Time to Talk with Jennifer Graziano and Erika S. Krauss

Time to Talk with Jen Graziano

(377) Time to Talk with Jennifer Graziano and Erika S. Krauss - YouTube
https://www.youtube.com/watch?v=clwafYSwPNs
Transcript:
(00:00) Facebook live viewers happy to have you joining us on this unseasonably warm but beautiful post-super Bowl Monday congratulations to all the Chiefs fans out there and Tim judge Greenwich local.com behind the camera thank you happy to have you on air with us today so I'm joined on the line by a wonderful guest Dr Erica Krauss Krauss a physician with Glenville medical concierge right over the line in Glenville Connecticut I have them on the show often because I'm a huge proponent of the concierge model
(00:31) of medicine and in full disclosure Dr Krauss is my primary care physician and I can first hand attest to the difference one-on-one attentive Medical Care can provide so good morning Dr Krauss are you on the line with us I am good morning Jen how are you I'm okay great to have you here um so much I want to cover with you today but the month of February we're so focused on the shape of a heart and love and all things read but this is also the month where female heart health is brought to the spotlight and I'm sure
(01:06) you would agree that this is often an under recognized um under publicized condition that plagues women and is one of the leading causes of female morbidity am I correct you're absolutely correct in fact it is the leading cause of morbidity and mortality in not only men but women as well killing over 300 300 000 women per year worldwide um unfortunately the incidence is also rising in younger women by about five percent per year since 2010.
(01:45) wow that's definitely an issue yeah so so much that we have to break down but again the stigma is usually you just associate a heart attack with a middle-aged or older man so we want to really illustrate that this you know a heart attack recognizes no gender um it is it is anyone it's an equal opportunity it can come to anyone and there are risk factors involved so let's start there let's start with actually the point that you just Illustrated that studies are showing that this is impacting younger women what is ascribed to that lowering of the
(02:24) age is it environmental factors such as the excess stress that we all carry foods that we're eating increased alcohol intake what are they attributing this to Dr Krauss yeah it's actually it's actually and also just I just points out that that surveyed women and they've done this most women will say if you ask them what's the leading cause of death what are they most worried about they'll most of them will say cancer specifically breast cancer and obviously that's an important topic but the fact that heart
(02:59) disease is so much more deadly and so much more prevalent is is important for them to know so the risk factors the top three would be high blood pressure okay smoking and high cholesterol luckily smoking is going down and not as many people smoke as they used to but then there are other risk factors and the ones that may be rising are diabetes diets that are high and refined sugars and processed foods inactivity more so as people are working more and sitting at death and obesity is on the rise so we think that that accounts for the
(03:35) increase in in heart disease in the in the younger women so a few of the a few of the causes that you listed there are hereditary markers for this so I think you start with if you if you have a predisposition um or a family history of obesity of high blood pressure of high cholesterol of diabetes it is important that you develop a relationship with the primary care physician and that you are going for annual checkups correct yes and this is one disease that we know that there's so much that can be done to
(04:13) prevent it in fact about 90 percent of these risk factors are modifiable and the risk of heart disease can really go down we just have to recognize it we have to know these risk factors and we have to also look for it and there are there are good tests out there now to to look for it um and and obviously we have to modify these risk factors right but it all starts with a with a commitment to your health which is you know again going to see that doctor every year for an annual checkup or listening to your body we had
(04:45) a caller on the morning show right before it ended who was describing her own experience when I was discussing your show and just listening to your body when something doesn't feel right sound right look right getting the necessary attention so Dr Krauss what are the main risk factors for heart disease in women and how does that contrast to the risk factors for men well I'd say the main difference is would be the hormonal differences that women go through as compared to men so what's the first thing is we have we
(05:16) have menstruation so interestingly if you go through if a woman goes through uh her menarchy or the age that she first gets her period if it's very early say before age 11 that's a higher risk as is the late Anarchy or after age 17. so super early or super late both risk factors there are conditions like some there's something called polycystic ovary syndrome or PCOS we shorten it that is associated with often you know obesity High insulin levels high sugar levels that increases the risk infertility too actually increases the
(05:54) risk we think it may be that they share same risk factors like high blood pressure and obesity that will raise the risk also if women have gestational hypertension gestational diabetes clampsia when they're pregnant that can increase the risk short term and also long-term preterm delivery before 37 weeks is an increased risk so there's a bunch of these things breastfeeding luckily lowers the risk um having no children and having over five children increase the risk and then during menopause so after that then
(06:29) there's menopause and that that transition period is actually a time of higher risk and then after menopause so there is women are at a lower risk of heart disease before menopause so there is truth to that but after menopause so there's about a 10-year DeLay So women are are you know what men may be at a high risk at age 50 women are higher at 60 so it's about 10 men are just about 10 years behind men because of this protection before menopause which kind of goes away around menopause if women are getting a lot of hot lashes that
(07:06) could also increase the risk of heart disease yeah and then hormones there's the whole question of hormone replacement and you know should women take hormones and that's been debated that's been very sort of you know discussed for for years whether it's good whether it's bad and at first you know in the 80s and 90s we thought it was really good and then there was a big Women's Health Initiative study that the results came out in 2002 and it looked like this is really bad and everybody came off their
(07:37) hormones now we're sort of looking at that study again and and realizing that there were some you know some factors in in the way that the study was done and the participants themselves that actually it looks like if you go on hormones soon close to menopause you know within five years of menopause there actually may be some protection there so you know I think what I take away from what you just said is first of all most of these things we just would not associate with heart disease childbirth delivery um the beginning of menstruation
(08:11) um but there everything is all connected um and everything kind of opens that door for possibility um there's a strong correlation between the the whole endocrine system and the risk for heart disease which I don't think is something people would necessarily think of so it's all food for thought um yeah now you know so much of this we can change as a woman there are bodily processes that are going to occur that menstruation begins menstruation ends so you know and there's risk factors inherent in all of that so if there are
(08:45) you know many or most women you know they will they're a child the one two five so with so many factors based upon occurrences that we have no control over what becomes the prevention strategies for heart disease is it just being mindful that we run these risks and making sure we do proper diet and exercise throughout our lives or lowering alcohol intakes making sure there's no tobacco use how do you prevent uh something when the risk is so inherent yeah so and I don't think people should should worry you know if they hear okay
(09:27) oh I had you know I had some infertility or I had preeclamps and now you know I'm at higher risk it's good to know that there is this higher risk so that you can do what you need to do and yes exactly what you mentioned which is you know your lifestyle factors so so yes um keeping keeping alcohol to a minimum which for women we say you know less than nine drinks a week um men maybe you know maybe maybe 10 or so not much more than that exercising and not just moving you know we talk about that a lot like get up move around
(10:00) that's important but it's also really important to get your heart rate up you know some cardio for a period of time 30 minutes minimum um and strength training is super important because we lose we know that as you get older you lose about two for four two to four percent of muscle mass per year and strength is is important that muscle will you'll be able to move more you'll be able to do activities more um and that's important for your heart also stress this dress is a huge one so you know we can't always control the
(10:32) stress in our lives through our jobs but if you take breaks from it if you meditate and you just you have these periods of time where you're not always you're it's more of the constant high level of stress that's an issue if it's up and down that's a lot better um and then diet yeah staying away from from sugar from saturated fats and processed food eating more fish and fiber high fiber lots of veggies keeping the weight down and sleep too sleep is super important for for stress relief or recovery so that we can we can
(11:07) go and function and do what we need to do the next day so if you're just joining us online or on Facebook or on the air I'm speaking to Dr Erica Krauss a physician with Glenville medical concierge and we've been focused on women's heart health and the awareness that we should be carrying as females knowing that this is one of the leading Killers among women and the association with heart disease doesn't often fall on women and we really want to get good information out there today to create a mindfulness amongst our
(11:41) female listeners and viewers of what we should be thinking of aware of and how we can be altering our lifestyle to lower our risk of heart disease so weight is a touchy subject especially for women Dr Krauss um but the truth is food out there today is very different processed foods GMOs obesity rates are higher um and and again weight being a sensitive issue for women this is a reality um so the other side of that is there are so many fad diets that people do these rapid diets that take the weight down um diets or pills that are advertised for
(12:23) weight loss or certain type of diets where it's all or nothing you know all protein no carbs or all this none of that so about weight food diet amongst women yeah and you're right it is a really touchy subject and you know people have felt there's been too much of a focus maybe on on weight itself and the number and we know that there are different body types and genetics and so many factors that so many things that factor into how how easy it is for one person to lose to gain weight versus another
(13:01) person and that definitely makes it difficult and so I I think not looking so much at a specific number or a body mass index which is not always so accurate just knowing that there are differences but but basically keeping your body composition healthy so not having a lot of you know your weight might be high on the scale for for your you know your body mass index may be a little higher than it you know should be but that doesn't mean that you're necessarily you know not healthy you may have a lot of muscle mass I was going to
(13:35) say yeah muscles certainly especially if you're strength training um you can be lean and and you're right it's not so much important to pay attention to the number but it's also how you feel you know you can be there are certain women that are much taller and there's going to be a weight-bearing effect on that um so you're right it's not about a number Focus it's about an overall health Focus um yeah and it's not this you know your right to we have this propensity today with with everybody needing to look a
(14:04) certain way and we could get into how social media fuels that and drives that different conversation but it's not a from for a vanity perspective it's really just more for an overall health um and everyone should be doing something regardless of their body type there are so many ways that you can stay active now it's something as simple as going for a walk you know three times a week Dr Krauss correct oh yeah absolutely you know find something that you like to do and there's so much access now with you know
(14:34) with YouTube and yes yes and cable channels and Optimum and Verizon they all have these you know workout programs that you can easily find even dancing or whatever you like just find something that you like to do and maybe vary it so that you don't get get tired of it yeah and you're right with these with these back to like the diets Jen I mean that's you know there are so many different diets out there it's like what am I people ask me all the time like what am I supposed to eat and what's the right
(15:01) diet and I think with any of those diets they sort of work because anytime you restrict anything you're gonna you're gonna lose some weight you know just by the fact that you're restricting but the issue is how long are you gonna be able to do that for is it something sustainable or you know is it just a short-term weight loss which sometimes is worse than if you didn't lose weight at all because when you lose and then you gain it back and the yo-yo effect isn't good but so that's why I think
(15:29) just really watching I think food trackers are good you know there's a lot of apps now where you can kind of keep track of what you're eating be accountable yeah and well exactly awareness and accountability you're seeing it there and that's how our brains are wired yes yeah yeah and and varied you know not eating the same thing all the time eating different things but you know healthy eating it at home more than eating out cooking your own food having Whole Foods real foods not so much packaged stuff yes yes I mean again
(15:59) simple sustainable and attainable lifestyle changes that we can all make so Dr Krauss um your opinions regarding medic preventative medication or heart disease when we say preventative medication what are we talking about which pills are we talking about why would somebody take them is it more for genetic predisposition and risk factors um what are your thoughts on taking preventative medication for heart issues yeah so you know it's a it's a it's definitely very nuanced and I think it depends on on the person and I mean I'm
(16:37) like as a functional medicine provider I try to avoid medications when possible but as far as heart disease and seeing the benefits I mean if I have a patient and you know let's say the patient has some risk factors maybe they have a family history of heart disease maybe their cholesterol is high and I might send them you know depending on their age and we send them for for some kind of a hard um evaluation I use a lot of calcium scores those are CAT scans or low-dose Cat Scan they can look at the heart you're in the machine for you know a few
(17:10) minutes and it gives us a reading of the calcifications in the heart and we know that calcifications are sort of a proxy for for heart disease they show us you know we want zero we don't want to have any calcifications but you could have zero to really any number so and then we look at their age you know if they're 80 years old works expected to have some calcifications if there are 40 or 50 we want to see that as a zero so let's say we do a calcium score on someone and they have some calcifications even if
(17:40) it's just five but it's something above zero you know then I then we need to talk about medication I I use supplements too and I think there's some really good supplements out there fish oils have been studied and and have a lowering effect um on you know the risk of of events heart disease omega-3 fish oils also often use aged garlic which okay can be very beneficial and now there's a growing body of evidence that vitamins something called vitamin K2 is helpful in preventing calcifications and
(18:13) reducing the arterial stiffness of how stiff your vessels are okay um I will use the statins too which are the medications so that's like Lipitor and and Crestor and all of those and the studies you know really show a benefit so if the cholesterol is high if they are calcium score is high I think it's important to start the statins too and starting it you know at a younger age you know if you're seeing risk factors starting at 40 not waiting until they're 70 or 80 because we know that heart disease is a Continuum and it starts
(18:48) early and you want to catch it before it really starts to take off earlier the better so looking forward I mean do you see anything new on the horizon I mean is it you know I and I know we get into a very gray area talking to about insurance covering testing or for testing that foreshadows but do you see that there will be changes down the road are there going to be standard tests that a woman would endure as part of the normal course of an annual physical um are there you know new supplements or or new treatments
(19:27) that are going to be coming out um in effort to combat this disease specifically against women doctor yes there are there are new treatments coming out there are um there are medications that we're using you know in conjunction either in conjunction with the statins to lower uh cholesterol more and therefore lower risk more or sometimes instead of statins um sentence are generally easy to tolerate and I say statins those are the Lipitor and Crestor so but women actually have a harder time tolerating them more so than men Sometimes women
(20:04) will get muscle aches and crampy and you know maybe digestive issues so if they don't tell her that tolerate them there are medications called PCS canine Inhibitors which um and there's one called zedia also and those can work either with the satin or or instead of if they're not tolerating them and those are a little bit uh well the PCS canine Inhibitors are a little bit newer um another you know where there's something called life approaching a this is a particle within the LDL cholesterol
(20:34) that that we see elevated in certain families this is very genetic it really has nothing to do with the diet so and this has been an issue because when we see this in family we families we know that there's this higher risk it doesn't come down through diet and it doesn't come down through the typical sort of Statin Statin is actually lower it there are new medications that are that are now in like phase two trials they're called antisense follicle nucleotides and those will lower this lipoprotein a so it's exciting that
(21:07) there's some hope for people with this elevated number and this is something that people should get checked to when you get your cholesterol checked maybe ask your doctor to check your lipoprotein a to to see if life approaching a not A2 to see if you have this this elevation because it is important to know even though right now those medications are not out um there are other it's it's important to just lower your overall risk then and lower your other risk factors that you can lower if you do find that you have
(21:38) this elevation so I think all of this uh you know really just speaks to the point of having a relationship with a physician a trusted physician that you have an annual visit with that they're being comprehensive that they're going above and beyond to really understand you as a person understand your lifestyle understand your risk factors and their running the necessary tests looking for you know these somewhat hidden factors as well and Dr Krauss where can listeners and viewers find you personally and the other Physicians
(22:14) wonderful physicians in your practice so I'm in Greenwich Connecticut and the practice name is Glenville medical concierge care and that's actually our that's our website too Glenville medical conciergecare.com um and that's where you can you can check out our website and see we have um we have five positions in this practice all practicing concierge sort of personalized medicine and it's true concierge is exactly that it's personalized medicine it's an hour and a half visit with your doctor at least you
(22:51) know once a year for your physical um a blood test a thorough discussion about findings um it's a mindfulness about your health it's really an ideal way also for preventative care because when you establish that relationship and you have these baselines you know your doctor is really able to follow your health journey and adjust if any situations arise down the road there there's really a better ability to treat that I can't say enough about the concierge model um you do you pay for it but you
(23:25) certainly get more than what you pay for and Dr Krause you moved into this model uh you were with a larger group so you first hand see the difference in the care you're able to provide patients correct yes it's like night and day I you know I for me and for the patients I mean just to have all this time to speak with patients I can't tell you how many times in the course of that hour and a half physical that something has come up that I know would not have come up if I had 10 or 15 minutes with them that was so
(23:55) important and really change their care and and I was able to make much more of a difference than I would have otherwise it's so much more rewarding with patients get so much out of it they're happy we're happy it's it's it works it really works so no and I I personally am so grateful for for having come on board with you guys um and I and I see it firsthand um but the overall message today is we as women have to be mindful of heart health yes there are many terrible diseases that impact us and you know
(24:28) there are some that we tend to think of women as that we run greater risk for that but we need to be mindful of discussions of female heart health and you gave us some wonderful tips today um but I'm sure getting an annual physical is probably among the primary pieces of advice that you'd leave us with today correct doctor yes absolutely go get your physical for sure go get checked out well thank you Dr Kraus always wonderful to speak to you thank you for this wonderful information and it's Glenville medical
(25:00) concierge care.com doctor yes okay check them out today folks it'll be uh it's worthwhile to visit a trusted physician and to get the proper care be mindful of your heart health and this is Jen Graziano thanking you for taking the time to listen as we took the time to talk have a great day everyone bye-bye thank you foreign