High Blood Pressure

NEW BLOOD PRESSURE TREATMENT GUIDELINES MAY SAVE LIVES

November 2, 2015 by admin

A recent national blood pressure treatment trial call SPRINT has revealed some very promising results according to Dr. Steven Reisman a cardiologist in New York City. High blood pressure or hypertension is found in one of three American adults or approximately 79 million adults and is a major risk factor for heart disease, stroke, kidney failure, and other medical problems. One aim of therapy is to bring down the systolic blood pressure but there has been some controversy regarding what is the “ideal “number.

The Systolic Blood Pressure Intervention Trial (SPRINT)sponsored by the National Institutes of Health randomized participants according to their age and those who had a diagnosis of high blood pressure and were either at increased risk for heart disease or had kidney disease. One half of the participants were given a systolic blood pressure target of 120 mm Hg and the other half were given a target of 140. The study results showed aiming for a target of 120 mm Hg was superior to 140 and reduced the risk of death by almost 25% and also reduced the rate of cardiovascular problems such as heart attack, stroke, and heart failure by one third. Approximately two years ago the National Heart, Lung, and Blood Institute had announced a higher treatment target level of between 140 to 150 mm Hg systolic blood pressure. For the SPRINT trial the results targeting a lower systolic blood pressure of 120 were so dramatic and powerful that these new recommendations were announced prior to the ending of the study.

With more focus on these specific treatment goals for blood pressure it is critical that physicians treating patients with hypertension have an accurate way of monitoring the patient’s systolic blood pressure. One method is to have patients measure and track their blood pressure outside of the office. According to Dr. Steven Reisman, Director of the New York Cardiac Diagnostic Center another method is to track blood pressure using the BpTrRU device in the doctor’s office. This device eliminates the white coat effect and takes an average of five automated blood pressures in the office. Dr. Reisman, a Manhattan cardiologist, has been using the device for several years and it is an effective way of evaluating and treating patients with hypertension.

PREVENTION AND EARLY DETECTION OF STROKES AND MINI-STROKES

June 21, 2014 by admin

Mini-strokes or transient ischemic attacks (TIA’S) are important to be recognized early on because these episodes constitute a medical emergency according to Dr. Steven Reisman, a New York City Cardiologist. Dr. Reisman was interviewed on Inside Edition on June 18, 2014 regarding a 49 year old woman who recorded on her smartphone a video showing her facial movements to help doctors diagnose a mini-stroke which was later confirmed by MRI.

Several studies have shown that in the prevention of stroke it is important to be evaluated for cardiovascular risk factors such as elevated lipids, hypertension or high blood pressure, diabetes mellitus, and the buildup of plaque in the arteries. In addition, one study has shown that an adherence to a “low-risk” lifestyle can dramatically decrease the risk of stroke. The more factors one can adhere to the lower the risk. These factors include; not smoking, proper diet, exercise, optimal body weight as measured by body mass index, and moderate alcohol consumption.

One type of simple evaluation that emergency medical personnel utilize in their evaluation for a possible stroke is the three part pre-hospital stroke test. The first test is abnormal in this evaluation if the individual is asked to show their teeth or smile and one side of the face droops or it does not move as well as the other side. In the second test the individual is asked to close their eyes and extend both arms straight out, with the palms up for ten seconds. This test is abnormal if one of the arms does not move or drifts down compared to the other arm. The third test is an evaluation for abnormal speech where one might ask the patient to say “you can’t teach an old dog new tricks”. This is abnormal if the individual slurs their words or uses the wrong words or if the individual is unable to speak.

One of the most important risk factors for stroke is the presence of hypertension (high blood pressure). Hypertension is frequently silent and without symptoms and one can be evaluated for high blood pressure with a complete check up with their physician. According to Dr. Reisman, a Manhattan Cardiologist and Director of the New York Cardiac Diagnostic Center, the most effective way to screen for the risk of stroke is to perform a complete evaluation including blood tests, physical examination and in certain individuals carotid ultrasound to see if there is already plaque in the blood vessels supplying the brain.

THERE HAS BEEN AN INCREASING INCIDENCE OF STROKES IN YOUNG ADULTS AND MIDDLE AGED ADULTS ACCORDING TO CARDIOLOGIST DR. STEVEN REISMAN

December 18, 2012 by admin

Several studies over the past several years have shown an increase in strokes among those age 20 to 54 years old according to Dr. Steven Reisman, Director of the New York Cardiac Diagnostic Center, and a Cardiologist in New York City.

A stroke occurs when blood flow to a part of the brain stops and there is a decrease in oxygen supply to the brain and brain cells die. The symptoms of a stroke can occur suddenly and without any warning and the symptoms depend on which part of the brain is damaged. These symptoms can include a sudden headache, change in vision, muscle weakness on one side of the body, difficulty speaking, loss of balance and coordination and other neurologic symptoms.

The number one risk factor for stroke is high blood pressure or hypertension. The other risk factors includes diabetes mellitus, smoking, atrial fibrillation and high cholesterol. In young adults and those in middle age another factor can also be a congenital small hole in the heart from birth called a patent foramen ovale (PFO).

In young patients frequently there is found one of these cause such as hypertension, smoking and a occasionally a PFO. In addition, the increasing incidence of stroke may partly be related to improved medical technology and the increased adoption of MRI as a diagnostic tool to identify strokes in young people.

This increasing incidence of stroke should serve as a warning for young adults and middle age individuals to improve their lifestyle and early diagnosis of risk factors.

Dr. Steven Reisman, a New York City Cardiologist and Director of the New York Cardiac Diagnostic Center advocates early diagnosis of risk factors for stroke including blood pressure evaluation, blood testing, and potentially echocardiography and carotid ultrasound in prevention.

DR. STEVEN REISMAN, A NEW YORK CITY CARDIOLOGIST, ANNOUNCES THE USE OF AN ADVANCED AUTOMATIC DEVICE FOR THE DIAGNOSIS OF HIGH BLOOD PRESSURE.

April 1, 2011 by admin

Dr. Steven Reisman, a New York City Cardiologist and Director of the New York Cardiac Diagnostic Center announces the acquisition and implementation of a more accurate automatic device for the detection of high blood pressure also known as hypertension.

Hypertension is a major risk factor for people developing cardiovascular disease including heart attack and stroke. The problem with the detection of hypertension is the lack of symptoms at earlier stages. In addition, the difficulty in diagnosis occurs partly because of a variation in blood pressure and a phenomenon known as the “white coat effect” or “white coat hypertension”. The white coat effect is a tendency of some patients to have a higher blood pressure when medical personnel are present versus blood pressure being measured in the individual’s natural environment. White coat effect can lead to misdiagnosis of hypertension and unnecessary treatment.

Since patients may have an elevated blood pressure when being seen for the first time in a physician’s office, multiple visits may be required to make a definitive diagnosis. It has been reported that white coat hypertension may account for 20%-25% of hypertensive patients. Therefore, hypertension may be overdiagnosed. Some studies have reported that 24-hour ambulatory blood pressure monitoring and self measurement at home are more accurate in diagnosis. One problem with ambulatory blood pressure monitoring is that it is not always covered by insurance. Over the last several years a relatively new device called the BpTRU blood pressure device has found acceptance in several medical centers around the country and has recently been shown by the Cleveland Clinic Journal of Medicine to yield a significant increase in accuracy in the detection of hypertension over standard physician measured blood pressure. BpTRU readings have been shown to correlate with average awake ambulatory blood pressure. This device works by automatically recording blood pressure without any medical personnel in the room. It can record automatic blood pressures every two minutes with a readout of five blood pressures along with an average blood pressure in a single office visit. This has been shown to be an improved method for the diagnosis of hypertension.

Dr. Reisman, Director of the New York Cardiac Diagnostic Center, states that the New York Cardiac Diagnostic Center has begun using this device to accurately diagnose high blood pressure and is one of the few outpatient offices in Manhattan using it for the accurate diagnosis of hypertension.

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.

Dr. Steven Reisman, a Manhattan Cardiologist, at an Invited Lecture at the F.B.I. on June 30, 2010 Discussed the Relationship of Salt Intake to High Blood Pressure

August 14, 2010 by admin

Dr. Steven Reisman, Director of the New York Cardiac Diagnostic Center, at an invited lecture at the F.B.I. in Manhattan on June 30, 2010, discussed the relationship of salt intake and the development of high blood pressure or hypertension. Dr. Reisman referenced an article in the USA Today from April 28, 2010 entitled “Keeping A Lid On Salt; Not So Easy”. A recent report from the Institute of Medicine emphasized the relationship of salt intake to the development of heart disease and stroke. Hypertension is a common disease in the United States and this elevation of blood pressure can be easily diagnosed by a health professional taking several readings of an individual’s blood pressure in the resting state. Since hypertension is without symptoms, early diagnosis before the development of stroke or heart attack is extremely important.

According to the article, Americans now consume an average of 3,400 milligrams of sodium a day. The U.S Department of Agriculture guidelines recommend that adults including those with high blood pressure and individuals at risk should consume no more than 1,500 milligrams a day and other adults should consume less than 2,300 milligrams of sodium a day. The problem that occurs is many prepared foods or meals in restaurants especially fast foods have a high level of sodium.

The emphasis is to decrease the risk of heart disease and stroke by decreasing sodium intake along with weight control and physical activity. The article in USA Today gives examples of how many milligrams of salt are in different entrees at popular chain restaurants and also ways of decreasing the amount of salt intake. One of the hidden ways that Americans have an increased salt intake is in processed foods such as canned foods, soups, and other foods with additives. Tips for lowering sodium may include limiting salty snacks, add fresh lemon instead of salt to fish and vegetables, and learn how to use spices and herbs to enhance the taste of food instead of salt.

Dr. Reisman also spoke at the lecture about the other important risk factors for heart disease including hypertension, diabetes, hyperlipidemia including elevated cholesterol and elevated triglycerides, obesity, family history of heart disease, and smoking. The New York Cardiac Diagnostic Center, according to Dr. Reisman, can combine a consultation with both a cardiologist and a nutritionist to guide those who have an interest in a tasty diet with a low salt intake.

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