My triglycerides are high. Should I be worried and what can I do to decrease them?

Triglycerides are fats in the blood. They are directly measured in a standard lipid panel that your doctor runs on your annual visit. A healthy triglyceride level is less than 100. Having high triglycerides is very worrisome. High triglyceride levels lead to elevated VLDL levels in the blood, which are direct precursors to small, dense LDL particles. Small dense LDL particles (or type “B” particles) are highly “atherogenic”. This means that they cause blockages to be formed in the arteries, and subsequently heart attacks and strokes. So how do triglyceride levels become elevated? They are formed from excess sugar in the bloodstream. Too much sugar is toxic to the body. The body can only store a small amount of sugar as glycogen in the liver and muscles. To protect the body from toxic excess sugar, the liver turns extra sugar directly into triglycerides. Thus, eating a lot of carbohydrates directly leads to elevated triglycerides. Your body can then store extra triglycerides as fat in your belly. This is how you get fat. The best natural way to lower your triglycerides is to lower your intake of carbohydrates and sugar. Your body is taking all that pasta, rice, potatoes and pretzels you have been eating and turning them directly into triglycerides. This is making you fat and leading to an increased risk of a heart attack or stroke. The good news is that medications are usually not needed to improve the situation. Just decrease your carbohydrate intake and you will see a significant decrease in your triglyceride levels on your next blood draw.

My blood pressure is mildly elevated – is this harmful?


Blood pressure is the force of blood against the walls of your arteries. Blood pressure rises and falls during the day. Blood pressure tends to be higher in the morning and lower in the late afternoon and evening. When blood pressure stays elevated over time, it is called hypertension. Hypertension is dangerous because it makes the heart work harder and contributes to atherosclerosis (hardening of the arteries). It increases both the risk of heart disease and stroke. A blood pressure level of 140/90 mmHg or higher is considered high. If your blood pressure is between 120/80 mmHg and 139/89 mmHg, then you have prehypertension. Historically, prehypertension was not felt to be harmful and ignored. A new study in the journal Neurology shows that this thinking is incorrect. It demonstrates that people with prehypertension have a significantly increased risk of stroke. They found that those with blood pressures in the prehypertensive range were 66% more likely to have strokes than those with ideal blood pressures, below 120/80. The risk rose as the numbers did, nearly doubling at levels above 130/85. The link showed up whether or not people had other risk factors, such as diabetes and smoking.  Multiple studies have showed that the higher the blood pressure, the higher your risk of stroke, heart attack, heart failure and kidney disease. The good news is that high blood pressure can be reduced naturally. The number one way to lower blood pressure naturally is by losing weight. Even losing small amounts of weight such as 10-20 pounds can significantly lower your blood pressure without medication. Exercise is also a great way to lower blood pressure naturally. Regular aerobic exercise (20-30 minutes 4-5 times a week) has been shown to have beneficial effects in lowering blood pressure. Finally eating a healthy diet low in salt and high in fruits and vegetables can also help lower blood pressure naturally. Hypertension has been called the silent killer. Now we know even mildly elevated blood pressures are dangerous. If your blood pressure is high, take action now before damage has been done.


7 Numbers Everyone Should Know About Themselves

There are many numbers everyone should know to help gauge their health. Here are 7 important numbers everyone should know. They are easily measured at home or in your doctors office. Some are simple blood tests. Remember that knowledge is power. If your numbers are less than optimum, start making changes to improve them and your overall health.

1. C – reactive protein (CRP) – This is a very important number everyone should have measured. It may be more important that your cholesterol number. This number is a measure of your inflammation level. Inflammation has been linked to an increased risk of heart attacks, stroke, and possibly even cancer. An optimal CRP level is less than 1.0. CRP is a simple blood test.

2. Total LDL particle number (LDL-p) – This is a better measurement of your bad cholesterol levels than LDL. LDL alone is a concentration level of the bad cholesterol and may misrepresent your risk of heart attack or stroke. LDL-p measures the total number of bad cholesterol particles. A large number of small and dense LDL particles contributes to atherosclerosis and heart disease. A high LDL-p along with a high CRP is especially dangerous. LDL-p is also a simple blood test. An LDL-p level below 1000 is optimal.

3. Glucose – This simple blood test measures the glucose or sugar in your blood. A high blood glucose level may mean that your are a diabetic. High blood sugar levels lead to an increased risk of heart attack, stroke, kidney failure, eye damage, and nerve damage. A normal glucose level is less than 100. A glucose level between 100-124 is considered pre-diabetes. A glucose level of 125 and above means you are a diabetic.

4. Creatinine – This blood test checks your kidney function. A high creatinine level may represent kidney failure. Kidney failure puts you at increased risk of heart attacks and stroke.

5. Blood pressure – A normal blood pressure is 120/80 or less. A high blood pressure can lead to damage in the lining of your arteries and then to atherosclerosis. This can then lead to a heart attack or stroke. High blood pressure at any age is abnormal and should be treated.

6. Body Mass Index (BMI) – This number relates your weight to your height. It will help you decide if you are overweight. A normal BMI is less than 25. A BMI between 25 and 30 is considered overweight. A BMI above 30 is considered obese. A BMI greater than 40 is considered morbidly obese.

7.  Waist circumference – The size of your belly is actually a better predictor of heart disease than general obesity. People with central obesity tend to develop higher blood pressure, regardless of body mass index (BMI) than those who store fat in other areas of the body. A normal waist circumference in men is less than 40 inches and less than 35 inches in females.

I am healthy. Why do I need to see a cardiologist?

CardiacSolutionsLogoYou are healthy, right? You feel good and take reasonable care of yourself. You have not seen a doctor in years. What good reason is there to see a cardiologist? The answer in one word is: prevention. Heart disease and stroke are both highly preventable and treatable. There is no reason for anyone to have either a heart attack or stroke. Prevention is the key. There are several risk factors which can increase your risk of heart attacks and strokes including: hypertension, high cholesterol, elevated inflammation levels, diabetes and elevated blood sugar levels, being over weight, increased belly fat, lack of exercise, family history of cardiovascular disease, and smoking. Both heart attacks and stroke are vascular diseases. They both involve our arteries which carry blood and nutrients to the heart and brain. Many people think heart attacks and strokes are sudden events. They are not. In fact, there is usually evidence of diseased arteries (atherosclerosis) years, if not decades ahead of time. There are several non-invasive ways to assess the health of your arteries. Two methods are ultrasound and CT scans. Ultrasound is a favorite of mine, because no radiation is used. A simple ultrasound of the neck arteries (a carotid artery ultrasound) can give you important information on the health of your arteries. Plaque in the walls of the arteries can be visualized by ultrasound. In fact, it can be detected at an early stage. Even mild plaque can be visualized. If it is detected, corrective action can prevent future disasters. Clearly, if you smoke, you need to stop. Smoking directly damages the artery wall which leads to plaque formation. Lowering blood pressure will reduce risk of heart attacks and stroke. Lowering you cholesterol numbers can also help lower your risk. A new measure of cholesterol, LDL-(p), which measures the total number of bad cholesterol particles, can help define your risk. You want to avoid the small, dense LDL (bad) particles which help to promote plaque. Losing weight, shrinking your belly, and exercise all help to reduce your risk. Is your inflammation level high? Reducing inflammation levels will reduce your risk. Think of your cardiologist as a coach. He can help assess your risk and then discuss ways with you to help reduce your risk. It is all about being proactive. Most heart attacks and stroke are preventable. Do not delay! Do not procrastinate any longer! Get an assessment and reduce your risk. Reducing your risk will help you feel better and live longer.  Dr Greenberg specializes in preventive cardiology and nutrition. To make an appointment with Dr Greenberg at Cardiac Solutions please call 623.876.8816.

Causes vs. Symptoms of Disease – It is Important to Understand the Difference

It is very important to understand the difference between causes and symptoms of disease. High blood pressure, high cholesterol, diabetes, and atherosclerosis (hardening of the arteries) are all symptoms. They are symptoms of underlying serious health issues. For example, high blood pressure is a symptom of obesity, poor nutrition, unhealthy arteries, stress, ect. On the other hand obesity, poor nutrition, lack of exercise, and stress are all causes of diabetes, high blood pressure, and high cholesterol. To truly become healthy you need to treat the underlying causes and not just the symptoms of disease. Medications tend to treat the symptoms, but not the underlying causes. Taking high blood pressure medication will lower your blood pressure (which is important) but will not cure it. Statin medications will lower your cholesterol, but it goes back up once you stop them. In essence, medication covers up the real underlying issues. The ways to cure high blood pressure include losing weight, improving nutrition, and exercise. Ways to cure high cholesterol include weight loss, eating less saturated fat, eating more fiber, and exercise. Your goal should be a cure. By improving your overall health, less medication becomes necessary. Diabetics can naturally lower blood sugars through weight loss, improved diet and exercise. By lowering blood sugars naturally, less medication is required. Taking medications is very important, but should be thought of as a short term solution (if possible). Discuss curing yourself of your diseases with your personal physician. Never stop or decrease any medication without first discussing with your personal physician. You do not want to increase your risk of a serious event. Have long term goals. Be patient. By slowly improving your lifestyle, you will become healthier as will your arteries, heart and brain. The goal should be a long term “cure”!

Metabolic Syndrome

Metabolic syndrome (or insulin resistance syndrome) is a name for a group of risk factors that occur together and increase the risk for coronary artery disease, stroke, and diabetes. Unfortunately, it is becoming very common in the United States.  According to the American Heart Association and the National Heart, Lung, and Blood Institute, metabolic syndrome is present if you have three or more of the following signs: blood pressure equal to or higher than 130/85 mmHg (or on blood pressure medication),  fasting blood sugar (glucose) equal to or higher than 100 mg/dL, a large waist circumference (men – 40 inches or more and women – 35 inches or more), low HDL cholesterol (men – under 40 mg/dL and women – under 50 mg/dL), and triglycerides equal to or higher than 150 mg/dL. Having any one of these risk factors isn’t good. But when they’re combined, they set the stage for serious problems. Metabolic syndrome can lead to atherosclerosis (hardening of the arteries), diabetes, myocardial infarction (heart attack), kidney disease, fatty liver disease, peripheral artery disease, and stroke. The incidence of metabolic syndrome continues to rise as does the incidence of obesity. But the good news is that it is both preventable and treatable, largely with changes to your lifestyle and diet. Treatments include: losing weight (initial goal should be a BMI < 30, with ultimate goal < 25),  regular aerobic exercise (get 30 minutes of moderate intensity exercise, such as walking or bicycling, 5 – 7 days per week), lowering your cholesterol (using improved diet, weight loss, and cholesterol lowering medicines, if needed), and lowering your blood pressure (using weight loss, exercise, and medicine, if needed). Good nutrition is the key to treating metabolic syndrome. Eating processed foods loaded with sugar and simple carbs significantly increases your chances of developing metabolic syndrome. Fast foods, sweets, and snack foods lead directly to the metabolic syndrome. It is critical to change your diet to one low in fat, high in fresh fruits and vegetables (7-10 servings a day), and filled with whole-grain products high in fiber. Cut out simple carbs and sugar. If you have the metabolic syndrome or some of the signs, the time to take action is now. Don’t wait for hardening of the arteries or worse to occur. Be proactive! Take control of your health. Take action today!

Cardiovascular Disease and Inflammation

Cardiovascular disease (atherosclerosis) is an inflammatory process. Blockages in the arteries are like little pockets of inflammation. A good way to visualize atherosclerosis is like little “pimples” in the arteries filled with pus. If these “pimples” burst a heart attack or stroke can occur.  A good way to measure your inflammation level and your risk of heart attack or stroke is a blood test called C reactive protein (CRP). CRP is a non-fasting blood test. A level less than 1.0 puts you at low risk. 1-3 is considered average risk. Greater than 3.0 is high risk. Interestingly, people with “normal” cholesterol levels but high CRP levels are at increased risk for cardiovascular events. There are several ways to lower your CRP and thus, your risk. Exercise and weight loss are excellent ways to lower CRP. Regular aerobic exercise is a great way to lower your CRP levels. At least 20-30 minutes every other day is the minimum. Aspirin lowers CRP and lowers risk of heart attack and stroke. Statin medications (Lipitor, Crestor, ect.) lower levels of inflammation. Many think statins work more by lowering inflammation levels and less from lowering cholesterol levels. Eating a good diet is important for lowering inflammation. Eating lots of fruits and vegetables, which are loaded with antioxidants and phytonutrients, help reduce inflammation levels. There is no such thing as eating too many fruits and vegetables! Avoid sugar which is pro-inflammatory. Avoid omega 6 fats (which are found in many oils and baked products) which are pro-inflammatory. Omega 3 fats, on the other hand, are anti-inflammatory. Omega 3 fats are found in fish oil, wild salmon, flax seeds, and walnuts. Make sure your inflammation level is checked and work on lowering it if necessary to reduce your risk of heart attacks and strokes. Always talk with your personal physician before beginning or stopping any medications or supplements.