Men might be more vulnerable to heart disease, but their female counterparts are catching up, according to Dr. Thomas Vazzana, M.D., one of the top cardiologists in New York City.

"We're seeing younger and younger women with heart problems because a lot of women are smoking," Vazzana says. A senior partner at Vazzana and Bogin Cardiology Associates-a medical group practice located in Staten Island, whose mission is to provide patients with excellent care and help them better prevent heart disease-this native Staten Islander is board-certified in Internal Medicine, Cardiovascular Disease and Interventional Cardiology, and spells out some of the causes and crucial steps necessary for men and women alike to protect their tickers.

Do Not Smoke Your Heart Away

According to a 2005 study by NYC Department of Health & Mental Hygiene's Bureau of Vital Statistics, heart disease is New York City's leading cause of death, and high tobacco use leads to both pulmonary and heart disease. A 2007 survey conducted by the city's Health Department and other entities indicates that cigarette smoking is higher in Staten Island than in the other boroughs; and while teen smoking has declined in recent years, the Island still maintains the highest smoking rates within the five boroughs.

"We're also seeing younger and younger women with heart problems because a lot of women are smoking," says Vazzana, one of the top cardiologists in New York City. He notes that it is impossible to visit any of the Island malls without coming across smoking teenage girls gathered outside. He says they erroneously believe smoking will keep them thin. Such early usage is dangerous because it also leads to teen addiction.

"Normally we don't get heart disease until 50 to 60 years old, but if they smoke, they get it 10 years earlier," says Dr. Vazzana. "So we're seeing a lot of women in their 40s with heart problems, heart attacks, angioplasty and bypass surgery," he says. He adds that while many people feel "fine," it's hard to convince people in their 40s and 50s with no symptoms to take medicine, and take care of their health.

Back to Diet Basics

Dr. Vazzana says nutrition is another big issue on Staten Island that can cause heart problems. "Peoples' diets aren't what they should be. We have a lot of overweight people with high blood pressure and high cholesterol; and if you don't intervene early, then you're going to have problems later," he stresses.

Dr. Vazzana makes a habit of explaining to his patients what they should or should not eat. For breakfast he says, "instead of a donut and coffee, have an egg white omelet or whole wheat toast. For lunch, instead of a fast food burger, have grilled chicken with a salad." In addition to eating modest portions, patients should also pay attention to the kinds of food they eat. "Instead of processed food," he says, "eat a lot of fruits, vegetables and whole grains like brown bread and brown rice." He also cautions parents about what they serve their kids. "Instead of giving kids cupcakes, give them an apple or a banana."

The Perfect Pedigree

A graduate of New York University and Saint George's University School of Medicine in Grenada, West Indies, Vazzana completed his residency in internal medicine at Seton Hall University, New Jersey, and his Fellowship in Cardiology at Saint Vincent's Catholic Medical Center here in Staten Island. He is a Fellow of the American College of Cardiology and a Fellow of the Society of Cardiovascular Angiography and Intervention.

Vazzana is a member of the American College of Physicians and other prominent medical associations, and is an attending physician at Staten Island University Hospital (SIUH), Richmond University Medical Center and Saint Vincent's Catholic Medical Center of Manhattan. He is also President of the medical staff at SIUH, and has made the top doctor lists for the past few years by both the healthcare research and information company Castle Connelly and New York magazine.

The Practice

Dr. Vazzana opened his Cardiology practice in a small one-room office on Victory Boulevard in 1991. In 1993, his friend, Dr. Marc B. Bogin (they met during their fellowships in cardiology) joined him, and the two have been partners since.

Vazzana muses about the secret to an almost 20-year successful partnership. "We get along very well, understand each other. We're friends with each others' families, we respect each other and he's very easy to get along with," he says. The practice has grown over the years and the partners recently invested in a new state-of-the-art office in the Heart, Lung and Surgery Center at 201 Seaview Avenue. It boasts 12 examining rooms, 6 consulting rooms and electronic patient records, which are accessible anywhere, anytime. This "makes it easier to check on patients even when any one partner is away on vacation," says the doctor who has developed a reputation for keeping prompt appointments with his patients. "I always strive to stay on time and it's unusual for me not to be ... that's one of my pet peeves," says Vazzana.. "I'm never late for anything-it kind of drives my kids crazy."

With the help of a professional staff of 50 people, about 40 patients are seen daily at Vazzana and Bogin Cardiology Associates. Other partners in the practice include: Timothy K. O'Byrne, M.D., Foad Ghavami, M.D., and Frank V. Tamburrino, M.D., the newest partner. Vazzana says he is lucky to have such great partners. "We all get along well," he notes. "I think one of the biggest challenges in medicine today is to practice with people that practice the same."

Working with Staten Island University Hospital

As the current President of the medical staff at SIUH, Dr. Vazzana's job involves many hours of meetings trying to solve different hospitals problems, whether it be with a physician or a politician. "It is a good position because the CEO, Mr. Anthony Ferreri, is a wonderful person to work with. He is very open and doctor-friendly and I know if there's a problem, I can pick up the phone and he'll talk to me," says Dr. Vazzana. . He also tells Industry that the hospital-which is the largest on Staten Island-is a wonderful place to work.

Vazzana has also been actively involved in fundraising activities for SIUH.  He says the new emergency department on the North campus (The Elizabeth A. Connelly Emergency and Trauma Center) is on target to be opened on June 26th. He expects the ER to be full immediately as the Island is currently underserved by its three hospitals. He commends the hospital's president, Anthony Ferreri, for running a hospital that is "in the black" financially, and says the current administration engages in many performance improvement programs for health care on Staten Island.

Vazzana's fundraising efforts are also ongoing for the Regina M. McGinn, M.D. Education Center, located on the second floor of the new emergency building. "I've been working with John Demoleas (Vice President of Development and Community Relations)," he adds. "We're trying to raise the rest of the money to get the education center finished." His past successful fundraising efforts include St. Joseph's Hill Academy, where he and his family were able to raise $5 million for a new building.

Working in the Community

Vazzana acknowledges the role his community has played both in his success in the field of medicine as well as in his fundraising abilities. Like him, both of his parents are native Staten Islanders.

"It is important to remember where you came from. I grew up in New Brighton; my father had a little grocery store on Jersey St., and we lived in an apartment above the store. We didn't have anything growing up, and I was lucky enough to go to parochial grammar school, which at the time was free." He went to Monsignor Farrell High School, got a job and worked his way through high school.

"Those are the things in my life that helped me become what I am, and you always have to remember to give back to people...because if it wasn't for those things I wouldn't be where I am. So, whenever anyone asks us for time, we rarely say no." He adds that "a lot of people I see in the office are people who knew my parents or my grandparents, as well as a lot of people I went to high school with. So, it's being known in the community and staying active in the community that has also been good for business."

Some of Vazzana's other community activities include membership on the Board at Monsignor Farrell High School and presidency of the board at the Seton Foundation for Learning, an organization for developmental and disabled kids. His second child is diabetic, which prompted his involvement with the Juvenile Diabetic Association.

Life with Father

Vazzana has passed on his love for volunteer community service and charitable works to his four children: Kathleen (21), Virginia (18), Caroline (16) and Thomas (13). His wife of 25 years says Vazzana practices what he preaches. "We've always been partners," she says. "I met Tom when he was in college and we went through the whole medical school application process together... and I've been with him ever since."

Just as he advises his patients to stay physically active, he does the same thing at home. All of his children are involved in multiple athletic activities in school. He is also an avid runner, and trains outdoors when he can and has participated in three New York City marathons. Everyone in his home also follows his food and diet advice, eating healthy meals with only occasional treats. Two of his children might even follow in his footsteps and pursue careers in medicine.

The Physician Crisis

Dr. Vazzana is concerned about a possible shortage of physicians in the future. He says the average age for cardiologists is 56, explaining that the lack of young cardiologists is related to malpractice issues. Down the road, he says, "it'll be an issue with the population getting older. People now are living to be 80 or 85, so more money is being spent in their later years, but there are not enough physicians to take care of them."

Many health care facilities have shut down or scaled back on services because insurance reimbursement rates are going down while malpractice rates and overhead expenses rise-indirectly affecting the economy. Dr. Vazzana stresses that physicians and our hospitals are the largest employers on the Island. "If they keep squeezing, there will be lost jobs and layoffs, which no one wants," he says.

Patient's Health Should be the Number One Focus

Dr. Vazzana says the patient should always come first.

"We always try to do what's right by the patient whether we get paid or don't get paid by the insurance companies." He remembers when early insurance companies were not-for-profit entities, so any money made went back into patient care. Today, without regulations, these companies minimize the number of allowable tests for each patient within each year, a policy that reaps huge bonuses for them, even as patients are consistently denied the care they need.

Many patients also run out of their allotted prescription coverage in a year, especially in the last quarter. "We try to get them generics or give them samples and carry them over for as long as we can until the end of the year," says Vazzana. "That is one of the big challenges, especially for the senior citizens who can't afford their medicine and food at the same time."