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TCI V1 I2.Pdf 33 Heart & Vascular Update President’s Message A publication from Welcome to the second issue of the Thoracic and Cardiovascular Institute’s Heart & Vascular Update. You may find some very use- ful, interesting, and perhaps surprising information among the variety of articles in this magazine. This issue reports on “natural” and prescription substances for lowering your cholesterol levels, how heart disease can affect the dynamic power and endurance of the human heart, and studies indicat- WWW.TCIHEART.COM ing that anger can be a dangerous risk factor contributing to cardiovascular Thoracic and Cardiovascular Institute problems and even heart attacks. An article on sudden cardiac death explains the Ingham Professional Building cause of about half of all deaths from heart disease. Another article details the 405 West Greenlawn Avenue, complications of congestive heart failure, a progressive syndrome and serious Suite 400 threat to your health. Lansing, Michigan 48910 We hope that you find these articles helpful. We also plan to present similar (517) 483-7550 reports in future issues of Heart & Vascular Update. We welcome your suggestions for future topics to help us provide medical information most pertinent to the Mid-Michigan’s communities we serve. Heart & Vascular TCI strives to provide the highest quality service and up-to-date technol- ogy for our patients. Each of our eight convenient locations provides the highest Specialists standard of patient care available. And our cardiologists are very well trained T. Michael Brown, DO, FACC and dedicated to deliver excellence in diagnosis and treatment of cardiovascular Mark D. Castellani, MD, FACC conditions. These are just a few of the reasons our practice continues to grow. We at TCI are pleased to report on the advances in cardiology to help Nam S. Cho, DO improve the awareness of cardiovascular medicine in our communities. I hope Joel M. Cohn, MD, FACC you enjoy and learn something helpful from this issue of TCI Heart & Vascular Christopher M. D’Haem, DO, FACC Update and invite you to share this issue with your friends and loved ones. Edward T. Helble, DO, FACC Juan O. Hernandez, MD, FACC Michael J. James, DO, FACC, FACOI Todd G. Hickox, DO, FACC President John H. Ip, MD, FACC Michael J. James, DO, FACC Contents Ellen L. Kehoe, DO George E. Kleiber, DO, FACC 4 Treating High Cholesterol Choose a natural cure or prescription drugs? Kirk B. Laman, DO, FACC 5 TCI Physicians Daryl R. Melvin, MD, FACC 6 Sudden Cardiac Death Richard M. Pinke, DO You can assess your risk to improve survival odds James A. Schafer, MD, FACC 9 Take Your Workouts Outside David J. Strobl, DO How to get the most from your time in the great outdoors Joni R. Summitt, DO, FACC 10 Your Private Dynamo R. K. Thakur, MD, FACC The heart can beat 2.5 billion times per lifetime Mark Veenendaal, MD, FACC 12 Congestive Heart Failure Ronald A. Voice, MD, MS, FACC Patient shares how he felt before and after a heart transplant Matthew D. Wilcox, DO 14 Manage Your Anger Avoid the health risks of losing your temper Heart & Vascular Update is an informative and educational resource for health-care professionals, medical affiliates, employer groups, and the general public. This publication will feature physicians and facilities of the Thoracic and Heart & Vascular Update is published by QuestCorp Media Group, Inc., 885 E. Collins Blvd., Ste. Cardiovascular Institute, communicate educational news 102, Richardson, TX 75081. Phone (972) 447-0910 or (888)860-2442, fax (972) 447-0911., qcme- and treatment trends, and contain various health-oriented dia.com. QuestCorp specializes in creating and publishing corporate magazine for businesses. articles of interest. The information contained in this publi- Inquiries: Victor Horne, [email protected]. Editorial comments: Darren Nielsen, dnielsen@ cation is not intended to replace a physician’s professional qcmedia.com. Please call or fax for a new subscription, change of address, or single copy. Single consultation and assessment. Please consult your physician copies: $5.95. This publication may not be reproduced in part or in whole without the express on matters related to your personal health. written permission of QuestCorp Media Group, Inc. To advertise in an upcoming issue of this publi- cation, please contact us at (888) 860-2442 or visit us on the Web at qcmedia.com. October 2007 4 Treating High Cholesterol Choose a natural cure or prescription drugs? BY DAVID J. STROBL, DO MOST AMERICANS ARE WELL AWARE that high choles- terol levels are dangerous and linked to risk of a future heart attack and stroke. However, patients frequently are reluctant to take prescription medications to treat this genetic condition because they fear potential side effects. I am frequently asked if a “natural” cure is a safer alternative. Diet is probably the safest alternative to drugs and clearly plays an important part of any treatment plan. Restricting saturated fat (commonly found in dairy products, red meat, and many commercial baked goods) will cause some reduction in cholesterol. However, this effect may be modest in most patients. Only one of five high-risk patients will be able to achieve their cholesterol goal with diet alone. Many patients find it difficult to sacrifice their favorite foods and follow a strict diet. Regardless, I still emphasize diet as the cornerstone of therapy for my clinic patients. Even if medication is needed, lower dosages will be effective if the patient follows a low saturated fat diet. Patients frequently ask about or attempt on their own a nonprescription “natural” cure. Unfortunately, we are Choosing low-cholesterol foods can be simple, but hard to do when the exposed to exaggerated claims of the choice eliminates a favorite food. Heart-healthy eating and prescription benefits of a variety of advertised “natural” medications are two proven ways to reduce your cholesterol levels. products. There is very little scientific evi- dence that most of these products produce any significant changes in cholesterol levels. A very popular agent called polico- not demonstrate a reduction in lipid levels I am never opposed to a patient attempt- sanol (a sugar cane derivative) was proved beyond the placebo results. ing a so-called “natural” cure, but I insist ineffective in lowering cholesterol levels in Another agent, red yeast rice extract, a well designed actually contains lovastatin (a member study published in of the statin drug class) and can cause a “Many patients find it difficult to sacrifice the Journal of the reduction in LDL cholesterol levels. However American Medi- the unsupervised use of red yeast rice their favorite foods and follow a strict diet. cal Association. extract can cause side effects, including Regardless, I still emphasize diet as the Previously, most liver toxicity. cornerstone of therapy for my clinic patients.” of the support- Niacin, a water-soluble B vitamin, ing positive data can also modestly lower triglycerides – DaVID J. STROBL, DO about policosanol and LDL cholesterol as well as raise the as a lipid-lowering beneficial HDL cholesterol levels. Niacin on a check of the patient’s cholesterol agent came from small studies in Puerto is available over the counter, but again is level before and after treatment to make Rico. However, the much larger multicenter not recommended for use without medical sure they are not wasting their money on a study conducted in Germany concluded supervision. The short-acting forms are useless pill. that policosanol in usual and high doses did poorly tolerated with significant flushing 5 Cholesterol Countdown TCI Physicians The American Heart Association associates Each of the physicians practicing at Thoracic and Cardiovas- risk of heart disease from cholesterol levels cular Institute demonstrates high competence in his or her by these numbers: cardiology specialization. In addition, every member of our Total Cholesterol: medical staff stays proficient in the latest medical proce- dures and technology to ensure that TCI delivers the highest standard of patient Desirable: Below 200 mg/dL care. TCI has proud history of providing the most comprehensive diagnostic and Borderline High: 200 to 239 mg/dL treatment options for cardiovascular concerns in the Mid-Michigan region. High: 240 mg/dL and above. Twice the risk for coronary heart disease as at 200 mg/dL or below. HDL Cholesterol: High density lipoprotein, the good stuff. Low: 40 mg/dL for men, 50 mg/dL for women. T. Michael Brown, DO, Mark D. Castellani, MD, Nam S. Cho, DO Joel M. Cohn, MD, FACC FACC FACC A major risk factor for heart disease. High: 60 mg/dL or above. Protective against heart disease. LDL cholesterol: Low density lipoprotein, the bad stuff. Optimal: Below 100 mg/dL Christopher M. D’Haem, Edward T. Helble, DO, Juan O. Hernandez, MD, Todd G. Hickox, DO, Near optimal: 100 to 129 mg/dL DO, FACC FACC FACC FACC Borderline high: 130 to 159 mg/dL High: 160 to 189 mg/dL Very high: 190 mg/dL and above and occasional hypotension, particularly in patients treated with Michael J. James, DO, Ellen L. Kehoe, DO George E. Kleiber, DO, Kirk B. Laman, antihypertensive medications. The long-acting forms are better tol- FACC FACC DO, FACC erated, but have a greater risk of liver toxicity. Niacin can also cause atrial dysrhythmias and can aggravate peptic ulcer disease. Patients often are understandably reluctant to take prescribed medications, but for many high risk patients (such as diabetics or heart attack survivors), drugs such as statins can be life saving and are considered as safe as aspirin. Unlike many of the “alternative” or “natural” products mentioned above, statins have been studied Daryl R. Melvin, MD, Richard M. James A. Schafer, MD, David J. Strobl, DO in multiple trials with thousands of patients to document their FACC Pinke, DO FACC efficacy in reducing heart attack and death.
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