Tag Archives: Hypertension

Normal Blood pressure: How low should a person can go?

A new study suggests greater health benefits with a lower-than-standard number.

CLICK & SEE THE PICTURE : 

Blood pressure has long been one of the best markers of your health. It is a number you can remember and monitor. High blood pressure (hypertension) is linked to a greater risk of heart attacks and strokes.

About one out of three adults has high blood pressure, which is usually defined as a reading of 140/90 millimeters of mercury (mm Hg) or higher.

The first, or upper, number (systolic pressure) represents the pressure inside the arteries when the heart beats, and the second, or lower, number (diastolic pressure) is the pressure between beats when the heart rests.

Blood pressure rises with age because of increasing stiffness of large arteries, long-term buildup of plaque, and the effects of other diseases involving the heart and blood vessels. Typically, more attention is given to the diastolic reading as a major risk factor for cardiovascular disease.

“In fact, for a long time, some physicians felt that a systolic (upper) number higher than 140 could be tolerated in older people,” says Dr. Paul Huang, a cardiologist with Harvard-affiliated Massachusetts General Hospital. “But both upper and lower numbers are equally important.”

A new number to aim for

While 140/90 continues to be the blood pressure cutoff, a study published in the Nov. 26, 2015 issue of The New England Journal of Medicine shows that lowering pressure to around 120/80 may reap greater benefits.

Researchers examined the initial results from the Systolic Blood Pressure Intervention Trial, or SPRINT, which studied 9,361 adults over age 50 who either had hypertension or were at a high risk for cardiovascular disease.

The subjects were divided into two groups. The first received an intensive treatment to lower blood pressure to less than 120/80. The other group followed a standard treatment to lower it to less than 140/90.

After three years, the researchers found that the group with the target of below 120/80 had a 25% lower risk of heart attack, stroke, or cardiovascular death compared with those with the standard target of less than 140/90. They also had 27% fewer deaths from any cause. (The study was stopped early because the outcome in the intensive treatment group was so much better than in the standard treatment group.)
Ups and downs of lower numbers

This study supports observational studies that have found that lower blood pressure reduces cardiovascular risk.

But what does it take to get to the lower numbers? “On average, the people in the intensive treatment group took three blood pressure medications, while those in the standard treatment group only took two,” says Dr. Huang.

Moreover, the study found that the benefits in reducing heart attacks, strokes, and death were found equally in those older or younger than age 75. “So we can no longer say that a higher blood pressure is okay just because someone’s older,” he says.

But should older men focus on going lower? Is lower than 140/90 good enough, or should you be more aggressive and get that number down as close as possible to 120/80?

“If you currently are on blood pressure medicine, and your pressure is lower than 140/90, you should discuss with your doctor whether you should aim to go even lower,” says Dr. Huang. “There may be additional benefits to further reducing your stroke and heart attack risk.”

Still, there may be some downsides to going lower. For instance, many people may not want to take any additional medication. They may be concerned about battling common side effects, such as extra urination, erection problems, weakness, dizziness, insomnia, constipation, and fatigue. They also may have enough trouble monitoring their current medication without adding more to the mix.

Another potential problem: pressure that drops too low. “This could lead to dizziness and lightheadedness, especially when suddenly rising from a seated position, and increase your risk of falls,” says Dr. Huang.

Also, because the study was stopped early, other possible downsides of the extra medications, such as effects on cognitive function or kidney function, remain unknown.

Monitor your blood pressure:

If anything, this study reinforces the need for men to be more diligent about maintaining a healthy level, says Dr. Huang. He suggests older men follow these basic guidelines:

*Check your pressure every month and alert your doctor to changes. “If the upper number is repeatedly higher than 140, or the lower number higher than 90, let your doctor know,” he says.

*Continue to take your medications as prescribed. “If you suffer from any side effects, talk with your doctor about changing the dosage or drug.”

*Reduce your salt intake. “You do not have to go sodium-free, but be more aware of how much sodium is in the foods you eat,” he says. In general, try to keep your sodium intake below 2,000 milligrams a day. Foods that include the words “smoked,” “processed,” “instant,” or “cured” in the name or on the label are often quite high in sodium.

*Continue to exercise or adopt some kind of workout routine. “Activity and weight loss can help lower and maintain a healthy blood pressure,” says Dr. Huang.

From : Harvard Health Publications
Harvard Medical School

Advertisements

Complications In Pregnancy

 

Pre-eclampsia, eclampsia or toxemia of pregnancy
Definition:
Pre-eclampsia or preeclampsia (PE) is a disorder of pregnancy characterized by high blood pressure and a large amount of protein in the urine. The disorder usually occurs in the third trimester of pregnancy and gets worse over time. In severe disease there may be red blood cell breakdown, a low blood platelet count, impaired liver function, kidney dysfunction, swelling, shortness of breath due to fluid in the lungs, or visual disturbances. PE increases the risk of poor outcomes for both the mother and the baby. If left untreated, it may result in seizures at which point it is known as eclampsia.

CLICK & SEE

Toxemia of pregnancy is a severe condition that sometimes occurs in the latter weeks of pregnancy. It is characterized by high blood pressure; swelling of the hands, feet, and face; and an excessive amount of protein in the urine. If the condition is allowed to worsen, the mother may experience convulsions and coma, and the baby may be stillborn.
The term toxemia is actually a misnomer from the days when it was thought that the condition was caused by toxic (poisonous) substances in the blood. The illness is more accurately called preeclampsia before the convulsive stage and eclampsia afterward.

Preeclampsia affects between 2–8% of pregnancies worldwide. Hypertensive disorders of pregnancy are one of the most common causes of death due to pregnancy. They resulted in 29,000 deaths in 2013 – down from 37,000 deaths in 1990. Preeclampsia usually occurs after 32 weeks; however, if it occurs earlier it is associated with worse outcomes. Women who have had PE are at increased risk of heart disease later in life. The word eclampsia is from the Greek term for lightning. The first known description of the condition was by Hippocrates in the 5th century BCE

Symptoms:
Swelling (especially in the hands and face) was originally considered an important sign for a diagnosis of preeclampsia. However, because swelling is a common occurrence in pregnancy, its utility as a distinguishing factor in preeclampsia is not great. Pitting edema (unusual swelling, particularly of the hands, feet, or face, notable by leaving an indentation when pressed on) can be significant, and should be reported to a health care provider.

In general, none of the signs of preeclampsia are specific, and even convulsions in pregnancy are more likely to have causes other than eclampsia in modern practice. Further, a symptom such as epigastric pain may be misinterpreted as heartburn. Diagnosis, therefore, depends on finding a coincidence of several preeclamptic features, the final proof being their regression after delivery.

The symptoms of toxemia of pregnancy (which may lead to death if not treated) are divided into three stages, each progressively more serious:
Mild preeclampsia symptoms include edema (puffiness under the skin due to fluid accumulation in the body tissues, often noted around the ankles), mild elevation of blood pressure, and the presence of small amounts of protein in the urine.

Severe preeclampsia symptoms include extreme edema, extreme elevation of blood pressure, the presence of large amounts of protein in the urine, headache, dizziness, double vision, nausea, vomiting, and severe pain in the right upper portion of the abdomen.
Eclampsia symptoms include convulsions and coma.

Risk Factors:
Known risk factors for preeclampsia include:

*Nulliparity (never given birth)
*Older age, and diabetes mellitus
*Kidney disease
*Chronic hypertension
*Prior history of preeclampsia
*Family history of preeclampsia
*Advanced maternal age (>35 years)
*Obesity
*Antiphospholipid antibody syndrome
*Multiple gestation
*Having donated a kidney.
*Having sub-clinical hypothyroidism or thyroid antibodies

It is also more frequent in a women’s first pregnancy and if she is carrying twins. The underlying mechanism involves abnormal formation of blood vessels in the placenta amongst other factors. Most cases are diagnosed before delivery. Rarely, preeclampsia may begin in the period after delivery. While historically both high blood pressure and protein in the urine were required to make the diagnosis, some definitions also include those with hypertension and any associated organ dysfunction. Blood pressure is defined as high when it is greater than 140 mmHg systolic or 90 mmHg diastolic at two separate times, more than four hours apart in a women after twenty weeks of pregnancy. PE is routinely screened for during prenatal care.
Causes:
There is no definitive known cause of preeclampsia, though it is likely related to a number of factors. Some of these factors include:

*Abnormal placentation (formation and development of the placenta)
*Immunologic factors
*Prior or existing maternal pathology – preeclampsia is seen more at a higher incidence in individuals with preexisting hypertension, obesity, antiphospholipid antibody syndrome, and those with history of preeclampsia
*Dietary factors, e.g. calcium supplementation in areas where dietary calcium intake is low has been shown to reduce the risk of preeclampsia.
*Environmental factors, e.g. air pollution
*Those with long term high blood pressure have a risk 7 to 8 times higher than those without.

Physiologically, research has linked preeclampsia to the following physiologic changes: alterations in the interaction between the maternal immune response and the placenta, placental injury, endothelial cell injury, altered vascular reactivity, oxidative stress, imbalance among vasoactive substances, decreased intravascular volume, and disseminated intravascular coagulation.

While the exact cause of preeclampsia remains unclear, there is strong evidence that a major cause predisposing a susceptible woman to preeclampsia is an abnormally implanted placenta. This abnormally implanted placenta is thought to result in poor uterine and placental perfusion, yielding a state of hypoxia and increased oxidative stress and the release of anti-angiogenic proteins into the maternal plasma along with inflammatory mediators. A major consequence of this sequence of events is generalized endothelial dysfunction. The abnormal implantation is thought to stem from the maternal immune system’s response to the placenta and refers to evidence suggesting a lack of established immunological tolerance in pregnancy. Endothelial dysfunction results in hypertension and many of the other symptoms and complications associated with preclampsia.

One theory proposes that certain dietary deficiencies may be the cause of some cases. Also, there is the possibility that some forms of preeclampsia and eclampsia are the result of deficiency of blood flow in the uterus.

Diagnosis:
Pre-eclampsia is diagnosed when a pregnant woman develops:

*Blood pressure >_ 140 mm Hg systolic or  >_  90 mm Hg diastolic on two separate readings taken at least four to six hours apart after 20 weeks gestation in an individual with previously normal blood pressure.
*In a woman with essential hypertension beginning before 20 weeks gestational age, the diagnostic criteria are: an increase in systolic blood pressure (SBP) of   >_ 30mmHg or an increase in diastolic blood pressure (DBP) of   >_15mmHg.
*Proteinuria  >_ 0.3 grams (300 mg) or more of protein in a 24-hour urine sample or a SPOT urinary protein to creatinine ratio  >_ 0.3 or a urine dipstick reading of 1+ or greater (dipstick reading should only be used if other quantitative methods are not available)

Suspicion for preeclampsia should be maintained in any pregnancy complicated by elevated blood pressure, even in the absence of proteinuria. Ten percent of individuals with other signs and symptoms of preeclampsia and 20% of individuals diagnosed with eclampsia show no evidence of proteinuria. In the absence of proteinuria, the presence of new-onset hypertension (elevated blood pressure) and the new onset of one or more of the following is suggestive of the diagnosis of preeclampsia:

*Evidence of kidney dysfunction (oliguria, elevated creatinine levels)
*Impaired liver function (impaired liver function tests)
*Thrombocytopenia (platelet count <100,000/microliter)
*Pulmonary edema
*Ankle edema pitting type
*Cerebral or visual disturbances
*Preeclampsia is a progressive disorder and these signs of organ dysfunction are indicative of severe preeclampsia. A systolic blood pressure ?160 or diastolic blood pressure ?110 and/or proteinuria >5g in a 24-hour period is also indicative of severe preeclampsia. Clinically, individuals with severe preeclampsia may also present epigastric/right upper quadrant abdominal pain, headaches, and vomiting. Severe preeclampsia is a significant risk factor for intrauterine fetal death.

Of note, a rise in baseline blood pressure (BP) of 30 mmHg systolic or 15 mmHg diastolic, while not meeting the absolute criteria of 140/90, is still considered important to note, but is not considered diagnostic.

Predictive tests:
There have been many assessments of tests aimed at predicting preeclampsia, though no single biomarker is likely to be sufficiently predictive of the disorder. Predictive tests that have been assessed include those related to placental perfusion, vascular resistance, kidney dysfunction, endothelial dysfunction, and oxidative stress. Examples of notable tests include:

*Doppler ultrasonography of the uterine arteries to investigate for signs of inadequate placental perfusion. This test has a high negative predictive value among those individuals with a history of prior preeclampsia.
*Elevations in serum uric acid (hyperuricemia) is used by some to “define” preeclampsia,[14] though it has been found to be a poor predictor of the disorder. Elevated levels in the blood (hyperuricemia) are likely due to reduced uric acid clearance secondary to impaired kidney function.
*Angiogenic proteins such as vascular endothelial growth factor (VEGF) and placental growth factor (PIGF) and anti-angiogenic proteins such as soluble fms-like tyrosine kinase-1 (sFlt-1) have shown promise for potential clinical use in diagnosing preeclampsia, though evidence is sufficient to recommend a clinical use for these markers.
*Recent studies have shown that looking for podocytes, specialized cells of the kidney, in the urine has the potential to aid in the prediction of preeclampsia. Studies have demonstrated that finding podocytes in the urine may serve as an early marker of and diagnostic test for preeclampsia. Research is ongoing.

Differential diagnosis:
Pre-eclampsia can mimic and be confused with many other diseases, including chronic hypertension, chronic renal disease, primary seizure disorders, gallbladder and pancreatic disease, immune or thrombotic thrombocytopenic purpura, antiphospholipid syndrome and hemolytic-uremic syndrome. It must be considered a possibility in any pregnant woman beyond 20 weeks of gestation. It is particularly difficult to diagnose when preexisting disease such as hypertension is present. Women with acute fatty liver of pregnancy may also present with elevated blood pressure and protein in the urine, but differs by the extent of liver damage. Other disorders that can cause high blood pressure include thyrotoxicosis, pheochromocytoma, and drug misuse
Treatment:
Preeclampsia and eclampsia cannot be completely cured until the pregnancy is over. Until that time, treatment includes the control of high blood pressure and the intravenous administration of drugs to prevent convulsions. Drugs may also be given to stimulate the production of urine. In some severe cases, early delivery of the baby is needed to ensure the survival of the mother.

Prevention:
Recommendations for prevention include: aspirin in those at high risk, calcium supplementation in areas with low intake, and treatment of prior hypertension with medications. In those with PE delivery of the fetus and placenta is an effective treatment. When delivery becomes recommended depends on how severe the PE and how far along in pregnancy a person is. Blood pressure medication, such as labetalol and methyldopa, may be used to improve the mother’s condition before delivery. Magnesium sulfate may be used to prevent eclampsia in those with severe disease. Bedrest and salt intake have not been found to be useful for either treatment or prevention.

Diet:
Protein or calorie supplementation have no effect on preeclampsia rates, and dietary protein restriction does not appear to increase preeclampsia rates. Further, there is no evidence that changing salt intake has an effect.

Supplementation with antioxidants such as vitamin C and E has no effect on preeclampsia incidence, nor does supplementation with vitamin D. Therefore, supplementation with vitamins C, E, and D is not recommended for reducing the risk of pre-eclampsia.

Calcium supplementation of at least 1 gram per day is recommended during pregnancy as it prevents preeclampsia where dietary calcium intake is low, especially for those at high risk. Low selenium status is associated with higher incidence of preeclampsia.

Aspirin:
Taking aspirin is associated with a 1% to 5% reduction in preeclampsia and a 1% to 5% reduction in premature births in women at high risk. The WHO recommends low-dose aspirin for the prevention of preeclampsia in women at high risk and recommend it be started before 20 weeks of pregnancy. The United States Preventive Services Task Force recommends a low-dose regimen for women at high risk beginning in the 12th week.

Physical activity:
There is insufficient evidence to recommend either exercise or strict bedrest as preventative measures of pre-eclampsia.

Smoking cessation:
In low-risk pregnancies the association between cigarette smoking and a reduced risk of preeclampsia has been consistent and reproducible across epidemiologic studies. High-risk pregnancies (those with pregestational diabetes, chronic hypertension, history of preeclampsia in a previous pregnancy, or multifetal gestation) showed no significant protective effect. The reason for this discrepancy is not definitively known; research supports speculation that the underlying pathology increases the risk of preeclampsia to such a degree that any measurable reduction of risk due to smoking is masked. However, the damaging effects of smoking on overall health and pregnancy outcomes outweighs the benefits in decreasing the incidence of preeclampsia. It is recommended that smoking be stopped prior to, during and after pregnancy

Restriction of salt in the diet may help reduce swelling, it does not prevent the onset of high blood pressure or the appearance of protein in the urine. During prenatal visits, the doctor routinely checks the woman’s weight, blood pressure, and urine. If toxemia is detected early, complications may be reduced.

Resources:
http://health.howstuffworks.com/pregnancy-and-parenting/pregnancy/complications/a-guide-to-pregnancy-complications-ga13.htm
http://en.wikipedia.org/wiki/Pre-eclampsia

Some Health Quaries & Answers

If the shoe fits
Q: I want to buy a sports shoe but they seem to range in price from less than Rs 500 to Rs 10,000. How do I know which one to buy?


A: When buying a sports shoe it is important to consider what you will be using it for. Is it to walk, run, for serious aerobics or just as a fashion statement?

If it is for exercise then you need to go to a sports store and ask for a shoe designed specifically for the particular activity you wish to do.

Look at a few shoes. Before selecting a shoe:

Look at it head on to make sure it is perfectly symmetrical.

See if the tongue is laced with the shoe. That way it will not slip around placing the eyelets in contact with your foot. That is potentially injurious.

Make sure the sole “gives” by bending the shoe.

There should be a little space between your toe and the tip of the shoe. Shoes do not “loosen” with use. Your foot will get damaged before that happens. Nor will you “grow” into a shoe that is too large.

Buy your shoe in the evening when your foot is slightly swollen from the days activity.

The colour is the least important criteria. With use, all shoes eventually become the same colour.
You may click to see : How to Choose Sports Shoes

Grey smoke
Q: My hair is prematurely grey — I am only 29 years old. My mother says it is because I started smoking in college. Is that true?

A: Your mother is right. The nicotine in cigarettes does cause premature greying. That is however the least of the problems it causes. It also weakens your bones, precipitates heart attacks and causes cancer.

Stroke effect
Q: My father had a stroke (brain attack) and now he mumbles his words. Food drools out of the side of his mouth when he eats. He also cannot close one eye.

A: Your father has lost the use of one side of his body. Paralysis of the eyelid muscles prevents him from closing his eye fully. Similarly, the muscles for speech and swallowing are affected.

He will improve to some extent with physiotherapy. You need to make sure that he does not have a second stroke by treating any pre-existing disease like diabetes, hypertension or high lipids that caused the first stroke.

You need to protect his eye by closing it manually, placing a gauze piece over it and taping it shut with medical tape.

Facial paralysis
Q: My forty-year-old aunt developed isolated paralysis of one side of the face. She opted for ayurvedic treatment and recovered. She is not diabetic nor does she have high blood pressure. What was wrong with her?

A: She seems to have developed a condition called Bell’s palsy, paralysis of the facial nerve. Quite often it is due to an infection with the Herpes virus. In 80 per cent cases recovery is spontaneous and complete. This is probably the category to which your aunt, fortunately for her, belonged.

Lens safety
Q: I want to use a pair of contact lenses to change the colour of my eyes. Is it safe?


A: These are called novelty lenses as they only have cosmetic value. If novelty contact lenses are not properly fitted or if care instructions are ignored, they can cause corneal damage and loss of sight. Eye infections can occur if the lenses are not thoroughly sterilised prior to each use.

This seems a high price to pay for an altered appearance. After all, beauty is in the eye of the beholder.

Shampoo time
Q: How often should I wash my hair?


A: It depends on how dirty your hair becomes, but three times a week is about average. There is no need to use a lot of shampoo. About a Re 1 coin sized dollop is sufficient.
You may click to see : How often should I wash my hair?

Fast food
Q: My son loves instant noodles. He eats them 3-4 times a day. He is 4 years old.


A: Noodles are a good snack once or twice a week, but they should not substitute for good wholesome home cooked food. Some times the instant variety of noodles contains preservatives or ajinomoto. Both these ingredients are best avoided in children’s food.

Rash shave
Q: I got a shave at a barber shop and now, after two weeks, I have developed boils and rashes all over my beard area.

A: This is a very common infection which is either due to the bacteria S. aureus, or a fungus or due to ingrowth of thick beard.

It responds well to hot fomentation, cleansing with a bactericidal soap and local application of ointment. A dermatologist can usually determine accurately whether the infection is fungal or bacterial and prescribe the appropriate ointment. Applying steroid cream will worsen the condition. It usually clears up in a few weeks but can recur. It is probably better to shave at home.

Source : The Telegraph (kolkata, India)

Enhanced by Zemanta

Some Health Quaries & Answers

Ouch! My back hurts:

Q: I am 69 years old and have a pain in my lower back which, when I stand, radiates down both my legs. I am a housewife and the pain makes it very difficult for me to do housework. The orthopaedic I consulted said I have spondylolisthesis but none of the tablets I was prescribed seem to work.


A: Spondylolisthesis can be congenital but usually, especially if it occurs after the age of 50, is due to degeneration of the spinal vertebrae. One vertebra then tends to slip over the other and presses on the nerves (in your case the ones going to the legs) causing the pain.

This condition can usually be managed without surgery. A few days of bed rest should be followed by physiotherapy, concentrating on exercises that help with flexion of the spine and strengthening of the “core” muscles. You should also walk or take up a similar aerobic activity for 40 minutes every day. A lumbosacral brace should be worn at all times, except when lying down or exercising. If you are overweight, you will need to reduce.

Warts and all:

Q: I have had a wart on my finger for some time. Now another one has appeared near it. Both have a repulsive cauliflower like appearance.


A: Warts are a viral infection spread by contact from person to person. They are more likely to occur in children and young adults. They are harmless and not cancerous. They usually disappear on their own without treatment in six months to two years.

Dermatologists also remove them with cryotherapy (freezing), laser and cauterisation. Sometimes they may advise repeated application of medication.

Tread right:

Q: I want to buy a treadmill but do not know how effective exercise on it will be. Also I do not know what type of treadmill to buy.


A: Manual treadmills do not use a motor and move only when the person moves. Electric treadmills use a conveyor belt and motor. There is no wind resistance in a treadmill so unless the incline of the platform is set at 1 per cent, the calorie consumption is 10-15 per cent less than running the same distance on the road. The gait on the treadmill is also more bouncy because of the platform. This leads to bad running form and difficulty when returning to running on the road. Using the treadmill also tends to get repetitive and monotonous so that more mental effort is needed to persist. In short treadmill is expensive, occupies space and is less efficient and interesting than running on the road.

Life after work :

Q: I looked forward to retiring for 30 years, but once I did retire, I feel more stressed and depressed. My wife, who is a housewife, seems to have more to do than me. Also she is stressed because I am around all the time and in her way.

A: The retirement age in India is 58-60 and that is really too early! Most people are healthy, active and still in their prime. If you just sit around the house watching television, eating and sleeping, you will soon deteriorate mentally and physically. To ward this off, try getting a part-time job, starting a small business, joining socially relevant political peoples movements or doing volunteer work. You will feel needed and everyone (including your wife) will be happy.

Salt control :

Q: I have high blood pressure and am on enalapril to control it. My doctor told me to “control salt intake” but was not very specific about how exactly that is done. What should I do?

A: You need around 2.5gm (half a teaspoon) of salt a day if you are less than 50 years old and 1.5gm (quarter teaspoon) if older. This includes hidden salt intake from pickles, pappads, chips and other salty snacks. A rule of thumb is to take half a teaspoon of salt per day per person in the household and use it for cooking. People in the family who do not have high blood pressure can add extra salt if needed.

Down at heel :

Q: A severe pain shoots up my leg whenever I put my foot down in the morning. The doctor took an X-ray and said I have a calcaneal spur. He said I need surgery but I am not really willing to go for it. Is there any other remedy?


A: A calcaneal spur is an extra growth of bone under the heel. It can cause agonising pain. Before you consider surgery, try a few simple measures.

Soak your feet in salted hot water morning and evening. Rock your feet gently in the water.

• Always wear soft footwear. Do not go bare foot even in the house.

• Go to a physiotherapy centre. Ultrasound treatment often helps.

Lose weight if you are obese.

Light therapy:

Q: What should you do if an insect enters your ear?


A: Immediately place your ear near a bright light and turn off all other lights. The insect will usually fly back out again.

Source: The Telegraph ( Kolkata, India)

Enhanced by Zemanta

Metabolic Syndrome

Alternative Names: metabolic syndrome X, cardiometabolic syndrome, syndrome X, insulin resistance syndrome, Reaven’s syndrome (named for Gerald Reaven), and CHAOS (in Australia).

Definition:
Suddenly, it’s a health condition that everyone’s talking about. While it was only identified less than 20 years ago, metabolic syndrome is as widespread as pimples and the common cold. According to the American Heart Association, 47 million Americans have it. That’s almost a staggering one out of every six people.

CLICK TO SEE THE PICTURE

Indeed, metabolic syndrome seems to be a condition that many people have, but no one knows very much about. It’s also debated by the experts — not all doctors agree that metabolic syndrome should be viewed as a distinct condition.

So what is this mysterious syndrome — which also goes by the scary-sounding name Syndrome X — and should you be worried about it?

Understanding Metabolic Syndrome
Metabolic syndrome is not a disease in itself. Instead, it’s a group of risk factors — high blood pressure, high blood sugar, unhealthy cholesterol levels, and abdominal fat.

Obviously, having any one of these risk factors isn’t good. But when they’re combined, they set the stage for grave problems. These risk factors double your risk of blood vessel and heart disease, which can lead to heart attacks and strokes. They increase your risk of diabetes by five times.

Many people who have either diabetes, high blood pressure or obesity also have one or more of the other conditions, although it may have gone unrecognised.

Individually, each of these conditions can lead to damage to the blood vessels, but together they’re far more likely to do harm. People with these conditions in combination become much more likely to experience heart disease, stroke and other conditions related to problems with the blood vessels.

When a person has such a combination, they’re said to have metabolic syndrome. This is also sometimes called insulin-resistance syndrome (because one of the features is a very high level of the hormone insulin in the blood, which the body doesn’t react to or is ‘resistant’ to) or syndrome X.

There are currently two major definitions for metabolic syndrome provided by the International Diabetes Federation  and the revised National Cholesterol Education Program, respectively. The revised NCEP and IDF definitions of metabolic syndrome are very similar and it can be expected that they will identify many of the same individuals as having metabolic syndrome. The two differences are that IDF state that if BMI > 30 kg/m2, central obesity can be assumed, and waist circumference does not need to be measured. However, this potentially excludes any subject without increased waist circumference if BMI < 30, whereas, in the NCEP definition, metabolic syndrome can be diagnosed based on other criteria, and the IDF uses geography-specific cut points for waist circumference, while NCEP uses only one set of cut points for waist circumference, regardless of geography. These two definitions are much closer to each other than the original NCEP and WHO definitions.

Metabolic syndrome is also becoming more common. But the good news is that it can be controlled, largely with changes to your lifestyle.

Symptoms:
The problems found in metabolic syndrome include:


•Central obesity – fat is laid down around the abdomen rather than spread evenly around the body

•Abnormal fat levels in the blood – specifically, high levels of triglycerides and low levels of HDL (or ‘good’) cholesterol, which can lead to arteriosclerosis (fatty plaques) on the walls of blood vessels

•High blood pressure

•Insulin resistance or glucose intolerance – an inability to use insulin properly or control blood sugar levels very well, which is a very important factor in metabolic syndrome

Prothrombotic state – an increased tendency to make tiny clots in the blood

Proinflammatory state – an increased tendency to inflammation

Having one component of metabolic syndrome means you’re more likely to have others. And the more components you have, the greater are the risks to your health.

Causes:
Experts aren’t sure why metabolic syndrome develops. It’s a collection of risk factors, not a single disease. So it probably has many different causes. Some risk factors are:

*Insulin resistance. Insulin is a hormone that helps your body use glucose — a simple sugar made from the food you eat — as energy. In people with insulin resistance, the insulin doesn’t work as well so your body keeps making more and more of it to cope with the rising level of glucose. Eventually, this can lead to diabetes. Insulin resistance is closely connected to having excess weight in the belly.

*Obesity — especially abdominal obesity. Experts say that metabolic syndrome is becoming more common because of rising obesity rates. In addition, having extra fat in the belly — as opposed to elsewhere in the body — seems to increase your risk.

*Unhealthy lifestyle. Eating a diet high in fats and not getting enough physical activity can play a role.

*Hormonal imbalance. Hormones may play a role. For instance, polycystic ovary syndrome (PCOS) — a condition that affects fertility — is related to hormonal imbalance and metabolic syndrome.

If you’ve just been diagnosed with metabolic syndrome, you might be anxious. But think of it as a wake-up call. It’s time to get serious about improving your health. Making simple changes to your habits now can prevent serious illness in the future.

Risk Factors:
The following factors increase your chances of having metabolic syndrome:

*Age. The risk of metabolic syndrome increases with age, affecting less than 10 percent of people in their 20s and 40 percent of people in their 60s. However, warning signs of metabolic syndrome can appear in childhood.

*Race. Hispanics and Asians seem to be at greater risk of metabolic syndrome than other races are.

*Obesity. A body mass index (BMI) — a measure of your percentage of body fat based on height and weight — greater than 25 increases your risk of metabolic syndrome. So does abdominal obesity — having an apple shape rather than a pear shape.

*History of diabetes. You’re more likely to have metabolic syndrome if you have a family history of type 2 diabetes or a history of diabetes during pregnancy (gestational diabetes).

*Other diseases.A diagnosis of high blood pressure, cardiovascular disease or polycystic ovary syndrome — a similar type of metabolic problem that affects a woman’s hormones and reproductive system — also increases your risk of metabolic syndrome.

Complications:
Having metabolic syndrome can increase your risk of developing these conditions:

*Diabetes. If you don’t make lifestyle changes to control your insulin resistance, your glucose levels will continue to increase. You may develop diabetes as a result of metabolic syndrome.

*Cardiovascular disease.High cholesterol and high blood pressure can contribute to the buildup of plaques in your arteries. These plaques can cause your arteries to narrow and harden, which can lead to a heart attack or stroke.

Diagnosis:
Although  doctor does not typically look  for metabolic syndrome, the label may apply if you have three or more of the traits associated with this condition.

Several organizations have criteria for diagnosing metabolic syndrome. These guidelines were created by the National Cholesterol Education Program (NCEP) with modifications by the American Heart Association. According to these guidelines, you have metabolic syndrome if you have three or more of these traits:

*Large waist circumference, greater than 35 inches (89 centimeters, or cm) for women and 40 inches (102 cm) for men. Certain genetic risk factors, such as having a family history of diabetes or being of Asian descent — which increases your risk of insulin resistance — lower the waist circumference limit. If you have one of these genetic risk factors, waist circumference limits are 31 to 35 inches (79 to 89 cm) for women and 37 to 39 inches (94 to 99 cm) for men.

*A triglyceride level higher than 150 milligrams per deciliter (mg/dL), or 1.7 millimoles per liter (mmol/L), or you’re receiving treatment for high triglycerides.

*Reduced HDL (“good”) cholesterol — less than 40 mg/dL (1 mmol/L) in men or less than 50 mg/dL (1.3 mmol/L) in women — or you’re receiving treatment for low HDL.

*Blood pressure higher than 120 millimeters of mercury (mm Hg) systolic or higher than 80 mm Hg diastolic, or you’re receiving treatment for high blood pressure.

*Elevated fasting blood sugar (blood glucose) of 100 mg/dL (5.6 mmol/L) or higher, or you’re receiving treatment for high blood sugar.

Treatment:
The first line treatment is change of lifestyle (e.g., Dietary Guidelines for Americans and physical activity). However, if in three to six months of efforts at remedying risk factors prove insufficient, then drug treatment is frequently required. Generally, the individual disorders that comprise the metabolic syndrome are treated separately. Diuretics and ACE inhibitors may be used to treat hypertension. Cholesterol drugs may be used to lower LDL cholesterol and triglyceride levels, if they are elevated, and to raise HDL levels if they are low. Use of drugs that decrease insulin resistance, e.g., metformin and thiazolidinediones, is controversial; this treatment is not approved by the U.S. Food and Drug Administration.

A 2003 study indicated that cardiovascular exercise was therapeutic in approximately 31% of cases. The most probable benefit was to triglyceride levels, with 43% showing improvement; but fasting plasma glucose and insulin resistance of 91% of test subjects did not improve.   Many other studies have supported the value of increased physical activity and restricted caloric intake (exercise and diet) to treat metabolic syndrome.

Restricting the overall dietary carbohydrate intake is more effective in reducing the most common symptoms of metabolic syndrome than the more commonly prescribed reduction in dietary fat intake

Controversy:
The clinical value of using “metabolic syndrome” as a diagnosis has recently come under fire. It is asserted that different sets of conflicting and incomplete diagnostic criteria are in existence, and that when confounding factors such as obesity are accounted for, diagnosis of the metabolic syndrome has a negligible association with the risk of heart disease.

These concerns have led to the American Diabetes Association and the European Association for the Study of Diabetes to issue a joint statement identifying eight major concerns on the clinical utility of the metabolic syndrome.

It is not contested that cardiovascular risk factors tend to cluster together, but what is contested is the assertion that the metabolic syndrome is anything more than the sum of its constituent parts.

Lifestyle and home remedies:
You can do something about your risk of metabolic syndrome and its complications — diabetes, stroke and heart disease. Start by making these lifestyle changes:

Lose weight. Losing as little as 5 to 10 percent of your body weight can reduce insulin levels and blood pressure, and decrease your risk of diabetes.

Exercise. Doctors recommend getting 30 to 60 minutes of moderate-intensity exercise, such as brisk walking, every day.

Doing Yoga :Doing Yoga exercise, meditation etc. under the guideline of a good yoga teacher

Stop smoking.Smoking cigarettes increases insulin resistance and worsens the health consequences of metabolic syndrome. Talk to your doctor if you need help kicking the cigarette habit.

Eat fiber-rich foods. Make sure you include whole grains, beans, fruits and vegetables in your grocery cart. These items are packed with dietary fiber, which can lower your insulin levels.

Prevention:
Various strategies have been proposed to prevent the development of metabolic syndrome. These include increased physical activity (such as walking 30 minutes every day),   and a healthy, reduced calorie diet.   There are many studies that support the value of a healthy lifestyle as above. However, one study stated that these potentially beneficial measures are effective in only a minority of people, primarily due to a lack of compliance with lifestyle and diet changes.   The International Obesity Taskforce states that interventions on a sociopolitical level are required to reduce development of the metabolic syndrome in populations.

.
Although much more research has to be done to work out the relationship between different factors in metabolic syndrome, and how drug treatments might be used to help people, there are steps you can take to reduce your risk.

Lifestyle changes can make a big difference, preventing or delaying the development of serious disease. Losing weight and getting active are the top priority. But make sure you get proper advice and support – research has shown that people who join a weight-loss group, for example, are more likely to lose weight and keep it off.

In terms of getting fit, join a gym or find a sport you enjoy. You’re more likely to stick at it if you like what you’re doing.

Some preventive treatments are also available from your GP. It’s important to keep your blood pressure under control, and blood fat (cholesterol) and blood sugar (glucose) at healthy levels. But some blood pressure treatments, such as diuretics and beta blockers, can actually make metabolic syndrome worse.

A 2007 study of 2,375 male subjects over 20 years suggested that daily intake of a pint (~568 ml) of milk or equivalent dairy products more than halved the risk of metabolic syndrome. Some subsequent studies support the authors’ findings, while others dispute them.

Check with your doctor if you’re concerned. Drugs to control blood fat and cholesterol levels, and blood glucose levels, are often needed.

Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose

Resources:
http://www.bbc.co.uk/health/physical_health/conditions/metabolicsyndrome1.shtml
http://www.webmd.com/heart/metabolic-syndrome/metabolic-syndrome-what-is-it
http://www.mayoclinic.com/health/metabolic%20syndrome/DS00522
http://en.wikipedia.org/wiki/Metabolic_syndrome
http://www.healthfocus.net.au/what-is-metabolic-syndrome/

http://www.myoptumhealth.com/portal/ADAM/item/Weight+control+and+diet