Thursday, June 28, 2012

Screening Tests and Why They Are Important

Why screening tests are important


hypertension, high blood pressure, screening, doctor, patient, health

Screening tests helps to identify people with increased risk for a health disorder before they have symptoms or even realize they may be at risk. These laboratory tests are important because finding out early that you have or at risk to contract certain condition means you can take preventive measures.
 


Because a good screening test detects a disease in the earliest stages, it's most beneficial when you are tested for diseases that are both serious and treatable. A good screening must be able to correctly identify individuals who actually have a given disease, meaning that test is sensitive.

A positive screening test result often requires follow-up testing with a more specific test. This is to avoid 'false positive' in which a person without the given disease came out with a positive result.

"Screening tests are most beneficial to detect serious but treatable diseases."


Every year the U.S. Preventive Services Task Force (USPSTF) publish a guidelines that contains recommendations pertaining to whom and when should these screening tests be performed. Below are a few examples:
teenager, girl, sitting, field, grass
hypertension screening begins at 18 years old
  • Screening for high blood pressure in adults aged 18 and older.
  • Both men aged 35 and older and women aged 45 and older who are not at increased risk for coronary heart disease are to be screened for lipid disorder.
  • If they are at increased risk for coronary heart disease, screening for lipid disorder should start early at age 20 to 35 for men and age 20 to 45 for women
  • Screening mammography for breast cancer detection in women aged 50 to 74 years, to be repeated every two years. 
  • Screening for colorectal cancer using fecal occult blood testing, sigmoidoscopy, or colonoscopy in adults begins at age 50 and continuing until age 75. 
  • Women aged 65 and older to be screened routinely for osteoporosis. In women who are at increased risk screening begin at age 60.
  • Screening for type 2 diabetes in otherwise healthy adult with sustained blood pressure (either treated or untreated) greater than 135/80 mm Hg.
Not every laboratory tests are necessary. Don't go ballistic and ask your physician to put a check next to every single test on the lab form. Instead discuss with your doctor which screening tests that are right for you taking consideration of your age, gender, and other risk factors like family history of cancer, unhealthy lifestyle, etc. Also there are diseases in which screening tests are unnecessary and ineffective, such as lung cancer, ovarian cancer, and pancreatic cancer.

Monday, June 25, 2012

Understanding Hypertension (High Blood Pressure) Part 2: About Treament

Continuing from Part 1: How high is high? This entry is all about the treatment of hypertension.

What is the goal of hypertension treatment?

The goal of treatment is to reduce blood pressure to <140/90 mmHg in otherwise healthy subject and to <130/80 in patients with diabetes or chronic kidney disease. Even though lifestyle modification is an important part in the treatment plan, most people with high blood pressure will require medication to achieve this goal.

Lifestyle modification


Lifestyle modification, however, remains as the first and most critical step in managing hypertension. Examples of changes you can try to help reduce your blood pressure are as follows:
  • Eat healthy diet, including the DASH (Dietary Approaches to Stop Hypertension) diet which consists eating more fruits and vegetables, reduce fatty foods and eating less red meat.
    salt, sodium, shaker, hypertension, diet,
    reduce salt intake
    Reduce the amount of sodium in your diet to less than 1500 milligrams a day (less than two-third teaspoon of salt).
  • Try to lose some weight if you are overweight or obese.
  • Quit smoking.
  • Exercise regularly, especially aerobic exercise such as brisk walking or jogging at least 30 minutes a day
  • Limit alcohol consumption to two drinks a day for men and one drink a day for women. Drinking red wine in a small amount helps maintain cardiovascular health due to its antioxidant properties.

Medications

If lifestyle modification fails to control the blood pressure, then starting medication is the next step. Depending on the stage of your hypertension, usually your physician will start giving a single drug or a combination of two drugs. Diuretics (a type of drug that makes you urinate a lot) are almost always the first choice regardless what your initial condition is. Listed below are the common medications for hypertension:
medication, pills, tablets, hypertension, drugs, high blood pressure, calendar
take your medicine regularly
  • Angiotensin-converting enzyme (ACE) inhibitors 
  • Angiotensin receptor blockers (ARBs)
  • Alpha blockers
  • Beta blockers
  • Calcium channel blockers
  • Central alpha agonists
  • Diuretics
  • Renin inhibitors
  • Vasodilators
The most important thing to be aware of when you're starting medication is to always remember to monitor your blood pressure regularly to avoid sudden drops in your blood pressure.

Friday, June 22, 2012

Ergonomics: Avoid Aches Without Pills

What is ergonomics?


Ergonomics (or human factors) is the scientific discipline concerned with the understanding of the interactions among humans and other elements of a system, and the profession that applies theoretical principles, data and methods to design in order to optimize human well being and overall system

Basically, ergonomics intend to reduce fatigue and discomfort while you are working by modifying your workstation.
sitting, reading, poor posture, ergonomics, female
Everyday activities can cause poor posture and gives you aches and pains.

This is one of the entries I personally implement on myself. You see, I am sitting in front of a computer right now and I'm starting to feel a bit uncomfortable with my position. So, I'm going to get up, move around a bit, and make some adjustment to my table.

Everyday activities such as sitting in office chairs, working with computer, standing for long periods of time, driving, or even sleeping can cause poor posture. It can easily develop into a bad habit, causing or aggravating episodes of back pain, headache, and joint disorders such as osteoarthritis.

Fortunately, the main factors affecting posture and ergonomics are completely within one’s ability to control and are not difficult to change.

Poor posture maybe the cause of your aches and pains.


Awareness that your pain and aches may be caused by poor posture is important. Pain that is worse at certain times of day or weekdays, but not during the weekends, pain that goes away after changing positions, pain that occurs with a new office chair, or pain that comes and goes for months are some examples.

One of the easiest way to avoid straining your muscles is by changing positions frequently. Any single position maintained for a long time, even if it's the right one, will cause fatigue. Take a break from sitting in an office chair every half hour for two minutes in order to stretch, stand, or walk. Always try to distribute body weight evenly when you are sitting, standing or walking.

These simple measures might me be more effective in reducing your aches rather than taking pain reducing medications.

Wednesday, June 20, 2012

Physiology and Psychology of Pain

Everyone experience pain at some point of their life. Pain is the most common reason for physician consultation in the United States.

What is pain?


From physiology point of view, it is defined as an unpleasant sensation often caused by intense or damaging stimuli. It's a sign that something wrong is happening in your body. In this sense, pain is actually a good thing as it warns us to take measure to prevent further damage.

In the simplest form, the pain circuit in our body starts whenever a painful stimulus came in contact with pain receptors. This stimulus is then transferred via specialized nerves to the spinal cord and from there to the brain. The pain stimulus is processed in the brain, which then sends an impulse down the spinal cord and through appropriate nerves which command the body to react, for instance by withdrawing the hand from a needle prick.

"Pain is the most common reason for physician consultation in the United States."


pain, psychology, male, pierce, ethnic, tribal, needle, trance
Our body is able to produce natural painkillers.

Modulation of pain


The psychology point of view argues that not everyone who think they are in pain actually have physical injury or disease. Psychological factors play a huge role in pain perception and pain is intimately tied to brain functions that regulate our behavior. A stoic individual may have a higher threshold for pain compared to other people. For this reason, reassurance and positive thinking may actually reduce the intensity of pain.

Our body is able to produce their own painkillers, sometimes known as natural opioids. When pain impulse reaches the brain, these opioids are released from their storage areas to block the transmission and perception of pain. There are many factors that influence the production of these natural opioids and psychological factors may be one of them.

It's all in your mind?


Logically speaking, if there's no visible or proven source of pain (such as trauma or diseases), then the source of that pain might be psychological. 'It's all in your mind' so to put it. But that doesn't mean that the person in pain doesn't need any help. Prolonged pain may lead to depression and reduce your sense of well-being. There are many ways to manage pain and not all of them are pharmacological. You can try relaxation or self hypnosis technique, for example. 



Other articles about pain:

  • The head is one of the most common location of pain in the body. There are many causes of headache, making it difficult to classify. Read more about different types of headaches 
  • Fibromyalgia is a syndrome in which a person has long-term, body-wide pain and tenderness in the joints, muscles, tendons, and other soft tissues. Read more about fibromyalgia syndrome 
  • Abdominal pain is one of the most common reasons for doctor visit with severity ranging from mild to life threatening. Everyone experiences abdominal pain from time to time. Read more about common causes of abdominal pain

Monday, June 18, 2012

Choosing the Right Blood Pressure Monitor

There are many types of blood pressure monitor available to choose from. Here are a few things you need to know before choosing a home blood pressure monitor that suits your needs.

What are the types of blood pressure monitor?


blood pressure monitor, stethoscope, note, hypertension, cuff, manometer
manual blood pressure monitor
  • Manual monitor is the oldest model and probably the one you seen the most used by your doctor. This model requires a stethoscope to use, the cuff requires manual pumping, and the gauge contains mercury. Using this model requires a bit of skill compared to the automatic ones because you will need to put the stethoscope over the artery on your elbow and pay attention to the sound of blood flowing through the artery as you inflate and deflate the cuff. 


blood pressure monitor, hypertension, digital, cuff, electronic, monitor, automatic
automatic blood pressure monitor
  • Automatic monitor is easier to use because all you need to do is to turn it on and the machine will do everything for you. You do not need to pump the cuff yourself, nor do you need to use a stethoscope. The measurement result will be displayed on a digital screen. Semi automatic monitors are basically the same with automatic ones, except that you will still need to pump the cuff manually.
 

  • A newer variety of blood pressure monitor which is the wrist blood pressure monitor. It's compact in size, easy and convenient to use, but it is also one of the most expensive monitors available. The latest model of wrist blood pressure monitor appears like a watch. This type is useful to measure your blood pressure continuously or during exercise.
 

What brand should I get? 


Known reputable manufacturers such as Omron, Braun, and Microlife claim their brand to have more benefits than the other, but there's no evidence that one brand is better than the other. The accuracy of a blood pressure monitor depends more on how the operator uses the machine rather than the build of the product.

What are the parts of a blood pressure monitor?


The two most important parts of a blood pressure monitor are the cuff and the gauge or monitor. The cuff is an inflatable band that is wrapped around your upper arm when you measure your blood pressure. The gauge or monitor is the part that where you read the result of the measurement.

Things to consider in choosing a blood pressure monitor


  • Choose the right size of cuff for you. If the cuff too big for your arm, the reading will appear to be reduced than it actually is. Similarly, if the cuff is too small, the reading may appear higher than it actually is. You may be falsely diagnosed yourself with high blood pressure this way.
  • Make sure the gauge or monitor display is clearly visible and easy to read. Make sure the device is validated and calibrated for accuracy by the manufacturer. 
  • Ease of use. Manual monitors are harder to use than automatic ones and you may require another person’s assistance to use it.
  • The price. The more expensive devices usually come with advanced function such as memory or print out capability, but measurement capability is not that different than cheaper ones.

Things to consider when performing blood pressure readings


Sometimes, your blood pressure will appear higher in a physician's office compared to when you measure it by yourself. This condition is called white coat hypertension and is the result of fear and anxiety when you visit your doctor to have your blood pressure measurement. It doesn't mean that blood pressure monitor is not accurate.

When taking measurement, the level of your arm and the manometer itself must be at the same level as your heart in order to provide accurate measurement.

Caffeine, alcohol, and tobacco may temporarily raise your blood pressure. Avoid taking any of them at least 30 minutes before measuring your blood pressure. Exercise, pain, and a full bladder may also falsely increase your blood pressure.



Other articles on hypertension:

  • According to the American Heart Association, hypertension affects one in three adults in the United States. Approximately one in three people with high blood pressure don't realize they have it. Read more about hypertension
  • The DASH (Dietary Approaches to Stop Hypertension) eating plan was originally designed to lower blood pressure, but it turns to be beneficial for other conditions like diabetes, stroke, and even several types of cancer. Read more about DASH eating plan
  • The goal of treatment is to reduce blood pressure to <140/90 mmHg in otherwise healthy subject and to <130/80 in patients with diabetes or chronic kidney disease. Read more about hypertension treatment

Friday, June 15, 2012

Understanding Hypertension (High Blood Pressure) Part 1: How High Is High?

How high is your blood pressure? 


hypertension, high blood pressure, digital, monitor, pulse, systolic, diastolic, health
systolic ≥160 and diastolic ≥100 in stage 2 hypertension
Blood pressure readings are usually given as two numbers, for example 120 over 80 (written as 120/80 mmHg). The top number is called the systolic blood pressure, and the bottom number is called the diastolic blood pressure. Both numbers are equally important to consider in the diagnosis of hypertension.


The classification of hypertension or high blood pressure in the Seventh Report of the Joint National Committee on Prevention, Detection, and Treatment of High Blood Pressure (JNC7) is as follow:

Normal                           : systolic <120 mmHg and diastolic <80 mmHg
Prehypertension          : systolic 120-129 mmHg and diastolic 80-89 mmHg
Hypertension, stage 1 : systolic 140-159 mmHg and diastolic 90-99 mmHg
Hypertension, stage 2 : systolic ≥160 mmHg and diastolic ≥100 mmHg

If you are measuring your blood pressure by yourself, the best time to measure your blood pressure is in the morning after you wake up. Blood pressure tends to be higher after exercise. Anxiety, such as in the cases of white coat hypertension, pain, a full bladder, caffeinated drinks, and smoking can also cause the measurement to go higher than it should. Therefore, make sure you are in a resting condition when taking your measurement.

When you find your blood pressure to be higher than normal, don't start panicking. More importantly, do not engage in self-medication. A few years back, I met a person who took over five types of herbal medications to treat hypertension. She ended up getting a kidney failure either because of the disease itself or because of the numerous shady treatment options she undertook. Consult your doctor first if you think your blood pressure readings are abnormal. There's always a possibility for error in measurement.

Note that some electronic self measuring devices may yield slightly different numbers with the ones obtained by a healthcare professional. Some factors like the cuff size and your position when taking your measurement may also affect your result. When in doubt, repeat your measurement over a few days or ask trained individual to repeat it for you.

Hypertension is a silent disease.


According to the American Heart Association, hypertension affects one in three adults in the United States. Approximately one in three people with high blood pressure don't realize they have it. Under diagnosis is a major problem even with the campaign to routinely screen for hypertension in people as young as 18 years old.

What causes hypertension?


The majority (about 95%) cases of hypertension is called primary or essential hypertension, which is caused by a combination of many risk factors like age, genetics, lifestyle, obesity, and dietary habit (especially salt intake). A small number of cases (around 5%) is caused by a specific disease that affects one or more organs in our body and is called secondary hypertension. Kidney diseases or a tumor of the adrenal gland may cause secondary hypertension.

What are the symptoms and complications of hypertension?


Most of the time people feel no symptoms even when their blood pressure is high. Because of this, people can develop complications like cardiovascular diseases, kidney failure, eye problems, and brain damage without knowing they have high blood pressure. The range of symptoms varies from mild headache or dizziness in mild hypertension to heart attack or stroke in severe cases. If you experience severe headache, nausea or vomiting, confusion, changes in your vision, or nosebleeds you may have a dangerous form of high blood pressure that requires immediately medical attention.



Other articles on hypertension:

  • The goal of treatment is to reduce blood pressure to <140/90 mmHg in otherwise healthy subject and to <130/80 in patients with diabetes or chronic kidney disease. Read more about hypertension treatment
  • The DASH (Dietary Approaches to Stop Hypertension) eating plan was originally designed to lower blood pressure, but it turns to be beneficial for other conditions like diabetes, stroke, and even several types of cancer. Read more about DASH eating plan
  • Here are a few things you need to know so you can choose the right blood pressure monitor that suits your needs. Read more about choosing blood pressure monitor