311: Understanding Blood Pressure: Lowering Stroke Risk Through Healthy Lifestyle | DOCTOR IN THE HOUSE

Dr. Rizwan Bukhari  00:00

And it stopped. And it told me Maya's blood pressure is 99 over 73. And it told me her heart rate is 87. And those are both extremely healthy blood pressure and heart rate. So we won't have to be sending you to the doctor anytime soon.

Maya Acosta  00:21

This is the healthy lifestyle solutions podcast and I'm your host, Maya Acosta. If you're willing to go with me, together, we can discover how simple lifestyle choices can help improve our quality of life. Let's get started. Alright, welcome back to another episode of the healthy lifestyle solutions podcast. I'm your host, Maya Acosta.

Dr. Rizwan Bukhari  00:41

And I'm Dr. Rizwan Bukhari.

Maya Acosta  00:43

And today we have another segment of DOCTOR IN THE HOUSE. And this is really Dr. Risk, the expert that joins me every Monday as his segment every Monday, he talks to you about a health topic, and we've been covering in the past things like heart disease, type two diabetes, atherosclerosis, this is part three of a three-part series where we're talking about stroke, for the month of May Stroke Awareness Month, Doctor risk, we have spoken about everything from really explaining to the audience the differences in the different types of strokes, how to know when a stroke is coming on? What are the risk factors of strokes, we learned in our last episode that women are at a higher risk of having a stroke, and even more African American women are at a greater risk of having a stroke. So I was thinking in this last episode, we can talk about those modifiable risk factors, the things that women and really people can do to reduce our risk. And so we're gonna talk about blood pressure, just talking about that, in general, and how to use the monitors. And we're gonna focus on nutrition and exercise as being those things that people can do to take control of their health.

Dr. Rizwan Bukhari  02:01

Those are the two primary things that people can focus on where they get the biggest bang for their buck.

Maya Acosta  02:06

Yeah, yeah. Because we know that there are other things that we can't control. We can't control the fact that we're aging, or that we're women, if we're higher risk for being women, we can't really control even the fact that our hormones are changing. You can't you can't control your genetics. That's right. So but you can control smoking. In other words, and you know, not smoking, but in Yeah, I'm excited about this one, because we're going to show the viewers, if you're watching the video, we're going to show you two different monitors. And, you know, we're going to explain what the numbers mean. Because sometimes people don't know what they mean, or what numbers to look for, what are ideal numbers. And if you're following Dr. Rissa, social media, you're going to see diagrams, so we're going to include in there, and one of them is like this. I don't know if you can see it in the camera. But it's titled, blood pressure measurement instructions. And it just shows you what to do before and how to take your blood pressure. Let me just kind of go down the list real quickly. And then Dr. Risk is going to take my blood pressure, and he's going to talk to me about what's happening. Now remember, you can go to a local pharmacy and do the same thing on a machine. You don't have to do anything but put your arm in that slot area, and it'll take your blood pressure.

Dr. Rizwan Bukhari  03:27

Yep. Yeah. Most pharmacies have it if they're working. Yeah,

Maya Acosta  03:32

exactly. All right. Now, 30 minutes before you take your blood pressure. Don't smoke, don't exercise. Don't drink any caffeine, and no alcohol. And that's just so that you can better get a better reading. Is that right?

Dr. Rizwan Bukhari  03:46

Yeah. I mean, I think the we're, that's just trying to optimize and see which blood pressure is when you're not doing anything. But our blood pressure is going up and down all day in response to many different things. Just like in response to what we if we've smoked or if we've had some caffeine, or if we've had an adrenaline response due to something. So our blood pressure is going up and down at many times. Yeah. So you know, when we when we take a resting blood pressure, that may not be a true reflection of what your blood pressure is all day long. Ah, well, even so I'm I'm a big advocate for what we're going to get to in this episode, which is, I suggest people have their own blood pressure monitor. And they check their blood pressure several times a day. And what they're going to find out is they're going to see patterns in their blood pressure, and patterns that occur at different times of day due to different responses.

Maya Acosta  04:45

Okay, it says here that when right before you take your blood pressure, just be still in the chair for about five minutes. And during the blood pressure while it's being taken. Relax. Don't talk ress the car Left arm comfortably on a flat surface or a table, at heart level, sit upright back straight and support it, keep the legs uncrossed, I also would like for you to tell us whether we should have like a little journal to keep tabs of all these readings. Okay, I think I'm ready.

Dr. Rizwan Bukhari  05:17

So you know, kind of I kind of say, in the old days, the standard way to take a blood pressure was to put a cuff on somebody's arm, you would blow it up with a bulb, and that cuff would cut off the blood flow in your arm. And that cuff also is connected to a pressure nanometer, which is on there. And so then you would start to slowly release the pressure in the cuff and allow the blood flow to come back into the arm. And you would use a stethoscope to listen to the artery, and then you would listen to when the noise would return. And then when the noise would go away, and when the noise would return, that would be your systolic blood pressure. And when the noise would go away, that would be your diastolic blood pressure. And those have to do with the the cycle of your heart and the beating of your heart. And they each have their own clinical significance.

Maya Acosta  06:17

Wow, I'm glad you're covering all this. Can I just I know you're about to say something. So I don't want to interrupt. But what would you say that this here, this monitor is what you brought from the office? Typically people don't have this standard American is not using a stethoscope. Or are they?

Dr. Rizwan Bukhari  06:32

I mean, so we have newer devices available today, which make taking your blood pressure, so simple, okay, that there's almost no excuse not to do it. When it was like this blood pressure cuff and a stethoscope, it was a little bit more difficult. It required some skill set required some training some repetition. Wow. So you had to be a medical assistant or a nurse with a significant amount of experience, or somebody who would you who was doing it at home a lot who had had some training. So but you know, this is the way it was when I started medicine back in the 80s. And this new device is the way we you know, people can take their blood pressure at home today, very, very simply. Without any, there's no complexity to it, you just put your arm in the cuff, press a button, it inflates the cuff, it takes your blood pressure and a gives you a reading. And there's a few for there's a few various different types of devices, there's the ones that go on your arm up here on your bicep, there's even the ones that go on your wrist. And you know, different people have different opinions about the accuracy of one over the other, I think it'll be interesting to take your blood pressure, both with the kind of standard old way of doing it. And with the, with the blood pressure cuff. I'll tell you today in our ICUs. And in our recovery rooms, we hook patients up to these automatic blood pressure cuff machines. And that way, that's one less thing the nurse has to do because nurses have so many responsibilities. And this thing then is set on a timer to automatically take your blood pressure can be every five minutes, it can be every 15 minutes, it can be every hour every hour. And of course because things are so computerized, their blood pressures just automatically downloaded into the computer for review. And if it's high, alarms will go off, etc. But so this, this is kind of the modern way of doing it. And in and so this is why I say it's so easy. And it's and it's quite affordable. You can get something like this for less than $50 from the drugstore.

Maya Acosta  08:46

What about Amazon? Can you find it on? Oh, absolutely. And we find a link we'll put it in the show notes so that we can send you straight to it. Absolutely.

Dr. Rizwan Bukhari  08:52

In fact, I'll do some research and find something that I think is good quality for a very reasonable price. And we'll add that to the show notes now

Maya Acosta  09:03

is this so this is wireless, I see that you can plug it to charge it and looks like you can either

Dr. Rizwan Bukhari  09:10

this is battery-operated but that is a charger so it could be plugged into a charger

Maya Acosta  09:15

okay, but I love that you can if you need it to travel with it along with your medications.

Dr. Rizwan Bukhari  09:20

So yeah, we use this one for when we go and do some of our seminars and different things and take blood pressures because it's quite portable, and easy to use and as battery power. You don't have to carry the charger around with you. So this is the this is the one we take around with us that I liked the most because I think its accuracy is very good. But I'll even show you I did mention that they even have one that's even smaller, it's portable. Look at it. It's all contained in something this big. And this is the one that you can put on the wrist. It literally has a little strap you put it around your wrist. And this is the size of it. It's very, very, very small.

Maya Acosta  09:59

So it's all it all in one kind of a thing. Yep. And it's also

Dr. Rizwan Bukhari  10:03

a battery operated. But I actually personally don't find the ones that work on the wrist to be as accurate. So I don't, I don't rely on it.

Maya Acosta  10:13

So we're not going to use this one for demo. So this is the one that it's called the Omron,

Dr. Rizwan Bukhari  10:19

this, the Omron there's a million, there's a million companies, but this one is called online. I'm real big into recording my health, my sleep, my meditation, my yoga, my cycling, my walking my hiking. And so I use my Apple Watch. This is not a plug for Apple Watch, but, and then I use my Apple Health app, and I put my blood pressure in it, it takes just seconds, you know, too. So I have lots of records and patterns, where I can follow all these things. So the Apple Watch, I think is kind of this interesting thing ever in evolution. And as are many devices, this is just the one I choose to use. Right now the Apple Watch can check your oxygen saturations. Okay, and I so I can see what my oxygen saturation is when I'm walking or exercising. I can also see what my oxygen saturation is when I'm asleep at 3am at night. That's one thing it does, it monitors my heart rate. When I'm awake, it monitors my heart rate when I'm exercising, it monitors my heart rate when I'm asleep, it tells me my resting heart rate. And then it does have this special function where it can tell you if you have an irregular heartbeat. It just only makes a distinction between a normal heartbeat, and an irregular heartbeat. Okay, but it doesn't tell you about all the different types of irregular heartbeats it Okay, so I we're gonna go ahead and demonstrate the blood pressure machine. And I'm just going to show you the the new automatic one because it's not my recommendation that you go out there and get a blood pressure cuff with the Manam er and and a stethoscope and do that yourself, when we have these really nice new things available to us for that are very affordable. So my is going to come around here. And we're going to put the blood pressure cuff on her arm.

Maya Acosta  12:09

And I can't do too much about the mic because they might fall off. So I'm just going to try to you tell me how to position myself for an accurate reading.

Dr. Rizwan Bukhari  12:16

So just stick your arm out, we'll put it on put it through there, she got a very skinny arm. So I'm gonna have to try to get this on there nice and tight. Okay, so that's all she does. And then just rest your arm will literally just turn the device on. And you can hear it kind of pushing air and she's probably going to feel that it's getting tight right now. I don't know if you can see the numbers, but that number right there represents the pressure in the cuff. And I read 140s. And now it's going to start slowly letting air out of the cuff. And I'm going to I'm going to go ahead and put it down. So I'm not really disturbing it. And it stopped. And it told me my as blood pressure is 99 over 73. And it told me her heart rate is 87. And those are both extremely healthy blood pressure and heart rate. So we won't have to be sending you to the doctor anytime soon. But that's as simple as it is. You just put your arm and you press a button, and within a minute you get a number.

Maya Acosta  13:24

So speaking of the numbers, Dr. Riz, thank you for that. I used to find myself every time I went to a doctor's office and had the blood pressure taken. They would give me the numbers and asked if I if I know the numbers. They're like, Oh, it's this and that. And I'm like, is that good or bad? Right, because and so I'm wondering if people question, I guess if you have a blood pressure issue over time, you kind of know what numbers are ideal. But please go over that with us.

Dr. Rizwan Bukhari  13:53

Yeah, you're probably right that if people have blood pressure issues, your doctor is going to talk to you about what your goals are and what's too high and what's too low. In my opinion. Even when we're managing people with high blood pressure, we don't get their blood pressure as low as it should be. Because and we've, as we've evolved in our knowledge and understanding about blood pressure, we've actually lowered what we think the blood pressure should be. Back when I started in medicine a few decades ago, if your blood pressure was below 140 And below 90, so 138 over 88. People would say that's a normal blood pressure, you're fine. Go about your normal business. You don't need to do anything. Today. 138 over 88 is considered hypertension. Oh wow. Okay. And so today they want your blood pressure to be below 130 And below 80. Okay, so ideally, that upper number in the 120s and that lower number or in in the 70s. Okay. And in my opinion, the lower the better, as long as you're not symptomatic, okay, what I mean by symptomatic, getting dizzy, when you stand up fainting spells, things like that

Maya Acosta  15:15

those are signs of having high blood pressure, those are signs of having low blood pressure blood. Yes.

Dr. Rizwan Bukhari  15:21

And so what the, the interesting thing is, you'll see that athletes have extremely low blood pressures. And it's scary to some people, my blood pressure runs 90 over 60. And at the doctor's office, when they take my blood pressure, I went in for a CAT scan one time, and my blood pressure was 90 over 60. And they didn't want to let me go home. And I kept telling them, that's my normal blood pressure. And I showed them my I showed him my Apple Health thing, and I said it, but they still wouldn't let me go home and they call the doctor. And then they gave me some IV fluids. And they were treating a number and not understanding. But so in my opinion, the lower the better. Yeah, because the blood pressure is kind of a reflection of the health of your artery. And it's a reflection of what your heart is working against for your entire lifetime.

Maya Acosta  16:15

Can we talk about nutrition and even exercise and how that can help blood pressure? Yeah,

Dr. Rizwan Bukhari  16:20

I have my order on how we can affect blood pressure with lifestyle. Okay, I think the most important and significant impact that we can have on our blood pressure is through our nutrition. Basically, the way we eat, probably the second most important way that we can have an impact is through exercise. Okay? So and I really want to stress that because there's a lot of people who think that they're obese, and their blood pressure's 180 over 120. And they think that they're going to go out and exercise and that's going to cure their blood pressure, but not really, really what's going to help their blood pressure their most is their nutrition. Okay, and then exercise comes in second. And then then I do believe that other lifestyle factors have an impact. And that has to do with sleep, and stress. And that's because both of those have significant impacts on hormones in our body, that are cyclical in nature, that have impacts on our blood pressure throughout the day, specifically, epinephrine, which is adrenaline, and cortisol. Okay, and those two hormones have significant impacts on our blood pressure throughout the day.

Maya Acosta  17:36

Okay, so as you know, Dr. Riz, I referenced the American Stroke Association, some of the recommendations are to increase fruits and vegetables, whole grains, legumes, nuts, and seeds, and limit intake of saturated fat, trans fat, red meat, sugar, and salt. What I find interesting is that they throw these words out there, like saturated fat and trans fat without going into detail of where you find the saturated fat in the cholesterol. So can you touch on that a little bit,

Dr. Rizwan Bukhari  18:07

the cholesterol and the saturated fat come from animal products. And so I'm also an advocate for limiting the amount of animal products that you eat. Really, taking it down as low as possible, or even eliminating, if that's within, you know, your lifestyle and, and your belief set. The most important thing I think you can do from the from a dietary standpoint is to eliminate salt, or sodium in your diet, you're gonna get plenty from all of the foods you eat, so there's no reason to add it. And also read the labels on the foods that you get, you can buy canned beans that have 15 milligrams of sodium, and you can buy canned beans that have 600 milligrams of sodium. So you know, that makes a big difference. And if you do that on a daily basis over the course of a lifetime, that makes a huge difference. So I think that's very important. Now, cholesterol and saturated fat, do something to your arteries, they stiffen your arteries. And there are studies out there that show that when you eat a meal that has saturated fat and cholesterol in it within just a short time within a couple of hours of having that meal, your arteries stiffen and that leads to increased blood pressure. So cholesterol and saturated fat not only are bad for you from the standpoint of developing atherosclerosis, but they are bad for you from the standpoint of the health of your arteries and your blood pressure.

Maya Acosta  19:42

So a number of studies now show that high fiber intake may help ward off stroke. So less than 3% of Americans meet the minimal daily recommendations of fiber that's 97% of Americans that are fiber deficient. Now fiber is concentrated in Whole Foods. As you just said, those are the main foods that you recommend processed foods have less fiber, and animal derived foods have no fiber at all correct. This is interesting. So if you just add seven grams of fiber daily to your diet, and seven grams can look like a bowl of oatmeal, or berries or even a serving of baked beans, that will reduce your risk by 7%. Just seven grams of fiber. Also the fiber helps control cholesterol, blood sugar, and reduce blood pressure. But we never talk about fiber in terms of blood pressure, like in everything that I referenced through the larger organizations, they don't really talk about fiber, they just say, you know, eat more fruits and vegetables, whole grains, legumes, which have fiber, but they don't emphasize the importance of dietary fiber. We're not talking about the supplement that you put, you know, the powder in water. The other thing was potassium, that can also help lower blood pressure. And many times when we think of potassium we think of bananas. Dr. Greger made this wonderful comparison in saying that actually bananas in potassium are very, very low on the list, the potassium level could be equivalent to that of a Reese's Pieces. Right? Right, that you want to eat foods that are really rich in potassium like greens, beans, and sweet potatoes, and also hibiscus tea for hypertension, and you talk often about hibiscus tea.

Dr. Rizwan Bukhari  21:39

So I'm a big fan of hibiscus tea. It's one of those, you know, again, I'm an advocate for a whole food plant based diet. You know, wherever you are on the spectrum of that, but just the more fruits and vegetables and beans and greens that you get, I call myself a beans and greens kind of guy, there's something very special about habits, his tea that will help you lower your blood pressure. And I personally saw this again. This is just my own personal experience or an anecdotal story about myself. But because I'm so into my Apple Health app, and recording my blood pressure and my heart rate I eat when I would drink just one glass of hibiscus tea on a nightly basis, I saw my blood pressure dropped 10 points. And I saw my heart rate dropped 10 points. And it was very very, you know very timely, I started drinking the tea. Within a couple of days that drop happened. Then when you saw me stopped drinking the tea. Everything returned back to where it was.

Maya Acosta  22:44

That is amazing. And the cardiovascular how to prevent cardiovascular disease guide that you have has your recipe for hibiscus. So it's not just the basic hibiscus flower, but you put some nice spices in there too.

Dr. Rizwan Bukhari  22:59

Yeah, I mean, you can just drink hibiscus tea, but I kind of I kind of spiced it up in the way my mom would make, would would make Chai when I was a child and she throws throws in some cardamom, so my nice clove and so you know a couple of different spices in there that really make it spicy and tasty. And not to mention the fact that spices are extremely healthy for you as well. So it's a nice way to get some spices as well.

Maya Acosta  23:28

Absolutely. And so I want to recommend How Not to Die to our listeners. If you've never heard of Dr. Michael Greger that's a he really lists like the top 10 leading causes of death and how not to die from them. And he has a whole section of how not to die from brain diseases, which includes stroke, and Alzheimer's disease dementia, as well. But the second half of his book has all the dietary recommendations that he makes as well. And that's a great resource. We know that nutrition plays a significant role. You just talked about it in terms of contributing to high blood pressure, cholesterol levels, diabetes, obesity, you name it, but unfortunately some of these larger national organizations don't promote this way of eating. So I just kind of wanted to reiterate that and also talk about exercise just being physically active. We I recently had an episode on blue zones where we talk about like, people in their community just being active, not so sedentary. So can you talk about that you you lead a walk every month here in the Dallas area as part of Walk With A Doc in you also during your walk have a short, brief health topic, but can you tell us why moving is important?

Dr. Rizwan Bukhari  24:50

So yeah, well thanks for bringing up the walk we do with our walk every third Saturday of the month. Right now it's at noon, but during this Summer months, we're gonna move it up to earlier in the day when it's little bit cooler. And I like to start with a short health topic. You might it might be whatever the health topic of the month is, or it might be something that's of interest to me. People tell me I talk too much and talk too long, so I got to keep them short. And because I really like to be thorough and give you as much information as possible, but you know, at least we introduce a health topic. And then and it might be, that's a good way to a good topic then for us than when we go walking. And people can talk to me about it. And what we do is we have a nice little one mile track on a lake, with ducks and squirrels and wildlife, which, which is really fun to walk. And we typically go around two times, some people choose to go around more, and I walk back and forth between the people and and talk to them about different health topics. So for me, that's just a great way to get out and get some exercise. And exercise doesn't have to be, we've kind of got this exercise culture where everybody thinks about being marathoners and Olympic athletes and bodybuilders. And that's not what that's not what healthy exercise is. healthy exercise is, is moderate exercise on a regular basis on Mott on on a regular repetitive basis. And so it just means going out for a brisk walk several times a week, I recommend and this is based on the national societies that I work with on lifestyle medicine, which is 30 minutes, five times a week of a nice brisk walk. If you're a runner, it can be 15 minutes, five times a week. So it changes depending on the pace that you go at. Okay, but the thing about exercise, and specifically, hypertension, which we've been talking about is that it's good for your arteries, it's good for your heart, it can exercise slows down your heart rate, and it helps your arteries dilate. And so it is good for lowering your blood pressure. So people who exercise regularly can lower their blood pressure, a few points, somewhere between six to 10 points. So when you start talking about people, you know, if somebody's got a blood pressure of 148, over 90, they could be on a pill. And that takes them down, but they still have the underlying mechanism that's causing the blood pressure. But if you go out there and you make some lifestyle changes, start exercising, eliminate sodium from your diet, start to limit your cholesterol and in saturated fat, get better sleep when each of those things if all of those things each take five points off, or eight points off of your blood pressure, suddenly, you've gone from something in the 140s down to 120 or something and you've normalized your blood pressure just through lifestyle. So your blood pressure is normal. Okay, you don't have hypertension, that you're taking a pill for. And you still have hypertension. Yeah, you now have cured your hypertension. Yeah, so there's a big difference to live a lifestyle with normal blood pressure, versus living a lifestyle with hypertension and taking a pill, right, you're still going to encounter the complications of that hypertension. Later on down your life. Drink your high viscous tea, too.

Maya Acosta  28:34

Yeah, and drink that tea. It's so good. You talked earlier about reducing the intake of saturated fat I did a whole episode on protein and the myths associated with protein. So I'm going to link that one too, because many people think they have to eat meat to thrive to survive, they think and also the dairy products. So I I have to eat meat to build muscle or to lose weight. Or to have my iron otherwise I'm might be anemic or I have to have dairy to have calcium, while all these things are found in the beans and in the greens. So you can have a very healthy diet with those foods. And it's just a matter of sending people to the right places to get the right foods. And that's how you get rid of the trans fat. Well, the saturated fat, the added cholesterol and then reducing our intake of junk food, which processed foods that's where the trans fats are found the cookies and the cakes and all of that. And then you also mentioned I wanted to touch on something else that you mentioned associated with stress. You were talking about reducing the stress and we now do yoga in this into we have calm the app that I use on a regular basis to reduce my anxiety I find that even restorative yoga is very used Well for me to reduce my stress, because stress can contribute to high blood pressure. Right.

Dr. Rizwan Bukhari  30:06

Right. Right. So that's the I think those are important things, too. When you put all of these lifestyle factors together, they each contribute to lowering your blood pressure it to differing extents, but then they can, you know, you, but they're additive.

Maya Acosta  30:21

Yeah. One more thing that I wanted to mention Dr. Riz, I wanted to send people to your social media, Instagram is at dr_riz_bukhari you're releasing a lot of great content associated with the topic of strokes, you know, prevent stroke prevention, and also Walk With A Doc, depending on when this episode airs, your next walk is the third Saturday of May. At noon, there's a link for the Walk With A Doc page that we have, so you know exactly where we're walking. And do you have a final message for our listeners?

Dr. Rizwan Bukhari  31:02

Yeah, a couple of things, talking about links. Number one, I think you should put a link for Dr. Gregers book, How Not to Die, okay. Because I think that's a great book, it addresses all of the major health issues that we face today. And what you can do in your life, to reduce your risk related to that, okay, so I think a link in the show notes would be very nice. Okay. And now, uh, you know, as far as the messages, I deal with very, very sick patients. My patients all have diabetes, and hypertension, and kidney problems, and they're all overweight, they all have atherosclerosis, they all have heart disease. Many have had strokes. Lots of them have gangrene. And a significant contributing factor to all of this is hypertension. And, and we've I've addressed the term metabolic syndrome on one of my my walks, and maybe I think we should have that as one of our topics. Sure, for an upcoming doctor in the house. Did I get that? Right? Yes. But what I got to say is that hypertension is a silent killer, it sits inside your body for years, you don't know it, it's causing damage. And by the time you find out about it, and by the time you start taking a pill for it, so much of the damage is already done, that it's hard to reverse. So understanding more about hypertension, recognizing it earlier, making the lifestyle changes necessary to get rid of it, and or treating it as needed, is extremely important in such an important disease to to address that it can make a tremendous impact on your life.

Maya Acosta  32:56

Oh, thank you for that. And we know that with the recommendations that you've already made that people can, with time reduce or improve their blood pressure.

Dr. Rizwan Bukhari  33:06

Everybody should go out and get one of those simple blood pressure machines. Yeah, check the blood pressure, there's no reason not to.

Maya Acosta  33:13

Absolutely. We hope that you have enjoyed this series on stroke prevention for the month of May. You know, we try pulling resources, mainly from the big organizations. But also we know that a lot of the people that we follow, that are trained in lifestyle medicine and plant-based nutrition have a lot of real science-based content. And so we try to incorporate that as well. There's a guy the American Stroke Association has a guide for patients and caregivers. So Dr is in the previous episode, you kind of talked about how people live with complications. Stroke Survivors can live with very debilitating complications. And this guide kind of helps you to have a little bit more control. It's like a little workbook where you go through it, and you talk about lifestyle changes that you've been making, and you recognize your risk factors and all of that. And it really gives you tools for yourself and for your caregiver, as a survivor. Depending on the damage that happened. You might have to see various specialists and work closely with other people to support you, including a caregiver to help you with day to day activities that you no longer have freedoms to do. You said that in the past that your patients have said that they would rather die than to live debilitated.

Dr. Rizwan Bukhari  34:33

Yep. I mean, stroke is the number one cause of disability in the United States. Yeah. And so it's it's not it's, it's not a fun lifestyle.

Maya Acosta  34:44

That's right. So we hope that you take a lot of this content to heart that you share these episodes with people that you love, who you also want to benefit from the content that we're sharing. We spend a lot of time researching these topics so that you can have more knowledge to take into Love your health and let us know if there are other health topics that you would like us to address. We try to, you know, when they're being highlighted in a particular month we try to choose those but strokes like you said, it's the number two killer. It's up there with heart use

Dr. Rizwan Bukhari  35:15

number three, heart diseases. Number one, cancer is number two stroke is number three.

Maya Acosta  35:20

Okay, so we want to thank you again, and Dr. Riz, thank you again for making yourself available to educate our listeners on the things that they can do to take control over their

Dr. Rizwan Bukhari  35:29

health. I'm happy to be here. Yeah, we'll see you next time.

Maya Acosta  35:32

All right. Thanks again for listening. You've been listening to the healthy lifestyle solutions podcast with your host Maya Acosta. If you've enjoyed this podcast, do us a favor and share with one friend who can benefit from this episode. Feel free to leave an honest review as well at rate this podcast.com forward slash HLS. This helps us to spread our message. And as always, thank you for being a listener.