June 12, 2025 • 30 mins
In the U.S., someone dies from heart disease every 33 seconds. Men face a higher risk, yet many are reluctant to see a doctor for regular screenings. Manny Munoz spoke with Dr. Jane Wilcox, associate chief of cardiology at Northwestern Medicine, about why Father’s Day is the perfect time to encourage dad to take care of his heart health.
AND, Men…Father’s deal with as many mental health issues as women do, some you might be surprised to hear bout. Manny spoke with Psychologist Dr. Daniel Singley, founder of the Center for Men’s Excellence about that and the stigma surrounding men asking for help.
AND, Men…Father’s deal with as many mental health issues as women do, some you might be surprised to hear bout. Manny spoke with Psychologist Dr. Daniel Singley, founder of the Center for Men’s Excellence about that and the stigma surrounding men asking for help.
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Episode Transcript
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Speaker 1 (00:01):
Welcome to iHeartRadio Communities, a public affairs special focusing on
the biggest issues in facting you this week. Here's many Munios.
Speaker 2 (00:11):
And welcome to another edition of Iheartradios Communities. As you heard,
I am Manny Muno's. In the US, someone dies from
heart disease every thirty three seconds. Men higher at risk,
yet we are the ones that are less likely to
go visit our doctors.
Speaker 1 (00:29):
Let's talk about it.
Speaker 2 (00:30):
Get a little bit of clarity on this with doctor
Jane Wilcox. She's Associate chief of Cardiology at Northwestern Medicine
Cardiovascular Institute. Doctor Wilcox, I appreciate the time.
Speaker 3 (00:42):
Well, thanks so much, many, it's the pleasure to be
with you.
Speaker 2 (00:45):
Explain to me why men are more likely than women
to develop heart disease.
Speaker 3 (00:50):
Well, to be clear, men, both men and women are
at high risk for partiovascular disease. It is the number
one killer of both men and women here in the
US and globally. However, men reasons you mentioned earlier, maybe
the reluctance to go see the doctor. But men have
(01:12):
a bit of an earlier risk. Heart disease can present
earlier than in women, and that's due to several factors,
one of which might be the factor s right, the
stubbornness factor of kind of putting our head in the
sand and avoiding symptoms. That's not always the case, So
men don't have the benefit of estrogen that women have
(01:38):
with through their fourth and fifth decade of life. Now
men don't have the hot flashes and everything else that
goes along with menopause, but they do. They're at higher
risk for atherosclerotic cardiovascular disease, that hardening of the arteries
a little bit earlier than women.
Speaker 2 (01:54):
As someone who's been married for twenty three years, I
always thought it was the women who are were hard headed,
but obviously it is the men as well. I always say,
I always say, if you can't trust your doctor, who
can you trust?
Speaker 1 (02:06):
And and there's a reason why men, I guess, are
more at.
Speaker 2 (02:09):
Risk because they have that aversion to going and getting
yearly checkups and things like that, don't they.
Speaker 3 (02:16):
Sometimes that's the case, you know, But but like you said,
that's not always the case. Men also, I will say,
you know, tend to carry weights a little bit differently
than women. So men have this the carry weight in
their bellies and they're abdomen and that's called visceral fat.
That type of fat that surrounds the organs can be
(02:37):
particularly inflammatory and that can increase the risk for cardiovascular disease.
Speaker 2 (02:43):
Did you not play an influence in a man's likelihood
of developing heart disease or anybody's.
Speaker 1 (02:49):
A likelihood.
Speaker 3 (02:52):
One percent? So there, you know, it's important to talk, especially,
you know, Father's Day is coming up. When families get together,
it's important that families have these conversations to understand what
sort of runs in the family. You know, do we
have grandmas and grandpas and aunts and uncles who have
(03:12):
had stents, have had bypassed surgery, have had high blood pressure,
or diabetes. All of those things have a genetic component
in addition to a lifestyle component. But if those things
run in your family, it's important to talk to your
doctor about it because your risk is likely higher than
an average risk.
Speaker 2 (03:28):
And the frightening thing about it. High blood pressure is
often called the silent killer, right, because I think it's
what it's something like thirty percent of heart attacks, the
first symptom is sudden death.
Speaker 3 (03:42):
Yeah, so's it's hypertension. High blood pressure is called the
silent killer because you really can't feel high blood pressure.
And that's why knowing your numbers really I encourage patients
to know their numbers because knowledge is really power. And
so that one twenty over eighty stolic or the top
number should be one twenty, the bottom number should be eighty,
(04:04):
and anything higher than that, you really should understand why
it's higher, like why do you have high blood pressure?
And then you know, talking with your doctor about ways
to lower the blood pressure.
Speaker 2 (04:15):
Does that change what your your goal blood pressure is
as we age?
Speaker 4 (04:22):
It does?
Speaker 3 (04:23):
It does? In general, though, we are targeting this one
twenty over eighty definitely less than one thirty over eighty,
even even in older population, because we know that high
blood pressure over the life course is really what, like
you said, brings about heart attack and stroke and that's
that major risk factor. The no led pressure can also really.
Speaker 1 (04:45):
Affect kidneys kidney Yeah go ahead, yeah.
Speaker 3 (04:49):
Yeah, well was it. It can really affect the kidneys.
It's it's a reason that people end up with progressive
kidney disease and end up needing to be on dialysis
from years of untreated blood pressure. So it's definitely a
definitely important number to know.
Speaker 2 (05:05):
You mentioned know your numbers that's obviously been part of
a campaign. I would imagine because I've heard about it,
but that would require regular screenings, regular checkups, and not
everybody goes for that yearly physical every year, do they.
Speaker 3 (05:23):
No, it's something that if you're going to make a
commitment to yourself this Father's Day, it's really go to
that yearly physical.
Speaker 5 (05:29):
Right.
Speaker 3 (05:30):
We take our cars in for the oil change and
to rotate the tires, but we don't take ourselves in
to check our numbers.
Speaker 2 (05:38):
Have a few more minutes here with doctor Jane Wilcox.
That's an excellent assessment. She's Associate chief of Cardiology at
Northwestern Medicine's Cardiovascular Institute. I hope you don't mind if
I get personal for a moment before we go back
into some of the symptoms and signs and treatments and
everything else. You cared for your dad through years of
(05:58):
heart failure that I influenced your career in medicine.
Speaker 1 (06:02):
Talk to me about that.
Speaker 3 (06:05):
Yeah, thanks, Nanny. I think you know, like most dads
on Father's Day, right, My dad was sort of my
hero growing up, but then when I was in college,
he was diagnosed he was really really sick with hearts failure.
He had a cute heart failure, was actually lifted for
heart transplant for a short period of time, and then
ended up actually getting better with medical therapy, and over
(06:28):
the next ten to fifteen years he had improved quality
of life. And I finished my training and now I
direct the heart failure and transplant program here at Northwestern.
And then he eventually, you know, got worse and ended
up meeting a heart pumped something called in left and
tricular assist device, and that was placed in twenty seventeen,
(06:49):
and my team here at Northwestern took care of him
and got him five more years of life. And so
it's really he really has been a modern almost a
modern success story and definitely my motivation for becoming a cardiologist.
Speaker 1 (07:04):
That's awesome. That story brought a smile to my face.
Speaker 2 (07:08):
Obviously, lifestyle changes, diet and a lack of exercise can
all contribute to not only high blood pressure, but all
sorts of other cardiovascular issues, I imagine, right.
Speaker 3 (07:22):
That's right, that's right. We talk about like life's essential
aids and knowing our numbers, and so you know, when
we get together on Father's Day, it's talking about our
family risk. But then also you know talking about are
we exercising, are we moving most days of the week
thirty minutes and sweating? Are we reducing the sugar eat
(07:43):
intake that we're taking in reducing our risk for diabetes,
eating more fruit or eating more vegetables, leafy greens, these
sort of anti inflammatory foods, not smoking, and getting enough sleep.
All of those things sound like, you know, sometime I'm
really hard to achieve, but it really just takes sort
(08:04):
of one step towards those things, you know.
Speaker 2 (08:07):
I always like to mention Knowledge is power nm dot
org slash heart is the website you could go to
for more information nm dot org slash heart.
Speaker 1 (08:20):
What role you mentioned getting a good night's sleep?
Speaker 2 (08:22):
And I think that's probably something not enough of us
think about, not off of us make an effort to do.
Speaker 1 (08:29):
What role does stress play in heart disease?
Speaker 3 (08:34):
So stress is incredibly important in managing We do know
that high levels of stress can cause heart muscle damage
over time. There's actually this there's this relatively rare finding
of something called stress cardiomiopathy, where you have an acute
stressor and the heart muscle can get acutely worse. And
(08:55):
if you think about low levels of stress over the
course of your lifetime that actually can lead to high
blood pressure, can lead to hardening of the arteries, and
so managing stress with things like meditation or yoga or
just a good night's sleep in addition to exercise are
really really important. And so that mind body connection, all
(09:15):
of those hormones are very important to keep in mind.
And so you should be getting close at least seven
hours of sleep at night, which sometimes seems hard to do,
but that's really the goal for most adults.
Speaker 2 (09:27):
What are the signs of heart disease that you think
often get missed?
Speaker 3 (09:33):
So, you know, I think we were pretty attuned to
like oh the elephants crushing my chest or pain down
my left arm that I need to go to the
doctor for call nine to one one. But it's really
those subtle things, like I tell patients and family members,
really pay attention to what you're able to do, like
your exercise capacity. So if you are getting what we call,
(09:57):
you know, short of breath, like a little winded more
than you used to going upstairs, right, that's not always conditioning.
We always think, oh, well, maybe we're getting a little
bit older, and it's just that's normal.
Speaker 1 (10:07):
I'm just out of shape, breath.
Speaker 3 (10:10):
Yeah, that's not the case, so that needs to be
you need a diagnosis for that.
Speaker 2 (10:16):
What screenings should men prioritize them? Other than just knowing
their numbers?
Speaker 3 (10:24):
So you know, I think going into your primary care
physician or seeing a cardiologist just to get that baseline
risk assessment, because you know, may not know your entire
family history. You may not know that there are other
what we call comorbid conditions like pre diabetes or diabetes
(10:44):
or other inflammatory conditions that could increase your risk for
heart disease. So I think knowing your numbers and then
having a shared decision making conversation with your position are
things that you should prioritize.
Speaker 2 (10:56):
This Father's say, we're focused on men obviously, because I
guess you established that that we're the ones that are
that have harder heads when.
Speaker 1 (11:04):
It comes to going to get checked out.
Speaker 2 (11:06):
Are there are there different warning signs though, seriously, between
between men and women and the development of heart disease.
Speaker 3 (11:14):
So that's often you know, sort of talked about that
men and women can present, you know, they present differently.
I will say that that that can be the case,
but women can also just get regular, you know, sort
of chest pain, and I see women who are like, oh,
well I have chest pain. But I know that women
present differently, so that's probably not my heart. I'm like,
(11:35):
oh no, that's your heart, yeah.
Speaker 1 (11:37):
Right now, it's in the same spot.
Speaker 3 (11:39):
Yeah, there's the same spot. And they also can have
a typical symptoms, so a lot of times indigestion, right, So, oh,
maybe I ate something bad. I'm having belly pain, or
maybe this is my gallbladder. That actually can be a
sneaky sign or symptom of an active heart attack in women.
(12:01):
So that's something to keep in mind.
Speaker 2 (12:03):
Obviously, the first thing you would do is try to
change your diet, work, you know, exercise a little bit more,
try to lose weight, things like that.
Speaker 1 (12:13):
But it's really easy to treat.
Speaker 2 (12:16):
Things like high blood pressure with with with medicine these days,
is it not.
Speaker 3 (12:24):
It really is, And so I would say that it's
not just one thing, right when we you know, nothing
is ever that simple in life, right, Yeah. Unfortunately, it's
the combination of life, right, it's unfortunately. Yeah, So it's
a combination of lifestyle changes. You know, every five to
ten pounds of weight loss can give you maybe close
(12:44):
to five ten points of blood pressure, the weight loss
into play, as well as reducing particularly the sodium in
our diet, so shopping on the outside of the grocery
store and avoiding foods that are high in salt, and
then sometimes medication and medication can be very well tolerated.
(13:05):
You know a lot of patients tell me I'd rather
take this pill in addition to the lifestyle medications that
I've made, or lifestyle modifications that I've made in order
to prevent heart attack, stroke, going on dialysis, all of
those things. So it's often, you know, a multi pronged approach.
Speaker 1 (13:23):
Yeah, steak isn't the same without the salt.
Speaker 2 (13:25):
Right, What are some heart healthy foods that we might
want to increase in our diet while decreasing maybe the
ones that are at higher and fat are not as
good for us.
Speaker 3 (13:38):
Yeah, that's a great question. So thinking about sort of
the food the pyramid, right, our tech classical food pyramid
is really really focusing on whole grains and leafy green vegetables,
you know, avoiding sodium and then those dietary those unsaturate
the saturated fat, the athogenic fried foods, really avoiding those
(14:03):
foods and things like blueberries, fruits, and lean meat, salmon, chicken,
avoid fried foods. You know, I think it's doable. It
takes an adjustment, sure, but those can be delicious as well.
Speaker 2 (14:21):
Right, How important is early detection, uh, the impact of
the prognosis for not only controlling heart disease, but not
dying from it.
Speaker 3 (14:32):
Yeah, so I think if you know your numbers and
you can manage your risk. They're in addition to the
lifestyle changes and sometimes medication changes, we're finding that patients
are living you know, people are living so much longer
and living so much better. Right, even if you have
cardiovascular disease, you know, with the available treatments, we can
(14:56):
you know, really move the needle and have more health,
relate health, you know, sort of our quality of life.
Speaker 2 (15:01):
Father's Day is a great time to remind dads everywhere
to know their numbers. Nm dot org slash heart is
the website you could go to for more information. Nm
dot org slash heart. We've been speaking with doctor Jane Wilcox,
Associate Chief of Cardiology, Northwestern Medicine Cardiovascular Institute. Doctor Wilcox,
(15:24):
I appreciate the time, Thanks so much for the information.
Speaker 3 (15:26):
Thanks Manny, it was a pleasure to be with you.
Speaker 2 (15:29):
Moms understandably get all the attention, no debating that every
day should be Mother's Day, but as we celebrate Father's Day,
we should take a moment to consider the dads too
deal with their own set of mental health issues. As
a matter of fact, Monday, June sixteenth is International Father's
Mental Health Day. That's right, it is a real thing.
(15:49):
So why don't we discuss everything that entails in including
some unique areas of men's mental health as we bring
in doctor Daniel Singley, San Diego based Board certified psychologist.
He is the founder of the Center for Men's Excellent
and the advisory council chair of the nonprofit Postpartum Support International.
Speaker 1 (16:09):
Doctor Singley, thanks so much for sharing some time with us.
Speaker 5 (16:12):
Thanks for having me on.
Speaker 1 (16:14):
I wanted to ask.
Speaker 2 (16:15):
You about men and mental health because it still feels
like it's a little bit taboo for men and fathers
to even talk about the fact that they might have
all sorts of mental health issues and stressors, even in
this day and age.
Speaker 5 (16:30):
Yeah, so if we kind of back up, oftentimes it's
the identity piece here. The fatherhood identity tends to sit
on a platform of the guy's masculinity and these days,
you're right, it's kind of a it's a hot topic,
and it's pretty controversial in particular because there's kind of
(16:51):
the SoundBite, which is, you know, masculinity means toxic masculinity, right,
And I guess the top level point I want to
make is that, certainly, according to the research in this area,
it's not being a man or maleness or masculinity per
se that is problematic, and problematic means, you know, contributing
(17:13):
to negative health outcomes for men and fathers, including depression,
including postpartum depression. And we'll get there. The issue is
when a guy a father will only be that.
Speaker 4 (17:28):
Marlborough Man version of masculinity, so without the flexibility, just
being stoic, independent, aggressive, hardcore and so on.
Speaker 5 (17:42):
The reality is there are plenty of circumstances where that
is very helpful, that that is the kind of masculinity
that's called for. However, there are plenty of other context
and certainly fatherhood and co parenting or one of them,
where the healthiest approach will be able to also show
up with empathy, compassion, and the willingness to accept influence.
(18:06):
It's not just provide sacrifice but the healthiest men that
live the longest and have the best mental health, the
best relationships. You know, if your deaths of despair are
also able to allow other people to protect them and
to provide for them and to sacrifice for them, when
that's what's called for.
Speaker 2 (18:26):
We've come a long way since the nineteen fifties, I think,
is what you're trying to tell us.
Speaker 5 (18:30):
At a time when what it means to be a
man is in some ways I think less clear it
than what it means to be a father. Sure in
that sense, like we can always go back to well
established tropes that look like that kind of nineteen fifties
mad men routine because that prevents guys and fathers from
(18:52):
experiencing shame. Like that's really what that does. Right, When
you step out of that eyebox like that, you're running
the risk of being perceived as feminine or weak or whatever.
But I really do see early fatherhood as the tip
of a spear in sort of the evolution of what
(19:12):
it means to be a man, or sort of updating
the male operating system to include that traditional guy guy
while also adding a caring and caregiving element and normalizing
that Yeah, let me.
Speaker 2 (19:26):
Talk to you about that, because that's part of one
of the things you're here to talk about is men
experiencing postpartum depression. And I'm not sure I had ever
even heard about that. We all know about, you know,
moms going through postpartum depression after birth and everything that
mothers deal with after they've given birth.
Speaker 1 (19:47):
Talk to me about how men experience it.
Speaker 5 (19:49):
Sure, Just a really good friend of mine once said
that if you don't believe something exists, you won't look
for it, right, And the fact of the matter is
that one in ten dads gets postpartum depression. And I
don't just mean like you know, they get kind of down.
I mean they meet criteria for major depressive disorder with
perry partum onset, and even higher percent to nearly twenty
(20:11):
percent will develop an anxiety disorder. And again not just
kind of stress, but post traumatic stress, acute stress, obsessive
compulsive disorder, specific COVIA, and so on. And part of
that we don't look for it because we don't think
it's a thing, is reflected in the terminology. So generally speaking,
(20:32):
this area of mental health is called maternal mental health.
Whereas my colleagues and I are looking at this as
broadly parental mental health, and there are some aspects of
it which are maternal specific and others which are paternal specific.
But what we're trying to do is is broaden the tent.
(20:53):
And so I work with Postpartum Support International and when
our mission is we are the largest provider of able
to connect help seekers in the perinatal period conception to
about a year or so postpartum and beyond that with
(21:13):
the resources, the people, the handouts, the helpline that we
have that can help them. And that's as you say,
people don't necessarily connect that with fatherhood. But we absolutely
have lots of resources for dads on our website as
well as we have every Friday we have breakout groups
(21:37):
that are specifically just for the new dads to come
together and have some community. It's pretty hard to find.
Speaker 2 (21:43):
The website, by the way, is postpartum dot net. Postpartum
dot net. We have a few more minutes here with
Doctor Daniel Singley's the San Diego based Board certified Psychologists,
the founder of the Center for Men's Excellence and part
of the Advisory Council. He's the chair of the nonprofit
Postpartum Support International, so if I could just interject some
(22:04):
of my personal experience when we found we waited a
long time before we even tried having children, so I
was an older dad. But I remember the moment we
found out that my wife was pregnant. I ran out
and bought the book What to Expect, What You're Expecting,
went through all of that stuff for nine months, and
I remember sitting in a recovery room by myself at
(22:25):
two thirty in the morning, crying as they sewed up
my wife and cleaned up our son when he was born,
And all of a sudden, in those moments, everything about
life had changed, right, and then I was ready to
experience the joys of fatherhood. And it seems like we
can understand a woman going through postpartum depression because not
(22:49):
only of all the hormones that it entails and motherhood
and everything else and what they've been through for the
last nine months. I think it might be more difficult
to understand how a man deals with it.
Speaker 5 (23:00):
Can you explain that, Yeah, I hear this one a
lot that Hey, you know that can't be a thing.
You know, fathers don't carry the baby, they don't have
the hormonal changes. The research shows very clearly that it
is a mistake to boil perinatal depression, meaning it happen
during the pregnancy, it can happen after the pregnancy, to
(23:22):
boil down that kind of experience, that mental health issue
to just hormones. Hormones are very important, They're a very
important element of it. But other factors that are critically
important are what's the nature of the coparental relationship. Do
they have a history of mental health trauma? Do they
have to work three jobs to keep the lights on
(23:43):
and baby formula going? And the list goes on. Now,
one thing that most people don't know is that, in fact,
bothers who are hands on with their infants also it
do experience the same hormonal shifts that moms do, so
the magnitude is different, so it's not as much of
(24:03):
a change for the fathers. And several longitudinal programs of
research that follow these dads over time have been able
to clearly show that there are relationships between fathers. It's dudes.
So they always look at testosterone right early postpartum testosterone
functioning and then the subsequent development of it. But again
(24:25):
I want to repeat my point, Yes, hormones matter, but
it is a mistake to boil postpartum depression or anxiety
down to just a hormone hormone right.
Speaker 2 (24:37):
More to it, I often say that my children are
my greatest joy in life, also my greatest.
Speaker 1 (24:42):
Stressor in life.
Speaker 2 (24:44):
And it strikes me that if the father of an infant,
a newborn, is beginning to experience these, you know, postpartum
depression symptoms, they miss out on some of the especially
the initial joys of fatherhood.
Speaker 1 (25:01):
Does that lend itself to the depression worsening?
Speaker 5 (25:05):
Yes, so everything writ large. People with postpartum depression think
they're terrible. The world is terrible, the future is terrible,
and the world thinks they're terrible, including their baby. And
what a lot of the dads that that experienced postpartum
depression will say is my baby hates me, or I'm
(25:26):
not attached to my baby, I'm bad for my baby,
my baby loves my partner. And they sort of use
their infant to to cut a back up there. We'll
call it their poop covered or colored glasses, but that
oftentimes causes the fathers to back off.
Speaker 1 (25:46):
The long term effects of dealing with that are what.
Speaker 5 (25:50):
So let me let me look at this the other way.
So the long term effects of having a highly involved
and engaged father in that first year post part arm
predicts better emotional regulation on the part of the child.
More words, when they start school, higher IQ, greater social agency,
(26:11):
less involvement with the juvenile justice system. Like the list
goes on, and a lot of people just don't know that. Yeah,
in fact, fathers have something really important to contribute. All
these outcomes that we want for our children have been
shown to be linked to highly engaged fathers, even in
that first year with an infant.
Speaker 2 (26:30):
The difference between experiencing the exhaustion and the stress and
maybe even in a lot of cases, the disconnect between
the father and the mother and actually experiencing these postpartum
depression symptoms.
Speaker 1 (26:44):
Where's the line.
Speaker 5 (26:46):
Yeah, that's tough. I mean reality, what we like to
think of is psychopathology is really just an exaggerated, completely
normal and functional response. So with this experience of depression,
(27:06):
it causes a lot of these dads to sort of
pull back, and like for moms, we do the differential
diagnosis between just kind of baby blues versus major depressive disorder.
With perry partum onset, it's that four weeks postpartum for dad.
Dads tend to spike postpartum depression three to five months postpartum,
(27:32):
and so for that reason, a lot of people miss it,
and also for the reason that a lot of times
fathers will present with depressive symptoms that are a little bit
different than what we usually think of in terms of,
you know, vegetative, they can't get out of bed, they're
not going to work, they're suicidal, they're weeping in the corner,
and so forth. A lot of these dads manifest what
(27:52):
we call masked male depression, and it more looks like anger,
like anger, frustration, irritation, sometimes all the way up into
rage and increased. They talk about substances and other drugs.
In the literature of the reality is video gaming, risky sex, gambling,
(28:14):
chop lifts, and kind of whatever gets your cerebral joy
juice flowing going to an extreme with that where it
ends up causing problems. The third is isolation or being withdrawn.
And to clarify, you could be a dad that's at
work around other people all day, or in a fit
based community or in a multi generational household, so you're
(28:34):
around people a lot, but you're not connected, you're not engaging.
That's that social withdrawal piece. And then the last really
common symptom of this last male depression the dazzle show,
is what's called somaticizing, and that means taking a psychological
difficulty and turning it into a physical one. And this
(28:55):
tracks with what we know about about shame and stigma,
right guys like I can't be the pressed, but I
can have migraines, I can have muscle tension, I can
have you know, gi problems, like there's a weight on me.
And so keeping an eye on some of those samaticized
or physical symptoms is another really important piece to this.
Speaker 2 (29:15):
If that sounds like you, or it sounds like somebody
that you know, a loved one. The website is postpartum
dot net postpartum dot net. We've been speaking with doctor
Darryl Singley, Board certified Psychologists, founder of the Center for
Men's Excellence, and the chair of the Advisory Council of
the nonprofit Postpartum Support International. Doctor Single, I really appreciate
(29:38):
the time, thanks for the conversation, the information be well.
Speaker 5 (29:42):
Thanks so much. Happy Father's Debt.
Speaker 2 (29:45):
And that'll do it for another edition of iheartradios, communities.
Speaker 1 (29:49):
I'm many Muno's until next time.
Welcome to iHeartRadio Communities, a public affairs special focusing on
the biggest issues in facting you this week. Here's many Munios.
Speaker 2 (00:11):
And welcome to another edition of Iheartradios Communities. As you heard,
I am Manny Muno's. In the US, someone dies from
heart disease every thirty three seconds. Men higher at risk,
yet we are the ones that are less likely to
go visit our doctors.
Speaker 1 (00:29):
Let's talk about it.
Speaker 2 (00:30):
Get a little bit of clarity on this with doctor
Jane Wilcox. She's Associate chief of Cardiology at Northwestern Medicine
Cardiovascular Institute. Doctor Wilcox, I appreciate the time.
Speaker 3 (00:42):
Well, thanks so much, many, it's the pleasure to be
with you.
Speaker 2 (00:45):
Explain to me why men are more likely than women
to develop heart disease.
Speaker 3 (00:50):
Well, to be clear, men, both men and women are
at high risk for partiovascular disease. It is the number
one killer of both men and women here in the
US and globally. However, men reasons you mentioned earlier, maybe
the reluctance to go see the doctor. But men have
(01:12):
a bit of an earlier risk. Heart disease can present
earlier than in women, and that's due to several factors,
one of which might be the factor s right, the
stubbornness factor of kind of putting our head in the
sand and avoiding symptoms. That's not always the case, So
men don't have the benefit of estrogen that women have
(01:38):
with through their fourth and fifth decade of life. Now
men don't have the hot flashes and everything else that
goes along with menopause, but they do. They're at higher
risk for atherosclerotic cardiovascular disease, that hardening of the arteries
a little bit earlier than women.
Speaker 2 (01:54):
As someone who's been married for twenty three years, I
always thought it was the women who are were hard headed,
but obviously it is the men as well. I always say,
I always say, if you can't trust your doctor, who
can you trust?
Speaker 1 (02:06):
And and there's a reason why men, I guess, are
more at.
Speaker 2 (02:09):
Risk because they have that aversion to going and getting
yearly checkups and things like that, don't they.
Speaker 3 (02:16):
Sometimes that's the case, you know, But but like you said,
that's not always the case. Men also, I will say,
you know, tend to carry weights a little bit differently
than women. So men have this the carry weight in
their bellies and they're abdomen and that's called visceral fat.
That type of fat that surrounds the organs can be
(02:37):
particularly inflammatory and that can increase the risk for cardiovascular disease.
Speaker 2 (02:43):
Did you not play an influence in a man's likelihood
of developing heart disease or anybody's.
Speaker 1 (02:49):
A likelihood.
Speaker 3 (02:52):
One percent? So there, you know, it's important to talk, especially,
you know, Father's Day is coming up. When families get together,
it's important that families have these conversations to understand what
sort of runs in the family. You know, do we
have grandmas and grandpas and aunts and uncles who have
(03:12):
had stents, have had bypassed surgery, have had high blood pressure,
or diabetes. All of those things have a genetic component
in addition to a lifestyle component. But if those things
run in your family, it's important to talk to your
doctor about it because your risk is likely higher than
an average risk.
Speaker 2 (03:28):
And the frightening thing about it. High blood pressure is
often called the silent killer, right, because I think it's
what it's something like thirty percent of heart attacks, the
first symptom is sudden death.
Speaker 3 (03:42):
Yeah, so's it's hypertension. High blood pressure is called the
silent killer because you really can't feel high blood pressure.
And that's why knowing your numbers really I encourage patients
to know their numbers because knowledge is really power. And
so that one twenty over eighty stolic or the top
number should be one twenty, the bottom number should be eighty,
(04:04):
and anything higher than that, you really should understand why
it's higher, like why do you have high blood pressure?
And then you know, talking with your doctor about ways
to lower the blood pressure.
Speaker 2 (04:15):
Does that change what your your goal blood pressure is
as we age?
Speaker 4 (04:22):
It does?
Speaker 3 (04:23):
It does? In general, though, we are targeting this one
twenty over eighty definitely less than one thirty over eighty,
even even in older population, because we know that high
blood pressure over the life course is really what, like
you said, brings about heart attack and stroke and that's
that major risk factor. The no led pressure can also really.
Speaker 1 (04:45):
Affect kidneys kidney Yeah go ahead, yeah.
Speaker 3 (04:49):
Yeah, well was it. It can really affect the kidneys.
It's it's a reason that people end up with progressive
kidney disease and end up needing to be on dialysis
from years of untreated blood pressure. So it's definitely a
definitely important number to know.
Speaker 2 (05:05):
You mentioned know your numbers that's obviously been part of
a campaign. I would imagine because I've heard about it,
but that would require regular screenings, regular checkups, and not
everybody goes for that yearly physical every year, do they.
Speaker 3 (05:23):
No, it's something that if you're going to make a
commitment to yourself this Father's Day, it's really go to
that yearly physical.
Speaker 5 (05:29):
Right.
Speaker 3 (05:30):
We take our cars in for the oil change and
to rotate the tires, but we don't take ourselves in
to check our numbers.
Speaker 2 (05:38):
Have a few more minutes here with doctor Jane Wilcox.
That's an excellent assessment. She's Associate chief of Cardiology at
Northwestern Medicine's Cardiovascular Institute. I hope you don't mind if
I get personal for a moment before we go back
into some of the symptoms and signs and treatments and
everything else. You cared for your dad through years of
(05:58):
heart failure that I influenced your career in medicine.
Speaker 1 (06:02):
Talk to me about that.
Speaker 3 (06:05):
Yeah, thanks, Nanny. I think you know, like most dads
on Father's Day, right, My dad was sort of my
hero growing up, but then when I was in college,
he was diagnosed he was really really sick with hearts failure.
He had a cute heart failure, was actually lifted for
heart transplant for a short period of time, and then
ended up actually getting better with medical therapy, and over
(06:28):
the next ten to fifteen years he had improved quality
of life. And I finished my training and now I
direct the heart failure and transplant program here at Northwestern.
And then he eventually, you know, got worse and ended
up meeting a heart pumped something called in left and
tricular assist device, and that was placed in twenty seventeen,
(06:49):
and my team here at Northwestern took care of him
and got him five more years of life. And so
it's really he really has been a modern almost a
modern success story and definitely my motivation for becoming a cardiologist.
Speaker 1 (07:04):
That's awesome. That story brought a smile to my face.
Speaker 2 (07:08):
Obviously, lifestyle changes, diet and a lack of exercise can
all contribute to not only high blood pressure, but all
sorts of other cardiovascular issues, I imagine, right.
Speaker 3 (07:22):
That's right, that's right. We talk about like life's essential
aids and knowing our numbers, and so you know, when
we get together on Father's Day, it's talking about our
family risk. But then also you know talking about are
we exercising, are we moving most days of the week
thirty minutes and sweating? Are we reducing the sugar eat
(07:43):
intake that we're taking in reducing our risk for diabetes,
eating more fruit or eating more vegetables, leafy greens, these
sort of anti inflammatory foods, not smoking, and getting enough sleep.
All of those things sound like, you know, sometime I'm
really hard to achieve, but it really just takes sort
(08:04):
of one step towards those things, you know.
Speaker 2 (08:07):
I always like to mention Knowledge is power nm dot
org slash heart is the website you could go to
for more information nm dot org slash heart.
Speaker 1 (08:20):
What role you mentioned getting a good night's sleep?
Speaker 2 (08:22):
And I think that's probably something not enough of us
think about, not off of us make an effort to do.
Speaker 1 (08:29):
What role does stress play in heart disease?
Speaker 3 (08:34):
So stress is incredibly important in managing We do know
that high levels of stress can cause heart muscle damage
over time. There's actually this there's this relatively rare finding
of something called stress cardiomiopathy, where you have an acute
stressor and the heart muscle can get acutely worse. And
(08:55):
if you think about low levels of stress over the
course of your lifetime that actually can lead to high
blood pressure, can lead to hardening of the arteries, and
so managing stress with things like meditation or yoga or
just a good night's sleep in addition to exercise are
really really important. And so that mind body connection, all
(09:15):
of those hormones are very important to keep in mind.
And so you should be getting close at least seven
hours of sleep at night, which sometimes seems hard to do,
but that's really the goal for most adults.
Speaker 2 (09:27):
What are the signs of heart disease that you think
often get missed?
Speaker 3 (09:33):
So, you know, I think we were pretty attuned to
like oh the elephants crushing my chest or pain down
my left arm that I need to go to the
doctor for call nine to one one. But it's really
those subtle things, like I tell patients and family members,
really pay attention to what you're able to do, like
your exercise capacity. So if you are getting what we call,
(09:57):
you know, short of breath, like a little winded more
than you used to going upstairs, right, that's not always conditioning.
We always think, oh, well, maybe we're getting a little
bit older, and it's just that's normal.
Speaker 1 (10:07):
I'm just out of shape, breath.
Speaker 3 (10:10):
Yeah, that's not the case, so that needs to be
you need a diagnosis for that.
Speaker 2 (10:16):
What screenings should men prioritize them? Other than just knowing
their numbers?
Speaker 3 (10:24):
So you know, I think going into your primary care
physician or seeing a cardiologist just to get that baseline
risk assessment, because you know, may not know your entire
family history. You may not know that there are other
what we call comorbid conditions like pre diabetes or diabetes
(10:44):
or other inflammatory conditions that could increase your risk for
heart disease. So I think knowing your numbers and then
having a shared decision making conversation with your position are
things that you should prioritize.
Speaker 2 (10:56):
This Father's say, we're focused on men obviously, because I
guess you established that that we're the ones that are
that have harder heads when.
Speaker 1 (11:04):
It comes to going to get checked out.
Speaker 2 (11:06):
Are there are there different warning signs though, seriously, between
between men and women and the development of heart disease.
Speaker 3 (11:14):
So that's often you know, sort of talked about that
men and women can present, you know, they present differently.
I will say that that that can be the case,
but women can also just get regular, you know, sort
of chest pain, and I see women who are like, oh,
well I have chest pain. But I know that women
present differently, so that's probably not my heart. I'm like,
(11:35):
oh no, that's your heart, yeah.
Speaker 1 (11:37):
Right now, it's in the same spot.
Speaker 3 (11:39):
Yeah, there's the same spot. And they also can have
a typical symptoms, so a lot of times indigestion, right, So, oh,
maybe I ate something bad. I'm having belly pain, or
maybe this is my gallbladder. That actually can be a
sneaky sign or symptom of an active heart attack in women.
(12:01):
So that's something to keep in mind.
Speaker 2 (12:03):
Obviously, the first thing you would do is try to
change your diet, work, you know, exercise a little bit more,
try to lose weight, things like that.
Speaker 1 (12:13):
But it's really easy to treat.
Speaker 2 (12:16):
Things like high blood pressure with with with medicine these days,
is it not.
Speaker 3 (12:24):
It really is, And so I would say that it's
not just one thing, right when we you know, nothing
is ever that simple in life, right, Yeah. Unfortunately, it's
the combination of life, right, it's unfortunately. Yeah, So it's
a combination of lifestyle changes. You know, every five to
ten pounds of weight loss can give you maybe close
(12:44):
to five ten points of blood pressure, the weight loss
into play, as well as reducing particularly the sodium in
our diet, so shopping on the outside of the grocery
store and avoiding foods that are high in salt, and
then sometimes medication and medication can be very well tolerated.
(13:05):
You know a lot of patients tell me I'd rather
take this pill in addition to the lifestyle medications that
I've made, or lifestyle modifications that I've made in order
to prevent heart attack, stroke, going on dialysis, all of
those things. So it's often, you know, a multi pronged approach.
Speaker 1 (13:23):
Yeah, steak isn't the same without the salt.
Speaker 2 (13:25):
Right, What are some heart healthy foods that we might
want to increase in our diet while decreasing maybe the
ones that are at higher and fat are not as
good for us.
Speaker 3 (13:38):
Yeah, that's a great question. So thinking about sort of
the food the pyramid, right, our tech classical food pyramid
is really really focusing on whole grains and leafy green vegetables,
you know, avoiding sodium and then those dietary those unsaturate
the saturated fat, the athogenic fried foods, really avoiding those
(14:03):
foods and things like blueberries, fruits, and lean meat, salmon, chicken,
avoid fried foods. You know, I think it's doable. It
takes an adjustment, sure, but those can be delicious as well.
Speaker 2 (14:21):
Right, How important is early detection, uh, the impact of
the prognosis for not only controlling heart disease, but not
dying from it.
Speaker 3 (14:32):
Yeah, so I think if you know your numbers and
you can manage your risk. They're in addition to the
lifestyle changes and sometimes medication changes, we're finding that patients
are living you know, people are living so much longer
and living so much better. Right, even if you have
cardiovascular disease, you know, with the available treatments, we can
(14:56):
you know, really move the needle and have more health,
relate health, you know, sort of our quality of life.
Speaker 2 (15:01):
Father's Day is a great time to remind dads everywhere
to know their numbers. Nm dot org slash heart is
the website you could go to for more information. Nm
dot org slash heart. We've been speaking with doctor Jane Wilcox,
Associate Chief of Cardiology, Northwestern Medicine Cardiovascular Institute. Doctor Wilcox,
(15:24):
I appreciate the time, Thanks so much for the information.
Speaker 3 (15:26):
Thanks Manny, it was a pleasure to be with you.
Speaker 2 (15:29):
Moms understandably get all the attention, no debating that every
day should be Mother's Day, but as we celebrate Father's Day,
we should take a moment to consider the dads too
deal with their own set of mental health issues. As
a matter of fact, Monday, June sixteenth is International Father's
Mental Health Day. That's right, it is a real thing.
(15:49):
So why don't we discuss everything that entails in including
some unique areas of men's mental health as we bring
in doctor Daniel Singley, San Diego based Board certified psychologist.
He is the founder of the Center for Men's Excellent
and the advisory council chair of the nonprofit Postpartum Support International.
Speaker 1 (16:09):
Doctor Singley, thanks so much for sharing some time with us.
Speaker 5 (16:12):
Thanks for having me on.
Speaker 1 (16:14):
I wanted to ask.
Speaker 2 (16:15):
You about men and mental health because it still feels
like it's a little bit taboo for men and fathers
to even talk about the fact that they might have
all sorts of mental health issues and stressors, even in
this day and age.
Speaker 5 (16:30):
Yeah, so if we kind of back up, oftentimes it's
the identity piece here. The fatherhood identity tends to sit
on a platform of the guy's masculinity and these days,
you're right, it's kind of a it's a hot topic,
and it's pretty controversial in particular because there's kind of
(16:51):
the SoundBite, which is, you know, masculinity means toxic masculinity, right,
And I guess the top level point I want to
make is that, certainly, according to the research in this area,
it's not being a man or maleness or masculinity per
se that is problematic, and problematic means, you know, contributing
(17:13):
to negative health outcomes for men and fathers, including depression,
including postpartum depression. And we'll get there. The issue is
when a guy a father will only be that.
Speaker 4 (17:28):
Marlborough Man version of masculinity, so without the flexibility, just
being stoic, independent, aggressive, hardcore and so on.
Speaker 5 (17:42):
The reality is there are plenty of circumstances where that
is very helpful, that that is the kind of masculinity
that's called for. However, there are plenty of other context
and certainly fatherhood and co parenting or one of them,
where the healthiest approach will be able to also show
up with empathy, compassion, and the willingness to accept influence.
(18:06):
It's not just provide sacrifice but the healthiest men that
live the longest and have the best mental health, the
best relationships. You know, if your deaths of despair are
also able to allow other people to protect them and
to provide for them and to sacrifice for them, when
that's what's called for.
Speaker 2 (18:26):
We've come a long way since the nineteen fifties, I think,
is what you're trying to tell us.
Speaker 5 (18:30):
At a time when what it means to be a
man is in some ways I think less clear it
than what it means to be a father. Sure in
that sense, like we can always go back to well
established tropes that look like that kind of nineteen fifties
mad men routine because that prevents guys and fathers from
(18:52):
experiencing shame. Like that's really what that does. Right, When
you step out of that eyebox like that, you're running
the risk of being perceived as feminine or weak or whatever.
But I really do see early fatherhood as the tip
of a spear in sort of the evolution of what
(19:12):
it means to be a man, or sort of updating
the male operating system to include that traditional guy guy
while also adding a caring and caregiving element and normalizing
that Yeah, let me.
Speaker 2 (19:26):
Talk to you about that, because that's part of one
of the things you're here to talk about is men
experiencing postpartum depression. And I'm not sure I had ever
even heard about that. We all know about, you know,
moms going through postpartum depression after birth and everything that
mothers deal with after they've given birth.
Speaker 1 (19:47):
Talk to me about how men experience it.
Speaker 5 (19:49):
Sure, Just a really good friend of mine once said
that if you don't believe something exists, you won't look
for it, right, And the fact of the matter is
that one in ten dads gets postpartum depression. And I
don't just mean like you know, they get kind of down.
I mean they meet criteria for major depressive disorder with
perry partum onset, and even higher percent to nearly twenty
(20:11):
percent will develop an anxiety disorder. And again not just
kind of stress, but post traumatic stress, acute stress, obsessive
compulsive disorder, specific COVIA, and so on. And part of
that we don't look for it because we don't think
it's a thing, is reflected in the terminology. So generally speaking,
(20:32):
this area of mental health is called maternal mental health.
Whereas my colleagues and I are looking at this as
broadly parental mental health, and there are some aspects of
it which are maternal specific and others which are paternal specific.
But what we're trying to do is is broaden the tent.
(20:53):
And so I work with Postpartum Support International and when
our mission is we are the largest provider of able
to connect help seekers in the perinatal period conception to
about a year or so postpartum and beyond that with
(21:13):
the resources, the people, the handouts, the helpline that we
have that can help them. And that's as you say,
people don't necessarily connect that with fatherhood. But we absolutely
have lots of resources for dads on our website as
well as we have every Friday we have breakout groups
(21:37):
that are specifically just for the new dads to come
together and have some community. It's pretty hard to find.
Speaker 2 (21:43):
The website, by the way, is postpartum dot net. Postpartum
dot net. We have a few more minutes here with
Doctor Daniel Singley's the San Diego based Board certified Psychologists,
the founder of the Center for Men's Excellence and part
of the Advisory Council. He's the chair of the nonprofit
Postpartum Support International, so if I could just interject some
(22:04):
of my personal experience when we found we waited a
long time before we even tried having children, so I
was an older dad. But I remember the moment we
found out that my wife was pregnant. I ran out
and bought the book What to Expect, What You're Expecting,
went through all of that stuff for nine months, and
I remember sitting in a recovery room by myself at
(22:25):
two thirty in the morning, crying as they sewed up
my wife and cleaned up our son when he was born,
And all of a sudden, in those moments, everything about
life had changed, right, and then I was ready to
experience the joys of fatherhood. And it seems like we
can understand a woman going through postpartum depression because not
(22:49):
only of all the hormones that it entails and motherhood
and everything else and what they've been through for the
last nine months. I think it might be more difficult
to understand how a man deals with it.
Speaker 5 (23:00):
Can you explain that, Yeah, I hear this one a
lot that Hey, you know that can't be a thing.
You know, fathers don't carry the baby, they don't have
the hormonal changes. The research shows very clearly that it
is a mistake to boil perinatal depression, meaning it happen
during the pregnancy, it can happen after the pregnancy, to
(23:22):
boil down that kind of experience, that mental health issue
to just hormones. Hormones are very important, They're a very
important element of it. But other factors that are critically
important are what's the nature of the coparental relationship. Do
they have a history of mental health trauma? Do they
have to work three jobs to keep the lights on
(23:43):
and baby formula going? And the list goes on. Now,
one thing that most people don't know is that, in fact,
bothers who are hands on with their infants also it
do experience the same hormonal shifts that moms do, so
the magnitude is different, so it's not as much of
(24:03):
a change for the fathers. And several longitudinal programs of
research that follow these dads over time have been able
to clearly show that there are relationships between fathers. It's dudes.
So they always look at testosterone right early postpartum testosterone
functioning and then the subsequent development of it. But again
(24:25):
I want to repeat my point, Yes, hormones matter, but
it is a mistake to boil postpartum depression or anxiety
down to just a hormone hormone right.
Speaker 2 (24:37):
More to it, I often say that my children are
my greatest joy in life, also my greatest.
Speaker 1 (24:42):
Stressor in life.
Speaker 2 (24:44):
And it strikes me that if the father of an infant,
a newborn, is beginning to experience these, you know, postpartum
depression symptoms, they miss out on some of the especially
the initial joys of fatherhood.
Speaker 1 (25:01):
Does that lend itself to the depression worsening?
Speaker 5 (25:05):
Yes, so everything writ large. People with postpartum depression think
they're terrible. The world is terrible, the future is terrible,
and the world thinks they're terrible, including their baby. And
what a lot of the dads that that experienced postpartum
depression will say is my baby hates me, or I'm
(25:26):
not attached to my baby, I'm bad for my baby,
my baby loves my partner. And they sort of use
their infant to to cut a back up there. We'll
call it their poop covered or colored glasses, but that
oftentimes causes the fathers to back off.
Speaker 1 (25:46):
The long term effects of dealing with that are what.
Speaker 5 (25:50):
So let me let me look at this the other way.
So the long term effects of having a highly involved
and engaged father in that first year post part arm
predicts better emotional regulation on the part of the child.
More words, when they start school, higher IQ, greater social agency,
(26:11):
less involvement with the juvenile justice system. Like the list
goes on, and a lot of people just don't know that. Yeah,
in fact, fathers have something really important to contribute. All
these outcomes that we want for our children have been
shown to be linked to highly engaged fathers, even in
that first year with an infant.
Speaker 2 (26:30):
The difference between experiencing the exhaustion and the stress and
maybe even in a lot of cases, the disconnect between
the father and the mother and actually experiencing these postpartum
depression symptoms.
Speaker 1 (26:44):
Where's the line.
Speaker 5 (26:46):
Yeah, that's tough. I mean reality, what we like to
think of is psychopathology is really just an exaggerated, completely
normal and functional response. So with this experience of depression,
(27:06):
it causes a lot of these dads to sort of
pull back, and like for moms, we do the differential
diagnosis between just kind of baby blues versus major depressive disorder.
With perry partum onset, it's that four weeks postpartum for dad.
Dads tend to spike postpartum depression three to five months postpartum,
(27:32):
and so for that reason, a lot of people miss it,
and also for the reason that a lot of times
fathers will present with depressive symptoms that are a little bit
different than what we usually think of in terms of,
you know, vegetative, they can't get out of bed, they're
not going to work, they're suicidal, they're weeping in the corner,
and so forth. A lot of these dads manifest what
(27:52):
we call masked male depression, and it more looks like anger,
like anger, frustration, irritation, sometimes all the way up into
rage and increased. They talk about substances and other drugs.
In the literature of the reality is video gaming, risky sex, gambling,
(28:14):
chop lifts, and kind of whatever gets your cerebral joy
juice flowing going to an extreme with that where it
ends up causing problems. The third is isolation or being withdrawn.
And to clarify, you could be a dad that's at
work around other people all day, or in a fit
based community or in a multi generational household, so you're
(28:34):
around people a lot, but you're not connected, you're not engaging.
That's that social withdrawal piece. And then the last really
common symptom of this last male depression the dazzle show,
is what's called somaticizing, and that means taking a psychological
difficulty and turning it into a physical one. And this
(28:55):
tracks with what we know about about shame and stigma,
right guys like I can't be the pressed, but I
can have migraines, I can have muscle tension, I can
have you know, gi problems, like there's a weight on me.
And so keeping an eye on some of those samaticized
or physical symptoms is another really important piece to this.
Speaker 2 (29:15):
If that sounds like you, or it sounds like somebody
that you know, a loved one. The website is postpartum
dot net postpartum dot net. We've been speaking with doctor
Darryl Singley, Board certified Psychologists, founder of the Center for
Men's Excellence, and the chair of the Advisory Council of
the nonprofit Postpartum Support International. Doctor Single, I really appreciate
(29:38):
the time, thanks for the conversation, the information be well.
Speaker 5 (29:42):
Thanks so much. Happy Father's Debt.
Speaker 2 (29:45):
And that'll do it for another edition of iheartradios, communities.
Speaker 1 (29:49):
I'm many Muno's until next time.
Host
Manny Munoz
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