Healthy Nugget with Dr Robert Okyere | Cardiovascular Disease Pt1

I want to welcome every one of you joining us right now. This is a special program, special edition at Columbus Ghanaian Church. Today's special edition is called Healthy Nugget. This is a quote that I want to say. Health is no value unless sickness comes. Because of that, So this is the time you need to take good care of your health. On my story, this special edition is called Healthy Nugget. We're going to have a couple of health lecture series from doctors. This week, in a couple of weeks, I'm going to have a special edition of the special health program. The first person I'm going to talk to is Dr. Robert Otrin. Dr. Robert Otrin is a cardiologist. He's a doctor who specializes in heart disease. He's a cardiologist who specializes in heart disease. Another aspect is cardiac imaging. Advanced cardiac imaging. Dr. Otrin is the main leader for this Healthy Nugget. Officially, Dr. Otrin, Robert Otrin. Doc, quick overview. I know it's in my car and then I'll be there. I'm sure I need more for the upcoming series. And as a series I have up on the quick one for his. Okay, that's a time for a very good evening to everyone. and watching us, you don't want to say much. You can tell me what they're saying. And that's segments we send out past the second, you know, friendly, healthy nuggets. Now they go, you say, it's me educating, now you see I'm more about supporting. Now you need to say kind of, so you're promoting a strong guy. It's me boy. I need to be served by each other. Well, it's hard to me, boy. I'm it's me. So I'm going to go point. Okay. I'm piebald. Any objective said, as we kind of learn about our health, no, we'll be able to share with others. And I say, if you have any question, we also saw a bit of my feeling free, not putting the comment section. You should be able. We can always go over the questions in tea. Hey, I'm piebald. See between this year, maybe a few nights, my buying a strength. Yeah. You know me so much. So, so. Hmm. All right, doc. Thank you so much. And see, and then which aspects are we looking at today? And then a very, a very broad overview of cardiovascular disease. He has a cardiovascular disease. I mean, you say it would be a bit before you can, what does it really mean to be a very quick, broad overview. And then kind of in the next couple of weeks, as we kind of get to meet, you get into a little bit more detail, into kind of the different topics within cardiovascular disease. All right. Any, you betcha. I said, you know, maybe I am enough. He won't be able to do it. I remember Nancy, Mr. One or two, you know, maybe about, Oh, any question. Yeah. Feel free to put it in the comment section or not. You're making kind of a doctor. And so, yeah, no, I'm like, all right. All right. Very quickly. All right. Thank you. Patch us. So you see kind, you know, in a topic near cardiovascular disease. Now, when the outline of kind of the topics are, or kind of the details that we'll go into regarding that cardiovascular disease, intercourse, a cardiovascular disease, and your body, now you mean it by that into kind of, it goes to kind of tell more, about kind of different constellation of including a freebie coronary heart disease, stroke, heart failure, and a peripheral artery disease, diseases coming together with an umbrella term of cardiovascular disease. Now, one of the kind of the leading causes of premature morbidity, meaning says symptoms. And I say, it will be four or more time. I'm almost a, it was a kind of a very prevalent disease. A very common, both here and also kind of in Africa and almost worldwide. Now it's also a, one of the big, and the biggest leading cause of death and they kind of different people from different racial backgrounds and ethnicities. Now in 2022, based on statistics, not one in five deaths was attributed to health, to heart disease, meaning that's about 20%. It's again, it's speaking about how prevalent, and how common a cardiovascular disease a, into the more, it to me, more about it. No need to me a year. No, my, I prevent it. Yeah. From CBN. Yeah. Really? No. It beats my boy. I mean, it's me a level, a healthy life. Now, in terms of kind of the different factors, I contributed to cardiovascular disease. your table. We are a train and a five-year cardiovascular risk per a hundred people. And it's your funny part. A hundred in five years. No, what are, what are the risks of sign? Yeah. And if a coroner would develop us a cardiovascular disease in T reference bar, we know mainly referring to 50 year old woman, me, cholesterol level, a, okay. Smokey, and a blood pressure into kind of bars. We already have my, you know, meaning, no, say blood pressure, looking at systolic blood pressure, whether it's one 10, one 30, one 50, or one 70, mainly kind of speaking to increasing blood pressure into looking at the reference bar, no in five years, looking at a hundred people, no, your hand, you have a, a, a kind of bare four or five, any bit. Yeah. It's risk for developing cardiovascular disease. Now, as we go from the left to the right here, Joe, I don't know. I refer to total cholesterol. And it will be always smokey and a HDL cholesterol. You make us about this in a little bit, any gender, any diabetes, any age into day. We catch her and say, say, oh, cholesterol level, total cholesterol. Yeah. Hi. Yeah. As for blood pressure, no, or five-year risk of developing cardiovascular disease. And so it becomes high on top of that. And I said, we use smoke on our cholesterol side. Hi. Yeah. We can see, say the risk of developing cardiovascular disease increases and kind of, we get to the sense and the trend of what this bar is telling us, saying, yeah, basically a 60 year old on a cholesterol level, a high smokey and a good cholesterol. And you know, well, yeah, bear my house, our diabetes, or DNA blood pressure. No, no, because if you have cardiovascular disease and much significantly higher, it's when you, different risk factors, I contribute to stay, you may develop a, g?" Nwayere. Not in terms of your my BATMI, I increase the risk of developing it's now I be pertaining to family history. And to be more, hold on my, I kind of, as part of kind of, uh, in the context of formal genetic history, and I helped we a predisposed to develop small grant. And at the definition that you use it for, for it, you know, in terms of kind of ASCV, the major atherosclerotic cardiovascular disease, usually say ABR, BEMA, or family, and in your family referring to the first degree relatives, meaning parents, siblings, or children, there will be one on BEMA at the less than 55 years, and I'll say OBAR at the less than 65 years term. Now, when your cardiovascular disease, your friend, a premature, and that can increase the risk of those first degree relatives, again, being children, siblings, or parents of them developing cardiovascular disease. Another kind of risk factor, and so your cholesterol, it be more one of a, in him say a DDA, it to me contributed to your cholesterol levels, but sometimes to genetic aspects also can contribute in your friend or primary hypercholesterolemia. It be more, one of more, more genes be on my predisposable, more, more, more cholesterol on a year higher than the, the ordinary person. Now, in those kinds of contexts, now you look at the bad cholesterol, your friend or LDL. So usually a more than 190, I know, yeah, kind of a really big marker say, when in fact coronary directs will be developing significant blockages, and I'll say disease, and when the coronary is not, and when they are much higher. Other things, I mean, to me, you see the, the, the risk of developing cardiovascular disease, a metabolic syndrome, a metabolic syndrome, a collection of different salient points, and also increase your risk of, again, developing cardiovascular disease. And that includes a, b, a waist circumference, which I can waist, not waist, no, kind of circumference, no. And I say a bigger, and I say belly, kind of a, kind of on the largest size, size, speaking more about kind of having adipose, and I say fat tissue, I know your one risk factor, and that's a triglycerides, which are a type of fat, and also a higher blood pressure, your sugar level. Me now, you're kind of part of the, the markers, a bit may increase your risk of cardiovascular disease now. Other things also include chronic kidney disease, and I'm sure, say, kind of in one of our upcoming lectures, we'll spend some time talking about kidney disease, but that's one of the risk factors, and inflammatory disease, to say rheumatoid arthritis, lupus, HIV, any, in the cases of women, any history of premature menopause, definition of that being that you get your menopause before the age of 40, and I say, once we develop a pretty significant hypertension, and you're in a pre-eclampsia, and also, it may contribute you to the risk of cardiovascular disease, and as some ethnicities, and so kind of, they are predisposed to having kind of a higher risk, more so with the South Asian, those with South Asian ancestry, and there are many other kind of biomarkers, and also to me, contribute you to the risk of, or an increased risk of cardiovascular disease. Now, in terms of kind of knowing side risk factors, we know, the good thing, they say, so, to prevent yourself from getting, kind of, or mitigating these risk factors, and it'll be to prevent early death, now you have, within the past 40 years now, because of aggressive treatment, with regards to side risk factors, whether it pertains to smoking, and I say treating blood pressure, and I say cholesterol levels, now, we know why it may prolongate your life. Now, in terms of the risk factors, now, we'll go through a few of them very quickly, and the first one, they're best treated with, now, hypertension, and hypertension, according to the American College of Cardiology, I mean, the AHA, or American Heart Association, now, definition of it's, so, blood pressure, now, systolic blood pressure, now, greater than 130, and also, diastolic may be greater than 80, kind of the definition, there are different kind of grades of hypertension, and maybe a later on, we might find a time, now, to discuss about, but that is the definition of it. Now, usually speaking, now, according to, kind of, different guidelines, say, with the 18 years in order, you should, kind of, undergo at least one time screening for hypertension. Now, as, kind of, your blood pressure increases, especially, kind of, the systolic or diastolic pressure, if it's more than 20 millimeter increase, that can increase, significantly increase your risk of cardiovascular disease, and hypertension, a big risk factor for cardiovascular disease. Another risk, in terms of hypertension, or actually, in terms of management, there are many things, it's me, I reduce your risk of having elevated blood pressure. One of them, a weight loss, typically, about one kilogram, yeah, it's me, reducing blood pressure by one millimeter of mercury, high blood pressure, it's me, lose weight, either through dietary adherence, and I said, through physical exercise, now, reducing the blood pressure, now, up to five millimeters of mercury, blood pressure, 145, which may reduce it just by losing weight, reducing it from 145 to 140, and it'll be under blood pressure, so you're normal, with me losing weight, it'll be to me, I'm bringing down the blood pressure, now, by up to three millimeters of mercury. The same thing, kind of, and the same logic goes for these other parameters, in tea, with healthy diets, now, and here, the example I used in your DASH diet, which is a diet that mainly consists of, kind of, rich in fruits and vegetables, whole grains, and reduced saturated fat, it's an ultimate follow diet, a rich in fruits and vegetables, which may reduce your blood pressure, now, so hypertension, which may reduce, you know, by 11 millimeters of mercury, and to say, you pay attention to the exercise here, now, you have to say, it's me losing weight, right, it's me losing weight, again, one kilogram of weight loss equals a reduction of one millimeter of mercury, it's just by weight loss, it's me losing five millimeters of mercury, with a healthy diet, you can lose an additional 11 millimeters of mercury, and to combine here, that's 16 millimeters of mercury already, right, into blood pressure here, you have to say 145 millimeters of mercury, now, between weight loss and diets, you know, healthy diets, which me taking it seriously, you can go from 145 to 129, which is, kind of, which would be a normal blood pressure, and the additional things, and so I beat my ear, I'm gonna, to my boy, with your blood pressure, reducing your sodium intake, it's me reducing your sodium intake up to just one gram per day, and it's me reducing your blood pressure by up to five to six millimeters of mercury, again, with potassium, any exercise, any exercise, you know, different types of exercises, if you're aerobic exercise, which is the one usually, and I say, will be swimming, and also will be riding a bicycle, up to 90 to 150 minutes per week, up to five, I'll be bringing down blood pressure up to five to eight millimeters of mercury, the same goes for these other types of exercises, you cast a dynamic resistance, and you're more with your push-ups, and I say pull-ups, and I say squatting, which me, you know, for this amount of time during the week, and I said, this frequency, which may reduce it, an additional four millimeters of mercury, and I mean, I'm saying, as a Christian, but for kind of some of our other audience, reducing your alcohol intake can also bring down your blood pressure up to four millimeters of mercury, into your heart, just by lifestyle changes now, see, it's me taking it serious, it makes me bring it down, your blood pressure significantly down, even before, say, introducing medications, into, I know, yeah, kind of one thing that we should keep note of, another risk factor I kind of earlier on, diabetes, it's because of diabetes, the way it's diagnosed, you know, by getting a lab value called hemoglobin A1c, and basically, hemoglobin A1c, an average of kind of your blood glucose over the previous three months, and I saw A1c, you know, say, more than 6.5%, greater than or equal to 6.5%, then it's diagnostic of diabetes, if you want to measure glucose level from a blood, say, greater than 126, kind of glucose, measure levels, you know, after two hours, say, more than 200, and we are diagnostic of diabetes. Now, usually speaking, the guidelines, again, recommend for screening for individuals between ages of 35 to 70 years old, are more risk factors, including overweight, obesity, and as other risk factors may increase your risk of diabetes, you know, that is kind of a recommendation to be at 35 to 70 years old. Now, with these risk factors, screening for diabetes, a primary care doctor, that's one thing that can be considered. Now, in terms of diabetes and also the management, you know, again, lifestyle plays a significant role. It is a table with the A1c and A1c greater than or equal to 6.5% kind of gives you a diagnosis of diabetes. But so, to me, exercise, now, to me, a loser waiter, which might bring it down, say, A1c from one to two percentage points. And to me, A1c is 7.5%. Now, to me, exercise, which might bring it down up to 2%, which might bring it down up to 5% or 5.5% and kind of avoid the complications associated with diabetes. And we also use certain medications, including metformin and some of these other medicines for those who have diabetes. And the other risk factors as well, you can say about, you know, overweight and obesity. If you can say overweight and obesity, I refer to kind of the way you diagnose, you know, by looking at the body mass index, and that's the BMI. Now, you know, it kind of gives you an idea of kind of the fat, how much fat you have based on your height and your weight. Usually, so BMI, between 25 and 29.9, when we're calling it overweight, and anything greater than or equal to 30, you're obese. And obesity, there are different classes of it. So BMI, I'll go into detail later on. And in terms of obesity, as adults know, should be screened for it at least once annually, also kind of based on the additional risk factors on the wall. Now, the higher your weight, the more you also increase your risk of coronary heart disease. And also, to me, increase your risk before or time. Now, obesity, so getting diagnosed with obesity may increase your risk of getting heart failure, kind of a heart arrhythmia for atrial fibrillation, and that's a sudden cardiac death, into a lot of complications associated with it. And in terms of weight loss, so overweight and obesity is a big contributor in kind of developing hypertension, kind of high cholesterol, and also kind of insulin resistance. Insulin resistance is leading to diabetes. Now, we should keep in note that kind of a weight loss of up to 5% can significantly reduce the cardiovascular risk. And in terms of obesity, again, just looking at a few things that we can do to kind of reduce our weight, again, the diet. Making sure to avoid ultra-processed foods, whether it's kind of sweet, refined carbohydrates. And I say kind of, again, in terms of carbohydrates, white rice, white bread, sweetened cereals, and I say high in saturated fats. Now, see, to me, including more fruits and vegetables, preventing you from getting obese. And also, getting those complications that is associated with obesity. And the other risk factor, again, dyslipidemia, and I say elevated cholesterol. Again, by guidelines, and so the recommendation is to kind of get a lipid screen. And that's where we get cholesterol checked for individuals who are more than 20 years old. Now, some cholesterol, there are different types of cholesterol. Maybe I don't want to be referring to bad cholesterol. And usually I refer to some, maybe referring to LDL, and I say low-density lipoprotein. Basically, they're wasting the, I have to say, transport. And I say kind of car, instead of say, bad cholesterol within the body, I better get rid of it. So, LDL, a transport, and I say a car, I carry cholesterol to the blood vessel. I bet to me, of course, it's high cholesterol. It's me depositing the arteries. Now, it's me leading to issues. Meanwhile, good cholesterol, it carry cholesterol from the blood vessel and from the body and brings it to the liver. So, the liver, I better get rid of it. And LDL, good cholesterol. And triglycerides, fats. And I say, if you have extra, it gets stored as fats. And the way that it gets stored as fats, triglycerides. And the more triglycerides you have, that can also predispose to having more cholesterol being deposited by the LDL into the blood vessels. And also the total cholesterol, another part of the lipid panel. Now, you look in terms of making diagnosis of dyslipidemia, and that's a high cholesterol. Now, and also, so, and you might be to my young man, a reduced cholesterol levels, no, again, weight loss, it goes back again to lifestyle intervention or into weight loss, no, it play a significant role. And then again, you did the exercise. Now, kind of these are a few risk quickly talk about. And you say kind of later on down the line, we can kind of get a little bit more specific with it. Now, the other thing in terms of talking about cardiovascular disease, another part of it, a coronary artery disease, it has a coronary artery, with blood, right? And there are two main coronary arteries. There's one called the right coronary artery, and about once your friend and left coronary artery into right one, or at the blood echo, a command on the bottom part of the heart to your friend of the inferior part of the heart. And on the left coronary artery, no, there were two main branches, backwards supply the top part of the heart. And on the other one, no, your friend, the left circumflex artery has supplied the lateral part of the heart into the mobile or gets a cholesterol deposited in the in these arteries, no, and only leading to heart attack. Now, in terms of coronary artery disease, again, family history, say, yeah, again, for parents and as a sibling, with the less than 55 for Bama, and I say 65 for, but then when your heart attack, and it'll be to my predispose within the family to get in a heart attack as well. Now, in that context, no, and no, my say, would he diet and exercise, no, we're taking it seriously to me. I'm going to get your risk of getting some coronary artery disease. Now, in terms of symptoms, I'm up for tie in with coronary artery disease. No, usually I'm up for describing as a kind of chest pain. So you'll be, it will be in your heart attack. And I said, cholesterol, no, I, yeah, a lot. So when the vessels, usually chest pressure belly pain, right? Described as epigastric pain, the way you see making side diagnosis, different tests, including say, EKG, and I say, ECHO. Now, again, just to kind of make it kind of really clear to us now, yeah, these are the blood vessels, right? It's coronary arteries now, and the blood, normally I would say it look like this one over here into kind of as a young person. So I want to keep diet seriously. And I say, exercise, want to take it seriously. So that cholesterol, a bit of my body up gradually, right? It's a building up to this extent, a bit to me, a limited blood not from flowing. And see when that happens, that's when people get heart attack, right? And again, it goes back to the importance of diet. Now you're hearing in general, black individuals, 32 times more likely to die from cardiovascular disease when you compare to kind of a Caucasians or other kind of ethnicities, right? And to where you're kind of looking at the age adjusted mortality. And I say, it will cost 100,000. So the year 2008 and the year 2018, even though the number of deaths are cut down from 2008 to 2018, which means in those who are non-Hispanic black, the rate of mortality, the rate of death are much higher than white, American Indians, Hispanic, and Asian or Pacific Islanders. And money is even more important to young as a black individuals. So you're at risk for developing heart attack and these cardiovascular diseases. You will see it taking some of these measures, a bit more preventing from getting it very seriously. Now, in terms of management, the infant will be a coronary artery disease. Again, the first step is to try and avoid getting it in the first place, right? And the way you do it is what we talked about with the risk factor strategy modification. But once it will be in your heart attack, it's me, a manager, and I see you on my distance, of course, have a blood vessel. Now I get to block, you know, so they beat me. I beat me, allow blood to flow again to the heart. Sometimes it'd be more, so I am more multiple blockages with different arteries. And usually I require a surgery to fix. Now, usually kind of, there are many other medicines. I beat me individuals after they get a stent. And I say as part of treatment for those who get a kind of heart attack, kind of just to give an example, right? So you can see ABOB in your heart attack. To this individual, this is the supply, the lateral part of the heart with blood, your frontal left circumflex. Pretty tight over here, right? I go from being narrow to now patent. And again, this is the concept. It's the way to fix it. In terms of heart attack, when you hear about it, this is kind of the usual kind of way in which that is treated acutely. It's me getting dangerous, right? Because how part of the heart, you know, it doesn't get enough blood and saying, yeah, you know, blood as a part. I lead to kind of the death of that individual. These are all very kind of serious things. This is kind of a very quick overview of cardiovascular disease in general. Just to kind of bring this to kind of conclusion, going back to 1 Corinthians 10 verse 31. Say whatever you do, do it all for the glory of God. In a kind of a life journey, a health journey. It's really important to take good care of yourself. Again, this is a very quick overview of cardiovascular disease. Next time I go into details, into kind of other topics. Any questions? Thank you so much. Millimeters. Millimeters of mercury. Right. So, yeah, kind of fruits and vegetables and they kind of grains kind of and avoiding carbohydrates, like white bread. And in terms of weight loss, so kind of one of the big things, kind of looking at your calories and monitoring your calories. Kind of, I should kind of keep an eye on it. That can also kind of can help with your weight loss journey. But the main diet that I recommend, and that's a Mediterranean diet, another kind of a diet recommended by the American Heart Association, American College of Cardiology. Blood pressure. That's a reducible risk of cardiovascular disease in general. Yes, yes. Usually, I'm also kind of and it speaks more to Mediterranean diet, with kind of fish and lean meat instead of kind of red meat. Red meat is not usually not that recommended, but I think the lean meat in moderation, I think that will be the key then. Right, exactly. Yes. Amen. Bye-bye.