THIS PROGRAM IS MADE BY MPT TO ENRICH ALL OF OUR DIVERSE COMMUNITIES AND IS MADE POSSIBLE BY THE GENEROUS SUPPORT OF OUR MEMBERS.

THANK YOU.

LIVE FROM MARYLAND PUBLIC TELEVISION, THIS IS "DIRECT CONNECTION" WITH JEFF SALKIN.

♪♪] >> JEFF: GOOD EVENING AND WELCOME TO YOUR "DIRECT CONNECTION."

COMING UP CONTINUANCES TO YOUR QUESTIONS ABOUT TREATING AND PREVENTING HEART DISEASE.

FIRST TONIGHT BIG CHANGES HOW YOU GET YOUR NEWS.

"THE WASHINGTON POST" LAYING OFF HUNDREDS.

JOURNAL LIFTS OTHER PAPERS TURNING TO ARTIFICIAL INTELLIGENCE TO WRITE THEIR STORIES.

JOINING US TO EXPLAIN WHY THE NEWS IS BREAKING ARE RAFAEL LORENTE DEAN OF THE PHILLIP MERRILL COLLEGE OF JOURNALISM AT THE UNIVERSITY OF MARYLAND AND HERE IN THE STUDIO WE ARE JOINED BY AUDREY COOPER THE NEW EDITOR-IN-CHIEF OF THE BANNER.

RAPHAEL IF I CAN START WITH YOU, WHY SHOULD PEOPLE WATCHING CARE OTHER THAN HUMANITARIAN REASONS THAT THE "THE WASHINGTON POST" LAID OFF REPORTERS?

>> FIRST OFF JEFF, THANK YOU FOR HAVING ME.

THE REASON FROM MY PERSPECTIVE I LIVE IN THE AREA AND I'VE HAD THE PRIVILEGE OF 28 YEARS OF ENJOYING TREMENDOUS JOURNALISM FROM AMAZING REPORTERS AND EDITORS AND OTHERS.

BUT THE REASON PEOPLE SHOULD CARE, IS THAT WHEN LOCAL NEWS GOES AWAY THEIR COMMUNITIES SUFFER.

OUR COMMUNITIES ARE LESS FOR IT.

PEOPLE VOTE AT LOWER RATES.

PEOPLE VOLUNTEER AT LOWER RATES.

LOCAL NEWS LOSE -- IS CRITICAL TO THE HEART AND SOUL OF A COMMUNITY AND CRITICAL TO DEMOCRACY.

AS THIS HAPPENS IN WASHINGTON BUT ALL OVER THE COUNTRY WE ARE AS A SOCIETY ARE SUFFERING.

>> Jeff: THAT BRINGS US TO THE NEW SUCCESSFUL NEWS START UP VENTURE THE BANNER IS ABOUT THREE YEARS?

>> WE ARE NEW IN TERMS OF NEWS OPERATIONS.

>> Jeff: BUT A GOOD SIZE.

HOW LARGE A NEWSROOM NOW?

>> WE ARE GOING TO HAVE A HUNDRED PEOPLE IN THE NEWSROOM ALONE IN THE NEXT COUPLE OF MONTHS.

>> Jeff: FELL US THE MARKET YOU SERVE AND WHAT YOU DO THAT MAYBE OTHER PUBLICATIONS OTHER MEDIA ARE NOT DOING?

>> WELL, FIRST, WE HAVE SUBSCRIBERS IN EVERY STATE IN AMERICA.

>> Jeff: REALLY?

>> YEAH, IT'S GREAT I DON'T KNOW WHY THEY ARE SPEED IN MARYLAND NEWS IN ALASKA OUR FOCUS IS PROVIDING THE BEST LOCAL NEWS TO THE PEOPLE OF MARYLAND.

WE STARTED WITH A FOCUS ON BALTIMORE AND THE SURROUNDING AREAS.

BUT IN THE LAST COUPLE OF MONTHS WE HAVE EXPANDED TO THE DC SUBURBS OF MARYLAND.

LAST WEEK, I THINK, WE ANNOUNCED IT GOES FAST -- WE ANNOUNCED WE WERE EXPANDING OUR COVERAGE IN PRINCE GEORGE'S COUNTY AND WOULD START COVERING THE WASHINGTON SPORTS TEAMS.

>> Jeff: IT'S EXPENSIVE TO DO THIS WHY IS WHY SO MANY OTHER PAPERS AND JOURNALISM VENTURES ARE DOWNSIZING HOW IS IT YOU ARE UP SIZING?

>> WE HAVE A UNIQUE MODEL WE ARE A NONPROFIT ORGANIZATION.

A LOT OF THE ORGANIZATIONS YOU SEE PULLING BACK ON LOCAL NEWS BECAUSE THEY ARE FOR-PROFIT ENTERPRISES AND THEY HAVE TO KEEP MAKING MONEY.

THEY DO GREAT JOURNALISM I'VE WORKED FOR THEM.

AT THE BANNER WE NEED TO BREAK EVEN AND ANYTHING OVER THAT WE POUR BACK INTO THE JOURNALISM AND IT MAKES A BIG DIFFERENCE TO OUR JOURNALISTS AND HOW THEY SEE THEIR ROLE.

IT'S MISSION-ORIENTED INSTEAD OF PROFIT MOTIVATED.

AND I THINK IT ALSO MEANS THAT WHEN WE DO WELL IT JUST FEEDS BETTER JOURNALISM, TOO.

>> Jeff: WHAT HAPPENED TO THE BUSINESS MODEL?

YOU THINK ABOUT THE GREAT FORTUNES THAT WERE MADE IN THE NEWSPAPER BUSINESS ALL OF THAT KILLED BY THE INTERNET?

>> THE INTERNET IT WAS KILLED BY REALLY THE ADVERTISING MODEL AT THAT TIME WENT AWAY AS A RESULT OF THE INTERNET.

THE NEWSPAPERS THAT YOU AND I GREW UP WITH WERE FILLED WITH ADS FOR PURCHASING CARS, FOR TRAVEL, FOR BIG BOX RETAILORS THAT NO LONGER EXIST.

FOR CLASSIFIED ADS IF YOU WANTED TO SELL OR BUY ANYTHING AN AMERICAN COULD SEE THE NEWSPAPER WAS THE PLACE TO DO IT.

AND IT IS NO LONGER THERE.

AND NOW THERE ARE MANY EXPERIMENTS AROUND THE COUNTRY NONPROFIT NEWS LIKE THE BANNER IS IS ONE OF THE MORE PROMISING ONES WHERE FOLKS ARE LOOKING FOR I ANEW BUSINESS MODEL.

I DON'T PRETEND TO HAVE THE ANSWER I HAVE FACULTY WORKING HARD INSIDE OUR COLLEGE AND WITH OUR PARTNERS AT THE SMITH SCHOOL OF BUSINESS LOOKING FOR RESEARCH LOOKING FOR WAYS WE CAN HELP FIND SOLUTIONS TO THIS.

>> Jeff: AUDREY, WHEN YOU WERE LOOKING AT ACCEPTING THIS JOB YOU KICKED THE TIRES ON THE BUSINESS MODEL.

HOW DOES IT COMPARE TO SOME OF THE OTHER START-UPS WE'VE HEARD ABOUT?

>> I THINK THE MOST IMPORTANT IS THE SIZE OF THE BANNER TO BE HONEST WITH YOU.

THERE ARE LOTS OF EXPERIMENTS IN NONPROFIT MEDIA, THE PROBLEM IS A LOT ARE SMALL AND THEY HAVE SMALL AUDIENCES.

I KNOW YOU APPRECIATE THIS, THE CHALLENGE WITH THAT IS WE REALLY NEED SCALE, WE NEED LARGE VIEWERSHIP WE NEED LARGE READERSHIP IF WE ARE GOING TO HAVE THE IMPACT WITH OUR JOURNALISM.

THE TRUTH IS NOWADAYS IT'S HARD TO SHAME A POLITICIAN.

THEY ARE NOT AS AFRAID OF THE MEDIA THEY USED TO BE AND THE MORE SCALE WE HAVE THE MORE IMPACT WE WILL HAVE POINTING OUT WRONGDOING AND DO OTHER STORIES THAT BRING THE COMMUNITY TOGETHER, TOO.

>> Jeff: THE HIGH-WATER MARK OF JOURNALISTS, MAKING CHANGES IN THE WORLD, I GUESS RAPHAEL WAS WATERGATE AT "THE WASHINGTON POST" AND WOODWARD AND BERNSTEIN AND LOTS OF PEOPLE WANTING FOR TO BE JOURNALISTS DO PEOPLE WANT TO BE JOURNALISTS WHEN YOU LOOK HOW MANY KIDS ARE APPLYING TO YOUR PROGRAMS WHAT IS THE TREND?

>> YES, THEY DO.

HAVE THE NUMBERS FLUCTUATED OVER THE YEARS?

ARE WE SMALLER?

WE ARE A BIT.

BUT INTERESTINGLY, THE STUDENTS THAT COME TODAY COME WITH A PASSION AND A MISSION FOR WHAT THEY WANT TO DO.

AND THEY'VE ALSO SEEN NOT JUST WHAT THE BANNER BUT OTHERS AROUND THE COUNTRY ARE DOING WITH INVESTIGATIVE JOURNALISM, WITH SOMETHING WE PRIDE OURSELVES ON, DATA JOURNALISM WHICH ALLOWS YOU TO TELL STORIES THAT YOU COULD NOT TELL WHEN I STARTED 30 YEARS AGO.

WE ARE STILL GETTING APPLICANTS BUT THE APPLICANTS ARE ACTUALLY MORE TALL LENDED THAN THEY WERE I WOULD SAY, WHEN I APPLIED TO SCHOOL.

>> Jeff: DATA JOURNALISM MAKES ME THINK OF ARTIFICIAL INTELLIGENCE JOURNALISM WHICH IS A TREND.

WHAT ARE YOU SEEING OUT THERE?

>> SO, WE'VE DECIDED THAT WE'RE NOT GOING TO RUN FROM IT.

AND WE THE PHILLIP MERRILL COLLEGE OF JOURNALISM AND THE UNIVERSITY OF MARYLAND, WE ARE GOING TO RUN AT IT.

EVERY TIME PEOPLE RUN FROM TECHNOLOGY THEY USUALLY DON'T DO SO WELL.

AND SO WE HAVE BEEN LOOKING FOR WAYS TO EXPERIMENT AND USE A.I.

TO MAKE JOURNALISM BETTER FOR THE COMMUNITIES THAT JOURNALISTS COVER.

WE UNDERSTAND THAT SOME FOLKS ARE USING IT TO WRITE OR CREATE THEIR JOURNALISM WE DON'T THINK THAT IS THE BEST USE OF IT.

HUMANS ARE STILL THE BEST JOURNALISTS.

BUT WE HAVE FOUND CREATED ALREADY SEVERAL PILOT PROJECTS WHERE WE ARE CREATING TOOLS IN PARTNERSHIP WITH LOCAL NEWSROOMS SO THAT THEY CAN DO MORE THAN THEY CAN DO ON THEIR OWN.

THESE TOOLS INCLUDE ALLOWING THEM TO KEEP TABS ON PUBLIC MEETINGS WHEN THEY CAN'T SEND A REPORTER AND THE A.I.

TOOL WILL TELL THEM HEY THERE IS A NEWS TIP THAT YOU MIGHT WANT TO FOLLOW.

THEY INCLUDE GOING THROUGH ARCHIVES AND HELPING NEW BEAT REPORTERS.

WE ARE TEACHING THIS WE ARE HAVING STUDENTS BILLION THE TOOLS AND PROVIDING THEM TO NEWS ORGANIZATIONS TO HELP THEM OUT.

>> Jeff: AT THE BANNER HAVE WE PUBLISHED AN ARTICLE WRITTEN BY A.I.?

>> WE HAVE AN A.I.

POLICY AND IT SAYS CLEARLY IF WE USE A.I., IN ANYWAY, WE NEED TO DISCLOSE IT.

BUT THAT DOESN'T MEAN THERE ARE NOT VERY ETHICAL APPROPRIATE USES.

SPELL CHECK IS AN A.I.

AND GOODNESS KNOWS WE NEED TO USE THAT.

THERE ARE A LOT OF EXPERIMENTS WE'RE RUNNING WITH USING THE POWER OF MACHINE LEARNING TO FIGURE OUT WHAT IS HAPPENING IN A COMMUNITY, WHAT ARE PEOPLE TALKING ABOUT ON REDDIT AND SOCIAL MEDIA.

WE CAN PUT THAT TOGETHER AND IT WILL HELP SURFACE STORIES.

YOU STILL NEED, AND I THINK WILL ALWAYS NEED A REPORTER TO GO OUT AND HAVE HUMAN TO HUMAN CONVERSATIONS TO UNCOVER THE TRUTH.

BUT WE SHOULDN'T SHY AWAY FROM SOMETHING THAT CAN MAKE THE LEGWORK PART OF IT A LITTLE BIT MORE EFFICIENT.

>> Jeff: WELL, LET'S SEE.

VIEWER IN SOUTHERN MARYLAND, SAYS THANK YOU FOR FEATURING THE BANNER IT IS A GREAT PAPER THOUGH THERE'S TO PAPER.

>> NOT YET.

NO.

>> WE LIVE IN SOUTHERN MARYLAND AND NOTICE THERE'S LITTLE COVERAGE OF NEWS IN OUR AREA.

ESPECIALLY CONCERNED ABOUT THE LACK OF INVESTIGATIVE REPORTERS, DO YOU PLAN TO EXPAND COVERAGE IN OUR AREA?

>> I DON'T KNOW EXACTLY WHERE YOU LIVE, BUT YOU SHOULD E-MAIL ME AUDREY AT THE BANNER.COM.

I RESPOND TO MY E-MAILS IF YOU HAVE A STORY LET US KNOW.

I WANT TO HAVE AS MANY REPORTERS IN AS MANY COUNTIES AND MANY CITIES OF MARYLAND AS POSSIBLE.

TO DO THAT WE WILL NEED PEOPLE TO SUBSCRIBE TO THE BANNER AND SUPPORT US BUT WE WANT TO SERVE EVERYBODY IN MARYLAND.

>> >> WHAT DO PEOPLE CLICK?

IN THE DAYS OF NEWSPAPER YOU DIDN'T KNOW WHAT PEOPLE WHERE THE EYEBALLS WENT ON THE PAGE.

NOW, OF COURSE YOU KNOW EXACTLY WHAT THEY CLICK, HOW LONG THEY ARE ON IT, HOW MUCH OF IT IS NEWS VERSUS COOKING OR RESTAURANT OR ARTS OR SPORTS?

>> WELL, YOU KNOW IT'S INTERESTING BECAUSE TO ME IT'S NOT JUST ABOUT WHAT PEOPLE CLICK ON BUT WHAT DO OUR SUBSCRIBERS KEEP CLICKING ON WHAT DO THEY READ THE MOST.

I WOULD SAY ANYTHING WE HAVE THAT IS UNIQUE AND INVESTIGATION, A SCOOP, THOSE THINGS DO WELL.

PEOPLE WANT TO KNOW WHERE THE BEST RESTAURANTS ARE.

AND THE GREAT THING ABOUT NEWSPAPERS OF ONCE UPON A TIME IS YOU HAVE THE FRONT PAGE BUT YOU HAVE THE COMICS.

AND WE NEED TO REMEMBER THAT.

SOMETIMES YOU WANT TO HAVE A DISTRACTION IN ADDITION TO BECOMING SMARTER ABOUT YOUR COMMUNITY SMOOR RAPHAEL, VIEWER E-MAIL.

PITTSBURGH POST GAZETTE, PITTSBURGH'S REMAINING DAILY ANNOUNCED IT WILL CLOSE THE PRINT AND DIGITAL NEWSPAPERS.

TOO BAD IT SAYS IT CAN NO LONGER MAKE A PROFIT TO REMAIN OPERATIONAL.

ANY THOUGHTS ON THE SITUATION THERE?

WHICH MAY INVOLVE A LABOR DISTRIBUTE.

DISPUTE.

DON'T KNOW IF THEY CAN COME TO TERMS?

>> I KNOW IT INVOLVES A LABOR DISPUTE AND I'M NOT AN EXPERT SO I WILL STAY AWAY FROM THE SPECIFICS ON THAT.

PITTSBURGH IS A WONDERFUL CITY AND THE KIND OF CITY THAT DESERVES THE KIND OF COVERAGE THAT THE BANNER IS DOING AND ALL OVER MARYLAND AND THAT OTHER OUTLETS ARE DOING.

I KIND OF WANT TO GO BACK TO YOUR LAST VIEW ARE AND ASKING ABOUT INVESTIGATIVE REPORTING.

THAT IS ONE OF THE WONDERFUL PLACES WHERE A.I.

IS REALLY USEFUL, BECAUSE IT HELPS YOU UNCOVER PATTERNS THAT HUMANS CANNOT UNCOVER, CAN'T UNCOVER AT THE SAME SPEED.

WE'VE USED IT ON ALL KINDS OF PROJECTS WHERE WE COULDN'T HAVE OTHERWISE HAVE DOPE THE WORK ON OUR OWN.

>> Jeff: BEFORE WE GO, GIVE US A REASON FOR OPTIMISM THAT A DECADE, TWO, THREE, INTO THE FUTURE WE'RE GOING TO HAVE A VIBRANT NEWS MEDIA?

>> IF I COULD PICK UP MY COMPUTER AND IF IT WAS EARLIER IN THE DAY I WOULD SHOW THEM TO YOU.

THEY ARE ALL OVER THE BUILDING.

THEY ARE LOOKING FOR GREAT STORIES.

THE STUDENTS OF THIS COLLEGE WERE PULITZER PRIZE FINAL LISTS LAST YEAR FOR USING LARGE LANGUAGE MODELS AND HELPING "THE ASSOCIATED PRESS" TRACK A STORY THAT THEY COULD NOT DO OTHERWISE.

THE FUTURE IS IN PLACES LIKE THIS, AND I HAVE FULL FAITH AND CONFIDENCE THAT THEY ARE GOING TO FIX WHAT WE MY GENERATION SCREWED UP.

>> Jeff: AUDREY YOUR THOUGHTS ON THE FUTURE?

THE BANNER ITSELF IS A REASON FOR OPTIMISM?

>> I THINK SO.

THAT IS WHY I'M HERE.

AND I THINK EVERY PERSON IN OUR NEWSROOM WOULD AGREE.

I THINK THE FUTURE IS BRIGHT.

WE DO NEED EVERYBODY TO COME ALONG WITH US.

BUT AMERICA CAN'T EXIST WITHOUT LOCAL NEWS TO ME THERE IS NO OTHER OPTION.

>> Jeff: GOOD DEALS ON SUBSCRIPTIONS.

WE APPRECIATE YOUR TIME.

THANK YOU.

WE WILL BE RIGHT BACK AFTER THIS.

>> Jeff: JOINING US TO TALK ABOUT YOUR HEALTH IS Dr.

ALEX GYFTOPOULOS A CORDOLOGIST AT THE UNIVERSITY OF MARYLAND MEDICAL CENTER AND ASSISTANT PROFESSOR OF MEDICINE AT THE UNIVERSITY OF MARYLAND SCHOOL OF MEDICINE.

DOCTOR THANK YOU FOR JOINING US.

YOU SPECIALIZE IN PREVENTATIVE CARDIOLOGY.

TELL US ABOUT THAT SUBSPECIALTY.

>> SO, THANKS FOR HAVING ME.

SO I SPECIALIZE IN PREVENTATIVE CARDIOLOGY AND CHOLESTEROL MANAGEMENT AT THE UNIVERSITY OF MARYLAND.

AND THE FOCUS OF THAT SUBSPECIALTY IS ADDRESSING RISK FACTORS BEFORE DISEASE PRESENTS.

>> Jeff: NEW REPORT FROM THE AMERICAN HEART ASSOCIATION NEW STUDY FINDING SOME POSITIVE TRENDS, HEART DISEASE IS STILL THE NUMBER ONE KILLER.

>> RIGHT.

SO THERE WAS SOME POSITIVE DATA REPORTED OUT FROM THE AMERICAN HEART ASSOCIATION.

BUT WITH IT, SOME REALLY SOBERING DATA, TOO.

AS YOU MENTIONED STILL THE NUMBER ONE KILLER.

AND IT'S REALLY STRIKING THAT EVERY 34 SECONDS AN AMERICAN DIED OF CARDIOVASCULAR DISEASE IN 2023.

AND SOMEBODY DIED OF STROKE EVERY MINUTE AND 14 SECONDS IT IS A CALL TO ACTION FROM US AS THE HEALTHCARE PROVIDERS AND FOR THE PUBLIC TO REALLY TAKE THIS SERIOUSLY.

>> Jeff: WHAT CONTINUES TO DRIVE THIS RISK?

AND I IMAGINE THERE'S PLACES IN THE WORLD WHERE EXERCISE AND HABITS ARE DIFFERENT, DIETS ARE DIFFERENT, ARE THESE TRENDS DIFFERENT AS WELL?

>> YEAH, SO AS YOU MENTIONED DIFFERENT PARTS OF WORLD HAVE DIFFERENT RISK FACTORS.

IN THE UNITED STATES WE ARE LOOKING AT METABOLIC RISK FACTORS, DIABETES, OBESITY, PHYSICAL INACTIVITY AND POOR DIET AND THESE PLAY A ROLE AND THE CHALLENGE IS THE RISK FACTORS DON'T HAVE SYMPTOMS THAT GO WITH THEM LIKE HIGH CHOLESTEROL OR HIGH BLOOD PRESSURE.

>> Jeff: YOU WERE TELLING ME ABOUT ONE CARDIOVASCULAR KIDNEY METABOLIC SYNDROME WHAT IS THAT?

>> THE AMERICAN HEART ASSOCIATION WANTED TO HIGHLIGHT CKM SYNDROME, TO HIGHLIGHT THE FACT THAT HEART DISEASE IS NOT ON AN ISLAND BY ITSELF.

DIABETES, OBESITY, AND KIDNEY DISEASE ALL PLAY A ROLE AND INDIVIDUALS THAT HAVE THOSE RISK FACTORS ARE AT HIGHER RISK FOR HEART DISEASE AND STROKE.

>> Jeff: LET'S TALK ABOUT SOME OF THE THINGS WE CAN ALL DO TO LOWER OUR RISK, AND IT STARTS WITH HEALTHY EATING?

>> THAT IS RIGHT.

AND THIS IS WHAT I SPEND MY DAY DOING TALKING TO MY PATIENTS.

THE AMERICAN HEART ASSOCIATION HAS HIGHLIGHTED SOMETHING CALLED LIFE ESSENTIAL EIGHT.

ONE OF WHICH IS HEALTHY DIETARY PATTERN THAT IS ONE OF THE BIG PIECES OF REDUCING RISK.

WITH THAT, IS PHYSICAL ACTIVITY, CONTROLLING BLOOD PRESSURE, AVOIDING TOBACCO, CONTROLLING CHOLESTEROL, CONTROLLING BLOOD SUGAR, CONTROLLING WEIGHT AND HEALTHY SLEEP.

>> Jeff: GIVE US EXAMPLES.

WHEN WE TALK ABOUT EXERCISE, THIS TIME OF YEAR, ASIDE FROM SHOVELING A LOT OF US AREN'T GETTING OUTSIDE THAT MUCH.

>> THAT'S TRUE FOR ME, TOO.

IT'S A FACT OF LIFE.

WE TRY TO EMPHASIZE THERE ARE GOALS WE TRY TO REACH.

THESE ARE ASPIRATIONAL GOALS WE WANT TO GET PEOPLE TO DO ABOUT TWO-AND-A-HALF HOURS IN A WEEK TOTAL OF WHAT WE CALL MODERATE INTENSITY AEROBIC EXERCISE, INTENSE ENOUGH THAT YOU CANNOT HOLD A CONVERSATION LIKE WE'RE HAVING YOU GET WINDED IF YOU ARE TRYING TO TALK AND IT IS A STEP WISE APPROACH.

NOT JUMPING RIGHT IN IF YOU HAVE NOT DONE IT IT'S INCREASING OVER TIME.

>> Jeff: HOW ABOUT ON THE DIET FRONT?

ONE THING YOU DON'T WANT PEOPLE TO EAT AGAIN, SOMETHING YOU WANT US TO EAT MORE OF?

>> THAT A GREAT QUESTION AND IT'S REALLY A CHALLENGING ONE BECAUSE YOU HAVE TO TAKE INTO ACCOUNT WHERE PEOPLE ARE LIVING, WHAT THEY GREW UP WITH, WHAT IS CULTURALLY IMPORTANT TO THEM.

BUT THERE ARE SOME PIECES THAT ARE TRUER ACROSS THE BOARD.

WE WANT TO AVOID HIGHLY PROCESSED FOODS, FOODS THAT HAVE A LOT OF ADDED SODIUM, AND A LOT OF ADDED SUGAR.

THOSE ARE THE TOP THREE THAT I ENCOURAGE PEOPLE TO AVOID.

>> Jeff: LET'S LOOK AT ONE MORE PIECE OF THE DATA ON THIS.

SOME HEART HEALTH NUMBERS STARTING WITH BLOOD PRESSURE AND WHAT IS THE RELATIONSHIP THERE BETWEEN BLOOD PRESSURE AND HEART DISEASE?

>> SO WE KNOW THAT AS BLOOD PRESSURE INCREASES ABOVE THAT IDEAL RANGE OF 120 OVER 80, THE INCREASE OF HEART DISEASE AND STROKE GOES UP EXPONENTIALLY.

WE WERE TALKING ABOUT IS CHALLENGING PAUSE IT DOESN'T CAUSE YOU SYMPTOMS.

SO WHAT I ENCOURAGE PEOPLE TO DO IS KNOW YOUR RISK.

BY MEETING WITH YOUR HEALTHCARE TEAM AND GETTING THESE THINGS CHECKED.

>> Jeff: ALL RIGHT.

NEXT WAS CHOLESTEROL.

AND THE PROBLEM WITH CHOLESTEROL, YES THERE'S LDL BUT FOUR OTHER NUMBERS AND IT GETS CONFUSING.

IS THIS THE ONE YOU WANT US TO FOCUS ON?

>> THAT IS THE HIGHEST YIELD ONE AND LDL ARE THE LOW LIPO PROTEINS WE TRY TO GET THAT UNDER 100 BUT IT'S INDIVIDUALIZED BASED ON A PERSON'S SPECIFIC RISK AND WE MAY GO LOWER THAN THAT.

>> Jeff: LET'S DIG INTO THE BLOOD SUGAR STUFF.

YOU WANT THE A1C LESS THAN 5.7 IF SOMEBODY IS NOT DIABETIC DO THEY NEED TO KNOW THIS NUMBER?

>> I THINK WE SHOULD KNOW THIS NUMBER.

BECAUSE PEOPLE AREN'T GOING TO FEEL IT JUST LIKE WITH THE BLOOD PRESSURE.

AND HEMOGLOBIN A1C IS PRESENTED AS A PERCENTAGE.

SO 5.7 PERCENT TELLS US AN IDEA OF OVER THE PAST THREE MONTHS HOW HAS THAT PERSON'S BLOOD SUGAR BEEN CONTROLLED?

IT GIVES US A GOOD IDEA OF THEIR RISK OF DIABETES AND HEART DISEASE.

>> Jeff: HOW IMPORTANT A TOOL FOR PEOPLE IN PREVENTATIVE CARDIOLOGY IS THE CALCIUM SCORE, I NEVER HEARD ABOUT UNTIL A FEW YEARS AGO?

>> THAT IS A GREAT QUESTION WE ARE USING IT MORE AND MORE.

WHAT A CALCIUM SCORE IS A SPECIFIC TYPE OF IMAGING TEST.

IT'S A CAT SCAN THAT YOU GET.

AND IT QUANTIFIES THE AMOUNT OF CALCIUM IN THE ARTERIES OF THE HEART.

AND THE HIGHER THE AMOUNT OF CALCIUM, THE MORE PLAQUE THERE IS AROUND THAT CALCIUM, THE HIGHER THAT SCORE IS THE HIGHER THE PERSON'S RISK FOR CARDIOVASCULAR DISEASE.

>> Jeff: IF YOU SEND 10 PEOPLE FOR A CALCIUM SCORE WHAT NORMALLY COMES BACK?

>> GREAT QUESTION AND IT HARPS ON WHAT THAT INDIVIDUAL PERSON'S RISK IS.

IF YOU GET A YOUNG PERSON, WHO MAY HAVE SOME PLAQUE IN THEIR ARTERIES THEY MAY HAVE A TOTALLY NORMAL CALCIUM SCORE IT MIGHT BE ZERO.

BUT AN INDIVIDUAL WHO IS IN THEIR 80s WHO HAS HAD RISK FACTORS THEIR WHOLE LIFE THE NUMBERS WILL BE MUCH HIGHER THAN THAT.

>> Jeff: WHEN DO YOU GET OUT THE STATINS AND IS THAT THE FRONTLINE THERAPY FOR REDUCING RISK THAT CAN'T BE REDUCED THROUGH DIET AND EXERCISE?

>> YOU ENDED THAT QUESTION WITH THE MOST IMPORTANT STATEMENT.

THE FIRST STEP IS DIET AND EXERCISE.

WHEN WE CAN'T USE -- WHEN THOSE TWO DON'T GET US TO THE GOAL THE INDIVIDUALIZED GOAL FOR THAT PATIENT, STATIN METHOD KICKSES ARE THE FIRST LINE WE USE.

>> Jeff: DO YOU USE THE GLP DRUGS IN YOUR PRACTICE?

>> I USE THEM A FAIR AMOUNT.

THERE'S STRONG DATA SHOWING THAT THEY ARE BENEFICIAL FOR INDIVIDUALS WHO HAVE CARDIOVASCULAR DISEASE.

SO I TRY TO USE THEM IN THE APPROPRIATE PATIENTS.

>> Jeff: FOR SOMEBODY WATCHING WHAT HAS FAMILY HISTORY, OF HEART DISEASE, WONDERS ABOUT THIS HAS NEVER HAD A SPECIFIC WORK UP FOR IT, THEY COME SEE YOU OR GO TO THE PRIMARY CARE WHAT DO YOU ADVISE?

>> PART OF IT IS WHAT IS AVAILABLE TO YOU.

SOME PEOPLE ARE OUT AND THEY CAN'T GET TO A BIG MEDICAL CENTER THAT HAS A LOT OF SPECIALISTS BUT THAT DOESN'T MEAN THEY SHOULDN'T HEAT WITH THEIR HEALTHCARE TEAM.

THERE'S NOTHING SPECIFIC OR SPECIAL THAT I ORDER FOR THE MOST PART THAT SOMEONE ELSE CAN'T.

PRIMARY CARE IS THE FIRST STEP AND THEY DO AN EXCELLENT JOB OF ASSESSING RISK.

>> Jeff: AND SOMEBODY'S HAVING SYMPTOMS, YOU HEAR ABOUT PEOPLE, YOU KNOW, CHEST PAIN BUT I WILL SLEEP IT OFF IT'S PROBABLY HEARTBURN WHAT WOULD YOU ADVISE?

>> I WOULD ADVISE THEY SHOULD TALK TO THEIR HEALTHCARE TEAM.

WE TAKE THAT COMPLAINT VERY SERIOUSLY.

I SEE INDIVIDUALS IN THEIR 20s AND 30s COMPLAINING OF CHEST PAIN AND I'M HAPPY TO SEE THEM BECAUSE I WANT TO MAKE SURE IT'S NOT COMING FROM THEIR HEART.

>> Jeff: Dr.

ALEX GYFTOPOULOS WE APPRECIATE YOUR TIME THANK YOU.

THANK YOU FOR JOINING US FOR "DIRECT CONNECTION".

WE'RE BACK FRIDAY WITH "STATE CIRCLE" NOW FOR ALL OF US AT MPT HAVE A GOOD NIGHT.

[♪♪]