Speaker 1: Initial Life Sequencing coming to you live from Houston, Texas,
Speaker 1: home to the world's largest medical center in the.
Speaker 2: Approach ras everything looking ability.
Speaker 1: This is your Health First. It's the most beneficial health
Speaker 1: program on radio with doctor Joe Galotti. During the next
Speaker 1: hour you'll learn about health, wellness and the provention of disease.
Speaker 1: Now here's your host, doctor Joe Galotti.
Speaker 2: Well, good Sunday evening to everybody. Doctor Joe Glotti, thanks
Speaker 2: for tuning into your Health First. We're here every Sunday
Speaker 2: between seven and eight pm. And our mission year after year,
Speaker 2: twenty two plus years that we've been doing this, it
Speaker 2: is very simple to make you better consumers of healthcare,
Speaker 2: raise your health IQ and give you some insight as
Speaker 2: to how to take care of your body. Being a
Speaker 2: good consumer can certainly, without a doubt, prevent a lot
Speaker 2: of the chronic disease that we see. By now, everybody
Speaker 2: should know our website. It is doctor Joegalotti dot com,
Speaker 2: d R J O E G A L A t
Speaker 2: I dot com. Go there and sounder from newsletter send
Speaker 2: me a message. All of our social media posts are there,
Speaker 2: including YouTube and Instagram and Facebook, and our website Doctor
Speaker 2: Joegalotti dot com all right, So the month of February
Speaker 2: is American Heart Month, and that is the time of
Speaker 2: the year where we raise awareness, have a conversation about
Speaker 2: heart disease, heart disease and men heart disease and women.
Speaker 2: Making sure you understand your risk factors, because really, if
Speaker 2: you know your risk factors, you can look in the
Speaker 2: mirror and say, hey, I did not realize I am
Speaker 2: at risk for premature heart disease or a premature heart
Speaker 2: attack or stroke or heart failure, or these palpitations I'm
Speaker 2: having may be something more serious that needs a more
Speaker 2: formal workup. So that is the idea. And on the
Speaker 2: program tonight, we have to we have doctor ran Deep Sunasia.
Speaker 2: He is an acclaimed cardiologist here in Houston, and I
Speaker 2: had the opportunity a little earlier in the week to
Speaker 2: sit down and have a conversation with him. So that
Speaker 2: is what we have tonight, a conversation with doctor ran
Speaker 2: Deep Sunasia, a cardiologist here in Houston. Listen and take
Speaker 2: in for yourself what information do I need to know?
Speaker 2: Look at it that way?
Speaker 1: All right?
Speaker 2: Well, as I was saying earlier, it is American Heart Month,
Speaker 2: a month of February, and if it was up to me,
Speaker 2: it would be part month every month of the year,
Speaker 2: but we have to deal with what we're dealt here
Speaker 2: and no stranger to your health. First, doctor ran Deep Sunasia.
Speaker 2: He is one of the finest cardiologists, not only in
Speaker 2: Houston but in the United States. And I've known him
Speaker 2: a very long time. And when sometimes we are lacking
Speaker 2: compassion in the medical field to our patients, doctor Snasia
Speaker 2: certainly excels in that area. It's great to have you
Speaker 2: on tonight, and thanks for participating in our little contribution
Speaker 2: to American Heart Month.
Speaker 3: Thank you, Joe, thank you for inviting and always look
Speaker 3: forward to our yearly meetings here on and during this month.
Speaker 2: Yes, exactly. Now, just a little background on doctor Sunasia.
Speaker 2: He has been here is it twenty three years now? Well,
Speaker 2: thirty three thirty three thirty three years, over one hundred
Speaker 2: thousand patients. That was a landmark just recently and he
Speaker 2: has founded the Cardiology Center of Houston. He's on staff
Speaker 2: at Houston Methodist Hospital West right or is that in Katie.
Speaker 2: It's in Katie, Texas, and you've held various positions there
Speaker 2: over the years. Board certified in five separate areas ranging
Speaker 2: from internal medicine, cardiology, nuclear cardiology, cardiovascular ct which I
Speaker 2: want to hear about, and what I think is most
Speaker 2: important is lifestyle medicine. So I would say, there's so
Speaker 2: much to talk about here, but let's really orient everybody
Speaker 2: with some of the basics and risk factors for heart disease,
Speaker 2: cardiovascular disease, and the way I look at it, for
Speaker 2: everybody listening tonight, if you do not have a good
Speaker 2: understanding of what your risk factors are, then you're really
Speaker 2: not paying as much attention as you need to. So
Speaker 2: knowing risk factors is very powerful. Doctors in Asia go
Speaker 2: over the list of risk factors people need to know about.
Speaker 4: Sure.
Speaker 3: I think risk factors get divided into two, which is
Speaker 3: modifiable and non modifiable. Non modifiable risk factors are where
Speaker 3: you cannot modify them. That includes family history, age, and race.
Speaker 3: So there are age where premature Corno disease happens before
Speaker 3: the age of fifty five, a family history or in
Speaker 3: women before the age of sixty five does strong family history.
Speaker 3: Age as is basically is when you get older, higher
Speaker 3: the risk and number. Some races where you have African,
Speaker 3: American and even some Asian population, I had highly Soccardivasca
Speaker 3: disease compared to Caucasian population. And then we have the
Speaker 3: modifiable risk factors where we can modify the risk factors
Speaker 3: and those are most importantly hypertension, diabetes, history of smoking, hyperlipidemia,
Speaker 3: lack of sleep and in activity, and weight is a
Speaker 3: very big factor. Now we are talking about sitting is
Speaker 3: the new smoking risk factor we're all been setting for
Speaker 3: our specially post COVID and during COVID, people have been
Speaker 3: working on their desk for eight eight hours a day
Speaker 3: and on average, people have gained between ten to twenty pounds.
Speaker 3: And Joe you, I'm sure you've seen this.
Speaker 2: Yeah, and you know the people people in many times
Speaker 2: they aren't able to shake it off. They gain the
Speaker 2: weight during COVID. You know what I would share with you,
Speaker 2: and I think from my own personal experience, and so
Speaker 2: we when COVID hit in the pandemic, and we did,
Speaker 2: or at least I did some remote work from home
Speaker 2: seeing patients online. And I remember the very first day
Speaker 2: and I got my Apple Watch. On my very first day,
Speaker 2: I came up to my office, saw my eighteen twenty patients.
Speaker 2: Then I went down for dinner. That was basically I
Speaker 2: was up here for breakfast. Maybe I went down for
Speaker 2: lunch to go to the bathroom. I don't know. I
Speaker 2: walked only about three hundred and fifty steps the entire day.
Speaker 2: We're normally at work, it's seven to eight thousand steps
Speaker 2: just doing the normal work. And I'm sure you're the same.
Speaker 2: And it dawned on me that the adults that have
Speaker 2: desk jobs is a horrible, horrible situation to be in.
Speaker 3: Ye And you know, as you know, the percentage of
Speaker 3: and prevalence of obesity in the US now we are
Speaker 3: talking about on an average, forty percent the adult US
Speaker 3: population is obese, thirty percent is overweight and painfully, but
Speaker 3: to twenty two percent of the adolescent kids are no obese. Right, So, yeah,
Speaker 3: it's an epidemic.
Speaker 2: Yeah, it's it's really getting out of control now, you know,
Speaker 2: with with the risk factors. When when you see let's
Speaker 2: say a new patient and they have hypertension and it's
Speaker 2: gone undiagnosed for years, and they have these other either
Speaker 2: family or lifestyle risk factors, and you alert them and
Speaker 2: you educate them and teach them and enlighten them, what
Speaker 2: do they say do they say? Gee, I had no
Speaker 2: idea smoking caused high blood pressure. I had no idea
Speaker 2: that no exercise caused hypertension. Where is a public on this?
Speaker 2: Are they just in more denial than really being completely
Speaker 2: ignorant on this? What do you think?
Speaker 4: I see?
Speaker 3: The question is that if the patient comes with hypertension,
Speaker 3: when we do the echocardiogram and we measure the wal
Speaker 3: thickness and we see that their val thickness is increase,
Speaker 3: and they've got leftritical hypertrophy, and I show them the statistics.
Speaker 3: You know, when you show the patient that you got
Speaker 3: leftritical hypertrophy, your heart is working harder. It really dawns
Speaker 3: on them that you know the amount of blood fruit
Speaker 3: to the heart is fixed, and if you have leftritical
Speaker 3: epotrophy then you're going to have someone to call it ischemia.
Speaker 4: Your heart is working harder.
Speaker 3: And when you present these facts, it makes them aware
Speaker 3: that they must take very proactive measures. You define that
Speaker 3: you have to control the blood pressure very well. Every
Speaker 3: ten percent drop in systolic BP reduces the cardiovestor complications
Speaker 3: by but to twenty two percent. Yeah, so it's critically
Speaker 3: important to control the blood pressure and along with that
Speaker 3: other dis factors and you know weight gain leads to
Speaker 3: elevated levels of lipids, metabolic syndrome, sugar is up, the
Speaker 3: blood pressure all go hand in hand. And if you're
Speaker 3: addressing one factor, I think the key factor here is
Speaker 3: managing the weight and that will improve all the parameters.
Speaker 3: But you have to make an effort and it requires
Speaker 3: a lot of effort. Proactivity, regular exercise one hundred and
Speaker 3: fifteen minutes per week, as you know, thirty minutes five
Speaker 3: times a day and then ah and American artizens also
Speaker 3: emphasize that you must do weight training about two times
Speaker 3: a week because we are being muscle as we're getting older,
Speaker 3: so it's very important.
Speaker 2: All right, let's take a quick break on down to
Speaker 2: Joe Glotti. We're talking with doctor Ran Deep Ssunasia, cardiologist
Speaker 2: here in Houston, Texas. Is website to get more information
Speaker 2: is Houston Cardiology dot com. Stay tuned, We will be
Speaker 2: right back. Welcome back, everybody, back with doctor Ran Deepsunasia
Speaker 2: cardiologists here in Houston, Texas, talking about American Heart Month
Speaker 2: and all that you need to know about heart disease.
Speaker 5: You know, the other thing just to shift to symptoms,
Speaker 5: because again the patients that I see, they are you know,
Speaker 5: limping around with symptoms.
Speaker 2: They're short of breath, they have palpitations, they're not sleeping well,
Speaker 2: they have some swelling in their legs. And again, you know,
Speaker 2: I asked them, what were you thinking?
Speaker 4: And I think people are not.
Speaker 2: Putting all the dots together to say, you know what,
Speaker 2: this might be a problem with my heart. Let me
Speaker 2: get it checked out. So what do you see from
Speaker 2: a symptoms standpoint?
Speaker 4: One point?
Speaker 3: I think that varies from anywhere from chestice comfort, tightness,
Speaker 3: heaviness in the chest, which are signs of precipitated by exertion,
Speaker 3: activity or stress, indicating anginal symptoms. You can have shortness
Speaker 3: of breath, which can be related to again, symptoms of
Speaker 3: high blood pressure. Exertional disney can be an anginal equivalent.
Speaker 3: Also palputations that can be related to rhythmia. As we
Speaker 3: are seeing a ton of atrial fibrillation all these days,
Speaker 3: almost an epidemic of a FIB, right, Yeah, so yeah,
Speaker 3: I mean.
Speaker 2: Is it just to stop you there for a second,
Speaker 2: would you say, twenty five years ago you saw as
Speaker 2: much a FIB as we all see now.
Speaker 3: No, definitely, not definitely, not right, Yeah, And I think
Speaker 3: that there's multi factorial aspects in that age is one
Speaker 3: of the biggest risk factors. People are living longer, aging
Speaker 3: longer than we have people we are treating them well
Speaker 3: with if they have microinfunction, they'll be treating with intervention.
Speaker 3: They may have allued dysfunction, and as they are aging,
Speaker 3: then they will ultimately develop interfibrillation liter in life. So
Speaker 3: it is and then presence. People who have been affected
Speaker 3: with COVID also have had disease processes from that, and
Speaker 3: we have seen a higher amounts of aphibian patients who
Speaker 3: are bad COVID also and other rhythmias. So definitely seeing
Speaker 3: a whole lot of a FHIB. And again obesity rate
Speaker 3: is going up. That leads to sleep apnea, which is
Speaker 3: sleep apnea is putting increases or intrifibrillation. So every patient
Speaker 3: with a FIB, we are screening them for sleep apnia.
Speaker 3: And then fatty liver is going hand in.
Speaker 2: Hand, right, Yeah, I mean data doesn't go by that.
Speaker 2: I think you're contacting us about a fatty liver patient
Speaker 2: and it's it's really really we we say obesities that
Speaker 2: have been a FIB is an epidemic, Fanny livers an epidemic.
Speaker 2: We're we're just exploding with complications. And it is so said.
Speaker 2: You know one one thing you know again Uh, I
Speaker 2: like to say, I am a cardiologist in the closet, uh,
Speaker 2: and I leave the expertise to you and your colleagues.
Speaker 2: But imagine if we could wake up the American public
Speaker 2: to know their blood pressure. And I've even spoken on
Speaker 2: the radio here that wouldn't it be great if every
Speaker 2: household had a blood pressure cuff, even if you did
Speaker 2: not have blood pressure, a blood pressure issue, high hypertension,
Speaker 2: that and that would be great. But imagine if once
Speaker 2: a quarter you just check the blood pressure everybody in
Speaker 2: your heart okay, and just say get the kids, your
Speaker 2: young adults, your wife, your husband, your mother, whoever, and
Speaker 2: just say, okay, it's the first quarter of the year.
Speaker 2: We're going to check and document everybody is okay. We'll
Speaker 2: do it again next quarter. But create alertness to blood pressure.
Speaker 2: The numbers are staggering on the amount of people that
Speaker 2: have hypertension. What do you think regarding the value of
Speaker 2: home monitoring. I think that's phenomenal.
Speaker 3: In fact, when patients come in with hypertension, you know
Speaker 3: sometimes many times you see you know, white foot hypertension, Also,
Speaker 3: patients blood pressure at home is okay and when they
Speaker 3: come to the office they are elevated. So it's critically
Speaker 3: important to get good data and we recommend Actually AHH
Speaker 3: never endorses any products, but American Heart as Solcition has
Speaker 3: stated that for us to treat hypertension, we must collect data.
Speaker 3: So omron VP arm cuff, ARM cuff not a risk,
Speaker 3: cut the risk, not the risk, not the risk. Aren't
Speaker 3: cuff done in a proper way with patient preferable lying
Speaker 3: down and this the sigam monometer right next to you,
Speaker 3: done two three readings after taking a few minutes of rest.
Speaker 3: Collecting data over period of time because if pressure is elevated,
Speaker 3: you don't want to just start it right away because
Speaker 3: if the BP readings are higher in the office, so
Speaker 3: you want to collect data for at least two to
Speaker 3: three four weeks.
Speaker 4: But if the patient comes in with significantly.
Speaker 3: Elevated blood pressure they got left final hypertrophy on their
Speaker 3: EKG and on their eco cortagram, obviously you're going to
Speaker 3: start treating. But when they are borderline elevated, then you
Speaker 3: make them aware lifestyle modification, making sure their resalt intake
Speaker 3: is reduced, their calory intake is being monitored. I mean
Speaker 3: I talk about the Suneja equation, which I've talked and
Speaker 3: created that video which almost hit thirty six thousand views
Speaker 3: on LinkedIn that I posted on New Years about the
Speaker 3: way production formula where you reduce thirty fi hundred where
Speaker 3: thirty five hundred calory count negativity is leads to negative
Speaker 3: balance leads to one pound of weight loss of fact.
Speaker 4: So if you have five.
Speaker 3: Hundred caloriy negative balance per day and multiply by seven
Speaker 3: aver day of the week, you lose thirty five hundred carries.
Speaker 3: And that five hundred I'm dividing into two parts, two
Speaker 3: and fifty negative balance by eating less mostly carved everybody.
Speaker 3: Everybody loves carves, bread, pasta, dessert, snacks, potatoes, rice, alcohol,
Speaker 3: a little bit less consumption per day, two and fifty
Speaker 3: cars less per day, and two and fifty car is
Speaker 3: burning more per day. That's half our of brisk walking.
Speaker 3: And third component, which is also equally very important as
Speaker 3: long as there is no history of congest of heart failure,
Speaker 3: drinking sixty to seventy ounces of water, right, and you
Speaker 3: combine that and if you do it consistently, seventy is
Speaker 3: a week lose a pound a week.
Speaker 4: If you do three to four days a week, you
Speaker 4: lose a half a pound a week. So life cell
Speaker 4: modification is critically important.
Speaker 3: And I think, I, you know, just for my own curiosity,
Speaker 3: last Tuesday, I have plied a continuous glucose monitor myself CGM,
Speaker 3: which are now available without a prescription a month ago,
Speaker 3: and I have myself reduced my sugar. I have an
Speaker 3: AVNCY of five point seven, which is minimally elevated. I
Speaker 3: want to make it better, bring it down, so you know,
Speaker 3: you can modify it by reducing.
Speaker 4: And within a week I've noticed that I have cut
Speaker 4: down the.
Speaker 3: Foods and I could monitor my sugar and react the
Speaker 3: intake so that I can bring the glucose in a
Speaker 3: completely normal level.
Speaker 4: So I think awareness and education is critically important.
Speaker 2: Yeah, and I think that the CGM, the continuous glucose monitoring,
Speaker 2: the deck scam is probably one of the more popular ones.
Speaker 2: I think if if you know you're overweight, you have
Speaker 2: pre diabetes and hypertension, lipids, and you know that doctor
Speaker 2: Sunasia or doctor Galati is not looking at you twenty
Speaker 2: four hours a day. But if you get that little
Speaker 2: hatch you on your arm and you're contemplating a piece
Speaker 2: of chocolate pie and you see that your glucose is
Speaker 2: just a little too high. That may be enough to
Speaker 2: stop you and in the end be beneficial. So as
Speaker 2: you know, we need oversight, we need accountability, and I
Speaker 2: think electronically AI in a sense is doing this.
Speaker 4: Absolutely.
Speaker 3: I think this is one of the finest examples of
Speaker 3: how we can utilize AI and technology because this is
Speaker 3: continuous glucouse mountor is actually AI.
Speaker 4: And when you're able to see your sugar.
Speaker 3: And then that is automatically going to have a positive
Speaker 3: impact in eating, making you eat better because you're going.
Speaker 4: To see if you eat particular food, your level is
Speaker 4: going up.
Speaker 3: Within the last five six days, I have myself modified
Speaker 3: my own eating habits, even though I consider myself a
Speaker 3: good eater. And you know, I did my fifteenth half
Speaker 3: methon last weekend. That's great, but there is room for improvement,
Speaker 3: right Nobody's room for improvement. And within a week I've
Speaker 3: noticed that I'm making some very positive changes in what
Speaker 3: I'm eating, eating a little bit less and watching the cobs,
Speaker 3: and I'm noticing this reduction in my lucas is amazing
Speaker 3: today and the entire office day I was running around.
Speaker 4: My peak sugar was only one twenty.
Speaker 3: Yeah, and I'm morty eating, you know, I eat very
Speaker 3: healthy breaksace with white omelets and lunches salad.
Speaker 4: And you can make modify it, you know.
Speaker 2: Yeah, yeah, I think it's just a willingness to do it.
Speaker 2: You know, it's a willingness to do it now. You know,
Speaker 2: of course, one of the big pillars of heart disease
Speaker 2: and prevention is cholesterol. And there's still a lot of
Speaker 2: sort of misunderstanding of cholesterol. Patients will still come in
Speaker 2: and say, well, the ratio is good, so nothing needs
Speaker 2: to be done. Is it true that the ratio of
Speaker 2: good lesterol to bad cholesterol? And that may not be
Speaker 2: a good way to say it is sort of outdated.
Speaker 2: Now we need to look at cholesterol a little differently.
Speaker 4: What do you say?
Speaker 3: Absolutely so, I think the entire emphasis noise on the
Speaker 3: Lder number. The ratio is pretty much outdated. But Lder
Speaker 3: number in relation to risk factors and presence of corneatic disease,
Speaker 3: and here comes as utility of the cornaty cassium score. Right,
Speaker 3: we are utilizing I've been doing this for almost twenty four,
Speaker 3: twenty five years, I have been a very big proponent
Speaker 3: of calcium score and potentially probably are practiced at the
Speaker 3: biggest database of cusum scores in the state of Texas.
Speaker 3: So when you do the cornerity custum score on a
Speaker 3: patient and then we are able to use that number
Speaker 3: and put them into the mesa registant calculated persentile. Now,
Speaker 3: if you've got a fifty year old male coms and
Speaker 3: his custom score is one hundred and his persentile is ninety,
Speaker 3: his LDL will.
Speaker 4: Need to be below fifty five.
Speaker 3: But if you have one hundred year old mail with
Speaker 3: the custum score of zero and his LDL is one fourteen,
Speaker 3: there is no data that we need to be that aggressive.
Speaker 4: That is life sele modification. So the castium score is
Speaker 4: able to guide us how we need to manage the
Speaker 4: eldeal number and if you're ELDAL.
Speaker 3: Now November of twenty twenty three, high the spaces American
Speaker 3: hunt as American conture cardiology.
Speaker 4: Now we're talking about high risk places where they have cornea.
Speaker 3: Intervention, corniati bypass graft surgery, they have diabetes and other
Speaker 3: equivalent corneaty disease reris factors.
Speaker 4: We are talking about bringing the ldeal below fifty five.
Speaker 2: All right, let's take a quick pray. Come down to
Speaker 2: Joe Gladi your two did your health first, don't forget
Speaker 2: go to doctor Joegalori dot com. Stay tuned, we'll be
Speaker 2: right back. Welcome back, everybody, to your health first. Comes
Speaker 2: out to Joe Galati. And in honor of the month
Speaker 2: of February, it is American Heart Month, that one month,
Speaker 2: even though it really should be twelve months out of
Speaker 2: the year that we think about our heart, heart disease,
Speaker 2: heart disease prevention and understanding our risk factors. And in
Speaker 2: the studio tonight is doctor ran Deepsunasia, a well known
Speaker 2: cardiologist here in Texas, trying to explain the key points
Speaker 2: that we all need to know with regard to how
Speaker 2: to take care of your heart. You've taught me a
Speaker 2: lot about the calcium score corrintory calcium score ct score.
Speaker 2: And with all of the patients with fatty liver that
Speaker 2: I see, almost all of them have diabetes, hypertension, they're overweight,
Speaker 2: high cholesterol, et cetera. I have been recommending and sending
Speaker 2: a lot of these patients for calcium scores. Is that overkill?
Speaker 2: So people that are listening tonight, and let's say they're
Speaker 2: fifty five sixty, they're over weight or obese and have
Speaker 2: a cholesterol problem, Okay, they're asymptomatic, yes or no? Should
Speaker 2: they go for a carnary calcium scan?
Speaker 4: Absolutely? Yes, okay, absolutely yes.
Speaker 3: Forty year old male with one res factor, fifty year
Speaker 3: old female with one risk factor. And if you are
Speaker 3: risk factors, you talk about forty percent of the population
Speaker 3: is obese, thirty percent is olverad.
Speaker 4: That's seventy percent of them.
Speaker 3: A body called one respector already mentioned hyperlipidemia, pre diabetes,
Speaker 3: you name it. I am screening patients as young as
Speaker 3: forty and forty five any res factors, and then we
Speaker 3: repeat the scan in five to seven years, depending on
Speaker 3: their scores. And the beauty is the moment you do
Speaker 3: the calcium score and you've got premature corneoder disease.
Speaker 4: Both the doctor and the patient.
Speaker 3: You share the data with the patient, tell them, hey,
Speaker 3: you are in the seventy fifth percent. Time, sir ma'am
Speaker 3: you're in the eightieth percentile. They become very prove active.
Speaker 3: They taking care of medications, whether we're going to give
Speaker 3: them aspen, give them statin or something more, piece of.
Speaker 4: Skin and inhibitor. We have other tools available now.
Speaker 3: So we and the patient will become very, very engaged,
Speaker 3: pro active and including the lifestyle modification.
Speaker 2: Right, is there in your in your generic patient here
Speaker 2: an age that's a little too young now we're seeing
Speaker 2: and you're seeing them, oh piece, twenty year olds with
Speaker 2: hypertension and diabetes. Would you engage them in this type
Speaker 2: of screening at twenty That's a tough it's a tough point.
Speaker 4: Well, I have done as young as thirty five year old.
Speaker 4: I have screened with multiple res factors with hyphpertension, hypilipidemia.
Speaker 4: I had a young.
Speaker 3: Patient, twenty five year old patient who had came to
Speaker 3: me in fact in the last one month, and he
Speaker 3: was his father had a heart attack at the age
Speaker 3: of thirty five, okay, and uncles, so he was young
Speaker 3: and he was just totally worried and he's almost having
Speaker 3: these almost anxiety attacks that I got heart disease. And
Speaker 3: I had I kind of screen him and gave him
Speaker 3: a customs score and tell him I'm going to see
Speaker 3: you in fifteen years or ten years and if go okay,
Speaker 3: you know what I because they have people are reading
Speaker 3: about cornerity custom scores and they are you know, the
Speaker 3: information is out there, so you know that young typically
Speaker 3: I don't, but there's an unusual cases.
Speaker 4: One may do it. But around the age of thirty
Speaker 4: five forty, if you've got multiple.
Speaker 3: Distractors, and I'm picking up corneaty disease and young patients,
Speaker 3: absolutely young WROLD the score of one hundred fifty seventy five,
Speaker 3: they should be absolutely should have score of zero.
Speaker 4: So these people have premature corneatter disease.
Speaker 2: Right, No, exactly to get more into the social pray
Speaker 2: make America healthy again? What is your take?
Speaker 1: Now?
Speaker 2: What I've told everybody is trying to separate the intense
Speaker 2: political reaction people are having too RFK Junior, they love them,
Speaker 2: they hate them. I say, just forget about that for
Speaker 2: a second. We have to think about making America healthy again.
Speaker 2: Someone like you is right on the front line every day.
Speaker 2: What do you think of that?
Speaker 3: Well, I think in any way we can improve the
Speaker 3: health of the common people and the general population. Increase awareness,
Speaker 3: increase our I mean, our food industry has not done
Speaker 3: a good job. As you know, there's so much is
Speaker 3: this commercialized food products and processed foods. We need to
Speaker 3: clean up our foods. Absolutely, education has to be improved.
Speaker 3: So I think there's a lot of things that it
Speaker 3: can be done at multiple levels, but ultimately it all
Speaker 3: comes down to the individual. And I think increased awareness,
Speaker 3: increase knowledge just as simple as measuring your blood pressure
Speaker 3: you talk about at home and getting yourself a glucose monitor,
Speaker 3: and now with the availability of getting a CGM by yourself.
Speaker 3: And I'm telling you, the moment you start looking at data,
Speaker 3: you will automatically become proactive and it has a very
Speaker 3: tremendous impact in patient awareness. And then they start executing,
Speaker 3: will increase walking, increase activity, and obviously you have to
Speaker 3: have cardiologic clearance if they're having any symptoms. You don't
Speaker 3: want to start running preparing for a marathon if you've
Speaker 3: got symptoms. But obviously you can make some lifestyle modification
Speaker 3: changes and help yourself in more ways than you realize.
Speaker 4: Right.
Speaker 2: You know, probably thirty years ago there were some initial
Speaker 2: studies where they found that people that just weigh themselves
Speaker 2: every day, we're losing weight. So we're just seeing that
Speaker 2: feed back. Now, let alone you add you're weighing yourself,
Speaker 2: you're being conscious of the food you're eating, you're taking
Speaker 2: your blood pressure. It goes a long way. But as
Speaker 2: you've said so many times, it is the engagement. We
Speaker 2: need the engagement. Everybody listening tonight. You know, one of
Speaker 2: my sayings is that good health doesn't come by chance.
Speaker 2: You have to work at it.
Speaker 4: You have to make an effort, and you have to
Speaker 4: be proactive.
Speaker 3: And you know, whether one hundred and fifty minutes of
Speaker 3: exercise per week, making sure you give plenty of water,
Speaker 3: as long as you know history, condut are field, and
Speaker 3: then incorporating lifestyle modification degree including yoga, meditation. And interestingly,
Speaker 3: in our textbook of cardiology, we call it our bible,
Speaker 3: the Bronz Wall's textbook.
Speaker 2: Get asked.
Speaker 3: In the last edition, this is a two volume, one
Speaker 3: thousand page each book. For the first time, we have
Speaker 3: five six page chapter on integrative cardiology.
Speaker 2: Okay, so tell us tell us about that. People may
Speaker 2: have heard of this, but it's really worthwhile to talk now.
Speaker 3: So you know, in the past, the textbooks of cardiology
Speaker 3: never incorporated anything like this, and this is a paradigm shift.
Speaker 3: If one may say, having a chapter of integrated cardiology
Speaker 3: in our Bible of Cardiogies is the Bronz World's textbook,
Speaker 3: and they talk about multiple things have been addressed. They
Speaker 3: talk about yoga, meditation, tai chi in patience for helping
Speaker 3: lifestyle modification. As we know, meditation techniques help in reducing
Speaker 3: the sympathetic nomber system, increasing parasympathetic symptom, reducing the activation
Speaker 3: of amygdala, and also improving the connection between amygdala and
Speaker 3: ventromedial frontal cortex. All these techniques have been shown to
Speaker 3: reduce stress, manage the stress, reduce the sympathetic activity. So
Speaker 3: they have mentioned in this chapter that you can incorporate
Speaker 3: these in managing for stress high pretension. The concept of
Speaker 3: coqute ten also has been added into that chapter where
Speaker 3: I am a huge believer. Where As you know, statin
Speaker 3: associated muscle symptoms started to induced muscle symptoms is very
Speaker 3: very common. In fact, in clinical practice we see much
Speaker 3: more than its described on textbooks. But when because when
Speaker 3: you give the statins and they inhibit the hmg coins
Speaker 3: and retectives inhibitors. Also, it reduces the synthes of co
Speaker 3: q ten and coqutin is a very important molecule important
Speaker 3: in the respiratory life cycle in these skeletal muscles. By
Speaker 3: exogensy supplementing coq ten minimum two in the millions a day,
Speaker 3: we can definitely reduce the symptoms. Although data is somewhat conflicting,
Speaker 3: but in my practice I have seen that it absolutely helps.
Speaker 3: In our practice we emphasize that patients taking status must
Speaker 3: take two milliums of coq ten with food. It is
Speaker 3: a fat soluble vitamin that should be taken food so
Speaker 3: that it reduces the chances of statin associate meddle center.
Speaker 4: So the concept of.
Speaker 3: Coq ten has come, then Ready's rice has been incorporated
Speaker 3: in that chapter.
Speaker 2: Yeah, that is you know, you know, look you know
Speaker 2: better than me. But that has been talked about for
Speaker 2: probably twenty years. And I remember twenty twenty five years
Speaker 2: ago patients coming in with red rice yeast and at
Speaker 2: first you'd sort of say, well, it probably won't hurt you.
Speaker 2: But now it seems like there's some pretty.
Speaker 3: Decent data and patients who are not receptive who taking
Speaker 3: statins or they cannot take any statans.
Speaker 4: It is pretty much like a natural statin.
Speaker 3: And in this textbook of Cardiologia Braunold, they said, yes,
Speaker 3: this can be considered an alternative for patients who are
Speaker 3: not able to handle.
Speaker 4: It's literally and like a natural statin, and there has.
Speaker 3: Been some data that it may reduce you a deal,
Speaker 3: maybe between fifteen to eighteen percent in some percent of cases.
Speaker 2: Well, now with that, would it ever be a case
Speaker 2: where you take a statin or maybe a little bit
Speaker 2: less of a statin and the red rice yeast as
Speaker 2: a as a combo or is it one or the other?
Speaker 3: I try not to combine the two because it becomes
Speaker 3: difficult to really objectively know if they're having any problem
Speaker 3: work contributing to it.
Speaker 4: But typically I keep.
Speaker 3: Those I'm keeping for patients who are resistant or taking
Speaker 3: statins or they would like to have a natural alternatives
Speaker 3: and READI strize. I do offer patients who are but
Speaker 3: I'm a very big believer in statin and they have
Speaker 3: been shown with so much data for all these decades,
Speaker 3: would be so useful. But if people are totally resistant,
Speaker 3: then this is a reasonable alternative.
Speaker 2: All right, final segment of your health first coming up.
Speaker 2: Don't forget If you want more information about autorin deep
Speaker 2: sination is practice, it is Uston Cardiology dot Comuston Cardiology
Speaker 2: dot com and don't forget. Go to doctor Joeglotti dot com.
Speaker 2: Stay tuned. Final segment coming right up, the final segment
Speaker 2: of this week's Your Health First, and don't forget. Join
Speaker 2: us at doctor Joegalotti dot com and you can sounder
Speaker 2: forraur newsletter. Send me a message as a tab there
Speaker 2: that says contact me, and all of our social media
Speaker 2: is there, and all of our past programs, podcasts, other
Speaker 2: educational material is there. But you have to go to
Speaker 2: doctor Joegalotti dot com.
Speaker 4: All right, so.
Speaker 2: Doctor Snasa has been in the office with us talking
Speaker 2: about heart disease, heart prevention, heart symptoms, some new therapies,
Speaker 2: how to manage your cholesterol, things that you need to
Speaker 2: know and do. Keep in mind that the number one
Speaker 2: killer for all of us is going to be cardiovascular disease.
Speaker 2: So we need to raise the bar and really pay
Speaker 2: attention to heart disease. If you have heart disease, pay
Speaker 2: attention to it. If you have risk factors, really do
Speaker 2: get it checked out.
Speaker 1: You know.
Speaker 2: One other area and the golp one agents, the oxepics
Speaker 2: of the world. Of course, they started off in the
Speaker 2: diabetes circle and then into obesity. But now there are
Speaker 2: some studies on being protective for heart disease and heart failure.
Speaker 2: What are you seeing and where do you think the
Speaker 2: future lies with these GLP one agents GLP one.
Speaker 3: Initially I was to be very frank, I was quite
Speaker 3: apprehensive of giving them to patients. But the more and
Speaker 3: more I'm studying the data, we have seen that they
Speaker 3: definitely some percentage of population of patients who are struggled
Speaker 3: to lose weight. Right an effective, very effective class of drugs,
Speaker 3: and they absolutely help you in reducing weight. However, you
Speaker 3: know you have to be mindful of the fact that
Speaker 3: there are some significant side effects, and I'm sure you've
Speaker 3: seen fair share of that. But you cannot just prescribe
Speaker 3: a GLP one and not emphasize lifestyle modification because that
Speaker 3: is not the right way to manage your diabetes and
Speaker 3: hypotension and overweight problems and obixity. However, the data that
Speaker 3: is coming out in benefit of reduction and heart failure
Speaker 3: and other cardivorskit benefits is all. If you lose the
Speaker 3: question is that is it the weight loss that is
Speaker 3: helping you reduce it or there is some question that
Speaker 3: the drugs are And my thought process is I say
Speaker 3: weight loss is the best medicine.
Speaker 4: Way, your blood.
Speaker 3: Pressure will get better, your liperds will get better, your
Speaker 3: everything will get better, your exercise.
Speaker 4: Todance will get better, and your heart failure.
Speaker 3: Of course, you sleep will get better if it will
Speaker 3: get better, and your heart failure will get better.
Speaker 4: There's no quest about it. So, yeah, is the best medicine.
Speaker 2: Yeah, no, no, no, I mean it is. And unfortunately
Speaker 2: with all of the advertising and marketing and things on
Speaker 2: social media, that message gets lost. They think this the medicine.
Speaker 2: Of course, the weight loss they see it. But you know,
Speaker 2: the gop ones, You're right, there are a whole host
Speaker 2: of gastro intestinal side effects, nausea, vomiting, constipation, people are miserable.
Speaker 2: But weight loss through lifestyle, the Sunasia formula, of course
Speaker 2: is it might not be as fast as a golp one.
Speaker 2: You know, you have to be patient, you know, you know,
Speaker 2: fifty pounds was not gained in six months, you can't
Speaker 2: expect to lose it in six months. But it's that
Speaker 2: lifestyle change that it is, learning to eat better, learning
Speaker 2: to cook, learning to exercise, and just integrating this all
Speaker 2: in there. So we've got a couple of minutes left here,
Speaker 2: doctor Sunasia and for those that might just be joining
Speaker 2: us late this evening. Doctor ran Deepsynasia. He is a
Speaker 2: very very well known cardiologist here in Texas Cardiology Center
Speaker 2: of Houston. His website is Houston Cardiology dot com. A
Speaker 2: couple of parting remarks. If you had to tell a
Speaker 2: patient people listening tonight, let's say one intervention. Now, there's
Speaker 2: many things to do, right, But if you were going
Speaker 2: to start off with one win, one thing that you
Speaker 2: could cross up and say I was able to start
Speaker 2: doing that tomorrow and I stuck with it, what do
Speaker 2: you think that would be?
Speaker 3: Just start walking fifteen minutes a day and increase with
Speaker 3: thirteen minutes a day. I think regular exercise does wonders right.
Speaker 3: Journey of one thousand miles begins with a single step.
Speaker 3: Just start walking and tell patients you know, doesn't matter.
Speaker 3: Could be ten minutes, fifteen minutes, please, best thing is
Speaker 3: just start walking and you will see it will transcribe
Speaker 3: into benefits beyond your belief. You know, you don't have
Speaker 3: to walk ten miles or three miles, just ten minutes,
Speaker 3: fifteen minutes, and gradually you will see then you can
Speaker 3: increase it. And with that you need to work on
Speaker 3: diet and reduce the card consumption, reduce the carry consumption,
Speaker 3: and weight loss has to be the most primary thing.
Speaker 3: But seventy percent of the population with fortys in thirty
Speaker 3: percent overweight, absolutely is critical importance America healthy. Again we
Speaker 3: miss a control of the epidemic of weight gain.
Speaker 2: All right, Another scenario, So most patients are being seen
Speaker 2: by a primary care physician or internest or maybe even
Speaker 2: there upstir g yn and somebody is sitting there tonight
Speaker 2: and saying, look, gee, gosh, I am overweight. I've got
Speaker 2: this touch of blood pressure. The doctor said, my glucose
Speaker 2: was just a touch elevated. What is the conversation you
Speaker 2: want to have the patient initiate with their primary care
Speaker 2: doctor to say, please address these heart risk factors or
Speaker 2: maybe even symptoms. How do you frame that conversation?
Speaker 4: What do you think?
Speaker 3: I think controlling getting your lipids done, collecting data on
Speaker 3: your blood pressure, and as a doctor they can refer
Speaker 3: for calcium. School Houston Methodist does it for one hundred
Speaker 3: and forty dollars any of the Methodist system and then
Speaker 3: you have the heart scan.
Speaker 4: Plus they can scan.
Speaker 3: Your carotis, aota, the legs and including the heart scan
Speaker 3: for two hundred and five dollars. I tell them that
Speaker 3: is the best two hundred five dollars that you'll ever spend.
Speaker 3: And once you have the data and then based on
Speaker 3: the results, it is going to have a very positive impact.
Speaker 3: Once you have the data with you, share that data
Speaker 3: with your cardiologists, let the cardiology explain to you where
Speaker 3: you cat some scores, what it means, and then you
Speaker 3: take it from there. I think these are critically important
Speaker 3: issues that you brought up and it is so important
Speaker 3: for us to take care of our patients and increase
Speaker 3: education and awareness.
Speaker 2: Right And that's and that's my gosh. You could you
Speaker 2: could be in front of a microphone three hundred and
Speaker 2: sixty five days a year, doctor Sunesia, and get get
Speaker 2: the word out there. So as always, thanks for coming
Speaker 2: on tonight, doctor Suonisia. Don't forget you can catch up
Speaker 2: with doctor Sunesia at Houston Cardiology dot com. Randeep. It's
Speaker 2: been awesome. It's always great to have you on.
Speaker 3: Well, thank you so much for the ortunity. Look forward
Speaker 3: to always working with you and enjoying your conversations with you,
Speaker 3: and look forward to many more