Vital Numbers

Blood Pressure

blood pressure

When the heart beats, it contracts and pushes blood through the arteries to the rest of the body. This pressure on the arteries is called Systolic Blood Pressure.

A normal systolic blood pressure is 120 or below. A systolic blood pressure of 120-139 indicates borderline high blood pressure. A systolic blood pressure number of 140 or higher, on repeated measurements, is considered to be hypertension, or high blood pressure.

The pressure in the arteries between heartbeats - when the heart muscle is resting between beats and refilling with blood, is called Diastolic blood pressure.

A normal diastolic blood pressure number is less than 80. A diastolic blood pressure between 80 and 89 indicates pre-hypertension. A diastolic blood pressure number of 90 or higher is considered to be hypertension or high blood pressure.


Cholesterol

cholesterol-1 cholesterol-2

Cholesterol is a waxy, fatty substance produced in the liver and other cells from certain foods, such as dairy products, eggs and meat. The human body needs cholesterol to function properly. The cell membranes need cholesterol to produce hormones, vitamin D and the bile acids that help digest fat.

But the body only needs a limited amount of cholesterol. When there is too much cholesterol present, plaque - a thick, hard substance - may form in the arteries, thereby narrowing the space through which blood flows. Over time, this buildup causes hardening of the arteries, also known as atherosclerosis. When enough oxygenated blood does not reach the heart, you may have chest pain called angina. If the blood supply is completely blocked, a heart attack occurs.

Cholesterol travels through the blood attached to a protein. The combination protein and cholesterol is called a lipoprotein. There are three types of lipoproteins in your blood: high density, low density, and very low density. The specific type depends on how much protein there is in relation to fat.

Low density lipoproteins (LDL) are also called "bad cholesterol" because it can cause plaque buildup on the walls of arteries. The more LDL there is in the blood, the greater the risk of heart disease.
High density lipoproteins (HDL) are also called "good cholesterol". It helps the body get rid of LDL. Maintaining a higher level of HDL is good. If your HDL level is low your risk of heart disease goes up.
Very low density lipoproteins (VLDL) are similar to LDL in that it contains mostly fat and not much protein.

When your cholesterol is checked, you get a number for total cholesterol, one for the HDL level, and one for the LDL level. Your total cholesterol will be more than the sum of the HDL and LDL numbers. Either a high HDL number or a high LDL number can make your total cholesterol number high. If it's high because of a high HDL number, your health is not necessarily in danger. However, if it is high because your LDL cholesterol level is high, it is important to talk with your doctor about your health.


Blood Sugar

A Blood Sugar Test measures the amount of glucose in the blood. Glucose comes from carbohydrate foods and is the main source of energy used by the body. Insulin is a hormone, produced in the pancreas, that helps the body cells use the glucose.

blood-sugar

Normally, the blood glucose level increases slightly after you eat. This increase causes your pancreas to release insulin to normalise the blood sugar level. Blood glucose levels that remain high over time can damage your eyes, kidneys, nerves and blood vessels. There are several different types of blood glucose tests.

  • Fasting blood sugar (FBS): This measures blood glucose levels after you have not eaten for at least 8 hours. It is often the first test done to check for pre-diabetes and diabetes.
  • PP blood sugar : 2-hour Post-Prandial blood sugar measures blood glucose exactly 2 hours after you start eating a meal. This test is used to see if the right amount of insulin is secreted or not, after a meal.
  • Random blood sugar (RBS): This measures blood glucose regardless of when you last ate. Several random measurements may be taken throughout the day. Random testing is useful because glucose levels in healthy people do not vary widely throughout the day. Blood glucose levels that vary widely may mean a problem. This test is also called a casual blood glucose test.

Heart Health Checkup

ECG (Electrocardiogram)

ecg

ECG is a test that checks for problems about the electrical activity of the heart. An ECG translates the heart's electrical activity into line tracings on paper. The spikes and dips in the line tracings are called waves.

Electrocardiography (ECG or EKG from Greek: kardia, meaning heart) is the recording of the electrical activity of the heart. Traditionally this is in the form of a transthoracic (across the thorax or chest) interpretation of the electrical activity of the heart over a period of time, as detected by electrodes attached to the surface of the skin and recorded or displayed by a device external to the body. The recording produced by this noninvasive procedure is termed an electrocardiogram (also ECG or EKG). It is possible to record ECGs invasively using an implantable loop recorder.

An ECG is used to measure the heart's electrical conduction system. It picks up electrical impulses generated by the polarization and depolarization of cardiac tissue and translates into a waveform. The waveform is then used to measure the rate and regularity of heartbeats, as well as the size and position of the chambers, the presence of any damage to the heart, and the effects of drugs or devices used to regulate the heart, such as a pacemaker.


TMT Test

tmt test

It is common to find heart patients who have normal ECG. One must remember that the ECGs are taken at rest when the heart is beating at its lowest rate. Even with 90% blocks the patients can have a normal ECG. In such cases the patient would also agree that at rest there is no pain in the chest, the angina symptoms would only come when they increase the heart rate, while doing some physical exertion like walking.

This is the condition where we need a TMT test. The patients are to gradually increase their heart rate, thus increasing the blood requirement of the heart muscles. Simultaneously ECG records are taken. If there is a blockage of approximately more than 70% ECG shows changes, suggestive of Angina.

Patients have to physically exert for this test which uses a computerized machine. The level of the exercise is gradually increased according to a standard protocol. The continuous ECG monitoring during the exercise would reflect any blood and oxygen deficit in the muscles of the heart during exercise. The patient is asked to stop exercising as soon as ECG changes appear or any symptoms of chest pain or discomfort or breathlessness are felt.

A negative TMT or Stress Test is declared when the patient can reach a certain heart rate without showing any ECG changes. This rate is called a target heart rate and is calculated by a formula (Target Heart Rate = 220 - age of patient). If this rate is reached by the patient without producing any ECG changes, though the TMT can be called negative, but it would not mean that the blockage is zero. It will only mean that the person performing the test probably has a blockage less than 70%.


Angiogram

Angiogram (Angiography) is an X-ray test that uses a special dye and camera (fluoroscopy) to take pictures of the blood flow in an artery (such as the aorta) or a vein (such as the vena cava). An angiogram can be used to look at the arteries or veins in the head, arms, legs, chest, or back.


Blood Tests

Periodical blood tests are essential to keep a track on the various Vital Numbers like Blood Sugar, Thyroid and Cholesterol.


spect scanner

SPECT

Single-photon Emission Computed Tomography (SPECT) is a nuclear medicine tomographic imaging technique using gamma rays.

It is very similar to conventional nuclear medicine planar imaging using a gamma camera. However, it is able to provide true 3D information. This information is typically presented as cross-sectional slices through the patient, but can be freely reformatted or manipulated as required.

The technique requires delivery of a gamma-emitting radioisotope (a radionuclide) into the patient, normally through injection into the bloodstream. In certain cases, the radioisotope is a simple soluble dissolved ion, such as a radioisotope of gallium(III). Most of the time, though, a marker radioisotope is attached to a specific ligand to create a radioligand, whose properties bind it to certain types of tissues. This marriage allows the combination of ligand and radiopharmaceutical to be carried and bound to a place of interest in the body, where the ligand concentration is seen by a gamma camera.


Myocardial Perfusion Scan

Myocardial perfusion scan is a nuclear medicine [Nuclear medicine is a medical specialty involving the application of radioactive {the emission of alpha particles, beta particles, and gamma rays} substances in the diagnosis and treatment of a disease.] procedure that illustrates the function of the heart muscle. It evaluates many heart conditions such as coronary artery disease (CAD), hypertrophic cardiomyopathy and heart wall motion abnormalities. The function of the myocardium is also evaluated by calculating the left ventricular ejection fraction (LVEF) of the heart.

This scan is done in conjunction with a cardiac stress test - is a test used in medicine and cardiology to measure the heart's ability to respond to external stress in a controlled clinical environment. The stress response is induced by exercise or drug stimulation.


FFR

Fractional Flow Reserve (FFR) is a technique used in coronary catheterization to measure pressure differences across a coronary artery stenosis (narrowing, usually due toatherosclerosis) to determine the likelihood that the stenosis impedes oxygen delivery to the heart muscle (myocardial ischemia).

Ideal Diet

diet

An all-fruit diet for three to five days, with three meals a day of fresh juicy fruits, at five-hourly intervals, and use warm water enema to cleanse the bowels. Thereafter, adopt a well-balanced diet on the following lines...

  • Upon arising: A glass of lukewarm water with half a freshly squeezed lime and a teaspoon of honey.
  • Breakfast: Fresh fruits and skimmed milk, sweetened with honey.
  • Lunch: A bowl of freshly prepared steamed vegetables, two or three whole-wheat wheat tortilla and a glass of buttermilk.
  • Mid-afternoon: Vegetable or fruit juice or coconut water.
  • Dinner: Fresh green vegetables salad and sprouts with lemon juice dressing. Follow it by a hot course, if desired.
  • Bedtime Snack: A glass of milk or one apple.
  • Do not take water with meals, but half an hour before or an hour after a meal.
  • Eat slowly, chew your food thoroughly and never eat to full stomach.
  • Restrict the intake of salt.
  • Take foods rich in vitamin E liberally.
  • It is important to consult a doctor, for information on your ideal calorie intake.

Tips & Tricks of a Healthy Diet

Foods that are rich in Vitamin C are good for heart patients, as it can help boost the immune system in a person and can reduce the risks of any complications. However, oranges and lemons should not be the only source of Vitamin C in a heart patient diet. Green leafy vegetables like spinach, lettuce and cabbage are very high in Vitamin C too.

ideal diet

The level of sugar in the blood should be controlled even by those heart patients that are not suffering from diabetes. Therefore, foods that are high in sugar, white flour and other simple carbohydrates should be avoided or even preferably eliminated from a heart patient diet. Foods that contain whole wheat flour are preferable to products that are made from refined flour.

Skipping meals, especially breakfast, is strongly discouraged in any healthy diet. It is better to eat six small meals each day, instead of two or three large meals. The meals that should be a part of a heart patient diet are breakfast, snack, lunch, snack, dinner and a snack.

Eating foods, that contain over 6 grams of soy protein in each serving, is excellent for reducing cholesterol,, by up to 10%. For people who don't eat soybean or tofu, there are other options, like cereals that have been fortified with soy.

Several heart patients are asked to go on a soupy diet. This could include clear celery soup, cabbage soup or any other soup that restricts the intake of fats. The diet for a heart patient should have no more than 30% of the calories that are from fat and no more than 10% of the calories that are from saturated fat. Therefore, foods that are a part for animal products will need to be strictly avoided.

Try to lose weight if you are above your ideal body weight, as determined by your height and age. This should be a gradual process, so avoid any fad diets or quick weight loss methods.

Quality of fat is more important than quantity. Along with reducing the quantity emphasize on omega 3 fats in the diet; this can be done in the form of adding flaxseeds and fish. Avoid consumption of margarine, oily or fried foods, red meat, carbonated drinks and sweet preparations like cakes & pastries.

Foods high in magnesium, helping to protect the heart, include foods such as broccoli, potatoes, tofu, spinach, and wheat germ. Include at least 8-9 servings of fresh fruits and vegetables in a day's diet and 1 serving of green leafy vegetable daily.

Exercise Regimen

exercise

How much and how often?

There is no clear consensus on the basis of trial data as to the optimal duration, frequency and type of exercise in primary or secondary prevention of coronary artery disease. However, it can be agreed that exercise undertaken to prevent coronary artery disease, in order to be effective, should...

  • Be sustained in the long term.
  • Be regular, i.e. at least 4-5 days per week.
  • Last for about 30 minutes.
  • Be of mild-to-moderate intensity, i.e. enough to make people feel warm and out of breath, but not so vigorous as to cause extreme breathlessness.

What sort of exercise?

Useful activities would include regular walking, cycling, swimming, gardening or dancing. Aerobic exercise is thought to be more beneficial and less risky than anaerobic exercise. Patients should be advised to avoid exertion that causes straining or raised intra-abdominal/intra-thoracic pressure, such as weightlifting, etc. if they are inactive and/or are suffering from coronary artery disease. Sedentary people should start with mild exertion for short periods, and then gradually build the duration and intensity of the exercise over a few weeks.

It is best to avoid sudden, erratic bouts of exercise in middle age or in those suffering from coronary artery disease, as there is good evidence that it increases the risk of myocardial infarction (MI) and sudden cardiac death in these groups. There is no evidence that vigorous, prolonged exertion provides any further benefit than moderate, gentle, aerobic exercise of moderate duration, but more extreme exercise does appear to increase the risk of adverse cardiac events.

Those that take regular exercise are much less likely to develop complications as a consequence of vigorous exercise. There is some evidence to suggest that the risk of adverse events due to exercise is increased in those who exercise early in the morning. There is evidence that the benefits of regular exercise are available to all, including healthy older patients, particularly in terms of peripheral blood flow mediated through enhanced endothelial nitric acid production.

Things to Avoid

80% of premature heart attacks and strokes are preventable. If you really want to avoid a heart attack, consider the tips below...


Stop Smoking and using Tobacco

no smoking

Tobacco in every form is very harmful to health - cigarettes, cigars, pipes, or even chewable tobacco. Exposure to second-hand tobacco smoke is also dangerous. Chemicals in tobacco can damage your heart and blood vessels, leading to narrowing of the arteries (atherosclerosis). Atherosclerosis can ultimately lead to a heart attack.

Carbon monoxide in cigarette smoke replaces some of the oxygen in your blood. This increases your blood pressure and heart rate by forcing your heart to work harder to supply enough oxygen. Women who smoke and take birth control pills are at greater risk of having a heart attack or stroke.

The risk of heart attack and stroke starts to drop immediately after a person stops using tobacco products, and can drop by as much as half after one year.


Regulate your Blood Pressure

High blood pressure usually has no symptoms, but can cause a sudden stroke or heart attack. Have your blood pressure checked.


Regulate your Blood Sugar

Raised blood glucose (diabetes) increases the risk of heart attacks and strokes. If you have diabetes it is very important to control your blood pressure and blood sugar to minimize the risk.


Regulate your Cholesterol levels

Raised blood cholesterol and abnormal blood lipids increase the risk of heart attacks and strokes. Blood cholesterol needs to be controlled through a healthy diet and, if necessary, by appropriate medications.


no junk foods

Avoid Junk Foods

Junk food is food that is calorie-dense and nutrient poor. Today, junk food businesses are dominating the food industry to a great extent, with each huge food chain generating multibillion dollar revenue, creating thousands of employment opportunities and influencing diet globally. But all this comes at the cost of health and well-being of millions of consumers.

Junk food items are loaded with saturated fats and Trans-fats that directly increase triglyceride and bad cholesterol (LDL) levels in the blood, contributing to plaque formation and heart disease. Further, causing a sudden spike in blood sugar level increases, junk food damages the linings of the blood vessels causing chronic inflammation. This inflammation causes bad cholesterol to stick to the walls of the arteries, blocking blood flow to the heart. When they're blocked enough, heart attack occurs.

Fats from junk food can accumulate over a period of time in your body to make you obese. The more weight you put on, the higher your risk of suffering from heart attack.


Stay Informed

The only constant is change. This is especially true in the medical field, as new techniques and insights develop constantly. Do not believe every piece of "scientific information" you find in the media or advertisements.

An overwhelming number of research studies that make it into scientific publications are poorly designed or yield data that are not representative, e.g., due to a lack of a sufficient number of participants. Keep in mind that many studies are financed or sponsored by individuals or companies with a vested interest in gaining favorable results. So, keep your eyes open.


Reduce Stress

reduce stress

Stress contributes to cardiovascular diseases in a major way. Severe stress can cause a heart attack or even death. There are plenty of options that help reduce stress, such as regular exercise, adequate sleep, striving for a happy family life, laughing, volunteering or attending religious services, etc.

Watching TV generally does not relieve, but can aggravate stress. Also, try to avoid situations and people who make you anxious or angry. Meditation and other Yogic exercises also help in a great way to remove the stress factor.

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