Podcast transcript

INTRO
Welcome to Docs in a Pod, presented by WellMed. Over the next half hour, Docs in a Pod will educate you about the health and wellness of adults everywhere. Co-hosts Dr. Tamika Perry and award winning veteran broadcaster Ron Aaron will share information to improve your health and well-being. And now here are Ron Aaron, and Dr. Tamika Perry.


RON AARON
Hello everybody, and welcome to the award winning Docs in a Pod. I'm Ron Aaron and along with our co-host today, Dr. Tamika Perry. Dr. Perry is associate regional medical director for quality for North Texas and Houston for WellMed. She oversees a number of large clinics, and it's something that she was recently promoted to. Congratulations! Dr. Perry earned her undergraduate degree from Prairie View A&M University, then went on to graduate from Philadelphia College of Osteopathic Medicine. She was a National Health Service Corps Scholar, and then she completed her family medicine residency at Methodist Charlton Medical Center, where she served as chief resident. Dr. Perry lives in Dallas with her daughter, and in their free time they love to travel. Her goal was to hit all seven continents. Dr. Perry, you're pretty close to accomplishing that goal.


DR. TAMIKA PERRY
I am. I have Australia and Antarctica left. My goal was to go to Antarctica in maybe 18 months. I wanted friends to go because I'll be turning 50, but I recently discovered that to go from South America to Antarctica was like $10,000. I had no idea. So, I may have to rethink this whole thing if I want a bunch of people to go with me, but I will make it there.


RON AARON
Or stick up a bunch of stop and go’s.


DR. TAMIKA PERRY
Well, I don't think I'm gonna do that right. I think I like my day gig better and I don't look good in orange.


RON AARON
I don't want to raise your blood pressure as we talk about this. Let's introduce our guest who is going to talk about managing high blood pressure. Dr. Jyothi Rereddy. Dr. Rereddy is a board certified internal medicine physician. You find her at WellMed at Richardson in Richardson, Texas. She earned her medical degree from Osmania University in India and completed her residency at Strong Memorial Hospital in Rochester, New York. Dr. Rereddy provides comprehensive, patient centered care. In college, it’s hard to believe she was an award winning javelin and shot putter. She also trained in shooting, so you want to be careful around her. She has a passion for mission trips, especially to Guatemala. Dr. Rereddy, nice to see you. Thanks for joining us.


DR. JYOTHI REREDDY
That's so exciting to be on this show. Dr. Perry and Ron, I have listened to some of your shows and every time he just tickles me and I really thoroughly enjoy and thank you for inviting me for this.


RON AARON
Well, thank you so much. She was telling me that at one point, she was on a camping trip with her kids who were shooting, and she said, let me try that. They said, no, no, no, mom, you're going to hurt yourself. And she said, no, let me try this. Then they went and got the target. All bull's eyes.


DR. TAMIKA PERRY
I would have never thought that Dr. Rereddy. I’m so impressed.


RON AARON
That's pretty cool. Dr. Rereddy, let's talk a little bit about managing high blood pressure without over medicating. First let's do a 411 on what high blood pressure is.


DR. JYOTHI REREDDY
Yes, absolutely. High blood pressure is when your heart pumps the blood for your whole body. So, whenever the heart is pumping the blood, the pump has a pressure that the blood comes out as well as the blood vessels are receiving the blood to take it to the rest of your organs. So, that has the pressure as well. Blood pressure is measured in two numbers. The top number is what the heart is pumping with the pressure and then the bottom number is where the blood vessels are receiving the resistance. It has two numbers. Usually, for a more normal number we say about 120/80. Most of us probably heard about that. But again, depending on the numbers, the pressures are called normal pressures, elevated or stage 1 or 2. Then when it gets elevated, then we call hypertension.


RON AARON
What causes high blood pressure?


DR. JYOTHI REREDDY
High blood pressure can be caused by many, many things, but most of all, people can inherit that. It can be inherited genetically coming through family history. So, it's very important to know what family members have any conditions about this and get screened early. Also, lifestyle, food habits and not exercising. Eating very salty food and DoorDash, Uber Eats and fast food. So, a lot of them would contribute. But again, lifestyle is a major effect of how these can be under control. I would say it's a combination.


RON AARON
Stay with me for just a moment. We're going to get right back to you. We're talking with our co-host Dr. Tamika Perry. Our guest today is Dr. Jyothi Rereddy. I'm Ron Aaron and you're listening to the award winning Docs in a Pod. Our podcast is available wherever you get your podcasts. We're delighted to have you with us. By the way, if you do listen on podcasts, do us a favor, give us a positive Yelp review and a Google review. That will encourage others to tune in, and we appreciate that. As I'm listening to you, Dr. Perry, you know a whole lot about obesity. You've got a certification in obesity management. What is it about salt? Because everybody mentions it as a potential problem.


DR. TAMIKA PERRY
Salt is a substance that can cause vasoconstriction. And what that means is that the arteries clamp down. So, think of one of the mechanisms for high blood pressure like this. As the artery diameter gets smaller, the pressure gets higher. In essence, as the hole gets smaller, the pressure gets higher. Think of your arteries as a water hose. And when you put your finger over the end of the hose, the hole gets smaller, but the pressure of that water gets higher. So, over time, the ability of the arteries to vaso dilate, which means the diameter gets bigger and the vessel constricts. That ability to auto regulate decreases over time because our body ages on the inside, just like it does on the outside. You may not know this, Ron, but I dye my hair on a regular and consistent basis.


RON AARON
I would never know that.


DR. TAMIKA PERRY
You would never know. These fancy glasses that I have on, guess what? They're progressive lenses. They're fancy bifocals because my body ages on the outside just like it ages on the inside. So, that auto-regulatory mechanism that we have kind of decreases over time. I have some of my patients, and I know Dr. Rereddy has the same thing. They'll come to me and they'll be 62 years old and the pressure's high, and they'll say, well, I've never had high blood pressure before. I didn't give it to you. You've never been 62 before or however old they are when they come to the office. What sodium does is it causes that smooth muscle contractility and that artery kind of clamps down and that diameter that already become smaller. Dr. Rereddy will tell you if the arteries are really, really teeny, that diameter gets so small that it will close up, right Dr. Rereddy?


DR. JYOTHI REREDDY
Yes.


DR. TAMIKA PERRY
They will close up. What can happen? I'm going to let you tell us.


RON AARON
What happens when that happens?


DR. JYOTHI REREDDY
As we are aging, like they say, if you live long enough everybody gets hypertension. So, that's the process Dr. Perry mentioned. As the arteries are getting narrower on one end, the other end they are also getting stiffer as you age. So, that also contributes to high blood pressure as well. On top of that, as the stiffness increases, the narrows increases that decreases the blood flow to many, many organs, especially the vital organs are the ones that get most brunt about it. So, vision, eyes, brain, your kidneys and your heart. As Dr. Perry mentioned, these arteries sometimes can be so small. You can imagine a strand of your hair and blood flowing through that. So, that small and these kinds of pressures can have a significant effect on those. Those you're not going to see until you have some organ damage. So, it's already past that stage of prevention when you get to that kind of stage. So, it's very, very important. That's why we highly recommend Dr. Perry and I do these yearly preventive screenings to identify this early stage.


RON AARON
How often should you check your blood pressure?


DR. JYOTHI REREDDY
That depends. If I'm screening for a normal healthy patient, I'm checking when I'm doing their annual screening. If I'm suspicious, they have some borderline elevation in their pressures, I'm going to ask them to keep monitoring me at home. It also depends on if it's too high, then I would be telling them twice a day and put it in a blood pressure log and then bring it to me, and these are the ones I'm going to closely follow up and bring them back into the office. I'm not going to let them leave and then say, keep checking and then come back in a year. That is the most important thing to monitor from home as well as from the office.


RON AARON
I know that there's some medication that can help lower blood pressure. Can you lower it with and without medication?


DR. JYOTHI REREDDY
Absolutely we can do that. Number one is lifestyle changes. It can lower the pressure by at least 5 to 10 points.


RON AARON
What would be a lifestyle change?


DR. JYOTHI REREDDY
Lifestyle change would be like Dr. Perry mentioned about the salt, which we recommend usually 1,500 to 2,000mg per day. Just as an alert, one soup can might have 1,000 or more milligrams of salt. People don't realize and then throughout the day it adds up too much. The second one would be weight loss. That also can give you a 5% to 10% reduction in the numbers. Of course, nothing can beat doing good things, good deeds like exercise. If you're doing aerobic exercise, a recommendation is about 30 minutes a day, five days a week. So, that can definitely significantly lower and may prevent you from getting on the medication and improving better habits. Tobacco, alcohol, and then also stress relieving. A lot of people are unaware of how to manage their stress. So, that definitely impacts blood pressure when they're able to manage the stress, how to deal with it, how they cope. Some people have recently started a big trend in yoga nowadays. Also mindfulness.


RON AARON
Meditation?


DR. JYOTHI REREDDY
Yes, sir. All those have significantly impacted in improving health outcomes recently.


RON AARON
All right. Stay with me for just a minute. We're going to get right back to you. We'll kick it off with you, Dr. Perry. I'm Ron Aaron. Dr. Tamika Perry is our co-host, and we're talking with Dr. Jyothi Rereddy. You don't want to cross her because she is a sharpshooter beyond compare and throws javelin and shotput. That's one dangerous lady. I'm Ron Aaron and you're listening to the award-winning Docs in a Pod.


AD
Turning 65? It's time for an important choice. Deciding what Medicare coverage is best for you. WellMed can help. When you become a WellMed patient, you can connect our primary care with a Medicare Advantage plan. WellMed doctors and care teams spend quality time with you listening and learning about your health. WellMed and a Medicare Advantage plan could be right for you. Choose WellMed. Learn more at (866) 433-5048. That's (866) 433-5048.


RON AARON
Thank you so much for sticking with us right here on the award winning Docs in a Pod. Our podcast is available wherever you listen to your podcasts. We're also on the radio in a number of markets in Texas and Florida as well. I'm Ron Aaron. Dr. Tamika Perry, our co-host is with us. Our guest today is Dr. Jyothi Rereddy. She's a physician. You can find her at WellMed at Richardson in Richardson, Texas. Dr. Perry, back to you.


DR. TAMIKA PERRY
I'm so glad that before the break Dr. Rereddy had already mentioned mindfulness and stress. These are two concepts that are common to the individuals who live in the blue zones in the world. These are areas where people typically live past 100. Stress reduction and being mindful is something that is not only tied to your mind, but is intimately tied to your body. When I say that there is something, and Dr. Rereddy can expand on this if she wants to, but there's something called broken heart syndrome where stress will mimic the effects of a heart attack, oftentimes more common in women. They just don't get that left ventricular, that left ventricle dysfunction. You'll have constriction of those arteries on your heart, and you will have a heart attack. So, can stress kill you? Absolutely. Things like yoga are essential for stress reduction and blood pressure reduction. Now we're not running on the treadmill, but very purposeful movements, very purposeful thinking while we're doing yoga. So, thank you Dr. Rereddy for mentioning that before the break because this is so important. We didn't mention a beta blocker, calcium channel blocker, great drugs that are used to treat blood pressure, ARBs, none of that stuff, How you think and how you deal with stress.


DR. JYOTHI REREDDY
For my patients, I tell them they have to know themselves, like what their stressors are. Without knowing that, then you just go on and you can handle it. Personally for me, gardening and music and just hanging out with friends, those are my interests. That's what I think patients also need to know. What would help them? If they cannot figure it out, they can always talk to their health care providers. We are very good at helping them and talking to them and figuring out what would be the route they should take. We can always advise which route to go. My nine year old does chair yoga. We just celebrated a 101 year-old patient two weeks ago, and we asked her, like, what's the secret for your healthy life? She said, don't stress about anything. Life goes on. Take life as it comes and keep going. That was attitude. Also, that attitude is so important in how patients take things and how they deal with it.


DR. TAMIKA PERRY
Super important. When it comes to stress, many of us know what those stress triggers are. In our household, we've got a 13 year-old girl who is a daily stress trigger. Some days she's as sweet as a little bunny rabbit and other days she's a barracuda. So, when you have those things in your life, Dr. Rereddy, how do you manage stress?


DR. JYOTHI REREDDY
One time I was giving a talk, and then I asked the audience, I said, when is the first time a human being experiences stress?


RON AARON
Birth.


DR. JYOTHI REREDDY
Absolutely. Ron, you're right on. You're my first one who gave the correct answer.


RON AARON
It comes through that tunnel.


DR. JYOTHI REREDDY
Exactly. You're born to deal with stress, right? Now, the younger generations, generation X, generation Z, all the generations. They always think everything is stressful. Going to school is stressful. Getting stopped at a traffic light is stressful. With my boys growing up, I told them, you have a stressful situation? Look at a solution. What's the solution to it? Is this something that we can fix? If you can fix it, then you change your attitude about it. Some of the teenagers are that way. But again, I strongly believe in exercise, yoga, and good sleep. Also, good nutrition. Avoiding all those carbs, sugary drinks, staying well-hydrate. All of that kind of helps in general to feel good. Exercise, for sure, is my top bet on stress relief.


RON AARON
When you were shooting in competition, you had to manage stress before you pulled that trigger. How did you calm yourself down?


DR. JYOTHI REREDDY
I go in there. I love the sport. I am competitive. I want to win this. Then I said, okay, what's my goal here? When I'm standing there, I'm when I'm aiming, my goal and my focus was only on the dot. I'm not focusing on the winning part, because if I think about winning then that's going to stress me out. So, I'm just kind of looking at the dots like, okay, this is the dot I need to get. So, focus.


RON AARON
The dot being the bullseye?


DR. JYOTHI REREDDY
Yes, the dot is the bullseye. Then, I feel like I am focused on what actually will get me there. For example, I lost my job, I'm stressed. Sitting home and stressing is not going to help. I'm going to make my resume, I'm going to refresh it and start the search. So, I tell them, make your points. Even though you're not working, still make your schedule. Staying on top of things and having a purpose to do things. Having a purpose for the day I think is what can keep people moving.


DR. TAMIKA PERRY
I think it's also important to recognize that you gave very definitive examples of this is a stressor. I lost my job. Sometimes people have so many stressors in their lives, they're kind of accustomed to it and they don't even realize that they're stressed because they take so much. So, it's important to recognize what are my life's stressors? And it's also important to recognize what can I change in that change? Because in some situations you're not going to be able to change. You're just not. One of my favorite and my worst boyfriends told me one time he said, love me like I am or leave me like you found me. So, I decided to leave him like I found him.


DR. JYOTHI REREDDY
There you go. Good choice. Yes, absolutely.


RON AARON
She said, thank you very much. Bye-bye.


DR. JYOTHI REREDDY
Absolutely, yes. That's how it is. Either you find a solution or change your attitude.


RON AARON
That's right. Tamika, that was really, really good advice. Love me like I am or leave me like me or leave me like you found me. We're not a self-help love show, but how many people, and I think this is more women than men who may be in a stressful situation, think they can change him?


DR. TAMIKA PERRY
Him, them, or even adult children. Dr. Rereddy and I see a lot of adult senior patients, and a lot of times, pressure is high, they're stressed out all the time because of that adult child situation or maybe even that long term spouse. You're absolutely right. There's nothing that Dr. Rereddy and I can do to medicate that away. And unless you have recognized and come to terms with your stress, like, what do I need to do? Do I need to exit the door on stage left? What am I going to do to deal with this situation that is causing me physiologic distress?


RON AARON
I want to come back, Dr. Rereddy, to something Dr. Perry said. She ran off a few types of medication. Let's go back to that because for those who are listening and are wondering what kind of medication does treat high blood pressure, she mentioned beta blockers, for example. What's in that arsenal?


DR. JYOTHI REREDDY
In your body, we have two systems like the sympathetic system, which is flight and fight and that gives you your adrenaline and epinephrine. All these high kicking hormones. Then the other one is parasympathetic, which is getting you down, calming down, getting your heart rate down and getting your blood pressure down. So, you have this constantly kind of working in your system. The beta blockers are working more towards the parasympathetic system where it's trying to get your blood pressure down and then also get your heart rate down. So, it actually helps the heart to work less. There have been a lot of studies and significant benefits to the beta blockers when used appropriately and when needed. They are actually used to prevent a heart attack if patients have that risk. So, medications used for the right reason in the right amounts can definitely decrease cardiovascular risk. But at the same time, we are also talking today about how we can effectively manage hypertension and not over medicating. So, that involves a thoughtful combination of lifestyle changes, evidence based medication use, and you have to individualize the risk assessment for your patients. All that combined together, I think we can effectively treat them with the safest doses of medications.


RON AARON
The other day, I was talking to Dr. Chris Thompson, who is a WellMed cardiologist, and he was telling me that for the longest time, cardiologists worried about the diastolic, the squeezing function of the heart, and didn't really pay much attention to the lessening, weakening systolic where the heart relaxes. And he said now the focus is on both and that there's a lot of concern about how that heart relaxes to let the blood flow back in.


DR. JYOTHI REREDDY
Right. Because if you don't have a stiff heart, then it's not going to allow the good blood from the lungs, which is oxygenated, coming to the heart, it's going to be too stiff. Then that's the one that's going to come out to supply the rest of your body. That's why the heart needs to have a strong pump to get the blood out. At the same time, it needs to relax enough to receive the good blood from the lungs so that it can supply the body.


RON AARON
When you practice mindfulness, as you were suggesting, both you in Dr. Perry, and try to relax yourself, there are those who do that who actually can feel their heart relax.


DR. JYOTHI REREDDY
Yes, absolutely. You can definitely not feel like your heart is running or you don't have palpitations. We can actually control and keep your basal heart rate in the 60s if you're exercising and practicing mindful yoga, which is the best thing you can do for your heart.


RON AARON
So, talking about pulse heart rate should be ideally in the 60s.


DR. JYOTHI REREDDY
If you're working out and exercising, that would be in the 60s. More controlled. But the acceptable heart rates could be anywhere in the 70s. So, that is also acceptable. But we consider a little bit lower the heart rate would be good because the heart is working less.


RON AARON
I know some marathon runners who say they get their heart rate down into the 50s.


DR. TAMIKA PERRY
Yeah, and they don't need a pacemaker because their heart is so efficient. It doesn't take as many beats per minute to get the blood all over their body. So,people like Troy Aikman and Michael Jordan, Shaq, these retired athletes, they have great cardiovascular systems because they've worked so hard their entire lives. Their resting heart rate may be 58/55, and they don't need pacemakers.


RON AARON
Wow.


DR. TAMIKA PERRY
Now their joints are torn up.


RON AARON
All right. I've got to stop you both right here. We're flat out of time. I got to say, Dr. Jyothi Rereddy, you're a great guest. You're at risk of being invited back, and we really appreciate it. Thank you to our co-host, Dr. Tamika Perry. I'm Ron Aaron. Thanks for joining us on the award winning Docs in a Pod.


OUTRO
Executive producer for Docs in a Pod is Dan Calderon. The producer is Cherese Pendleton. Thank you for listening to Docs in a Pod presented by WellMed. Be sure and listen next week to Docs in a Pod presented by WellMed.


DISCLAIMER
This transcript is generated using a podcast editing tool; there may be small differences between this transcript and the recorded audio content.

Docs in a Pod airs on Saturdays in the following cities:

• 7 to 7:30 a.m. CT – San Antonio (930 AM The Answer)
• 7 to 7:30 a.m. CT – DFW (660 AM, 92.9 FM [Dallas], 95.5 FM [Arlington], 99.9 FM [Fort Worth])
• 6:30 to 7 p.m. CT – Houston (1070 AM/103.3 FM The Answer)
• 7 to 7:30 p.m. CT – Austin (KLBJ 590 AM/99.7 FM)

Docs in a Pod also airs on Sundays in the following cities:

• 1:30 to 2 p.m. ET – Tampa (860 AM/93.7FM)
• 5 to 5:30 p.m. CT – San Antonio (930 AM The Answer)