Cardiovascular Matters

In this episode of Cardiovascular Matters, Dr. Craig Walker and Terry Roberts discuss the critical issue of critical limb ischemia (CLI), a severe form of peripheral artery disease. They explore the historical treatment approaches, the evolution of minimally invasive interventions, and the importance of a comprehensive approach to limb salvage. The conversation covers the various techniques, including balloon angioplasty, stenting, atherectomy, and lithoplasty, as well as the significance of early intervention and the role of medical therapy in managing this condition. The discussion highlights the need for increased awareness and a multidisciplinary approach to address the challenges posed by CLI.
~~~~ Key Points Discussed ~~~~

• Historical treatment approaches for critical limb ischemia, including bypass surgery and endarterectomy
• The development of minimally invasive interventions, such as balloon angioplasty, stenting, atherectomy, and lithoplasty
• The importance of a comprehensive approach to limb salvage, including medical therapy and preventive measures
• The need for early intervention to improve outcomes and reduce the risk of amputation
• The significance of addressing the progressive nature of peripheral artery disease and the importance of patient education and compliance
• The potential impact of newer diabetic medications on the progression of atherosclerosis and critical limb ischemia

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Throughout the episode, Dr. Walker emphasize the need for increased awareness and a multidisciplinary approach to addressing the challenges posed by critical limb ischemia. He stress the importance of educating both healthcare providers and the general public about the severity of this condition and the availability of effective treatment options.
By sharing their extensive knowledge and experience, Dr. Walker and Terry Roberts aim to empower listeners with the information they need to advocate for their own health or that of their loved ones, and to seek the appropriate care and treatment for critical limb ischemia.
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In this in-depth podcast, cardiologist Dr. Craig Walker provides a thorough overview of high blood pressure (hypertension) - one of the leading risk factors for heart disease and stroke. Dr. Walker explains what blood pressure is and why it's important to control. He discusses the various causes of high blood pressure, including both primary (essential) hypertension as well as secondary causes related to underlying medical conditions. Dr. Walker stresses the importance of evaluating patients to determine if high blood pressure has a reversible medical cause. He also covers the risks of uncontrolled high blood pressure, symptoms of hypertensive crisis, lifestyle factors like salt intake, and non-pharmacological and pharmacological treatment approaches. This educational podcast is ideal for anyone looking to gain a better understanding of high blood pressure from a cardiologist's perspective.
Key points discussed in the podcast:

• Definition of blood pressure and the two numbers typically reported
• Normal blood pressure ranges and the goal of having the lowest possible blood pressure without symptoms
• Primary/essential vs secondary causes of high blood pressure
• Examples of secondary causes like renal artery stenosis, pheochromocytoma, Cushing's syndrome, coarctation of the aorta
• Risks of uncontrolled high blood pressure like heart attack, stroke, heart failure, kidney damage
• Evaluation steps the cardiologist takes when a patient presents with high blood pressure, including checking for secondary causes
• Hypertensive crisis and the need to rapidly lower blood pressure in symptomatic patients
• Importance of medications that don't interfere with treating an underlying secondary cause
• Role of salt/sodium intake and how it can raise blood pressure by increasing fluid retention

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This podcast discusses obesity as a major health problem and explores new medical treatments that are safe, effective and help patients feel better. The host Dr. Craig Walker and guest Terry Roberts discuss causes of obesity, health risks, challenges with past treatments and promising new medications.
Terry Roberts provides context for the episode by noting the rising rates of obesity, especially in children. He introduces Dr. Walker as an expert in treating the whole patient and addressing root causes of health issues like obesity.
Dr. Walker explains obesity has many causes related to lifestyle like eating highly processed foods and lack of exercise, but some patients struggle to lose weight no matter their efforts. Genetic and physiological factors play a role in why weight is difficult for some to lose.
Dr. Walker outlines the various health problems and diseases linked to obesity like heart disease, hypertension, diabetes, sleep apnea and more. Being overweight also increases orthopedic problems and lowers quality of life.
Previous weight loss options had problems. Medications that blocked nutrient absorption caused diarrhea, and amphetamine-like drugs were addictive and unsuitable for long-term use. Invasive surgeries also had high risks and complications.
Terry Roberts shares his own weight loss journey with encouragement from Dr. Walker. Dr. Walker discusses new medications that help the body release fat cells more easily and make patients feel good, unlike past options. When combined with lifestyle changes, these new treatments can safely and effectively help patients lose weight and improve health.
Key points:

• Obesity rates are rising, especially in children and teenagers
• Obesity increases risks of heart disease, hypertension, diabetes and more
• Past weight loss treatments had poor safety profiles or caused unpleasant side effects
• New medications help the body release fat cells more readily and make patients feel good
• When combined with lifestyle changes, new medications can safely and effectively help patients lose weight and improve health

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www.cardio.com

Dr. Craig Walker and Terry Roberts discuss a new class of injectable cholesterol-lowering drugs called PCSK9 inhibitors. These medications provide an additional option for lowering LDL ("bad") cholesterol beyond statin therapy alone.
Dr. Walker explains how PCSK9 normally works to block the recycling of LDL receptors in the liver, preventing further removal of LDL from the bloodstream. Two PCSK9 inhibitor drugs, Repatha and Praluent, use monoclonal antibodies to bind to PCSK9 instead, allowing LDL receptors to function properly and clear more LDL.
Viewers will learn about the mechanism of action of PCSK9 inhibitors and how they can significantly reduce cardiovascular risk by optimizing cholesterol levels.
Key Points:

• Introduction of PCSK9 inhibitors as a new class of injectable cholesterol-lowering drugs
• Explanation of how the PCSK9 protein works to block LDL receptor recycling in the liver
• Mechanism of action of PCSK9 inhibitor monoclonal antibodies like Repatha and Praluent
• Ability of PCSK9 inhibitors to further lower LDL cholesterol beyond statin therapy alone
• Potential role in optimizing cholesterol management and reducing cardiovascular risk

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Join Dr. Craig Walker as he provides an in-depth look at cholesterol-lowering medications, with a focus on statins. In this informative discussion, Dr. Walker breaks down the science behind these life-saving drugs, explaining how they work to reduce cholesterol production and increase its removal from the body. Learn about the two main types of statins, their differences, and why they're crucial for heart health. Dr. Walker addresses common misconceptions, discusses potential side effects like muscle aches, and offers practical advice on managing them. Discover why there's no such thing as "too low" LDL cholesterol and how regular monitoring can help optimize your treatment. Whether you're currently taking statins or considering them, this video provides valuable insights into one of the most important tools in fighting cardiovascular disease.
Key points:
• Statins are the most common cholesterol-lowering medications
• They work by reducing cholesterol production and increasing its removal
• The biggest side effect of statins is increased life expectancy
• Muscle aches are a common side effect, but can often be managed
• There's no such thing as "too low" LDL cholesterol
• Regular blood tests are important for monitoring cholesterol levels
• Statins are generally safe and effective for most patients
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www.cardio.com