Your patients want a quick fix for their heart, with two Mayo Clinic cardiologists

Francisco Lopez-Jimenez, M.D., M.S., and Kyla M. Lara-Breitinger, M.D., M.S., are preventive cardiologists at Mayo Clinic and co-authors, with the late Amir Lerman, M.D., of the "Mayo Clinic Guide to a Healthy, Happy Heart." More than 30 Mayo Clinic clinicians who see patients regularly contributed to the book.

Earlier this year, Medical Economics Senior Editor Richard Payerchin sat down with Lopez-Jimenez and Lara-Breitinger. They explain how primary care physicians can steer patients who want one quick fix toward small changes that last. They also explain why the most useful goals are behaviors a patient controls, like eating less salt, instead of a blood pressure number.

They also discuss normal weight obesity and the limits of body mass index (BMI), advanced lipid markers, how to bring patients' home blood pressure readings into care and what primary care physicians should weigh before prescribing glucagon-like peptide-1 (GLP-1) drugs without a specialist on hand. Proceeds from book sales support the Mayo Clinic Cardiovascular Research Department.

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Editor's note: Episode timestamps and transcript produced using AI tools.

0:00 – 0:48 | Cold open. Lopez-Jimenez on the question he asks patients who don't own a blood pressure monitor: how many TVs they have.

0:48 – 2:03 | Introduction. Austin Littrell introduces the episode and the guests.

2:03 – 3:10 | Remembering Amir Lerman, M.D. Lopez-Jimenez describes his late co-author's pioneering work on how the inner lining of the arteries functions.

3:10 – 4:48 | Behind the book. Lara-Breitinger on the more than 30 contributors across Mayo Clinic campuses, and Lopez-Jimenez on why every one of them sees patients.

4:48 – 7:50 | Beyond the quick fix. Lopez-Jimenez says the biggest benefit comes from going from doing nothing to doing something, and Lara-Breitinger explains why delayed gratification makes heart health a hard sell.

7:50 – 12:25 | Goals patients can control. Simple goals that are easy to track, asking patients about their biggest source of stress and why eating less salt is a better patient goal than a blood pressure number.

12:25 – 16:52 | Advanced markers and body fat. Lara-Breitinger on adding high-sensitivity C-reactive protein, lipoprotein(a) and apolipoprotein B to a lipid panel, and Lopez-Jimenez on making risk testing easier for patients to get. Lara-Breitinger also explains why where patients carry fat matters more than the number on the scale.

16:52 – 17:45 | P2 Management Minute. Keith Reynolds shares practice management tips and invites listeners to submit their own workflow ideas.

17:45 – 22:18 | Talking about weight. Normal weight obesity, raising weight with tact and sensitivity, metabolically healthy patients with a higher BMI and why measuring waist circumference is hard in a 15- to 30-minute visit.

22:18 – 28:25 | Home blood pressure data. Lopez-Jimenez on getting home readings into the electronic health record without burying physicians, why some devices aren't reliable and why diagnosis should happen at home. Lara-Breitinger on why patients need to hear that blood pressure is a big deal.

28:25 – 31:35 | GLP-1s without a specialist. Lara-Breitinger on the patients who clearly qualify, the harder cases at a BMI of 25 or 26 and the cost barrier for patients paying full price.

31:35 – 35:57 | One thing to change. Lopez-Jimenez's four tenets of prevention, and Lara-Breitinger on asking patients what brings them joy and lowering low-density lipoprotein cholesterol.

35:57 – End | Outro. Payerchin thanks the guests and Littrell wraps the episode.