SOME JNC 8 PHYSCIANS COME OUT AGAINST LOOSENING BP THRESHOLDS FOR OLDER ADULTS

The Cleveland Plain Dealer (1/14, Townsend, 966K) reports that five physicians “who were part of the panel that issued updated treatment guidelines for high blood pressure last month” have written an article in the Annals of Internal Medicine in which they come “out against one of the recommendations saying that there is insufficient evidence to support it.” These “physicians – part of the 17-member panel Eighth Joint National Committee, or JNC 8 – are against raising the threshold at which older adults begin taking medication to control their blood pressure. The majority of the panel voted to raise the systolic blood pressure...from 140 to 150 for people age 60 and older who don’t have chronic kidney disease or diabetes.”

On its website, TIME (1/14, Sifferlin, 21.77M) reports that they wrote, “We, the panel minority, believed that evidence was insufficient to increase the [target systolic blood pressure] goal from its current level of less than 140 mm Hg because of concern that increasing the goal may cause harm by increasing the risk for CVD [cardiovascular disease] and partially undoing the remarkable progress in reducing cardiovascular mortality in Americans older than 60 years.”

CardioSource (1/14, 2K) reports, “The editorial does agree, however, with recommendations that SBP < 150 mmHg for frail individuals ≥ age 80 is a reasonable alternative approach to addressing concerns that elderly patients are at higher risk for treatment-related serious events.” Additionally, “the authors...add that ‘a target SBP less than 140 mmHg for patients less than 80 years would also be in line with guidelines from Europe, Canada, the ACCF/AHA, the United Kingdom, and the ASH/ISH.’”

MedPage Today (1/14, Neale, 122K) reports that while “the impact of the latest guidance – and the disagreement among the panel members – remains unclear...it is possible that clinicians will wait for hypertension recommendations from the American Heart Association and the American College of Cardiology, which are expected to be completed by early 2015.” Medscape (1/14, Wood, 164K) also covers the story.

Posted by:  Steven Almany M.D.

HEART HEALTHY RECIPE (LUNCH): ITALIAN SEAFOOD CHOWDER

·         1½ TBSP olive oil

·         3 medium cloves garlic

·         1 cup onion, finely chopped

·         ½ cup celery, finely chopped

·         ¼ tsp. basil

·         ¼ tsp. oregano

·         Pinch of thyme

·         1 (28 ounces) canned diced tomatoes            with juice

·         1 cup tomato sauce

·         6 cups clam juice or fish bouillon

·         1 lb. tilapia

·         1 lb. frozen cooked salad shrimp

·         2 TBSP fresh parsley

1.      In a 4-quart soup pot, heat olive oil

2.      Add garlic and when it turns brown remove it quickly with a slotted spoon and discard, then reduce the heat

3.      Add celery, onions and spices to oil and cook over medium heat for 5 minutes

4.      Add tomatoes and tomato sauce and simmer for 5 minutes

5.      Add clam juice and tilapia, cover and bring to a boil

6.      Remove cover and boil for 10 minutes longer

7.      With a wire whisk, whip soup to break up fish into pea sized flakes and add cooked shrimp

8.      Reduce to simmer and cook for 20 minutes, then add parsley and salt to taste

Servings:  8

Serving size:  1 cups

Nutritional Information

Calories:  110

Fat:  4 g

Saturated Fat:  1 g               TIP:               

Cholesterol:  20 mg              You can substitute Pollack, bluefish, striped

Sodium:  420 mg                   bass or trout for the tilapia.

Carbohydrate:  10 g               

Fiber:  3 g

Protein:  9 g

"The Perfect Day"
By: Nanette Cameron, RD

LAB RESULTS, HOW TO ENSURE YOU WILL GET YOURS...

Ever been to your doctor and asked for your lab results and they aren't in your chart? This is because while most office run on some type of EMR (Electronic Medical Record), those EMR's don't connect with one another.  So if you had labs done at your PCP (Primary Care Physicians) office and didn't ask them to forward them to your Cardiologist, Endocrinologist, Hematologist, etc. The only person seeing the blood work will be your PCP.

If you have blood work done at a lab such as Quest Diagnostic or a Beaumont Lab these labs will get mailed or faxed to  ONLY the ordering physician.  If any of your physicians have access to EPIC, (The EMR that Beaumont uses) then they will be able to access your records.  Unfortunately Quest labs don't have don't have a system physician's can access from their offices, so the only way a specific physician will get your results is if you tell Quest where to send them.

In review, Labs taken at:
Physicians office:  Ask them to send labs to every physician office you think may need or want them

Quest Diagnostic:  Ask them to send labs to every physician office you think may need or want them

Beaumont Lab:   Ask them to send labs to every physician office you think may need or want them (Just to be certain)

HEART HEALTHY RECIPE (BREAKFAST): CARROT MUFFINS

·         3 cups shredded carrots (6 carrots)

·         ½ cup Splenda

·         ¼ cup brown sugar

·         3 TBSP canola oil

·         4 eggs whites

·         2 tsp. vanilla extract

·         1-8 ounce can crushed pineapple,       undrained in its own juice

·         ½ cup low fat buttermilk or soy milk

·         ¼ cup raisins

·         2 ½ cups whole wheat pastry flour

·         2 tsp. baking soda

·         1 tsp. ground cinnamon

·         1 tsp. pumpkin pie spice

·         ⅛ tsp. salt

·         Cooking spray

·         2 scoops natural flavor whey protein powder (30-40 grams protein)

1.      Preheat oven 350˚

2.      Spray muffin tins with non-stick cooking spray

3.      In a large bowl whisk together Splenda, brown sugar, canola oil, vanilla & egg whites

4.      Stir in pineapple, buttermilk and raisins

5.      In a separate bowl, stir together pastry flour, baking soda, cinnamon, pumpkin pie spice and salt

6.      Add flour mixture a little at a time to the pineapple mixture and mix well

7.      Stir in the carrots

8.      Pour the batter into the muffin cups until they are 2/3 full

9.      Bake about 20-25 minutes or until the center comes out clean when tested with a wooden toothpick

10.  Muffins may be frozen for 3 months

Servings:  18-22

Serving Size:  1 muffin

Nutritional Information

Calories:  110

Fat:  3 g

Saturated Fat: .5 g                       TIP:      

Cholesterol:  0 mg                        A brand called Designer Whey can be found in  

Sodium:  150 mg                           the natural food section of your grocery store.

Carbohydrate:  14 g

Fiber:  3 g

Protein:  7 g

Serving Suggestion:

Add 10 grams of protein such as a cup of plain yogurt.

"The Perfect Day"
By: Nanette Cameron, RD

ACCESS YOUR MEDICAL INFORMATION ONLINE!!!!!

WHY YOU SHOULD SIGN UP FOR THE PATIENT

 PORTAL AT MICHIGAN HEART GROUP

·         24/7 accessibility to medical records and important health information form any computer or smart phone

·         Quicker test results online

·         You now have the ability to email the office securely for:

§  Direct messaging to your physician

§  Appointment requests

§  Prescription refill requests

                                                                                                                                                         

HOW TO SIGN UP FOR THE PATIENT PORTAL AT

 MICHIGAN HEART GROUP

·         Go to www.mhgpc.com

·         Click the link on the left hand side of the page that says “Patient Portal”

·         Click “Create an Account”

·         Fill in the necessary account information

·         You will be directed to page called “Select a Log-in Method”. Click on the logo..........

·         Create a Username and Password and enter in your email address.  Click “continue”

              **Write your username down somewhere secure, if lost we cannot 

                 recover it**

·         You will be directed to a page that says, “Request Connection to Healthcare Organization”.  Type in the zip code 48098 and hit enter, and then select “Connect” next to Michigan Heart Group.

·         Click on the “Next” button where you will be directed to ta page that says, “Sign Release of Information Authorization”.  Select “I Accept”.

·         Once your account has been matched with your health record at our office you will receive an email notification, then you are ready to use the portal and view all of your information.

                                                                                                                                                            

EFFECTS OF 5-HOUR ENERGY DRINKS AND SENIORS

DETROIT (WWJ)- The energy drink “5-Hour Energy” based in Farmington Hills has quite a following, especially among the senior populations, but one local doctor fears this new trend could be lethal for his aging patients.

WWJ’s Kathryn Larson reports that teens aren't the only ones guzzling down the energy drinks and spoke with Beaumont Hospital Cardiologist and Michigan Heart Groups own Dr. Steven Almany about the trend toward seniors using the quick pick-me-up.

Almany says he’ having to ask more and more senior not about their caffeine use—but their energy drink use.

Dr. Almany says these types of drinks can cause heart palpitations and heart clots: “I think that you've got to weigh, is one, I’m telling you that there is not a lot of scientific proof that is a benefit, and certainly with some of the stuff we are seeing the way it effects, blood, blood pressure and heart rate, is that is could be detrimental,” Almany said.

Dr. Almany said what’s worse is that his senior patients think these drinks are good for them—because of all the supplements.

“I think that a lot of patients say, “Hey, I don’t want to take drug,” and they look at this as almost a natural supplement, but the reality is—that is a drug,” stated Almany.

“The concern about any of these supplements is these are not regulated by the FDA, so there are not trials to say this has benefit, not trials to say it has risk, they can get these things approved and get them on the market…so I think that people should be cautious about what they eat and drink,” said Dr. Almany

Meantime, WWJ reached out to “5-Hour Energy”, but we are awaiting their verbal response.  Recently they marketed their drinks to seniors at a national AARP event.

POSTED by:  Steven Almany, MD

HEART HEALTHY RECIPE (DINNER): CHICKEN AND BEAN ENCHILADA

·         1 (16 oz.) can fat free refried beans

·         10 ounces cooked white meat chicken, chopped

·         8 whole wheat flour tortillas

·         1 (4 oz.) can green chopped chilies

·         1 (10 oz. can) enchilada sauce

·         8 ounces shredded soy cheese

·         ½ cup light or fat free sour cream

·         Minced fresh onion

·         Salsa of your choice

1.      Preheat oven to 350˚

2.      Gently combine chicken and beans in a medium bowl, enough to break up the chicken into small pieces

3.      Place 1/3 cup of bean/chicken mixture in a long single row on a tortilla and roll it up

4.      Place the roll in a 9x13 baking dish, then repeat with the remaining 7 tortillas

5.      Pour enchilada sauce over each rolled tortilla

6.      Sprinkle shredded cheese over the top of the enchiladas

7.      Place in the oven uncovered and bake for 30 minutes

8.      Serve enchiladas with light or low fat sour cream and top with onions and salsa, if desired

Servings:  8

Serving size:  1 enchilada

Nutritional Information

Calories:  250

Fat:  5 g

Saturated Fat: 0 g                       TIP:             

Cholesterol:  70 mg                     As a time saver you can use

Sodium:  350 mg                         chicken in a can, drained.

Carbohydrate:  34 g              .       

Fiber:  5 g

Protein:  23 g

"The Perfect Day"
By: Nanette Cameron, RD

HEART HEALTHY RECIPE (LUNCH): GRILLED TUNA NICOISE

·         4 cubed red potatoes (about 1¼ lbs.)

·         ½ lb. green beans, trimmed

·         1 (8-ounce tuna steak about ¾ inch thick, cut into 1 inch chunks

·         Cooking spray

·         ½ cup vertically sliced red onion

·         ½ cup chopped fresh parsley

·         1 TBSP chopped fresh or 1 tsp. dried tarragon

·         ¼ cup Nicoise olives

·         ½ cup fat-free, low sodium chicken broth

·         3 TBSP white wine vinegar

·         1 TBSP extra-virgin olive oil

·         1 TBSP Dijon mustard

·         ¼ tsp. salt

·         ¼ tsp. freshly ground black pepper

·         8 cups gourmet salad greens

·         1 cup cherry tomatoes, halved

1.      Cook the potatoes in boiling water for 6 minutes or until tender and remove with a slotted spoon

2.      Add green beans to boiling water and cook 3 minutes or until crisp-tender, then drain

3.      Prepare grill or broiler and place the fish on a grill rack or broiler pan coated with cooking pray; cook for 3 minutes on each side or until desired degree of doneness

4.      Combine potato, fish, onion, parsley, and tarragon in a large bowl

5.      Combine the broth and next 5 ingredients (broth through pepper); stir well with a whisk

6.      Pour ½ cup broth mixture over potato mixture, and toss well

7.      Divide greens, beans, and tomatoes evenly among 4 plates and top each serving with 1½ cups potato mixture and 1 tablespoon olives

8.      Drizzle 1 tablespoon of remaining broth mixture over each serving

Servings:  8

Serving size:  ¼ recipe

Nutritional Information

Calories:  229

Fat:  9 g

Saturated Fat:  0 g                TIP:               

Cholesterol:  21 mg              This makes a nice Sunday brunch

Sodium:  458 mg                   

Carbohydrate:  37 g               

Fiber:  4 g

Protein:  20 g

"The Perfect Day"
By: Nanette Cameron, RD

MICHIGAN HEART GROUP'S LOCATIONS AND SATELLITE OFFICES

Michigan Heart Group has 2 main locations and 2 satellite locations.  Different physicians see patients out of different suits.  

THERE ARE TIMES, when a physician will need to SWITCH SUITES for one reason or another. It usually has to do with coverage or addition of office time.  

You will ALWAYS BE NOTIFIED of this DURING YOUR REMINDER  CALL so PLEASE pay close attention to the LOCATION when we call you. 

MAIN CAMPUS:

Beaumont Michigan Heart Group:

4600 Investment Drive, #200

Troy, MI 48098

(248) 267-5050

www.mhgpc.com

OPEN MON-FRI (7AM-4PM), Different Physicians are in on different days (see below)

Steven L. Almany, MD (Wednesday and Friday)

Steven C. Ajluni, MD (Monday and Wednesday)

William D. Devlin, MD (Tuesday and Thursday)

Terry R. Bowers, MD (Monday and Wednesday)

Michael J. Gallagher, MD (Tuesday and Friday)

Beaumont Michigan Heart Rhythm Group

4550 Investment Drive, #250

Troy, MI 48098

(248) 267-5050

OPEN MON-FRI (7AM-4PM), Different Physicians are in on different days (see below)

David R. Cragg, MD (Wednesday and Thursday)

Brian D. Williamson, MD (Tuesday and Friday)

Ilana B. Kutinsky, DO (Monday and Thursday)

SATELLITE OFFICES:

Beaumont Western Wayne Heart Group

39500 Ten Mile, #103

Novi, MI 48375

(248) 267-5050

Physicians in on certain days (see below)

Steven C. Ajluni, MD (Most Tuesdays)

William D. Devlin, MD (3^rd Monday of the Month)

Ilana B. Kutinsky, DO (2^nd Wednesday of the Month)

Beaumont Michigan Heart Group- Macomb

15959 Hall Road, #304

Macomb, MI 48044

(248) 267-5050

Physicians in on certain days (see below)

David R. Cragg, MD (Friday morning)

Terry R. Bowers, MD (Thursday morning)
Michael J. Gallagher, MD (Wednesday afternoon)

MEDITERRANEAN DIET LINKED TO REDUCED HEART RISKS

Research on the Mediterranean diet's link to heart health received extensive coverage in print, online and on all of last night's national news broadcasts. The study was praised by physicians and other experts, many of whom touted its size and methodology. Most sources also pointed out that the study was stopped early after finding that the Mediterranean diet was so clearly beneficial. In its lead story, the CBS Evening News (2/25, lead story, 2:45, Pelley, 5.58M) reported that "we were hesitant at first to begin this broadcast with yet another scientific study about what we should or should not eat. But our Dr. Jon LaPook brought us what he says is the most definitive study yet that the so-called Mediterranean diet - including olive oil and nuts, wine, and fish - can prevent the leading cause of death in America: Heart disease."

       

ABC World News (2/25, story 4, 1:20, Muir, 7.43M) reported "that in the middle of" the "new study, researchers were so astounded by what they found, they halted the study, made it public and jumped on the diet themselves."

       

NBC Nightly News (2/25, story 8, 0:30, Williams, 7.86M) reported, "Over this five-year study people on the diet were 30% less likely to develop cardiovascular disease than those on a general low-fat diet."

       

USA Today (2/25, Szabo, 1.71M) reports, "The Spanish researchers who led the study focused on particular types of food, rather than cutting calories. The" more than 7,400 "study participants were allowed to consume as many calories as they wished, and were given no instructions about exercise." The investigators "randomly assigned people to follow one of three diets: a Mediterranean diet supplemented with olive oil; a Mediterranean diet supplemented with nuts; or a low-fat diet, including bread, potatoes and pasta, according to" the "study published in today's New England Journal of Medicine."

       

The AP (2/26, Marchione) reports that participants were aged "55 to 80, just over half of them women. All were free of heart disease at the start but were at high risk for it because of health problems - half had diabetes and most were overweight and had high cholesterol and blood pressure."

       

In a front-page story, the New York Times (2/26, A1, Kolata, Subscription Publication, 1.68M) reports, "The magnitude of the diet's benefits startled experts. The study ended early, after almost five years, because the results were so clear it was considered unethical to continue."

       

The Washington Post (2/25, Brown, 489K) reports, "The researchers looked at numerous health outcomes, the main one being a combination of heart attack or stroke or cardiovascular death (measured as the number of events per 1,000 years spent consuming each diet)." Among patients on one of "the two Mediterranean diets there were eight events, compared with 11 in the control diet - a reduction of about 30 percent." The investigators found that when they "examined the events, the most dramatic decline was in the rate of stroke in the Mediterranean diet groups."

       

The Wall Street Journal (2/26, D3, Petersen, Subscription Publication, 2.29M) reports on the significance of the study, pointing out that there is not much prior research that has successfully proven a direct association between a particular diet and a reduced risk of certain life-threatening events.

       

In a front-page story, the Boston Globe (2/26, A1, Lazar, 250K) reports, "Health and nutrition specialists who reviewed" this "study...said its size, controlled structure, and focus on patients who were at risk of heart disease offered powerful and much-needed evidence of a protective heart effect from a Mediterranean diet."

       

The Los Angeles Times (2/25, Healy, 692K) "Booster Shots" blog reports, “The study's findings 'blow the low-fat diet myth out of the water,' said Cleveland Clinic cardiologist Steven Nissen, who was not involved in the current research. Nissen, an expert on the effects of drugs and nutrition on cardiovascular risk, called the study 'spectacular' and touted the findings as impressive."

       

The TIME (2/25, 3.38M) "Healthland" blog reports that "the findings add to the body of evidence that suggests the Mediterranean diet can play an important role in protecting the heart, and should guide doctors and patients who want to avoid heart disease toward eating the foods that can help them the most."

       

The San Francisco Chronicle (2/26, Colliver, 220K) reports, "While the findings were heralded by many in the health-care community, not everyone was impressed." For instance, "Dr. Dean Ornish, UCSF professor and president of the nonprofit Preventive Medicine Research Institute in Sausalito, criticized the study, contending that the control group was not monitored carefully enough and wasn't assigned a truly low-fat diet."

       

Also covering the story are Bloomberg News (2/26, Cortez), Forbes (2/25, Husten, 928K), the NPR (2/25, Hensley) "Shots" blog, the Baltimore Sun (2/26, Walker, 184K) "Picture of Health" blog, the Boston Globe (2/26, Lazar, 250K) "Daily Dose" blog, MedPage Today (2/26, Smith), HealthDay (2/26, Doheny),

Posted by:  Steven Almany M.D.

HEART HEALTHY RECIPE (BREAKFAST): BREAKFAST WRAP

·         1 cup Vegetable Egg Beaters (garden style preferred)

·         1-11 ounce package of Morning Star Breakfast Starters

o   (Classic Scramble contains vegetables)

·         Whole wheat 10” tortilla cut in half

·         ¼ cup fresh cut vegetables such as asparagus, mushrooms, tomato or broccoli

1.      Preheat large 12 inch nonstick skillet: coat with nonstick cooking spray

2.      Pour the contents of the morning Star Breakfast Starters into the skillet, add additional vegetables and sauté’ for 10 to 12 minutes

3.      Once heated, move mixture to one side of the skillet and pour the Egg Beaters on the other side and scramble until cooked

4.      Cut whole wheat tortilla in half and place ½ of the egg mixture down the center and roll it up

Servings:  2

Serving Size:  ½ wrap

Nutritional Information

Calories:  154

Fat:  2 g

Saturated Fat: 0 g                             TIP        

Cholesterol:  0 mg                             To save extra calories, look for lo carb whole

Sodium:  490 mg                               wheat tortillas.

Carbohydrate:  16 g

Fiber:  5 g

Protein:  18 g

"The Perfect Day"
By: Nanette Cameron, RD