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Smoking, Diet
and Exercise |
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A. Smoking |
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It is clear, and has been clear for years,
that smoking is destructive to the human body. It significantly
increases the risks of many cancers and clearly accelerates
the aging process and the development of coronary artery
disease as well as pulmonary disease. Clearly, if you
smoke, stop and if you don’t smoke, don’t start.
Smoking cessation programs are available through many
health agencies and easily accessible today. |
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B. |
Diet |
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Clearly a diet that is rich in fruits,
vegetables, whole grains, nuts, and oily fish such as
salmon, can significantly reduce the rate of development
of atherosclerosis (hardening of the arteries) as well
as high blood pressure. Soy based products contain isoflavones
felt to be beneficial to the heart. The elimination of
saturated fat found in the fatty red meats, full fat
dairy products, and some of the tropical oils should
be reduced and replaced with monounsaturated oils such
as olive oil and polyunsaturated omega 3 oils found in
oily fish and canola oil. Some of the worst fats are
called "trans fats" which are hydrogenated vegetable
oils that can increase the "bad" cholesterol or the low
density lipoprotein cholesterol (LDL-C) and lower the "good" cholesterol
or high density lipoprotein cholesterol (HDL-C). All
nuts including walnuts and peanuts are good for the heart
with peanuts being especially high in folic acid as well
as mono and polyunsaturated fats. |
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C. |
Exercise |
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Exercise on a regular basis is one of the
most important factors in the prevention of heart disease.
Although vigorous exercise which accelerates the heart
rate is especially good, 30 minutes of brisk walking
or its equivalent each day can achieve the same benefits
as more vigorous exercise. Exercise can help reduce the
bad cholesterol (LDL-C) and elevate the good cholesterol
(HDL -C). |
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| 2. |
Diabetes
Mellitus |
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HbA1c
(Hemoglobin A1c) Diabetes Test
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A blood test called the hemoglobin A-1C
(glycosylated hemoglobin) will be performed by OBI as
a potential screening test for diabetes mellitus, commonly
known as "diabetes". An abnormal hemoglobin A1C test
indicates that an individual has had higher than normal
blood sugar levels over the prior 3-4 weeks. If this
blood test is abnormal the recommendation will be for
the individual to have further evaluation by their family
physician. |
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Type II diabetes, when unrecognized and
untreated, leads to accelerated development of cardiovascular
disease and subsequently to diabetic retinopathy (retinal
eye disease and blindness), diabetic nephropathy (kidney
disease possibly requiring dialysis) and heart attacks,
strokes, and peripheral vascular disease (decreased blood
flow to extremities especially the lower extremities).
Early identification of diabetes with early treatment
can significantly reduce the risks of all diabetic complications.
Diet, medication and exercise all play a critical role
in the control of diabetes. |
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| 3. |
High Blood Pressure |
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BP
(Blood Pressure) Test |
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Blood pressure will be checked by OBI personnel
on all individuals participating in the Heart Check program. |
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The old standard of acceptable blood pressure
has been a systolic (top number) of 140 mm of mercury
over a diastolic blood pressure (lower number) of 90
mm of mercury. Newer data suggests that a systolic blood
pressure less than 130 with a diastolic less than 80
is better and less apt to lead to the production of coronary
artery disease, strokes, or peripheral vascular disease.
In the case of individuals with adult onset diabetes,
the blood pressure should be below 130 systolic and 80
diastolic in order to prevent diabetic kidney disease.
Again, diet, exercise, cessation of smoking, weight reduction,
and appropriate medications can lower the blood pressure
to normal levels and prevent or reduce the subsequent
development of accelerated cardiovascular disease. |
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Systolic / Diastolic
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<130 / <80
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Desirable |
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130-135 / 80-85
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Borderline elevation |
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136-140 / 86-90
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Mildly elevated |
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>140 / >90
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Elevated |
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| 4. |
Abnormal
Cholesterols and Triglycerides |
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FCHO
(Total Fasting Cholesterol), FHDL (High Density Lipoproteins),
LDL (Low Density Lipoproteins), and TRIG (Triglycerides)
Tests |
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The cholesterols are the most important
of the fats in the blood and are comprised of the high-density
lipoprotein-cholesterol (HDL-C), the low-density lipoprotein-cholesterol
(LDL-C), and the very low density lipoprotein-cholesterol
(VLDL-C). Cholesterol breakdown will be measured through
blood tests performed by the Oklahoma Blood Institute.
The total cholesterol is the sum of all cholesterols
in the blood (Total Cholesterol = HDL-C + LDL-C + VLDL-C).
HDL-C is known as the "good " cholesterol and LDL-C and
VLDL-C are known as the "bad " cholesterols . |
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The total cholesterol should be below 170
mg/dl. A total cholesterol below 140 mg/dl may even help
in reversing some of the effects of cholesterol induced
atherosclerosis (hardening of the arteries). The normal
level for HDL-C is greater than 40 mg/dl. For LDL-C the
normal level is less than 100 mg/dl and for VLDL-C the
normal level is less than 35 mg/dl. Another blood fat
known as triglycerides is also linked to the development
of coronary artery disease. The normal level of triglycerides
is less than 150 mg/dl. |
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The total cholesterol and the HDL-C can
be performed on a non fasting blood sample. The LDL-C
and triglycerides must be performed on a blood sample
obtained from at least a fast of 12-15 hours, which means
that the individual cannot eat anything except to drink
water during that 12-15 hour time period, otherwise the
test results are invalid. OBI can perform the total cholesterol
and the HDL-C on a blood sample obtained from a non fasting
individual. If the total cholesterol is below 170mg/dl
and the HDL-C is above 40mg/dl, then the LDL-C and VLDL-C
will most likely be within normal limits. The point to
remember then is a high HDL-C and a low LDL-C is the
most beneficial scenario. The triglycerides are a different
series of fats which are also linked to the development
of coronary artery disease. Elevated triglyceride levels
are frequently seen in diabetics and pre diabetics. |
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Diet is a critical factor as is exercise
and cessation of smoking in the management of healthy
cholesterol and triglyceride levels. For those individuals
who are unable to lower their total cholesterol and triglycerides
through these previously mentioned measures there are
a number of medications that can be prescribed by a physician.
A major category of medications used to lower total cholesterol
and specifically lower LDL-C and possibly raise HDL-C
are called "statin" drugs. Statin drugs are prescribed
under a variety of names which include Lescol, Lipitor,
Mevacor, Pravachol, and Zocor. |
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| 5. |
Iron Overload |
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FERR
(Ferritin) Test |
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The Blood Institute will perform as part
of Health Check a test called serum ferritin to evaluate
the total amount of iron accumulated in a person’s
body. |
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There are a number of conditions which
can lead to excessive absorption and storage of iron
in the body with deposition of the iron in critical organs
such as the pancreas, liver, heart, lungs, and joints
as well as other tissues and organs. The end result is
serious and potentially fatal disruption of the function
of these organs with the heart being one of the critical
organs that can be involved. A condition called Hereditary
Hemochromatosis (HH) is found in approximately one out
of every 400 Caucasian Americans. These individuals have
inherited two genes for HH. Although not all of these
individuals will develop serious complications, many
of the men and some of the women with HH will ultimately
develop serious organ involvement and cardiovascular
disease. In addition, one out of every 10 Caucasian American
carries one gene for HH and may have some increased iron
absorption and excessive storage of iron. |
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If the serum ferritin test performed by
OBI is elevated, then the individual may need further
evaluation by their family physician or by a hematologist
or gastroenterologist to rule out liver disease (cirrhosis)
or pancreatic disease (development of diabetes). The
most effective way to remove iron from the body is by
donating blood, since red blood cells contain major amounts
of iron. Individuals who donate blood can significantly
reduce the risk of iron overload. In addition to heart
disease, iron overload can lead to the development of
diabetes, cirrhosis of the liver, and possibly liver
cancer. |
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| 6. |
Chronic
Inflammation |
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CRP
(C-Reactive Protein) Test |
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There are a number of proteins in the blood,
including C-Reactive Protein which may become elevated
in anyone who has a chronic inflammatory condition. The
elevation of these proteins may lead to increased deposits
of LDL-C in the coronary arteries and the development
of coronary artery disease. |
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OBI will perform the test called C-Reactive
Protein and if elevated, the individual should be evaluated
by their physician to find out what kind of inflammatory
process is present and how to reverse or reduce the inflammatory
process to reduce the level of the inflammatory proteins. |
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| The Heart Check Program will help individuals
identify cardiac risk factors by making individuals aware
of the issues related to: (1) Smoking, diet and exercise,
(2) measurement of an individual’s blood pressure,
(3) the performance of a series of blood tests necessary
to define other cardiac risk factors. All test results
will be mailed and made available through OBI’s
web site (www.obi.org) through a special confidential
web based test reporting system which will allow the
individual to track all test results indefinitely. |
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| The primary purpose of Heart Check is to
provide a program to help reduce heart disease to individuals
participating in the Heart Check program. |
