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OMEGA-3 FATTY ACIDS: HOW THEY AFFECT YOUR HEALTH

January 30, 2014 by admin

Omega-3 fatty acids are an important part of a healthy diet according to Dr. Steven Reisman, a Manhattan Cardiologist. Omega-3 fatty acids are what are known as “essential” fatty acids which means they are not made in the human body but must be obtained directly from an outside source. These substances are very important for normal metabolism. They are important in reducing inflammation in the blood vessels, joints and in other locations. It is suggested that Omega-3 fatty acids be obtained from foods rather than from supplements. Fish high in these substances include salmon, herring, sardines and anchovies. Omega-3 fatty acids may be also obtained from ingestion of nuts and seeds and plant oils but to a lesser degree than from fish.

Eating a diet high in these fatty acids appears to decrease the risk of stroke and possibly cardiovascular and coronary artery disease. It has been shown that in the United States compared to other countries such as Japan there is a reduced percentage of these Omega-3 fatty acids in the diet along with a higher heart disease rate suggesting a protective effect of these substances. The American Heart Association recommends eating at least two servings of fish per week and also other sources such as eating walnuts and tofu. These substances have also been found to be useful in the management of rheumatoid arthritis and they have been shown to reduce joint pain and stiffness. A recent study looking at the brain suggests that individuals that have a higher level of Omega-3 fatty acid in their diet have less brain shrinkage, particularly those in their 70’s suggesting a larger brain size. These substances may limit the progression of diseases such as Alzheimers.

Consuming Omega-3 fatty acids along with a healthy diet such as the Mediterranean diet is highly recommended in an attempt to decrease the risk of cardiovascular disease and stroke and is also useful in decreasing the triglyceride level in the blood according to Dr. Steven Reisman, a Manhattan Cardiologist. Consumption of fish high in Omega-3 Fatty acids does appear to be more beneficial than utilizing supplements.

ACUTE TRIGGERS FOR CARDIOVASCULAR EVENTS SUCH AS HEART ATTACK AND STROKE

July 3, 2012 by admin

Dr. Steven Reisman, a New York City cardiologist, will discuss the relationship between acute risk factors or acute triggers and the development of a heart attack or stroke. It is well known that there are chronic risk factors for heart disease such as hypertension, hyperlipidemia, diabetes mellitus, smoking, and other factors. There are also acute risk factors that can precipitate a cardiac event. Acute risk factors may result in a rapid increase in blood pressure, vasoconstriction, or even increase in coagulability.

There are several psychological triggers that are known to play a role. These include anger, emotional upset, anxiety, stress in the work place, bereavement, and sexual activity.

An interesting phenomenon has been observed that showed a significant increase in heart attacks at 9 am in the morning. It appears that the act of waking up, when a person who is vulnerable to a heart attack, goes from a supine to an upright position increases the catecholamines in the body. These particular individuals most likely have an underlying plaque that is vulnerable and is more likely to clot in the morning.

There are physical triggers that can include vigorous physical activity along with sexual activity. These factors play a bigger role in those who are sedentary and a lesser role in those who have the habit of exercising on a regular basis.

There are psychological stresses which include an outburst of anger which elevates the risk of heart attack. Also, episodes of anxiety can increase the risk of a heart attack. In addition, depression and frustration may also be associated with increasing the risk of a heart attack.

There are also population stresses that can increase the risk of a heart attack such as earthquakes, war, and even elevated pollution levels and respiratory infection and also floods.

Dr. Steven Reisman, a New York City cardiologist and director of the New York Cardiac Diagnostic Center feels that an initial evaluation with a cardiologist in consultation to evaluate risk of a heart attack along with proper exercise and treatment of psychological stress and prevention of psychological stress is key to helping diminish the risk of heart attack and stroke in these individuals.

DR. STEVEN REISMAN, A CARDIOLOGIST IN NEW YORK CITY, DISCUSSES THE RELATIONSHIP BETWEEN PRE-DIABETES, TYPE 2 DIABETES AND METABOLIC SYNDROME

March 13, 2012 by admin

The prevalence of type 2 diabetes is increasing in the United States according to Dr. Steven Reisman, Director of the New York Cardiac Diagnostic Center and a cardiologist in New York City. Pre-diabetes is usually defined as an elevation of fasting or post-prandial glucose levels. The American Diabetes Association has defined impaired fasting glucose as a level of 100 to 125 mg/dl. Also, an elevation in hemoglobin A1c or glycosylated hemoglobin (HbA1c) at a level of 5.7% to 6.4% may also represent pre-diabetes.

Metabolic Syndrome is related to pre-diabetes. Metabolic Syndrome is defined as any three of the following five components. These components include an elevated glucose level, abdominal obesity, elevated blood pressure, elevated triglycerides, and reduced high-density lipoprotein (HDL) cholesterol. Most individuals with metabolic syndrome have abdominal obesity. It is felt that insulin resistance may be mediating the metabolic risk factors of the metabolic syndrome. Most people with metabolic syndrome have insulin-resistance. It should be noted that the prevalence of pre-diabetes and metabolic syndrome overlap but not exactly. One can consider the metabolic syndrome as a pre-diabetic state. When comparing individuals without metabolic syndrome, those with this syndrome have an approximate 5-fold increase in diabetes risk. Once pre-diabetes is combined with metabolic syndrome, the risk is increased even more for diabetes.

The major adverse outcomes in individuals with pre-diabetes are macrovascular disease and type 2 diabetes, the leading contributors to microvascular disease. Macrovascular disease occurs both before and after the onset of diabetes, whereas microvascular disease occurs predominately several years after becoming diabetic. Metabolic Syndrome is a risk factor for macrovascular disease. Initial management is lifestyle intervention including weight reduction in obese subjects, reduced intake of dietary saturated and trans-fatty acids, cholesterol, and sodium along with increased physical activity.

According to Dr. Steven Reisman the Director of the New York Cardiac Diagnostic Center and a cardiologist in New York City these initial steps of lifestyle intervention in first line management should be emphasized to this group of individuals along with a thorough assessment of cardiovascular risk.

DR. STEVEN REISMAN, A CARDIOLOGIST IN NEW YORK CITY, DISCUSSES THE EFFECT OF DIETARY PROTEIN AND CONTENT ON WEIGHT GAIN DURING OVEREATING

March 8, 2012 by admin

According to Dr. Steven Reisman, one of the best cardiologists in New York City and the Director of the New York Cardiac Diagnostic Center, obesity and overweight affect greater than 60% of the United States public. It is estimated that the United States government spends in excess of $200 billion per year on obesity associated conditions and diseases.

Obesity is the result of an accumulation of excess body fat. Obesity is not just excess body weight because overweight can occur from either muscle or fat deposition. Diet composition can affect the relationship between total body fat and body weight. Obesity related medical conditions may be associated with an accumulation of excess fat while increased muscle mass is beneficial because of its positive effect on metabolism.

There is a large body of scientific evidence that indicates that protein is the most satisfying of the macronutrients. High protein diets providing 25% of total energy compared to diets with low protein may lead to greater weight loss. Reduced total caloric intake with an increase in the intake of low-fat protein-rich foods may result in more successful weight loss in the long term secondary to the effects on resting energy expenditure.

It is possible that patients who exercise and eat adequate protein may build lean body mass more efficiently than those who are on a low protein diet. Because muscle weighs more than fat per unit of volume it is possible for patients to gain weight with muscle mass while reducing weight circumference and overall fat.

In addition to a healthy long term diet, it is important to increase the proportion of omega-3 fats, increase the intake of colorful fruits and vegetables, and limit the intake of refined carbohydrates from soft drinks, cookies, cakes, pastries, candies, and many processed foods with both hidden fat and sugar. In addition, physical activity is important along with behavioral interventions including self-monitoring stimulus control, stress reduction, and social support that may be helpful in weight loss.

Clinicians should consider evaluating a patient’s overall fatness rather than simply by measuring body weight or body mass index and concentrate on the potential complications of excessive fat accumulation. The goals for treatment of obesity should involve fat reduction rather than simply weight loss, along with a better understanding of nutrition.

Dr. Steven Reisman director of New York Cardiac Diagnostic Center and a leading cardiologist in New York City advocates and promotes a healthy lifestyle in the prevention of heart disease and the reduction of obesity.

DR STEVEN REISMAN, A NEW YORK CITY CARDIOLOGIST DISCUSSES THAT FIBER FROM WHOLE GRAINS REDUCES THE RISK OF DYING FROM HEART DISEASE.

March 2, 2011 by admin

In an article in WebMD (2/14/11, Mann), a review of a recently published study found that men and women eating the most dietary fiber were 22% less likely to die from any cause including heart disease, infections, and lung disease compared to those who ate the least amount of fiber.

The importance of this study was that prior studies have described the relationship between fiber intake and cardiovascular disease but few studies have examined the relationship between dietary fiber and mortality. Diets rich in fiber help lower blood cholesterol levels and blood sugar levels which may explain its beneficial effect. It is not known how fiber reduces risk but it may have something to do with an anti-inflammatory effect. The effect in this study appeared to come from cereal fiber, grain, and beans.

The new US dietary guidelines recommend that at least half of all grains eaten be whole and unrefined. The goal for fiber is 25 grams per day for women and 28 grams per day for men. One of the easier ways to accomplish this is to eat “whole grain” breads, cereals, and baked goods as opposed to refined varieties. Another way to increase cereal fiber would be to eat cooked cereal. Dr. Reisman, a Manhattan Cardiologist advises increasing dietary fiber to add a beneficial effect in both men and women.

IMPROVED HIGH BLOOD PRESSURE AWARENESS LEADS TO IMPROVED TREATMENT

November 10, 2010 by admin

The AP (10/28, Stobbe) has reported that in a study released by the Centers for Disease Control and Prevention (CDC), more Americans are aware that they have high blood pressure and more of them are taking medication to control it. High blood pressure also known as hypertension is called the “silent killer” because it doesn’t have symptoms and thus many people are not aware that they have this condition.

In the report from the CDC it was noted that 30% of American adults suffer from hypertension equaling approximately 66 to 74 million adults. The CDC study looked at surveys done from 1999 through 2008. One of the findings was that the percentage of adults who were aware of their condition increased from 69.6% in 1999 – 2000 to 80.6% in 2007-2008. The percentage of individuals who are being treated with medication increased from 60.2% to 73.7%. In addition, a larger percentage of adults were able to control their blood pressure over this time period. This report suggests that efforts to inform the public about the dangers of high blood pressure are succeeding but there is room for improvement. Dr. Steven Reisman, a Manhattan Cardiologist, and Director of the New York Cardiac Diagnostic Center states that hypertension is a treatable risk factor involved in heart attack, heart failure, stroke, and premature death in the United States. Early detection, Dr. Reisman, noted requires just a simple blood pressure check which can be done in a brief period of time and a standard office visit.

Modest Fat Gain May Increase the Risk for Cardiovascular Disease.

September 10, 2010 by admin

Healthday (8/9/10, Reinberg) reported that people who put on a little weight might hinder the
function of cells that line their blood vessels increasing the risk for both high blood pressure
and possibly cardiovascular disease. The researchers performed a controlled study in young
adult healthy volunteers with one group having moderate weight gain of approximately eight
pounds and the other group maintaining their weight and then measuring endothelial function
which directs the ability of blood vessels to contract and dilate which controls blood flow. They
measured endothelial function by measuring function of the brachial artery which is located in
the arm.

The researchers measured the function of the artery before eight weeks of weight gain and again
after sixteen weeks of weight loss. In particular, they measured the fat deposited in the area
of the belly in both groups. They found that people who gained weight in this area showed a
decreasing ability of the brachial artery to dilate and when they lost that weight the ability of the
artery to dilate returned.

Dr. Steven Reisman, a Manhattan Cardiologist and Director of the New York Cardiac Diagnostic
Center, advises that endothelial dysfunction may be an early marker of coronary artery
disease and this study may strengthen the case for weight control as a means of diminishing
cardiovascular risk. These findings suggest that endothelial dysfunction may be caused by
moderate weight gain in the abdominal area and can be reversed through diet and a decrease in
weight. This study is also consistent with previous studies linking cardiovascular risk to certain
measures of obesity.

DR. STEVEN REISMAN, A MANHATTAN CARDIOLOGIST, DISCUSSES THE RELATIONSHIP OF VITAMIN D DEFICIENCY AND THE RISK OF HEART DISEASE

September 7, 2010 by admin

Med Page Today (8/25, Walsh) recently reported that a person’s vitamin D status can predict
their clinical outcome in a trial of patients with heart failure. The study being presented at the
European Society of Cardiology found that lower levels of vitamin D were associated with an
increased risk of mortality in patients with congestive heart failure.

Dr. Reisman, Director of the New York Cardiac Diagnostic Center, describes how vitamin D
deficiency is highly prevalent in the United States and a growing body of evidence suggests that
diminished levels of vitamin D may adversely affect the cardiovascular system. In an article
published in Circulation in 2008, the authors found that in a community based study vitamin D
deficiency was associated with increased cardiovascular risk. They found this higher risk was
in particular evident in individuals with hypertension. In other studies, lower vitamin D levels
have been observed in individuals with heart attacks, stroke, heart failure, and other forms of
cardiovascular disease.

In another study presented at the American College of Cardiology in March 2010, in patients
whose blood test revealed low vitamin D levels, those who are able to raise their blood levels
were 33% less likely to have a heart attack, 20% less likely to develop heart failure, and 30%
less likely to die over an average follow up period of one year. Individuals can increase their
vitamin D levels by taking vitamin supplements and carefully and briefly exposing their skin to
the sun’s vitamin D producing ultraviolet light. Dr. Steven Reisman, a Manhattan Cardiologist
recommends that people should refrain from taking supplements on their own. This should
always be done under a doctor’s supervision after a blood test evaluating the vitamin D blood
level.

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