Category: Blog

As a patient you may have heard the term hypertension before, which is really just another word for having high blood pressure. However, hypertension is a real concern affecting roughly one third of the adult population in the United States.

Blood pressure is recorded as two numbers – the first representing the pressure when the heart is beating (systolic), and the second pressure during the relaxation of the heart (diastolic). So why are these two numbers so important? Blood pressure represents the pressure in the arteries that supply nutrients to the organs. Too much pressure in any system is harmful long-term. We measure blood pressure at rest to determine if a person has hypertension, or if the hypertension is controlled. Individual readings (no matter how high) do not predict immediate risk of stroke and do not require emergency treatment; rather averages of multiple readings indicate blood pressure control.

 

 

But why is hypertension such a big concern? Hypertension is highly associated with vascular diseases such as diabetes, stroke, kidney failure, coronary heart disease and congestive heart failure. The best way to prevent a stroke is to control hypertension by controlling blood pressure. Hypertension treatment also decreases the risk of other vascular diseases and risk of heart attack.

Some things to consider:

 

1. The treatment of hypertension has noticeably improved over the past several decades. The current treatments usually result in once-a-day drugs that have rare, minor, and reversible side-effects. These drugs have no side-effects for most people. Many of these drugs are generic and can cost as little as $10 for a three month supply. There are several classes of medications. The majority of patients need more than one class of drug to control their hypertension, however there are many agents with two or three drugs in one pill.
2. If you have hypertension, you also need to control your other risk factors for ‘hardening of the artery’ diseases such as heart attack, stroke and peripheral vascular disease. Areas to work on include quitting smoking, exercising more, controlling your cholesterol and limiting your salt intake. Remember, salt is found in many common foods such as luncheon meats, soups, catsup, ham and cheese.
3. If you have hypertension, your physician will most likely recommend you purchase a home blood pressure monitor. They are easy to use and very accurate. I recommend taking your blood pressure in the morning and before dinner after about three to five minutes of sitting, and then record the readings. You should take your blood pressure twice daily for a month after your blood pressure medicine has been added or changed. Monthly readings are sufficient if your blood pressure is controlled. I suggest taking your blood pressure on the first day of each month. Don’t forget to bring in these readings for your health care provider.

 

Strokes are life-changing and debilitating. Don’t ignore controlling your hypertension as it is a truly silent killer that can be prevented by easy treatment.

Over 1 in 6 Americans have high cholesterol, a risk factor for heart disease which is the leading cause of death in both men and women in the U.S. That is one of the many reasons why every September is National Cholesterol Education Month.

Let’s first answer the question “What is cholesterol and why is it important?” Cholesterol is a waxy, fat-like substance that is made in the liver and found in food. It is an important part of the body’s cells needed for health, but it can be dangerous at high levels. When there is too much cholesterol it can build up on the walls of blood vessels, leading to narrowing of the vessel and blockage of blood flow, possibly leading to a heart attack or stroke.

 

 

After understanding the risks caused by high cholesterol, it is important to ask, “What can I do to prevent high cholesterol?” High cholesterol does not cause symptoms and is caused by both things we can control (diet, lack of exercise, being overweight) and things we can’t control (genetics). The first step to controlling your cholesterol is discussing these factors with your doctor and, if appropriate, having your cholesterol levels checked.

Your health care provider will check the levels of a few different kinds of cholesterol in your blood:

 

1. The type of cholesterol that clogs the arteries is low density lipoproteins (LDL), or “bad” cholesterol. ideally your LDL score would be <130 goal=”” varies=”” by=”” risk=”” li=””>
2. Another type of cholesterol, high density lipoproteins (HDL), helps to remove LDL from the blood stream. This is “good” cholesterol and its score should be >40.
3. A third type, triglycerides, is a type of fat that is in the blood stream and stored in fat cells throughout the body. This is also “bad” and the score should be <150.

 

The next step in managing high cholesterol is making changes to your lifestyle. These include eating a low fat diet (<35% of calories should come from fat), and eating plenty of fiber. Not all fat is bad, however. Unsaturated (but not trans) fats may lower your LDL and raise your HDL. It is also important to maintain a healthy weight and exercise regularly.

Unsaturated Fats: Avocados, Olive Oil, Peanut Oil

High Fiber: Whole grain bread/cereals, dried fruits, vegetables, legumes

Sometimes these lifestyle changes are not enough. If that is the case, there are medications that can help lower your cholesterol. Your doctor can discuss how to make these healthy lifestyle changes and if medication is needed.

Flu vaccination can be scheduled as soon as flu vaccine arrives, usually around August, and can continue into late spring.

Flu vaccine is indicated for everyone over 6 months of age, each year.

It is especially important for those at high risk of receiving complications from the flu to get vaccinated. Please click here for the CDC recommendations.

 

Receiving a vaccine each year is important because coverage from the vaccine only lasts for about 1 year.

This year’s vaccine is the same as last year, it covers against 3 – strains of the flu, including the 2009 H1N1, but you need to receive a dose this year to protect you this year!

Ask your provider if your child younger than 9 years of age needs to receive 2 doses of vaccine this year, for those that only receive one dose but require 2, it may only be 50-60% effective.

Let’s look forward to a healthy 2011-2012!

September is National Whole Grain Month – perfect timing for planning healthy back-to-school meals and snacks.

Eating a diet rich in whole grain foods can decrease your risk of heart disease, cancer, diabetes, obesity and digestive disorders. The USDA’s Dietary Guidelines 2010 recommend that adults eat at least 3 full servings of whole grains per day and that kids eat at least 2 to 3 servings. A full serving provides 16 grams of whole grain at a time.

 

 

Most people have heard of whole grains and know they are healthy but, in reality, the average American eats less than one full serving of whole grains per day. Many foods that look and sound healthy, such a “multi-grain” cereal or “high fiber” bread may in fact be refined grains. A grain, whether it’s wheat, corn, rye or barley to name just a few, has several layers called the germ, the endosperm and the bran. When the entire grain kernel is left in a product, it is considered a “whole” grain. When a grain is “refined,” the bran and the germ are removed, along with most of the fiber and about half of the other key nutrients. Some of the nutrients and fiber can be added back, which makes the food “fortified,” but the whole foods with the original nutrients intact are the foods that provide the most benefit. Consumers need to look for the words “100% whole grain” or the stamp of the Whole Grain Council on labels to be sure to get the best choices. The words “100% whole grain” mean that there are at least 16 grams (a full serving) of whole grain, while the Whole Grain Council stamp by itself means at least 8 grams (1/2 serving) of whole grain.

How can a person get all the whole grains they need? It’s as easy as starting the day with oatmeal or a slice of 100% whole wheat bread, having whole grain rye or wheat crackers with your soup or salad for lunch, and having whole wheat pasta or brown rice for dinner. Kids can enjoy a bowl of whole grain oat cereal for breakfast, a sandwich made with 100% whole wheat bread for lunch, and a snack of popcorn or half of a 100% whole grain English muffin with pizza sauce and a sprinkle of cheese for an afternoon snack.

The following list gives a few suggestions for full servings of whole grains. Try to get at least 3 servings per day.

 

• 1/2 – 1 cup cooked oatmeal, quinoa, barley, brown rice or whole wheat pasta.
• 1 serving of crackers such as Triscuit™ or Rye Krisp™.
• 1 slice of 100% whole wheat bread, a 100% whole wheat mini bagel or a 100% whole wheat English muffin.
• 3-4 cups of popcorn.

 

Health consumers are confronted with lots of choices when considering how to maintain or improve their health. Many of these options might be considered “alternative” to traditional western medicine, or could be thought of as “holistic.” Holistic health care is sometimes described as care that addresses body, mind, and spirit, and seeks a healthy balance. For the interested consumer, evaluating strategies which they might not find at their local doctor’s office or hospital can be challenging.

The spectrum of holistic strategies is very wide. The most commonly used in the US are manual therapies such as chiropractic and massage, supplements such as herbs and nutrients, stress management tools like meditation, and traditional healing tools which may be thousands of years old like acupuncture. Surveys have shown that Americans utilize such approaches in large numbers. They may find out about such options from friends, relatives, the internet or their usual health care providers.

 

Research into the effectiveness of holistic therapies is being funded and overseen by the National Institutes of Health, and careful reviews are being written and made available online by other health professionals. Still navigating the world of holistic therapies can be difficult and confusing.

Here are some things to consider if you are contemplating something new.

1. It is always prudent to consult your usual health care provider when contemplating nontraditional strategies. Although most holistic approaches to health care are safe, there may be risks such as combining herbs with medication. At the very least, it is good to keep your health care provider in the loop – you might also educate them in the process!
2. Doctors are trained to “first do no harm.” This principle applies to any therapy. It is up to you to communicate about your experience to your provider, holistic or traditional. Trust your experience – can you tell that the therapy is helping? If so, that’s great. If not, perhaps it is not for you.
3. Finally, there is no substitute for living well. Eating nutritious food in moderate quantities, getting more physical activity, working on your relationships, and cultivating a positive attitude are all very powerful and holistic strategies.

I recently examined a middle-aged woman who had multiple complaints including fatigue, excessive thirst, and vision changes. The only significant factor of her medical history was a lifelong struggle with obesity and dramatic weight gain over the last few years. After an extensive workup, I notified her of the unfortunate news that she was diabetic. Although she found this new diagnosis alarming and scary, I reassured her that diabetes is a disease that can often be well-managed with lifestyle changes.

Diabetes is a chronic disease that affects over 24 million people in the United States today. Specifically, it is a disorder that affects the way your body regulates sugar levels. In normal circumstances, your pancreas is able to produce a hormone called insulin to normalize sugar levels. However, with diabetes, this process breaks down causing blood sugar levels to rise to concerning levels. Diabetes increases your risk for several health conditions including heart attacks, stroke, kidney disease, and circulation problems.

 

 

There are two main types of diabetes. Type 1 diabetes often occurs in young individuals when the pancreas is completely unable to produce insulin. Type 2 diabetes, which is much more common, tends to occur at an older age. Ninety percent of people with Type 2 diabetes are overweight. These individuals produce insulin from the pancreas, but it is not used effectively to regulate blood sugar levels.

The top 7 risk factors for Type 2 diabetes include:

 

1. Obesity
2. Sedentary lifestyle (lack of physical activity or exercise)
3. Unhealthy eating habits
4. A family history of diabetes
5. Increased age
6. Hypertension and high cholesterol
7. Diabetes during pregnancy

 

There are several treatments for diabetes. For all individuals, nutrition is the key element for managing diabetes. In addition, since most people diagnosed with Type 2 diabetes are overweight, exercise and weight loss are extremely important. Other therapies include the use of oral medications, and insulin administration.

Diabetes is a unique disease in that treatment often requires a proactive approach with aggressive lifestyle changes, which can dramatically alter the course of the disease. I am pleased to report that the individual I mentioned earlier is doing very well today. She has been able to control her diabetes well through appropriate nutrition, exercise, and weight loss. She is also currently on oral medication, however her ultimate goal is to completely eliminate this need as she gets closer to obtaining a healthy weight. As a physician, I find it exciting to empower patients; giving them the tools and instruction they need to live long healthy and fulfilling lives.