Hypertension, Diabetes & Vascular Disease › NuHealth - Nassau Health Care Corporation

The Zaki Hossain Center for
Hypertension, Diabetes & Vascular Disease

Diabetes has reached epidemic proportions in America, and is frequently accompanied by both hypertension and vascular disease. All three are major contributors to heart disease and stroke – the number one and three causes of death in the U.S. – and African-Americans, Hispanics and South Asians are especially prone to developing both the diseases and dangerous complications, including loss of limbs, vision and mobility.

That’s why NuHealth created the Zaki Hossain Center for Hypertension, Diabetes & Vascular Disease at Nassau University Medical Center – to help our patients prevent, diagnose, monitor and treat these diseases as interrelated parts of a complex medical puzzle. The Center is housed on a beautifully renovated floor, specifically designed to encourage collaborative care of diabetes and related diseases.

  • A multi-disciplinary team approach to the management of these interconnected diseases.
  • Easy access to other medical specialties often needed to treat complications of diabetes and hypertension, including ophthalmology, cardiology, neurology, podiatry, bariatric surgery and wound management.
  • Training to help patients manage their health conditions.
  • Patient and public education to help diagnose and manage diabetes and prevent its complications, and public education to help Long Islanders prevent the onset of diabetes, hypertension and vascular disease by encouraging healthier living and awareness of symptoms associated with these diseases.

What is Hypertension? Click here »

Hypertension is commonly known as “high blood pressure.” A normal blood pressure reading is around 120/80. These numbers refer to millimeters of mercury, a standard measure of pressure. Hypertension is diagnosed when the first number (systolic pressure) exceeds 140, or when the second number (diastolic pressure) exceeds 90.

Why do I need to manage it?
A variety of serious health conditions are linked to hypertension, including atherosclerosis (hardening of the arteries), heart disease, kidney disease, stroke and diseases of the eye. To avoid these complications, patients must take steps to manage their blood pressure with lifestyle and diet adjustments and, in certain cases, with medication.

Do I have hypertension?
Hypertension is often called “the silent killer” because people who have it don”t tend to feel anything unusual. It is, however, found most frequently in people who smoke, who are obese, and who are not getting enough exercise. Hypertension is also more common among African-Americans, and is somewhat more common amonmg men than women. It is found mor frequently among people who suffer from diabetes and/or vascular disease. If you are in any of these risk groups, or have a family history of hypertension, you should be screened for it by a medic al professional.

To diagnose and manage hypertension and associated diseases, NuHealth”s Zaki Hossain Center at Nassau University Medical Center provides:

  • Specialists in Hypertension and Nephrology (kidneys)
  • Hypertension Monitoring and Management
  • Patient Education
  • Cholesterol Screening

What is Diabetes? Click here »

Diabetes is a disease that impairs the body’s ability to process sugar, fat and protein in food. Affecting millions of Americans, diabetes is the fifth leading cause of death and the leading cause of disability worldwide. Moreover, diabetes is on the rise because it is often brought on by today”s diets, which are often high in sugars, starches and fat, as well as a lack of physical activity.

Do I have diabetes?
You may feel fine and have diabetes. The only sure way to know is to have a screening blood test that shows how well your body processes blood sugar. Routine blood tests performed by your doctor may not reveal the presence of a diabetic conditions. Some signs of diabetes may include unusual thirst, frequent urination and, in some instances, unexplained weight loss. People with a family history of diabetes, who are obese, or who are not physically active should be screened for diabetes. African Americans, Hispanics and South Asians also have a higher risk of developing diabetes.

What should I do if I have diabetes?
Untreated diabetes can contribute to a variety of serious health complications, including diseases of the heart, kidneys, eyes, nerves and vascular system that literally threaten both life and limb. A coordinated approach to disease management is required to help control diabetes, prevent complications and protect your overall wellness.

To diagnose and manage diabetes and associated diseases, NuHealth”s Zaki Hossain Center at Nassau University Medical Center provides:

  • Patient education in diabetes management, including training for self-monitoring, insulin administration and adherence to care regimens.
  • Dietary counseling
  • Cholesterol screening and treatment
  • Screening for hypertension and early signs of vascular disease.

What is Vascular Disease? Click here »

Vascular diseases are disorders of the blod vessels, many of which are known as “hardening of the arteries.” While this problem is usually associated with heart disease, such disorders can also affect other parts of the body and cause a variety of serious conditions, including:

Abdominal Aortic Aneurysms (AAA) – These dangerous malformations in the wall of your body”s largest artery are among the most common causes of death in people over 60.

Stroke – If the carotid artery, which supplies a significant portion of the blood supply to the brain, becomes blocked by plaque, the brain becomes starved of blood and oxygen, which can cause permanent damage.

Blocked Arteries – When the flow of blood through arteries in the abdomen, pelvis and legs is restricted, it can cause sores, prevent the healing of wounds and cause tissue death leading to the loss of limbs and extremities, as well as loss of function in critical organ systems.

How can vascular disease be treated?
If you have diabetes, you have a much higher risk of having vascular disease that, if untreated, can result in limb loss, stroke and other complications … even death. Minimally-invasive interventions and surgical procedures can be performed to remove or bypass vascular blockages and treat other disorders. The vascular team at Nassau University Medical Center also treats aortic and other aneurysms, and provides diabetic foot care and state-of-the-art treatment of varicose veins.

To diagnose and manage vascular disease and associated health problems, NuHealth”s Zaki Hossain Center at Nassau University Medical Center provides:

  • Specialists in vascular surgery
  • Diagnosis, monitoring and management of vascular disorders
  • Reconstructive procedures to relieve the effect of blocked blood vessels.
  • Minimally invasive techniques to treat varicose veins.

Contact Information

Appointments: (516) 572-4848

Except Wound Management: (516) 572-5201

Center Divisions:

Diabetic Endocrinology
Vascular Disease & Surgery
Weight Loss Surgery
Wound Management
Cardiology
Gastrointestinal

 

Diabetic Endocrinology

Diabetes is a disease of the endocrine system – the various hormone-secreting glands that control growth and reproduction and regulate the actions of every organ in the body. Diabetes occurs when the pancreas doesn’t produce enough insulin, or the cells become “insulin resistant” and unable to turn carbohydrates (sugars) into useable fuel. As a result, NuHealth’s endocrinologists play a leading role in the treatment of both Type 1 (formerly known as juvenile diabetes) and Type 2 (previously known as adult-onset) diabetes and associated diseases at the Zaki Hossain Center for Hypertension, Diabetes & Vascular Disease at Nassau University Medical Center.

Type 1 Diabetes
Type 1 diabetes affects approximately three people in 1,000 in the United States. It begins suddenly, most often during childhood or adolescence. Type 1 diabetics produce little or no natural insulin, and usually require daily insulin injections. It occurs more frequently in people of Northern European descent. NuHealth’s endocrinologists help Type 1 diabetics regulate their glucose levels through proper management of carefully controlled doses of insulin – including so-called “brittle diabetics” who swing quickly and often between hyperglycemia (abnormally high blood glucose) and hypoglycemia (abnormally low blood glucose), and may need multiple doses of different types of insulin throughout the day or insulin administered by an insulin pump.

Type 2 Diabetes
By far the more common form of the disease, Type 2 diabetes was once considered primarily a disease of older Americans. As a result of our national epidemic of obesity and our sedentary lifestyles, however, Type 2 diabetes is now a growing national health problem that is a major contributor to the high cost of health care – and a serious threat to millions of Americans of all ages. People of Native American, Hispanic, and African-American descent are especially vulnerable.

Fighting this disturbing national trend is the top priority of the endocrinologists and other team members of the Zaki Hossain Center for Hypertension, Diabetes & Vascular Disease. Type 2 diabetes has been incorrectly considered
a milder form of diabetes because it often has no symptoms when it first occurs and may not necessarily require medication if the patient responds well to changes in diet, commitment to exercise and weight loss. Nonetheless, uncontrolled and untreated Type 2 diabetes is just as dangerous as Type 1, carrying the same risks of blindness, heart and vascular disease and more. Our endocrinologists not only help balance your blood sugar through better eating and medications, but ensure that any of the conditions that can arise from diabetes are quickly addressed through medical, pharmaceutical or surgical means.

To make an appointment or consult with a specialist in diabetic endocrinology at the Zaki Hossain Center, call (516) 572-4848

Clinical Staff
Chief - Ken Hupart, MD, FACS
Salini Kumar, MD, FACP, FACE
Alice Lee, MD, FACP
Terry Gray, ANP-C, PhD

Podiatry

Diabetics are especially prone to foot problems that can quickly become serious…even life threatening. To protect NuHealth’s patients, we include a Doctor of Podiatric Medicine on the multidisciplinary care teams at The Zaki Hossain Center for Hypertension, Diabetes & Vascular Disease. Our podiatrists treat a range of problems that are prevalent among diabetics, including:

  • Infections
  • Diabetic Ulcers (the leading condition requiring foot amputation)
  • Diabetic Neuropathy
  • Peripheral Nerve Damage
  • Peripheral Artery Occlusion
  • Poor wound healing

We offer a comprehensive diabetic foot care program including screenings, preventative medicine, and treatment of diabetes-related foot problems. We also provide special services such as diabetic shoes, custom braces, off-loading devices, and custom foot orthotics.

To make an appointment for a podiatric examination or treatment at the Zaki Hossain Center, please call (516) 486-NUMC (6862)

Clinical Staff
Tara Richman, DPM
Robert Stabile, DPM

Vascular Disease & Surgery

Although not the only cause of vascular disease, diabetes and vascular problems often go hand in hand. Diabetes is linked to a number of vascular problems, including retinopathy (an eye condition), nephropathy (a kidney condition), coronary heart disease and atherosclerosis or hardening of the arteries). In fact, diabetics are five times more likely to have a stroke, two to four times more likely to have coronary artery disease, and up to five times more likely to have peripheral arterial disease, a leading cause of amputations.

NuHealth’s vascular surgeons help patients of the Zaki Hossain Center for Hypertension, Diabetes & Vascular Disease prevent or many of the serious complications of diabetes and associated diseases. than people without diabetes. Using a variety of non-invasive surgical and open surgical procedures, our vascular surgeons help restore proper blood flow to starving tissues, helping to stave off infections and tissue death that leads to amputated limbs. Diagnostic and surgical procedures performed at the Zaki Hossain Center include:

  • Ambulatory Phlebectomy (Varicose Vein Treatment)
  • Angioplasty
  • Balloon Embolectomy
  • Minimally-Invasive Surgery
  • Peripheral Arterial Bypass Surgery
  • Revascularization
  • Thrombectomy

To make an appointment or consult with a vascular surgeon, call (516) 572-4848

Clinical Staff
Glenn Faust, MD – Chair
Richard Batista, MD
Paul Scott, MD

Weight Loss (Bariatric) Surgery

Excessive weight is one of the leading risk factors for the development of diabetes, hypertension and cardiovascular disease. Fortunately, significant weight loss usually improves or eliminates these conditions. At NuHealth’s Zaki Hossain Center for Hypertension, Diabetes and Vascular Disease at Nassau University Medical Center, we work closely with our patients to modify their diets and follow a regimen of exercise specifically designed to achieve safe weight loss. When those and other methods have failed, however, NuHealth’s bariatric surgeons can help you achieve substantial weight loss through a variety of procedures, including the two most popular methods:

  • Roux en Y Gastric Bypass (pronounced “Roo-N-Why”)
  • Adjustable Gastric Banding (also known as the LAP-Band procedure)

NuHealth’s bariatric surgeons are also experienced with a number of less common procedures, including:

  • Biliary Pancreatic Diversion
  • Gastric Sleeve Resection

Long-term studies show that patients who undergo bariatric surgery can achieve percentage losses ranging from 25% to 80% of excess body weight, recovery from diabetes, improvement in cardiovascular risk factors, and a reduction in mortality of nearly half.

How does bariatric surgery work?
Weight loss surgeries work by restricting the amount of food that you eat and/or altering your body’s ability to absorb food. Overeating is curbed because exceeding the capacity of the stomach, or eating foods that are high in fat causes nausea and vomiting. The two most common procedures are described below:

Roux en Y Gastric Bypass – Click to see illustration »

Gastric bypass can be performed as an open or minimally invasive (laparoscopic) procedure. The surgeon creates a small stomach pouch and bypasses a part of the intestine, restricting both the amount of food you eat and the opportunity for food to be absorbed.

Adjustable Gastric Band – Click to see illustration »

Usually performed as minimally invasive surgery, gastric banding entails placing a band around the upper part of the stomach. This band compartmentalizes the stomach into a small upper pouch and a larger lower part. You feel full earlier as the upper pouch is small. Thus it works by only restricting the amount of food you eat. As the name suggests, your surgeon can adjust the band via a port placed under the skin to ensure proper weight loss.

Is bariatric surgery right for me?
The U.S. National Institutes of Health recommends bariatric surgery for obese people with a body mass index (BMI) of at least 40, and for people with BMI 35 and serious coexisting medical conditions such as diabetes. Any surgical procedure carries some degree of risk that should be factored into your decision making, but the overall risk of remaining morbidly obese generally outweighs the surgical risks. Still, bariatric surgery is not a “magic pill” – to achieve significant, permanent weight loss you must be prepared to exercise and follow a restricted diet (the level of restriction varies with the type of surgical procedure) for the rest of your life. If you can’t make that kind of commitment, you probably won’t lose the weight you desire, and you may be putting yourself at additional risk for serious, even deadly, complications.

Which type of weight loss surgery is best?
Ultimately, the right bariatric procedure for you is the one that will help you to safely achieve your weight loss goals. While many believe gastric bypass enables faster and more significant weight loss, it is also irreversible and often requires a longer recovery period both in and out of the hospital. What’s more, gastric bypass surgery patients must be even more careful about adhering to a strict diet than those who undergo gastric banding (although both typically require a high-protein, low-fat and nearly alcohol-free diet) . As a result of these factors, the LAP-BAND® and other gastric banding procedures have increased in popularity. But recent studies have shown that successful weight loss is more dependent on the individual’s willingness to exercise and follow a healthy nutritional plan. Your bariatric surgeon and others in the Zaki Hossain Center will explain the details and help you select the procedure that makes the most sense for you.

Post Surgery
The care you receive following surgery is just as important as the skill and expertise of the surgeon. At the Zaki Hossain Center, every aspect of your recovery and ongoing weight loss is managed by a team of physicians, nurses, nutritionists, psychotherapists, exercise consultants and others. These caring professionals work together to you help you adjust to the lifestyle changes associated with bariatric surgery and monitor your health as you progress toward your weight loss goals. They are almost as invested in your success as you!

To make an appointment to discuss bariatric surgery, call (516) 572-6703.

Clinical Staff
George Angus, MD
Venkatesh Sasthakonar, MD
Nelka Lewis-Johnson – Program Coordinator
Cathy Hill - Dietician

Wound Management

Patients with diabetes and vascular disease are especially prone to having difficulty in healing wounds due to restricted blood flow and excess blood sugars that can greatly slow the healing process. In fact, foot ulcers are the leading reason for the foot amputations that are an all-too-frequent effect of diabetes. That’s why specialists at NuHealth’s Zaki Hossain Center for Hypertension, Diabetes & Vascular Disease at Nassau University Medical Center keep close track of all wounds and infections. When problem wounds become a threat to life and limb, the wound care specialists at NuHealth’s Wound Care & Hyperbaric Oxygen Treatment Center are ready with the latest in sophisticated healing technologies.

What is Hyperbaric Oxygen Treatment?
Hyperbaric Oxygen (HBO) therapy delivers pure oxygen to a patient in an airtight chamber at an atmospheric pressure that is greater than normal. Traditionally associated with the treatment of decompression sickness (what divers refer to as “the bends”), HBOT has more recently emerged as a leading therapy in the treatment of problem wounds, infections and trauma. Under high pressure, blood is able to absorb more oxygen which, when carried to damaged or infected tissue, promotes faster healing.

Nassau University Medical Center is the tri-state area’s first Level I Trauma Center with a multi-disciplinary wound care team and a large, multi-station hyperbaric oxygen chamber. Working closely with the other team members from the Zaki Hossain Center, NuHealth’s wound care specialists evaluate and treat the entire spectrum of problem wounds, providing not only the high tech healing power of HBOT, but wound cleansing, debridement, and daily changing of dressings if needed.

To contact a wound care specialist, call (516) 572-5201

Clinical Staff
Louis Riina, MD