>> My name is Chiadi Ndumele.
I am a general and preventive cardiologist at Johns Hopkins
who both takes care of patients
and does research related
to preventing cardiovascular disease.
So my specialty is general and preventive cardiology
and I care for patients primarily in two settings.
I spend some of my time in the coronary care unit
where I see people who are coming in
with very severe acute cardiovascular disease
but most of my time,
I spend in the cardiology clinic
where I care for patients really on two sides
of a spectrum.
I care for patients who have existing cardiovascular disease
where we partner to better manage
that cardiovascular disease,
try to improve quality of life and symptoms
and also try to improve long-term outcomes.
I also care for individuals who are interested
in preventing cardiovascular disease events.
Many times that's individuals
who have what we call risk factors
for cardiovascular disease
but have not yet developed
actual cardiovascular event-like heart attack or stroke
or clear coronary artery disease or heart failure.
So we basically work together
to try to prevent them from happening.
In individuals who do have existing cardiovascular disease,
we also focus on prevention
but that was what we call secondary prevention
where we basically try to prevent more bad things happening
from a cardiovascular standpoint.
I came into the field of cardiology
because it's a challenge that affects the most individuals
in the United States and across the world.
And I wanted to contribute to helping
to address that challenge.
The cardiovascular system is very intricate
and something that I was drawn to
as part of understanding how the body works.
And because cardiovascular disease
is associated with such high mortality,
I love the idea of being able
to prevent bad outcomes with my patients.
My research is centered on two major themes.
First, I'm the directory of obesity research
for the Division of Cardiology.
Obesity is one of the major drivers
of cardiovascular disease events within the population.
However, we don't know a lot about the mechanisms
underlining the relationship
between obesity and excess adiposity
and the development of cardiovascular disease.
Additionally, obesity has variable associations
with various metabolic risk factors,
such as diabetes, high blood pressure,
abnormal cholesterol, inflammation
and trying to understand why some individuals
develop those metabolic risk factors
and some do not is also quite important
because the development of those metabolic risk factors
is also associated with higher risk
of cardiovascular disease.
I also am the director
of the Heart Failure Prevention Program at Johns Hopkins.
Heart failure is a major public health
and clinical challenge,
which have very high associated morbidity
and mortality in the short term.
Therefore, our group is particularly interested
in identifying modifiable risk factors
for the development of heart failure
so we can better predict heart failure
and hopefully prevent heart failure
before it even starts,
which is associated with the best clinical outcomes.
My philosophy of patient care is really one
of a partnership.
A lot of what I like to do
with patients is share decision making
so we can basically make a plan together.
I've found over the years
that my value system really shouldn't just be imposed
on somebody else, so I love the idea
of together us understanding the challenge
and then charting a path forward together.
I can prescribe medications
and I can give recommendations
but it often doesn't mean so much
if we're not really fully in it together.
I'm also very engaged with the idea
of explaining complex physiology
and complex clinical issues to patients
in a way that they can digest and understand
as I think that's also a really important part
of that partnership as well.
(pensive music)