. And it becomes actually more a little bit more like a man's. But there's other unique things that related to hormones that can affect the heart , that are specific to women. Because , you know , we know certain risk factors , like things that can occur during pregnancy , increased the risk of heart disease. And of course , only a biological woman can be pregnant. There's other things also that occur in women , things like polycystic ovarian syndrome that heighten the risk for heart disease. Even early menarche and late menarche also increase the risk of heart disease as well. Wow.
S1: Wow. Lots of factors there. You know , earlier you talked about medical bias and cardiovascular health. I'm curious how is is bias compounded by factors like race , class and even age.
S6: Yeah , that's a great question. We do know that there's bias in the medical community. We're no different than our general public. Right. So meaning that there's biases that are existent everywhere including in medicine. So when we see women we might respond differently. And when we see people of different races , we respond differently. And every time I said something about women being not treated equally , you can almost replace people from diverse backgrounds into those same sentences because we know those gaps in healthcare exist. We are trying to really educate our medical community to understand , first of all , that , um , implicit bias exists and we need to train people how to overcome our biases. We all have biases. We all make assumptions based on how somebody looks or how somebody is dressed or , um , you know , by their gender. But we need to recognize those biases and try to check them because they are affecting people's health care and ultimately affecting their lives.
S1: Your focus is on preventative care.
S6: I think if we can empower people to know , first of all , are they at risk for heart disease ? Have they been screened for heart disease ? Because particularly for women , you know , we we I always like to say we do bikini care of women. When people go to their primary care , they know about their breasts , they know about their reproductive system. But everything else seems to be play second fiddle to any of those things. And we need to start getting screened and asking , are we at risk for heart disease ? Do you know if I'm at risk ? That's what patients should be asking their physicians. And really it changes every year. So people need to know if things have changed year to year. And for everyone , we should know our numbers. Numbers give us power. Don't let somebody tell you that your blood pressure is normal. Get those numbers. Because , you know , we keep changing those numbers of how aggressive we need to be about blood pressure. Um , and knowing the number matters , knowing your lipids , your cholesterol and the number that I would tell you to focus the most on is your LDL cholesterol. You want it lowers better is the way to remember that , but is really important to know your numbers and know if you have diabetes or not , and if you need to be screened for it. Many people need to be screened for it , particularly people that have a strong family history of diabetes , but also anybody who's had gestational diabetes or if they had diabetes during their pregnancy. That needs to be checked annually because you're at a much higher risk of developing diabetes in the future. And that means you're at a much higher risk of developing heart disease.
S1: Is there anything patients can do or look out for ? Um , when it comes to finding a doctor who can give them the right care.
S6: What I tell people , you know , if you're complaints aren't being heard , meeting your symptoms or not being addressed or being misattributed to anxiety , stress , lack of sleep which we all suffer from anyway , male and female , um , you know , but if it's particularly , they're not hearing you. If they're not hearing your symptoms , get a second opinion or find a new doctor. There's good doctors out there. There's lots of good doctors. But we also know that just like any profession , there are doctors who aren't trained necessarily to listen to patients. And particularly perhaps listening to women takes more effort. And maybe it takes a female voice or a female ear , should I say to really , um , listen. Well , we do have some evidence , actually , that female doctors not only listen better , but take better care , follow guidelines better for both men and women. You know , I'm not even saying it tongue in cheek. I just think that , you know , again , the more diversity we bring into our field , the better things will be for everyone.
S1: I've been speaking with Doctor Martha Gulati. She is the director of prevention at Cedars-Sinai Heart Institute in Los Angeles. Doctor Gulati , thank you so much for being here today.
S6: Oh , thank you for having me.
S1: That's our show for today. I'm your host , Jade Hindman. Thanks for tuning in to Midday Edition. Be sure to have a great day on purpose , everyone.
