Amanda Wilde (Host): Welcome to the Live Greater podcast series, Information for a Healthier You from the University of Maryland Medical System. Heart disease risks are rising, but the cost of protecting your heart doesn't have to rise as well. Learn affordable habits, nutrition tips, and preventive steps that can make a real difference for families watching their spending with Dr. Abid Fakhri, cardiologist at UM Baltimore Washington Heart Associates. I'm Amanda Wilde, your host. Dr. Fakhri, welcome. Thank you so much for being here.

Dr. Abid Fakhri: Great. Thanks for having me today, Amanda.

Host: Recent national data shows many heart disease risk factors like high blood pressure, diabetes, and obesity are rising, especially among younger and lower income adults. Why are we seeing this trend?

Dr. Abid Fakhri: So, we've seen this trend emerge around 2019 pre-COVID pandemic, but it accelerated during the pandemic due to logistical challenges faced by folks accessing healthcare. But also, what we're seeing is that there's a growing realm of misinformation that is leading people away from accessing traditional healthcare and seeking alternative solutions. So, I think there's a growing inertia that began and it was accelerated during the pandemic. Now, we're trying to play catch up, trying to reverse the inertia that began during the pandemic.

Host: For families who are worried about costs, what are the most impactful heart-healthy habits that don't require an expensive gym membership or specialty foods?

Dr. Abid Fakhri: So, there's three that I emphasize to all my patients. The first one is value added. And that is if you're picking up a cigarette today, put it down. Not only bang for your buck are you going to prevent heart disease, cancer, and any number of health conditions, but it's actually the one habit you can change that will put money in your pocket.

Number two, use what you're sitting on right now. We have the most powerful muscles in the body. And if we don't use them and engage them, high blood pressure, glucose control, heart disease risk, all of that goes up. So, get up and move. The American Heart Association recommends 30 minutes a day of moderate intensity aerobic exercise, and it can be as simple as a daily walk.

Number three, make good simple food choices. You can start by moving away from processed foods and getting back to home-cooked meals. A quote that I give to my patients is, you can eat anything you want as long as you make it yourself. What we're getting at is to move away from processed foods and move back to being invested in what we put in our bodies.

Host: But healthy eating is often seen as costly. What are some realistic budget-friendly nutrition swaps that truly make a difference for heart health?

Dr. Abid Fakhri: So, we emphasize a whole food plant-based diet for heart disease prevention. My go-tos tend to be legumes. For those who aren't familiar, that's going to be your beans, your chickpeas, lentils. So, one cup of black beans will run you about a $1.50 at Aldi's. That'll get you about 50 grams of protein. So, bang for your buck. That's probably one of the best things you can get out there. Chickpeas, again, probably run you about $2.12 last I checked and get you another 49 grams of protein. So, plant-based protein is underutilized, and should be a part of everyone's diet. Second thing, lean protein, chicken, fish, eggs, egg white, very nutritious, healthy source of protein.

Host: Many people avoid medications and doctor visits because of the cost. Are there screening or preventive steps that are most important to prioritize? And also, are there low cost or community resources people should know about?

Dr. Abid Fakhri: Absolutely. Preventing heart disease does not have to be pricey. We've got a bunch of designer drugs out there, surgeries and expensive healthcare. The basics are really accessible and affordable. Starting with blood pressure management, we know that one in two US adults is walking around either with pre-hypertension or actually has blood pressure that warrants treatment.

Most blood pressure medications are available generic and at low cost. Starting at age 18, you should be having an annual physical where your blood pressure is checked. And if you can't manage to do that, you can walk into any pharmacy in the United States, get your blood pressure checked there.

The next low-hanging fruit is getting your cholesterol checked once every five years, is what the American Heart Association recommends. So, all US adults age 18 and above should get their cholesterol panel checked once every five years at a minimum.

Host: Well, you may have just answered this next question, but there was a recent study that highlights gaps between what we know works and what care people actually receive. From your perspective, what are simple actions that individuals can take to close that gap for themselves? I think you just mentioned a couple with taking control of seeking out these annual screenings, for example.

Dr. Abid Fakhri: Absolutely. So, we recommend that anybody with high blood pressure start with diet and lifestyle change. So, there should be at least three to six months of commitment to healthy living. And if you're not making progress, it's time to start talking to your doctor about starting treatment. Again, blood pressure medications are not costly, and many of them are reasonably well-tolerated.

Second, we know that 60% of US adults that benefit from adding cholesterol, reducing medication called statins are on treatment. That means 40% are not getting the necessary treatment for prevention of heart attack and stroke. This is low cost, and very well-tolerated, very well-validated treatment for heart disease prevention.

Host: Following the program that you've just pointed out, parents are going to be modeling these heart-healthy behaviors for children without adding financial strain or stress to the household. Do you have any other tips in that area?

Dr. Abid Fakhri: So, I'm a big fan of referring my patients to the American Heart Association website, wealth of resources and recipes. Sometimes it's just getting back to basics, home economics, getting those recipes, trying some new things out. So for those who are interested, www.heart.org/healthyliving, you'll find a wealth of resources there.

Host: Now, if someone is listening right now and feels discouraged by statistics, what's one encouraging takeaway you want them to remember about protecting their heart no matter what their budget?

Dr. Abid Fakhri: So, the basics work. It does not have to be fancy care. Quitting smoking, working on blood pressure, cholesterol, making simple efforts to engage in regular activity does not require any investment on your part. A lot of those things are right there in your back pocket without you going anywhere.

Host: Or even using more of your time. Very simple, very basic. Well, Doctor, thank you for showing us how heart health is actually accessible, no matter what your budget. Really appreciate your time.

Dr. Abid Fakhri: Thanks for having me. And again, for those who are interested, we can find more information on our website, www.umms org.

Host: That was Dr. Abid Fakhri, cardiologist at UM Baltimore Washington Heart Associates. Find more shows just like this one at umms.org/podcast and on YouTube. Thank you for listening to Live Greater, a health and wellness podcast, brought to you by the University of Maryland Medical System. We look forward to you joining us again, and please share this on your social media.