Feb. 16, 2021—It may start with a sense of impending doom. Then comes the lightheadedness and the pain that feels like a clenched fist has taken up residence in your chest. A heart attack is an experience that strikes fear in even the bravest of people. According to Wilmington, Delaware-based interventional cardiologist Yolanda Hendley, M.D. ’05, it doesn’t have to be the ending it may feel like. In fact, it could be the beginning of a new chapter of a patient’s life.
“When I see patients coming in with heart attacks, whether it be from genetics or poor lifestyle, therein lies a prime opportunity to engage them because something serious and life-changing has happened, and I’m the first provider they see in that moment,” says Hendley. “I can talk to them and instill some motivation for change, whether that be to stop smoking, be more active or to even be aware of their genetics and risk factors.”
Hendley’s interventions don’t begin and end with that initial visit – one week after her patients leave the hospital, she meets with them again to jumpstart plans for future change.
“A lot of the time, I find there is a shock factor after that life-changing event. My patients are now given medicines they’ve ever taken before. They’re wondering, ‘Is my heart OK now? Is this going to happen again?’ Talking through those issues is important,” she says. “I try to cultivate relationships with patients by getting to know them, their partners and their families to learn what their support system is like, what makes them happy and what we can strive to get them back to doing. Maintaining those activities will reduce stress and depression and help mitigate future health issues.”
Hendley takes care to tell patients that no matter their age or current state of health, it’s never too late to adopt healthier habits and begin to chip away at the cardiovascular issues that already exist.
“You can definitely impact change and stop things from progressing by taking away the offenders like smoking and eating poorly, like a high-carbohydrate, high-sugar, heavy-in-red-meat diet,” she says. “I recommend physical activity at least 30 minutes a day five times a week. And know your risk — your family history, your cholesterol levels and your blood pressure. These are things you don’t feel and you don’t know are an issue until something happens.”
Hendley’s own family history is replete with physicians and health care providers. Witnessing her mother’s career as a nurse and her father’s as a veterinarian, Hendley knew from a young age that medicine was where her passion laid. By the time Hendley was a sixth-grader, she had set her sights on cardiology, which would allow her to create close relationships with patients and perform technical procedures.
During Hendley’s training at the UF College of Medicine, she gained advice that would prove to last a lifetime from long-time anatomy professor Kyle Rarey, Ph.D.
“I remember Dr. Rarey used to show us a video of the Iron Man strength and endurance contests to galvanize us to stay the course, do what we’ve trained to do, complete these tests and get through school,” Hendley recalls. “Even today, when I’m struggling with something, I remember, this is what I trained for.”
After receiving her medical degree, Hendley was accepted to the Johns Hopkins Osler Medical Training Program to study internal medicine before earning a master’s of science degree in clinical research from Emory University. It was at Emory where Hendley began conducting research on health disparities, specifically looking at the differences in weight perception as a potential cause for an increase in the prevalence of obesity among African Americans. That research sparked a lifelong commitment to achieving health equity for all. Today, she speaks virtually with underserved communities in or around Wilmington about cardiovascular health, affording those who tune in the opportunity to ask questions they may not have the ability or confidence to ask during a doctor’s visit.
“One big barrier to health care that transcends race, age and gender is health care literacy. At a doctor’s visit, there are boxes to be checked. A patient is prescribed blood pressure medication but doesn’t know why they have high blood pressure. If someone understands the nuances of their condition and what we do in the clinic, they’ll be more engaged with their own health,” says Hendley, who also served as a fellow and attending physician at the Johns Hopkins Cardiac Surgical Intensive Care Unit and an interventional cardiology fellow at George Washington University. “Having that knowledge will reduce health care disparities.”
In Hendley’s field of cardiology, health care disparities create a vastly negative impact on the Black American community. According to the Centers for Disease Control and Prevention, Black Americans are two times as likely to die from heart disease and 50% more likely to have high blood pressure compared to their white counterparts. Younger Black Americans are living with cardiovascular diseases more commonly found in older Americans. To combat this issue, Hendley recommends interventions at the individual and systemic level. When it comes to defeating health care disparities, knowledge is power.
“Individuals knowing their family history and risk factors that can impact them later on is highly important. We can sometimes feel invincible, but by the time you’re 20, you may already have a certain amount of lipid-layered plaque that may be in your coronary vessels depending on genetics, lifestyle and diet. Those have even been seen at an adolescent age,” says Hendley. “In urban communities where African Americans live, consistent heart health education at the elementary level will be helpful. If we can affect students at every level and plant those seeds in young individuals, then we can impact some change in a future generation.”