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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. |
Elevated
Homocysteine |
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HOCY
(Homocysteine) Test |
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Homocysteine is an amino acid found
normally in small amounts in the blood and when
elevated may increase the deposits of LDL-C in
the arteries of the heart. Elevated homocysteine
called hyperhomocysteinemia is inherited and, if
present, can easily be treated by taking 800-1600
micrograms of folic acid or folate along with some
Vitamin B12 and pyridoxine (Vitamin B6) on a daily
basis. |
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The Blood Institute will perform
a test called a serum homocysteine to determine
if the levels are elevated.
If an individual has an elevated homocysteine
level, the recommendation will be to eat more
foods containing folic acid, such as green
leafy vegetables and peanuts as well as taking
folic acid, B12, and Vitamin B6.
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| 7. |
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. |
