LITMIR.BIZ

Скачать книгу

but when the sources are multiple and prolonged, stress can be a hazard to your health.

      When you lose control of the stressful events in your life, adrenalin is released; your body develops a state of readiness to react to danger—your pupils dilate, your heart beats faster, your blood pressure rises, your breathing rate increases. You are ready for flight or fight. But you can’t flee and fighting would, in most instances, be undesirable, so you become irritable, angry and anxious, all signs suggesting you may be putting yourself at increased risk for heart disease.

      So, it becomes important to cope: eliminate or reduce caffeine; exercise; eat balanced meals; learn how to meditate. Stress control is important. Get professional help if necessary.

      Alcohol

      Alcohol, in moderation (an average of one drink a day for women and two drinks a day for men), can have beneficial cardiac effects.

      It increases HDL cholesterol and can inhibit clot formation. However, in excess, it enhances clot formation, can raise blood pressure, elevate triglyceride levels and promote visceral obesity—all cardiac risk factors.

      Now, knowing all this, it is not recommended that you start drinking if you haven’t been, or if you have been, you start drinking more.

      Family history

      If your grandparents, parents, or siblings have had heart attacks, you may be at risk. Your family may have inherited a genetic condition that raises “bad” cholesterol and lowers “good” cholesterol.

      High blood pressure also runs in families.

      Smoking and/or exposure to second hand smoke as you grew up may play a role, as can poor family eating habits (high fat diets).

      If your mother or grandmother or sister had heart trouble or a heart attack before age sixty-five, or your father or grandfather or brother had heart trouble or a heart attack before aged fifty-five, you are at greater risk.

      Homocysteine

      Homocysteine is an amino acid that has been implicated in the promotion of atherosclerosis by damaging the inner lining of arteries and promoting clot formation.

      An elevated level has been postulated as increasing one’s risk for heart attack, as well as other vascular disease.

      Folic acid and vitamins B-6 and B-12 break down homocysteine in the body, and, indeed, it has been shown that reduced blood levels of folic acid have been correlated with increased risk for heart attack and stroke.

      Research is still being done on this correlation, so the American Heart Association has not yet called an elevated homocysteine level a cardiac risk factor, but they do endorse determining the level in those patients with a strong family history of heart disease.

      If, in these patients, homocysteine is elevated, a diet high in fruits and green leafy vegetables should be consumed daily, and perhaps a multivitamin with folic acid and the B vitamins should also be taken.

      C-reactive protein (CRP)

      CRP is a protein found in the blood that is a marker for inflammation. In other words, an elevated CRP suggests that there is inflammation somewhere in the body. It is a non-specific test—something’s wrong someplace. It is important because inflammation has been shown to play a role in the initiation and progression of atherosclerosis and cardiac disease.

      Specifically, a variation of the CRP known as highly sensitive CRP, or hs-CRP has been used to predict cardiac disease. If your hs-CRP is elevated, then you should go all out on risk factor prevention and your physician may choose to treat you with anti-clot medications such as aspirin or clopidogrel and may also consider the use of statin drugs and ace inhibitors to reduce the CRP.

      In a clinical trial involving 18,000 physicians, an elevated CRP was associated with a three fold increase in heart attacks.

      It has also been shown that an elevated hs-CRP applies also to an increased risk for stroke and peripheral vascular disease and the likelihood of closure of a coronary artery after angioplasty.

      There are also some newer inflammatory biological markers whose worth is currently being evaluated.

      Fibrinogen

      Fibrinogen is a protein important in blood clotting, and too much of it may make your blood thick and sticky, an effect that you could do without.

      People with levels too high are twice as likely to die of a heart attack.

      Taken together with other risk factors it could add to the urgency of specific therapy such as the use of omega-3 fatty acids that have been shown to reduce fibrinogen levels, and the use of aspirin for its anti-clotting activity.

      Cardiovascular disease risk factor questions

      Is your blood pressure over 120/80? __Yes __No

      Are you on any hypertension (high blood pressure) medication? __Yes __No

      Do you have a pre-existing cardiac condition? __Yes __No

      If so, are you under the care of a physician? __Yes __No

      Have you ever had a heart attack? __Yes __No

      Have you ever been told that you have angina? __Yes __No

      About cigarettes: Check those that apply.

      ___I never smoked ___I smoke a few cigarettes a day ___I smoke 1 pack per day

      ___I smoke 1 to 2 packs per day ___I smoke 2 or more packs per day

      ___I quit smoking ___I inhale ___I do not inhale ___I smoke cigars

      ___I smoke a pipe ___I am exposed to second hand smoke

      ___How many years have you smoked?____

      ___I have quit smoking in the last 5 years.

      Have you ever had a total cholesterol test? __Yes __No

      Date of last cholesterol test_____

      Is your total cholesterol greater than 200? __ Yes __No

      Is your LDL cholesterol level higher than 100 mg/dl? __Yes __No

      Is your HDL cholesterol level lower than 40 mg/dl? __Yes __No

      Is your triglyceride level greater than 150? __Yes __No

      Do you have Diabetes? __Yes __No

      Would you describe the daily exercise you get as ‘minimal or none’? __Yes __No

      Are you overweight? __Yes __No

      What is your weight in pounds?____

      For a man: Does your waist at your belly button measure more than 37 inches? __Yes __No

      For a woman: Does your waist at your belly button measure more than 35 inches? __Yes __No

      What is your height in inches?_____

      Are you subject to unusual stress? __Yes __No

      Do you drink more than two drinks a day? __Yes __ No

      Did your grandfather, father, or brother have heart trouble or a heart attack before age 55? __Yes __No

      Did your grandmother, mother, or sister have heart trouble or a heart attack before age 65? __Yes __No

      Have you ever had any of the following blood tests: homocysteine, CRP, or fibrinogen? __Yes __No

      You have taken your first risk factor analysis in this book. You will take more as you continue. When you finish, you should bring this information to your physician for his or her analysis.

      You must be proactive as regards your health. This is crucial. Your physician may not be able to take the time to assess you completely in this way. Help him or her by identifying all your risk factors. Then together you both can decide what positive risk factors demand corrective action or specific therapy. Again, I repeat, early disease detection and

Скачать книгу