Heart Matters – March 2023

Cardiovascular Division Providers Participate in School Outreach Program

In February, the students at Barak Obama Elementary School got an education in heart health as faculty and staff from the Washington University School of Medicine Cardiovascular Division visited science classes with hands-on presentations.

Doctors presented to 5th, 6th, and 8th grade classes February 3rd, and to younger students on the 10th. They discussed the anatomy and basic function of the heart, taught children how to properly take their pulse, and overviewed causes and treatments for diseases and conditions of the heart. Sonographers even demonstrated portable cardiac ultrasounds so the students could all see a real heart in action.

Dr. Linda Peterson, who leads the outreach program spoke to the 8th grade class about the importance of CPR, demonstrated by the recent lifesaving measures administered to NFL player Damar Hamlin after he suffered cardiac arrest during a game.

Drs. Karen Joynt-Maddox, fellow Dr. Anne Marie Kerchberger, and sonographer Billy Cathey Joined Dr. Peterson in Dr. Vivian Johnson’s science class. In Ms. Brand’s 5th grade class, Dr. Joshua Mitchell and Dr. Justin Sadhu answered questions from the class about heart transplant, bypass, and the causes of heart failure, and helped the children calculate how many times their hearts beat in a year. Ms. Betts’s 6th graders watched videos about angioplasty and stent procedures explained by Cardio-Oncology fellow Dr. Zyad Qamer, and sonographer Rachel Myers talked about how she came to her career in medicine.

February is National Heart Month, and the Wash U Cardiovascular division is committed to improving the cardiovascular health of our St. Louis Metro Area community through programs like this one. Our faculty and staff are grateful for the opportunity to work with young people and encourage them to make healthy choices, be curious about science, and potentially pursue careers in medicine. Dr. Peterson and the team look forward to returning to the school next year.

Way to Shine!

“Today I had a patient rave about how amazing Keeyonna Harrison is at her job.  She said she was helpful, sympathetic, kind, and efficient.  This patient is a local healthcare administrator and wanted to make sure that I knew how lucky we are to have her!  Way to go Keeyonna. Thanks for being so great to our patients!”

Other Way to Shine’s for this month were Jenny Weimer, Mary Wingate, Brad Boyer, Lisa Fields, and Malinda Allen

If you catch someone in the act of shining, contact or send an email to bolhafner@wustl.edu.

Researchers elected to American Society for Clinical Investigation

Three physician-scientists in the Cardiovascular Division have been elected members of the newest class of the American Society for Clinical Investigation. They are being recognized for their original, creative and independent investigations in the clinical or allied sciences of medicine. The new members, who will be inducted April 21, are Karen Joynt Maddox, MD; Stacey L. Rentschler, MD, PhD; and Rajan Sah, MD, PhD.

Joynt Maddox, an associate professor of medicine, is a cardiologist whose research is focused on understanding how public policy, including Medicare and Medicaid, impacts health equity. Her work focuses on identifying policy solutions to reduce inequities for historically marginalized populations, including people from racially or ethnically minoritized groups, people living in poverty, and people living in rural areas. Also holding a master’s of public health degree, she co-directs the Center for Health Economics and Policy at Washington University’s Institute for Public Health.

Rentschler, an associate professor of medicine, is a cardiologist focused on understanding the electrical system of the heart. In heart failure and other conditions, the heart can develop abnormal rhythms that can be life-threatening. Her team recently has investigated how radiation therapy typically directed at cancer can be used to treat ventricular tachycardia, a life-threatening arrhythmia. She and her colleagues found that the radiation changed the gene expression in heart muscle cells, reprogramming them into what appears to be a younger, healthier state

Sah, an associate professor of medicine, is a cardiologist focused on understanding how mechanically responsive ion channels regulate fundamental cellular processes, including metabolism, that influence the risk of heart and vascular problems, such as heart attack and stroke. Sah and his team developed a class of compounds that target a novel family of mechanoresponsive ion channels to treat diabetes by improving insulin secretion and the ability of tissues to use that insulin to remove sugar from the bloodstream. In mouse studies, the drug improved blood sugar levels and reduced fat buildup in the liver.

Dr. Angela Brown Promotes Women’s Heart Health on KPLR News

Last month, cardiology division faculty member and Director of the Hypertension Clinic Dr. Angela Brown appeared on the Pulse of St. Louis segment of KPLR news. She was part of a panel to discuss high blood pressure and women’s heart health for Heart Month.

Dr. Brown spoke about the importance of blood pressure screening and demonstrated at-home options of blood pressure meters. She emphasized the risks of high blood pressure, and that many suffer from the condition without presenting any symptoms at all.

Also on the panel were Rachelle Bartnick, AHA St. Louis Senior Community Health Director, and Crystal Williams, a heart disease survivor. Check it out here!

Dr. Mark Huffman on Healthier Blood Pressure

Many Americans wrongly assume they understand what normal blood pressure is – and that false confidence can be deadly

False confidence, deadly consequences

Stunning as it may sound, nearly half of Americans ages 20 years and up – or more than 122 million people – have high blood pressure, according to a 2023 report from the American Heart Association. And even if your numbers are normal right now, they are likely to increase as you age; more than three-quarters of Americans age 65 and older have high blood pressure.

Also known as hypertension, high blood pressure is a major risk factor for heart disease and stroke.

Our research has found that most Americans don’t know the normal or healthy range for blood pressure – yet strikingly, they think they do. And that is cause for serious concern.

We are a health communications expert and a cardiologist. Together with our health communication collaborators, we surveyed more than 6,500 Americans about their knowledge of blood pressure. They were recruited through the Understanding America Study, a nationally representative sample of U.S. residents.

In our new study, published in January 2023, we found that 64% expressed confidence in their understanding of blood pressure numbers – but only 39% actually knew what normal or healthy blood pressure is.

False confidence, deadly consequences

Such false confidence can be harmful because it may prevent people from seeking care for high blood pressure. After all, if you think it’s normal, why bother talking to your doctor about your blood pressure?

Part of the reason for this overconfidence begins in the doctor’s office. Typically, a nurse brings over a blood pressure cuff, straps it on your upper arm and takes a reading. The nurse may announce the result, remove the cuff and record it for the doctor.

When the doctor arrives, the session may well move on to other matters without a word about the blood pressure reading. This likely happens because your doctor wants to focus on how you’re feeling and why you’re there. But as a result, you may leave your appointment thinking your blood pressure is fine, even if it’s not.

About 70% of Americans will have high blood pressure in their lifetimes. What’s more, only 1 in 4 patients with hypertension have their blood pressure under control. And because high blood pressure usually has no symptoms, you can have it without knowing it.

To lower your risk of heart attacks and strokes, it’s critical to understand your blood pressure readings. This is especially true for patients with conditions such as heart disease, kidney disease and diabetes.

What the numbers mean

Blood pressure is reported with two numbers. The first number is your systolic blood pressure; it measures the pressure in arteries when the heart beats. The second number, your diastolic blood pressure, measures the pressure in your arteries between heartbeats.

Normal or healthy blood pressure is less than 120/80 millimeters of mercury (mm Hg) for adults. This is a unit of measurement that stems from early blood pressure monitors, which looked at how far your blood pressure could push a column of liquid mercury. For most patients, lower tends to be better.

Stage 1 hypertension, which is the lower stage of high blood pressure, begins at 130/80. Stage 2 hypertension, which is the more severe stage of high blood pressure, begins at 140/90. Both numbers are critically important, because every increase of 20 millimeters of mercury in systolic blood pressure, or 10 in diastolic blood pressure, doubles a person’s chances of dying from a heart attack or stroke.

10 tips for healthier blood pressure

To avoid false confidence, ask about your blood pressure at every doctor’s visit, and find out what the numbers mean. If your blood pressure is above the normal or healthy range, then the American Heart Association recommends the following 10 tips.

  1. Talk with your doctor. If your blood pressure is high, ask your doctor about strategies for lowering it, and how you can track your blood pressure at home.
  2. Eat a heart-healthy diet. Vegetables, fruit, whole grains, low-fat dairy products, skinless poultry and fish, nuts and legumes, and olive oil are all good for your heart. Red meat, saturated and trans fats and ultraprocessed foods are unhealthy for your heart.
  3. Cut back on salt, which increases blood pressure. The Dietary Guidelines for Americans recommend no more than 2,300 milligrams of sodium per day – that’s less than one teaspoon – but the U.S. Food and Drug Administration reports that the average American takes in about 3,400 milligrams daily, roughly 50% more than recommended. Even if you don’t add any salt to your meals, you may still get too much from ultraprocessed foods. One serving of canned chicken noodle soup has 680 milligrams of sodium. One Big Mac from McDonald’s has 1,010 milligrams of sodium.
  4. Limit your alcohol use. Whether it’s beer, wine or spirits, alcohol increases your blood pressure. It’s better to not drink alcohol, but if you do, observe the limits recommended by the Dietary Guidelines for Americans. For women, that’s one drink per day at the very most. For men, it’s two drinks per day at most. One drink is 12 ounces of beer, 4 ounces of wine, 1.5 ounces of 80-proof spirits or 1 ounce of 100-proof spirits.
  5. Be more physically active. Just two and a half hours per week of physical activity can help lower blood pressure. For example, that’s a 30-minute walk five days a week. You might also switch up your physical activity by swimming, lifting weights, doing yoga or going dancing.
  6. Maintain a healthy weight. Even losing a few pounds can help manage high blood pressure in people who are overweight. Ask your doctor about a healthy approach to weight loss.
  7. Manage stress, which is bad for your blood pressure. While stress relief doesn’t always lower blood pressure, bringing down your stress level can help you feel better. The Mayo Clinic recommends several ways to manage stress, including learning to say no sometimes, spending time with family and friends and meditating.
  8. If you smoke, vape or both: Quit now. Both are bad for your heart and blood vessels and contribute to high blood pressure. Quitting smoking may reduce your heart disease risk to nearly the same level as people who never smoked. And the benefits of quitting start right away. A recent study found that after just 12 weeks, people who quit had lower blood pressure than when they were still smoking. The Centers for Disease Control and Prevention has recommendations for programs and medication that can help you quit.
  9. Take medication, which is often recommended for people with stage 2 hypertension, and for some with stage 1 hypertension, including those who also have heart disease, kidney disease or diabetes. Most patients need two to three medications to lower blood pressure to normal or healthy levels. A recent meta-analysis demonstrated that lowering systolic blood pressure by 5 mm Hg through medication reduces the risk of major cardiovascular events by about 10%, irrespective of baseline blood pressure or previous diagnosis of cardiovascular disease.
  10. Track your blood pressure at home. The American Heart Association recommends an automatic, validated cuff-style monitor that goes on your upper arm. A record of readings taken over time can help your doctor adjust your treatments as needed.

      High blood pressure is a silent killer. Being proactive and knowing your numbers can be a lifesaver.

      Health & Wellness

      Calcium: Your Heart and Bone Health
      Emma Greenhill, MS, RD, LDN

      Calcium’s Role in Heart and Bone Health

      Calcium plays a vital role in cardiac function and bone health. In the heart, calcium facilitates electrical signals that contract the muscle, pumping blood to the body. In the bones, calcium deposits reinforce bone tissue structure and strength. Too little calcium in the diet leads to heart failure, low blood pressure, arrhythmias and/or fibrillation, and osteoporosis. The National Institute of Health recommends a daily calcium consumption of 1000 mg for men aged 19-70 and women aged 19-50. This increases to 1200 mg for women over the age of 50 and men over 70.

      Calcium-Rich Foods Help Regulate Blood Pressure

      Adequate calcium intake is associated with reductions in hypertension, stroke, and coronary artery disease. In 2019, hypertension, the “silent killer”, was deemed the primary or contributing cause of over half a million deaths. A recent Cochrane Review published in January 2022 shows that increased calcium intake of at least 1000 mg/day is associated with reductions in both lower systolic and diastolic blood pressures in males and females ages 11-82 years old. Reductions in blood pressure were even greater on average for those under the age of 35. Dietary calcium offers a protective role against hypertension and its related risks of cardiovascular disease.

      Calcium Collaborators & Bone Health

      Remember to get adequate amounts of dietary calcium and its supportive collaborators, vitamin D, phosphorus, and protein. Calcium absorption requires a variety of nutrients to ensure adequate levels in the body. Vitamin D facilitates the active transport of calcium absorption. Phosphorus decreases the amount of calcium the body excretes, retaining it for vital functions and reabsorption in the bone. Protein makes up roughly 50% of bone structure and one-third of its mass. Dietary protein provides essential amino acids that contribute to bone health. Additionally, protein intake supports muscle protein building, reducing muscle mass loss. Muscle mass loss also increases the risk of falls and bone fracture.

      Dietary Sources of Calcium

      As we age, the amount of calcium our bodies absorb diminishes. Both individuals over the age of 70 and post-menopausal women are at increased risk of calcium deficiency. Dairy remains the highest source of dietary calcium. Choose non-fat plain Greek yogurt, non-fat or 2% unflavored milk, non-fat Ricotta cheese, and low-sodium cottage cheese. Another excellent option, lower in saturated fats than cow’s milk, is Fairlife non-fat or 1% milk. This ultra-filtered brand also provides 13 grams of protein per serving compared to 8 grams in other brands cow’s milk. A milk alternative that more closely matches the nutrient profile of cow’s milk is fortified soy milk, which provides comparative protein, calcium, vitamins D and B12.

      Sheet Pan BBQ Tofu Bowls

      Serves: 4     •    Prep Time: 25 minutes     •     Total Time: 40 minutes

      An easy prep meal, featuring a crispy BBQ tofu, packing in protein and roasted veggies, with a homemade Jalapeño Ranch dressing. the ordinary toast toppings and enjoy this herb cheese spread instead. It’s a delightful way to start off your day!

      Ingredients

      • 14 oz. block extra or super-firm tofu, drained, pressed to remove extra moisture, cut into 1” cubes
      • 1 ½ cups sweet potato, cubed
      • 2 Tbsp olive oil
      • 2 bell peppers, julienned
      • ½ large red onion, sliced
      • 1 cup uncooked quinoa
      • 3 cups shredded kale leaves
      • ¼ cup BBQ sauce (of your choice)
      • ¼ cup BBQ sauce (of your choice)
      • 1 tsp chili powder
      • ¾ tsp smoked paprika
      • ½ tsp cumin
      • ½ tsp garlic powder
      • ½ tsp onion powder

        Dressing:

        • ½ cup plain nonfat Greek yogurt
        • ¼ cup olive oil
        • ¼ cup fresh parsley
        • ½ cup diced jalapeño, seeds removed
        • 1 tsp white vinegar
        • ½ tsp garlic powder
        • ½ tsp dried dill
        • ½ tsp onion powder

        Directions

        1. Pre-heat oven to 425 degrees.
        2. On an aluminum foil lined sheet pan sprayed with olive oil, spread tofu and sweet potatoes.
        3. Mix chili powder, smoked paprika, cumin, garlic powder, and onion powder. Sprinkle over tofu and sweet potatoes. Stir to mix well. 
        4. Add bell pepper and onion to the sheet pan. Drizzle olive oil and stir to coat.
        5. Bake in oven for 35 minutes, stirring halfway through.
        6. Bake in oven for 35 minutes, stirring halfway through.
        7. In a small saucepan, add 2 cups of water and quinoa. Bring to a boil, reduce to a simmer, and allow water to be absorbed, around 15 minutes.
        8. Remove the quinoa from the burner, add the kale and stir well. Cover and allow kale to steam wilt for 10 minutes.
        9. In the blender mix the Jalapeño Ranch ingredients. Blend until smooth.
        10. Divide the quinoa kale mixture between four bowls. Top with BBQ mixture and drizzle with Jalapeño Ranch dressing.

        Recipe courtesy of https://dishingouthealth.com/sheet-pan-bbq-tofu/

        Do you have BJC Cigna? Remember that you have annual coverage to meet with me, Emma Greenhill, a Heart Care Institute dietitian. Call 314-996-8165 for more insurance information or to schedule an appointment.

        Welcoming Dr. S. Zyad Qamer

        S. Zyad Qamer, MD, has joined the Division as an Assistant Professor of Medicine. Dr. Qamer received his undergraduate degree (BA) at New York University in economics, medical degree (MD) from Georgetown University School of Medicine. Dr. Qamer completed an internal medicine residency at Medstar Georgetown University Hospital where he also completed a fellowship in cardiovascular disease. Dr. Qamer completed further training in Cardio-Oncology and Amyloidosis at Washington University School of Medicine under the leadership of Dr. Josh Mitchell.

        Dr. Qamer’s academic research focuses on cardio-oncology and amyloidosis with a special interest in cardiac imaging. His clinical expertise is general non-invasive cardiology with a focus on the intersection of cancer and cardiovascular diseases and the use of advanced cardiac imaging. Dr. Qamer aims to provide expert clinical care in cardio-oncology and amyloidosis. Dr. Qamer will see patients with a wide variety of cardiovascular diseases and will attend on the inpatient cardiology and cardio-oncology consultative services at Barnes Jewish Hospital. Additionally, Dr. Qamer will see outpatients at the Center for Advanced Medicine, West County and South County locations.

        Meet Your Colleague

        John Murphy, PhD

        Senior Scientist, Diwan Lab

        Fun Facts About John

        How long in the division: Since May of 2012.

        Family:  Monica Kelly, wife. EllaMarie oldest child, 12  Sean youngest, 10 years old

        Hobby: public speaking with Toastmasters International (since July of 2000) and helping the Boy Scouts of America 

        Favorite Food:  pizza – you can put anything
        on it

        Nickname:  JT when I’m surrounded by more than one person named John,  it’s the hazard of a common name.

        Bucket List: To write a book about being a parent. I’ll call it ‘All My Shirts Are Missing Buttons’ or ‘Where’s My Car Keys – I’m Late’.

        Cardiovascular Division Staffing Updates

        Positions open for hiring:

        JR70488 – Research Nurse Coordinator II

        JR70780 – Clinical Specialist PT/OT

        JR72048 – Coordinator Laboratory Support Services        

        JR71712 – Ultrasound Sonographer

        JR73092 – Coordinator Residency/Fellowship

        JR72346 – Billing Scheduling Associate I

        JR72337 – Clinical Research Coordinator I             

        JR72294 – Research Technician II              

        Welcome to the Cardiovascular Division:

        3/6/2023 – Jamie Conners, Clinical Research Study Assistant II

        3/6/2023 – Brielle Stephens, Medical Assistant II

        3/20/2023 –Lisa Brinkman, Administrative Coordinator II

        Departing Employees: 

        Farewell to these Cardiovascular Division employees. Thank you for your service, you will be missed!

        Ashley Lin, last day is 3/17

        Nien-Du Yang, last day is 3/20

        Washington University and BJC named to Forbes list of ‘America’s Best Large Employers’

        Three St. Louis companies finished among the Top 100 in Forbes’ latest list ranking America’s Best Large Employers.

        Forbes recognized Edward Jones (53rd), Washington University (69th) and BJC Healthcare (91st) among the Top 100. All three companies are headquartered in the St. Louis region and employ nearly 100,000 people combined.

        “We are proud of this national recognition for BJC HealthCare, our employees and our communities,” says Jackie Tischler, BJC senior vice president and chief people officer. “And we thank our 30,000 caregivers who bring their best every day to support our patients, each other and our promise that everyone deserves extraordinary care.”

        “We’ve made a commitment to provide extraordinary care to our communities — and our 30,000 team members are the ones who make that happen,” Tischler says. “We’re proud to give them the recognition they deserve, and we’re excited that they’ve recognized BJC as one of America’s Best Large Employers.”

        Spring Well-Being Challenge

        WashU’s Worldwide Wellness spring challenge is a six-week opportunity to prioritize physical activity, meaningful connections, and active relaxation. You can virtually travel the world, visiting amazing hot spots as you build well-being habits that last long after your journey is over. Benefits-eligible employees can now register online using their WUSTL Key and opting into the Worldwide Wellness challenge. 

        Registration Feb. 16 – March 10
        6-week challenge March 6 – April 16, 2023

        Thrive tip: Bookmark the challenge webpage for more details, read FAQs, and begin logging activity on March 6, 2023.

        Upcoming Discounted Tickets for Wash U Employees

        Skeleton Crew discounted tickets March 29 – April 16, 2023, at Berges Theatre, COCA WashU employees can purchase tickets at a discounted price for the Black Rep Theatre performance of Skeleton Crew. View additional perks on HR’s Culture & Community page. 
        WashU Night at the Ballpark Friday, Sept. 15, 2023, 7:15 p.m. at Busch Stadium Cheer on the St. Louis Cardinals against the Philadelphia Phillies during WashU Night at the Ballpark. WashU ticket holders will receive a WashU & Cardinals co-branded item upon arrival and be invited to walk the warning track before the game. Purchase discounted tickets to the Sept. 15 game at Busch Stadium. 

        Fauci to Speak at WashU Medicine Commencement

        Famed infectious diseases expert Anthony S. Fauci, MD, the recently retired director of the National Institute of Allergy and Infectious Diseases (NIAID) of the National Institutes of Health (NIH) and a medical adviser to seven U.S. presidents, will address graduating MD and MD/PhD students at Washington University School of Medicine in St. Louis on May 15, when the new doctors receive their diplomas.

        Fauci’s role as graduation speaker was announced by David H. Perlmutter, MD, executive vice chancellor for medical affairs, the George and Carol Bauer Dean of the School of Medicine and the Spencer T. and Ann W. Olin Distinguished Professor.

        “For almost 40 years, Anthony Fauci served as NIAID director, making seminal contributions in infectious disease and immunology research and to public health, most recently through his work to inform the public about COVID-19,” Perlmutter said. “His leadership in testing and developing treatments and vaccines has saved countless lives in the United States and around the world. He is also internationally recognized for his heroic role in confronting the HIV/AIDS epidemic, and for work that underpins our understanding of how HIV destroys the body’s defenses and makes people susceptible to deadly infections. He was instrumental in developing treatments that enable people with HIV to live long and active lives. He is the quintessential role model for physician-scientists and exemplifies all the virtues that science has contributed to improving health in our society. We are honored that he will share his wisdom with our school and our graduates on this special day.”

        The ceremony for WashU Medicine’s Class of 2023 will be held at Francis Olympic Field at 3 p.m. May 15. The universitywide Commencement will take place earlier the same day at 9 a.m., also at Francis Olympic Field.

        IT Spotlight: WashU IT Welcomes Microsoft 365 (M365) Apps

        WashU IT became the first department at WashU to adopt Microsoft 365 (M365) Apps, Washington University’s cloud-based productivity platform. All the latest productivity apps are included in M365, such as Microsoft Teams, Word, Excel, PowerPoint, Outlook, and OneDrive.  

        Microsoft has made a major change to the branding of its Microsoft Office product. Microsoft Office is being renamed “Microsoft 365” to reflect its growing collection of productivity apps. In addition to Excel, Outlook, Word, and PowerPoint, Microsoft will now refer to these apps as part of Microsoft 365 rather than Microsoft Office.

        This new branding has been in the works for years, following the renaming of Office 365 subscriptions to Microsoft 365 in April 2020, but the changes are now much deeper. “Office.com, Office mobile, and the Office app for Windows will become Microsoft 365 apps, with a new icon, new look, and even more features,” says a Microsoft FAQ.

        Office products have been a mainstay of WashU IT for many years. M365 includes everything you know about Office 365. M365 is designed to help people and businesses achieve more with innovative Office apps, intelligent cloud services, and world-class security.

        WashU IT will be the first department to use M365 operationally as WashU, with plans of migrating the rest of the university to the platform throughout 2023 and 2024. To get started, users can find the M365 KB instructions for PC and Mac for building user knowledge of the platform. There are a range of Microsoft training resources available to steadily build your knowledge of M365, including a short video overview from Microsoft and a brief course on LinkedIn Learning to learn more about how to access your M365 account and work with both desktop and browser versions of the apps. To learn about specific applications, search and select the application on the M365 Quick Start Guide.

        Keep up to date with IT news at the Office of Information Security blog

        Follow the Cardiovascular Division on Twitter!

        Check out our division account, @WashUCardiology! We will be sharing division accomplishments, announcements, news, events, and more. If you have a story about the cardiovascular division that you think deserves a social media spotlight, email bolhafner@wustl.edu.

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