Heart Disease Kills More Women than All the Forms of Cancer Combined

BUY THE BOOK! The Healing Power of Resistance by Dr. Tara Narula https://amzn.to/4h1TDu1 Heart disease is the number one killer of women in America. One of the country’s leading cardiologists is ABC News chief medical correspondent Dr. Tara Narula who, earlier this year, released her New York Times bestselling book The Healing Power of Resilience: A New Prescription for Health and Well-Being. Oprah and Dr. Narula discuss the hidden warning signs of heart disease and how you can take better care of your cardiovascular health. Dr. Narula also explains how your connection to faith, purpose and hope can help you live a more meaningful life and beat the odds of heart disease. We also hear from a young woman in her thirties currently living with heart failure, another woman who used GLP-1s with great results towards her cardiovascular health and a patient who says Dr. Narula saved her life. 00:00:00 Welcome Dr. Narula, author of “The Healing Power of Resilience" 00:05:20 - Stats of women’s heart health 00:11:20 - Cardiovascular disease is happening to women younger and younger 00:16:30 - Stress, women and heart health 00:24:10 - 60% of Black women live with cardiovascular disease 00:25:50 - social determinants of health 00:29:15 - Heart benefits of GLP-1s 00:32:20 - Menopause and heart health 00:37:00 - High blood pressure and heart health 00:39:20 - Faith, purpose and your health 00:42:40 - Life’s essential 8 checklist Follow Oprah Winfrey on Social: https://www.instagram.com/oprahpodcast/ https://www.facebook.com/oprahwinfrey/ Listen to the full podcast: https://open.spotify.com/show/0tEVrfNp92a7lbjDe6GMLI https://podcasts.apple.com/us/podcast/the-oprah-podcast/id1782960381

Speaker names marked ? are inferred from speaking time and the show’s known hosts — they are not voice-verified.

• 0:00Oprah Winfrey?

  This episode of the Oprah Podcast is presented by our partner, Geico. We're starting to see headlines that cardiovascular disease is impacting younger and younger women.

• 0:12Speaker 01

  I had just turned 30 and I taught a fitness class that morning and I was experiencing a STEMI heart attack.

• 0:19Oprah Winfrey?

  Wow.

• 0:19Speaker 01

  Three stents were placed in my heart. I then went into cardiac arrest and I needed multiple rounds of CPR and shocks. They told my husband I needed to be lifelighted to a different hospital.

• 0:31Oprah Winfrey?

  Well, nearly 60% of Black women just 20 years old and older are living with some form of cardiovascular disease. That stat knocked me out. That is a wake-up call.

• 0:48Oprah Winfrey?

  Hi, everybody. So great to be here with you on the Oprah Podcast. Think about this. During the time that you listen to this podcast, roughly 35 women in the United States will have a heart attack. 35. We hear this stat all the time, that heart disease is the number one killer of women in America, killing more women than all the forms of cancer combined. And yet, it seems like it gets nowhere near the urgency and focus of breast cancer, or menopause, or infertility as it relates to women's health. And now, we're hearing that it's impacting younger women in higher numbers. So I asked one of America's leading cardiologists

• 1:33Oprah Winfrey?

  to come on the podcast so that you can have all the latest and essential information to protect your one and only heart. And if you're a woman listening, please pay strict attention. Dr. Tara Narula is a board-certified cardiologist, journalist, chief medical correspondent at ABC News, New York Times bestselling author of "The Healing Power of Resilience: A New Prescription for Health and Well-Being." Glad to have you here on the porch.

• 2:02Speaker 02

  Thank you so much.

• 2:03Oprah Winfrey?

  Oh, I love this idea of the healing power of resilience. And I want to hear how we can actually tap into that. I want to know how you define resilience.

• 2:16Speaker 02

  It's a great question. And when I was researching the book Oprah, a lot of the psychologists have different definitions of what resilience is.

• 2:24Oprah Winfrey?

  Yes.

• 2:24Speaker 02

  And so for me, it was important to come up with my own, based on my experience as a physician, as a human, as a journalist. And so I love the concept of resilience being the idea that you never, ever go backwards, back to who you were.

• 2:37Oprah Winfrey?

  So I loved this. I loved this.

• 2:39Speaker 02

  And I like to frame it in the idea that you bounce forward to something new. I use the analogy in the book of Michelangelo, who says that he carved the marble until he set the angel free. And so this concept that we are the marble and we are the angel, we're constantly evolving and being shaped by what happens to us in life, but that what happens to us cannot pause us and freeze us in time and paralyze us. We can actually grow and move forward and create a beautiful life, a life where we can thrive and grow and suck all the meaning and joy out of every single day. And that is my hope for my patients, for people who read the book, is to say, no matter what life throws our way, no matter what challenges, we can bounce forward. We have that skill.

• 3:24Oprah Winfrey?

  And I think, I love your definition, because so many people want to go back to the way things were, whether it's in regards to your health, or whether it's in regards to relationship. I say to my friends who are going through divorce, you will create a new normal.

• 3:40Speaker 02

  That's right.

• 3:40Oprah Winfrey?

  And you will come through it and you will not be the same person you were. You're going to be a stronger person than you were. And that's part of what resilience is, whether it's relationships, or whether it's your personal health.

• 3:52Speaker 02

  That's exactly right. And the book is really meant for anyone going through any challenge, because at some point in time, we will all go through something, whether, as you said, it is a divorce, a loss, a death.

• 4:02Oprah Winfrey?

  Yeah, a disappointment.

• 4:04Speaker 02

  A disappointment, or a health challenge.

• 4:06Oprah Winfrey?

  Yes.

• 4:06Speaker 02

  And you know, I see this in my patients when I walk in the room and they have had a stroke and they can't move the right side of their arm, or they've had a heart attack and they have heart failure. And they look at me and they wonder, when am I going to be myself again? This is what they ask me. And I tell them, you will never, ever be yourself again. But you can be-

• 4:25Oprah Winfrey?

  You won't be that self.

• 4:26Speaker 02

  We won't be that self.

• 4:27Oprah Winfrey?

  You will be another self, another version of yourself.

• 4:30Speaker 02

  That can still have quality of life and meaning. That's what people want, Oprah. They want to still be able to enjoy every day, to see the sunset, to call their best friend, to really, as I said, take all the pure enjoyment out of every single day they can have.

• 4:46Oprah Winfrey?

  So I want to just jump into some of the basics about women's heart health for you all. And I know you've heard it, but I want you to actually take it in, not just listen to what we're saying, but to absorb. You know, I didn't realize that heart disease is really an umbrella term until reading your book, that many things fall under this. So what falls under this?

• 5:10Speaker 02

  So cardiovascular disease is a broad term, and it encompasses things like heart attack, electrical problems like atrial fibrillation. It encompasses heart failure, valve disease, stroke. So it's all of these things under this big umbrella term. And as you said in the opening, it is the leading cause of death for women in this country. One out of every three women, Oprah, are dying from cardiovascular disease. These are our sisters, our friends, our mothers, our colleagues. And I think it just has not become personal enough for people. I think that there is a lack of awareness. And what I would hope that every listener would do right now is to close their eyes and picture the faces of the women that they

• 5:54Speaker 02

  love. Because these are women that we're going to lose, that are not going to have the birthdays with us, that are not going to go to the graduations. We're not going to be able to be at their weddings. So all of those moments in life with the women that we love, they can be gone in a heartbeat.

• 6:08Oprah Winfrey?

  I think, and also because so many people misread what it means to have a heart attack or have heart disease, because everybody thinks unless you have the burning sensation in your arm, or unless all of a sudden you can't breathe, that it's not a heart attack. But the symptoms show up in so many other different ways. Can we talk about that?

• 6:28Speaker 02

  Absolutely. So by far and away, the most common symptom in women of a heart attack will be chest pain or pressure. Okay, so first of all, that's important to know. But it doesn't have to be the type of very sharp, strong chest pain that makes you fall out of your chair. It can be a sensation like my bra is just on too tight. I feel something heavy, or pressure, or tightness, or squeezing here. It can also look like jaw pain, or neck pain, or shoulder pain.

• 6:53Oprah Winfrey?

  Or stomach pain, you said.

• 6:55Speaker 02

  Or stomach pain. And then, when we think outside of the chest pain,

• 6:59Oprah Winfrey?

  Yes.

• 6:59Speaker 02

  There are other symptoms that women can have, like shortness of breath, right? I'm a little bit winded when I go up the stairs, or up a hill, or when I'm walking fast. It can be fatigue, which is another one.

• 7:10Oprah Winfrey?

  I start to feel fatigued, and people just ignore it. They just ignore it.

• 7:14Speaker 02

  Yes. I can't exercise as much as I used to. I'm nauseous. I'm breaking out into a cold sweat. I'm dizzy. I'm feeling my heart skipping, or fluttering, or racing. Any or all of these symptoms, I always tell women, it's really important to pay attention to, because you may be told that it's acid reflux. You may be told it's all in your head, or it's anxiety. And I always say, it's so important to rule out the heart first.

• 7:38Oprah Winfrey?

  I hear a lot of women are told by their doctors that their symptoms are anxiety.

• 7:40Speaker 02

  So many women, and it's missed. And the problem is, when those heart cells die, or those brain cells die, you can't get them back. But if you can catch cardiovascular disease or heart disease early with preventive measures, we can prevent the actual events.

• 7:55Oprah Winfrey?

  So what should a woman do when she feels like something's off, but I've told this doctor, and I've told this person, I've said this, but I still feel like I'm being dismissed?

• 8:06Speaker 02

  You have to listen to your body, and listen to yourself. And you need to find a doctor that listens to you. And if that means getting a second opinion, or a third opinion, that's what you have to do. I see a lot of women who come to me and say, I was blown off by the last doctor I saw. I was told that it was all in my head. You have to advocate, and push, and fight for your health. And you have to trust your body.

• 8:28Oprah Winfrey?

  Our listeners tell us that the podcast is resonating with you, and is serving as a bright spot in your day. That means a lot to me. So here's the thing. I would really appreciate it if you like and subscribe to the Oprah Podcast on YouTube, or wherever you podcast. It's just a quick tap of the subscribe button, and that way, you won't miss an episode in your queue. You don't have to pay anything. I know subscribe usually means you're paying something, but this time, it means you just are notified when there's something new. There are many more to come that we're excited about. So thank you for watching and listening. Those of you who watch the Oprah Podcast or listen to us, you know, every story we

• 9:10Oprah Winfrey?

  share, every guest we welcome is chosen with purpose. And when people share their stories, we're reminded that we're not alone in this journey called life. As the official insurance partner of the podcast, the folks at Geico understand that the way we move through life, and who we move through it with, matters. And I know that life starts to move even faster as a new school year begins. Fall routines get underway, the calendar fills up. Whether you're waiting in the school pickup line, loading up the car for a weekend getaway, taking a quiet drive home after a hard day, or cheering on your son or daughter from the sidelines, these moments remind us, the road is not always a straight line.

• 9:50Oprah Winfrey?

  Geico is there, with insurance design to help keep you covered along the way. Because life happens, and with the right support, we all just keep driving forward. And that, dear listener, is everything.

• 10:06Oprah Winfrey?

  This is another step that really was really enlightening for me. Women who've given birth, you say, pregnancy acts as a crucial stress test or window into a woman's future cardiovascular health. How so?

• 10:22Speaker 02

  So I think it's first of all important for women to understand that we have risk factors, Oprah, at every point in our life, starting as early as 11 or 12 years old. If you had early periods or irregular periods, you are at increased risk of cardiovascular disease. That's it as an 11 or 12 year old. Then we think about what happens to women in their 20s and 30s. There are female specific risk factors.

• 10:44Oprah Winfrey?

  So you're at risk for cardiovascular disease?

• 10:46Speaker 02

  If you had early periods, which of course, most women don't know. When you think about your 20s and 30s, you may have heard about high blood pressure and diabetes. But let's talk about female specific risk factors there. And those would include polycystic ovarian syndrome, inflammatory bowel disease like Crohn's or ulcerative colitis, migraine, autoimmune conditions like lupus, rheumatoid arthritis, and even psoriasis, a skin condition. And then pregnancy. So what happens during pregnancy is a marker of future risk. So if you have had preeclampsia, eclampsia, gestational diabetes, a baby that was born early, miscarriages, a baby that was small for gestational age, these are markers of future risk of cardiovascular disease.

• 11:30Speaker 02

  And unfortunately, most women don't get told this while they're pregnant and they don't get connected to a cardiologist after to make sure that they know how to manage that risk. We think about in a woman's 30s, 40s, 50s, breast cancer, for example, and the treatments they might receive, like radiation or chemotherapy that can damage the heart.

• 11:48Oprah Winfrey?

  Are you more prone to cardiovascular risk after a pregnancy?

• 11:53Speaker 02

  So if you have had one of those things that I mentioned, yes, you are at increased risk of cardiovascular disease. And then we think about early menopause and menopause. So this whole arc of a woman's life matters in terms of figuring out her cardiovascular risk.

• 12:09Oprah Winfrey?

  So like I said before, we're starting to see headlines that cardiovascular disease is impacting younger and younger women. Kayla is joining us on Zoom right now. She was just 29 when she started feeling that something was wrong. Hi, Kayla. Welcome.

• 12:25Speaker 01

  Hi. Thank you for having me.

• 12:27Oprah Winfrey?

  Yes. What happened at 29?

• 12:30Speaker 01

  Yes. In 2022, I was a 29 year old special education teacher. I lived a very busy life. I was also working at a tech startup on the side. Wellness was very important to me. So I was also a fitness instructor on top of that. So like many women, juggling a lot of competing priorities, that would be very stressful. In May, I started to experience pain between my shoulder blades. It was on and off at first, and then it eventually radiated to my chest.

• 12:56Oprah Winfrey?

  Where, where exactly could you point? Let's see, between your shoulder blades?

• 13:01Speaker 01

  Yep, in between my shoulder blades. So turning around, right back here. And then eventually it did radiate to my chest, but to the point where it was very dull. Like it wasn't, ah, I'm having a heart attack feeling. So when I had gone to the doctor, because I am otherwise healthy and no traditional risk factors, I was told that it was likely attributed to my anxiety that I'd already had and acid reflux, which I had never experienced before, even though I did know something was wrong. In August, the symptoms were much worse. I was exhausted constantly, feeling very weak.

• 13:44Speaker 01

  And August 22nd, I had gone to the emergency room because by that point, I also experienced jaw pain.

• 13:50Oprah Winfrey?

  Wow. All the things that you described in the book.

• 13:52Speaker 02

  Things we talked about.

• 13:53Oprah Winfrey?

  Yeah.

• 13:55Speaker 01

  At that point, I had just turned 30 and I taught a fitness class that morning. So I did not fit the picture of someone having a heart attack. So I was not immediately taken back. By the time I was taken back, I had already had 100% blocked heart. The entire left side of my heart was shut down and I was experiencing a STEMI heart attack.

• 14:15Oprah Winfrey?

  Wow.

• 14:16Speaker 01

  I was immediately rushed to the cath lab. Three stents were placed in my heart. I then went into cardiac arrest and I needed multiple rounds of CPR and SHOCs. At that point, they told my husband I needed to be lifelighted to a different hospital that has ECMO, which is the highest form of life support. It essentially acts as your heart and lungs when your body needs to rest. So at that point, I truly believe there is a...

• 14:44Oprah Winfrey?

  First of all, we're lucky to have you here. God bless that you're here. That you're here. Wow.

• 14:49Speaker 01

  Yes. There's definitely a mind-body component, I think, that came into play at that point because ECMO gets a pretty bad rap. People don't come off ECMO. It's usually a last ditch effort. And my ability to come off ECMO, I do believe it's when my mind-body connection kind of came into play. I did spend a month in the ICU, though. The cause of my heart attack was SCAD, which stands for spontaneous coronary artery dissection. Essentially, it's a spontaneous tear in your artery wall. If it's caught early, it's often managed by medications and then it can heal on its own. In my case, it was not caught early enough.

• 15:30Oprah Winfrey?

  So I thank you for being so open and candid in sharing with us because somebody is listening to us right now, I guarantee, who has been feeling the same thing, experiencing the same thing, and they're like, oh, my God, let me get myself to a doctor right now.

• 15:48Speaker 01

  Absolutely.

• 15:49Oprah Winfrey?

  And one of the key things that you said here, and Dr. Nerula was agreeing, I see you nodding, is that you felt something was off. You felt something was wrong. Yes?

• 16:02Speaker 01

  Yes. We as women, we know our bodies best. I think we've all said that right now. Dr. Nerula, you said that as well. And I now live with heart failure. And so my biggest thing, I am more intentional with my life than I ever have been at this point. I, you know, I'm intentional with my time, who I give my energy to now. And I give my permission, myself permission, to say no and set boundaries. And my hope is that women who are listening, because we are in a society where we are constantly being pushed, women to give themselves permission to slow down, listen to their bodies, advocate for themselves, because it is really challenging when, after the fact, you have to grieve a version of yourself. You were talking about it before, that you think that you just want to get back to normal.

• 16:47Speaker 01

  And for that first year, it was about survival for me. It was grieving a version of myself that I had lost and learning how to trust my body again and managing that fear. So I think for me, it was over time just really redefining what strength and resilience means in my life. And that meant not pushing through everything and truly knowing when to pause and listen.

• 17:09Oprah Winfrey?

  Yeah. Would you consider yourself, yeah, a model for this book now? That you are, you have experienced the healing power of resilience.

• 17:18Speaker 01

  I definitely have. I feel better now, even though I have heart failure. I feel better now, like I'm stronger now than I was pre-heart attack. And I think that is because I'm so intentional with, again, how I spend my time and who it's with and the decisions I make for myself. I'm truly putting myself first and I didn't before.

• 17:40Oprah Winfrey?

  I want to know, do you have a question? You have a question for Dr. Nerula?

• 17:43Speaker 01

  I do. I do. Dr. Nerula, from a cardiovascular perspective, how do chronic stress, constant busyness, and just the pressure for women to constantly keep it all together affect their heart health? And what do you wish more women understood about that connection?

• 18:00Speaker 02

  First of all, I'm so happy that you're okay. And second of all, I hope everyone sees this is the face of cardiovascular disease, is what I'm talking about. It looks like all of us.

• 18:08Oprah Winfrey?

  Yes.

• 18:09Speaker 02

  I think you said a couple of other things, which I think are really important to point out before I get to stress, which is that women, we say in cardiology, have been understudied, underdiagnosed, and undertreated. So we know that women come to the emergency room with chest pain. They will wait longer than men. They are less likely to receive guideline-directed medical therapy and treatments. This is a problem. So we need to work on it from the medical establishment side. And then I think what you mentioned about stress is so critical. And to be honest, that was really the impetus in so many ways for writing this book, was to recognize how much of a threat stress is to all of us in our daily lives. And we don't talk about stress. We say it's the same morphous thing that's really bad. But it really, truly has an impact on our body, the mind-body connection that you talked about.

• 18:52Speaker 02

  So stress was designed to help us survive. We have a stress response that's innate, that's built in, so that when we see a predator, for example, in the wild, if we're an animal, we have our heart rate go up, our blood pressure goes up. We turn off all functions that are not necessary, like digestion and reproduction. The issue is that we're meant to then turn it off. Once we've escaped something that's chasing us, we're meant to turn it off. In our daily lives, we are turning on our stress response all the time, every minute, for all kinds of little insults. I got a bill in the mail that I didn't want to see. I may be in trouble with my job. Something happened with my child. And that constant chronic stress is damaging everywhere but to our cardiovascular system. We turn on hormones like epinephrine and norepinephrine.

• 19:37Speaker 02

  We turn on hormones like cortisol that increases inflammation. And we have studies that show that stress will increase the ability of a plaque that may be stable in your arteries to rupture. It will increase arrhythmias. It increases blood pressure. It increases your risk of having not only SCAD, spontaneous coronary artery dissection, that is one of the risk factors, but also stress-induced heart attacks. There is actually a phenomenon of a stress-induced heart attack. So stress is something that we all have to do a better job navigating. And that is why I wanted to write the book about the resilient response that I talk about, which is to say, yes, we have the stress response, but we also have the power to get back to homeostasis, to turn it off, to dial it down

• 20:20Speaker 02

  by activating the resilience that we have inside of us.

• 20:23Oprah Winfrey?

  I wanted to ask you too, because the whole process, you know, Dr. Nerula talks about people getting to the moment of acceptance. And being such a young woman, was it difficult for you at first to accept? And you use the word so freely here. Of I've had heart failure. I have heart failure. I'm a woman who has had heart failure. Was that hard for you at first?

• 20:48Speaker 01

  Oh, yes. I as I don't like to be told no for things. And I was very much of that first year in the I will prove them wrong stage. And grief is not linear. So you at one point think you are proving them wrong. And then, of course, you have a bad day.

• 21:06Oprah Winfrey?

  Yeah.

• 21:06Speaker 01

  And I think you talked a lot about this at the beginning where you, again, you grieve the old version of yourself because you want to get back to that person, but they no longer exist. So for me, being told no was that I couldn't be who I was. And I didn't know for the longest time what the point was. And I think there's a mental health component to this, that you have to make the decision to figure out what you want to do and who you want to be moving forward. And I'm still a fitness instructor. I teach something completely different now. And I am so happy. I am so fulfilled because of it. But I had to actively make that decision to to move forward and decide what I was going to be after this.

• 21:51Speaker 01

  Because being 30 years old and knowing that I had the rest of my life, I didn't want to live it in fear. And that first year was truly that. And it was very challenging.

• 22:01Oprah Winfrey?

  Yeah, I I ask it because when I was going through menopause and later discovered that I had a thyroid issue. And I remember someone giving me heart medication. And I remember thinking, well, I'm too young to have heart medication. The idea of even like having to take heart medication was a reminder that you're not who you think you are, you're not what your body, what you think your body can do. And so when you use the word heart failure so openly, I was wondering whether or not that was a transition for you.

• 22:34Speaker 01

  I fought them on my medications for a while because I wasn't taking any prior to that. And I had a very hard time adjusting to the fact that I had to take these medications to help my heart's pump function. Otherwise, if I didn't take it, I, we don't know what would happen. And I was like, why does my body have to depend on this, to your point?

• 22:57Oprah Winfrey?

  Yeah.

• 22:57Speaker 01

  And over time, though, because there'd be times where I wouldn't take it on time and I would actually feel it. And now I take my little pill pack everywhere with me. And I think with a little bit of, you know, with the acceptance part of it, I talked about it a lot. I talked a lot about a lot of my struggles. And I think that actually helped me.

• 23:20Oprah Winfrey?

  Yeah.

• 23:21Speaker 01

  Talking about the dark parts.

• 23:22Oprah Winfrey?

  Yeah.

• 23:23Speaker 01

  And that also helped me to be okay with being on medication and to find the new me outside of it. But I was very angry in that first year.

• 23:32Oprah Winfrey?

  And Kayla, you're the perfect example because I'm sure you actually use the word grieving who you were. And I'm sure you went through all of those stages of grief, you know, shocking denial and anger and bargaining, and then finally reached the point of acceptance. And that's when you're able to turn the corner and and and and change the trajectory for yourself.

• 23:53Speaker 01

  Absolutely. I fought it for two and a half years because I'm three years out now. And strangely enough, the moment that I reached acceptance was when I realized that because I was trying to constantly improve my heart, improve my heart's function, your ejection fraction, until I realized something flipped in my brain where I'm like, oh, they are actually focused on making sure it doesn't get worse.

• 24:16Oprah Winfrey?

  Yeah.

• 24:17Speaker 01

  And it hit me when I realized that I couldn't, you know, have children. And that in that moment, I was like, okay, well, then if I can't have children and my heart, I'm focused on it not becoming worse, what what is my life now? And that acceptance piece was right there.

• 24:34Speaker 02

  I learned that very lesson. I wrote about in the book when I was in medical school and I lost vision in part of my eye. And it was the same story. And it was my mother sending me

• 24:43Oprah Winfrey?

  Who did it?

• 24:43Speaker 02

  The Serenity Prayer. God grant me the

• 24:46Oprah Winfrey?

  Before you all even knew it was a Serenity Prayer.

• 24:48Speaker 02

  Before, correct. And her words really changed my ability to accept that. You know, listening to the Serenity Prayer helped me to walk through my own diagnosis. And that's how I know how important it is to accept.

• 25:00Oprah Winfrey?

  Yeah, I I'm I'm hoping people will get the book, The Healing Power of Resilience. But the one of the major factors in being able to move forward in your life, whether it is medical or any other crisis, is getting to the point of accepting that this is what it is. Now, what do I do with it? Now, how do I use this?

• 25:18Speaker 02

  Exactly.

• 25:19Oprah Winfrey?

  Thanks, Kayla. Really enlightening. Thank you so much.

• 25:21Speaker 02

  Thank you.

• 25:22Oprah Winfrey?

  Well, nearly 60% of Black women just 20 years old and older are living with some form of cardiovascular disease. That stat knocked me out.

• 25:34Speaker 02

  Yeah.

• 25:35Oprah Winfrey?

  That is a wake up call.

• 25:36Speaker 02

  Oh, you know, it should be a wake up call. We need a wake up call in this country for all women of color. Because all women of color, Oprah, are at increased risk of cardiovascular disease, but Black women in particular. There's actually a new report by the American Heart Association. And they forecast that by 2050, 70% of Black women will have hypertension, 70% will have obesity, and almost 25 to 30% will have diabetes.

• 26:02Oprah Winfrey?

  And that's higher than any other group.

• 26:03Speaker 02

  Higher than any other group. They have the highest rates of cardiovascular disease, the highest rates of stroke and heart failure, least likely to really get treated, diagnosed, highest death rates.

• 26:14Oprah Winfrey?

  Listen to that again. We Black women have the highest death rates, highest rates of heart disease, highest rates of diabetes.

• 26:23Speaker 02

  Obesity and hypertension.

• 26:25Oprah Winfrey?

  Wow.

• 26:26Speaker 02

  And it's a big, big problem. And we need to do better in this country to address this. Because, you know, there are ways that we have to address it, but we have to understand where this comes from.

• 26:36Oprah Winfrey?

  And where is it coming from?

• 26:38Speaker 02

  Yeah, I think, well, a lot of it is driven by those risk factors, right? So we can get better control on the risk factors. But we talk about this term

• 26:44Oprah Winfrey?

  A lot of stress, carrying everything, being the breadwinner.

• 26:48Speaker 02

  We talk about

• 26:49Oprah Winfrey?

  Repressing all of your feelings, not really, yes.

• 26:53Speaker 02

  Intersectionality.

• 26:54Oprah Winfrey?

  Yes.

• 26:54Speaker 02

  This idea that there are social determinants of health, that we are more than just, you know, my hypertension and my diabetes. We are, what is my income level? What zip code do I live in? Do I live somewhere rural? Do I have access to food? Do I face racism and discrimination constantly? So all of that over

• 27:13Oprah Winfrey?

  What am I up against in the world?

• 27:14Speaker 02

  What am I up against? All of that translates into stress.

• 27:17Oprah Winfrey?

  Yes.

• 27:18Speaker 02

  Stress that we've been talking about that activates and damages our cardiovascular system.

• 27:23Oprah Winfrey?

  And all of that just sort of embeds within your cells. And there you are. Stacy's on Zoom and she's been nodding. Hey, Stacy, hello, hello, hello. In in Chicago, tell us your story.

• 27:35Speaker 03

  Thank you so much for having me. I'm so excited to share my story with you. So I am that Black woman that you were just talking about. I am married for 38 years to my high school sweetheart. We have six sons and 12 grandchildren. And my weight has been a struggle my entire adult life. And I knew that I needed to do something about it. My mother had suffered two strokes. So I knew that that was potentially something I was going to have to be concerned about for my future. And so I, you know, I tried every diet, done everything and told my doctor, I was like, hey, you know, something's not right. I'm I'm exhausted. I'm aching, my feet hurt, my ankles hurt, I'm inflamed, like everything, something's wrong.

• 28:17Speaker 03

  And my doctor wasn't listening. So I went to a weight loss center and said, okay, maybe they'll listen because this is what they specialize in because I knew I needed to get the weight off. And, you know, Menopause came and she brought 20 pounds with her friend of 20 pounds. And so I said, I

• 28:36Oprah Winfrey?

  Menopause came and brought her friend. Yes.

• 28:39Speaker 03

  And I said, I can't do this. I can't continue to do this.

• 28:42Oprah Winfrey?

  Girl, I can't deal. Yes.

• 28:45Speaker 03

  No, thank you. We are not participating. So I ended up getting on a GLP-1 in October of 2024, and it was a godsend. I mean, I definitely had all of those things you were talking about. I had the high blood pressure. I had the high cholesterol. Again, the the inflammation in my body with the plantar fasciitis, walking around in pain, waking up exhausted after sleep. I was prediabetic. So I got on that GLP-1 in October of 2024. And in the first week, I lost 10 pounds of just inflammation. And the pain was gone, like my feet. I had gone through cortisone shots and physical therapy and the pain that I was trying to get away,

• 29:26Speaker 03

  get out of my body through that, I lost in that that 10 pounds because the inflammation was gone. And so I've lost 80 pounds since October of 2024, and I just feel amazing. And I know that my health is better, my ability to have energy. I took up Pilates, which was something I never thought I could do. But, you know, just taking better care of my health because I I have 12 grandchildren I want to be around for and and have energy to, you know, play with. And I know that losing that weight was going to be key to my health.

• 29:57Oprah Winfrey?

  Congratulations, first of all. You know, I know that struggle.

• 30:03Speaker 03

  We have walked this walk together.

• 30:04Oprah Winfrey?

  I know that struggle. So congratulations. 80 pounds is that is that is pretty phenomenal.

• 30:14Speaker 03

  It's a blessing.

• 30:15Oprah Winfrey?

  It's a blessing. It's a that is some work, girl. That is some work.

• 30:19Speaker 03

  So the question that I have is I've obviously seen some wonderful benefits of taking a GLP-1. My blood pressure has normalized. My cholesterol has dropped tremendously and is also getting into good numbers. What are some of the heart benefits that I can? Expect as a result of being on a GLP-1 and losing the weight.

• 30:40Speaker 02

  Yeah, first of all, congratulations. That is incredible.

• 30:44Oprah Winfrey?

  Yeah.

• 30:44Speaker 02

  And, you know, GLPs have revolutionized how we are able to care for our patients. And I've seen it in my practice over the last year and a half. Patients just like you, losing up to 80 pounds and really reversing their risk. And so, you know, we knew that drugs like Wegovy, right? Or Ozempic have cardiovascular benefits. It has an FDA indication for that reduction of cardiovascular disease. But there was a big study that came out in October. It was 17,000 patients, the select trial, that had known cardiovascular disease, no diabetes, who were overweight and obese. And they basically found that no matter whether you started out overweight or obese, there were cardiovascular benefits. That the weight loss you had-

• 31:29Oprah Winfrey?

  With the GLP-1?

• 31:29Speaker 02

  Yes, that the weight loss that you had in those first three months didn't predict the cardiovascular benefits. So if you ended up losing more later, that belly fat seemed to be a big part of risk. So losing belly fat seemed to help. However, and this is where it gets interesting, the belly fat loss only explained about a third of the cardiovascular benefits, which tells us that-

• 31:49Oprah Winfrey?

  Because belly fat, if you have belly fat, particularly as a woman, that's even more dangerous, right?

• 31:53Speaker 02

  Correct.

• 31:54Oprah Winfrey?

  And you're more susceptible to having a heart attack.

• 31:56Speaker 02

  Exactly.

• 31:57Oprah Winfrey?

  Yeah.

• 31:57Speaker 02

  But the two thirds of the benefits were not from losing belly fat. They were not from the weight loss, which is exciting because it means that the GLPs are having effects outside of the weight loss on the cardiovascular system. So the researchers and those who study this hypothesize it could be for several reasons. Number one, it's decreasing inflammation.

• 32:16Oprah Winfrey?

  Ah.

• 32:17Speaker 02

  It's lowering blood pressure and cholesterol. It's affecting the lining of the blood vessels to make them healthier. And maybe it's even changing how the fat is working in our body. So it's doing all of these things outside of just losing weight. Eventually, these, I think, may become cardiac drugs, not weight loss drugs. So the same way that I give my patients a statin or a blood pressure medicine, if they're not overweight or obese, but they have cardiovascular disease or they're at high risk, we might end up giving them a GLP. It has completely changed the ballgame for how we're able to care for our patients. And thank God, because we need more tools to help lower risk.

• 32:54Oprah Winfrey?

  Not to mention how good you feel about yourself. I mean, doesn't-

• 32:58Speaker 02

  Absolutely.

• 32:58Oprah Winfrey?

  Didn't it just change everything, the way you felt about yourself?

• 33:02Speaker 03

  100%. You know, I got so tired of the yo-yo.

• 33:06Oprah Winfrey?

  Yeah.

• 33:06Speaker 03

  You lose the weight and then, you know, you change the way you're doing it and then the weight comes back on and it's just, oh, my gosh, I'm so done with that. So, so thankful.

• 33:15Speaker 02

  My 80-year-old mother started-

• 33:17Oprah Winfrey?

  Thank you, Stacy.

• 33:17Speaker 02

  Taking GLPs.

• 33:19Oprah Winfrey?

  Your 80-year-old mother?

• 33:20Speaker 02

  Yes, and she struggled with her weight her entire life. You're never too late. It totally changed how happy she is, how she's able to function in her 80s. So I think, you know, at any stage of the game, this is a conversation people should be having, should I be on a GLP?

• 33:36Oprah Winfrey?

  Yeah.

• 33:37Speaker 02

  It's so helpful.

• 33:38Oprah Winfrey?

  Stacy, thanks for sharing with us. Thank you so much. Congratulations on your new outlook on life and the new vitality and all that comes with it. Danielle is joining us from New York. She's a patient of Dr. - she's one of your patients.

• 33:52Speaker 02

  She is.

• 33:53Oprah Winfrey?

  Okay. Dr. Narula, I hear you were having the classic symptoms of menopause. Menopause came a call into you too, but felt that there was something deeper going on, something was off. What was happening with you? Share.

• 34:07Speaker 04

  Dr. Narula really, really paid attention to the things that I had said to her and the way that I was feeling. And I said something to her about a particular time where I had just had dinner with my family and we were running up to go catch a show. And by the time I got to the theater, I literally could barely, I could barely walk. And that was the heaviness and I was perspiring and I was nauseous and I was dizzy. And I just kept thinking, oh, my goodness, I shouldn't have eaten, had, I can't eat still anymore. I need to go on a diet. And I just really dismissed it so, so heavily.

• 34:50Speaker 04

  But when I told that to Dr. Narula, she whipped her beautiful face around and stared at me. And she said, Danielle, please tell me, tell me exactly how you were feeling. And I, you know, I really wasn't kidding because I was concerned. And she said, okay, I'm going to order this test for you. And so she did. And by the time I came home from the, having taken the test, they had just walked through my, my front door, my phone rang and it was Dr. Narula. And she said to me, where are you? It's, you, you have to come back here. She said, but it's a little too serious, I don't think, but I'd like to check something. And I'd also like for your husband to come with you.

• 35:32Speaker 04

  And I went in, I had the procedure done over at Northwell Lenox Hill. And when I woke up from the procedure, the surgeon said to me, do you know when your birthday is? And I said, yes, my birthday is July 26th. And I thought he was trying to like, see whether or not I was like, okay, from the anesthesia. And he was so pleasant and sweet. And he said to me, well, I'd like for you to take this day, December 28th, 2018, and change your birth date because you would not have lived more than two weeks. And none of that would have happened had I not had Dr. Narula.

• 36:13Speaker 04

  Because I had been saying to my regular, you know, primary care physician, I don't feel well. I was getting embarrassed at saying it repeatedly.

• 36:22Oprah Winfrey?

  Yeah. When you were saying, I don't feel well, were you being dismissed or were you told it was just anxiety? Were you told? What were you told?

• 36:30Speaker 04

  Both. Well, a little weight and like, you know, a little tap on the shoulder.

• 36:34Oprah Winfrey?

  Yeah.

• 36:34Speaker 04

  You know, a few pounds wouldn't do you too bad.

• 36:37Oprah Winfrey?

  Yeah.

• 36:38Speaker 04

  And it was just being wrapped around menopause. And yet I did have the other symptoms, you know, the, you know, perspiring, sleeplessness, things like that. But I just didn't feel well. And when I said all of that to Dr. Narula, I will never forget how she looked at me and, and just decided to just hear me. And being heard by her and told that, because I have met some of her patients, I went to the book signing that she recently had.

• 37:12Oprah Winfrey?

  Yeah, Gail was there.

• 37:13Speaker 04

  I managed to-

• 37:14Oprah Winfrey?

  Gail was there.

• 37:14Speaker 04

  Yeah.

• 37:15Oprah Winfrey?

  Yeah.

• 37:15Speaker 04

  And I managed, I didn't, yeah, I, my entire family came. Oh, we made a big party out of this.

• 37:20Oprah Winfrey?

  Okay.

• 37:21Speaker 04

  And so it was great. It was great. And I, I-

• 37:26Oprah Winfrey?

  Oh, I see why you say you thank her for saving your life because had she not listened, you would have continued on that circuit of going to your physician and the physician saying, you know, a few pounds wouldn't do you any harm and, and-

• 37:42Speaker 04

  Yes, Oprah.

• 37:43Oprah Winfrey?

  Yes.

• 37:44Speaker 04

  And it was shameful. I would feel embarrassed, almost as though like I was contributing to that. Like, okay, you know, you really have to not, okay, the weight was-

• 37:54Oprah Winfrey?

  Everyone else's doubt caused you to have doubts yourself or, or to reassess for yourself. Well, thank you so much.

• 38:01Speaker 04

  Yeah, yes.

• 38:02Oprah Winfrey?

  What a very, and congratulations on your new birthday, December 28th. December 28th, your new birthday.

• 38:08Speaker 04

  It's me a lot younger.

• 38:12Oprah Winfrey?

  Fantastic. Thank you, Danielle. Let's talk about high blood pressure. It's known as the silent killer. I don't think everybody understands how that impacts everything else in your health.

• 38:24Speaker 02

  Yes.

• 38:24Oprah Winfrey?

  Particular cardiovascular health. Tell us.

• 38:27Speaker 02

  It is, it is one of the most preventable risk factors for cardiovascular disease. And people should start, women especially, having their blood pressure checked in their 20s. It is a number that you should know. A normal blood pressure, Oprah, is 120 over 80 or less. 120 to 130 is actually already considered the start or the beginnings possibly of early hypertension. Once you cross the threshold of over 130 over 80, that is considered high blood pressure.

• 38:54Oprah Winfrey?

  What's the most important number, the top number or the bottom number?

• 38:56Speaker 02

  Both, both are important. And I see a lot of patients who have seen doctors for years and were told, oh, your blood pressure's fine, it's fine. And then I look at their chart and it's not fine. It's been 136 over 85, which is why you should write down the number. And definitely, you know, we talk about the value of seeing a cardiologist, but the cardiologist will definitely look at your blood pressure and tell you if it's well-controlled or not and what you can do about it, right? And so the what you can do about it, there are lifestyle ways to control it, whether that's exercise, weight, low sodium diets, diets that are higher in, potassium can help, avoiding alcohol or medication. And sometimes it's both, but blood pressure is so important, as are all of the other risk factors.

• 39:37Oprah Winfrey?

  Yeah, I was resistant, I was, I was like our earlier guest, Kayla. I was resistant to the idea of having to be on the medication because your medication means now you need medication. But I have a history of it in my family, father- Had high blood pressure, mother had high blood pressure. Every aunt, uncle, grandparent has had high blood pressure. It's a fact.

• 39:59Speaker 02

  And you can feel fine. That's the problem.

• 40:01Oprah Winfrey?

  And you can feel fine.

• 40:02Speaker 02

  You can feel fine, but it is damaging the blood vessels to every part of your body, your eyes, your kidneys, your heart, your brain. So it is so important to control it, even if you feel fine with things like medication.

• 40:13Oprah Winfrey?

  I know, because you don't even know when it's high unless there's lots of stress.

• 40:18Speaker 02

  And I always tell my patients, I know you don't want to take medicine, but what if we get you on it and you don't even notice you're taking the medicine? How great would that be, that we get you on something that's controlling your blood pressure and you still feel the same, right? And a lot of it is trial and error, working with people to get them on something that they can really tolerate.

• 40:32Oprah Winfrey?

  The other thing I know you talk about in The Healing Power of Resilience is that the connection to faith, to spirituality, to purpose, to hope, all of that contributes to your having a meaningful life and also beating the odds of risk of heart disease.

• 40:57Speaker 02

  It is. And so, you know, when I was designing the book and we were talking about what are the steps towards building resilience, a lot of them have been talked about a lot in the worlds of psychology, like flexible thinking and optimism and acceptance and all of that. But there were several that I wanted to include that I've seen and I know are important from my patient care. And those are the things that are intangible, the hope, the spirituality and faith, the purpose, the love and social connection, all of these things that are external to us or kind of bigger than us that help drive us forward and pull us forward when we are in the dark and we can't find our way out. I put purpose as the last tool in my kind of toolkit there, purposefully. I call it the lighthouse, Oprah.

• 41:42Speaker 02

  You know, it is what calls us forward when we're stuck, when we wonder, how can I go on? What is the meaning of me being here? And all of us have some sort of purpose inside of us. Some of us never went after it because we didn't think we should. And the journey, like a health scare, opens your eyes to saying, I should pursue that purpose. And some of us find it based on what happens to us. We become an advocate for that cause. But all of those intangible concepts, Oprah, are so powerful and meaningful. You know, love, another one that was very important for me to put in the book. I love the story from the Christopher Reeve documentary that I put in there.

• 42:22Oprah Winfrey?

  Yes, yes.

• 42:23Speaker 02

  Where he says to his wife, Dana, like, maybe we should let me go. And she says to him, you know, I'm only going to say this once, but you're still you and I love you. And he said those words saved him. Sometimes it's just words and knowing someone's there that can save us, that power of some other human being in our life.

• 42:40Oprah Winfrey?

  Tell me why it was important for you at this time in your life to write this.

• 42:45Speaker 02

  I am such a huge believer, Oprah, in the mind-body connection, okay? I believe in the power of our abilities to overcome what happens to us in life. And I have always sort of lived my life this way. You know, I look back, the opening quote in that book is from my high school yearbook page, I am the master of my fate, I am the captive of my soul.

• 43:06Oprah Winfrey?

  One of my favorite, Invictus.

• 43:08Speaker 02

  And I had it on my yearbook page at the age of 16 as my quote. I believe we have this innate strength and power in us to overcome what happens. We're just not told that. Nobody tells us how strong we are. And I wanted to write this to help everyone, and my patients and people who are struggling with medical challenges, to know that no matter what happens, not only are we most of us innately resilient, we carry that gift with us, but it is something that we can build, we can grow, we have that power. And I want to empower people to know that they can do that, no matter what happens to us. They can thrive, Oprah, in life. That is so important.

• 43:45Oprah Winfrey?

  Well, you are a living example of that. And I will have to say that the American Heart Association created what they call Life's Essential Eight.

• 43:55Speaker 02

  The ninth should be stress. I'm pushing for that, but yes, eight.

• 43:58Oprah Winfrey?

  Life's Essential Eight, and it's a checklist to improve cardiovascular health. What are they?

• 44:05Speaker 02

  Yes, so we think about the first four. Let's talk about which are the numbers. So controlling your blood pressure, your cholesterol, your blood sugar, and your weight, your body mass index. Then we think about things that you're doing. So exercising, eating a healthy diet, avoiding smoking, and sleep. Sleep was the one that they added. It used to be seven, they added the eighth, which was sleep, several years ago.

• 44:24Oprah Winfrey?

  Tell Gail King that, will you, please?

• 44:26Speaker 02

  Gail, if you're listening, please, I need you to sleep more than four hours. It's so important. But yes, sleep is, it's a time where we think our body's inactive, but actually, a lot of things are happening during sleep. But if you can work on those essential eight, you will lower your risk of cardiovascular disease. 80% of cardiovascular disease is preventable by lifestyle changes. The only things you can't control are your age and your family history. So that's so important, again, so empowering. If we find things early, if we get on the road for prevention for women, for people, we can have a huge impact. And that's what we have to start doing, is targeting this process earlier and earlier and earlier. And we have so many great screening tools, Oprah, that so many people don't know about. They think about their mammogram and their colonoscopy.

• 45:11Speaker 02

  We have ways to screen people to help identify those that are at higher risk.

• 45:15Oprah Winfrey?

  If there was a ninth, what would you want them to add?

• 45:18Speaker 02

  Stress. I remember sitting at a luncheon with Nancy Brown, who's the president of the AHA. She has one every year. This was a few years ago, when they added sleep. And I raised my hand and I said, I'd like to know why stress is not on that list, because it is so important. And we, as we talk about, it really affects the cardiovascular system. And she put me in touch with the man who was a cardiologist in charge of the guidelines. And we had a phone conversation. And he said, you know, you're right, it is really important. We just don't have the research there to push it to the top, to get it as the ninth, but eventually I think we will.

• 45:49Oprah Winfrey?

  It will be on there.

• 45:50Speaker 02

  It will. There's no doubt in my mind that it will be. And I hear it. When I walk in the room, the first thing I say to my patients is, how are you? And you know what they're telling me? They're not telling me their blood pressure or that they missed their medicine. They're telling me they're stressed, they're anxious, they're depressed. They're telling me everything about what's happening up here. How can we possibly help heal people if we're not addressing all of that other stuff that's going on, that's having an impact on the physical part of their bodies?

• 46:16Oprah Winfrey?

  Well, thank you. Thank you for your work and this really thoughtful book. The Healing Power of Resilience is available anywhere books are sold. And I also want to thank our guests, Kayla and Stacy and Danielle, for sharing their heart stories with us. They actually were heart stories. And no matter your age, I hope you begin to take your heart health seriously. Thank you. Go well, everybody. Go well. And thank you to our friends at Geico for presenting today's episode. I want to remind you again, heart disease is the number one killer of women in America. If you want to know more about what you or your loved ones can do to protect yourself and learn why resiliency is the key to building your physical and mental health, scan the

• 47:01Oprah Winfrey?

  QR code, buy a copy of Dr. Narula's New York Times bestselling book, The Healing Power of Resilience, A New Prescription for Health and Well-Being. Take good care of your one and only heart. Our listeners tell us that the podcast is resonating with you and is serving as a bright spot in your day. That means a lot to me. So here's the thing, I would really appreciate it if you like and subscribe to the Oprah Podcast on YouTube or wherever you podcast. It's just a quick tap of the subscribe button, and that way you won't miss an episode in your queue. You don't have to pay anything. I know subscribe usually means you're paying something, but this time it means you just are notified when there's something new.

• 47:46Oprah Winfrey?

  There are many more to come that we're excited about. So thank you for watching and listening.