Health Care – John Macoviak

Moderate Alcohol Consumption Can Increase the Risk of Hypertension

A retired heart transplant surgeon in California, John A. Macoviak, MD, focuses his time on being a medical author and blogger. Having written more than 50 peer-reviewed articles, along with performing many ground-breaking surgeries, John Macoviak MD MBA maintains a professional interest in both hypertension and diabetes.

According to research from September 2020, adults who have type 2 diabetes (T2D) are more likely to develop hypertension with moderate alcohol consumption. The study, which was published in the Journal of the American Heart Association, looked at data from 10,200 adults participating in the ACCORD trial. This trial previously compared methods of reducing the risk of cardiovascular disease in adults who had T2D.

For the current research, adults were split into three categories: those who were light drinkers, moderate drinkers, and heavy drinkers. Light drinkers only had one to seven drinks per week, where each drink was 12 ounces of beer, 1.5 ounces of liquor, or six ounces of wine. Meanwhile, heavy drinkers had upwards of 15 drinks per week, while moderate drinkers had between eight and 14 drinks.

Based on the study’s analysis, heavy drinkers had almost twice the risk of elevated blood pressure (BP) readings. They were also three times more likely to develop stage II hypertension and 2.5 times more at risk of stage I hypertension. For moderate drinkers, the risk dropped, but it was still significantly above their peers who drank less.

Percutaneous Septal Sinus Shortening for Functional MR

A retired heart transplant surgeon and researcher, John Macoviak MD MBA currently writes on a range of medical subjects, with special focus on the treatment of heart conditions. Among his previous research publications is the paper titled “Percutaneous septal sinus shortening: a novel procedure for the treatment of functional mitral regurgitation.”

The most common valve disease, functional mitral regurgitation, also known as secondary mitral regurgitation, is characterized by motion abnormalities in the wall of the left lower chamber of the heart (left ventricle), compromising closure of the mitral valve (the valve between the left upper and lower chambers of the heart). Mitral regurgitation causes the left ventricle of the heart to become susceptible to further damage, since the volume of blood it holds is higher than normal due to reverse flow of blood past the mitral valve. This condition can eventually cause death if not treated. Functional MR happens when other diseases of the left ventricle have resulted in severe left ventricular dysfunction. Often, it is inadvertently discovered during a patient’s examination for heart failure. Among other symptoms, patients with functional mitral regurgitation usually experience shortness of breath.

In the publication, John Macoviak and other researchers describe the percutaneous septal sinus shortening system for treating functional MR. This novel technique was applied to a sheep model, and the result showed significant success. This technique reduced the annular diameter of the mitral valve from center to the left in sheep with severe functional MR to a diameter optimal for reducing mitral regurgitation. While the study employed a standard catheter technique, the researchers noted that the technique could further be enhanced by using fluoroscopy.

Cortisol Levels Linked to Blood Sugar in People with Diabetes

John Macoviak MD MBA, a graduate of Georgetown University, is a retired Washington, DC, heart transplant surgeon. Now living in California, John Macoviak MD MBA continues to write about medical conditions, most notably chronic conditions like diabetes.

The results of a new study by researchers at the Ohio State University College of Medicine and the Ohio State University Wexner Medical Center has revealed a link between blood sugar and cortisol levels in people living with type 2 diabetes.

Published in Psychoneuroendocrinology, the July 2020 study builds on previous research that showed both stress and depression lead to more stable cortisol levels throughout the day. These sustained levels are not seen in healthy people, for whom cortisol naturally is high at the beginning of the day before dropping in the evening.

Since cortisol is linked to a decrease in insulin and an increase in blood sugar, having sustained levels makes diabetes much more difficult to control. This is why it’s essential that people with type 2 diabetes find ways to minimize their cortisol levels so that they do not experience blood sugar spikes.

To find this link, researchers examined data from more than 2,000 participants between the ages of 45 and 84. These participants were followed for a period of six years, during which time researchers noticed that people with diabetes had steadier cortisol levels and higher glucose levels than their peers without diabetes.

How Depression Increases the Risk of Heart Disease

A retired heart transplant surgeon and dedicated medical researcher, John Macoviak MD MBA has been a respected member of the medical community for more than four decades. Passionate about sharing his medical expertise with the public, John Macoviak MD MBA actively writes articles about different medical conditions. This includes an online article he wrote discussing heart disease in women, and common risk factors such as depression.

When people are depressed, they often experience low-grade inflammation, which contributes to the clogging of arteries. Beyond that, people who are depressed experience a higher production rate of stress hormones. Stress hormones contribute to artery blockages by activating platelets in the blood and making them more likely to clot. Such hormones also limit how much the arteries and heart respond to requests for increased blood flow in the body. Both factors increase the risk of heart disease in people with depression.

Depression increases the risk of heart disease in other ways as well. People who are depressed commonly experience lower energy levels or a lack of motivation. As a result, they struggle with eating healthy foods and maintaining a regular exercise routine. Such lifestyle choices are essential for reducing various cardiovascular and other health issues.

This change in motivation and energy additionally leads to disruptions in people’s medication behavior. They may take medicines incorrectly, or skip taking their medications altogether. Further, people who are depressed have a higher likelihood of self-medicating with alcohol or smoking.

How Cytomegalovirus Can Affect Adults

A retired heart transplant surgeon in California, John Macoviak MD MBA is an esteemed member of the medical community. Since performing his first heart transplant in Washington, DC, he has performed several groundbreaking surgeries and written upwards of 50 medical and surgical articles. John Macoviak’s publications have covered such medical conditions as cytomegalovirus (CMV) following heart-lung transplantation.

Related to the herpes virus, CMV is an extremely common infection. In the United States, anywhere from 50 percent to 85 percent of adults have the virus. Meanwhile, nearly all adults have CMV in developing countries. Part of why the virus is transmitted so easily is due to the fact that it does not cause serious symptoms in those with healthy immune systems. In fact, many people do not experience symptoms of the virus at all. If they do, they have a low-grade fever that lasts for a few days or weeks, decreased appetite, and fatigue.

However, this isn’t the case for people with weakened immune systems. This includes people who have immune-suppressing diseases, like AIDs, those who are receiving chemotherapy, and those who have had transplants of bone marrow or organs. In these individuals, CMV is linked to retinitis, an eye condition that leads to blindness, or issues with the gastrointestinal tract. Parts of the nervous system and the brain can also be affected by CMV when the immune system is weakened, thus leading to leg weakness and confusion.

Hemiarch Aortic Perfusion Reduces Brain Emboli

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A graduate with distinction from Georgetown University School of Medicine, John Macoviak MD MBA is a retired cardiothoracic surgeon. John Macoviak MD MBA has researched a wide variety of heart-related conditions, and is a co-author of several medical papers, including “Hemiarch aortic perfusion decreases brain emboli in beating heart surgery.”

An abbreviation of beating heart surgery, BHS refers to any surgery that is performed on the heart while it is still beating which avoids cross clamping the aorta as is usually done with the heart at rest. . One of the main concerns of doctors performing heart surgery is the maintenance of blood circulation (perfusion) during the procedure using the heart lung bypass machine. Aortic cross clamping to stop the heart can result in the formation of cholesterol emboli. Emboli are obstructions in blood vessels that can be also caused by air bubbles, blood clots, or other matter in the blood..

Research was conducted on 13 pigs to study the effect of directing cold blood perfusion in the aorta to the brain to prevent embolism damage to the brain. The aorta is the largest artery in the body, emanating from the upper left chamber of the heart to form an arch in the chest, with branches that convey blood to the brain and other parts of the upper body as well as lower parts of the body. .

During the research, tiny colored microspheres (15 micrometers in diameter) were injected into the base of the aorta and left upper heart chamber of some test subjects. A group of the test subjects had dual blood lumen catheters inserted into the base of the aorta to help channel blood from the upper lumen into the aorta with cold blood, and the lower lumen with warm blood to the rest of the body. While another group had no catheter (to serve as control). At the end of the research, the group with the catheter perfusing cold blood to the brain had fewer emboli going to the brain as compared to the control group.

Electrical Conditioning of Skeletal Muscle for Myocardium Replacement

A graduate of the Georgetown University School of Medicine, John Macoviak MD MBA is a former associate professor of cardiothoracic surgery at Harvard Medical School. John Macoviak MD MBA co-authored articles in several medical publications, including “Electrical conditioning of in situ skeletal muscle for replacement of myocardium.”

Also referred to as the cardiac muscle, the myocardium constitutes most of the heart and is known for the role it plays in the contraction of the heart. Due to the important roles performed by these cells, death of cardiac muscles in the heart can result in complications. To address these cases, surgical intervention may be necessary. Some approaches rely solely on the replacement of dead cardiac muscle cells.

Research conducted in-vivo investigated the efficacy of replacing dead cardiac muscle cells with electrically stimulated skeletal muscle cells from the right diaphragm of test subjects. Skeletal muscles are different from cardiac muscles and are responsible for voluntary movements. During the study, electrical frequencies of 2Hz and 10Hz were used for stimulation over a period of 135 days. The researchers discovered that almost all fast-twitch and easily fatigued muscle cells (known as type I) transformed into slow-twitch and fatigue-resistant muscle cells (type II) with a significant increase in the thickness of stimulated muscles.

Muscle cells that were electrically stimulated at 10Hz contracted vigorously and showed no symptoms of fatigue throughout the study. The conclusion suggested that skeletal muscles of the diaphragm may be a more suitable autograft (grafts gotten from recipient) for replacement of defective or dead cardiac muscle cells.

Health Aide Visits Lower Blood Pressure in Disadvantaged Nations

Affiliated previously with several major health care institutions, John Macoviak MD MBA is a retired cardiothoracic surgeon who is an author, having over 50 peer-reviewed medical and surgical publications. . John Macoviak’s professional interests include hypertension (high blood pressure), known by doctors as the silent killer because it most often has no apparent symptoms.

A study in the New England Journal of Medicine noted that many people living in rural areas of middle- and low-income nations do not regulate their hypertension with medication. Deaths due to cardiovascular conditions are therefore on the rise, especially in areas with significant poverty and insufficient health care systems.

Researchers investigated whether home visits from health workers could alleviate this problem. They worked with health aides in Mexico, South Asia, Africa, and China, who already travel to provide maternal and child care.

Every 90 days, workers in 30 communities carried digital blood pressure monitors and educated people on lifestyle changes and the necessity of consistent use of medications. Patients who were at risk were sent to specially trained doctors in nearby clinics.

When compared to a similar group that was not monitored and received no advice, those who received these interventions had a 5 mm Hg reduction in systolic blood pressure (the higher number of the reading). Many brought their blood pressure into safe limits, defined as under 140/90 mg.