By:
Dr. Joseph Kousa, MD
Doctor Mentor Ohio
Internal Medicine Mentor Ohio

High blood pressure (HBP) is a serious condition that can lead to coronary heart disease (also called coronary artery disease), heart failure, stroke, kidney failure, and other health problems.

“Blood pressure” is the force of blood pushing against the walls of the arteries as the heart pumps blood. If this pressure rises and stays high over time, it can damage the body in many ways.
Overview

About 1 in 3 adults in the United States has HBP. The condition itself usually has no symptoms. You can have it for years without knowing it. During this time, though, HBP can damage the heart, blood vessels, kidneys, and other parts of your body.

Getting to know your blood pressure numbers is important, even when you’re feeling fine. If your blood pressure is normal, you can work with your doctor to keep it that way. If your blood pressure is too high, treatment may help prevent damage to your body’s organs.
Blood Pressure Numbers

Blood pressure is measured as systolic  and diastolic  pressures. “Systolic” refers to blood pressure when the heart is pumping blood. “Diastolic” refers to blood pressure when the heart is at relaxed between beats.

You most often will see blood pressure numbers written with the systolic number above or before the diastolic number, such as 120/80 mmHg.

Blood pressure doesn’t stay the same all the time. It lowers as you sleep and rises when you wake up. Blood pressure also rises when you’re excited, nervous, or active. If your numbers stay above normal most of the time, you’re at risk for health problems.

All levels above 120/80 mmHg raise your risk, and the risk grows as blood pressure numbers rise. “Pre-hypertension” means you’re likely to end up with HBP, unless you take steps to prevent it.

If you’re being treated for HBP and have repeated readings in the normal range, your blood pressure is under control. However, you still have the condition. You should see your doctor and follow your treatment plan to keep your blood pressure under control.

Your systolic and diastolic numbers may not be in the same blood pressure category. In this case, the more severe category is the one you’re in. For example, if your systolic number is 160 and your diastolic number is 80, you have stage 2 HBP. If your systolic number is 120 and your diastolic number is 95, you have stage 1 HBP.

If you have diabetes or chronic kidney disease, HBP is defined as 130/80 mmHg or higher. HBP numbers also differ for children and teens. (For more information, go to “How Is High Blood Pressure Diagnosed?”)
Outlook

Blood pressure tends to rise with age. Following a healthy lifestyle helps some people delay or prevent this rise in blood pressure.

People who have HBP can take steps to control it and reduce their risk of related health problems. Key steps include following a healthy lifestyle, having ongoing medical care, and following your treatment plan.

Lower your intake of salt:

Getting rid of the salt shaker is hardly enough.  The WHO recommends persons not to exceed 5 gram salt intake daily.  Most persons ingest salt in excess of 10 grams daily.   The kidneys are the main salt filter in the body.  In children young adult the kidney works perfectly and ingested salt can be easily excreted in the urine.  The incidence and prevalence of high blood pressure among the young population are low.  As people grow older, the kidneys lose 1% of their function every year.   Around age 50, almost 30-40% of the kidney’s ability to filter the salt is lost.  Blood pressure rises and people start having the problem of “HTN”.  Of course there are many other causes for high blood pressure.

The list of foods with high salt content is ever growing as more and more products hit the market.   Salt brings out the flavor of food and is used by producers and restaurants as a marketing tool.  “Salt Sells”.   To lower your salt intake read the food labels for a while until you get the hang of what kind of food has high salt.

Lose weight:

Maintain ideal body weight.  Get an adequate intake of protein and greens.  Avoid carbohydrates and fat, unless you have a demanding physical job.

Get your blood pressure checked regularly:

High blood pressure is a silent killer.   Make sure you get it checked periodically, and that you know the numbers.

By:
Dr. Joseph Kousa, MD
Primary Care Mentor Ohio
Internal Medicine Mentor Ohio
Geriatrics Mentor Ohio
Family Doctor Mentor Ohio

Enjoying the golden years takes few steps of planning from many aspects in life. Maintaining health, however, is a critical part of planning a healthy and happy retirement. In this article, I will outline a plan that one can follow to maintain a good health during retirement and to make the golden years happier.

1) Heart disease remains number one in terms of prevalence and outcomes on one’s health in men and women. So, it is the number one priority to mitigate the risk of heart disease and to get a jump start on a good heart check up to ensure the heart is strong with no coronary blockage or valve blockage or leaks. Eat a healthy diet: Low fat and low carb diet. Avoid salt. Get a blood pressure check and treatment. Prevent and or treat diabetes . Take aspirin daily. Take fish oil daily. Ensure normal level vitamin D. Exercise gently (biking and swimming are good for cardiovascular fitness and have low impact on your joints). Avoid smoking and drinking.

2) Prevent strokes; Avoid salt. Keep normal weight. Treat high blood pressure. Take aspirin daily. Get your carotids checked. Make sure your heart rhythm is regular with no atrial fibrillation.

3) Prevent cancer: Get your colon check. get a mammogram and pap test (for women). Get a prostate check (men) Quit smoking. Quit drinking. Control diabetes . Lose weight.

4) Avoid arthritis, hip and knee injuries: Many people in the older age have arthritis from back and disc problems to hip and knee joint disease. This is from overuse, wear and tear and abuse over the years. Many people work in lifting, pushing and pulling heavy loads. Many people have sort of self inflicted injuries from sports, jobs, accidents, etc. Prevention becomes a key; Avoid harsh and rough sports. Avoid jobs that involve heavy lifting, pushing and pulling.

5) Maintain muscular strength. Elderly people are more susceptible to certain injuries, in particular, rotator cuff tear and atrophy in the leg muscles. It is a common place to see patient walk in the hospital with pneumonia and come out sitting in a wheel chair unable to stand or walk for weeks and months.
It is important to follow an exercise regimen to strengthen the quads and the muscles of the lower extremities and maintain health readiness to withstand and fight an intervening illness. Strengthen your shoulder muscles by lifting small weights above your shoulder levels.

6) Maintain your mind and intellect. Studying, learning a new subject, hobbies, puzzles, social life and general health exercise helps maintain higher level of intellect.

7) Get routine physical exams and check up with your doctor and ask him or her about the best possible way for you to get Bette and stay healthier.

By:
Dr. Joseph Kousa, MD
Primary Care Mentor Ohio
Internal Medicine Mentor Ohio
Geriatrics Mentor Ohio
Family Doctor Mentor Ohio

Depression and diabetes may be linked, according to new research in the Archives of Internal Medicine in year 2010.

People usually think of these as two isolated conditions, but there is growing evidence that they are linked behaviorally and biologically. This data provides strong evidence that we should not consider these two isolated conditions any longer.

About 23.5 million Americans have diabetes, and about 14.8 million Americans have major depressive disorder in a given year, according to statistics in the new report.

Of the 65,381 women aged 50 to 75 in 1996 who were study participants, 2,844 women were newly diagnosed with type 2 diabetes, and 7,415 women developed depression in the ensuing 10 years.

Depression and Diabetes Risk

Depression increased the risk for diabetes, and diabetes increased the risk for depression, the study shows. Specifically, women who were depressed were more likely to develop diabetes even after adjusting for other risk factors such as weight and lack of regular exercise.

Those women who were taking antidepressants were 25% more likely to develop diabetes than their counterparts that were not depressed, the study shows.

Women with diabetes were 29% more likely to develop depression after taking into account other depression risk factors, and those women who took insulin for their diabetes were 53% more likely to develop depression during the 10-year study.

While certain factors such as physical activity and body mass index may partially explain the link between depression and diabetes, they do not completely explain the connection.
The common denominator may be stress.

People who are depressed have elevated levels of stress hormones such as cortisol, which can lead to problems with glucose or blood sugar metabolism, increased insulin resistance, and the accumulation of belly fat, all diabetes risk factors.

However, there are long-term stress and strain associated with diabetes management such as blood sugar control and treatment for complications, and this can lead to decreased quality of life and increased probability of depression.
Diabetes and depression are both common diseases. Diabetes can make depression worse because diabetes is a chronic illness with a lot of worries. So much of the treatment for diabetes is self-care, and people who are depressed may not take good care of themselves. They don’t exercise as much and may have issues in terms of watching their diet, checking their blood sugar, and taking medications.

Certain medications used to treat depression can also increase the risk for developing diabetes,

By Dr. Joseph Kousa, MD

Some conditions as well as some lifestyle factors can put people at a higher risk for developing heart disease. All persons can take steps to lower their risk of heart disease and heart attack by addressing these risk factors. Control of risk factors is especially need by people who already have heart disease.

Cholesterol

Cholesterol is a waxy substance produced by the liver or consumed in certain foods. It is needed by the body, and the liver makes enough for the body’s needs. When there is too much cholesterol in the body—because of diet and the rate at which the cholesterol is processed—it is deposited in arteries, including those of the heart. This can lead to narrowing of the arteries, heart disease, and other complications.

Some cholesterol is often termed “good,” and some often termed “bad.” A higher level of high–density lipoprotein cholesterol, or HDL, is considered “good,” and gives some protection against heart disease. Higher levels of low–density lipoprotein, or LDL, are considered “bad” and can lead to heart disease. A lipoprotein profile can be done to measure several different forms of cholesterol, as well as triglycerides (another kind of fat) in the blood.

High Blood Pressure

High blood pressure is another major risk factor for heart disease. It is a condition where the pressure of the blood in the arteries is too high. There are often no symptoms to signal high blood pressure. Lowering blood pressure by changes in lifestyle or by medication can lower the risk of heart disease and heart attack.

Diabetes Mellitus

Diabetes also increases a person’s risk for heart disease. With diabetes, the body either doesn’t make enough insulin, can’t use its own insulin as well as it should, or both. This causes sugars to build up in the blood. About three–quarters of people with diabetes die of some form of heart or blood vessel disease. For people with diabetes, it is important to work with a healthcare provider to help in managing it and controlling other risk factors.

Tobacco

Tobacco use increases the risk of heart disease and heart attack. Cigarette smoking promotes atherosclerosis and increases the levels of blood clotting factors, such as fibrinogen. Also, nicotine raises blood pressure, and carbon monoxide reduces the amount of oxygen that blood can carry. Exposure to other people’s smoke can increase the risk of heart disease even for nonsmokers.

Diet dessert

Several aspects of peoples’ dietary patterns have been linked to heart disease and related conditions. These include diets high in saturated fats and cholesterol, which raise blood cholesterol levels and promote atherosclerosis. High salt or sodium in the diet causes raised blood pressure levels.

Physical Inactivity

Physical inactivity is related to the development of heart disease. It also can impact other risk factors, including obesity, high blood pressure, high triglycerides, a low level of HDL (good) cholesterol, and diabetes. Regular physical activity can improve risk factor levels.

Obesity

Obesity is excess body fat. It is linked to higher LDL (bad) cholesterol and triglyceride levels and to lower HDL (good) cholesterol, high blood pressure, and diabetes.

Alcohol

Excessive alcohol use leads to an increase in blood pressure, and increases the risk for heart disease. It also increases blood levels of triglycerides which contributes to atherosclerosis.

Heart disease can run in the family. Genetic factors likely play some role in high blood pressure, heart disease, and other vascular conditions. However, it is also likely that people with a family history of heart disease share common environments and risk factors that increase their risk. The risk for heart disease can increase even more when heredity is combined with unhealthy lifestyle choices, such as smoking cigarettes and eating a poor diet.

Prevention:  What You Can Do

Live a Healthy Lifestyle
Eat a healthy diet. Choosing healthful meal and snack options can help you avoid heart disease and its complications. Be sure to eat plenty of fresh fruits and vegetables.
Eating foods low in saturated fat and cholesterol and high in fiber can help prevent high blood cholesterol. Limiting salt or sodium in your diet can also lower your blood pressure.
Maintain a healthy weight. Being overweight or obese can increase your risk for heart disease. To determine whether your weight is in a healthy range, doctors often calculate a number called the body mass index (BMI). Doctors sometimes also use waist and hip measurements to measure a person’s excess body fat.
Exercise regularly. Physical activity can help you maintain a healthy weight and lower cholesterol and blood pressure. The Surgeon General recommends that adults should engage in moderate-intensity exercise for at least 30 minutes on most days of the week.
Don’t smoke. Cigarette smoking greatly increases your risk for heart disease. So, if you don’t smoke, don’t start. If you do smoke, quitting will lower your risk for heart disease. Your doctor can suggest ways to help you quit.
Limit alcohol use. Avoid drinking too much alcohol, which causes high blood pressure.