Are you worried about your cholesterol levels?
Has your doctor said you have high cholesterol (called hypercholesterolemia)? Then you know you need to change your diet and lifestyle to lower cholesterol and your risk of heart disease. Even if your doctor prescribed a cholesterol drug to bring levels down, you'll still need to change your diet and become more active for cardiovascular health. These simple tips can help you keep cholesterol levels in check.
Understanding cholesterol: LDL vs. HDL
Cholesterol, Good and Bad
Your body needs a small amount of cholesterol to function properly. But we may get too much saturated fat and cholesterol in our diet – and both raise levels of LDL "bad" cholesterol. LDL cholesterol can cause plaque to build up in arteries, leading to heart disease. HDL"good" cholesterol, on the other hand, helps clear bad cholesterol from your blood. You want to lower LDL cholesterol and raise HDL cholesterol, starting with your diet.
Portion control helps you lose weight and lower cholesterol levels
Give Yourself a Hand
Most Americans eat super-sized meals, with portions that are twice the size recommended for good health. That can contribute to weight gain and high cholesterol. Here's an easy way to practice portion control for a meal: Use your hand. One serving of meat or fish is about what fits in the palm of your hand. One serving of fresh fruit is about the size of your fist. And a serving of cooked vegetables, rice, or pasta should fit in your cupped hand.
Eat more plants: Fruits and veggies are nature's low-cholesterol diet
Serve Up the Heart-Healthy Food
Load your plate with fruits and vegetables — five to nine servings a day — to help lower LDL "bad" cholesterol. Antioxidants in these foods may be provide the benefit. Or it may be that when we eat more fruits and veggies, we eat less fat. Either way, you'll also help lower blood pressure and maintain a healthy weight. Foods enriched with plant sterols, such as margarine spreads, yogurts, and other foods, can also help lower LDL cholesterol.
Fight cardiovascular disease by eating fish
For heart health, look to the sea.
A heart-healthy diet has fish on the menu twice a week. Why? Fish is low in saturated fat and high in healthy omega-3 fatty acids. Omega-3 fatty acids help lower levels of trigylcerides, a type of fat in the blood. They may also help lower cholesterol, slowing the growth of plaque in arteries. Go for fatty fish, such as salmon, tuna, trout, and sardines. Just don't drop the filets in the deep fryer – you'll negate the health benefits.
How to lower cholesterol?
Make time for breakfast Start Your Day With Whole Grains
A bowl of oatmeal or whole-grain cereal has benefits that last all day. The fiber and complex carbohydrates in whole grains help you feel fuller for longer, so you'll be less tempted to overeat at lunch. They also help reduce LDL "bad" cholesterol and can be an important part of your weight loss strategy. Other examples of whole grains include wild rice, popcorn, brown rice, barley, and whole-wheat flour.
Snack smart: Grab a handful of almonds, walnuts, or pistachios
Go Nuts for Cardiovascular Health
Need a snack? A handful of nuts is a tasty treat that helps in lowering cholesterol. Nuts are high in monounsaturated fat, which lowers LDL "bad" cholesterol while leaving HDL "good" cholesterol intact. Several studies show that people who eat about an ounce of nuts a day have lower risk of heart disease. Nuts are high in fat and calories, so only eat a handful. And make sure they're not covered in sugar or chocolate.
Aim for low cholesterol: Swap butter for healthy oils
Unsaturated Fats Protect the Heart
We all need a little fat in our diet – about 25% to 35% of our daily calories. But the type of fat matters. Unsaturated fats -- like those found in canola, olive, and safflower oils – lower LDL "bad" cholesterol levels and may help raise HDL "good" cholesterol. Saturated fats – like those found in butter and palm oil – and trans fats raise LDL cholesterol. Even good fats have calories, so eat in moderation.
Choose carbs wisely: Those high in fiber can reduce risk of atherosclerosis
More Beans, Fewer Potatoes
You need carbohydrates for energy, but some do your body more good than others. Whole grains – such as brown rice or quinoa – whole-wheat pasta, and beans have more fiber and raise sugar levels less. They lower risk of diabetes and high cholesterol. Other carbs, like those found in white bread, white potatoes, white rice, and pastries, quickly boost blood sugar and may raise risk of type 2 diabetes.
Be active: exercise boosts good cholesterol and lowers bad cholesterol
Move It!
Even 30 minutes of physical activity five days a week (20 minutes three times a week for vigorous exercise, such as jogging) can help lower LDL cholesterol and raise HDL cholesterol – although more exercise is even better. It also helps you maintain an ideal weight, reducing your chance of developing clogged arteries. You don't have to exercise for 30 minutes straight – you can break it up into 10-minute increments.
Fight high cholesterol with the easiest exercise in the world
Walk It Off
If you're not used to exercising – or hate the thought of going to a gym – just go for a walk. It's easy, healthy, and all you need is a good pair of shoes. Aerobic or cardiovascular exercise such as walking lowers risk of stroke and heart disease, helps you lose weight, and keeps bones strong. If you're just starting out, try a 10-minute walk and gradually build up from there
For cardiovascular health, activity counts if it increases your heart rate
Work Out Without Going to the Gym
If exercise sounds like a dirty word to you, here's some good news: You can boost your heart health by incorporating physical activity into your day. Any kind of cardiovascular activity counts – gardening, dancing, or taking the stairs instead of the elevator. Even housework can qualify as exercise – as long as you're doing serious cleaning that gets your heart rate up and not just light dusting.
Want to lower cholesterol? Make some simple changes in your life
Take Charge of Your Health
If you have high cholesterol, you and your doctor may be using a number of strategies to lower cholesterol levels. You may be working on your diet, losing weight, exercising more, and maybe taking cholesterol drugs. There are other actions you can take, too, to make sure you stay on the right track.
Watch what you order: Restaurant food can be bad for cholesterol levels.
What to Do When Eating Out
If you're eating healthy food at home to keep cholesterol in check, don't blow it when you eat out. Restaurant food can be loaded with saturated fat, calories, and sodium. Even healthy choices may come in super-size portions. Try these tips to stay on track:
* Choose broiled, baked, steamed, and grilled foods – not fried.
* Get sauces on the side.
* Practice portion control by asking for half your meal to be boxed up before it's brought out.
Shop smart: Read the nutrition label with a heart-healthy diet in mind
Look for Hidden Traps
A close look at nutrition labels is essential for a low-cholesterol, heart-healthy diet. Try these tips:
* Check serving sizes. The nutrition info may look good, but does the package contain two servings instead of one?
* If it says "whole grain," read the ingredients. Whole wheat or whole grain should be the first one.
* A food with "0 grams cholesterol" could still raise your LDL cholesterol. Saturated fat is the other culprit to watch for.
Relax – Lowering stress is good for heart health
Don't Stress Out
Chronic stress can raise blood pressure, adding to your risk of atherosclerosis, which occurs when plaque from cholesterol builds up in arteries. And research shows that for some people, stress might directly increase cholesterol levels. Reduce your stress levels with relaxation exercises, meditation, or biofeedback. Focus on your breathing and take deep, refreshing breaths. It's a simple stress-buster you can do anywhere.
Lose weight to feel great: Drop pounds and lower cholesterol
When Losing Means Winning
Losing weight is one of the best things you can do to fight cardiovascular disease. Being overweight affects the lining of your arteries, making them more prone to collect plaque from cholesterol. Losing weight – especially belly fat, which is linked to hardening of the arteries – helps raise HDL "good" cholesterol and reduce LDL "bad" cholesterol. Aim to keep your body mass index (BMI), an indicator of body fat, under 25.
Watch your numbers: Pay attention to weight, cholesterol, and blood pressure
Follow Your Doctor's Advice
Managing your cholesterol is a lifelong process. See your doctor regularly to keep tabs on your health. Follow your doctor's recommendations on diet, exercise, and medication. Working together, you and your doctor can lower your cholesterol levels and keep your heart going strong.
Thursday, February 12, 2009
15 Tips for Avoiding Heart Disease
Best Diet Tips Ever
Before you tear into that bag of potato chips, drink a glass of water first. People sometimes confuse thirst with hunger, so you can end up eating extra calories when an ice-cold glass of water is really all you needed. If plain water doesn't cut it, try drinking flavored sparkling water or brewing a cup of fruit-infused herbal tea.
Tip No. 2 Be choosy about nighttime snacks
Mindless eating occurs most frequently after dinner, when you finally sit down and relax. Snacking in front of the TV is one of the easiest ways to throw your diet off course. Either close down the kitchen after a certain hour, or allow yourself a low-calorie snack, like a 100-calorie pack of cookies or a half-cup scoop of low-fat ice cream.
Tip No. 3 Enjoy Your Favorite Foods
Instead of cutting out your favorite foods altogether, be a slim shopper. Buy one fresh bakery cookie instead of a box, or a small portion of candy from the bulk bins instead of a whole bag. You can still enjoy your favorite foods - the key is moderation.
Tip No. 4 Eat several mini-meals during the day
If you eat fewer calories than you burn, you'll lose weight. But when you're hungry all the time, eating fewer calories can be a challenge. "Studies show people who eat 4-5 meals or snacks per day are better able to control their appetite and weight," says obesity researcher Rebecca Reeves, DrPH, RD. She recommends dividing your daily calories into smaller meals or snacks and enjoying most of them earlier in the day - dinner should be the last time you eat.
Tip No. 5 Eat protein at every meal
Protein is the ultimate fill-me-up food - it's more satisfying than carbs or fats and keeps you feeling full for longer. It also helps preserve muscle mass and encourages fat burning. So be sure to incorporate healthy proteins like lean meat, yogurt, cheese, nuts, or beans into your meals and snacks.
Tip No. 6 Spice it up
Add spices or chiles to your food for a flavor boost that can help you feel satisfied. "Food that is loaded with flavor will stimulate your taste buds and be more satisfying, so you won't eat as much," says American Dietetic Association spokeswoman Malena Perdomo, RD. When you need something sweet, suck on a red-hot fireball candy. It's sweet, spicy, and low in calories.
Tip No. 7 Stock your kitchen with healthy convenience foods
Having ready-to-eat snacks and meals-in-minutes on hand sets you up for success. You'll be less likely to hit the drive-through or call in a pizza order if you can throw together a healthy meal in five or 10 minutes. Here are some essentials to keep on hand: frozen vegetables, whole-grain pasta, reduced-fat cheese, canned tomatoes, canned beans, pre-cooked grilled chicken breast, whole grain tortillas or pitas, and bags of salad greens.
Tip No. 8 Order children's portions at restaurants
Ordering a child-size entree is a great way to cut calories and keep your portions reasonable. This has become such a popular trend that most servers won't bat an eye when you order off the kids' menu. Another trick is to use smaller plates. This helps the portions look like more, and if your mind is satisfied, your stomach likely will be, too.
Tip No. 9 Swap a cup of pasta for a cup of vegetables
Simply by eating less pasta or bread and more veggies, you could lose a dress or pants size in a year. "You can save from 100-200 calories if you reduce the portion of starch on your plate and increase the amount of vegetables," says Cynthia Sass, RD, a spokeswoman for the American Dietetic Association.
Skinny Sipping: The Best and Worst Beverages for Weight Loss
Skinny Sipping: Drink Pounds Away
Many of us watch what we eat but not what we drink when on a diet. That's a mistake. The average American gets a fifth of daily calories from beverages. Choosing the right drinks can tweak your metabolism, curb your appetite, and reduce your total calorie count. Which drinks are spoilers and which are helpers on the path to weight loss?
Spoiler: Soda
Every time you chug a bottle of soda, you're consuming hundreds of empty calories. According to the Center for Science in the Public Interest, carbonated soft drinks are the single biggest source of calories in the American diet. Switching to diet soft drinks is an obvious way to cut calories, but it's unclear whether this switch results in weight loss. In some people, diet soda may increase their sweet tooth.
Helper: Water
Replacing carbonated soft drinks with water will cut hundreds of calories per day, and the benefits don't stop there. Drinking two glasses of water before a meal may encourage the stomach to feel full more quickly, so you don't eat as much. In addition, new research suggests drinking plenty of water may have a positive effect on your metabolism.
Jury's Out: Fruit Juice
Juice can have as many calories as soda, but it has far more to offer in the way of nutrients. This presents a dilemma -- you want the vitamins and antioxidants without all the extra sugar. The safest bet: Look for 100% fruit juice. Steer clear of juice drinks that have added sweeteners. Look for the percent of real juice, noted on the nutritional label. You can also slash calories by drinking water with a tiny bit of juice added.
Helper: Vegetable Juice
Vegetable juice is every bit as nutritious as fruit juice with about half the calories. A 12-ounce serving of tomato juice has 80 calories, compared to 160 calories for orange juice. Vegetable juice with pulp is also high in fiber and can help control hunger.
Jury's Out: Smoothies
Blend a banana, strawberries, and blueberries into a frothy smoothie, and you've got a delicious arsenal of disease-fighting vitamins and minerals. The homemade variety is best when you're counting calories, because you can control the ingredients -- skim milk and fresh fruit are all you need. Restaurant smoothies may contain ice cream, honey, or other sweeteners that boost the calorie count sky-high.
Jury's Out: Low-Fat Milk
Consuming calcium-rich foods may do a body good, but calcium probably won't help you lose weight, new research now reveals. Some earlier studies suggested calcium may prompt the body to burn more fat, but there's little evidence to support these claims. Depriving the body of calcium, on the other hand, has been show to trigger an increase in the production of fat cells. To get the benefits of calcium without consuming extra fat, stick to skim or low-fat milk, yogurt, and cheese.
Spoiler: Energy Drinks
Sports and energy drinks are calorie bombs like soda. They may have more added nutrients, but you can find the same vitamins and minerals in low-calorie foods. People who are serious about losing weight should stay hydrated with water rather than sports drinks.
Helper: Black Coffee
When you need a shot of caffeine, coffee is a better choice than soda or energy drinks. Black coffee is calorie-free and rich in antioxidants. Studies have shown that consuming moderate amounts of coffee (about 3 to 4 cups a day) may improve mood and concentration, and reduce the risk of type 2 diabetes and several types of cancer.
Spoiler: Fancy Coffee
Once you add heavy cream, flavored syrups, and/or a snowcap of whipped cream, that innocent mug of black coffee becomes a minefield of fat and sugar. Specialty coffees can contain up to 570 calories per cup -- possibly more than an entire meal! If you don't like your coffee black, add a little skim milk and artificial sweetener to keep the calorie count low.
Helper: Green Tea
Green tea is another excellent choice when you're looking for a little caffeine. Not only is it calorie-free, some research suggests green tea extract may stimulate weight loss through the action of phytochemicals. These are plant-based compounds that may temporarily cause the body to burn more calories and melt fat. The benefit appears to last only a few hours, so it may help to drink green tea at least twice a day.
Spoiler: Wine Coolers
Wine coolers may sound light and airy, but they are heavy on calories. A 12-ounce wine cooler can have 190 calories and 22 grams of carbs. Regular wine is not much better with at least 100 calories in a 5-ounce glass. A low-calorie alternative is a wine spritzer: mix a dash of wine with some sparkling water.
Spoiler: Cocktails
A shot of hard liquor has fewer calories than wine or wine coolers, but once you mix in soda or cream, watch out… An 8-ounce white Russian made with light cream has 715 calories. A less fattening option is to mix rum or vodka with diet soda.
Helper: Light Beer
OK, beer is not really going to help you lose weight. But if you're out with friends and want to share a pitcher, light beer is the way to go. A serving has 100 calories, compared to 150 calories for regular beer.
http://www.medicinenet.com/
The Power of Aromatherapy
Alan Hirsch M.D., F.A.C.P. is a neurologist and psychiatrist working on the treatment of smell and taste loss. Dr. Hirsch is the Neurological Director of the Smell & Taste Research and Treatment Foundation in Chicago, Illinois. Here are some excerpts from his article, The Power of Aromatherapy.
Aromatherapy can be a remarkable remedy. When a patient smells a particular odor, scent molecules bind to the surface of cell walls at the top of the nose. This triggers the release of neurotransmitters and other chemicals that stimulate different parts of the brain. Scents that patients enjoy are more effective remedies than those that they find unpleasant. Many health conditions can be improved with aromatherapy. Whether or not these problems can be prevented with aromatherapy is still being researched.
Anxiety: Green apple and/or cucumber have been shown to reduce anxiety by about 18%. Also, patients who sniff lavender have an increase in alpha waves, a sign of heightened relaxation.
Energy: People who smell a peppermint scent or chew a piece of peppermint gum or candy experience a sudden burst of energy. Also helpful: The smell of strawberries or buttered popcorn. Both cause an increase in energy as well as metabolism.
Obesity: A number of studies have shown that particular odors can help people lose weight. Some scents stimulate the part of the hypothalamus that controls appetite. Odors also may act as a displacement mechanism--a reminder to eat less. Peppermint and green apple have been shown to be effective. One large study found that people who sniffed either one of these scents when they felt hungry lost an average of 30 pounds over a six-month period. It's also helpful to take frequent deep sniffs of food while eating. Odor molecules, regardless of the food they come from, can fool the brain into thinking that more has been consumed, which helps suppress the appetite.
Concentration and memory: Aromatherapy can be used to accelerate learning speed and promote better concentration and memory. Sniffing a floral essential oil triggers the release of norepinephrine and adrenocorticotropic hormone, hormones that increase attention. Floral scents have been shown to improve memory and learning speed by about 17%. In one study, people were exposed to different scents prior to bowling. Those who smelled jasmine knocked down 28% more pins, probably because it improved their concentration and hand/eye coordination.
Hepatitis C
Researchers estimate that in Australia 0.5 to 1% of the general population tests positive to hepatitis C virus. In the USA the incidence is estimated to be around 1.8% of the population, while in many parts of Asia infection rates are much higher than this. HCV was only identified in 1988. Previously it was known as non-A, non-B hepatitis. HCV is 10 times more infectious than HIV (the AIDS virus), and it may survive for long periods on needles and other equipment contaminated with blood. In the 1980's, AIDS was the major public health challenge for community based doctors. Now Hepatitis C has this dubious honor.
How can you catch the Hepatitis C virus?
Hepatitis C is transmitted mainly by blood. This occurs through the sharing of equipment to inject drugs, needle stick injuries in health care workers, and unsafe techniques of body piercing and tattooing. Cocaine snorting is recognized increasingly as a potential mode of transmission through the sharing of contaminated straws.
Only a tiny quantity of virus is necessary for the virus to become established in the case of hepatitis C, and transmission usually occurs when the skin becomes contaminated by injecting paraphernalia, such as spoons, mixing tools, tourniquets, cotton buds or by hands. Razor blades and toothbrushes can become contaminated with blood, so it is important not to share these things. Always wear gloves when wiping up blood spills, using paper towels and good quality bleach. While bleach is an effective surface antiseptic, there is no absolute evidence that it can kill the HCV. In about 10 to 15 percent of cases no definite risk factor is detected and the mode of transmission remains unclear.
The incidence of sexual transmission from a patient with chronic hepatitis C infection seems to be quite low, in comparison with hepatitis B and HIV (AIDS). However, those with an acute hepatitis C infection are possibly more likely to spread the virus sexually. It is important to practice safe sexual techniques to avoid blood to blood contact. The risk of sexual transmission is estimated to be around 4%
Transmission of the disease from mother to baby also occurs but much less frequently than with hepatitis B. This occurs in only around 6% of such cases. Infection of the baby through breast-feeding from an infected mother is very uncommon, however great care should be taken to avoid nipple trauma.
Nowadays the risk of catching hepatitis C from a blood transfusion is extremely low, because blood banks now screen all donated blood. As with hepatitis B it is possible to be a symptom-free carrier of the virus. Hepatitis B sufferers in the acute stage of infection and all hepatitis C patients should consider themselves infectious.
HCV is NOT spread by:
* sneezing
* hugging
* coughing
* food or water
* sharing eating utensils or drinking glasses
* casual contact
* shaking hands
The following precautions must be taken by Hepatitis C patients:
* Do not donate blood or organs
* Do not share needles, toothbrushes, razors or other intimate articles
* Blood spills should be wiped up with bleach and all cuts and wounds covered with adhesive dressings.
* Blood stained tissues, sanitary napkins and so on must be disposed of safely.
* "Safer sex" should be practised, with the use of condoms recommended, especially for anal intercourse. However, in the case of hepatitis C, the need for condom use in heterosexual intercourse with a stable partner is not entirely clear. The risk of oral sex is also not fully known, though oral-anal contact should be avoided. Intercourse during menstruation should also be avoided.
Initial effects of infection with Hepatitis C virus
People are generally completely unaware that they have contracted this virus because it does not produce any symptoms in the early or acute stages of the infection. During the first 3 to 6 months after infection, the virus replicates itself rapidly and the immune system tries to fight it by producing antibodies against it. Unfortunately in 80 to 85 percent of infected people, the virus is not eliminated and becomes a long-term inhabitant of the body. In other words, the infection becomes chronic. In a significant percentage of people with chronic infection, there are no signs or symptoms of disease and many are unaware that they are carrying an infection that can be transmitted to others through contact with their blood.
What are the symptoms?
The symptoms of acute hepatitis infection are similar for all three viruses, although generally less severe with hepatitis C. Initially the patient feels unwell with symptoms such as nausea, vomiting, diarrhea, loss of appetite, headaches, tiredness and a distaste for cigarettes. Fever and upper abdominal discomfort may occur. After one to two weeks the patient frequently becomes jaundiced (the skin and eyes turn yellow), and the symptoms then often improve. The urine may become dark and the bowel motions pale. Most Hepatitis C sufferers, however, do not develop this jaundice.
Long term effects of the Hepatitis C virus.
The long term liver damage caused by the Hepatitis C virus varies from person to person, and those with a strong immune system and a healthy diet and lifestyle will have a much better outcome.
In those who become infected with this virus we find the following approximate outcomes:
- 15 to 20 percent of people will completely eliminate the virus from their bodies within 3 to 6 months (much like we overcome the flu virus).
- 60 percent of people will develop a long-term (chronic) infection that may not cause any problems or may go on to varying degrees of liver damage.
- 20 to 25 percent of people will suffer serious liver damage, although this takes around 20 years to develop. In this group, 10 to 15 percent will remain stable and be able to survive with their disease, while 10 percent will go on to develop liver failure and/or liver cancer. The absolute risk of liver cancer from hepatitis C is not yet clear, but it only occurs if there is already established cirrhosis and generally takes about thirty years after the initial infection.
- Chronic infection may also cause severe loss of liver cells and extensive scarring of the liver which is called cirrhosis. The death rate from chronic hepatitis C infection is around 5 to 10% and is due to end stage liver failure or the development of liver cancer.
Excerpt from "The Liver Cleansing Diet" by Dr Cabot
"The LCD will help to repair liver damage in those who drink too much alcohol or those who have taken recreational drugs, especially intravenously. Those who test positive for Hepatitis B and/or Hepatitis C and are chronic carriers of these viruses will have less chance of developing chronic liver disease if they follow the Liver- Cleansing Diet.
http://www.liverdoctor.com/
Being Overweight Doesn't Mean You're Unhealthy!
Medical Author: Benjamin C. Wedro, MD, FAAEM
The results of a study published in the Archives of Internal Medicine should not come as a shock to most people. Being overweight doesn't necessarily make you unhealthy, according to researchers in both the United States and Germany. Sports fans have known this forever; elite athletes can have an appearance ranging from tiny Olympic gymnasts to massive NFL linemen. Athletes at both extremes- and all those in between- are in shape and trained to perform at high levels.
The new research confirmed this. People who are overweight have a fifty-fifty chance of having high cholesterol, high blood pressure, or elevated blood sugar levels. Pretty good odds, but not as good as those for people who are within the normal weight range. They have a 75% chance of having normal results on blood tests for cholesterol and blood sugar. And for those who are obese, the chance of having normal results falls to one-third.
The definition of "ideal body weight" has been a thorn in the side of many people. Perceptions of how people appear, how their clothes fit, and how fat they are have permitted whole industries to flourish. Weight loss clinics, gyms and fitness centers, liposuction, and gastric bypass surgeries all were based at least partly on the presumption that being overweight equaled being at risk for heart disease and diabetes. The studies in the Archives of Internal Medicine found that there may be more to health than meets the eye.
There aren't many risk factors for heart disease and stroke, the big killers in the United States. Smoking, high blood pressure, high cholesterol, diabetes, and family history are the factors that decide who will develop atherosclerosis (narrowing of the arteries). Aside from family history, the rest of these factors can be controlled and therefore, risk minimized.
The key to risk management is not what you look like, but what the numbers say; that may require a person to take preventive action. You can't look in the mirror and see high blood pressure or high cholesterol; you need to take positive action and visit a health care provider.
The study reminds us that looking after the body is no different than car maintenance. You can look at the exterior of a car or truck and decide whether you like the shape and style, but its external appearance gives you little information on how the engine is holding up. Routine maintenance with an oil, lube, and filter, checking the fluid level, and changing the belts will the let the car run almost forever. The same principles apply to the body. Routine maintenance allows the body to function well and hopefully run forever.
Deciding about what constitutes an ideal weight using a scale or measuring body mass index (BMI) can be deceiving. Professional basketball players tend to have elevated BMI scores, but they carry significant muscle and little fat on their frames. Football players tend to be big, but their physical activity and training decreases their heart and stroke risk factors.
The bottom line remains the same. What we look like on the outside doesn't really matter; it's what's inside that really counts.
http://www.medicinenet.com/script/main/art.asp?articlekey=91817
Gout
What is gout? What is hyperuricemia?
Gout is a condition that results from an overload of crystals of uric acid depositing in tissues of the body and features recurring attacks of joint inflammation (arthritis). Chronic gout can lead to deposits of hard lumps of uric acid in and around the joints, decreased kidney function, and kidney stones.
Gout has the unique distinction of being one of the most frequently recorded medical illnesses throughout history. It is often related to an inherited abnormality in the body's ability to process uric acid. Uric acid is a breakdown product of purines that are part of many foods we eat. An abnormality in handling uric acid can cause attacks of painful arthritis (gout attack), kidney stones, and blockage of the kidney-filtering tubules with uric-acid crystals, leading to kidney failure. On the other hand, some patients may only develop elevated blood uric-acid levels (hyperuricemia) without having arthritis or kidney problems. The term "gout" commonly is used to refer to the painful arthritis attacks.
Gouty arthritis is usually an extremely painful attack with a rapid onset of joint inflammation. The joint inflammation is precipitated by deposits of uric-acid crystals in the joint fluid (synovial fluid) and joint lining (synovial lining). Intense joint inflammation occurs as white blood cells engulf the uric-acid crystals and release chemicals of inflammation, causing pain, heat, and redness of the joint tissues.
Who is affected by gout?
Approximately 1 million people in the United States suffer from attacks of gout. (Did you know that none other than Benjamin Franklin had terrible gouty arthritis!) Gout is nine times more common in men than in women. It predominantly attacks males after puberty, with a peak age of 75. In women, gout attacks usually occur after menopause.
While an elevated blood level of uric acid (hyperuricemia) may indicate an increased risk of gout, the relationship between hyperuricemia and gout is unclear. Many patients with hyperuricemia do not develop gout, while some patients with repeated gout attacks have normal or low blood uric-acid levels. Among the male population in the United States, approximately 10% have hyperuricemia. However, only a small portion of those with hyperuricemia will actually develop gout.
What are symptoms of gout?
The small joint at the base of the big toe is the most common site of an acute gout attack of arthritis. Other joints that can be affected include the ankles, knees, wrists, fingers, and elbows. Acute gout attacks are characterized by a rapid onset of pain in the affected joint followed by warmth, swelling, reddish discoloration, and marked tenderness. Tenderness can be intense so that even a blanket touching the skin over the affected joint can be unbearable. Patients can develop fever with the acute gout attacks. These painful attacks usually subside in hours to days, with or without medication. In rare instances, an attack can last for weeks. Most patients with gout will experience repeated attacks of arthritis over the years.
Uric-acid crystals can deposit in tiny fluid-filled sacs (bursae) around the joints. These urate crystals can incite inflammation in the bursae leading to pain and swelling around the joints, a condition called bursitis. In rare instances, gout leads to a more chronic type of joint inflammation which mimics rheumatoid arthritis.
In chronic (tophaceous) gout, nodular masses of uric acid crystals (tophi) deposit in different soft tissue areas of the body. Even though they are most commonly found as hard nodules around the fingers, at the tips of the elbows, and around the big toe, tophi nodules can appear anywhere in the body. They have been reported in unexpected areas such as in the ears, vocal cords, or (rarely) around the spinal cord!
How is gouty arthritis diagnosed?
Gout is suspected when a patient reports a history of repeated attacks of painful arthritis at the base of the toes. Ankles and knees are the next most commonly involved joints in gout. Gout usually attacks one joint at a time, while other arthritis conditions, such as systemic lupus and rheumatoid arthritis, usually attack multiple joints simultaneously.
The most reliable test for gout is finding uric-acid crystals in the joint fluid obtained by joint aspiration (arthrocentesis). Arthrocentesis is a common office procedure performed under local anesthesia. Using sterile technique, fluid is withdrawn (aspirated) from the inflamed joint, using a syringe and needle. The joint fluid is then analyzed for uric-acid crystals and for infection. Shiny, needle-like uric-acid crystals are best viewed with a polarizing microscope. The diagnosis of gout can also be made by finding these urate crystals from material aspirated from tophi nodules and bursitis fluid.
Some patients with a classic history and symptoms of gout can be successfully treated and presumed to have gout without undergoing arthrocentesis. However, establishing a firm diagnosis is still preferable since other conditions can mimic gout. These include another crystal-induced arthritis called pseudogout, psoriatic arthritis, rheumatoid arthritis, and even infection.
X-rays can sometimes be helpful, and may show tophi-crystal deposits and bone damage as a result of repeated inflammations. X-rays can also be helpful for monitoring the effects of chronic gout on the joints.
Cholesterol
Cholesterol is a fatty substance (a lipid) that is an important part of the outer lining (membrane) of cells in the body of animals. Cholesterol is also found in the blood circulation of humans. The cholesterol in a person's blood originates from two major sources; dietary intake and liver production. Dietary cholesterol comes mainly from meat, poultry, fish, and dairy products. Organ meats, such as liver, are especially high in cholesterol content, while foods of plant origin contain no cholesterol. After a meal, cholesterol is absorbed by the intestines into the blood circulation and is then packaged inside a protein coat. This cholesterol-protein coat complex is called a chylomicron.
The liver is capable of removing cholesterol from the blood circulation as well as manufacturing cholesterol and secreting cholesterol into the blood circulation. After a meal, the liver removes chylomicrons from the blood circulation. In between meals, the liver manufactures and secretes cholesterol back into the blood circulation.
What are LDL and HDL cholesterol?
LDL cholesterol is called "bad" cholesterol, because elevated levels of LDL cholesterol are associated with an increased risk of coronary heart disease. LDL lipoprotein deposits cholesterol on the artery walls, causing the formation of a hard, thick substance called cholesterol plaque. Over time, cholesterol plaque causes thickening of the artery walls and narrowing of the arteries, a process called atherosclerosis.
HDL cholesterol is called the "good cholesterol" because HDL cholesterol particles prevent atherosclerosis by extracting cholesterol from the artery walls and disposing of them through the liver. Thus, high levels of LDL cholesterol and low levels of HDL cholesterol (high LDL/HDL ratios) are risk factors for atherosclerosis, while low levels of LDL cholesterol and high level of HDL cholesterol (low LDL/HDL ratios) are desirable.
Total cholesterol is the sum of LDL (low density) cholesterol, HDL (high density) cholesterol, VLDL (very low density) cholesterol, and IDL (intermediate density) cholesterol.
Does lowering LDL cholesterol prevent heart attacks and strokes?
Lowering LDL cholesterol is currently the primary focus in preventing atherosclerosis and heart attacks. Most doctors now believe that the benefits of lowering LDL cholesterol include:
* Reducing or stopping the formation of new cholesterol plaques on the artery walls;<
* Reducing existing cholesterol plaques on the artery walls;
* Widening narrowed arteries;
* Preventing the rupture of cholesterol plaques, which initiates blood clot formation;
* Decreasing the risk of heart attacks; and
* Decreasing the risk of strokes. The same measures that retard atherosclerosis in coronary arteries also benefit the carotid and cerebral arteries (arteries that deliver blood to the brain).
The 2004 NCEP treatment goals according to risk categories
| Risk category | LDL goal | More intense LDL goal option | Initiate TLC if LDL is: | Consider drugs + TLC if LDL is: |
| High risk | <> | | > 100 mg/dl | >100 mg/dl |
| Very high risk | <> | <> | > 100 mg/dl | <100> |
| Moderately high risk (10 yr. risk 10-20%) | <130> | <100> | > 130 mg/dl | >130mg/dl, consider drug option if LDL is 100-129 mg/dl |
| Moderate risk (10 yr. risk <10%) | <130> | | > 130 mg/dl | >160 mg/dl |
| Lower risk | <160> | | > 160 mg/dl | >190 mg/dl, consider drug optional if LDL is 160-189 mg/dl |
- High risk patients are those who already have coronary heart disease (such as a prior heart attack), diabetes mellitus, abdominal aortic aneurysm, or those who already have atherosclerosis of the arteries to the brain and extremities (such as patients with strokes, TIA's (mini-strokes), and peripheral vascular diseases). High risk patients also include those with 2 or more risk factors (e.g., smoking, hypertension, or a family history of early heart attacks) that places them at a greater than 20 percent chance of having a heart attack within 10 years. (A person's chance of having a heart attack can be calculated by using the Framingham Heart Study Score Sheets, at http://nhlbi.nih.gov/about/framingham/riskabs.htm).
- Very high -risk patients are those who have coronary heart disease in addition to having either multiple risk factors (especially diabetes), or severe and poorly controlled risk factors (such as continued smoking), or metabolic syndrome (a constellation of risk factors associated with obesity, including high triglycerides and low HDL). Patients hospitalized for acute coronary syndromes are also at very high risk.
- Moderately high risk patients are those who have neither coronary heart disease nor diabetes mellitus, but have multiple (2 or more) risk factors for coronary heart disease that put them at a 10 to 20 percent risk of heart attack within 10 years. (Use the Framingham Heart Study Score Sheets, at http://nhlbi.nih.gov/about/framingham/riskabs,htm to calculate the 10 year risk.)
- Moderate risk patients are those who have neither CHD nor diabetes mellitus, but have 2 or more risk factors for coronary heart disease that put them at a <10%>
- Lower risk patients are those with 0 to 1 risk factor for coronary heart disease.
Why is HDL the good cholesterol?
HDL is the good cholesterol because it protects the arteries from the atherosclerosis process. HDL cholesterol extracts cholesterol particles from the artery walls and transports them to the liver to be disposed through the bile. It also interferes with the accumulation of LDL cholesterol particles in the artery walls.
The risk of atherosclerosis and heart attacks in both men and is strongly related to HDL cholesterol levels. Low levels of HDL cholesterol are linked to a higher risk, whereas high HDL cholesterol levels are associated with a lower risk.
Very low and very high HDL cholesterol levels can run in families. Families with low HDL cholesterol levels have a higher incidence of heart attacks than the general population, while families with high HDL cholesterol levels tend to live longer with a lower frequency of heart attacks.
Like LDL cholesterol, life style factors and other conditions influence HDL cholesterol levels. HDL cholesterol levels are lower in persons who smoke cigarettes, eat a lot of sweets, are overweight and inactive, and in patients with type II diabetes mellitus.
HDL cholesterol is higher in people who are lean, exercise regularly, and do not smoke cigarettes. Estrogen increases a person's HDL cholesterol, which explains why women generally have higher HDL levels than men do.
For individuals with low HDL cholesterol levels, a high total or LDL cholesterol blood level further increases the incidence of atherosclerosis and heart attacks. Therefore, the combination of high levels of total and LDL cholesterol with low levels of HDL cholesterol is undesirable whereas the combination of low levels of total and LDL cholesterol and high levels of HDL cholesterol is favorable.
What are LDL/HDL and total/HDL ratios?
The total cholesterol to HDL cholesterol ratio (total chol/HDL) is a number that is helpful in estimating the risk of developing atherosclerosis. The number is obtained by dividing total cholesterol by HDL cholesterol. (High ratios indicate a higher risk of heart attacks, whereas low ratios indicate a lower risk).
High total cholesterol and low HDL cholesterol increases the ratio and is undesirable. Conversely, high HDL cholesterol and low total cholesterol lowers the ratio and is desirable. An average ratio would be about 4.5. Ideally, one should strive for ratios of 2 or 3 (less than 4).
What are the treatment guidelines for low HDL cholesterol?
In clinical trials involving lowering LDL cholesterol, scientists also studied the effect of HDL cholesterol on atherosclerosis and heart attack rates. They found that even small increases in HDL cholesterol could reduce the frequency of heart attacks. For each 1 mg/dl increase in HDL cholesterol, there is a 2 to 4% reduction in the risk of coronary heart disease. Although there are no formal NCEP (please see discussion above) target treatment levels of HDL cholesterol, an HDL level of <40>How can levels of HDL cholesterol be raised?
The first step in increasing HDL cholesterol levels (and decreasing LDL/HDL ratios) is therapeutic life style changes. When these modifications are insufficient, medications are used. In prescribing medications or medication combinations, doctors have to take into account medication side effects as well as the presence or absence of other abnormalities in cholesterol profiles.
Regular aerobic exercise, loss of excess weight (fat), and cessation of smoking cigarettes will increase HDL cholesterol levels. Regular alcohol consumption (such as one drink a day) will also raise HDL cholesterol. Because of other adverse health consequences of excessive alcohol consumption, alcohol is not recommended as a standard treatment for low HDL cholesterol.
Medications that are effective in increasing HDL cholesterol include nicotinic acid (niacin), gemfibrozil (Lopid), estrogen, and to a much lesser extent, the statin drugs (discussed below). A newer medicine, fenofibrate (Tricor) has shown much promise in selectively increasing HDL levels and reducing serum triglycerides.
What are triglycerides, chylomicrons, and VLDL?
Triglyceride is a fatty substance that is composed of three fatty acids. Like cholesterol, triglyceride in the blood either comes from the diet or the liver. Also, like cholesterol, triglyceride cannot dissolve and circulate in the blood without combining with a lipoprotein. Thus, after a meal, the triglyceride and cholesterol that are absorbed into the intestines are packaged into round particles called chylomicrons before they are released into the blood circulation.
A chylomicron is a collection of cholesterol and triglyceride that is surrounded by a lipoprotein outer coat. (Chylomicrons contain 90% triglyceride and 10% cholesterol.)
The liver removes triglyceride and chylomicrons from the blood, and it synthesizes and packages triglyceride into VLDL (very low-density lipoprotein) particles and releases them back into the blood circulation.
Low Blood Pressure (Hypotension)
What is low blood pressure?
Blood pressure is the force exerted by circulating blood on the walls of blood vessels, and constitutes one of the principal vital signs of life, which also include heart beat, rate of breathing, and temperature. Blood pressure is generated by the heart pumping blood into the arteries and is regulated by the response by the arteries to the flow of blood.
An individual's blood pressure is expressed as systolic/diastolic blood pressure, for example, 120/80.The systolic blood pressure (the top number) represents the pressure in the arteries as the muscle of the heart contracts and pumps blood into them. The diastolic blood pressure (the bottom number) represents the pressure in the arteries as the muscle of the heart relaxes after it contracts. Blood pressure always is higher when the heart is pumping (squeezing) than when it is relaxing.
Systolic blood pressure for most healthy adults falls between 90 and 120 millimeters of mercury (mm Hg). Normal diastolic blood pressure falls between 60 and 80 mm Hg. Current guidelines define normal blood pressure as lower than 120/80. Blood pressures over 130/80 are considered high. High blood pressure increases the risk of developing:
- heart disease,
- kidney disease,
- hardening of the arteries (atherosclerosis or arteriosclerosis),
- eye damage, and
- stroke.
Low blood pressure (hypotension) is pressure so low it causes symptoms or signs due to the low flow of blood through the arteries and veins. When the flow of blood is too low to deliver enough oxygen and nutrients to vital organs such as the brain, heart, and kidney, the organs do not function normally and may be permanently damaged.
Unlike high blood pressure, low blood pressure is defined primarily by signs and symptoms of low blood flow and not by a specific blood pressure number. Some individuals may have a blood pressure of 90/50 with no symptoms of low blood pressure and therefore do not have low blood pressure. However, others who normally have high blood pressure may develop symptoms of low blood pressure if their blood pressure drops to 100/60.
Is low blood pressure bad for your health?
People who have lower blood pressures have a lower risk of stroke, kidney disease, and heart disease. Athletes, people who exercise regularly, people who maintain ideal body weight, and non-smokers tend to have lower blood pressures. Therefore, low blood pressure is desirable as long as it is not low enough to cause symptoms and damage organs in the body.
What are low blood pressure signs and symptoms?
The cardinal symptom of hypotension is lightheadedness or dizziness. If the blood pressure is sufficiently low, syncope (fainting) and often seizures will occur.
Hypotension, depending on one's own body chemistry and genetics, may often cause mild depression, mostly in regard to taking other medications which do not fit one's personal unique needs.
Low blood pressure is often accompanied by: (Most of these are related to causes rather than effects of hypotension.)
- Chest pain
- Shortness of breath
- Irregular heartbeat
- Fever higher than 101 °F (38.3 °C)
- Headache
- Stiff neck
- Severe upper back pain
- Cough with phlegm
- Prolonged diarrhea or vomiting
- Inability to eat or drink
- Burning with urination
- Foul-smelling urine
- Adverse effect of medications
- Acute, life-threatening allergic reaction
- Dizziness, or light-headedness, particularly when suddenly standing up from sitting down
- Seizures
- Loss of consciousness
- Profound fatigue
What are the causes of low blood pressure?
Conditions that reduce the volume of blood, reduce cardiac output (the amount of blood pumped by the heart), and medications are frequent causes of low blood pressure.
- Dehydration is common among patients with prolonged nausea, vomiting, and diarrhea. Large amounts of water are lost when vomiting and with diarrhea, especially if the patient does not drink adequate amounts of fluid to replace the depleted water.
- Moderate or severe bleeding can quickly deplete an individual's body of blood, leading to low blood pressure or orthostatic hypotension. Bleeding can result from trauma, surgical complications, or from gastrointestinal abnormalities such as ulcers, tumors, or diverticulosis. Occasionally, the bleeding may be so severe and rapid (for example, bleeding from a ruptured aortic aneurysm) that it causes shock and death rapidly.
- Severe inflammation of organs inside the body such as acute pancreatitis can cause low blood pressure. In acute pancreatitis, fluid leaves the blood vessels to enter the inflamed tissues around the pancreas as well as the abdominal cavity, depleting the volume of blood.
Causes of low blood pressure due to heart disease
- Weakened heart muscle can cause the heart to fail and reduce the amount of blood it pumps. One common cause of weakened heart muscle is the death of a large portion of the heart's muscle due to a single, large heart attack or repeated smaller heart attacks. Other examples of conditions that can weaken the heart include medications that are toxic to the heart, infections of the muscle of the heart by viruses (myocarditis), and diseases of the heart's valves such as aortic stenosis.
- Pericarditis is an inflammation of the pericardium (the sac surrounding the heart). Pericarditis can cause fluid to accumulate within the pericardium and compress the heart, restricting the ability of the heart to fill and pump blood.
- Pulmonary embolism is a condition in which a blood clot in a vein (deep vein thrombosis) breaks off and travels to the heart and eventually the lung. A large blood clot can block the flow of blood into the left ventricle from the lungs and severely diminish the blood returning to the heart for pumping. Pulmonary embolism is a life-threatening emergency.
- A slow heart rate (bradycardia) can decrease the amount of blood pumped by the heart. The resting heart rate for a healthy adult is between 60 and 100 beats/minute. Bradycardia (resting heart rates slower than 60 beats/minute) does not always cause low blood pressure. In fact, some highly trained athletes can have resting heart rates in the 40s and 50s (beats per minute) without any symptoms. (The slow heart rates are offset by more forceful contractions of the heart that pump more blood than in non-athletes.) But in many patients bradycardia can lead to low blood pressure, lightheadedness, dizziness, and even fainting.
Several common reasons for bradycardia include: 1) sick sinus syndrome, 2) heart block, and 3) drug toxicity. Many of these conditions occur in the elderly.
- Sick sinus syndrome: Sick sinus syndrome occurs when the diseased electrical system of the heart cannot generate signals fast enough to maintain a normal heart rate.
- Heart block: Heart block occurs when the specialized tissues that transmit electrical current in the heart are damaged by heart attacks, degeneration from atherosclerosis, and medications. Heart block prevents some or all of the electrical signals from reaching the rest of the heart, and this prevents the heart from contracting as rapidly as it otherwise would.
- Drug toxicity: Drugs such as digoxin (Lanoxin) or beta blockers for high blood pressure, can slow the transmission of electricity in the heart chemically and can cause bradycardia and hypotension (see section below "Medications that cause low blood pressure").
- An abnormally fast heart rate (tachycardia) also can cause low blood pressure. The most common example of tachycardia causing low blood pressure is atrial fibrillation. Atrial fibrillation is a disorder of the heart characterized by rapid and irregular electrical discharges from the muscle of the heart causing the ventricles to contract irregularly and (usually) rapidly. The rapidly contracting ventricles do not have enough time to fill maximally with blood before the each contraction, and the amount of blood that is pumped decreases in spite of the faster heart rate. Other abnormally rapid heart rhythms such as ventricular tachycardia also can produce low blood pressure, sometimes even life-threatening shock.
Medications that cause low blood pressure
- Medications such as calcium channel blockers, beta blockers, and digoxin (Lanoxin) can slow the rate at which the heart contracts. Some elderly people are extremely sensitive to these medications since they are more likely to have diseased hearts and electrical conduction tissues. In some individuals, the heart rate can become dangerously slow even with small doses of these medications.
- Medications used in treating high blood pressure (such as ACE inhibitors, angiotensin receptor blockers, beta blockers, calcium channel blockers, and alpha-blockers) can excessively lower blood pressure and result in symptomatic low blood pressure especially among the elderly.
- Water pills (diuretics) such as furosemide (Lasix) can decrease blood volume by causing excessive urination.
- Medications used for treating depression, such as amitriptyline (Elavil), Parkinson's disease, such as levodopa-carbidopa (Sinemet), erectile dysfunction (impotence), such as sildenafil (Viagra), vardenafil (Levitra), and tadalafil (Cialis) when used in combination with nitroglycerine, can cause low blood pressure.
- Alcohol and narcotics also can cause low blood pressure.
Other conditions that cause low blood pressure
- Vasovagal reaction is a common condition in which a healthy person temporarily develops low blood pressure, slow heart rate, and sometimes fainting. A vasovagal reaction typically is brought on by emotions of fear or pain such as having blood drawn, starting an intravenous infusion, or by gastrointestinal upset. Vasovagal reactions are caused by activity of involuntary (autonomic) nervous system, especially the vagus nerve, which releases hormones that slow the heart and widen the blood vessels. The vagus nerve controls the heart rate (slows it down). The vagus nerve also controls digestive tract function and senses activity in the digestive system. Thus, some people can have a vasovagal reaction from straining at a bowel movement or vomiting.
- Postural (orthostatic) hypotension is a sudden drop in blood pressure when an individual stands up from a sitting, squatting, or supine (lying) position. When a person stands up, gravity causes blood to settle in the veins in the legs, so less blood reaches the heart for pumping, and as a result the blood pressure drops. The body normally responds automatically to the drop in blood pressure by increasing the rate at which the heart beats and by narrowing the veins to return more blood to the heart. In patients with postural hypotension, this compensating reflex fails to occur, resulting in symptomatic low blood pressure. Postural hypotension can occur in persons of all ages but is much more common among the elderly, especially in those on medications for high blood pressure and/or diuretics. Other causes of postural hypotension include dehydration, adrenal insufficiency (discussed later), prolonged bed rest, diabetes that has caused damage to the autonomic nerves, alcoholism with damage to the autonomic nerves, and certain rare neurological syndromes (for example, Shy-Drager syndrome) that damage the autonomic nerves.
- Another form of postural hypotension occurs typically in young healthy individuals. After prolonged standing, the individual's heart rate and blood pressure drops, causing dizziness, nausea, and often fainting. In these individuals, the autonomic nervous system wrongly responds to prolonged standing by directing the heart to slow down and the veins to dilate.
- Micturition syncope is a temporary drop in blood pressure and loss of consciousness brought about by urinating. This condition typically occurs in elderly patients and may be due to the release by the autonomic nerves of hormones that lower blood pressure.
- Adrenal insufficiency, for example, due to Addison's disease, can cause low blood pressure. Addison's disease is a disorder in which the adrenal glands (small glands next to the kidneys) are destroyed. The destroyed adrenal glands can no longer produce sufficient adrenal hormones (specifically cortisol) necessary to maintain normal bodily functions. Cortisol has many functions, one of which is to maintain blood pressure and the function of the heart. Addison's disease is characterized by weight loss, muscle weakness, fatigue, low blood pressure, and, sometimes, darkening of the skin.
- Septicemia is a severe infection in which bacteria (or other infectious organisms such as fungi) enter the blood. The infection typically originates in the lungs (as pneumonia), bladder, or in the abdomen due to diverticulitis or gallstones. The bacteria then enter the blood where they release toxins and cause life-threatening and profound low blood pressure (septic shock), often with damage to several organs.
- Anaphylaxis (anaphylactic shock) is a potentially fatal allergic reaction to medications such as penicillin, intravenous iodine used in some x-ray studies, foods such as peanuts, or bee stings (insect stings). In addition to a severe drop in blood pressure, individuals may also experience hives, wheezing, and a swollen throat with difficulty breathing. The shock is caused by enlargement of blood-containing blood vessels and escape of water from the blood into the tissues.
How is low blood pressure treated?
Low blood pressure in healthy subjects without symptoms or organ damage needs no treatment. However, all patients with symptoms possibly due to low blood pressure should be evaluated by a doctor. (Patients who have had a major drop in blood pressure from their usual levels even without the development of symptoms also should be evaluated.) The doctor needs to identify the cause of the low blood pressure because treatment will depend on the cause. For example, if a medication is causing the low blood pressure, the dose of medication may have to be reduced or the medication stopped, though only after consulting the doctor. Self-adjustment of medication should not be done.
- Dehydration is treated with fluids and minerals (electrolytes). Mild dehydration without nausea and vomiting can be treated with oral fluids and electrolytes. Moderate to severe dehydration usually is treated in the hospital or emergency room with intravenous fluids and electrolytes.
- Blood loss can be treated with intravenous fluids and blood transfusions. Continuous and severe bleeding needs to be treated immediately.
- Septic shock is an emergency and is treated with intravenous fluids and antibiotics.
- Blood pressure medications or diuretics are adjusted, changed, or stopped by the doctor if they are causing low blood pressure symptoms.
- Bradycardia may be due to a medication. The doctor may reduce, change or stop the medication. Bradycardia due to sick sinus syndrome or heart block is treated with an implantable pacemaker.
- Tachycardia is treated depending on the nature of the tachycardia. Atrial fibrillation can be treated with oral medications, electrical cardioversion, or a catheterization procedure called pulmonary vein isolation. Ventricular tachycardia can be controlled with medications or with an implantable defibrillator.
- Pulmonary embolism and deep vein thrombosis is treated with blood thinners, intravenous initially with heparin, and oral warfarin (Coumadin) later.
- Pericardial fluid can be removed by a procedure called pericardiocentesis.
- Postural hypotension can be treated by increasing water and salt intake*, increasing intake of caffeinated beverages because caffeine constricts blood vessels, using compression stockings to compress the leg veins and reduce the pooling of blood in the leg veins, and in some patients, the use of a medication called midodrine (ProAmatine). The problem with ProAmatine is that while it increases blood pressure in the upright position, the supine blood pressure may become too high, thus increasing the risk of strokes. Mayo Clinic researchers found that a medication used to treat muscle weakness in Myasthenia gravis called pyridostigmine (Mestinon) increases upright blood pressure but not supine blood pressure. Mestinon, an anticholinesterase medication, works on the autonomic nervous system, especially when a person is standing up. Side effects include minor abdominal cramping or increased frequency of bowel movements. *Note: Increasing salt intake can lead to heart failure in patients with existing heart disease and should not be undertaken without consulting a doctor.
- Postprandial hypotension refers to low blood pressure occurring after meals. Ibuprofen (Motrin) or indomethacin (Indocin) may be beneficial.
- Vasovagal Syncope can be treated with several types of drugs such as beta blockers [for example, propanolol (Inderal, Inderal LA)], selective serotonin reuptake inhibitors [fluoxetine (Prozac), escitalopram oxalate (Lexapro), paroxetine (Paxil), sertraline (Zoloft), citalopram (Celexa), fluvoxamine (Luvox)], fludrocortisone (Florinef) (a drug that prevents dehydration by causing the kidney(s) to retaining water). A pacemaker can also be helpful when a patient fails drug therapy.
- Low Blood Pressure At A Glance
- Low blood pressure, also called hypotension, is blood pressure that is low enough that the flow of blood to the organs of the body is inadequate and symptoms and/or signs of low blood flow develop.
- Low pressure alone, without symptoms or signs, usually is not unhealthy.
- The symptoms of low blood pressure include lightheadedness, dizziness, and fainting. These symptoms are most prominent when individuals go from the lying or sitting position to the standing position (orthostatic hypotension).
- Low blood pressure that causes an inadequate flow of blood to the body's organs can cause strokes, heart attacks, and kidney failure. It's most severe form is shock.
- Common causes of low blood pressure include a reduced volume of blood, heart disease, and medications.
- The cause of low blood pressure can be determined with blood tests, radiologic studies, and cardiac testing to look for arrhythmias.
- Treatment of low blood pressure is determined by the cause of the low pressure
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Vitamin B12 (Cobalamin)
Vitamin B12, also known as cobalamin, works with folic acid to produce healthy red blood cells. Vitamin B12 also keeps your central nervous system healthy. The only natural sources of Vitamin B12 are animal products.
Nutritionists categorize vitamins by the materials that a vitamin will dissolve in. There are two categories: water-soluble and fat-soluble vitamins. Water-soluble vitamins, which include the B-complex group and vitamin C, travel through the bloodstream. Whatever water-soluble vitamins are not used by the body are eliminated in urine, which means you need a continuous supply of them in your food. Vitamin B12 is a water-soluble vitamin.
How Much B12 Is Enough?
Both adult men and women need 2.0 micrograms of vitamin B12 each day.
Sources of Vitamin B12
* Meat
* Milk products
* Eggs
* Cheese
* Chicken
* Fish
Can You Have Too Much or Too Little?
B12 deficiency can cause a type of anemia marked by fewer but larger red blood cells that's called pernicious anemia. It can also cause walking and balance problems, sore tongue, weakness, confusion and, in advanced cases, dementia. Vegetarians who eliminate all animal sources from their diet (also known as vegans) may benefit from taking a vitamin B12 supplement. If you are pregnant or breastfeeding, do not take vitamin B12 in doses greater than the RDA for pregnant (2.6 micrograms/day) or breastfeeding women (2.8 micrograms/day). Some people who have problems with absorption or have had bowel surgery may need injections of Vitamins B12 to prevent deficiency because their bodies can't absorb oral supplements properly. People over age 50 may also need B12 supplements because the aging process diminishes the body’s ability to absorb vitamin B12 from natural food sources.
Vitamin Storage
If you want to get the most vitamins possible from your food, refrigerate fresh produce, and keep milk and grains away from strong light. Vitamins are easily destroyed and washed out during food preparation and storage. If you take vitamin supplements, store them at room temperature in a dry place that's free of moisture.
http://www.lifeclinic.com/focus/nutrition/vitamin-b12.asp
http://adam.about.com/encyclopedia/nutrition/Vitamin-B12.htm
Vitamin C Benefit
Definition
Vitamin C is a water-soluble vitamin that is necessary for normal growth and development.
Water-soluble vitamins dissolve in water. The body cannot store them. Leftover amounts of the vitamin leave the body through the urine. That means you need a continuous supply of such vitamins in your diet.
Alternative Names
Ascorbic acid
Function
Vitamin C is required for the growth and repair of tissues in all parts of your body. It is necessary to form collagen, an important protein used to make skin, scar tissue, tendons, ligaments, and blood vessels. Vitamin C is essential for the healing of wounds, and for the repair and maintenance of cartilage, bones, and teeth.
Vitamin C is one of many antioxidants. Vitamin E and beta-carotene are two other well-known antioxidants. Antioxidants are nutrients that block some of the damage caused by free radicals, which are by-products that result when our bodies transform food into energy.
The build up of these by-products over time is largely responsible for the aging process and can contribute to the development of various health conditions such as cancer, heart disease, and a host of inflammatory conditions like arthritis. Antioxidants also help reduce the damage to the body caused by toxic chemicals and pollutants such as cigarette smoke.
The body does not manufacture vitamin C on its own, nor does it store it. It is therefore important to include plenty of vitamin C-containing foods in your daily diet.
Food Sources
All fruits and vegetables contain some amount of vitamin C. Foods that tend to be the highest sources of vitamin C include green peppers, citrus fruits and juices, strawberries, tomatoes, broccoli, turnip greens and other leafy greens, sweet and white potatoes, and cantaloupe.
Other excellent sources include papaya, mango, watermelon, brussels sprouts, cauliflower, cabbage, winter squash, red peppers, raspberries, blueberries, cranberries, and pineapples.
Side Effects
Vitamin C toxicity is very rare, because the body cannot store the vitamin. However, amounts greater than 2,000 mg/day are not recommended because such high doses can lead to stomach upset and diarrhea.
Too little vitamin C can lead to signs and symptoms of deficiency, including:
* Dry and splitting hair
* Gingivitis (inflammation of the gums)
* Bleeding gums
* Rough, dry, scaly skin
* Decreased wound-healing rate
* Easy bruising
* Nosebleeds
* Weakened tooth enamel
* Swollen and painful joints
* Anemia
* Decreased ability to fight infection
* Possible weight gain because of slowed metabolism
A severe form of vitamin C deficiency is known as scurvy, which mainly affects older, malnourished adults.
Recommendations
The best way to get the daily requirement of essential vitamins, including vitamin C, is to eat a balanced diet that contains a variety of foods from the food guide pyramid.
Vitamin C should be consumed every day because it is not fat-soluble and, therefore, cannot be stored for later use.
The Food and Nutrition Board at the Institute of Medicine recommends the following amounts of vitamin C:
Infants and Children
* 0 - 6 months: 40 milligrams/day (mg/day)
* 7 - 12 months: 50 mg/day
* 1 - 3 years: 15 mg/day
* 4 - 8 years: 25 mg/day
* 9 - 13 years: 45 mg/day
Adolescents
* Girls 14 - 18 years: 65 mg/day
* Boys 14 - 18 years: 75 mg/day
Adults
* Men age 19 and older: 90 mg/day
* Women age 19 year and older: 75 mg/day
Women who are pregnant or breastfeeding and those who smoke need higher amounts. Ask your doctor what is best for you.
http://adam.about.com/encyclopedia/nutrition/Vitamin-C.htm
Vitamin A Benefit
Vitamin A, also called retinol, helps your eyes adjust to light changes when you come in from outside and also helps keep your eyes, skin and mucous membranes moist. Vitamin A mostly comes from animal foods, but some plant-based foods supply beta-carotene, which your body then converts into Vitamin A. It also has antioxidant properties that neutralize free radicals in the body that cause tissue and cellular damage.
Early information from scientific studies suggests that beta-carotene might help people who already have Coronary Artery Disease (CAD). The American Heart Association doesn't recommend taking supplements of beta-carotene until more is known, however.
Nutritionists categorize vitamins by the materials that a vitamin will dissolve in. There are two categories: water-soluble and fat-soluble vitamins. Fat-soluble vitamins—vitamins A, D, E and K—are stored in the fat tissues of the body for a few days to up to six months. If you get too much of a fat-soluble vitamin, it can be stored in your liver and may sometimes cause health problems. Vitamin A is a fat-soluble vitamin.
Some people take mega-doses of fat-soluble vitamins, which can lead to toxicity. Eating a normal diet of foods rich in these vitamins won't cause a problem. Remember, you only need small amounts of any vitamin. In the case of vitamin A, overconsumption has been linked with an increased risk of fractures in postmenopausal women.
Some health problems can make it hard for a person's body to absorb these vitamins. If you have a chronic health condition, ask your doctor about whether your vitamin absorption will be affected.
How Much Vitamin A Is Enough?
It's recommended that women consume 800 mcg and men consume 1000 mcg of vitamin A daily.
Sources of Vitamin A
Top sources of vitamin A include:
* Beef liver
* Egg yolk
* Cheddar cheese
* Fortified milk
Top sources of beta-carotene include:
* Sweet potato
* Carrots
* Pumpkin
* Cantaloupe
* Broccoli
* Apricots
* Spinach and collard greens
Can You Have Too Much or Too Little?
Vitamin A deficiency is rare in the United States, but it can cause night blindness, eye inflammation, diarrhea and other problems. Overconsumption of vitamin A can cause nausea, irritability and blurred vision in its mild form. In addition, the palms of the hands and the bottoms of the feet can turn orange if a person has a high intake of Vitamin A. Vitamin A toxicity can cause growth retardation, hair loss and enlarged spleen and liver in its more severe form. Vitamin A overdose can also cause birth defects and has been linked to increased risk of bone fractures in some people.
Vitamin Storage
If you want to get the most vitamins possible from your food, refrigerate fresh produce, and keep milk and grains away from strong light. Vitamins are easily destroyed and washed out during food preparation and storage. If you take vitamin supplements, store them at room temperature in a dry place that's free of moisture.
http://www.lifeclinic.com/focus/nutrition/vitamin-a.asp
http://adam.about.com/reports/Vitamin-A-benefit.htm
Fruit and Weight Loss
Studies have shown that weight loss is quicker if fruit or vegetables make up a third of the food consumed each day. This is because fruit helps fill the stomach faster but is low in calories and fat. It is also thought that eating plenty of fibre and eating a wide variety of food will help us burn more energy.
To live a healthy and energetic life our bodies must be fit for the job. This requires a balanced diet that incorporates plenty of fresh fruit.
Five-a-Day
For fruit to have a positive impact on your weight loss you need to eat around five portions of it each day. This can be dried squeezed, bottled or fresh. Try sprinkling dried fruit over your breakfast cereal, eating an apple, banana or pear as a mid-morning snack, or feasting on a punnet of grapes or strawberries instead of heading for the chocolate.
Not only are fruits loaded with minerals, vitamins and antioxidants to keep the body healthy, but they also contain no fat, and very few calories. This means that you can fill your stomach with fruit, and help your body repair itself with all those nutrients, minerals and antioxidants. Because there is no fat involved, your body will start to lose weight naturally.
Water Weight
Fruit also contains no sodium, which is thought to increase what’s known as ‘water weight’. Sodium in the body is mainly found in the fluids around the body's cells, including the lymph fluid and blood. When sodium intake is greater than what the body can deal with, it accumulates in the intestinal region. The kidneys then work harder to flush this excess sodium out of the body, and the body stores the extra fluids in the blood and around the cells. This leads to increased blood pressure and excess weight gain from water.
Western Diets
The average diet in the west is made up of convenient, packaged or fast food. These always consist of high levels of salt, or sodium, as well as fat, calories and artificial chemical preservatives. It is estimated that many people in the UK and USA may carry up to 2.5kg of extra weight due to the effects of a high sodium diet.
Energy
Our bodies need energy to function properly. Traditionally, this energy was absorbed from dietary fibre consumed, but in recent years, this has shifted, and now over 50% of the energy absorbed in the average western diet is taken from sugar, dairy products, alcohol and vegetable oils. None of these foods contains any dietary fibre. This can result in poor bowel movements, but also sluggish behaviour, a lack of concentration and motivation, and an increased risk in developing heart disease and cancer.
Fruit contains plenty of dietary fibre to wake you up and provide you with plenty of energy. This has the double benefit of giving you more energy with which to exercise and burn excess calories, which will help you loose weight even faster.
Fruit is a fantastic source of all things good for you. Vitamins, minerals, dietary fibre and antioxidants are all important in our diets and should be consumed regularly. Eating plenty of fruit can help achieve the ideal weight, and make you feel more alert and energetic too. So what’s stopping you!
