Oct. 29, 2025
Heart health in older adults
In this episode, hosts Ron Aaron and Dr. Rajay Seudath welcome Dr. Peter Gulati to explore a topic that affects millions: heart health in older adults. From managing blood pressure and cholesterol to recognizing early signs of heart disease, Dr. Gulati shares insights on how aging impacts cardiovascular wellness—and what older adults can do to stay heart-healthy. Whether you're caring for a loved one or looking to improve your own health, this conversation offers practical advice and empowering strategies for living well at any age.
Docs in a Pod focuses on health issues affecting adults. Clinicians and partners discuss stories, topics and tips to help you live healthier.
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Show transcript
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. Rajay Seudath and award winning veteran broadcaster Ron Aram will share information to improve your health and well-being. Now, here are Ron Aaron and Dr. Rajay Seudath.
RON AARON
Thank you so much for joining us today on the award winning Docs in a Pod. I'm Ron Aaron. We come to you every week with a Docs in a Pod program, dealing with all kinds of health and wellness issues that affect folks of any age, but many of them seniors 65 and over. Our co-host, Dr. Rajay Seudath is with us, Dr. Seudath is a board certified family medicine physician. He's a Tampa native and is currently the lead physician for Optum. He's at the University location for Optum, and Dr. Seudath and has a passion for primary care, guiding his patients to meet their health care goals while maintaining his patientsÕ values. The other thing you ought to know about Dr. Seudath, he loves teaching, and that's one of the reasons we love having him as our co-host on Docs in a Pod. Dr. Seudath, one of the things that we want to talk about today is heart health for older adults and what you need to know. A week or so ago, we talked with you about hearing and vision and what's normal, what's not normal, and what you can expect as you age. When it comes to heart health, I'm assuming in your patient population you pay attention to their tickers.
DR. RAJAY SEUDATH
Absolutely. Every time they walk through the door, they sit down and somebody is getting their heart listened to and their lungs listened to it. Heart health is very important.
RON AARON
And you take blood pressure as well.
DR. RAJAY SEUDATH
Absolutely.
RON AARON
Let's introduce our guest today. We're delighted to have him with us as we talk about the kinds of issues that folks experience as they age. We're talking with Dr. Peter Gulati. He's board certified in family medicine. He has a passion for providing comprehensive, patient centered care. He earned his medical degree from Queen's University School of Medicine in Kingston, Canada, and completed his residency at the Jewish General Hospital in Montreal. With a strong foundation in family medicine, Dr. Gulati is dedicated to building lasting relationships with his patients. He's at the WellMed clinic in Dallas at the new Oak Cliff clinic, and he plays electric guitar when he's not playing doctor. Dr. Gulati, thanks for being with us.
DR. PETER GULATI
It's a pleasure, Ron. Thanks for having me.
RON AARON
Now, you want to emphasize when I ask you what clinic you're with. That is the new Oak Cliff, and I gather the old cliff is not a place you want to be.
DR. PETER GULATI
Well, actually it is. We've had tremendous success in this community helping patients over many, many years. I'm afraid to tell you how many years. Then you'll know our age. But the Oak Cliff clinic came to be in 1987. I joined a little bit later on and we joined WellMed several years ago, and we really enjoyed practicing Medicare Advantage and value based care. Recently, three clinics in the local area merged to create the new Oak Cliff. So, we are one of the largest, if not the largest, clinic by patient panel size in the Dallas.
RON AARON
Is that good or bad for the patients? I mean, you don't want to go into a clinic where they never have time to see you.
DR. PETER GULATI
This is a great point. I would say to you that the quality of care that we provide and the amount of time that we spend with our patients is very, very high. Patients are extremely satisfied with the care that they receive and the service that they receive in our clinics.
DR. RAJAY SEUDATH
All right. Great.
RON AARON
As we talk about heart health and heart issues, and as I tell Dr. Seudath all the time, Docs in a Pod is not about me. So, let's talk about me for just a moment. I am an example of some of your patients who end up with a couple of issues that affect their heart. One is AFib and the other is sleep apnea. Both of which I have. I'm one of the lucky ones. For those who don't know about AFib, it's something that affects the fluttering beating of your heart. I'm assuming that it's something you see among your patient's, Dr. Seudath.
DR. RAJAY SEUDATH
Oh, yes. Yes, we see it quite often. It's one of the major reasons for people to be on blood thinners.
RON AARON
Dr. Gulati, when it comes to AFib, which former president, as it turns out, had. As you think about what that's all about, can you go through how you know you have it and how it should be treated because it's so common?
DR. PETER GULATI
Excellent question, Ron. Atrial fibrillation is an irregular beating of the heart. It's an area of the atria that beats too quickly where the heartbeat originates. That is a simple way of saying this. There's a disconnect or the communication between the atria and the ventricles. The ventricles, as you may recall, are responsible for producing the blood flow, every heartbeat, to the rest of the body. Sometimes, when there's an asynchrony or desynchrony between the atrium, the ventricles or a rapid heartbeat, you get this condition called atrial fibrillation. The reason that it's important is number one, it can make you feel real funny. Patients can have all kinds of symptoms such as chest discomfort, chest pressure, dizziness is a big one, breathlessness. Rapid heartbeat is another big one. Other patients may actually feel nothing at all, as Dr. Seudath probably knows as well. The other reason that it's important is that it has been proven that this is a risk factor for stroke. So, a patient may not feel anything sometimes, but again, reminds us of the importance of seeing your doctor regularly. That's what we believe at WellMed is we believe in prevention. So, this begins with an annual health checkup and regular checkups thereafter, depending on a patient's condition.
RON AARON
Let's hold that thought. WeÕll come right back to you, but I want to let folks know who may have just joined us, you're listening to the award winning Docs in a Pod. I'm Ron Aaron, and our podcast is available wherever you get your podcasts. We're also on the radio in a number of markets in Texas and Florida as well. We're talking with our co-host, Dr. Rajay Seudath, and our guest, Dr. Peter Gulati. We're talking about heart health for older adults, and what you often need to know. We were talking about AFib. It turns out I happen to be one of those who didn't know they had a problem. I can remember like it was yesterday sitting in my doctor's office for a regular checkup, and whenever the nurse looks at you and says, I'll be right back, you know there's an issue. Out she went, in came the doctor, and it turns out my heart was beating at about 165 beats a minute, which is really pretty rapid. I couldn't feel it. I had no idea. They figured, man, you got a problem. They gave me some medication to slow my heart rate down, sent me to the E.R., and 3 or 4 days later, I had a diagnosis.
DR. PETER GULATI
That's a great story, Ron. Sounds like you're feeling great, and we're so happy about that. Other patients, unfortunately, are not as lucky. Again, it reminds us of the importance, Dr. Seudath would agree, to come in for an annual checkup. This can be discovered with a simple examination, as your nurse and doctor found an irregular heartbeat, and then an EKG, which is the standard routine office test. It is very, very inexpensive. This actually can save lives. It's so much better to prevent cardiovascular disease then treat it after the fact.
RON AARON
When it comes to something like AFib, is it an equal opportunity issue for men and women or more men than women?
DR. PETER GULATI
I might defer to Dr. Seudath on this one.
DR. RAJAY SEUDATH
That's a good one. I don't know the epidemiology between the sexes if there's a higher incidence or not in females or males. We can look into that. We can definitely get an answer on that.
RON AARON
As you look at other issues that may affect the heart, I want to come back to stroke because you listed that as a possibility, Dr. Gulati, as an aftermath of AFib, and I'm sure other problem. Talk to us about stroke.
DR. PETER GULATI
Stroke is a very, very debilitating condition, as we all know. This is actually a leading cause of mortality in the United States as well, in addition to overall cardiovascular disease, which includes heart attack. Other leading cause of death, as you may know, is cancer, chronic lung disease, diabetes, Alzheimer's in the older adults. Atrial fibrillation is one of those conditions where fortunately, we've been able to identify and have a good treatment for in many, many cases. In addition to heart rate control for symptom relief, and removing strain off the heart, we also have discovered that there is a high propensity or high chance that patients can develop a tiny little blood clot in the atrium. If that happens, there's a small chance that that blood clot can break off and travel through the ventricles into the arterial circulation. One of the first places that can stop is the brain unfortunately. If that happens, then that results in a brain attack, also known as a stroke or other syndrome like TIA, which can be very devastating.
RON AARON
TIAs are kind of mini strokes?
DR. PETER GULATI
TIAs are exactly what you said in simple terms. They're essentially neurological symptoms that resolve with within 24 to 48 hours. So, they're like a stroke, but fortunately, patients can get better from them as well.
RON AARON
Do you know you're having a TIA? I've got a friend who, in fact, was the mascot for the San Antonio Spurs, who had a series of TIAs that he really didn't pay attention to and then he had a massive stroke. His doctor told him, I wish you'd told me about the other previous symptoms that you've had because we might have been able to intervene earlier.
DR. PETER GULATI
Yeah, the TIA can feel just like a stroke. Some of the most common symptoms using the FAST acronym, as you may know from American Heart Association, is facial droop, arm weakness, speech trouble. If you're feeling any of those things, I mean, you need to probably call for help. Either dial 911, which is the T, or time, because time is so essential in an acute stroke situation. The reason is that within a few hours of these symptoms, sometimes patients can receive lifesaving treatment and reverse all symptoms of the stroke, which is quite amazing.
RON AARON
Now, we'll talk about that in just a minute. Stay with me. We'll find out about stroke busting drugs and what those are all about. I'm Ron Aaron and we're talking with our co-host, Dr. Rajay Seudath and our special guest, Dr. Peter Gulati. You'll find him at the new WellMed at Oak Cliff clinic in Dallas. 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 team 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.
RON AARON
Thank you so much for sticking with us right here on the award winning Docs in a Pod. I'm Ron Aaron and our co-host, Dr. Rajay Seudath, is with us along with Dr. Peter Gulati. Dr. Gulati can be found at WellMed at Oak Cliff in Dallas. The new Oak Cliff clinic is where he hangs out, and we're talking about issues involving the heart and ways in which those issues can be treated. We were talking about stroke. Before we jump off of the stroke, Dr. Gulati, TIA is a mini stroke, as I described it. You gave us some of the symptoms that can be used to diagnose it. Do folks know when they have it or can it be something that just occurs periodically and you don't know?
DR. PETER GULATI
You mean TIA, sir?
RON AARON
Yes.
DR. PETER GULATI
Yeah. It can occur and you may not know you're having it. It can be subtle sometimes. It can even be weakness in one body part, or numbness in an arm or a leg. There was a very interesting patient that I saw recently, actually, a 55 year-old African-American man, who wasn't taking his medications perfectly. He unfortunately did develop weakness and speech disturbance. But fortunately, he and his family were very, very in tune and did the right thing. They went to the E.R. within four hours, and he was found to have an acute stroke. It's quite amazing. In most major urban centers now with their protocols that we have here in the U.S., he was able to be saved. So, this patient underwent CT scanning, angiogram, which showed a blockage, and he was able to have a thrombectomy. Sometimes a radiologist can go right into the brain and remove that little clot. This patient, I kid you not, was feeling normal within a few days. When I saw him back in the office three weeks later, he said he felt completely normal. So, amazing technology, amazing medicine that we're practicing today. It just goes to show you the importance of taking your symptoms seriously.
RON AARON
Now, you mentioned earlier that time is often of the essence when it comes to a stroke. I mentioned that there are some so-called clot busting drugs. Do they work?
DR. RAJAY SEUDATH
Yes, they absolutely do work. I had a similar story with a patient whose wife was saying, what are you doing? What are you making that face for? Are you mad? What's going on? He was actually having a stroke, and he was having facial droop. He felt perfectly fine. As he started to walk in move around, he noticed his balance was off. They called us and I said, no, you need to get to the hospital immediately. So, he got there and he was available to have clot buster therapy. So, there is a time limit for which they can use those types of therapies. When you notice something, yes, absolutely. Thrombolytic agents that are administered are very tailored to this specific place. So, they're able to put it in right where it's at. Before we had those, we had to anticoagulant you globally. So, we would just pump it with a whole bunch of blood thinners and hope that it went to your brain and did its job. Now they're directed specifically to that one spot. So, there's a lot less side effects and complications when you're delivering thrombolytic therapy directly to the clot.
RON AARON
Dr. Gulati, you mentioned in managing AFib, atrial fibrillation, that often those folks are on a blood thinner, which I happen to be on. The downside is you bruise simply by looking at a wrist or a hand. Boom, you got a bruise.
DR. PETER GULATI
Yeah. That is one of the downsides of blood thinners. Blood thinners have gotten better. So, our prototype blood thinner for decades, as you may know, was warfarin. As Dr. Seudath probably knows, too, is that the problem with warfarin was that you had to monitor the blood tests at least every month, sometimes even more frequently for the patient. There would be a variability. Just the way it worked. Nowadays, we have direct oral anticoagulants, and they're much better tolerated and have a slightly less risk of bleeding. But yes, all the medications that we use, like any other treatment, has a risk and a benefit.
DR. RAJAY SEUDATH
Especially with the newer Doaks or the newer anticoagulants. They don't have a lot of those dietary restrictions. As we were talking about previously, green leafy vegetables are some of the best things for your health. But for people who were on warfarin, that was going to decrease the action of that medicine, it would thicken their blood instead of thinning it. So, that was one of the things they could not have. So, with these newer medicines, those types of dietary restrictions are pretty much gone. So, it's been a wonderful breakthrough.
RON AARON
Dr. Gulati, when you look at other issues that folks should pay attention to as we age, what do we need to know about the heart?
DR. PETER GULATI
The heart disease and cardiovascular disease is a broad area, as we've just discussed in the last few minutes. I think what's important to know for a patient in listening to this podcast is that the symptoms can be anything. They could be having no symptoms and have a silent problem, for example, blood pressure, which we should talk about. Or you could be having an emergency or anything in between. An emergency that could be heart emergency, as you guys know, is like a typical heart attack which can be presenting typically as chest pain, chest pressure, some radiation to the jaw or the arm. If a patient is diabetic, they'll have much more subtle symptoms sometimes. If a woman has a heart attack, sometimes they present very unusually with back pain or breast symptoms. You can have anything in between. It's important to know your numbers, which is the blood pressure, which has a direct effect on cardiovascular health. That's been proven. It's important to know your cholesterol because that can have an impact. Your sugars can also have an impact. The last area would be lifestyle and life choices.
RON AARON
What does that mean? No smoking?
DR. PETER GULATI
The American Heart Association in 2022, which is www.heart.org, came up with a new set of guidelines for the life's essential aid, which are key measures for monitoring and improving our cardiovascular health as a nation. In there, yes, smoking is definitely in there. There's no, unfortunately, safe level of smoking. Also to that end is alcohol. But eating better in general is important. A diet that's rich in fruits and vegetables is very important. Eating less refined sugars. Activity is very, very important. I actually spend a few minutes when I can on all of our annual exams with our patients to discuss the importance of prevention. One of the key areas is, hey, you've got to stay active. The recommendation is a minimum of 30 minutes a day for everyone. There are a few other recommendations as well that are on the website.
RON AARON
Do you recommend when it comes to staying active, both cardio and weightlifting as a way to improve your health and heart health?
DR. PETER GULATI
Absolutely. A simple recommendation for everybody, honestly, is do something that you like and try and do it every day. Even if it's a little step. As time goes on, and if you like what you're doing, then try and increase that to a few minutes a day and then 30 minutes a day. The other official recommendation is about 75 minutes of vigorous exercise, total per week, in addition to weight training and strength training because maintaining our muscle mass is so important as well.
RON AARON
To the patient who says, Dr. Gulati, what I love the most is sitting on the couch watching football.
DR. RAJAY SEUDATH
Then what I tell them is put a treadmill in front of your TV. You can still watch it while you walk.
DR. PETER GULATI
I love that idea.
DR. RAJAY SEUDATH
Absolutely. Get a recumbent bicycle and put it in the living room. I had one patient who actually got rid of all of his furniture in the living room, and he only has exercise machines. He was a smoker, he was diabetic, he had uncontrolled hypertension, and he was making massive life changes, and he said, from now on, if I'm watching TV, I have to be doing exercise. And he stuck to it.
RON AARON
What results did you see?
DR. RAJAY SEUDATH
A1 see decreased. This is also associated with dietary changes as well. There was improvement in his diabetes, improvement in his blood pressure coming from 150 systolic all the way down to the 110's or 120's. He was also able to lose weight. So, he looked a lot better, looked a lot cleaner, looked a lot sharper. He was a widower, so he had more girls chasing after him, so he was happy.
RON AARON
Now, Dr. Gulati, what else should we consider when it comes to heart health? You mentioned blood pressure. Should people take it every day at home, or should they just wait till they get to the doctor every six months?
DR. PETER GULATI
Some patients are very motivated these days. We have the internet. We've seen the internet develop, come to life in our own lifetimes, which is amazing. So, we have so much more information at our fingertips, and some patients are very proactive. I would recommend it. Why not take your blood pressure? That's an easy thing to do. The devices now are not very expensive. They're easily available. When you're taking your blood pressure it is important to sit, relax in a chair, have your feet on the ground, have your legs uncrossed and have your arm just relax and maybe supported with the arm at the level of the heart. It's okay to use an automated blood pressure machine, but use it over the upper arm, not the wrist. In my opinion. I feel that the wrist measurements are a little bit overestimating the true blood pressure. At least we can get a baseline and bring that information in to see your doctor when you have your checkups. If the blood pressure reading is above 120 over 80, and especially if it's above 130 over 80, I would be a little concerned.
RON AARON
Those numbers have changed over the years. It used to be 120 over 80, was it. If you were 121, you were in trouble.
DR. PETER GULATI
Yeah. The latest guidelines, the JNC guidelines have not changed in 2014, but the American College of Cardiology and the American Heart Association have updated the guidelines recently. So, stage one hypertension is considered anything above 130 for systolic number and above 80 for the diastolic number. Stage two hypertension is greater than 140 over 90. So, I would say if you're listening to this podcast and your numbers are in that range, it's definitely time to make an appointment and see your doctor.
RON AARON
Good idea. We are about out of time. Dr. Seudath, any final remarks?
DR. RAJAY SEUDATH
Take your medicine. If you have high blood pressure, take the medicine.
RON AARON
ThatÕs something that Dr. Gulati hinted at earlier that a patient wasn't as regular with that medicine as they should be. Peter, thank you so much. Really enjoyed having you on. Now get back to that guitar on the side. He loves playing an electric guitar. Dr. Rajay Seudath, thank you. Thank you all for joining us today on the award winning Docs in a Pod. I'm Ron Aaron and we'll talk with you soon.
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.
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