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It's time to be well
with your health.

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I'm Shanna, and we're back with
another episode of the Adventist

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HealthCare and You podcast.

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I have a special guest filling
in today that I'm super excited

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to welcome who's been on the
podcast before, but infrequent,

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but I'm happy to have her back.

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Tina, welcome.

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Thanks, Shanna. It's
so great to be back.

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Let's first introduce
doctor Chen.

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Doctor Chen, you are an
interventional cardiologist,

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a chair of cardiology at
Shady Grove Medical Center,

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and then a medical director
of the cardiac catheterization

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lab at White Oak Medical Center.

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Welcome. We're glad
to have you back.

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Great. Thank you for
having me, Shanna.

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Tell us a little bit about your
background and how you help patients.

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Sure.

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So I grew up in Columbus, Ohio,
and my dad was a cardiologist.

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With that, I always had a aim towards
possibly becoming cardiologist.

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Although, as an aside,
it's a little funny.

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In fourth grade, I
remember my dad asking me,

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what do you wanna
be when you grow up?

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And fourth grade,
Columbus, Ohio,

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home to Ohio State Buckeyes.

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So I said, I wanna play
football for the Ohio State

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Buckeyes.

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And if you know my size,

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I would've gotten crushed
on football field.

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So with that, yeah, I
became a cardiologist.

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Did my training at
Cleveland Clinic,

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three years of
general cardiology,

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two years of in
eventual cardiology,

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finished up in two thousand six,

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and joined Dennis Friedman's group,
Cardiac Associates, at that time.

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And since then, we've been I've been
with Cardiac Associates, which in,

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two thousand twenty two became
part of Adventist HealthCare.

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As an eventual cardiologist, I
do procedures in the hospital,

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taking care of heart attack
patients if they need stents.

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That is we fix blockages with,

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balloons and stents to
open up the blockage.

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And then I also see
patients in the office,

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not just in Adventist
cardiology patients,

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but general cardiology
patients too.

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Okay. Well, thank you.

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You've been a long time
member of Adventist HealthCare

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as part of Cardiac Associates,

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and we've come to you a lot over the
years to talk about heart health.

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So we very much appreciate your
expertise and being part of the

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Adventist Healthcare
family. So thank you.

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It's my pleasure.

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Alright. Let's get into it.

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What overall would
you say about the role

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genetics play in heart health?

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We talk about genetics a lot
when it comes to cancer care

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and other types of things.

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But what about for
for your heart?

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Genetics definitely plays a
role in heart health and and

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heart risk, but genetics
is not everything.

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So I think it's a combination
of your genes can increase or

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decrease your risk for
heart disease, say,

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coronary disease or other heart entities
such as arrhythmias or heart failure.

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But then, say, speaking of
coronary disease specifically,

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other factors such as the
usual risk factors for heart disease,

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smoking, diabetes, high
blood pressure, lifestyle,

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that that plays a role too.

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As somebody who has a family
history of heart disease,

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one of the things I'm curious
about is how far back do you

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have to look and be worried?

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And if you have heart disease
running in your family,

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what can you do?

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So as far as how
far back to look,

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certainly the further back
you can go, the better.

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But I would say most patients
may know back to their

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grandparents, sometimes
great grandparents,

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and that's probably
adequate, you know, for most,

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most things that
we're looking at.

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And if you do have a family
history of heart disease,

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what can you do?

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Well, the most important thing
would be focusing on your lifestyle

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to address those risk
factors for heart disease.

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You can't change your genes,
at least for the most part.

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Not yet.

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We're talking about Not yet.

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Exactly.

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So it's really making sure
you're at a healthy weight,

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exercising, avoiding
diabetes, watching

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your blood pressure,
watching cholesterol,

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the traditional risk
factor for heart disease.

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It's not like if you have
heart disease in your family,

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you're not destined to
have a heart attack.

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Is that correct?

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Correct. Yes.

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You can definitely play a
role and change that course,

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change that trajectory.

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Yes. So knowing it can
help you prevent it.

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That's what's important here
is if you know your family

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history, then you can do
a lot to to reduce it.

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Absolutely. Yeah.

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So with your family history,
you may be at higher risk,

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but it's not hundred
percent as I'm pointing out.

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What is the connection between
genetics and specific heart

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conditions like arrhythmias
or heart failure?

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Is there any links?

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Yes. Definitely.

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So one very well studied
link is between arrhythmia,

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say something called long
QT syndrome, and genetics.

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And with long QT syndrome,

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it's an entity where patients
may have sudden cardiac arrest.

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And that's been linked
to several genes,

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but three genes in particular.

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Two genes affect the potassium
channel in the heart and one

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that affects the sodium channel,

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and that probably counts for
the vast majority of these long

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QT, syndrome.

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A different arrhythmia, and
one one that's more common,

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something called atrial
fibrillation Mhmm.

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Which I think
we've all heard of.

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AFib. Right?

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AFib. You got it.

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So AFib, there's definitely a
genetic link to AFib as well.

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Heart failure entities would
be something called a dilated

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cardiomyopathy, and that's, say,

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heart failure not
coming because of heart,

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blockaging arteries
of the heart,

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not coming because of
thickening of the heart muscle.

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The heart just dilates, and
often there's no real reason.

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And that has a genetic link too to
something called the titin gene.

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And the titin gene is a gene
that encodes a protein in

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skeletal muscle and
and heart muscle.

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So when there's defects in that,

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that can result in
in heart failure.

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Some of these things that
you're talking about,

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are these some new discoveries
when it comes to heart care,

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or have we known these
things for a while?

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I mean, I tell you,

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we're always finding new
genes associated with cardiovascular

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disease entities.

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And so some are newer, some
have been around for a while.

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But you're right.

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So for instance,
comparing, like,

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some of what we knew
what we I'm sorry.

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What we know now about
Gen X compared to, say,

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when I was going through med school
with which is a vast world different.

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And how are you
testing patients to understand,

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do they have these genes and what
risk they have because of that?

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Right now, I'd say in
community medicine,

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genetic testing is not being
used extremely commonly.

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Occasionally, there are patients who
are very interested in their genetic

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profile and and
want gene testing.

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And so then, you know, we
do order gene testing for them.

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Say, for instance, a
dilated cardiomyopathy,

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someone with heart failure,

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you can't find a cause for
someone maybe on the younger side.

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We may order gene
testing there to see,

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are there any genes for
heart failure that are contributing

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to them having heart failure?

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But, also another common time,
at least in community medicine,

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where my order gene testing would
be for hypertrophic cardiomyopathy.

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That's a condition where you have
thickening of the heart muscle.

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And with that, there's
also disarray in the,

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muscle fibers in the heart.

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And when that happens, then
heart can become thicker.

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It's hard for blood to be
pumped out of the heart.

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And sometimes they're prone to
arrhythmias and sudden cardiac death too.

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Hypertrophic cardiomyopathy,

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that probably is one probably
the most common genetic

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cardiovascular disorder in
about one in two hundred people

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to one in five hundred, people.

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And that's often
when you hear, like,

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athletes having
sudden cardiac death,

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that's probably the
one to think of.

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Okay.

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So when someone were
suspicious for hypertrophic

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cardiomyopathy, then we
can run a a panel on,

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say, hypertrophic
cardiomyopathy genes,

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try and confirm that diagnosis or or
move perhaps away from that diagnosis.

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So it sounds like if you
are maybe outside of the typical

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risk factors of age or
there's some other indication

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of a problem that doesn't
align with those risk factors,

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that might be a a case in
which you use a genetic test to kinda

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get deeper into the cause?

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Right now, yeah. Yeah.

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Although, stay tuned because there's
a really interesting type of test

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called, polygenic risk score.

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That may be applicable more to
the general population as it

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gets using clinical
practice more often.

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And what, polygenic
risk score is is

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looking at, your
your whole genome,

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and then rather than just
looking at the effect of one

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gene on one disease entity,
they're looking at, like,

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hundreds or thousands of genes.

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And each of those genes
can play a little role,

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but you sort of calculate
that risk together through

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sophisticated models.

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That can then give you sort
of a a risk for heart disease,

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for diabetes, or high blood
pressure, for high cholesterol.

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And this might be a strange
question or maybe not.

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Is all of this the more
you know about your risk

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and the percentages, is it almost
the more you know, the better?

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It can scare people.

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Right.

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So what's your what's
your thought on that one?

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My thought on that is that
for the majority of patients,

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I think the more you
know, the better.

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It's better to be
informed. Mhmm.

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And it's interesting because
it comes back to what we were

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talking about earlier.

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I know I have a high
risk of heart disease.

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Am I predestined to have
a heart attack? Yeah.

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Where I would argue strongly,
you're not predestined.

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You can do something to
do something about it.

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But key here would be, if you
know you have hygienic risk,

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then you want to be even more
proactive More proactive.

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In your loss in lifestyle
changes in your risk factors.

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Okay.

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And that does go further
into so for instance,

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this polygenic risk score.

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Mhmm.

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With that, you might find out
you have a high genetic risk

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of of coronary disease.

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Mhmm.

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And so right now,

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there's certain risk models
which help us determine who

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should be on a
cholesterol medicine from the American

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College of Cardiology. And in
general, the threshold is, hey.

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If based on your blood pressure,
your cholesterol, your age,

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you have more than a seven
point five percent chance of

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having heart attack or
stroke in the next ten years,

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then you should probably be
on a cholesterol medicine.

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If it's below that,

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then based on the American
College of Cardiology guidelines,

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you don't necessarily need to be
on a on a cholesterol medicine.

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What that doesn't integrate
though is the family history,

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the genetic component of things.

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And so I could definitely
see in the future,

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probably in the near future,

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in integrating the polygenic
risk score or some other

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genetic assessment
with this risk model,

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then try and see to
possibly reclassify people.

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Gotcha.

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For instance, you know,

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someone may have a based
on traditional risk model,

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three percent chance.

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But then if you integrate
the genetic part of things,

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that risk may go up some.

246
00:10:11,145 --> 00:10:12,425
And so then they may say, hey.

247
00:10:12,425 --> 00:10:15,625
I actually do wanna be
on a cholesterol medicine. Yeah.

248
00:10:15,625 --> 00:10:20,265
Doctor Chen, your team, the
cardiac team at both hospitals,

249
00:10:20,265 --> 00:10:22,825
Shady Grove Medical Center,
White Oak Medical Center,

250
00:10:22,825 --> 00:10:27,490
national recognition for the work
that you've done for many, many years.

251
00:10:27,490 --> 00:10:28,850
Same thing with our stroke team.

252
00:10:28,850 --> 00:10:30,850
There's a correlation there.

253
00:10:30,850 --> 00:10:34,610
Can you talk a little bit about
that relationship between the

254
00:10:34,610 --> 00:10:39,010
risk for heart disease and the
risk of stroke and how you work

255
00:10:39,010 --> 00:10:42,030
with patients to prevent
both of those things?

256
00:10:42,345 --> 00:10:42,665
Yes.

257
00:10:42,665 --> 00:10:46,025
Heart disease, coronary disease
is essentially plaque building

258
00:10:46,025 --> 00:10:48,005
up in the arteries of the heart.

259
00:10:48,825 --> 00:10:52,105
And stroke, one of the main causes
for stroke would be plaque building

260
00:10:52,105 --> 00:10:55,960
up either in the neck or
or in the, brain vessels.

261
00:10:55,960 --> 00:10:59,720
So if you think of the blood
vessels in the body as a

262
00:10:59,720 --> 00:11:01,400
systemic entity,

263
00:11:01,400 --> 00:11:04,040
then when you have plaque
buildup in one vascular bed,

264
00:11:04,040 --> 00:11:05,960
say the heart, you're
at high risk for,

265
00:11:05,960 --> 00:11:07,720
plaque buildup in
other vascular beds,

266
00:11:07,720 --> 00:11:09,365
say the carotid arteries.

267
00:11:09,365 --> 00:11:12,245
And it's well studied that
patients with heart disease

268
00:11:12,245 --> 00:11:15,685
coronary disease have higher
chance for carotid disease,

269
00:11:15,685 --> 00:11:16,885
blockage in neck arteries,

270
00:11:16,885 --> 00:11:18,965
and also have higher higher
chance for blockage in the

271
00:11:18,965 --> 00:11:21,425
legs, peripheral heart disease.

272
00:11:21,460 --> 00:11:24,980
That's really because a lot
of the same factors that drive

273
00:11:24,980 --> 00:11:29,540
coronary disease, diabetes,
high blood pressure, smoking,

274
00:11:29,540 --> 00:11:31,540
can, you know, they cause
plaque buildup in the heart.

275
00:11:31,540 --> 00:11:33,780
It can also cause plaque
buildup in other arteries,

276
00:11:33,780 --> 00:11:36,885
in the neck, in the
brain, in in the legs.

277
00:11:36,885 --> 00:11:40,245
I think it's less well studied
whether someone with, like,

278
00:11:40,245 --> 00:11:43,445
a genetic risk for
coronary disease,

279
00:11:43,445 --> 00:11:46,485
does that increase the genet
the risk for for stroke?

280
00:11:46,485 --> 00:11:48,165
Probably a little less
well studied there.

281
00:11:48,165 --> 00:11:49,060
Okay.

282
00:11:49,060 --> 00:11:50,260
You talked about,

283
00:11:50,260 --> 00:11:53,220
a little earlier about how much
has changed since you were in

284
00:11:53,220 --> 00:11:55,860
training and then over these
over these last years that

285
00:11:55,860 --> 00:11:57,520
you've been in practice.

286
00:11:58,500 --> 00:12:00,340
What breakthroughs
have you seen?

287
00:12:00,340 --> 00:12:04,175
And then what can we expect
in the next ten years,

288
00:12:04,175 --> 00:12:06,735
when it comes to heart
care, heart health,

289
00:12:06,735 --> 00:12:08,015
and and genetics too?

290
00:12:08,015 --> 00:12:11,855
Like, overall, what's your what's
your thoughts on what we can expect?

291
00:12:11,855 --> 00:12:16,190
Right. So I think gene therapy
is pretty exciting. Mhmm.

292
00:12:16,190 --> 00:12:19,790
It hasn't really hit forefront
in cardiovascular medicine yet.

293
00:12:19,790 --> 00:12:23,017
On the other hand, say, it
was just approved recently,

294
00:12:23,017 --> 00:12:26,670
a company called Vertex Pharmaceuticals
in conjunction with CRISPR.

295
00:12:26,670 --> 00:12:30,155
They actually have gene
therapy for, for sickle cell.

296
00:12:30,155 --> 00:12:31,675
And so that's really cool,

297
00:12:31,675 --> 00:12:33,915
the fact that we'll be able to
go in, edit a gene potentially,

298
00:12:33,915 --> 00:12:35,575
and cure a disease.

299
00:12:35,595 --> 00:12:39,595
And so with some of what we've
talked about, say, you know, long QT,

300
00:12:39,595 --> 00:12:42,315
that's an that arrhythmia
where there's defects in either

301
00:12:42,315 --> 00:12:43,755
potassium channel
or sodium channel.

302
00:12:43,755 --> 00:12:47,860
If you could do gene therapy
for for that and cure patients

303
00:12:47,860 --> 00:12:48,980
of long QT,

304
00:12:48,980 --> 00:12:50,980
that might prevent them
from needing a defibrillator

305
00:12:50,980 --> 00:12:53,920
potentially, even
even save lives.

306
00:12:54,100 --> 00:12:57,460
That's maybe little ways
down the road though. Mhmm.

307
00:12:57,460 --> 00:12:58,420
On the other hand,

308
00:12:58,420 --> 00:13:02,515
I think there is more and more
focus on genetic testing and

309
00:13:02,515 --> 00:13:03,955
cardiovascular disease for sure.

310
00:13:03,955 --> 00:13:04,275
Okay.

311
00:13:04,275 --> 00:13:07,715
And that's probably gonna be
more on the polygenic risk

312
00:13:07,715 --> 00:13:11,215
score as opposed to, like,
single gene variance.

313
00:13:11,235 --> 00:13:13,555
So I do think something along
the lines of polygenic risk

314
00:13:13,555 --> 00:13:16,470
score where you look at your
whole genome and then trying to

315
00:13:16,470 --> 00:13:18,050
calculate a risk,

316
00:13:18,550 --> 00:13:21,350
will you'll be seeing more and
more of that as as time goes on.

317
00:13:21,350 --> 00:13:24,370
And then patients will be
integrating that information

318
00:13:24,550 --> 00:13:28,230
with their traditional risk
factors to try and provide more

319
00:13:28,230 --> 00:13:29,405
personalized medicine.

320
00:13:29,405 --> 00:13:32,285
I think this goes back to
one of the questions Shanna asked

321
00:13:32,285 --> 00:13:35,085
earlier, but changing
behaviors Mhmm.

322
00:13:35,085 --> 00:13:36,665
Is so hard.

323
00:13:36,765 --> 00:13:37,725
And so, you know,

324
00:13:37,725 --> 00:13:40,905
if you're a patient and
you come and you have

325
00:13:41,005 --> 00:13:44,125
whether it's a family history
or several of these risk

326
00:13:44,125 --> 00:13:46,820
factors, I'm just
curious from what

327
00:13:46,820 --> 00:13:49,540
you've seen, and you've
cared for so many patients,

328
00:13:49,540 --> 00:13:52,980
is is there one thing in
particular that you see that

329
00:13:52,980 --> 00:13:56,500
really motivates patients to
take the steps that they need

330
00:13:56,500 --> 00:13:58,320
in reverse course?

331
00:13:58,580 --> 00:14:02,645
You know, is is what is the
thing that you see that really

332
00:14:02,645 --> 00:14:06,725
sort of ignites that desire and
patience to make a change and

333
00:14:06,725 --> 00:14:11,685
maybe get on the path to being
healthier in terms of their

334
00:14:11,685 --> 00:14:13,745
their heart and their lifestyle?

335
00:14:15,200 --> 00:14:20,080
I would say the biggest thing
I see to then really motivate

336
00:14:20,080 --> 00:14:23,920
patients often
is, unfortunately,

337
00:14:23,920 --> 00:14:28,700
some kind of cardiac event
affecting a loved one, a friend.

338
00:14:28,725 --> 00:14:30,805
I get patients coming in.

339
00:14:30,805 --> 00:14:33,205
My best friend,
who's the same age

340
00:14:33,205 --> 00:14:36,405
as me, just had a heart attack,
just needed bypass surgery,

341
00:14:36,405 --> 00:14:37,845
just needed a stent.

342
00:14:37,845 --> 00:14:40,325
And that really gets
them focused on their own

343
00:14:40,325 --> 00:14:42,485
cardiovascular risk and
potential mortality.

344
00:14:42,485 --> 00:14:44,790
And, you know, my
father, my brother,

345
00:14:44,790 --> 00:14:48,130
my sister had some
kind of cardiac event.

346
00:14:48,150 --> 00:14:50,630
I would say it's really
unfortunate, you know,

347
00:14:50,630 --> 00:14:53,510
some kind of cardiac event
touching someone close to a

348
00:14:53,510 --> 00:14:56,550
patient, which is probably a
very strong motivator for them

349
00:14:56,550 --> 00:14:58,710
to, you know, change their lives

350
00:14:58,710 --> 00:15:00,450
out if they haven't already.

351
00:15:00,535 --> 00:15:03,255
That's why I think
that risk score,

352
00:15:03,255 --> 00:15:06,375
whether to the way we calculate
it today and the way we might

353
00:15:06,375 --> 00:15:09,955
be able to calculate it,
you know, years from now,

354
00:15:10,375 --> 00:15:12,935
knowing that risk and having
that conversation with your

355
00:15:12,935 --> 00:15:17,160
doctor is is important because
there are things that you can do.

356
00:15:17,160 --> 00:15:19,160
You've talked about
your genetic risk.

357
00:15:19,160 --> 00:15:21,480
You can't do that much can't
do anything about that,

358
00:15:21,480 --> 00:15:23,460
and you can take medications.

359
00:15:23,480 --> 00:15:27,560
But how much can making the
lifestyle changes affect your

360
00:15:27,560 --> 00:15:28,680
risk and lower it?

361
00:15:28,680 --> 00:15:31,395
Like, we don't talk about
that enough that, yeah,

362
00:15:31,395 --> 00:15:35,475
you can take medications and you can
not do too much about your genetics,

363
00:15:35,475 --> 00:15:39,795
but if you know about it but
lifestyle can really affect your risk.

364
00:15:39,795 --> 00:15:41,395
Oh, for sure. Sure.

365
00:15:41,395 --> 00:15:44,815
So for instance,
Cardiac Associates

366
00:15:45,150 --> 00:15:47,150
was approached by a small,

367
00:15:47,150 --> 00:15:49,150
startup company called Open DNA,

368
00:15:49,150 --> 00:15:51,870
and we actually did a pilot
project with them on the

369
00:15:51,870 --> 00:15:53,310
polygenic risk score Mhmm.

370
00:15:53,310 --> 00:15:54,190
A couple years ago.

371
00:15:54,190 --> 00:15:56,590
And that was along with a
couple other clinical sites.

372
00:15:56,590 --> 00:15:59,945
I think one in New Jersey,
one in in Rockville,

373
00:16:00,125 --> 00:16:01,965
a primary care, provider.

374
00:16:01,965 --> 00:16:03,785
And that was pretty interesting,

375
00:16:04,525 --> 00:16:07,405
pilot study because for
this company, OpenDNA,

376
00:16:07,405 --> 00:16:11,190
we took a cheek swab to get the
DNA, and then it was sent off.

377
00:16:11,190 --> 00:16:13,430
We got a polygenic risk
score, and then, you know,

378
00:16:13,430 --> 00:16:16,870
I would go over with the patients
their polygenic risk score.

379
00:16:16,870 --> 00:16:19,990
So what I would get would be,
say, for coronary disease,

380
00:16:19,990 --> 00:16:24,285
your genetic risk for coronary
disease is in the ninetieth

381
00:16:24,285 --> 00:16:26,285
percentile, the which
would be very high.

382
00:16:26,285 --> 00:16:26,845
Mhmm.

383
00:16:26,845 --> 00:16:28,845
Well, more risk than ninety
percent of people out there.

384
00:16:28,845 --> 00:16:30,925
Or it could be in the
twentieth percentile,

385
00:16:30,925 --> 00:16:32,765
which actually would
be pretty low risk.

386
00:16:32,765 --> 00:16:34,285
But then beyond that, you know,

387
00:16:34,285 --> 00:16:36,525
patients wouldn't start
freaking out if their pay their

388
00:16:36,525 --> 00:16:37,565
risk is very high.

389
00:16:37,565 --> 00:16:38,045
Mhmm.

390
00:16:38,045 --> 00:16:41,080
But then with, say, for, you
know, for this company's,

391
00:16:41,980 --> 00:16:43,100
sort of model,

392
00:16:43,100 --> 00:16:46,220
you they then would also
provide not just genetic risk,

393
00:16:46,220 --> 00:16:50,700
but then also your absolute
risk at ten years and

394
00:16:50,700 --> 00:16:52,625
then also lifetime.

395
00:16:52,625 --> 00:16:54,145
So someone like that, let's say,

396
00:16:54,145 --> 00:16:57,665
if you were fifty and you
had ninetieth percentile,

397
00:16:57,665 --> 00:16:59,105
they might be very worried.

398
00:16:59,105 --> 00:17:01,425
I would then, you know,
look and say on that report,

399
00:17:01,425 --> 00:17:05,970
it might say, your ten year
risk is really, you know,

400
00:17:05,970 --> 00:17:07,090
say seven point five percent.

401
00:17:07,090 --> 00:17:08,530
So that's gonna be higher than
the average fifty year old,

402
00:17:08,530 --> 00:17:10,690
but it's not like a
hundred percent chest pain or heart

403
00:17:10,690 --> 00:17:12,610
attack or stroke in
the next ten years.

404
00:17:12,610 --> 00:17:15,170
And then your lifetime risk
might be, for instance,

405
00:17:15,170 --> 00:17:16,530
forty or fifty percent.

406
00:17:16,530 --> 00:17:17,810
So point there being, yeah,

407
00:17:17,810 --> 00:17:19,250
genetics is
definitely part of it,

408
00:17:19,250 --> 00:17:20,815
but it's not the only thing,

409
00:17:20,815 --> 00:17:23,295
and lifestyle plays a
super important role.

410
00:17:23,295 --> 00:17:23,775
Mhmm.

411
00:17:23,775 --> 00:17:27,055
I mean, I if you had to say
which one plays, you know,

412
00:17:27,055 --> 00:17:29,515
just pick one,
genetics or lifestyle,

413
00:17:29,615 --> 00:17:31,135
I'd probably go
more with lifestyle.

414
00:17:31,135 --> 00:17:34,075
I think there's a more much
more conflict with lifestyle

415
00:17:34,180 --> 00:17:35,300
than with genetics.

416
00:17:35,300 --> 00:17:35,620
K.

417
00:17:35,620 --> 00:17:36,020
Yeah.

418
00:17:36,020 --> 00:17:36,980
That's great.

419
00:17:36,980 --> 00:17:39,300
Where where would you
tell someone to start?

420
00:17:39,300 --> 00:17:42,100
If they've got a whole
checklist of risk factors,

421
00:17:42,100 --> 00:17:43,060
what are the, you know,

422
00:17:43,060 --> 00:17:46,345
top one or two things they
can do to reverse course?

423
00:17:46,345 --> 00:17:48,265
Number one would
be stop smoking.

424
00:17:48,265 --> 00:17:49,145
But, fortunately,

425
00:17:49,145 --> 00:17:50,825
most of my patients right
now are are not smoking.

426
00:17:50,825 --> 00:17:53,145
I was gonna say, I I feel
like we say that a lot,

427
00:17:53,145 --> 00:17:56,025
but I rarely see
someone smoking anymore.

428
00:17:56,025 --> 00:17:59,625
How about vaping? That's a
great question. Feel like Yeah.

429
00:17:59,625 --> 00:18:01,460
I see that more often.

430
00:18:01,460 --> 00:18:03,300
Yeah. The traditional
cigarette. Yeah.

431
00:18:03,300 --> 00:18:05,700
Right. And I would stay
away from vaping too. Yeah.

432
00:18:05,700 --> 00:18:07,220
Probably not as
toxic as smoking,

433
00:18:07,220 --> 00:18:08,900
but still not good either.

434
00:18:08,900 --> 00:18:11,540
Yeah. One place I would start
probably would be exercise.

435
00:18:11,540 --> 00:18:14,660
I mean, love exercise, you
know, huge in exercise.

436
00:18:14,660 --> 00:18:17,705
And I'll say exercise
has has so many benefits.

437
00:18:17,705 --> 00:18:21,465
With exercise, it can help with your
blood pressure regardless of whether

438
00:18:21,465 --> 00:18:22,265
you lose weight or not.

439
00:18:22,265 --> 00:18:24,905
Let's say even if a
patient is exercising,

440
00:18:24,905 --> 00:18:26,105
doesn't drop a single pound,

441
00:18:26,105 --> 00:18:28,505
their blood pressure will go down
just from the fact of exercise.

442
00:18:28,505 --> 00:18:30,485
Exercise can help
with cholesterol.

443
00:18:30,640 --> 00:18:33,740
It just helps with
being able to,

444
00:18:34,080 --> 00:18:37,520
carry on with your activities
of daily life as opposed to

445
00:18:37,520 --> 00:18:39,680
some patients as they get older,

446
00:18:39,680 --> 00:18:41,680
become just bound to the chair,

447
00:18:41,680 --> 00:18:43,605
to the couch because
they're just not active,

448
00:18:43,605 --> 00:18:44,965
not able to get
around and do things.

449
00:18:44,965 --> 00:18:45,285
Yeah.

450
00:18:45,285 --> 00:18:48,325
So I think people associate
exercise with losing weight.

451
00:18:48,325 --> 00:18:50,965
And I loved what you said.
It's it's it's not about that.

452
00:18:50,965 --> 00:18:54,565
It actually does a whole
lot more that you can't see.

453
00:18:54,565 --> 00:18:56,565
And that's that's
important to note, I think.

454
00:18:56,565 --> 00:18:58,325
I've been trying
to exercise more,

455
00:18:58,325 --> 00:18:59,730
and I'm so so proud of myself,

456
00:18:59,730 --> 00:19:02,050
but I have not seen a
change in the number.

457
00:19:02,050 --> 00:19:05,330
And I'm trying to stay
motivated even though I'm not

458
00:19:05,330 --> 00:19:06,930
seeing that, and I
have to remember, no.

459
00:19:06,930 --> 00:19:07,490
No.

460
00:19:07,490 --> 00:19:09,730
Let me go to my physical
in a couple months,

461
00:19:09,730 --> 00:19:12,695
and I'll see my cholesterol levels
because they were a little high.

462
00:19:12,695 --> 00:19:13,095
Well, call me.

463
00:19:13,095 --> 00:19:13,975
I'll be your buddy.

464
00:19:13,975 --> 00:19:15,095
Oh, yes. We can do it today.

465
00:19:15,095 --> 00:19:15,495
I love it.

466
00:19:15,495 --> 00:19:17,175
That probably helps. Right?

467
00:19:17,175 --> 00:19:19,655
Keep keep the motivation up.
Yeah. Having a accountability.

468
00:19:19,655 --> 00:19:19,895
Yeah.

469
00:19:19,895 --> 00:19:21,015
But I I like that.

470
00:19:21,015 --> 00:19:22,775
I like it's it's not the number.

471
00:19:22,775 --> 00:19:26,695
It's the overall health, and
then it helps you age well.

472
00:19:26,695 --> 00:19:27,095
Oh, yeah.

473
00:19:27,095 --> 00:19:29,310
You know? And the heart's
a muscle. Right? Yeah.

474
00:19:29,310 --> 00:19:30,910
You have to keep
working it out. Yeah.

475
00:19:30,910 --> 00:19:31,950
Heart heart's a muscle.

476
00:19:31,950 --> 00:19:32,910
And then with exercise,

477
00:19:32,910 --> 00:19:37,070
it also releases endorphins and
people mentally feel better.

478
00:19:37,070 --> 00:19:37,870
Yeah.

479
00:19:37,870 --> 00:19:40,915
I love what you how you
were bringing in some of the very

480
00:19:40,915 --> 00:19:43,235
interesting things that
Cardiac Associates has been

481
00:19:43,235 --> 00:19:48,495
participating in and just
your, in the in the practice's,

482
00:19:49,555 --> 00:19:53,010
approach to care and just
staying on the forefront of of

483
00:19:53,010 --> 00:19:56,290
new things and new treatments
and how you've helped Shady

484
00:19:56,290 --> 00:19:59,090
Grove and White Oak become very,

485
00:19:59,090 --> 00:20:02,850
forefronts in our area
with with heart care.

486
00:20:02,850 --> 00:20:04,930
You've been practicing
for a long time.

487
00:20:04,930 --> 00:20:07,505
You've been a part of Adventist
HealthCare for a long time.

488
00:20:07,505 --> 00:20:09,345
To me, that's what
makes us special. Right?

489
00:20:09,345 --> 00:20:12,785
You can get really wonderful care
right here in your neighborhood.

490
00:20:12,785 --> 00:20:16,465
For you, what's special about being
a part of Adventist Healthare and

491
00:20:16,465 --> 00:20:18,625
our our system of care?

492
00:20:18,625 --> 00:20:20,225
You kind of started
to touch on it.

493
00:20:20,225 --> 00:20:23,025
We are the health care system
that's in your neighborhood.

494
00:20:23,025 --> 00:20:23,265
Mhmm.

495
00:20:23,265 --> 00:20:26,920
You know, we are the doctors,
nurses, technicians Mhmm.

496
00:20:26,920 --> 00:20:28,920
Who, you know,
maybe your neighbor.

497
00:20:28,920 --> 00:20:32,040
For instance, just
this past Friday,

498
00:20:32,040 --> 00:20:35,400
I was invited to go to my son's
high school where we have a

499
00:20:35,400 --> 00:20:36,360
meet a pro day.

500
00:20:36,360 --> 00:20:38,635
And so just spent lunchtime
with the kids there who were

501
00:20:38,635 --> 00:20:39,435
interested in medicine.

502
00:20:39,435 --> 00:20:42,315
About twenty five kids
showed up and, you know,

503
00:20:42,315 --> 00:20:43,195
bought them some lunch,

504
00:20:43,195 --> 00:20:46,075
and it was in the media center
and just talked to them about

505
00:20:46,075 --> 00:20:47,975
what it's like to
be a cardiologist.

506
00:20:48,155 --> 00:20:50,640
So it's nice to have that
community outreach, and, you know,

507
00:20:50,640 --> 00:20:54,800
this is not a Johns Hopkins or hospital
center where it's some faraway entity.

508
00:20:54,800 --> 00:20:56,560
We're right here in the
neighborhood and Yeah.

509
00:20:56,560 --> 00:20:57,600
And we're there with you.

510
00:20:57,600 --> 00:20:59,760
And it's and there's
breakthroughs happening,

511
00:20:59,760 --> 00:21:01,680
and there's excellent,

512
00:21:01,680 --> 00:21:04,935
very high quality care
happening right here that you

513
00:21:04,935 --> 00:21:05,895
don't have to drive to.

514
00:21:05,895 --> 00:21:08,215
You you don't you
can rely on it.

515
00:21:08,215 --> 00:21:09,255
For sure. Yes.

516
00:21:09,255 --> 00:21:10,535
So people don't know this,

517
00:21:10,535 --> 00:21:12,615
but Shady Grove is probably
one of the busiest heart attack

518
00:21:12,615 --> 00:21:15,095
centers in, in the
state of Maryland.

519
00:21:15,095 --> 00:21:18,030
Busy ER and with that, a
busy heart attack center.

520
00:21:18,030 --> 00:21:20,030
We have very good care for
heart attacks at Shady Grove

521
00:21:20,030 --> 00:21:20,910
Hospital.

522
00:21:20,910 --> 00:21:24,030
At White Oak, the cardiothatic
surgery program has been excellent.

523
00:21:24,030 --> 00:21:27,390
Often, there there's something
called the Society for Thoracic

524
00:21:27,390 --> 00:21:29,950
Surgeons, and they award programs
one, two, or three stars.

525
00:21:29,950 --> 00:21:32,315
And this Cardio Thoracic
Surgery Program has

526
00:21:32,315 --> 00:21:36,455
consistently gotten three stars
for their top notch care in,

527
00:21:36,555 --> 00:21:37,515
doing surgery there.

528
00:21:37,515 --> 00:21:39,915
Yeah. And minimally
invasive surgery too.

529
00:21:39,915 --> 00:21:43,890
And invasive and and now also
with let's call it TAVRs.

530
00:21:43,990 --> 00:21:46,390
Yeah. We have a great
structural heart team there.

531
00:21:46,390 --> 00:21:46,790
Yeah.

532
00:21:46,790 --> 00:21:49,590
So there's really wonderful
things going on with heart and

533
00:21:49,590 --> 00:21:52,070
and just a lot of things that
have been a self care that's

534
00:21:52,070 --> 00:21:55,755
really high quality that we
continue wanna wanna emphasize.

535
00:21:55,755 --> 00:21:59,835
And truly a prestigious
history of cardiac care Yeah.

536
00:21:59,835 --> 00:22:00,795
Throughout our system.

537
00:22:00,795 --> 00:22:02,795
And you've you've been an
important part of that.

538
00:22:02,795 --> 00:22:04,235
So thank you for
your work. Yeah.

539
00:22:04,235 --> 00:22:04,715
Oh, thank you.

540
00:22:04,715 --> 00:22:05,835
Thank you so much.

541
00:22:05,835 --> 00:22:08,075
One last question
that we like to ask.

542
00:22:08,075 --> 00:22:09,995
You've touched on it a
little bit throughout,

543
00:22:09,995 --> 00:22:15,740
but what is your
one tip for a happy

544
00:22:15,740 --> 00:22:17,340
heart healthy life?

545
00:22:17,340 --> 00:22:21,580
My one tip for a heart healthy
life would be exercise. Mhmm.

546
00:22:21,580 --> 00:22:25,605
And here's a a
fun little tidbit.

547
00:22:25,605 --> 00:22:28,645
So in this coming July,

548
00:22:28,645 --> 00:22:32,325
my mom and I my mom is
eighty now, and, you know,

549
00:22:32,325 --> 00:22:34,325
I'm fifty four.

550
00:22:34,325 --> 00:22:38,430
But we're going to, Des
Moines, Iowa to compete in the,

551
00:22:38,430 --> 00:22:40,110
national senior games.

552
00:22:40,110 --> 00:22:44,350
So my mom is gonna be doing
a five k power walk and,

553
00:22:44,350 --> 00:22:46,910
and also a fifteen
hundred meter power walk.

554
00:22:46,910 --> 00:22:50,565
And I guess I'll be running a
ten k and a five k race there.

555
00:22:50,565 --> 00:22:53,445
And it's kinda interesting the
way this this happened because

556
00:22:53,445 --> 00:22:56,945
back in, I think it was
two thousand twenty one,

557
00:22:57,285 --> 00:22:58,325
BodyMind said, hey.

558
00:22:58,325 --> 00:22:59,605
You should I you know,

559
00:22:59,605 --> 00:23:01,845
you should run the Kentlands
in Lakeland's five k.

560
00:23:01,845 --> 00:23:03,445
We're close to there.
Never really ran it.

561
00:23:03,445 --> 00:23:05,710
I I was never a track runner,
like that in high school.

562
00:23:05,710 --> 00:23:07,390
But I was just trying
to keep in shape.

563
00:23:07,390 --> 00:23:08,830
And so I said, alright.

564
00:23:08,830 --> 00:23:11,550
And so at that point, I guess
I was fifty at that time.

565
00:23:11,550 --> 00:23:14,190
So ran the, Kenlands 5k,

566
00:23:14,190 --> 00:23:15,870
and this is around Labor Day.

567
00:23:15,870 --> 00:23:18,315
I I actually came in
first in my age division.

568
00:23:18,315 --> 00:23:19,195
Oh. Congratulations.

569
00:23:19,195 --> 00:23:21,495
Must have been a weak
competition that much.

570
00:23:22,315 --> 00:23:24,635
And and so then, maybe
two, three weeks later,

571
00:23:24,635 --> 00:23:26,235
I guess a something in the mail,

572
00:23:26,235 --> 00:23:28,235
and it's a gift
card from Panera.

573
00:23:28,235 --> 00:23:29,355
I think maybe twenty dollars.

574
00:23:29,355 --> 00:23:30,795
Like, oh, I actually want
something from Riggs.

575
00:23:30,795 --> 00:23:31,355
This is pretty cool.

576
00:23:31,355 --> 00:23:32,795
Never happened to me before.

577
00:23:32,795 --> 00:23:33,730
Then fast forward, like,

578
00:23:33,730 --> 00:23:36,850
maybe November two thousand
twenty one, get an email.

579
00:23:36,850 --> 00:23:40,290
You qualify for the National
Senior Games in two in Fort

580
00:23:40,290 --> 00:23:42,050
Lauderdale in two thousand
twenty two in the spring.

581
00:23:42,050 --> 00:23:45,010
I'm like, well, it's cool,
but I don't wanna be a senior.

582
00:23:45,010 --> 00:23:46,590
I'm only fifty.

583
00:23:46,850 --> 00:23:47,970
I really don't
wanna be a senior.

584
00:23:47,970 --> 00:23:48,825
So I looked into it,

585
00:23:48,825 --> 00:23:50,745
and it's actually a lot
of people who participate.

586
00:23:50,745 --> 00:23:53,305
There's maybe, like,
ten thousand people or

587
00:23:53,305 --> 00:23:54,585
so, but these are
all kinds of events.

588
00:23:54,585 --> 00:23:54,905
Yeah.

589
00:23:54,905 --> 00:23:59,545
Track and field, race races,
walks, basketball, pickleball,

590
00:23:59,545 --> 00:24:00,990
tennis, etcetera.

591
00:24:00,990 --> 00:24:02,190
And so, yeah, my mom and I,

592
00:24:02,190 --> 00:24:04,830
we did it in two thousand
twenty two in Fort Lauderdale.

593
00:24:04,830 --> 00:24:06,430
And usually, supposed
to be every other year,

594
00:24:06,430 --> 00:24:08,910
COVID had screwed that up. So
then it's usually odd years.

595
00:24:08,910 --> 00:24:11,230
So in two two thousand
twenty three in Pittsburgh,

596
00:24:11,230 --> 00:24:13,450
my mom and I did it again, and,

597
00:24:13,565 --> 00:24:15,405
I actually came in she
got a silver medal.

598
00:24:15,405 --> 00:24:17,725
She actually came in
second in the ten k,

599
00:24:17,725 --> 00:24:19,245
which I was pretty
thrilled about.

600
00:24:19,245 --> 00:24:19,965
Yeah. Yeah.

601
00:24:19,965 --> 00:24:22,445
And so, you know, my mom and
I were signed up again in,

602
00:24:22,445 --> 00:24:25,920
two thousand twenty five, about
three or four months from now.

603
00:24:25,920 --> 00:24:28,400
Alright. So we need
pictures. That's right.

604
00:24:28,400 --> 00:24:31,280
And we need to hear we
need to congratulate you.

605
00:24:31,280 --> 00:24:32,800
So we wanna hear how it goes.

606
00:24:32,800 --> 00:24:34,000
Well, I'd say more more my mom.

607
00:24:34,000 --> 00:24:35,920
I mean because it I love it.

608
00:24:35,920 --> 00:24:37,680
That's amazing. Yeah. For sure.

609
00:24:37,680 --> 00:24:40,615
And I love, again, having
someone to do it with. Yeah.

610
00:24:40,615 --> 00:24:42,215
It's a good time
with your mother.

611
00:24:42,215 --> 00:24:42,935
For sure.

612
00:24:42,935 --> 00:24:45,335
And I also like the
point that, one,

613
00:24:45,335 --> 00:24:47,575
you don't have to be a athlete.

614
00:24:47,575 --> 00:24:47,815
Yes.

615
00:24:47,815 --> 00:24:47,975
Right?

616
00:24:47,975 --> 00:24:49,715
You don't have to
be competitive.

617
00:24:49,735 --> 00:24:53,025
Just find something you like
to do and get moving Yeah.

618
00:24:53,025 --> 00:24:54,270
And see where it takes you.

619
00:24:54,270 --> 00:24:55,710
And in your case,
it's, you know,

620
00:24:55,710 --> 00:24:58,650
it's too high achievement and,

621
00:24:58,750 --> 00:25:00,590
the senior And it can
be little stuff too.

622
00:25:00,590 --> 00:25:02,590
You know? It's it's
we're all so busy.

623
00:25:02,590 --> 00:25:07,035
And so just fitting in just a
little bit and work your way up

624
00:25:07,035 --> 00:25:10,395
or just stay with that, and
you'll see the benefits.

625
00:25:10,395 --> 00:25:11,595
It really does work.

626
00:25:11,595 --> 00:25:12,235
Oh, absolutely.

627
00:25:12,235 --> 00:25:15,275
I tell patients, oh, you
don't have time to exercise.

628
00:25:15,275 --> 00:25:17,355
Well, I mean, you can always
make time, but I was alright.

629
00:25:17,355 --> 00:25:20,250
Then, hey, when you drive
to the grocery store,

630
00:25:20,250 --> 00:25:21,290
park as far away as you can.

631
00:25:21,290 --> 00:25:22,890
Yeah. Get that walk in. Yep.

632
00:25:22,890 --> 00:25:24,810
Take the stairs and
set the elevators.

633
00:25:24,810 --> 00:25:27,930
Yep. Just start small.
Yeah. So wonderful.

634
00:25:27,930 --> 00:25:30,250
Thank you, doctor Chen.
We wanna have you back.

635
00:25:30,250 --> 00:25:31,290
You'll come back. Right?

636
00:25:31,290 --> 00:25:31,610
Of course.

637
00:25:31,610 --> 00:25:33,485
We'll have you back, for sure.

638
00:25:33,485 --> 00:25:35,485
Thank you, Tina, for
stepping in today.

639
00:25:35,485 --> 00:25:38,125
It was lovely having you.
It's always a pleasure.

640
00:25:38,125 --> 00:25:41,085
Alright. Well, thank you,
to our listeners as well.

641
00:25:41,085 --> 00:25:45,400
To find out, more information about
doctor Chen and cardiac associates and

642
00:25:45,400 --> 00:25:47,560
our excellent care at Shady
Grove Medical Center and White

643
00:25:47,560 --> 00:25:50,360
Oak Medical Center,
visit HealthCare dot com.

644
00:25:50,360 --> 00:25:52,600
You can click on find
a doctor to search.

645
00:25:52,600 --> 00:25:55,720
More information and resources
will also be available in

646
00:25:55,720 --> 00:25:57,480
today's, show notes.

647
00:25:57,480 --> 00:26:00,125
We'd also always love to
hear from our listeners.

648
00:26:00,125 --> 00:26:02,765
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649
00:26:02,765 --> 00:26:04,365
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650
00:26:04,365 --> 00:26:07,565
And also email podcast at
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651
00:26:07,565 --> 00:26:11,085
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652
00:26:11,085 --> 00:26:13,065
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