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Are you caring for your health ?

Eight out of ten people examined at the Executive Clinic, including men and women executives and housewives, had a variety of unsuspected problems, such as :

  • Obesity
  • Harmless looking lumps in the body
  • High Blood Pressure +
  • High Blood Pressure

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    Pre Hypertension :

    • pressure 120/80 mmHg to 139/89 mmHg
    • not a disease category

    Hypertension :

    • blood pressure of 140/90 mmHg or above
    • The diagnosis of hypertension should be made only after noting a mean elevation on three readings 6 hours apart

    Classification of Hypertension :

    BP CLASSIFICATION SBP* MMHG DBP* MMHG LIFESTYLE MODIFICATION INITIAL DRUG THERAPY
    WITHOUT COMPELLING INDICATION WITH COMPELLING INDICATIONS (SEE TABLE 8)
    NORMAL < 120 and < 80 Encourage No antihypertensive drug indicated. Drug(s) for compelling indiactions.±
    PREHYPERTENSION 120 - 139 OR 80 - 89 Yes
    STAGE 1
    HYPERTENSION
    140 - 159 OR 90 - 99 Yes Thiazide-type diuretics for most. May consider ACEI, ARB, BB, CCB, or combination. Drug(s) for the compelling indications.± Other antihypertensive drugs (diuretics, ACEI, ARB, BB, CCB) as needed.
    STAGE 2
    HYPERTENSION
    2160 OR 2100 Yes Two-drug combination for most (usually thiazide-type diuretic and ACEI or ARB or BB or CCB).

    DBP - Diastolic Blood Pressure
    SBP - Systolic Blood Pressure

    Drug abbreviations :

    ACEI - Angiotensin Coverting Enzyme Inhibitor
    ARB - Angiotensin Receptor Blocker
    BB - Beta - Blocker
    CCB - Calcium Channel Blocker.

    * - Treatment determined by highest BP category.
    ± - Treat patients with chronic kidney disease or diabetes to BP goal of <130/80 mmHg.
    † - Initial combined therapy should be used cautiously in those at risk for orthostatic hypotension.

    Symptoms of Hypertension :

    • No symptoms
    • Non-specific symptoms
    • Headache
    • Morning headache
    • Tinnitus
    • Dizziness
    • Confusion
    • Sleepiness
    • Vision problems
    • Angina
    • Difficulty breathing
    • Irregular heartbeat
    • Blood in the urine
    • Epistaxis
    • Many symptoms occur from complications of hypertension

    B. Signs of Hypertension :

    • Vital Signs - Elevated blood pressure, bradycardia, bounding pulse
    • Skin - Flushed, diaphoresis, pallor
    • Cardio-Vascular - Distended neck veins, extremity edema, pulmonary edema
    • Neurologic - Decreased level of consciousness, impaired movement, symmetry of face and extremities, seizures, unequal pupils

    Evaluation of Hypertension :

    Three main objectives :

    • To assess lifestyle and other cardiovascular risk or concomitant disorders that may affect prognosis and guide treatment.
    • To reveal identifiable causes of BP
    • To asses the presence or absence of target organ damage and CVD

    Laboratory tests and diagnostics :

    These are a must (Rule of 9) :

    • ECG
    • Urine analysis
    • Blood glucose (9 to 12 hr fasting)
    • Hematocrit
    • Serum potassium
    • Serum creatinine
    • Serum calcium
    • Lipid profile (LDL & HDL with triglycerides) (9 to 12 hr fasting)
    • Albumin creatinine ratio

    Treatment of Hypertension :

    1. Non pharmacological management :

    Life Style changes :

    • reducing salt intake: reduce dietary sodium intake to no more than 100 m mol per day (2.4gm sodium of 6 gm sodium chloride)
    • reducing fat intake
    • losing weight : maintain normal body weight (BMI 18.5-24.5 kg/meter square)
    • getting regular exercise : 30 minutes of daily aerobic exercise
    • quitting smoking : strictly
    • reducing alcohol consumption : not more than 2 drinks / day for men and 1 drink per day for women
    • managing stress

    DASH Diet (Dietary Approaches to Stop Hypertension) :

    • low in saturated fat, cholesterol, and total fat, and that emphasizes fruits, vegetables, and low fat dairy foods, whole grain products, fish, poultry, and nuts

    2. Pharmacological management of Hypertension :

    • diuretics
    • beta-blockers
    • calcium channel blockers
    • angiotensin converting enzyme inhibitors (ACE inhibitors)
    • alpha-blockers
    • alpha-beta blockers
    • vasodilators
    • peripheral acting adrenergic antagonists
    • centrally acting agonists

     

     
     
     
  • Stress related problems +
  • Stress Related Problems

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    Stress :

    Stress affects virtually everyone at some time in their life. As well as the emotional and psychological disruption it causes, stress-related medical problems are becoming increasingly common. In the modern world, we all need to learn how to cope with stress.

    What is stress ?

    The body has an inbuilt physical response to stressful situations. Faced with pressure, challenge or danger, we need to react quickly, and our bodies release hormones such as cortisol and adrenaline to help us do this. These hormones are part of the "fight or flight" response and affect the metabolic rate, heart rate and blood pressure, resulting in a heightened - or stressed - state that prepares the body for optimum performance in dealing with a stressful situation.

    Very often, modern stresses do not call for either fight or flight. Nevertheless, the same stressing hormones are released as part of the reaction and this natural reaction to challenge or danger, instead of helping, can damage health and reduce the ability to cope.

    What causes stress ?

    Many things (or the anticipation of them) can lead to stress :

    • pressure to perform at work, at school or in sports
    • threats of physical violence
    • money worries
    • arguments
    • family conflicts
    • divorce
    • bereavement
    • unemployment
    • moving house
    • alcohol or drug abuse
    • Sometimes, there is no particular reason for developing stress, or it arises out of a series of minor irritations.

    Who gets stressed ?

    The list above shows that everyone is at risk of being stressed, since it can be caused by a range of commonplace situations. However, people have very different mental responses to the body's natural reaction to a stressful situation. For some it can be an essential stimulus, helping motivate them to achieve more. In others it causes an adverse reaction, causing a sense of not being able to cope and demotivation.

    It is important to differentiate between temporary stress that you know will go away when a situation is resolved, and long-term or chronic stress. Most people can cope with short periods of stress, and it can often be relieved by relaxing, taking a walk, chatting through issues with friends, or having a good night's sleep. Chronic (long-term, continuous) stress is much harder to deal with, and can be psychologically and emotionally damaging, both for an individual and for friends and family.

    The symptoms of stress

    Everyone reacts to stress differently, but there are some common effects that help us recognise it. In times of extreme stress, people may shake uncontrollably, hyperventilate (breathe faster and deeper than normal) or even vomit. For people with asthma, stress can trigger an attack. People who are chronically stressed are also susceptible to any of the following :

    • periods of irritability or anger
    • apathy or depression
    • constant anxiety
    • irrational behaviour
    • loss of appetite
    • comfort eating
    • lack of concentration
    • loss of sex-drive
    • increased smoking, drinking or recreational drug-taking

    There can also be physical effects, which may include the following :

    • excessive tiredness
    • skin problems
    • aches and pains resulting from tense muscles, including neckache, backache and tension headaches
    • increased pain from arthritis and other conditions
    • heart palpitations
    • for women, missed periods

    Post-traumatic stress :

    Post-traumatic stress can affect anyone who has been through an extremely difficult or violent experience, such as witnessing a violent death or disaster, being involved in a serious car crash or surviving a fire.

    People suffering from post-traumatic stress may experience any of the symptoms listed opposite. They may also feel a mixture of emotions such as fear, shame, depression, guilt or anger, and recurrent memories or images that may be haunting or lead to nightmares. These feelings can last for weeks, months or even years after the traumatic event that triggered them. Specialist treatment, possibly with medicines and psychological therapies, is available.

    When to see a doctor :

    If stress is causing physical symptoms, severe distress or making it difficult for you to function as normal, it is worth seeing the doctor.

    It is important to remember that although stress is a usual part of life, extreme or prolonged stress can lead to other illnesses that will need treatment, so it is better to visit a doctor sooner rather than later. Stress has been linked to the development of high blood pressure and heart disease, as well as insomnia and depression, for example.

    There is no diagnostic test for stress since everyone reacts to it differently, but a doctor will be able to spot the physical symptoms, and should ask pertinent questions to identify any underlying problems that might be the cause. In case there are physical reasons for the symptoms, the doctor may also want to do some tests to exclude certain conditions.

    Tackling stress :

    If you feel that you are suffering from stress, try to identify the aspects of your life that are causing it. Sometimes you may not be able to change or avoid them, but at other times simple lifestyle changes can make all the difference.

    There are several strategies that can help you deal with stress :

    • delegating or sharing your responsibilities at work
    • avoiding confrontation with difficult colleagues
    • learning to be more assertive
    • taking regular exercise
    • not using drink or drugs to cope
    • eating a healthy, balanced diet, rich in fruit and vegetables
    • finding humour or absurdity in stressful situations
    • never taking on more than you know you can cope with
    • organising your time better to get as much done as possible
    • talking to friends or family, and sharing your thoughts and fears
    • listening to music or relaxation tapes
    • tensing and then relaxing your muscles, starting at the toes and working up to the head and neck.

    If you think that you would benefit from help, either in identifying the things that are causing your stress, or in learning techniques to help you relax, talk to your doctor about this. There are many people who can give you professional help in these areas.

    Medicines :

    Only in exceptional circumstances is your doctor likely to prescribe medication to help you cope with stress, although some types of anxiety can be treated with antidepressants. See the separate BUPA factsheets on Anxiety and Depression.

    Tranquilising drugs such as diazepam (Valium) or temazepam are not suitable for treating stress because they can cause addiction after only a few weeks of taking them.

    Rather than relying on medicine, it is usually far better to try and identify the things in your life that are causing stress and try to deal with them.

    Other treatments :

    There are many stress management techniques in the form of counselling, psychotherapy and hypnotherapy. Complementary approaches include aromatherapy and reflexology and these may, if nothing else, provide a quiet, relaxed environment in which to wind down. Meditation can help relaxation, and practising yoga or the Alexander technique may help to relieve muscle pains and help to control breathing in stressful situations.

    How will stress management help?

    The aim of stress management is to help you balance the various aspects of your life - your work, your relationships and your leisure - and to balance the physical, intellectual and emotional aspects of life. People who effectively manage stress consider life a challenge rather than a series of irritations and feel they have control over their lives, even in the face of setbacks.

     

     
     
     
  • Diabetes +
  • Diabetes

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    Diabetes :
    In simple words diabetes means "levels of sugar more than the desired normal levels".

    There are two types of Diabetes :

    Type 1 diabetes is caused by an autoimmune disorder-a problem with the body's immune system. In a healthy body, specialized cells (called beta cells) in the pancreas make insulin. Insulin is a hormone that allows the body to use energy from food. In type 1 diabetes, the immune system mistakes beta cells for invaders and attacks them. When enough beta cells are destroyed, symptoms of diabetes appear.

    In type 2 diabetes, the beta cells still produce insulin. However, either the cells do not respond properly to the insulin or the insulin produced naturally is not enough to meet the needs of the body. So insulin is usually still present in a person with type 2 diabetes, but it does not work as well as it should. Some people with type 2 can keep it under control by losing weight, changing their diet, and increasing their exercise. Others take one or more medications, including insulin.

    A diabetes myth - diabetes is not caused by eating too much sugar. This myth probably began when people with diabetes were absolutely forbidden from consuming sugar. Researchers no longer believe this. Your child can still have all of her favorite sweets as long as they are scheduled in her eating plan.

    Diabetes Symptoms:

    Diabetes often goes undiagnosed because many of its symptoms seem so harmless. Recent studies indicate that the early detection of diabetes symptoms and treatment can decrease the chance of developing the complications of diabetes.

    Some diabetes symptoms include :

    • Frequent urination
    • Excessive thirst
    • Extreme hunger
    • Unusual weight loss
    • Increased fatigue
    • Irritability
    • Blurry vision

    How to reduce the risk of Diabetes :

    To reduce the risk of developing diabetes, as well as heart disease, you should :

    • Follow a heart healthy eating plan, which is low in saturated fat and cholesterol, and moderate in total fat.
    • Aim for a healthy weight.
    • Be physically active each day–try to do 30 minutes of moderate-intensity physical activity such as brisk walking on most and, preferably, all days of the week.
    • Don’t smoke.
    • Prevent or control high blood pressure.
    • Prevent or control high blood cholesterol.

    If you already have diabetes, you can delay its progression, or prevent or slow the development of heart, blood vessel, and other complications by following the steps given above and these:

    • Eat your meals and snacks at around the same times each day.
    • Check with your doctor about physical activities that are best for you.
    • Take your diabetes medicine at the same times each day.
    • Check your blood sugar every day. Each time you check your blood sugar, write the number in your record book. Call your doctor if your numbers are too high or too low for 2 to 3 days.
    • Check your feet every day for cuts, blisters, sores, swelling, redness, or sore toenails.
    • Brush and floss your teeth and gums every day.
    • Take any prescribed medication for other conditions, such as coronary heart disease.
    • Check with your doctor about taking aspirin each day if you have heart disease.

    Lifestyle Tips :

    • Eat a balanced diet Seeing a dietitian every one to two years can be helpful. They, along with your diabetes heath care team, will help you plan a diet that is right for you.
    • Exercise at least three to four times a week for 20 to 40 minutes each session. A regular exercise program can improve blood sugars, decrease the risk of heart disease and help you lose weight. Talk to your health care provider before starting any exercise program. He or she may want to do a few tests prior to you starting a program. If you have complications relating to your diabetes like neuropathy or retinopathy there are certain types of exercise that you should avoid. Tell your doctor what kind of exercise you want to do so adjustments can be made to your medicine schedule or meal plan. Remember it is important to check your sugars prior to vigorous exercise.
    • Get plenty of sleep Keeping a regular schedule and getting enough sleep will help you keep your blood glucose levels in good control.
    • If you smoke, quit.
    • Manage stress as best you can. Consider a stress management workshop to help you learn better coping methods.
    • Practice good foot and skin care. Check your feet daily for calluses, cracks or skin breakdown. If you notice redness, ulcerations, pus or a foul smelling drainage from your feet or if you notice that any of the toes have turned black and cold, notify your doctor immediately. Also, tell your doctor if you have any swelling in your ankles or feet.
    • Report signs of infection to your doctor. If you have any signs of infection -- redness in areas of the skin, fevers, vomiting, etc., call your doctor or health care provider immediately.
    • Discuss sexual problems with your doctor.
    • Stay knowledgeable about diabetes. Continue learning about diabetes to maintain and improve your health. Attend a diabetes class or schedule visits with your diabetes educator at least once a year.

    Medication Guidelines :

    • Follow a medicine schedule as prescribed by your health care provider.
    • Know your medicines. Know the medicines (brand and generic names) you are taking and how they work. Keep a list of your medicines with you at all times. When traveling, make sure to bring enough medicine and supplies with you on your trip. Keep medicines, syringes, and blood glucose testing supplies in your carry-on bag. Do not check these supplies in case your luggage is lost. Bring copies of your prescriptions and consider getting a medical alert bracelet.

    Glucose Control Guidelines :

    • Maintain normal blood glucose. Test your blood glucose regularly as recommended by your health care provider. Test your blood glucose more often when you are sick. Keep your blood glucose level at the range recommended by your health care provider at all times. Call your doctor if your numbers fall below or above what is recommended.
    • Record your blood glucose results in a record-keeping log. Bring your logbook with you to all of your doctor's visits.

    Screening Tips :

    • Keep your scheduled appointments with your health care providers. Many of you doctors will want to see you every 3 months. You may need to be seen more often if your blood glucose levels are not controlled or if you are having problems with your medicine. People whose diabetes is under good control or who do not need medicines for their diabetes may be able to see their doctor less frequently.
    • Have a glycated hemoglobin blood test (HbA1c) every 3 months, or as recommended by your health care provider. Keeping this below 7% helps protect you from the complications of diabetes.
    • Check your blood pressure regularly
    • Have an eye exam once a year, or more frequently, as recommended by your eye doctor. Make an appointment with your eye doctor sooner if you have blurred vision in one eye or are having "blind" spots in your vision.
    • Check for microalbumin every year or as recommended by your doctor. This test measures the 'health' of your kidneys.
    • Check your cholesterol and triglyceride levels (lipid profile test) once a year or as recommended by your doctor.
    • Have a dental exam every six months.

     

     
     
     
  • Dental ill health
  • High cholesterol +
  • High Cholesterol

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    Why Is Cholesterol Important ?

    Your blood cholesterol level has a lot to do with your chances of getting heart disease. High blood cholesterol is one of the major risk factors for heart disease. A risk factor is a condition that increases your chance of getting a disease. In fact, the higher your blood cholesterol level, the greater your risk for developing heart disease or having a heart attack. Heart disease is the number one killer of women and men in the United States. Each year, more than a million Americans have heart attacks, and about a half million people die from heart disease.

    How Does Cholesterol Cause Heart Disease ?

    When there is too much cholesterol (a fat-like substance) in your blood, it builds up in the walls of your arteries. Over time, this buildup causes "hardening of the arteries" so that arteries become narrowed and blood flow to the heart is slowed down or blocked. The blood carries oxygen to the heart, and if enough blood and oxygen cannot reach your heart, you may suffer chest pain. If the blood supply to a portion of the heart is completely cut off by a blockage, the result is a heart attack.

    High blood cholesterol itself does not cause symptoms, so many people are unaware that their cholesterol level is too high. It is important to find out what your cholesterol numbers are because lowering cholesterol levels that are too high lessens the risk for developing heart disease and reduces the chance of a heart attack or dying of heart disease, even if you already have it. Cholesterol lowering is important for everyone--younger, middle age, and older adults; women and men; and people with or without heart disease.

    What Do Your Cholesterol Numbers Mean ?

    Everyone age 20 and older should have their cholesterol measured at least once every 5 years. It is best to have a blood test called a "lipoprotein profile" to find out your cholesterol numbers. This blood test is done after a 9- to 12-hour fast and gives information about your :

    • Total cholesterol
    • LDL (bad) cholesterol--the main source of cholesterol buildup and blockage in the arteries
    • HDL (good) cholesterol--helps keep cholesterol from building up in the arteries
    • Triglycerides--another form of fat in your blood

    If it is not possible to get a lipoprotein profile done, knowing your total cholesterol and HDL cholesterol can give you a general idea about your cholesterol levels. If your total cholesterol is 200 mg/dL* or more or if your HDL is less than 40 mg/dL, you will need to have a lipoprotein profile done. See how your cholesterol numbers compare to the tables below.

    Total Cholesterol Level Category
    Less than 200 mg/dL Desirable
    200-239 mg/dL Borderline High
    240 mg/dL and above High

    * Cholesterol levels are measured in milligrams (mg) of cholesterol per deciliter (dL) of blood.

    LDL Cholesterol Level LDL-Cholesterol Category
    Less than 100 mg/dL Optimal
    100-129 mg/dL Near optimal/above optimal
    130-159 mg/dL Borderline high
    160-189 mg/dL High
    190 mg/dL and above Very high

    HDL (good) cholesterol protects against heart disease, so for HDL, higher numbers are better. A level less than 40 mg/dL is low and is considered a major risk factor because it increases your risk for developing heart disease. HDL levels of 60 mg/dL or more help to lower your risk for heart disease. Triglycerides can also raise heart disease risk. Levels that are borderline high (150-199 mg/dL) or high (200 mg/dL or more) may need treatment in some people.

    What Affects Cholesterol Levels ?

    A variety of things can affect cholesterol levels. These are things you can do something about :

    • Diet Saturated fat and cholesterol in the food you eat make your blood cholesterol level go up. Saturated fat is the main culprit, but cholesterol in foods also matters. Reducing the amount of saturated fat and cholesterol in your diet helps lower your blood cholesterol level.
    • Weight Being overweight is a risk factor for heart disease. It also tends to increase your cholesterol. Losing weight can help lower your LDL and total cholesterol levels, as well as raise your HDL and lower your triglyceride levels.
    • Physical Activity Not being physically active is a risk factor for heart disease. Regular physical activity can help lower LDL (bad) cholesterol and raise HDL (good) cholesterol levels. It also helps you lose weight. You should try to be physically active for 30 minutes on most, if not all, days.

    Things you cannot do anything about also can affect cholesterol levels. These include :

    • Age and Gender As women and men get older, their cholesterol levels rise. Before the age of menopause, women have lower total cholesterol levels than men of the same age. After the age of menopause, women's LDL levels tend to rise.
    • Heredity Your genes partly determine how much cholesterol your body makes. High blood cholesterol can run in families.

    What Is Your Risk of Developing Heart Disease or Having a Heart Attack ?

    In general, the higher your LDL level and the more risk factors you have (other than LDL), the greater your chances of developing heart disease or having a heart attack. Some people are at high risk for a heart attack because they already have heart disease. Other people are at high risk for developing heart disease because they have diabetes (which is a strong risk factor) or a combination of risk factors for heart disease. Follow these steps to find out your risk for developing heart disease.

    Step 1: Check the table below to see how many of the listed risk factors you have; these are the risk factors that affect your LDL goal.

    Major Risk Factors That Affect Your LDL Goal

    • Cigarette smoking
    • High blood pressure (140/90 mmHg or higher or on blood pressure medication)
    • Low HDL cholesterol (less than 40 mg/dL)*
    • Family history of early heart disease (heart disease in father or brother before age 55; heart disease in mother or sister before age 65)
    • Age (men 45 years or older; women 55 years or older)

    * If your HDL cholesterol is 60 mg/dL or higher, subtract 1 from your total count.

    Even though obesity and physical inactivity are not counted in this list, they are conditions that need to be corrected.

    Step 2: How many major risk factors do you have? If you have 2 or more risk factors in the table above, use the attached risk scoring tables (which include your cholesterol levels) to find your risk score. Risk score refers to the chance of having a heart attack in the next 10 years, given as a percentage. My risk score is ________%.

    Step 3:Use your medical history, number of risk factors, and risk score to find your risk of developing heart disease or having a heart attack in the table below.

    If You Have You Are in Category
    Heart disease, diabetes, or risk score more than 20%* I. High Risk
    2 or more risk factors and risk score 10-20% II. Next Highest Risk
    2 or more risk factors and risk score less than 10% III. Moderate Risk
    0 or 1 risk factor IV. Low-to-Moderate Risk

    * Means that more than 20 of 100 people in this category will have a heart attack within 10 years.

    My risk category is ______________________.

    Treating High Cholesterol :

    The main goal of cholesterol-lowering treatment is to lower your LDL level enough to reduce your risk of developing heart disease or having a heart attack. The higher your risk, the lower your LDL goal will be. To find your LDL goal, see the boxes below for your risk category. There are two main ways to lower your cholesterol :

    • Therapeutic Lifestyle Changes (TLC)--includes a cholesterol-lowering diet (called the TLC diet), physical activity, and weight management. TLC is for anyone whose LDL is above goal.
    • Drug Treatment--if cholesterol-lowering drugs are needed, they are used together with TLC treatment to help lower your LDL.

    If you are in...

    • Category I, Highest Risk, your LDL goal is less than 100 mg/dL. you will need to begin the TLC diet to reduce your high risk even if your LDL is below 100 mg/dL. If your LDL is 100 or above, you will need to start drug treatment at the same time as the TLC diet. If your LDL is below 100 mg/dL, you may also need to start drug treatment together with the TLC diet if your doctor finds our risk is very high, for example if you had a recent heart attack or have both heart disease and diabetes.
    • Category II, Next Highest Risk, your LDL goal is less than 130 mg/dL. If your LDL is 130 mg/dL or above, you will need to begin treatment with the TLC diet. If your LDL is 130 mg/dL or more after 3 months on the TLC diet, you may need drug treatment along with the TLC diet. If your LDL is less than 130 mg/dL, you will need to follow the heart healthy diet for all Americans, which allows a little more saturated fat and cholesterol than the TLC diet.
    • Category III, Moderate Risk, your LDL goal is less than 130 mg/dL. If your LDL is 130 mg/dL or above, you will need to begin the TLC diet. If your LDL is 160 mg/dL or more after you have tried the TLC diet for 3 months, you may need drug treatment along with the TLC diet. If your LDL is less than 130 mg/dL, you will need to follow the heart healthy diet for all Americans.
    • Category IV, Low-to-Moderate Risk, your LDL goal is less than 160 mg/dL. If your LDL is 160 mg/dL or above, you will need to begin the TLC diet. If your LDL is still 160 mg/dL or more after 3 months on the TLC diet, you may need drug treatment along with the TLC diet to lower your LDL, especially if your LDL is 190 mg/dL or more. If your LDL is less than 160 mg/dL, you will need to follow the heart healthy diet for all Americans.

    To reduce your risk for heart disease or keep it low, it is very important to control any other risk factors you may have such as high blood pressure and smoking.

    Lowering Cholesterol With Therapeutic Lifestyle Changes (TLC)

    TLC is a set of things you can do to help lower your LDL cholesterol. The main parts of TLC are :

    • The TLC Diet This is a low-saturated-fat, low-cholesterol eating plan that calls for less than 7percent of calories from saturated fat and less than 200 mg of dietary cholesterol per day. The TLC diet recommends only enough calories to maintain a desirable weight and avoid weight gain. If your LDL is not lowered enough by reducing your saturated fat and cholesterol intakes, the amount of soluble fiber in your diet can be increased. Certain food products that contain plant stanols or plant sterols (for example, cholesterol-lowering margarines) can also be added to the TLC diet to boost its LDL-lowering power.
    • Weight Management Losing weight if you are overweight can help lower LDL and is especially important for those with a cluster of risk factors that includes high triglyceride and/or low HDL levels and being overweight with a large waist measurement (more than 40 inches for men and more than 35 inches for women).
    • Physical Activity Regular physical activity (30 minutes on most, if not all, days) is recommended for everyone. It can help raise HDL and lower LDL and is especially important for those with high triglyceride and/or low HDL levels who are overweight with a large waist measurement.

    Foods low in saturated fat include fat-free or 1percent dairy products, lean meats, fish, skinless poultry, whole grain foods, and fruits and vegetables. Look for soft margarines (liquid or tub varieties) that are low in saturated fat and contain little or no trans fat (another type of dietary fat that can raise your cholesterol level). Limit foods high in cholesterol such as liver and other organ meats, egg yolks, and full-fat dairy products.

    Good sources of soluble fiber include oats, certain fruits (such as oranges and pears) and vegetables (such as brussels sprouts and carrots), and dried peas and beans.

    Drug Treatment :

    Even if you begin drug treatment to lower your cholesterol, you will need to continue your treatment with lifestyle changes. This will keep the dose of medicine as low as possible, and lower your risk in other ways as well. There are several types of drugs available for cholesterol lowering including statins, bile acid sequestrants, nicotinic acid, fibric acids, and cholesterol absorption inhibitors. Your doctor can help decide which type of drug is best for you. The statin drugs are very effective in lowering LDL levels and are safe for most people. Bile acid sequestrants also lower LDL and can be used alone or in combination with statin drugs. Nicotinic acid lowers LDL and triglycerides and raises HDL. Fibric acids lower LDL somewhat but are used mainly to treat high triglyceride and low HDL levels. Cholesterol absorption inhibitorrs lower LDL and can be used alone or in combination with statin drugs.

    Once your LDL goal has been reached, your doctor may prescribe treatment for high triglycerides and/or a low HDL level, if present. The treatment includes losing weight if needed, increasing physical activity, quitting smoking, and possibly taking a drug.

     

     
     
     

Minor fleeting complaints, seemingly insignificant, are frequently ignored but not forgotten. A routine examination and set of investigations provide an opportunity for assuring oneself about good health, and how to achieve and maintain it, if silent factors that may be harmful in the future are recognized.

The major benefit of a health evaluation programme is to give you information about the status of your current health – the do’s and don’ts. In case you require follow-up with specialists, necessary appointments will be arranged, which are not included in these packages.

Keeping in mind the pressure at the office and at home the Executive Clinic has developed a number of time-efficient yet comprehensive check-up programmes to suit your individual needs.

Why do we do these evaluations?

  • Complete history and physical examination, which reviews the life-style, eating habits, exercise levels, genetic make-up, etc.
  • Dental examination – as teeth are often ignored and mouth is a gateway to the body.
  • Blood grouping – knowledge regarding your blood group is important, specially in emergency situations.
  • Haemogram gives information whether you are anaemic or not, resistance and defense capabilities of blood, clotting power and size and shape of blood cells.
  • Chest X-ray for detecting lung and heart diseases.
  • Blood analysis for the early detection of liver, kidney, and metabolic diseases (such as diabetes, gout, etc.) and blood fat examination.
  • Stool examination for detecting any intestinal worms, dysentery, gastrointestinal and hidden bleeding, etc.
  • Detailed urine report for kidney function or other infections.
  • Ultrasound of prostate gland and PSA (blood test for cancer of prostate) is advisable for men over 50 years, at extra charge.
  • Electrocardiogram (ECG) for heart screening.

Detailed medical report is mailed to you two to four weeks after your examination by the physician.