Educate Yourself to Live Longer, Live Better
Regulating High Blood Pressure Needs a Broad Approachby Dr. David Southren
High blood pressure (HBP), or hypertension, is a common risk factor which affects millions of individuals at all ages. It is commonly measured by blood pressure readings, although this is not all there is to high blood pressure, as even individuals with the condition can have normal bp readings at times.
HBP is associated with increased risk of heart disease, all blood vessel diseases, and stroke. Its presence also makes mental deterioration in older age more likely. It is commonly treated with a variety of medications. But keep in mind, that just because bp readings may go down to normal, the problem does not go away, because the disorder affects many organs such as the kidney and the heart, as well as the brain.
Even though there are many types of medications that can lower the blood pressure, it may even escape the doctor that some agents also worsen other problems, such as diabetes and high cholesterol. For instance, beta blockers are commonly used for HBP, but many of them raise blood glucose levels (diabetes) and triglyceride levels (part of the cholesterol problem).
When HBP is present, it leads to more risk if it is combined with elevated blood sugar, high cholesterol, obesity, or smoking.
The optimal approach to HBP is for the doctor to recognize the whole picture of a person’s health, their other risk factors and lifestyle, and to design an optimal treatment plan that maximizes bp control while working along with the treatment of the other issues.
There's More to Lipoproteins Than "Good" and "Bad" Cholesterolby Dr. David Southren
Cholesterol is a component of many essential body structures and is necessary for life. Cholesterol is carried in the bloodstream in packets called “lipoproteins”, which are the more important components of some needed bodily functions. These lipoproteins deliver cholesterol and another important fat, called triglycerides (which supply energy to all body organs) to the tissues that need them, and also are responsible for carrying away excess amounts before they deposit in blood vessels.
If too much cholesterol gets into the blood vessels,
it forms atherosclerotic plaque, which can later lead to blocked arteries. The consequences
of this include heart attacks and stroke, caused by loss of blood supply to vital
organs such as the heart and brain, due to blockage in the arteries. These processes
can occur slowly and gradually, or suddenly.
Most people want to know what their “cholesterol levels”
are, thinking this is the “gold standard” of their health! However, these numbers,
like the LDLcholesterol (bad cholesterol) or the HDLcholesterol (good cholesterol)
do not tell an accurate picture of risk. The parameters commonly measured and reported
to patients include the total cholesterol, triglyceride level, HDL-C and LDL-C.
Unfortunately, people with heart disease and people
without heart disease often have very similar levels of these parameters. That is
why they may not prove very useful in determining whether an individual is at risk.
More complex indicators, including lipoprotein levels,
are easily obtainable, but their interpretation requires a physician that has had
extra training in this area, or a physician that keeps up with the newest developments
in medical science.
It is important to realize that even though there are
a number of medications that can improve the lipid parameters once they are properly
assessed, careful and competent judgment is needed to know just how to use the medications
in combination with other medical issues. Only a highly-trained physician can understand
the specific properties as well as possible side effects of the medications that
can be used. In many instances, a combination of a statin (such as Crestor or Lipitor)
and another type of agent that works in different ways is the best approach. The
physician must know how these medications interact with other medications and with
It is also necessary to know under what instances lifestyle
changes can help. Although it is always important to optimize weight and exercise,
some patterns of the lipid panel have the potential for major change with lifestyle,
and some patterns do not.
The combination of the right testing and assessment in the hands of highly-trained doctors leads to the best understanding of the lipid testing, the best way to treat findings, and optimize individual risk.