Everything in Moderation

xmas dinnerDr. Bordenave tells us that it is okay to overindulge a little during the holidays, however, everything should be approached in moderation. Take only half of the serving you want to put on your plate. You can take a little of everything, be sated, and not overeat.

Serving the Hispanic Community

 

Jorge BordenaveDr. Jorge Bordenave was born in Havana, Cuba and moved with his physician father and educator mother to Miami, Florida when he was an infant. Being a medical doctor seems to run in his family, as his grandfather was also a physician.

First Focus

Dr. Bordenave’s first focus was internal medicine and he spent his medical internship in the Bronx, New York, at St. Barnabas Hospital. St. Barnabas is a teaching hospital and Dr. Bordenave was exposed to a wide range of medical conditions and diseases. This is where he first developed a strong interest in cardiovascular disease. He relocated to Chicago to complete his residency in general internal medicine.

Throughout his residency, his interest in cardiology grew and when it was completed, he applied to Mt. Sinai Medical Center in Miami Beach for a three-year cardiology fellowship.

Cardiology

His application to Mt. Sinai’s cardiology fellowship was accepted and he went on to become proficient at a great number of cardiac procedures such as cardiac catheterization and transesophageal echocardiography. He had a keen interest in new technology and began to learn about nuclear cardiology. This new method of diagnosis was non-invasive and involves the use of radioactive elements that show where blood is flowing through the heart and more importantly, where it was not, or where blood flow was restricted. Dr. Bordenave was on the ground floor of the use of this new method and was among the first cardiologists in South Florida to start using the practice in the field.

After several years in private practice as a clinical cardiologist and having performed hundreds of cardiac catheterizations, Dr. Bordenave realized that he was seeing younger and younger patients. He noticed a growing dependence on drugs, testing and invasive procedures. He decided to stop performing invasive procedures in his practice and wanted to find alternative treatments for helping his patients. With a mind toward holistic medicine, he took up another fellowship, this time in Integrative Medicine at the University of Arizona under Dr. Andrew Weil.

Focus on Integrative Medicine

While at the University of Arizona, Dr. Bordenave became reacquainted with the belief that the body has a natural ability to cure itself. His training and continued learning has placed him as a leader in preventative medicine in south Florida.

As a teacher at Florida International University, sought after lecturer and author, Dr. Bordenave is passing on his passion for patient’s health and wellness through teaching other medical professionals the benefits of integrative, complementary medicine.

Connecting with the Hispanic Communityfamily

Dr. Bordenave is well known throughout the south Florida communities in which he serves, but he places a special focus on the Hispanic community.

The doctor presents weekly television and radio programs in Spanish that features experts and advice from other fields that provide information on a wide range of medically related topics. Dr. Bordenave and Your Health is geared toward giving the Hispanic community the kind of information that they might not normally have access to; information that can help them live healthier lives.

Dr. Bordenave provides information in Spanish about obtaining a healthy body and mind through the use of proper nutrition, exercise and a peaceful mind. The information he provides cover subjects as diverse as coronary artery disease; Tai Chi for arthritis, diabetes, back pain and osteoporosis; meditation; depression; sleep apnea and insomnia; kidney disease; acupuncture and of course, nutrition for optimum health. He also puts out a Spanish language monthly magazine, Su Salud.

His outreach doesn’t stop at health, wellness and medicine. In addition, Dr. Bordenave provides information to Spanish speakers regarding Medicare and now, The Patient Protection and Affordable Care Act, better known as Obamacare. The information and resources he provides is invaluable to the Hispanic community.

As a leader in preventative and integrative medicine, Dr. Jorge Bordenave has been serving south Florida from his Coral Gables location since 1996. He has a sincere interest in patient health and wellness and teaching the Hispanic community how to obtain these through lifestyle choices, diet and exercise. Contact him today for an appointment and learn how the integrative medicine approach can help you achieve wellness.

Published by Axiom Health Care Marketing

 

When Something Bad Happens

Your general outlook on life has the most to do with your happiness. You can discover your view of yourself and the world around you by paying attention to the conversation that goes on in your head. Dr. Bordenave suggests that when you encounter setbacks, you shift your perspective to one of not a woes-me to “this is an inconvenience, but I can cope”.

 

Staying at Peace

Maintaining an inner peace is just as important to your health and wellness as the food choices you make. Learning to focus your mind on goodness will bring healthy benefits to your life; Peace and wellness are a healthy partnership. Dr. Bordenave suggests that you focus your mind on positive thoughts and you won’t be as inclined to overindulge or over-react. 

OPINION: New AHA/ACC Statin Guidelines

statinsI am greatly concerned with the new statin guidelines recently released by the American Heart Association and the American College of Cardiology during the yearly Scientific Sessions held in Dallas this November. Guidelines introduced to the public with great fanfare, and covered by all National media outlets.

These guidelines take healthy people and input certain risk factors that include age, body weight, smoking history, family history of heart disease, blood pressure and cholesterol levels to determine future cardiovascular (CV) risk. Those that are found to have a CV risk of 7.5% or greater, in the following 10 years would be candidates for statins. (Statins were first introduced in 1987, and over the years, their use has increased. The annual expenditure in 2000 on statins: $7.7 trillion, by 2007: $20 billion). These medications help reduce the amount of cholesterol and LDL (so-called bad cholesterol) in the blood. It is believed however, that statins work in decreasing heart disease because they decrease the degree of inflammation. An effect is given the name pleotrophic effect.

Under the new guidelines, an additional 31 million people would meet criteria for these drugs. Currently, about 15% of all adults in the U.S. take statins and the new guidelines would double it to around 33%. Generalizing treatment to a wide cross section is of concern, because the likelihood of success or failure of a treatment is not identical in all individuals treated, because therapy is not the only determinant of outcome.

pills

It is this continued reliance and focus on drugs that concerns me. I am also concerned and confused with the frequent changes, recommendations and mixed messages made by the medical establishment. How often do we read a medical “expert” recommending one thing, only to have another “expert” recommend something completely opposite, contraindicating the first expert? In a country with so many “experts,” it’s no wonder why patients (myself included) don’t know who or what to believe.

Are we really so sure we should proceed to double the number of U.S. adults on statins as suggested by the new guidelines? Can we be so sure that the benefits of this class of medicines outweigh the risks? We know that the use of statins short-term has side effects in some patients, but what happens after 10 or 20 years of use?

cholesterolCholesterol is not a villain. The absorption of vitamins and minerals including vitamin D, is dependent on cholesterol, which is why our bodies produce it. Multiple studies have shown that statin users have higher rates of cataract formation, increased muscle pains, increased musculoskeletal injuries, reduced blood levels of vitamin D, reduced levels of CoQ10, just to name a few side effects. Most importantly, statins may worsen and possibly cause diabetes. Nevertheless, in one of the ironies we have come to expect from modern medicine, the new AHA/ACC statin guidelines recommend statins for most diabetics.

I have nothing against statins. As a cardiologist, I prescribe statins when needed. What I am against is the indiscriminate use and abuse of not just statins but of all medications and an ever-increasing reliance of medications for everything that ails us.

I will continue to use statins as I do presently. In men younger than 75 years with coronary heart disease, including acute coronary syndrome, chest pain (angina), in those who have had heart surgery (bypass) or stents. People with hereditary hypercholesterolemia should also be considered for statin use. These are the groups that have been shown to get the most benefit from this class of drug. Their use in diabetic women and people with strokes (although current indications) is controversial.

Studies have shown that there is no reason or benefit for the elderly to be on long-term statin treatment. Low cholesterol levels in people over the age of 75, has been associated with decreased cognitive function. Maybe it’s because 25-30% of our brain is made up of cholesterol and cholesterol is essential for many metabolic functions including the production of hormones. However, there are even other medical “experts” who have suggested that it would be a good idea to start giving statins to children.

I find the reliance on medications that have potent side effects to be ongoing failure of the U.S. healthcare system, the costliest healthcare system in the world that only manages a quality and efficiency ranking of 46, behind Iran and ahead of Serbia. It is time to end the “pill for every ill” mentality of disease care synonymous with U.S. health care and make a radical shift back to using common sense and reasoning.

saladInstead of prescribing more drugs, we should be educating and stressing to the general public the importance and need for lifestyle and nutritional change first. The same inflammation and conditions that causes the elevated cholesterol levels that is treated with statins, are caused by and therefore can also be limited and controlled by diet and improved nutrition.

I find it interesting that the dietary advice of 40 years ago, which stressed the importance of eating minimally processed foods, avoidance of artificial sweeteners, selection of meats from organically raised animals and not industrially produced variety, went directly against the recommendations of the experts of that time.

I’ll continue to individualize treatment, educating my patients on the importance of food, exercise and lifestyle and prescribing drugs only when appropriate. I doubt future studies will find anything contradictory with this approach.

Jorge Bordenave, MD FACP ABIHM
Coral Gables, Florida (11-15-2013)
Integrative Cardiologist
Assistant Clinical Professor of Medicine, Herbert Wertheim College of Medicine FIU
Cardiology Lecturer IM and FP Residency Program

Published by Axiom Health Care Marketing