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Conditions & Treatments

Everything you need to know about Hypertension

by Guest Blogger
written by Guest Blogger

Hypertension is a state when there are consistent high blood pressure levels. Notably, there are no visible symptoms of hypertension. It could happen to anyone, irrespective of age, and can cause several health issues if not treated timely.

For identifying if you have hypertension, start having regular blood pressure checkups either at a clinic or your home. Hypertension or high blood pressure levels reduce the heart’s efficiency and make it work more rigorously than regular. Furthermore, delicate tissues that are present in the arteries also get affected by the impact of high blood pressure.

The below-depicted infographic gives us an overview of the following:

  • Hypertension around the globe
  • Possible causes of Hypertension
  • How Hypertension affects humans?
  • Potential signs and precautionary measures of Hypertension
  • Hypertension Treatment.

Hypertension affects all of us at some point in our lives. Hence, it is critical to take the necessary steps to manage our blood pressure levels both in terms of our physical and mental health. Thus, take enough care of yourself and your loved ones, and work hard to overcome the high blood pressure levels.

Author Bio: Anurag works as a Marketing Manager for Wisdom Policy, India’s leading online insurance provider. His passion for marketing is never-ending, and his contributions so far are unmatched.

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CBD for Health

Medosi Long Lasting, Refreshing CBD Relief

by Guest Blogger
written by Guest Blogger
Medosi Tincture Drops are refreshing, simple, and effective!

Nowadays there are so many flavors to choose from in the CBD world, but nothing beats a classic peppermint flavored oil. Medosi takes a whole spectrum health approach to their company, and they use the whole hemp plant in their products. Hemp and peppermint are a match that goes beyond just complementary flavoring, which Medosi has put together beautifully.

Peppermint is a great companion for CBD because it may help with a variety of things like pain relief, stomach spasms, indigestion, and low-energy. These are things CBD has been known to help with as well. We agree that combining the two in Medosi Tincture Drops is a great move.

Medosi Tincture Drops helped ease our reviewer’s anxiety, along with her everyday aches and pains.

Medosi paid us a fee and offered us free products in return for our honest opinion.

We tried Medosi at varying times of the day, for pain relief, severe anxiety, and to help us relax before bed. Read on to find out how well it worked for us.

Just three ingredients in Medosi’s formula

We love a simple ingredient list, especially when it comes to CBD oils. Medosi uses organic, non-GMO, USA grown hemp in their products and it shows. Organic hemp combined with natural mint flavor offers an earthy, subtle yet enjoyable flavor.

Hemp seed oil is a great base for CBD products because it includes omega-3 and omega-6. Hemp seed oil may also benefit skin and heart health. We enjoyed getting our omegas and healthy fatty acids along with our CBD supplement in one place. Just be sure to store this product in the fridge to keep it fresh.

This full spectrum oil also has some of our favorite cannabinoids like CBG and CBN, which show up in their easily accessible test results. CBG may help with inflammatory bowel disease among other issues. This potential is another reason we love that this oil is paired with peppermint. Medosi’s high quality makes use of the entourage effect and enhances the benefits of CBD with other cannabinoids.

How did our reviewer like Medosi Tincture Drops?

“Focusing on the cooling mint flavor immediately starts to relieve some anxiety, and the fresh breath didn’t hurt either. We felt pain from tension and stiff muscles ease, and we felt a sense of calm throughout the day. We think it’s great for a post lunch dose to help get us through the afternoon into the evening. And the mint flavor is great between meals.”

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Alzheimer’s Disease and Cardiovascular Health
Conditions & Treatments

Alzheimer’s Disease and Cardiovascular Health

by Guest Blogger
written by Guest Blogger

Alzheimer’s is a growing disease that currently affects an estimated 5.5 million Americans. This number is expected to climb because of the growing number of individuals living far longer than in any previous generation. Although longer life expectancy is a sign of a healthier and better cared for population, it is also an indicator that diseases which afflict the elderly will become more prevalent as the population ages.

10% of individuals older than 65 are living with Alzheimer’s dementia, and two-thirds of these are women.

These rates are also far higher in Hispanic and African American, although researchers do not fully understand why women and minorities experience a higher prevalence of the disease.
Some believe that this is associated with higher rates of depression and anxiety, others have found links to external socioeconomic factors such as nutrition, preventative health care, and smoking. Regardless, what is known is that as America’s population continues to age and the number of the very old rises, so too will the number of individuals living with dementia.

While research is still being conducted to determine possible causes, identify early indicators, and pursue possible cures, deaths from Alzheimer’s disease have increased almost 90% since 2000. On the other hand, deaths from heart disease have decreased 14% in the same time.

Currently, one in three elderly Americans die with dementia and it is the sixth leading cause of death.
Apart from those living with cognitive impairment, a second and larger group affected by Alzheimer’s are the family and friends who care for their loved ones. Dementia takes a heavy toll on caregivers and is associated with substantial financial and emotional challenges. Although Medicare and Medicaid cover close to 70% of the $259 billion associated with Alzheimer’s and dementia care, out of pocket costs to individuals are estimated at nearly $70 billion per year.

Healthcare and long term care costs for those living with Alzheimer’s are up to three times higher than other diseases because dementia is associated with a higher number of hospital stays and with higher rates of other chronic conditions – including cardiovascular illness.

Cardiovascular disease (CVD) and Alzheimer’s disease have been recently found to be related in several ways. One association involves evidence demonstrating that pre-existing cardiovascular illness dramatically increases the long-term risks of developing Alzheimer’s disease. One study found that individuals with hypertension, or high blood pressure, in their 40s have a 24% higher risk of developing Alzheimer’s disease. Another study found that higher cholesterol is likewise associated with an increased risk of cognitive dysfunction later in life. Another association between heart disease and Alzheimer’s is that the incidence of ischemic stroke, which is often caused by CVD, also increases an individual’s probability of developing Alzheimer’s disease.

While cognitive impairment is associated with heart disease and stroke, CVD also shares common risk factors with Alzheimer’s – meaning that some of the reasons why people develop cardiovascular illness are the same reasons why some people develop dementia. These include preventable conditions such as obesity and type II diabetes (which accounts for 90% of individuals living with diabetes), as well as non-preventable or genetic factors such as the elevated presence of apolipoprotein E – a naturally occurring protein associated with the transport of cholesterol to the brain.

Studies have found that frequency of a specific variant of apolipoprotein E is associated with a higher incidence of Alzheimer’s disease and that it is likewise a genetic risk factor for CVD. While it may not be possible to change genetics, apolipoprotein E has been found to interact with environmental risk factors such as smoking or poor diet. This means that while an individual’s genetics may predispose them to cardiovascular or Alzheimer’s disease, having healthy habits may reduce the elevated risks due to genetic factors. In fact, studies have shown that comprehensive treatment for heart disease may be beneficial in the treatment and prevention of Alzheimer’s disease.

Current diagnosis of Alzheimer’s relies largely on documenting mental decline, meaning that most patients will not know that they have Alzheimer’s until they begin experiencing cognitive impairment and the disease has already caused severe brain damage.

Although researchers are trying to determine new means of identifying Alzheimer’s before irreversible brain damage occurs, these are not yet readily available. For this reason, ongoing preventative care and monitoring of cognitive functions is the best way to reduce the risks of developing Alzheimer’s or diagnose the disease early on in order to implement a comprehensive treatment plan.

The strong link between Alzheimer’s and cardiovascular disease implies that many of the same preventative and disease management options used in the treatment of CVD will be effective in protecting patients from Alzheimer’s. Such options include physical exercise to improve cardiovascular fitness, lowering cholesterol through diet and medication, and quitting smoking.

Here at Dr. Leonard Pianko’s medical practice, we strongly believe that comprehensive preventative care is integral to the health of each of our patients. We offer holistic medical care to improve the overall well-being of our patients, and one important aspect of well-being is cognitive health. Because of the association between heart health and dementia, we are uniquely equipped to help our patients strategize the most effective means of lowering the risks of both CVD and of Alzheimer’s disease.

If you are interested in hearing more about protecting your heart and your mind from unnecessary health risks, please book an appointment at Dr. Pianko’s Aventura Cardiovascular Center today.
Call us at (305) 384-4720, our staff is waiting to help you live every day to its fullest with improved health outcomes. To find out more check us out on the web http://www.leonardpiankomd.com/

From the Desk of Dr. Leonard Pianko MD PA FACC

Dr. Leonard Pianko, the founder of the Aventura Cardiovascular Center, is board certified in cardiology and internal medicine with special expertise in cardiovascular disease, preventive cardiology, and non-invasive treatment options, including echocardiogram and nuclear stress testing. A native of New York, Dr. Leonard Pianko, M.D., F.A.C.C., was born in the Bronx, and earned an undergraduate degree from Yeshiva University in New York before receiving his medical education at top-ranked Mount Sinai School of Medicine and completing his training at the prestigious Robert Wood Johnson School of Medicine in New Brunswick, New Jersey. For more information about this blog contact Dr. Pianko at http://www.leonardpiankomd.com/contact.php.
Alzheimer’s Disease and Cardiovascular HealthAlzheimer’s Disease and Cardiovascular Health Alzheimer’s Disease and Cardiovascular Health

Alzheimer’s Disease and Cardiovascular Health

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Conditions & Treatments

Improve Your Heart Health at Home and Work

by Guest Blogger
written by Guest Blogger

How many people do you think suffer from heart issues? A couple of million, maybe? That, unfortunately, would be vastly underestimating the total number. In fact, 92.1 million Americans suffer from some form of cardiovascular disease. Maybe they are recovering from a heart attack, for example. Or maybe they have a different form of heart disease.

For these people, heart health is a primary concern. But it should be a concern for all of us, and we should be concerned about it every minute of the day—including when we are at work. At work or at home, what we eat—too much salt and sugar and fat, for example—matters to our heart health. When you snack at your desk, those snacks impact your heart health, too.
How much you move at work can deal your heart a bad health blow. So what can you do to make a positive impact? This graphic explains it. I

mprove Your Heart Health at Home and Work

https://zerocater.com

Improve Your Heart Health at Home and Work

Improve Your Heart Health at Home and Work Improve Your Heart Health at Home and Work Improve Your Heart Health at Home and Work Improve Your Heart Health at Home and Work

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Conditions & Treatments

Treatment Options for Afib

by Guest Blogger
written by Guest Blogger

Have you ever wondered what your greatest risk is if you have irregular heart beat/atrial fibrillation, commonly known as Afib? A stroke is commonly what most people worry about, but as you will read in my case, the risk of bleeding from blood thinners can also be another risk. What options do you have?

For more than four years I dealt with fatigue that was indescribable. I wore heart monitors and made many visits to cardiologists, pulmonologist, gynecologist, and primary care physicians as they all tried to figure out what was going on, but the fatigue continued.

In February 2009, I was having stomach issues and my primary care physician set up for me to have a CAT scan and ultrasound, as he thought my gall bladder might be the issue. As a result of the CAT scan, it was determined there were issues with not only my gall bladder, but also with my heart. Following the scan, an ultrasound found that I had a tumor in my heart.

In March 2009, I had open heart surgery at Vanderbilt University Medical Center and a benign atrial myxoma was removed. The tumor was the size of a racquetball. Following surgery, and while still at Vanderbilt, I had several episodes of atrial fibrillation (Afib). When I returned home, these irregular heart beat episodes continued.

My home is in Paris, Tennessee, which is about 2 hours and 15 minutes from Nashville. I was transported by ambulance back to Vanderbilt three times following surgery due to Afib.

Afib increases the risk of stroke, so following heart surgery I was told to take 81mg of aspirin (baby aspirin) to reduce this risk. That was the only blood thinner needed for several years. Around 2013-2014, I began having noticeable Afib issues again and was prescribed a blood thinner in addition to the aspirin. After several medication changes, an internal loop monitor was implanted in July 2016.

During the first week of September 2016, I was experiencing extreme fatigue due to Afib. But by the third week of September I was feeling better. I had a girl’s trip planned to New Mexico, so decided to go ahead with my trip. I flew back to Nashville and was not feeling great, but thought I was just tired as my returning flight had been delayed. I got to my car to exit the parking area and could not figure out how much money to pay to exit. It was 2:00 a.m. and I was exhausted, so was not too concerned. My husband has reserved a hotel room close, so I did not have to drive the 2+ hours home.

I tried calling the clinic, but I could not dial the number. I called my husband and he took me to the local ER. It was determined quickly that I had a brain bleed, so I was flown by helicopter back to Nashville. Immediately I was taken off blood thinners, which was very concerning.

After being hospitalized for four days I returned home to recover and get back to “normal”, which was a struggle. I still was off blood thinners as it was determined that a combination of the blood thinner, altitude changes, and flying possibly attributed to the brain bleed. Even knowing this, there were no words to express the anxiety, panic and concern that I felt not having blood thinners to “protect” me from stroke.

I was truly interested in an option that would allow me to not have to take blood thinners due to my previous experience, but provided protection from stroke. Blood thinners- no matter the brand- were concerning due to bruising as well. The smallest injury caused bleeding that was difficult to stop. Working in the yard or any activity either inside or outside always seemed to lend itself to some kind of injury. My arms and legs always looked like I had been in a fight.

I am very thankful for cardiologists that worked to figure out the next step that was best for me. After many calls, doctor appointments, and some research on my own it was determined that a left atrial appendage closure implant was the best next step for me. The implantwould allow me to not take blood thinners, which was the answer I was searching for.

The devicewas implanted April 2017. By October 2017 I was totally off blood thinners, other than taking a “baby aspirin.” I can now work in the garden and yard, take my great nephew and nieces to the park, and just do things I enjoy.

Your first question may be….do I still deal with Afib? And the answer is “yes”, but I do not worry about the blood pooling that might cause a stroke. The peace of mind I have now since I had the deviceimplantedis truly wonderful.

I would share with anyone that talking to your physician and discussing issues you are having with your current treatment would be a good first step. I found it helpful to do some research myself and find out as much as I could about different treatment options for Afib. As I did research, the website www.WatchUsNow.com was a helpful resource. Another site that shares information about AFib and treatment is StopAfib.org.

By Jan Mitchell

Boston Scientific is a corporate contributor to StopAfib.org, a supporter of WatchUsNow.com, and has reviewed this article for technical accuracy.

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Health

How to Keep Your Heart Healthy at Work

by Kimberly Johnson
written by Kimberly Johnson

How many people do you think suffer from heart issues? A couple of million, maybe? That, unfortunately, would be vastly underestimating the total number. In fact, 92.1 million Americans suffer from some form of cardiovascular disease. Maybe they’re recovering from a heart attack, for example. Or maybe they have a different form of heart disease. How to Keep Your Heart Health at Work
For those people, of course, heart health is a primary concern. But it should be a concern for all of us, and we should be concerned about it every minute of the day—including when we are at work. At work or at home, what we eat—too much salt and sugar and fat, for example—matters to our heart health. When you snack at your desk, those snacks impact your heart health, too.
And how much you move at work can deal your heart a bad health blow. So what can you do to make a positive impact? This graphic explains it. How to Keep Your Heart Health at Work

Keep Your Heart Healthy at the Office

InfoGraphic by https://zerocater.com
How to Keep Your Heart Health at Work How to Keep Your Heart Health at Work How to Keep Your Heart Health at Work How to Keep Your Heart Health at Work How to Keep Your Heart Health at Work How to Keep Your Heart Health at Work How to Keep Your Heart Health at Work How to Keep Your Heart Health at Work How to Keep Your Heart Health at Work How to Keep Your Heart Health at Work

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Heart Disease: Silent Killer of Women
Conditions & Treatments

Heart Disease: Silent Killer of Women

by Kimberly Johnson
written by Kimberly Johnson

Heart disease and stroke are respectively the first and second leading causes of death in America – 30% of all deaths are from cardiovascular illness. Although heart disease is often thought of as affecting men primarily, this is a mistaken assumption. Cardiovascular disease is an equal opportunity killer and, in fact, more women die every year from heart disease than men. Heart Disease: Silent Killer of Women

More than 400,000 women die every year in the United States from heart disease, accounting for one out of every 4 female deaths. Heart Disease: Silent Killer of Women
However, researchers have found that many women underestimate their risks of heart attack and stroke.
Only about half of women recognize cardiovascular illness as the leading cause of death despite efforts to increase awareness.

Heart Disease is the Silent Killer of Women

Silent Killer

This low health literacy regarding heart health among women translates to suboptimal risk reduction and treatment. Studies have found that women are less likely to be counseled on steps to reduce risk and often receive less medical intervention than their male counterparts. Although nearly 7% of American women have coronary heart disease, most are unaware of the health risks entailed.
An additional challenge facing women with regards to cardiovascular illness is the discrepancy in presentation of symptoms between women and men. While men often exhibit early signs of heart disease, women frequently remain asymptomatic until the disease is very advanced and a cardiovascular incident is either imminent or has already occurred. Almost two-thirds of women who die suddenly from stroke or heart attack have experienced no previous symptoms, making cardiovascular illness a stealthy and silent killer. Furthermore, when women do experience symptoms of heart disease these may be very different from the symptoms generally described by men.

Men and Women: Different Symptoms

While many men describe chest pain – or angina – as a crushing or squeezing feeling in the chest that radiates down the arm, women may be more likely to describe sharp or burning chest pain that radiates to the neck, jaw, and back.
Women may also experience varied physical symptoms apart from chest pain, such as abdominal discomfort, nausea and vomiting, profuse sweating, dizziness, and fatigue.
Because of the wide variation in symptoms and the discrepancy from typical crushing chest pain, women are less likely to seek medical attention and be diagnosed with a cardiovascular illness.
Another difference in the presentation of symptoms between men and women is when episodes occur.
Frequently men who experience angina find that pain intensifies with physical activity and subsides while resting.
Women, on the other hand, are more likely to have pain while resting or even sleeping.
Angina in women will also be triggered during routine daily activities as well as during times of mental or emotional stress rather than during intense physical exercise.
These two major differences between how women and men present exacerbates the under-diagnosis and treatment of women with cardiovascular illness, which may, in turn, increase the risks of cardiovascular events such as heart attack and stroke.
If heart disease is not diagnosed until the patient suffers a serious medical crisis, rehabilitation may be more difficult.
For this reason, at our cardiology practice, we strive to prevent such events through early diagnosis and prevention.

Silence of Heart Disease in Women

Because of the relative silence of heart disease in the case of female patients, this intervention is only possible if we can monitor risk factors and implement risk reduction even without the presentation of symptoms.
These risks also increase dramatically after menopause, making it especially critical for older women to closely monitor heart health.

Lifestyle Choices that Can Make a Difference

To reduce the risks of heart disease, there are a number of lifestyle choices that can make a significant difference. These include:
· Quit smoking: women who smoke are 25% more likely to develop heart disease and suffer smoking-related complications than men who smoke. Smoking also doubles women’s risk of sudden cardiac death, making smoking cessation a top priority.
· Healthy eating: reduce intake of fatty meat, especially after menopause, and increase intake of fruits, vegetables, fiber-rich whole grains, and low-fat protein. High protein diets and yo-yo dieting in older women has been linked to increased risk of cardiovascular illness. It is important to consult with your physician prior to beginning any diet.
· Exercise regularly: just 150 minutes of activity per week can reduce risks of heart disease.
· Limit alcohol to one drink per day.
· Lower stress: stress at work has been linked to a 40% increase in heart health risk and has also been linked to obesity. Finding healthy ways to reduce stress can positively impact a woman’s overall health.

What Can Your Doctor Do?

While lifestyle changes are important, it is also necessary for women to undergo regular checkups to monitor heart health. Some things that your doctor will do to ensure that you are maintaining optimal cardiovascular health include: Heart Disease is the Silent Killer of Women
· Monitoring blood pressure: high blood pressure contributes to heart disease and increases the risk of adverse events, yet is often asymptomatic.
· Testing for diabetes: uncontrolled diabetes significantly raises the risks of cardiovascular illness. While diabetes can be controlled, it is important to diagnose it and implement an appropriate management plan.
· Monitoring triglycerides and cholesterol: high triglycerides combined with high levels of ‘bad’ LDL cholesterol and low levels of ‘good’ HDL cholesterol speed up the buildup of plaque along arterial walls, which in turn increases the risk of heart attack and stroke. These levels can only be determined through regular blood tests.
At our Aventura, Florida cardiology practice, we strive to implement early intervention to reduce the risks of cardiovascular illness. Heart Disease: Silent Killer of Women
We are here to guide and support all of our patients, and our staff is uniquely equipped to treat each patient according to their individual health needs and goals. Heart Disease: Silent Killer of Women

Heart Disease: Silent Killer of Women

Dr. Leonard Pianko, the founder of the Aventura Cardiovascular Center, is board certified in cardiology and internal medicine with special expertise in cardiovascular disease, preventive cardiology, and non-invasive treatment options, including echocardiogram and nuclear stress testing. A native of New York, Dr. Leonard Pianko, M.D., F.A.C.C., was born in the Bronx, and earned an undergraduate degree from Yeshiva University in New York before receiving his medical education at top-ranked Mount Sinai School of Medicine and completing his training at the prestigious Robert Wood Johnson School of Medicine in New Brunswick, New Jersey. For more information about this blog contact Dr. Pianko at http://www.leonardpiankomd.com/contact.php.

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Smoking Kills: It is Never too Late to Stop!
Conditions & Treatments

Smoking Kills: It is Never too Late to Stop!

by Jeff Dailey
written by Jeff Dailey

The dangers of smoking are well known, however, nicotine is highly addictive and it can be very difficult to quit – especially if the habit is decades old. At our practice, we offer preventative care and do not wait for serious medical challenges before we begin addressing the possible underlying causes for cardiovascular disease. Smoking Kills: It is Never too Late to Stop!

One such cause is undeniably smoking. Smoking Kills: It is Never too Late to Stop!
Smoking is the single greatest preventable cause of death and disease in the United States.
15% of Americans smoke, amounting to 36.5 million people. A majority of these are heavy smokers. Every year cigarettes kill close to half of a million Americans, with an additional 40,000 deaths resulting from exposure to secondhand smoke. In this sense, smoking is not solely a personal decision – other people may be affected even if they themselves do not smoke.
Another aspect of the wider reaching consequences of tobacco use are the health care costs. According to a 2014 study by the Center for Disease Control (CDC), national smoking-related costs amount to $300 billion each year, including both direct medical care and lost productivity.
Apart from the cost to taxpayers and the burden on the medical system, cigarette smoking is very expensive to the individual smoker as well. American smokers spend up to $80 million every year on cigarettes or about 70$ per week.
While most people understand that smoking increases the risks of cancer, fewer may realize that smoking also has an adverse effect on the cardiovascular system. Smoking is a major cause of cardiovascular disease (CVD) and is linked to one-third of deaths from CVD.
While smoking is the number one cause of preventable death in the United States, cardiovascular disease is the single greatest cause of death. More than 16 million Americans have heart disease, and 800,000 Americans die of heart disease every year.

Heart attack and stroke affect 15 million Americans every year.

What this amounts to is that smoking is a very dangerous habit that can seriously impact overall health, and in particular can affect cardiovascular health.
Even people who smoke fewer than five cigarettes per week may be increasing their risk of early CVD, and this risk increases both with a number of cigarettes smoked daily and the number of years a person smokes for.
So how does smoking contribute to heart disease? The chemicals in cigarettes inflame the cells lining arteries, leading to an increased buildup of fat, cholesterol, and other substances in the blood along the arteries – this is known as plaque. Plaque can form dangerous clots that can travel to the brain or the heart, causing a blockage that leads to heart attack or stroke. The narrowing of arteries due to the buildup of plaque is called atherosclerosis, a condition that can be treated with medication. However, medication is no replacement for quitting smoking.
Other cardiovascular conditions that have been linked to smoking are peripheral arterial disease (PAD) and peripheral vascular disease which is what happens when plaque causes the narrowing of blood vessels feeding the body’s extremities.
When blood flow is reduced and the limbs deprived of oxygen and nutrients, symptoms will include aching and muscle exhaustion, and in extreme cases may even result in infection and amputation.

Smoking is the most common preventable cause of PAD.

An abdominal aortic aneurysm occurs when the portion of the aorta that is in the abdomen suffers restricted blood flow. If an aneurysm ruptures it can be life-threatening – almost all deaths from abdominal aortic aneurysms are caused by smoking.
Smoking is a major risk factor for heart disease and a leading cause of death in the United States. When combined with other preventable and non-preventable risk factors, such as genetics, obesity, and high-cholesterol, smoking can greatly exacerbate the risk of heart disease, heart attack, and stroke.
Although smoking is very harmful and is increasingly harmful over time, even long-time smokers can reduce or even reverse these harms rapidly once they quit. Within just one year the risk of heart attack drops dramatically. Within five years, smokers who quit may cut their risk of stroke down to that of a person who has never smoked a single cigarette. Therefore, while smoking is a significant risk factor for cardiovascular disease, it is never too late to quit. Even just a few cigarettes a week can cause damage, so the safest strategy to prevent or reverse this damage is to quit as soon as possible.
At Dr. Leonard Pianko’s office, we treat the whole patient and not just disease.
This means that we are here to help you improve your overall well-being and day-to-day health holistically and preventatively rather than waiting for problems to appear.
If you smoke, we are here to advise and guide you through the process of quitting. Smoking is a serious addiction, and those who break free need serious support – our entire staff is dedicated to total care of every patient, including through the difficult process of quitting smoking. The gains of quitting are immeasurable, and we are here to help our patients attain their health goals. If you are interested in consulting with Dr. Pianko, please schedule an appointment at any time.

Dr. Leonard Pianko, M.D., F.A.C.C., is a specialist in Internal Medicine and Cardiovascular Disease.

Smoking Kills: It is Never too Late to Stop!

Smoking Kills: It is Never too Late to Stop!

Smoking Kills: It is Never too Late to Stop! Smoking Kills: It is Never too Late to Stop! Smoking Kills: It is Never too Late to Stop!

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Choosing the Right Anticoagulant For You
Conditions & Treatments

Choosing the Right Anticoagulant For You

by Kimberly Johnson
written by Kimberly Johnson

One of the most common classes of medications used in the treatment and management of heart or blood vessel disease are anticoagulants. Anticoagulants are recommended in particular to patients experiencing atrial fibrillation, an irregularity in the heartbeat that increases the risk of blood clots forming in the chambers of the heart. Choosing the Right Anticoagulant For You
According to the American Heart Association, more than 2.7 million Americans suffer from atrial fibrillation. The majority of these are treated with anticoagulants. These medications eliminate or reduce the formation of dangerous blood clots in the arteries and are often known colloquially as “blood thinners”. Although anticoagulants do not actually thin blood, they do break up clots that may form in the brain, blood vessels, or heart by interfering with the proteins in the blood that are involved in coagulation. Everyone has clotting factors in their blood to ensure that if they are injured or cut that they do not bleed to death. However, when cardiovascular conditions like hypertension or atherosclerosis present, dangerous blood clots can form that may block the flow of blood to the heart or the brain, increasing the risk of stroke and heart attack. The formation of these dangerous clots is called thrombosis, a condition that can be managed with the correct administration of anticoagulant medication. Choosing the Right Anticoagulant For You

The most popular anticoagulant on the market is warfarin. Warfarin inhibits the action of vitamin K, which assists in the production of proteins that contribute to coagulation. Since the 1950’s this drug has been used to reduce the risk of thrombosis, thereby reducing the risk of heart attack and stroke. Although it is highly effective, warfarin – which is sold under the brand name Coumadin – is known to interact with certain foods and medications or supplements.
These interactions can affect warfarin’s therapeutic effect and may lead to bleeding or increased risk of dangerous blood clots, thereby necessitating very close monitoring of the patient’s clotting factors. Many patients on warfarin may require certain dietary restrictions in order maintain a balanced dosage, and contraindicated drugs may either enhance or limit anticoagulant effects. A weak dosage can carry increased risk of stroke and heart attack while an excessive dosage can cause serious internal bleeding. Choosing the Right Anticoagulant For You

Patients must undergo regular blood tests called international normalized ratio (INR) tests that evaluate coagulation, liver function, and vitamin K levels. The results of these regular tests help doctors determine the correct dosage of warfarin while protecting the patient from potentially harmful side-effects and interactions. Although warfarin is not easy to manage and requires constant monitoring, an experienced and attentive physician will be able to successfully administer the medication.
One important benefit of warfarin is that it although it has a limited window of efficacy, its anticoagulant effects are easily reversible. Vitamin K is one antidote to warfarin that will hasten the reversal of the anticoagulant effect and allow blood to clot more rapidly if the patient needs to undergo surgery or has been injured.

For more than 60 years, warfarin has been the primary course of treatment for patients with heart and blood vessel disease, however recently a new class of anticoagulant medications was approved for use in the United States. The development of these novel oral anticoagulants, also known as NOACs or non-vitamin K antagonist anticoagulants, has been regarded as a tremendous advance in the field of cardiovascular care.
Compared to warfarin, NOACs have few interactions with foods or other prescription drugs and their effects last longer and are more predictable. These two benefits mean that there is no need for consistent monitoring and patients do not need to undergo frequent blood tests. This places much less demand on patients.

NOACs do have one drawback: while warfarin is easily reversible in case of anticoagulant-related complications, serious injury, or emergency surgery, NOACs take longer to reverse and do not have a specific antidote.
Prior to surgery, it is recommended that patients refrain from taking their medication for 24-48 hours prior. While there are currently antidotes in the advanced development stage, these are not yet available in a clinical setting. Nonetheless, the ease of adherence to NOACs in comparison to warfarin means that the drugs may be more suitable for patients with limited mobility who are unable to travel for frequent blood tests.
Another consideration when comparing warfarin and NOACs is cost. Warfarin is readily available and very inexpensive while popular NOACs are significantly more expensive – while Coumadin is about 10$ for thirty pills, available NOACs cost about 350$ for the same amount. However, with NOACs achieving widespread inclusion in most prescription insurance programs and Medicare, this high price may not translate to high out of pocket costs. Furthermore, the need for constant monitoring with warfarin should be factored as part of the total cost of this course of treatment.

When choosing between treatment alternatives in anticoagulant drug therapy, a number of factors need to be taken into consideration.

What are the relative benefits and drawbacks of each course of treatment and how can one decide between them?
The simple answer is that it depends on each individual patient’s needs. Making medical decisions can be challenging and it is important for patients to have an advocate working on their behalf.

As a cardiologist in practice for more than three decades, I have made it my life’s mission to treat every patient as though they are my only patient. Choosing the Right Anticoagulant For You
When deciding between two competing courses of action, it is easy to feel overwhelmed. A good doctor is not just there to dictate his preferred choice, but to explain the relative benefits of either one and assist the patient in making the best decision for their circumstances.
At my practice, the patient is always our first priority.
Whether choosing the appropriate anticoagulant or making any other medical decision, at Dr. Leonard Pianko’s Aventura Cardiovascular Center, our entire staff is invested in offering the best care for each individual patient.
From the desk of Dr. Leonard Pianko, MD PA FACC
Dr. Leonard Pianko, the founder of the Aventura Cardiovascular Center, is board certified in cardiology and internal medicine with special expertise in cardiovascular disease, preventive cardiology, and non-invasive treatment options, including echocardiogram and nuclear stress testing. A native of New York, Dr. Leonard Pianko, M.D., F.A.C.C., was born in the Bronx, and earned an undergraduate degree from Yeshiva University in New York before receiving his medical education at top-ranked Mount Sinai School of Medicine and completing his training at the prestigious Robert Wood Johnson School of Medicine in New Brunswick, New Jersey. For more information about this blog contact Dr. Pianko at http://www.leonardpiankomd.com/contact.php.

Choosing the Right Anticoagulant For You

Choosing the Right Anticoagulant For You

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