Cardiologist Lectures on Blood Pressure, Cholesterol

WILDWOOD – Blood pressure and cholesterol are things everyone has, some good, and some bad. Dr. Michael Boriss, D.O., a cardiologist with Cape Regional Physicians Associates, spoke to about 50 on the topic April 5 at the Cape May County Health Resource Day at Wildwoods Convention Center.
He spoke on the link between cholesterol and hypertension, gave a website where anyone can go, input their health data, and find out their approximate risk, over 10 years, of a heart attack, and answered questions.
Physicians have taken a more aggressive approach to treating patients with statin drugs, Boriss said. He cited an article that noted some 12 million Americans have been advised to take statin drugs to lower their cholesterol.
In years past, physicians used different criteria when assessing patients, especially senior citizens. In those earlier times, Boriss said, an 80-year-old patient who presented with blood pressure of 160/80 may have been considered normal. New guidelines for blood pressure are persons over 60 years should have systolic reading of 150 or less, and diastolic of 90 or less. Those from 30-59 should strive for a systolic pressure of 140 or less, and diastolic of 90 or less. The latter numbers also apply to those with diabetes or kidney disease.
Boriss reminded of the importance of monitoring one’s blood pressure, since, he said, there is no accurate means to gauge blood pressure without an instrument. Hypertension, he noted, remains the “silent killer” of Americans. He said a recent patient, while undergoing a stress test had a blood pressure of 210/110 “Yet she felt fine. I repeat you do not know what you blood pressure is.”
While a headache may be one indicator, there may not be any symptoms of high blood pressure, something that affects one in three Americans, Boriss said.
“What will happen if you don’t treat it?” he asked. “The number one killer is heart disease. We talked for years about smoking cessation and weight loss, still the number one killer is heart disease.”
Blood pressure left untreated can cause heart disease, heart failure, kidney failure and blindness.
What is a heart attack? When the heart cannot get enough oxygen, chest pain can occur. If the flow of blood is blocked, a heart attack results.
Boriss said he “is not a fan” of in-store blood pressure monitors, auto cuffs used in hospitals “unless they are done exactly correct, it could be a detriment.” He also advised those using a home blood pressure cuff to take it to their physician’s office. Have their blood pressure taken by the physician, then with their cuff to gauge its accuracy. “Make sure it’s working properly. There are so many nuances of taking blood pressure; they can be more of a detriment.”
Obesity remains rampant among Americans, Boriss said. “In this country it’s the way we eat, fast food, lack of exercise. I have been incentivizing people trying to do that for 28 years and have not been truly successful.”
Salt is part of the problem, but it is overrated, Boriss added, because only about 10 percent of the population is salt sensitive.
Still, he noted that lunch meat, for example, contains much salt, and ought to be avoided by those watching salt intake.
Maintain one’s optimum body weight and exercise, he advocates walking 20-30 minutes daily, regardless of the season. He said it would “Have such an impact on parameters of health, fitness, mental status. Anyone who exercises is less stressed out, if they exercise on a regular basis.”
“Exercise is the cheapest thing. It’s free,” said Boriss.
Smoking may have a long-term impact even on those who have quit, he said. That means possibly developing COPD, chronic obstructive pulmonary disorder, in a person’s 70s, if, for 50 years, they smoked. “They may still suffer the consequences of that behavior,” Boriss said.
“It’s rare I find someone who never smoked who has significant heart disease,” he added.
Boriss explained the difference between HDL and LDL in cholesterol and lipids.
Chylomicrons carry fats from the intestinal mucosa to the liver. In the liver, they release triglycerides and some cholesterol and become low-density lipoproteins (LDL). They carry fat and cholesterol to the body’s cells. Like tiny garbage trucks, high-density lipoproteins (HDL) carry fat and cholesterol back to the liver.
He showed a slide depicting atherosclerosis, when plaque builds in an artery, restricting blood flow.
Diet also plays an important role in staying healthy, Boriss said. He cited American Heart Association’s urging of eating fish twice weekly as having more benefit that fish oil tablets.
“I am not a big proponent of fish oil tablets,” he said. Omega 3 fatty acids are found naturally in oily fish, such as salmon, mackerel and sardines, he said. “No studies show that (fish oil tablets) lower cholesterol.”
Those who wish to check their heart attack risk over the next 10 years may visit: cvdrisk.nhlbi.nih.gov.
Prior to visiting that site, have systolic pressure (top) blood pressure number, HDL number.