Additional Resources

Feel free to look through this alphabetical listing of various patient education links. These links will opein in a new window on your compuater. Once you are done reviewing that particular document, simply close the window to return to our site.

You can expand an alphabetical category by clicking on one of the links below.

Educate Yourself to Live Longer, Live Better

Regulating High Blood Pressure Needs a Broad Approach

by 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" Cholesterol

by 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 medical conditions.

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.