New Year, New You

Keeping your New Year’s resolution

Experts agree that people make resolutions with the best of intentions, but often inadvertently set themselves up for failure.

Congratulations on finishing the first week of 2018. How is your resolution going this year?

To set yourself up for success: Write down your goals, share them with someone to help keep yourself accountable, and make sure they are as specific and achievable as possible. The most important thing: making sure your goals are reasonable.

Here are five small, meaningful changes you could think about making.

Eat mindfully.
The idea behind mindful eating is pretty basic: If you take the time to truly savor what you are eating, without distractions, then your body will tell you when you’re full and what it’s craving. The hope is that mindful eating can lead you to a balanced, healthy diet that also includes your favorite treats.

Go to sleep – and wake up – at the same time.
Many times we focus on getting enough sleep, which is important, by doing so we overlook setting a sleeping pattern or bedtime routine. One tool to help set that routine is your smartphone. Apple introduced the Bedtime feature on the iPhone last year. Bedtime lets you pick your ideal time to go to sleep and a time to wake-up and it will monitor how well you slept through the night. It provides graphs in the morning and adds this data to the Health app so you can see your habits over time.

Whether you use your phone, set your TV to sleep, or have your parter or spouse remind you at night: consistency is the key. Try putting yourself on a regular sleep schedule and see how it makes you feel.

Find activity that will help you achieve your goals.
First, narrow down what it is you want to achieve each day, whether that’s getting stronger, increasing flexibility, or burning fat. Then find activity that is aligned with your goals – and that you enjoy, so you’re more likely to make a habit of making time to move.

Cut down on sugar.
The average American consumes over 77 pounds of sugar or sweetener each year, even though eating too much of it increases your risk of heart disease, obesity, and type 2 diabetes. Think about evaluating how much sugar you consume, and if it’s a lot, take steps to cut back a bit.

Drink a bit more water.
If you want to up your water intake, try keeping a water bottle at your desk, drinking a glass before starting each meal, or sipping some H20 when you’re feeling hungry (experts say that we often confuse hunger and thirst).

Lack of accountability is one of the major reasons we let resolutions or goals slide. Make sure that when you commit to a goal or lifestyle change that you share that with a friend or family member who will challenge you to keep making progress. Make this the year that YOU achieve YOUR goals!

Patient Education

Learn more about cardiac conditions, procedures and treatments with our Patient Education videos and materials.

Written by: Michael Arce, Social Media Specialist, Capital Cardiology Associates.

A Heart Healthy New Year

Heart Disease, Heart Health, Nutrition

Resolve to start 2022 with a healthy heart

Five easy, heart healthy resolutions from the American Heart Association that fits every lifestyle

Happy New Year from Capital Cardiology Associates! This year, join us in resolving to make one change toward a healthy heart. We found five easy resolutions you can make in 2022.

Drink More Water

The 8×8 rule should be your guide: the average adult should drink eight 8-ounce glasses of water per day. While that seems like a lot of water, keep in mind that coffee in the morning, iced tea at lunch, or a cup of tea in the afternoon — are all sources of water. The goal is to steer clear of soda or other sweetened beverages that are loaded with sugars.

Keeping a measured water bottle for work helps with hitting your water intake goal during the day. Your smartphone can also help track your water goals with apps like Daily Water for iPhones or Water Drink Reminder for Android.

Go Green

Fresh, frozen, even canned (in a pinch) vegetables pack many health benefits. The goal is to consume between five and 13 servings of fruits and vegetables each day. The trick is, “sneaking” those nutrient rich veggies into our daily meals to reach the recommended servings.

Whether it’s an apple with peanut butter as a midday snack, adding fresh bananas or blueberries to our breakfast cereal or oatmeal, or enjoying a handful of strawberries with yogurt in the afternoon, you can add “raw” fruits to your daily diet. For those who like creative dishes, there are plenty of ideas on how to incorporate greens into your snacks and meals!

Read 40 ways to sneak veggies into any meal without sacrificing flavor.

Eat Seasonally

Good for your budget and waistline, eating seasonally means you are getting food at it’s peak performance and flavor level. Additionally, you’ll be supporting your local community and farmers, which is always a great resolution as well. Click on the links below to see what is “fresh” at our area Farmers’ Markets.

Saratoga Farmers’ Market
Schenectady Greenmarket
Troy Waterfront Farmers’ Market
Other Capital Region Farmers’ Markets

Cut Out Processed Food

Decide that 2018 is going to be the year you say no to aspartame, high fructose corn syrup, and hydrogenated oil. In addition to chemicals you’re body doesn’t need or want, processed foods are full of added salt. Higher salt intake puts you at risk for high blood pressure. In fact, 75 percent of the salt in the average American diet comes from salt added to processed food and restaurant food, according to the American Heart Association.

Eat More Fiber

Fiber helps with weight loss, may lower cholesterol levels, in addition to lowering your risk of diabetes and reducing the risk of heart disease. The other good thing about Fiber: it’s easy to add to your diet! Whole grains are filled with fiber, which makes digestion easier and helps you feel fuller when you’re done eating – both key factors in weight management.

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Written by: Michael Arce, Social Media Specialist, Capital Cardiology Associates.

A Healthy Holiday Heart

Heart Disease, Heart Health, Nutrition

Heart Health

Holiday Heart Health

Build your success plan to stay heart healthy this Holiday season

Studies show that on average, we gain about five pounds from Thanksgiving to New Year’s. The holidays bring changes in what we eat (drinks, food, and treats) as well as changes in our activity and stress levels. For heart disease patients, the changes in our diet and exercise routines around the holidays can be life-threatening. The temptations to overindulge, the risk of overexertion from stressing about shopping, or snow shoveling can elevate heart-related issues. To avoid holiday health issues, we recommend that you follow these goals from the American Heart Association.

Make a holiday “health” plan

For example, you could commit to having a heart-healthy lunch each day, combing your green vegetables with a protein like chicken or steak, or aim to be active for 30 minutes every day with a short walk around your neighborhood or office. Make time to relax by reading a book, listening to soft music, or having a conversation for 30 minutes each evening.

Watch overindulgence

Be strict on your portion sizes. A small slice of pie isn’t going to ruin your diet, but more than one stops at the dessert table will! Particularly limit the amounts of foods you consume that are heavy in cream, sugar, or salt, and never go back for seconds. A good plan to tackle overeating before parties or gatherings is to have a high-protein snack like a handful of almonds, a cup of nonfat yogurt, or an apple with peanut butter.

Moderate your alcohol intake

The American Heart Association recommends no more than two alcoholic beverages a day for men and one for women. Hold yourself to these limits, using sparkling water or seltzer as an option when beverages loaded with alcohol sugar are being served.

Manage stress

Easier said than done, right? Studies show that individuals experiencing stress for extended periods are more likely to have heart disease and die from a cardiovascular condition. Stress often causes us to fall back into bad behavior patterns like smoking more, drinking more alcohol, and make poor eating choices more often in an attempt to cope. Mentally prepare yourself for stressful people or situations, have a plan with your partner or spouse on how to limit your exposure to these moments, and if needed, leave the room to get fresh air, chew gum, or take time to calm your mind.

Avoid overexertion

Winter activities such as shoveling snow can be extremely strenuous on your heart. And when you’re home during the holidays or preparing your home for visitors, you are likely to engage in these activities more often than usual. Let those who offer help to assist you with household chores or entertaining. Make sure you take frequent breaks to give your heart a chance to rest. And most importantly — know the warning signs of a heart attack which include chest pain, shortness of breath, nausea, and cold sweats. If you experience these symptoms, get emergency help immediately. Do not wait for the symptoms to subside or the pain to go away.

The Blood Test That Confirms A Heart Attack

Corporate Woods, Heart Health

The Blood Test That Confirms A Heart Attack

How Capital Cardiology Associates Enhanced Cardiac Access can determine a heart attack

In the Enhanced Cardiac Access (ECA) Suite at Capital Cardiology Associates (CCA) is a sign that reads, “When it’s your heart… it just can’t wait.”

Many heart attacks surface a month in advance, the symptoms go undetected until the individual experiences common indicators like chest pain or pressure. Our ECA Suite is located on the 4th floor of our Corporate Woods office and is the only Capital Region walk-in cardiac clinic. It was specifically designed to serve patients and non-patients who need attention for chest pain, shortness of breath, palpitations, or rapid heart rate.

One of the key indicators that allows our cardiac team to determine whether a patient is having a heart attack starts with a blood test.

Cardiac patients will have their blood drawn by our phlebotomists. “The benefit of an on-site Blood Lab to our patients is that all of the work is done in house,” explains CCA phlebotomist Olana Crawford. “We test for troponin, a protein that’s released into the bloodstream during a heart attack. Your blood is drawn and processed in our lab down the hall.” CCA can provide ECA patient test results in under an hour if necessary. When your blood work is done here, the results are immediately sent your physician. If there are any critical issues, the results are taken to a nurse who calls your cardiologist who recommends treatment immediately.

“If we find that patient is having a heart attack, we get them admitted to the ER right away,” adds Crawford. When not administering blood tests for ECA patients, the CCA Blood Lab also processes blood work for our patients. These tests are ordered by doctors and can include baseline blood tests, “the kidney, the liver, to all cardiac tests. If it’s a specialized test that we can’t perform, we can collect the sample and send it to St. Peter’s. We get the results back in a few hours,” noted Crawford.

At Capital Cardiology Associates we are committed to providing the highest quality of health to our patients. Crawford’s level of passion confirms that promise. “I treat every single patient with the utmost care. We’re trained to draw blood from patient’s on blood thinner medications, we make sure you don’t have a large bruises, we use a special taping system, we make sure everything stays in one medical records systems. When you get your blood work done at CCA, the results are immediately sent your your physician. If there are any critical issues, the results are taken to the nurse, who calls the doctor and recommends treatment right away.” The CCA team also understand that at times, your health also applies to their mental well being. “At other testing facilities, blood results can take at least 7-10 days to be processed, unless you go to an ER. That’s a lot to time to wait and think, ‘oh no what went wrong?’ Here we get your doctor the answers as efficiently as possible”, said Crawford.

To learn more about Capital Cardiology Associates walk-in Enhanced Cardiac Access Suite, click here. Make an appointment to today at 518-292-6090

Written by: Michael Arce, Social Media Specialist, Capital Cardiology Associates.

Your Cholesterol Level Does Not Matter

Announcements, Heart Disease, Heart Health

Your Cholesterol Level Does Not Matter

How you and your Cardiologist can calculate your cardiac risk

The common “good” and “bad” cholesterol levels myth is not true

We have all heard over the course of the last several decades that one’s cholesterol level predicts their risk of heart attack and stroke. Patients frequently ask me, “How could I have heart disease – my cholesterol level is normal?” or report to me, “I don’t have to worry because my good cholesterol is high”. As a cardiologist, I have both bad and good news: Your cholesterol level does not matter!

As you likely already know, cholesterol is a type of fat found within all cells and is free floating in blood on molecules called lipoproteins. The two most common of these lipoproteins containing cholesterol are low-density lipoprotein (also known as LDL) which carries cholesterol to the tissues (“bad cholesterol”), and high-density lipoprotein (also known as HDL) which carries cholesterol to the liver to be flushed from the body (“good cholesterol”).

Cholesterol carried by LDL can invade the walls of blood vessels and lead to inflammation within the walls of these blood vessels. Cholesterol in this way forms the main constituent of “plaque” which builds up within the walls of blood vessels, in particular within the walls of arteries which carry oxygen-containing blood to the organs such as your heart and brain. This plaque can increase in size to eventually lead to a “clogged” artery, or the plaque can “rupture” which causes the blood near the ruptured plaque to clot. In the heart, these situations lead to chest pain (sometimes referred to as “angina”), shortness of breath, or a heart attack. In the head and neck, clogging or obstruction of an artery leads to stroke.

Why then does one’s cholesterol level not matter?

Cholesterol lipoprotein levels within the bloodstream are determined by two main factors. The first is the consumption of fats which alter levels of cholesterol metabolism: mainly saturated and trans-saturated fats. Saturated fats are found mainly within animal based foods such as fatty meat, butter, and cheese. Trans-saturated fats are found within processed foods such as margarine. The other major determinant for cholesterol levels within an individual is from genetics, which determines how much cholesterol lipoproteins circulate mainly by determining how much cholesterol the liver is able to remove from the bloodstream.

Yet, we know from observational data that these levels are only one component of a patient’s overall risk of developing plaque within the arteries, also known as atherosclerosis. Some patients with what appears to be an advantageous cholesterol risk profile (low LDL, high HDL) still have heart attacks and strokes. On the other hand, we all know those people who have terrible lifestyle habits and poor cholesterol levels, but who still do not have any adverse effects. That is because neither dietary cholesterol changes or genetic cholesterol metabolism alone can predict the predisposition of the artery wall to plaque formation, and it is the actual formation of plaque which really determines an individual patient’s risk of heart attack and stroke.

Most physicians thus look for ways other than cholesterol levels alone to determine risk of plaque formation. A common method is with a “risk calculator”, a validated (proven by studies) method of estimating the individual risk of a patient using known risk factors for developing atherosclerosis. The most common risk calculator was updated in 2013 by the American College of Cardiology and American Heart Association, and it utilizes not only cholesterol levels, but also age, sex, ethnicity, blood pressure, smoking status, and diabetes to help better gauge individual risk of having a heart attack or stroke.

When a patient’s risk is calculated to be over 7.5% (meaning the risk of having a heart attack or stroke is greater than 7.5% over the next 10 years), then most physicians will recommend that the patient consider starting a medication within the class known as statins to help lower the patient’s cholesterol level in order to alter their risk profile. A patient with what has been considered a normal cholesterol level can still be estimated to have a high enough risk based on other factors within the risk calculator that they would be told they need a statin! The issue is that, as a physician, I can only modify certain risk factors: I cannot change a patient’s age, sex, or ethnicity, but I can lower their cholesterol level — the basis of all plaque — and hopefully reduce their risk.

The second, more technological way, to determine risk is with an imaging study called a Coronary Calcium Scan. A Coronary Calcium Scan is a non-contrast, low-radiation, CT scan of the heart which takes about 30 seconds to acquire and costs about $50.

The heart scan is then reviewed for evidence of calcium within the arteries of the heart; the plaque within the heart arteries calcifies or scars over time and is easily seen on these scans. Using a standardized software, the amount of calcified plaque is scored by an automated process.

Image 1

Coronary calcium scores range from zero (normal) to the low thousands (see Image 1 and 2). Because tens of thousands of patients with different scores have been followed for years, we know that a patient’s coronary calcium score directly correlates to risk over time.

Image 2

Coronary Calcium scans are more predictive than risk calculators because they directly look for plaque formation within the artery walls. There is no test in the field of Cardiology which can portend a better prognosis for a patient than a score of zero on a Coronary Calcium Scan. Coronary calcium scores over 300 on the other hand are generally considered to be high-risk, and most physicians would agree that such a score warrants statin therapy. It is an important point that a coronary calcium score of zero in most cases indicates a patient who does not need a statin medication regardless of how high the measured cholesterol. Conversely, a high coronary calcium score indicates that a patient merits statin use regardless of how low measured cholesterol levels are.

What to make of all of this?

I find that many patients will tend to over value their absolute cholesterol levels rather than the entirety of their risk profile. While these levels are important, they only tell one “chapter” in what is essence “the book of your cardiac risk story”.

Ultimately, you as the patient and I as the physician care about your risk of having a heart attack or stroke and taking steps to gauge that risk accurately. Those numbers on your cholesterol blood tests tell only a fraction of that risk. Whether through a risk calculator or through a Coronary Calcium Scan, risk assessment is an important step in helping to decide if your risk (not your cholesterol levels!) need to be treated.

Written by: Dr. Lance E. Sullenberger, Capital Cardiology Associates board-certified cardiac physician.