Hypertension (High Blood Pressure), the Silent Killer


Miguel Nunez, MD


Joseph Poole, FNP

Many people in our community have an easily manageable health problem that can quickly be identified, treated and resolved to prevent future health issues and mortality.

Risks of Hypertension
The most widely known events from having high blood pressure are often known and include heart attack and stroke. While these 2 outcomes are the worst end result from high blood pressure, other less known issues can occur: These include heart enlargement (which can lead to heart failure) and kidney disease (which can result in a patient needing dialysis from kidney failure). Eye damage (retinopathy) and artery damage (peripheral artery disease) can also occur.

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Salads: Simple is best

Dr. Victor Sierpina

Dr. Victor Sierpina

Often when I called my dad to see how he was doing, he’d start with saying, “I’m making a salad.” He died at 92 and taught me the value of how enjoying a salad regularly is a truly healthy habit. Eating salads is an easy way to get close to our daily goal of 5 to 11 servings of fruits and vegetables. A half-cup of salad is pretty small so a typical lunch or dinner salad can garner 2 to 3 servings of veggies.

These days, making a salad is easier than ever. Pre-washed, pre-cut, packaged spinach, romaine lettuce, mixed greens, arugula, kale, radicchio/endive, collards, mustard greens, and others shave long eclipsed the boring and low nutrient iceberg lettuce most of us remember from childhood. This was perhaps drizzled
Thousand Island dressing or these days Ranch, currently the most popular U.S. dressing. Unfortunately it is relatively high in fats, carbs, and other unhealthy ingredients compared to simpler dressings like vinaigrettes which we will discuss next week.

Remember that the darker, leafy greens are chock full of health-essential fiber, phyto-oxidants, B vitamins, vitamin C, and omega-3 fatty acids, and are tastier by a long shot than common iceberg lettuce. Continue reading

Protein may be linked with weakening, failing hearts

Drs. Norbert Herzog & David Niesel

Drs. Norbert Herzog & David Niesel

Medical Discovery News

What exactly causes a heart to fail? It may come down to a simple protein, which scientists recently identified as having an important role in how a heart goes from weakening to failing.

Your heart is a strong, muscular pump slightly larger than your fist that pushes blood through your body. Blood delivers the necessary oxygen and nutrients to all cells in all the organs. Every minute, your heart pumps five quarts of blood. Human hearts have four chambers: two atria on top and two ventricles on bottom. Oxygenated blood leaves the lungs, enters the left atrium, moves to the left ventricle, and is then pumped out of the heart to the rest of the body. After it circulates, blood returns to the heart, enters the right atrium, moves to the right ventricle, and is then sent back to the lungs for a fresh dose of oxygen. Although your heart beats 100,000 times each day, the four chambers must go through a series of highly organized contractions to accomplish this. Continue reading

Doctor’s simple advice for men: a few simple steps can lead to a healthier life

Dr. Selwyn O. Rogers

Dr. Selwyn O. Rogers

When I moved to Galveston last year, I was overweight and out of shape.

An annual visit to the doctor diagnosed me with hypertension and an abnormal glucose level. I was anything but a model for wellness. And I was about to become the Chief Medical Officer at the University of Texas Medical Branch.

Confession is good for the soul and hard on the ego, but if I can grab control of my life, anybody can. It wasn’t long before I copied the behavior of healthy islanders and began jogging on the beach and cycling on the sea wall. The result for me is better controlled blood pressure and glucose and I lost 10 percent of my arrival weight!

This month, we celebrate National Men’s Health Month, a time to focus on heightening awareness of preventable health problems and encouraging early detection and treatment of disease among men and boys. I encourage all the men reading this column to think about taking some small steps toward a healthier lifestyle. Continue reading

Move On

Dr. Victor Sierpina

Dr. Victor Sierpina

A recent ode to the benefits of tennis by a 74-year-old writer caught my eye. Citing various classical authors, philosophers, and the gradual improvement of his game since his 20s, the author championed the power of vigorous sport on his writing and his mind. Riffing off a Robert Frost poem that ended “Here are your waters and your watering place. Drink and be whole again beyond confusion,” the author concluded: “The tennis court is my watering place where I drink and am whole again beyond confusion — at least for a couple of hours.”

As an aging tennis player myself, I found his essay in The Wall Street Journal’s opinion page uplifting as he described “tennis as a refuge from the racket of everyday life.” We all need some kind of healthy activity and discipline to allow us to shut down the grinding gears of our minds for brief periods and refresh it with the drink of stillness and the water of life.

The Physical Activity Council recently reported 28 percent of Americans over 6 get no physical activity meaning they are totally sedentary in the past year. This report is also included a sharp increase in inactivity for those over 65. These are unhealthy trends. Continue reading

A body in motion

Dr. Victor Sierpina

Dr. Victor Sierpina

In high school physics class, I learned from Sir Isaac Newton that a body in motion will stay in motion. The opposite is true and it is called inertia. The other day in clinic, I went in to see Dylan, a 12 year old. He didn’t look up or say hi to me as I came into the room as he was intently working his thumbs on a handheld device. His mother told him to be polite and say hello. He raised his head briefly, said, “Hi,” then back to the gaming thing. She shrugged apologetically and helplessly. I won’t dwell on how we should socialize the digital generation to learn polite human interaction, though it is quite relevant to bodies in motion.

Dylan’s complaint was a minor one and he basically came in needing a school excuse. It could have been a 5 to 10 minute visit but I noticed he was a bit chunky. In fact, his BMI at 29 was close to the obese range. At mom’s request, we ran a urine and blood test to make sure he wasn’t diabetic. He wasn’t, fortunately, at least not yet.

I asked Dylan what kinds of sports or other activities he liked to do. Mom motioned to me with both thumbs moving rapidly to mime the reality of his activity. Continue reading

Smoking combined with your DNA increase lung cancer risk

Drs. Norbert Herzog & David Niesel

Drs. Norbert Herzog & David Niesel

Smoking isn’t the only thing that raises your risk of lung cancer. As it turns out, your DNA can have that effect too.

A scientific study scanned the genomes, the entire genetic code, of 11,000 people of European descent in an effort to identify if there was any correlation between gene sequences and a common form of lung cancer, non-small cell carcinoma. They discovered that variants of certain genes increase a person’s susceptibility to developing lung cancer, especially in smokers.

One of the three gene variants they identified, named BRCA2, can double a smoker’s chance for developing lung cancer. BRCA2 is a tumor suppressor gene. It encodes a protein involved in the repair of damaged DNA, which is critical to ensure the stability of cell’s genetic material. When cellular DNA is damaged, there are several ways for the body to detect and repair that damage. If the damage to DNA cannot be repaired, then the cell is programmed to die by a process called apoptosis in order to prevent the damage being passed on to its daughter cells. Continue reading

I Spy for Heart Disease

Drs. Norbert Herzog & David Niesel

Drs. Norbert Herzog & David Niesel

Medical Discovery News

While a shrink ray like the kind used in science fiction is still stuck in the future, miniature devices are not. Tiny devices have been created to perform a variety of tasks, from an implantable telescope to improve vision in those with macular degeneration to the new pacemaker in clinical trials that is about the size of a large vitamin pill. Now, researchers have developed a catheter-based device smaller than the head of a pin that can provide real-time 3-D images of the heart, coronary arteries and other blood vessels. This is an important invention as the casualties of heart disease continue to rise. Statistically, 1 in 4 people will have a heart attack.

Many Americans are at risk for developing coronary artery disease due to the buildup of cholesterol and plaque. If there is a rupture or breakage of the plaque, creating a blood clot, that can result in a heart attack with little to no warning. Traditional diagnostic tests such as stress tests and echocardiograms show how much blood is flowing to the heart. If there are regions of the heart that are not getting as much blood as others, it might be a sign of clogged coronary arteries. However, blood flow can also appear to be normal even with plaque buildup. Continue reading

4 key questions, 7 steps to health

Dr. Victor Sierpina

Dr. Victor Sierpina

The noted heart surgeon Christiaan Barnard once said that our goal in life should be “to die young, as late as possible.”

These words of wisdom suggest that we need to tend to those things that keep us young functionally, mind, body and spirit. As we ascend in age, our goal should be to postpone as long as we can the depredations of unhealthy aging, premature disease and loss of function.

At a recent national conference for the Osher Lifelong Learning Institutes, a nationwide organization including an OLLI here in Galveston that is dedicated to promoting healthy aging, I heard a terrific and highly practical presentation.

The keynote speaker was a friend of mine, Dr. Margaret Chesney, head of the University of California in San Francisco’s Osher Integrative Medicine Center and also former head of the National Institutes of Health National Center for Complementary and Alternative Medicine.

Dr. Chesney shared data that showed the answer to four simple questions can largely determine how healthy your lifestyle is.

The four questions were:
1. Are you a nonsmoker?
2. Is your Body Mass Index (BMI) less than 30?
3. Do you engage in mild or moderate physical activity at least 21⁄2 hours per week?
4. Do you eat at least five servings of fruits and vegetables daily?
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Women: Care for your heart, know your risks

Dr. Rafic Berbarie

Dr. Rafic Berbarie

“I’m worried about my risk of having a heart attack.”

Whenever I start my office notes in seeing patients, the first line I fill out is the patient’s chief complaint. The above statement is a common complaint in my general cardiology practice. But often the patients have no symptoms; rather, a friend or loved one just had a heart attack and so they are worried and want a heart “checkup.”

February is heart disease awareness in women month, and as a physician, I want you to know what can be done to help prevent heart attacks.

While awareness is growing, people are often shocked to hear that heart disease is the No. 1 killer of women in the United States. In fact, if you added up how many women died of cancer, the number still would not equal the number of women dying from heart disease.

And while there are established screening guidelines for several cancers, there are no unifying screening guidelines for heart disease in women.

My first recommendation is to have a good primary care doctor who is reviewing your risk factors for heart disease. Continue reading