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Tuesday, December 29, 2020

Getting to the Heart of Good Health

Posted By: Advancing Care

A new, multifaceted cardiovascular program at WMCHealth focuses on prevention.

By Deborah Skolnik / Adobe Stock photo
As seen in the February 2021 Issue of Advancing Care.

If you have a history of heart disease in your family, the Cardiovascular Health Promotion Disease Prevention Program (CHPDP), a new program at Westchester Medical Center, the flagship of WMCHealth, is built for you.

Located on Westchester Medical Center’s Valhalla campus, in the brand-new Ambulatory Care Pavillion (ACP), the program is focused on the aggressive prevention and treatment of emerging problems based on the latest guidelines from the American College of Cardiology (ACC) and the American Heart Association (AHA). Cardiovascular disease is the leading cause of death in the United States — but it doesn’t have to be: According to the AHA, about 80% of cardiovascular disease is preventable.

“For so long, the specialty of cardiology has focused on treating patients after they have a problem, rather than trying to get to them before things become an issue,” says Joshua Melcer, MD, a noninvasive cardiologist at Westchester Medical Center, who leads the prevention program. When treating individuals with a family history of heart disease, “You want to be aggressive and proactive. We are a program that wants to see such patients, so we can diagnose and treat them at an earlier stage.”

Joshua Melcer, MD, leads the Cardiovascular Health Promotion Disease Prevention Program at Westchester Medical Center. Photo by WMCHealth

Cracking Down on Contributing Factors

The program’s staff includes cardiologists, endocrinologists, nurse practitioners and dieticians.

For starters, all new patients will undergo a full intake survey and receive a comprehensive physical examination. Blood pressure screening will be a crucial part of the checkup. Hypertension, or high blood pressure, can lead to cardiovascular problems including heart attack, stroke and heart failure. “A lot of people don’t even know they have high blood pressure, and that’s something we can detect and treat,” says CHPDP Program Coordinator Ana Sanchez.

Cholesterol levels are checked via blood work as well, as high levels of cholesterol can lead to fatty buildup in blood vessels. For those with less-than-optimal cholesterol numbers, the CHPDP Program staff offers advice on lifestyle modifications and medication, when appropriate.

Smoking is another risk factor for cardiovascular disease, linked to everything from narrowed, hardened arteries to strokes and fatal blood clots. Breaking this dangerous habit, though, can be difficult. “We are able to assist patients with this in a number of ways,” says Dr. Melcer. “That includes behavioral therapy and pharmacological therapy, such as nicotine replacement gum or lozenges and medications.”

Jerry Nadler, MD, one of CHPDP’s endocrinologists, also plays a vital role, treating patients whose blood work indicates diabetes. Over time, high blood sugar can damage the nerves that control the heart, as well as the body’s blood vessels. Dr. Nadler also assists patients who have metabolic syndrome, a cluster of conditions that elevate the risk for stroke, heart disease and type 2 diabetes — and offers his expertise on cholesterol issues.

A Focus on Diet and Exercise

Allison Weissman, RD, a clinical dietician with the program, helps patients align their eating habits with their health goals. “I meet with patients, usually after they have had their lab work done, and tailor their education specifically for them,” she says. If their lab work shows an issue such as high blood sugar or undesirable cholesterol levels, “I advise them on how we could get those levels in the normal range through diet and exercise.” Weissman also creates custom eating plans for each patient, aimed at helping to correct their specific problems.

Because exercise is vital for cardiovascular health, a cardiologist or nurse practitioner helps patients with a personalized plan to get moving, says Sanchez. “The program calls for at least 150 minutes of moderate-intensity exercise a week,” says Dr. Melcer.

Subsequent testing that the patient may undergo includes an echocardiogram, stress tests and coronary calcium scoring which can screen for asymptomatic coronary artery disease.

A Program for Life

“Our goal is not to be just a one-time, ‘Hey, you’re doing great, and hopefully we won’t need to see you for some real heart problems down the road’ type of program,” Dr. Melcer stresses. “Our goal is to maintain a relationship, encourage a healthy lifestyle, monitor that healthy lifestyle and be aggressive in managing any changes that come about.”

Heart disease, Dr. Melcer observes, is a complex matter, based on genetics, environment and personal choices in terms of diet, exercise and smoking. By encompassing all these issues and more, the CHPDP Program is structured to address even the most formidable challenges to cardiovascular health. “That’s the whole idea,” he shares. “It’s a multifaceted program.”

For more information about the Cardiovascular Health Promotion Disease Prevention Program, please call 646.385.3655 or email [email protected]