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Archive for February, 2011

Moderate Alcohol Consumption May Have Heart Health Benefits

While messages conveying the dangers of alcohol are prevalent in today’s society, the potential benefits of drinking alcohol are not as widely discussed. Now you can have your beer and drink it too—in moderation, of course! Read more »

Cardiovascular Disease Correlates with Memory Loss

Contemporary research has shown that there is an increasing correlation between cardiovascular risk factors and brain functionality. In a study conducted in France over a ten-year period, patients were tested on brain function including memory, reasoning, vocabulary and fluency.

Participants in the study were assessed and given a Framingham risk score, which predicts one’s risk of developing cardiovascular disease in the future. This score takes into account a variety of factors, including cholesterol level, age, blood pressure, smoking habits, and history of diabetes. They were then given memory tests, which they took 3 times during the 10-year study.

Over the course of ten years, patients with higher cardiovascular risk experienced a decrease in their level of brain function. A 10% increase in cardiovascular risk, as measured by the Framingham risk score, was associated with lower scores on the memory test—2.8% lower for men and 7.1% lower for women. Those with high cardiovascular risk also experienced, on average, a more rapid decline in cognitive function.

The results of this study come as no surprise to most health professionals. Many heart doctors have noted that cognitive decline and heart disease share many of the same risk factors, including smoking, hypertension and high cholesterol.

“As a cardiologist, it is my job to educate my patients on the risks of cardiovascular disease and the benefits to living a healthy lifestyle,” stated Dr. Steven Shayani, director of Long Island Heart Associates. “The increases in cardiac risk can decrease the blood flow to the brain and affect cognitive and overall mental capabilities.”

Can Nuclear Stress Tests Miss Severe Coronary Artery Disease?

Feb 24, 2011

Nuclear stress tests can miss severe coronary artery disease; former president Bill Clinton’s nuclear stress tests were normal, five years running, completely missing the severe coronary artery disease that eventually required quadruple bypass surgery.

Yes, nuclear stress tests can miss severe coronary artery disease. I consulted with cardiologist Dr. Steven Shayani, Medical Director of Outpatient Services for Mount Sinai Hospital and Long Island Heart Associates.

Dr. Shayani explains, “Nuclear stress tests may show normal perfusion even if there are multiple blockages, because this type of imaging modality looks at the relative changes/differences in myocardial perfusion.” (Perfusion means flow of blood through vessels.)

“If there are multiple obstructions in the arteries,” continues Dr. Shayani, “The overall image of the heart may appear to be normal — the obstructions appear to be a normal part of the heart. Therefore, the defects may not be detected. It is when one part of the heart is normal and another part is obstructed that the images will allow the clinician to clearly see a defect.”

Nuclear stress tests measure perfusion (flow of blood through the heart) while the heart is at rest, and while it is stressed. A commonly known form of nuclear stress test involves walking on a treadmill. While the patient walks, images of his heart are studied to see if impaired perfusion is detected (a contrast dye is used to make the blood vessels more visible). Sometimes a stationary bike is used.

A nuclear stress test may also be done with a pharmaceutical agent that taxes the heart. Images of the heart are taken while at rest, and under stress.

In the case of former president Bill Clinton, his exams indicated a normal heart, but ultimately, his nuclear stress tests missed what turned out to be severe coronary artery disease. This is truly scary, because one would think that of all people, a former U.S. president would have the best health care! This should include preventive, not just mitigating.

Though the former president’s quadruple bypass was a success (Sept. 2004), this in no way downplays the failure of his medical team for relying upon only nuclear stress tests, which proved to miss significant disease in the coronary arteries.

Does this mean that for coronary heart disease screening, you should skip the nuclear stress tests and jump right into a CT calcium score test or CT angiogram ? It is best to discuss options, including blood tests , with your cardiologist. He will need accurate information about your lifestyle habits and family history of heart disease.

Though nuclear stress tests can, indeed, reveal coronary artery disease, these kinds of exams can miss severe coronary artery disease; after all, look what happened with a former U.S. president.

For the original story, click here.

Soda May Increase the Risk of Heart Disease and Metabolic Syndrome

According to a recent study presented by the American Stroke Association, diet soda may increase the risk of heart disease and metabolic syndrome. While this may come as a shock to most, cardiologists are not surprised.  Dr. Steven Shayani, Medical Director of Long Island Heart Associates, states, “Patients who engage in poor nutrition habits such as drinking soda every day are endangering their health, so we try to educate patients on the benefits of choosing a healthier, more nutritious diet.”

Metabolic syndrome is a combination of several risk factors that increase the risk of cardiovascular disease, diabetes, and/or stroke.  Some indications of metabolic syndrome include obesity, high blood pressure and insulin resistance.

In 1948, The Framingham Heart Study was launched in order to identify the risk factors that contribute to cardiovascular disease.  The study followed 6,000 participants, and monitored a variety of lifestyle choices, including soda intake.  After years of observation, results showed an increase in metabolic syndromeamong adults consuming at least one soft drink per day, regardless of regular or diet soda.  The soda drinkers were actually 44% more likely than their non-soda-drinking peers to develop metabolic syndrome!

The Centers for Disease Control (CDC) reported that there were nearly 655,000 deaths in 2006 caused by cardiovascular disease, making it the number one killer in the US.  Numbers like this should cause us to think twice about the choices we make when it comes to diet and nutrition.

Can Bariatric Surgery Reduce the Risk of Heart Disease?

As obesity continues to rise in the US, more and more patients are turning to weight loss surgeries such as gastric banding and gastric bypass surgery.  These controversial surgeries have proven highly effective at achieving weight loss in patients—but do they also reduce the risk of heart problems associated with obesity?

Any cardiologist can tell you that obesity is linked to a wide variety of cardiovascular diseases.  Conditions such as hypertension, congestive heart failure, heart attack and stroke are all common heart problems associated with obesity.  Additionally, carrying significant extra weight can overwork the heart, causing it to undergo structural changes and become enlarged.

A study published earlier this week in the Journal of the American College of Cardiology provides compelling evidence that bariatric surgery does, in fact, improve heart health.  The study observed 423 severely obese patients for two years following gastric bypass surgery.  These patients were compared with a control group of 310 severely obese people who did not have the surgery.

Aside from having lost weight and reduced their BMI, the patients who had gastric bypass surgery saw health improvements in many of the major risk factors for heart disease, such as lower blood sugar, cholesterol levels and blood pressure.  The researchers also conducted an echocardiogram on each patient’s heart, which showed a widespread reduction in heart mass and volume.  This return to its normal shape and size indicates that there is less stress being placed on the heart, so it no longer needs to work as hard to pump blood to the body.

Is weight loss surgery really the way to go?  It’s hard to say.  The procedure has some health risks, is expensive and generally requires significant recovery time.  But for severely obese patients with a high risk of heart disease or heart failure, it may be worth considering.

The Mount Sinai Medical Center and Long Island Heart Associates Launch New Program for Diabetes and Heart Disease Patients

February 9, 2011

(New York, NY) – The Mount Sinai Hospital and Long Island Heart Associates have developed a new service for its patients on Long Island. The Diabetes and Cardiovascular Care Partnership is a new innovative service launched by The Mount Sinai Hospital with Long Island Heart Associates, one of its affiliate locations, in order to assist in managing patient care for those with diabetes and heart disease. With close to two million New Yorkers diagnosed with diabetes and the inherent relationship to heart disease, this new program provides Long Island residents a location for quality care without having to travel far to receive it.

This program, located in Mineola, ensures that patients are meeting the American Diabetes Association standards of care in order to minimize risks from diabetes. Doctors, educators, and coordinators work together to ensure proper diabetes care and education is accomplished. Patients in the program are screened for an eye examination, podiatric attention, wound development and healing, chronic kidney disease classification and cardiovascular care. The patient will be referred for specific care contingent upon the priority which is established during the assessment. Each person will have a specific plan and any barriers such as misinformation/cultural difference, inability to obtain medication or testing supplies, or dealing with depression will be addressed. Throughout the entire process it is important to note that the patient remains a patient of the primary care physician.

Additional information as well as interviews are available with qualified physicians from Mount Sinai and Long Island Heart Associates and Certified Diabetes Educators along with patients in the program.

For the full story, click here.

Could Watching the Super Bowl Give You a Heart Attack?

If you’re a New Yorker and a football fan, you’re probably pretty disappointed that the Jets didn’t make it to the Super Bowl this year.  But perhaps it’s a blessing in disguise—a new study published in Clinical Cardiology earlier this week suggests that the stress of watching your team lose the Super Bowl might just kill you!

As any cardiologist can tell you, there are many risk factors that contribute to heart disease.  These factors can be classified in one of two ways—chronic risk factors and acute risk factors.  Chronic risk factors are those which build up over time, such as diabetes, hypertension, obesity and smoking.  Acute risk factors, on the other hand, generally involve some sort of emotional or physical stress which can trigger a cardiac event, like getting dumped, being chased by a bear, or—apparently—watching your favorite team lose the Super Bowl.

The study looked at cardiac mortality rates in Los Angeles County during and immediately following the two Super Bowl games in which an L.A. team has played.  The first of these was in 1980, when the Los Angeles Rams played the Pittsburgh Steelers in an extremely intense Super Bowl game.  After seven lead changes, the Rams finally lost the lead in the 4th quarter, ultimately losing the game.  In 1984, Los Angeles went to the Super Bowl again—this time as the Raiders—playing against the Washington Redskins.   The Raiders had the lead for the entire time and ultimately won the game.

The results of the study showed an increase in cardiac deaths across the board for citizens of Los Angeles County immediately following the 1980 Super Bowl.  Compared to control data measuring all cardiac deaths between January 1980 and February 1983, the amount of cardiac deaths increased by a whopping 20.6% in the period of time covering the day of the 1980 Super Bowl and the 14 days following!

By contrast, the 1984 Super Bowl, in which Los Angeles won, triggered no such reaction.  Interestingly, there was actually a slight reduction in cardiac deaths after the Los Angeles Raiders took the Super Bowl in 1984!

So what does this mean for sports fans?  Should we avoid watching football, for the sake of our health?  There’s nothing wrong with enjoying a game of football, or even getting emotionally invested in the game—after all, yelling at the ref and trash-talking the opposing team through the TV half the fun!  But it’s important to ensure you don’t get too carried away, especially if you’re older or prone to heart problems.  Try to be aware of your stress level during games, and take a step back when you realize you’re getting worked up.  Head to another room and take a few deep breaths.  Go for a walk during commercial breaks.  Keep a cardiologist on hand to monitor your blood pressure if you have to.  After all, watching your team lose the big game may be heartbreaking—but it shouldn’t cost you your life!