Episode Transcript
[00:00:01] Speaker A: From Riverside Health System. This is the Healthy youy Podcast where we talk about a range of health related topics focused on improving your physical and mental health. We chat with our providers, team members, patients and caregivers to learn more about how to maintain a healthy lifestyle and improve overall physical and mental health. So let's dive in to learn more about becoming a healthier you.
Welcome to the Healthy youy the Podcast where we break down important health topics and explore how to manage common conditions so you can live your healthiest life. I'm your host, Franke, and today we're talking about a health issue that affects nearly half of adults in the United States. Wow. Hypertension or high blood pressure. Know a lot about that.
Joining me today is Dr. Meredith Hayes.
[00:00:56] Speaker B: Thank you so much. I'm happy to be here.
[00:00:58] Speaker A: Yes, yes. I'm excited to have you here. Dr. Hayes is a board certified internal medicine physician and the program director of Riverside's Internal Medicine Residency Program, which is now entering the second year.
[00:01:13] Speaker B: Yay.
[00:01:14] Speaker A: It's an incredible program shaping the next generation of of physicians and we are proud to have leaders like Dr. Hayes at the helm.
Welcome, welcome.
[00:01:26] Speaker B: Thank you so much. I'm really happy to be here and I'm happy to have this opportunity to help shine a light on hypertension because it is so important. And you are right. I'm very excited to have the new residency program and we're growing and we're part of Riverside community.
[00:01:41] Speaker A: Yes, yes, yes. Awesome, awesome, awesome. So tell me a little bit about how you ended up in the field of medicine and then how you pivoted and now leading a residency program.
[00:01:57] Speaker B: Well, I ended up in medicine, I think, because internal medicine is so we have breadth and depth of the medical problems. And I enjoyed the rapport that you form with your adult patients. So that was it called to my heart. So that's how I ended up there. I think as far as education, graduate medical education, to have the opportunity to work with residents and train the next generation of physicians is. It's truly a privilege to do what I do. And it's amazing to watch them grow over their three years of residency and become very confident physicians and then they give back to the community.
[00:02:40] Speaker A: Absolutely. That's a powerful legacy as well.
[00:02:42] Speaker B: It is a power to say that.
[00:02:43] Speaker A: You were able to bring others to the fold and support them. So. Yes. Thank you. Thank you for what you do.
[00:02:49] Speaker B: Thank you.
[00:02:50] Speaker A: Let's talk a little bit more about something exciting and you mentioned it a little bit more. But I want you to talk a little more in Depth about the internal medicine residency program. Some people may not know what that is, some of our listeners, and what that means for Riverside. Right. To have such a prestigious program associated with us.
[00:03:14] Speaker B: So a residency program is where we are taking people that have already graduated from medical school. So they are doctors, but they have not gone through training in a specialty. And internal medicine is medicine for adults. So 18 and up is who we see. And so that is who we take, people who are interested in doing that. And we train residents over a three year period and then they graduate and they are considered attending physicians. The impact at Riverside is pretty impressive because when my residency with their internal medicine is completely filled for the three years and we'll have 39 residents total, almost one in five physicians at Riverside Regional will be a resident physician. And what that means is you're not only getting the resident physician, you're getting the attending physician, because they're all being working directly with an attending physician who has more experience.
[00:04:07] Speaker A: Absolutely.
[00:04:08] Speaker B: And what's, I think, really exciting, particularly for Riverside in our population, our community, is that a number of these folks are going to want to put down roots and they're going to continue to give back to the community and they're going to carry on that Riverside mission.
[00:04:22] Speaker A: Absolutely. Whether they stay with us or stay in Virginia.
[00:04:25] Speaker B: Yes.
[00:04:25] Speaker A: It's a win win.
[00:04:26] Speaker B: It is a win win.
[00:04:27] Speaker A: Absolutely. That's awesome.
[00:04:29] Speaker B: Thank you.
[00:04:29] Speaker A: That's incredible.
So the second year. Yes, Year two. Year two.
So great. Congratulations on that. That's an incredible milestone as well.
[00:04:41] Speaker B: Thank you.
[00:04:42] Speaker A: All right, now, speaking of care, let's shift to our topic today.
Hypertension. This is something internal medicine physicians manage.
Sure. Pretty frequently and routinely, every day. Can you walk us through high blood pressure and hypertension and why it's something everyone should take very seriously.
[00:05:09] Speaker B: I would love to. So high blood pressure. Folks will see it if they see it written down. It's going to look. It's going to be two numbers. It's going to look like you're back in math class because it looks like a fraction. And your provider may say it as, for example, your blood pressure is 120 over 60. And so what that means is that that top number or your systolic blood pressure is the pressure of the blood against the walls of your blood pressure or your blood vessel.
[00:05:43] Speaker A: Excuse me.
[00:05:45] Speaker B: When your heart is pumping, when it's squeezing.
[00:05:47] Speaker A: Right.
[00:05:48] Speaker B: The bottom number or your diastolic is the pressure against those vessel walls when your heart is relaxed.
So hypertension, or elevated blood pressure is consistently elevated pressure against Those walls. And over time, it causes damage. Now, if we're talking numbers, hypertension is when your top number or your systolic is consistently at or above 130 or your bottom number, your diastolic, is consistently at or above 80. And I think the really important thing to know is that hypertension is often called the silent killer.
[00:06:29] Speaker A: Yes, it is.
[00:06:30] Speaker B: It's because people are walking around with very high blood pressure sometimes and they feel just fine. They have absolutely no idea. So it's important for people to. To know what their blood pressure is.
[00:06:42] Speaker A: Yeah. Wow, that's eye opening. So many people think they're just fine because they feel fine. Another thing is, unfortunately, everyone doesn't have a relationship with a physician, you know, whether it's an internal medicine or a primary care.
And don't get those annual checks. And I don't know your thoughts, but I think that is key to understanding what's going on with you holistically.
[00:07:11] Speaker B: It is so critical to have those relationships and to have that regular monitoring to make sure. Cause these are things that we can prevent.
[00:07:20] Speaker A: Yes, yes, absolutely. What are some of the biggest risk factors for developing high blood pressure? I know a lot about high blood pressure. It runs in my family. And fortunately I've been able to avoid it.
[00:07:33] Speaker B: Great.
[00:07:35] Speaker A: But I know when you have a family history, you have to work even harder because you have a predisposition.
[00:07:42] Speaker B: You do. So I think that's what you mentioned. Right. There is genetics. That's one thing that is definitely a risk factor. And it's not something that we can change about ourselves. Another risk factor we can't change is age. It becomes more of a risk the older you get. Some of the other things, and a lot of your listeners are probably aware of this, but things like a high salt diet, being overweight, and not exercising, those are all contributors. But there's also certain populations that are at increased risk. So for example, black patients are at an increased risk for more severe hypertension earlier on in their lives. Meaning it's critical for them to make sure they're monitoring their blood pressure. Women who had high blood pressure during their pregnancy are at risk later in life. And then we have populations of patients who maybe they don't have access to care, whether it's because of finances, transportation issues, mobility issues, and unfortunately, those are often the marginalized members of our society. They are also at increased risk. But there's some other things too. Any kind of tobacco use, because it all has nicotine. That increases your risk for high blood pressure, excess alcohol consumption, stress not sleeping very well. And then I think one of the things that people do consider are actually medications. Whether it's prescribed over the counter, a supplement, or even something like a natural remedy, all of those can contribute to high blood pressure, which is why it's so important when you talk to your provider, you make sure they know everything you're taking, whether it's prescribed or not.
[00:09:30] Speaker A: Stuff. That's good stuff. You know what my biggest challenges are? I grew up in the south, so mom was a great Southern cook.
[00:09:38] Speaker B: I bet.
[00:09:38] Speaker A: And so if. If I don't taste the food, I don't want to eat it. And so all the stuff that you add, the accent, the salt, the season, all the pepper, the.
[00:09:48] Speaker B: Yep.
[00:09:48] Speaker A: You know, and it's hard to move away from that.
[00:09:51] Speaker B: It's incredibly hard. And there is the Dash diet, which you can actually access online, and it's free D A, S H. And it's goes through. Gives you recipes, it gives you ideas how to help lower the sodium in your diet. And sodium's hidden everywhere. So you have to read labels.
[00:10:10] Speaker A: Yes, yes. That's another piece. Reading the labels and understanding that a serving size isn't the whole can or the whole box. Took me a while to grasp that.
All right, that's great information. Great information.
Is hypertension preventable?
[00:10:31] Speaker B: So in some people. So in some cases, yeah, it can be preventable, and that's through managing your lifestyle. So those changes that we. We just sort of talked about, watching your salt intake, increasing your exercise, managing your stress, which can be harder eating a balanced diet. So we can even sometimes manage people's high blood pressure by doing those simple things.
[00:10:55] Speaker A: Okay. Okay. Great stuff. So how is. We talked. You already talked a little bit about how, you know, what determines high blood pressure.
And so how is it diagnosed? Is it over a period of time?
Is it just one reading?
[00:11:13] Speaker B: That's a great question. So generally it is not just one reading unless it's just very, very high.
[00:11:18] Speaker A: Every time I go to the dentist, I have high blood pressure.
[00:11:20] Speaker B: Well, I do. When I go to dentist.
[00:11:21] Speaker A: It's called white coat syndrome.
[00:11:23] Speaker B: Yes, it is called white coat syndrome. I have it, too. And I wear a white co.
[00:11:26] Speaker A: Right.
[00:11:27] Speaker B: Go figure.
So you do generally need more than one reading, and it's gonna be done over time. Now, we encourage our patients to monitor their blood pressures at home, and I don't want to discourage anybody from doing that. But your provider is also going to need to monitor you in the clinic. So that's very important. When you talk to about that white coat Syndrome. So that's a very specific case. A lot of us do suffer from that.
Your provider can also do something called ambulatory blood pressure monitoring, where you wear a blood pressure device pretty much 24, seven for usually a seven to 10 days. And it takes your blood pressure randomly throughout the day and night, and then it averages it so you get a better understanding.
[00:12:16] Speaker A: That's good.
[00:12:16] Speaker B: That's good. So if you go to the dentist and your blood pressure is high consistently, maybe that's something your provider would want to do. And I think because of this, you know, we encourage our patients to monitor their blood pressure at home to make sure that their blood pressure monitor is accurate. We encourage people to bring it in so we can compare it to ours.
[00:12:37] Speaker A: Yes. And you have to make sure the cuff is not too small, too large.
[00:12:40] Speaker B: Yeah.
[00:12:41] Speaker A: A lot of these manual devices, you know.
[00:12:44] Speaker B: Yeah, yeah.
[00:12:46] Speaker A: So accurate information, for sure. Absolutely. That's very helpful for people monitoring at home. I mentioned a couple of them. What should they look for and how often should they check? Is it better first thing in the morning when you get up, like a weight, before you eat anything, maybe before you have any sodium at all?
[00:13:10] Speaker B: So I love this question because it's so important and it's part of the education we give our patients. And so the first part of it is, how are you going to take your blood pressure if you're doing it at home? And so we recommend the. The automated blood pressure cuff. That's for your arm, right? We recommend that one. And so what you're going to do is you're going to grab your blood pressure cuff and you are going to go find a quiet, calm place where you can sit comfortably with both feet on the floor and your arm is supported, like, for example, on a table.
[00:13:43] Speaker A: Okay.
[00:13:44] Speaker B: So you're going to have your blood pressure cuff, you're going to put it on your arm, directly on the skin, and then you're going to sit there for five minutes. You're not going to watch the news, you're not going to feel the questions and requests from your family. It's your quiet time.
And then after five minutes or 10 minutes, whatever you need, you're going to go ahead and take your blood pressure. Now, as for frequency, and I think that's a great question. Your provider may ask you to do it multiple times during the day, and you're going to vary it. So you may take it maybe in the morning, in the afternoon, or maybe the morning and the evening using that same technique. And you're going to record that generally you'll do it over a week and then you'll take those blood pressure readings to your provider. If you are just curious and you want to know what your blood pressure is, you're going to follow the same techniques. And I would recommend doing it a couple of times a day at different times, a few times a week.
[00:14:41] Speaker A: Okay. That's great information. We're learning a lot today.
All right.
We already talked about how important consistency is, right?
[00:14:53] Speaker B: Absolutely.
[00:14:54] Speaker A: Following the method you just described, using the same piece of equipment because all things may not be equal. Right, Right. So great stuff there. Are there any myths or misconceptions that you want to just hit on at a high level about high blood pressure?
[00:15:10] Speaker B: Yes. I'm going to re emphasize the silent killer piece because it is so important. Just because you feel fine does not mean your blood pressure is fine.
[00:15:19] Speaker A: Right.
[00:15:20] Speaker B: Again, you need to monitor your blood pressure. You need to follow up with your provider. The other piece is that even for those who live meticulously good lifestyles.
[00:15:33] Speaker A: Right.
[00:15:34] Speaker B: You can still have high blood pressure.
So just because you're doing all the right things doesn't mean your body is necessarily going to have great blood pressure.
[00:15:44] Speaker A: Right. Doesn't exclude you. I get.
[00:15:46] Speaker B: That's good. And the other piece is, I think sometimes people think, well, I'm not in my 60s, I'm not in my 50s, I'm younger. You can still have high blood pressure.
[00:15:56] Speaker A: Wow. Wow. Good information.
Before we wrap up, what advice do you have for someone who's just been diagnosed with high blood pressure?
[00:16:09] Speaker B: So if I were to have a patient in front of me who had just been told they had high blood pressure, I would tell them that this is a very manageable disease.
They can do this. And then when it comes to lifestyle changes, don't try to do it all at once.
Small incremental changes done over time are going to make you set up for success.
And the other piece is to take your medications if you need them and ask questions. Ask questions.
[00:16:42] Speaker A: Yes.
I've heard within my family and also, you know, outside of my family, people feel like they don't feel the same when they're on the medication.
[00:16:52] Speaker B: Yes.
[00:16:53] Speaker A: And it deters them, which is not good.
[00:16:58] Speaker B: So that will eventually pass. Sometimes what they're feeling is their body is so used to having such a high blood pressure, and I tend to see this in people who have had really elevated blood pressures for a long time that when you start to bring it down, they don't feel the same. And they don't because their body is now doing something.
[00:17:16] Speaker A: What's happening? Where's all that blood?
[00:17:18] Speaker B: What happened? Right, Right. So it will improve with time. They just need to stick to it and think about the benefits that they're doing for themselves in the long run.
[00:17:29] Speaker A: Absolutely.
That is so much information, but great information. Thank you. And needed information. And just thank you so much for sharing as we wrap up. Anything that you feel you want to add.
[00:17:49] Speaker B: Hypertension can lead to a lot of really bad things. Heart disease, heart attacks, strokes, kidney problems, among many other things. So making sure you don't have high pressure or if you do, treating it is going to help you live better and longer. So I encourage everybody based on those numbers.
[00:18:13] Speaker A: We've got work to do, right?
[00:18:15] Speaker B: Yeah. With half the US Adult population work to do.
[00:18:19] Speaker A: Yeah. Wow. All right.
Thank you so much for joining me today. You can come back anytime.
[00:18:26] Speaker B: I had fun.
[00:18:27] Speaker A: Thank you. I'd love to have you.
So thank you for joining us again and breaking down this important topic. It's such an important topic and it's so important that we get this information out and I need it myself. And I'm going to take your advice and I'm going to start narrowing down those seasonings, not try to do all of them in one day.
[00:18:50] Speaker B: Can't do it all.
[00:18:52] Speaker A: And congratulations again on the growth of the residency program.
[00:18:55] Speaker B: Thank you so much. I've really enjoyed being here.
[00:18:57] Speaker A: Thank you. And to our listeners, thank you. And to our listeners, thank you for tuning in to the Healthy youy. If you found today's episode helpful, please share it with someone you care about. And don't forget to subscribe so you never miss a health conversation that matters.
Thank you for listening to this episode of Healthy you. We're so glad you were able to join us today and learn more about this topic. If you would like to explore more, go to riversideonline.com.
