High Blood Pressure Accuracy

If your blood pressure is higher than 120/80 repeatedly, you have high blood pressure also known as hypertension. Three consecutive visits to the doctor's office with high readings can be all it takes to be diagnosed with high blood pressure. It is called the silent killer because there are often no symptoms until a heart attack or stroke occurs. 

Even when your blood pressure is normal at home, it is the readings at your doctor's office that determine the diagnosis and treatment.  Ambulatory blood pressure monitoring (ABPM) is changing the way to accurate diagnosis.  More doctors are becoming aware of this and ordering it to check for twenty-four hours. In addition, checks by patients with blood pressure devices are being recommended.  This allows for checks in everyday life situations versus the few high anxiety visits to the doctor.

ABPM can help with treatment as well.  You can see what makes it go up and avoid these things.  Some medication can make it go too low, and the dosage adjustment or type of medication may need adjustment.  These situations usually occur at home after doctors' office hours.

When blood pressure monitoring is done by your schedule, it may be more accurate. ABPM can be a healthy way to keep it stable for you and your family. Best health!  

MY PATIENT HANDBOOK: Ambulatory Blood Pressure Monitoring

MY PATIENT HANDBOOK: high blood pressure

Holiday Hypertension Healers

 Make less stress, tolerate even less.

Learn relaxation techniques.

Meditate daily.

Eat heart healthy food.

Exercise at least fifteen minutes or more a day in your best way.

Pursue enjoyable hobbies that you like.

Sleep soundly at least eight hours per twenty-four.

Let love keep you healthy.

Smile a lot.

Pray often.

Own a blood pressure device and /or an application on a phone.

Check your blood pressure at home. 

Give a blood pressure monitor as a gift.

Use positive kindness as daily medicine.

Best health!

MY PATIENT HANDBOOK: hypertension 

Know Your Medical History

One of the first things your doctors and healthcare providers want to know is why you made your appointment. Once you answer this question (hopefully before interruption) there will be questions about your general health and wellness, as well as more information about your reason for the visit. For specific concerns you may be asked:

• How long has this been going on?
• What have you done for it?
• Have you had it before?
• Where does it bother you?
• How often does it occur?
• What makes it better or worse?
• Are there any other symptoms?

You will be asked about how the other parts of the body are working, such as your eyes, ears, heart, breathing, and so on. This is called the “review of systems” (ROS). If there are any problems not related to your main problem, now is the time to let the doctor know.
This will be followed by your past medical history (PMH), which includes:

1. Diseases you have (high blood pressure, sugar diabetes, arthritis, cancer, depression,
   etc.), or have had that are better or gone (including childhood diseases such as
   measles, mumps, and inherited disease)
2. Operations and times you were in the hospital (including accidents)
3. Medication, including prescription, over-the counter (don’t forget about vitamins),
   natural (garlic, aloe), and herbal
4. Allergies and reactions to anything and what it did to you (for example: breaking out in a
   rash, swelling, itching, upset stomach, etc.)
5. Smoking, alcohol, drug use (how much, how often)
6. Shots (childhood, flu, last tetanus, etc.)
7. Sexual (active, using protection, number of partners, diseases)—in females this will also
   include menstrual period, pregnancy, last mammogram, and Pap test
8. Family history (conditions that run in family
   such as cancer, high blood pressure, etc.)
9. Social history—your job or jobs; family; marital status; living arrangement (house,
   apartment, alone, etc.); transportation (drive self, public transport, walk); ambulation
   (use walker, wheelchair); disability (deaf, blind, amputee, etc.); religion, ethnic customs, and traditions

If there is anything left out or that you feel the doctor should know, now is the time to speak up. It is sometimes hard to get someone’s full attention, so take advantage of it while you have it. Some doctors’ offices will have you fill out forms asking the above questions or will ask you the questions and fill out the form for you. This is not a substitute for the doctor’s personal interview and questions.
Writing or typing this information is a sure way to keep all of your PMH http://bit.ly/f8FZ55 . Make a copy for your doctor. While talking you both can refer to this vital source of health information.
Best health!

Preventive Guidelines: Do Lower Medical Numbers Make Chronic Disease More Likely?

Hypertension has new numbers that are lower for normal.  To be considered normotensive your blood pressure numbers should be lower than 120/80 versus the former normal blood pressure below 140/90.  This is the new recommendation from the cardiology experts.  This may be shown to cause less morbidity and mortality, but it may cause more people to be considered hypertensive.  If your reading on three doctor visits is over 120/80, you will be considered a patient with hypertension.

This is just one of the many medical measurements or blood tests where the WNL (within normal limits) has been lowered.  Cholesterol was at one time considered normal at 300.  The normal now is under 180.  New tests can have the same effect.  The BUN and creatinine were once the basic kidney function tests.  Now the GFR is added to these.  Your BUN and creatinine can be normal while your GFR suggests kidney disease based on your sex and your ethnicity. 

Do lower medical measurements and numbers really mean that more patients will have some chronic disease sooner? Or does it mean lower numbers mean better health with less morbidity and mortality?    Good health care will help keep you and your numbers healthier.  Keeping a lifestyle of healthy food, exercise, good sleep, and minimal stress are important health care routines for better health.  These can be integrated with complementary medicine and medication treatments if necessary. 
You should know the measurements and numbers of all your health tests.  This helps you attain better understanding and control of the unhealthy abnormal.  Lower numbers can mean less chronic disease if you know what you have and how to keep it from becoming chronic disease.  Best health!
  

Blood Pressure Home Checks

Do you know your average blood pressure reading? Do you know a normal blood pressure should be? High blood pressure, also called hypertension affects 1 in 3 adults worldwide.  It affects more people than any disease in the world. Untreated hypertension leads to unhealthy feelings and symptoms.  It causes heart disease, strokes, kidney failure, blindness, poor circulation, and more. 

A normal reading is 120/80 with borderline at 130/85 to 140/90.  For more accurate measures of your blood pressure and what affects it, you should do home blood pressure monitoring. Buy a blood pressure monitor for home use. Wrist and arm monitors are available in many stores on and off line. Record your blood pressure readings daily starting with morning, midday, and night. Make a note of your activity and how you are feeling. You may notice that extreme anxiety makes it go up. The correlation to your pressure will help you manage the things that make it go up. Share your results with your doctor so medication and lifestyle changes can be made if necessary.

You may find that while your blood pressure is high in the doctor's office, it may be normal in everyday activity. Remember, the doctor's result is a one time reading every one to four or more months. With normal home results, and high results at your doctor visits you may have "white coat" hypertension. There is much controversy over whether this should be treated. Check with your primary care doctor and cardiologist.

If your blood pressure is borderline at 130/85, you want o start a low salt, low fat diet. One of the best is the DASH diet. Integrating healthy food. exercise, weight control, and stress reduction in your treatment plan improves the way you feel and controls blood pressure. For higher blood pressure readings over 140/90, medication may be necessary. Be sure to take your home blood pressure results in to your doctor. This will help in deciding on the best treatment for you. Best health!

White Coat Hypertension: Is It Really High Blood Pressure?  http://bit.ly/1cGaeMj

High Blood Pressure: How Loud It Can Be

High blood pressure (HBP) is louder than you may think.  Often called the “silent killer”, hypertension has symptoms to let you know it is present.  Symptoms may include headache, dizziness, fatigue, weakness, blurred vision, seizures, unexplained anxiety, and more.  Though nonspecific these signs and symptoms do correlate with high blood pressure. If you have a family history of HBP and heart problems, it is very likely the symptoms will be present. Untreated hypertension may lead to more serious conditions like heart attacks and strokes.

When you experience symptoms suggestive of hypertension, it is important to get it checked.  This should be done by a health care professional, but can be done at home, also.  Consistent readings above 140/90 call for assessment and treatment.  A complete physical exam, complete blood tests, and EKG should be done to check for overall good health and findings that are seen with hypertension. 

On physical exam the eye exam may reveal retinopathy and artery narrowing.  This is associated with decreased vision and can proceed to blindness.  Bruits over the carotid arteries in the neck and over the abdomen area suggest vascular disease that can block the arteries off.  This can lead to strokes, chronic kidney disease, peripheral vascular disease (poor circulation in legs), sexual dysfunction and more.  Heart findings and EKG changes can show signs of heart disease that accompany hypertension.  Blood tests provide further information and can even help assess if there are secondary causes.  Your doctor correlates all the information to assess a treatment plan. 

Initial therapy includes lifestyle changes like a healthy, nutritious diet, good sleep, low stress, and exercise.  If your blood pressure reading consistently remains elevated medication may be needed.  This may be temporary or lifetime depending on your lifestyle health habits.  For example, weight loss and eating the right foods especially those known to decrease blood pressure, can totally eliminate the need for medication and its side effects that can create new chronic problems. The best part is that you will feel better, and hopefully prevent any problems from untreated high blood pressure.  Best health!

Chronic Disease: Controlling the Incurable

Chronic disease affects more people as they age. It will affect everyone at some time in their life. Over 80% of the health costs worldwide are incurred by 20% of persons with one chronic disease or more. Chronic disease is defined as any illness that lasts more than three months, and/ or is recurrent. This includes such diseases as morbid obesity, arthritis, heart disease, diabetes, depression and many more. Most primary care doctors and family physicians see more patients with chronic diseases than any other health conditions.  The initial visit of the majority of patients seen on first visit have at least two or more chronic conditions.


Chronic disease management begins first and foremost with knowing as much as you can about the diseases that affect you.  Research yields information that strengthens your knowledge base of cause, effects, and what can be done to make it better or even preventable.  There are many evidence-based treatments that work, but some may help you more than others if at all.  For example, low back pain may be helped with hot or cold therapy, massage. acupuncture, spinal alignment. epidurals. medication and more.  Your spouse benefits from cold therapy and massage which hardly helps you. Hot therapy and acupuncture improves your pain and function, but not that of your spouse.  You must find what works best for you.  Ask your doctors for different treatments other than those they order as well.


Chronic disease responds favorably to a nutritious diet.  With medication noncompliance over 50% for whatever reason, you eat daily which allows for good, healthy food. Many foods have medicinal qualities that help control disease processes while keeping the healthy parts healthier.  Cooked dry beans are the perfect example.  They can provide as much as 9 to16 grams of fiber and 15 to 25 grams of protein in one-fourth cup  (60 to 150 calories).  A 14 ounce bag can yield about eight to ten cups at a cost of less than $2. Eaten alone or in other dishes, beans have powerful potent antioxidants that overpower cellular oxidative stress of chronic disease states.  High fiber is good for so many chronic problems such as heart disease, high lipids, diabetes, hypertension and more.  As you decrease processed foods in your diet, and add more fresh food your body responds with lower blood pressure, less pain, less overall stress, and good feelings of good health!


As chronic diseases progress especially with aging, many people move less.  Less movement opens the door for more chronic disease, and worsening of any you may already have.  Daily motion is the magic potion lotion.  Movement in activities of daily living count, and exercise helps.  At least ten minutes per day helps.  At home exercise programs work and are less stressful than going out.  Fancy home gyms with exercise equipment are nice but unaffordable for many.  Sitting, standing or laying you can do arm circles, leg raises, torso twists, and more.  Walking in place also works.  This type of activity improves physical and mental status to better.


You can control chronic diseases by choosing that which helps what you have.  Controlling the incurable involves routines designed for you.  This in itself improves overall quality of life and gives positive personal satisfaction that helps mental issues that may become chronic in themselves.  Best health!

Keep a Happy Heart, Be Heart Smart

A healthy heart is a cheerful heart.  Keep your heart smart and happy with this quick, easy to understand information.

Check your heart list:
___Heart and vascular exam by health care provider
___Blood pressure, pulse, weight, height
___EKG

For further evaluation, especially if symptoms are present, and/ or if there is a strong family history of heart and vascular disease see a cardiologist.

Tests may include:
___Doppler echocardiogram (checks heart valves, size, etc.)
___Stress test - nuclear, doppler or exercise (heart function)
___Heart MRI scan (artery disease)
___Interventional studies like cardiac catherization, angiogram (checks artery blockage, valve function)

Heart health habits:

1. Maintain a healthy weight.
2. Eat healthy small portions.
3. Exercise regularly - every little bit counts! Just do it regularly.
4. Keep blood pressure under control.
5. Keep stress level low.
6. Get adequate sleep.
7. Take an aspirin a day if in a high risk group. Check with your health care provider.
8. Love, laugh, and let go!

Have a happy, healthy heart! Best health and love!

J.L. Richardson, MD, family medicine, is the author of the award winning Patient Handbook to Medical Care: Your Personal Health Guide.

Prevention Requires Less Intervention

Prevention and early detection are important for your health and wellness.  Routine check ups are shown to improve overall health while requiring less medical intervention and treatments.  Done on a "routine" basis means just that - in a consistent manner based on your health profile.  As one gets older, or if one has chronic disease they may become  more frequent than every few years.  As you prepare to see your doctor you will find that Patient Handbook to Medical Care: Your Personal Health Guide is the ideal reference book to inform you about what checkups and tests you may need for prevention intervention.

This Writer's Digest International Self-Published Book Award winner informs patients about basic medical care. By reading this how-to reference book you will learn:

• how to keep a medical diary
• how to get your medical records
• how to document your complete medical history
• what the physical exam should include
• about preventive tests and when to get them
• about tests your doctor orders
• about specialists and other medical providers
• about health care plans and coverage
• how to seek quality health services

Patient Handbook to Medical Care: Your Personal Health Guide is on Kindle, and can be borrowed via the Kindle Owner's Lending Library.

High Blood Pressure (HBP)

High blood pressure, also called hypertension affects 1 in 3 adults. Do you know your numbers? Do you what a normal reading is? Optimal is 120/80.  More precise classification is as follows:

  Normal 120-129/80-84

  High normal 130-139/85-89

  Mild 140-159/90-99

  Moderate 160-179/100-109

  Severe over 180/110

For more accurate measures of your blood pressure and what affects it consider home blood pressure monitoring. Buy a blood pressure monitor for home use. Wrist and arm monitors are available at retail stores, drugstores, and local medical supply stores.

Record your blood pressure readings daily starting with morning, midday, and night. Make a note of your activity and how you are feeling. You may notice that extreme anxiety makes it go up. The correlation to your pressure will help you manage the things that make it go up. Share your results with your doctor so medication and lifestyle changes can be made if necessary.

You may find that while your blood pressure is high in the doctor's office, it may be normal in everyday activity. Remember, the doctor's result is a one time reading every one to four or more months. With normal home results, and high results at your doctor visits you may have "white coat" hypertension http://bit.ly/1cGaeMj . There is much controversy over whether this should be treated. Check with your cardiologist.

If your blood pressure is borderline at 130/85, you want o start a low salt diet. The best is the DASH diet (http://bit.ly/hnbsL). Exercise, weight control, and stress reduction are other things to include in your treatment plan. For higher blood pressure readings over 140/90, medication may be necessary. Take your home blood pressure results in to your doctor. This will help in deciding on the best treatment for you.


by J.L. Richardson, MD, author of the Patient Handbook to Medical Care: Your Personal Health Guide.

White Coat Hypertension: Is it Really High Blood Pressure?

Is it really high blood pressure or is it the white coat? White coat hypertension is a term that refers to high blood pressure (HBP) when you visit your doctor or other health care provider.  It is normal during other times.  Are you really hypertensive if this is the case?  Do you really need the DASH diet and medication?

High blood pressure is defined as three consecutive blood pressure readings at or above 140/90, or one reading above 160/100.  These readings are most commonly obtained when you visit your doctor which can be from one time to several times a year.  Needless to say the preparation and anxiety that go with doctor's appointments is enough to make any one's blood pressure go up normally! Getting ready and getting there can surely create this effect, but is this enough to make a diagnosis of high blood pressure when your blood pressure checks weekly or daily are normal?

HBP monitoring by patients outside the doctor's office may prove that white coat hypertension is what it is.  Normal readings outside the health setting in your everyday environment are more accurate and real. By tracking your own blood pressure at home you may find that your blood pressure is normal most of the time.  You can also see what makes it abnormal, too, and avoid or decrease these things. If it stays consistently high without white coats, treatment with diet and medicine may be indicated.

Best health!

Health Education Affects Your Health & Care

Care systems can be set up based on the prevalence of disease and proven preventive measures. For instance, heart disease kills about 1 million/ year, and about 1.5 million hospitalizations occur as a result. We can build on existing programs that focus on guidelines and evidence-based data for the most prevalent conditions, and implement them in our clinics. The USPSTF is dedicated to this type of service. The USPSTF recently found evidence that early detection (with bone density tests), and treatment of osteoporosis in women without symptoms reduced the risk of fractures. Globally speaking, the recent World Cancer Report by WHO has found that cancer may rise by 50% by 2020. One third of these can be prevented. That is very significant! The following table lists (British Medical Journal, March 29, 2003) the costliest conditions to treat.

The 15 costliest treatments (and number of people with diagnosis) in 1997 Heart disease $58bn (17 million) Cancer $46bn (9 million) Trauma $44bn (37 million) Mental disorders $30bn (20 million) Diabetes $20bn (10 million) Hypertension $18bn (27 million) Cerebrovascular disease $16bn (2 million) Osteoarthritis $16bn, (16 million) Pneumonia $16bn (4 million) Back problems $13bn (13 million) Kidney disease $10bn (2 million) Endocrine disorders $10bn (18 million) Skin disorders $9bn (20 million) Infectious diseases $6bn (16 million)

Alongside the USPHS is the HHS which has in place the ACHI, Association for Community Health Improvement. This group focuses on communities
networking together for better health. It is in 42 states (D.C. and Canada), and is composed of people from different areas of medicine. This is a valuable resource to use in developing health system uniformity because it is almost nationwide, at the local community level, and very diversified. HHS has 300 programs that help in "protecting the health of all Americans and providing essential human services". The Medicare program is the largest health insurer in the nation. In April 2003 HHS had a national
summit, "Steps to a Healthier USA: Putting Prevention First" that addressed prevention and promotion of healthy lifestyles. Funds ($15 million) for “Healthy
Communities” will help communities do their part. The ODPHP works to promote disease prevention and healthy living. Their program, Healthy People 2010* is "the prevention agenda for the Nation". It outlines health objectives for the Nation.

Providing more health information is vital. TV is the most powerful, and most accessed way to get information. Almost everybody watches TV, has a TV, and talks about what is on TV (even if they say they don't watch TV you can be sure you will be asked, "Did you see on TV..."). In addition to public service announcements, more television programming on health issues can be added to the daily schedule on existing channels. Eventually Public Health TV will be available with daily medical news, and basic health information. After all, we have 24-7 dedicated channels for theology, sports, news, finance, cartoons, and music, to name a few, yet basic health programming is still in its infancy.

More basic health information should be available. Health TV channels now tend to focus on lifestyle changes (cooking, exercise, etc.), and reality shows focusing on emergencies, patient procedures, etc.. In the news media there is an occasional mention of the latest outbreak of the disease of the month, and maybe a mention of a profound medical study. This is good, but there is a need for more basic information programming that lets me know about this hypertension that I have, or the headache that won’t go away, or what doctor should I see for what I have. We need to know all the risks and complications as well as the different treatments for what we have so a more informed decision can be made. Like going on the Internet, or to a textbook, there will be a program that addresses a particular health concern. A daily health news show highlighting the latest medical developments is greatly needed. The Internet provides such information.
There are webcasts on the Internet that are becoming more accessible for professionals and the public. Some managed care providers have treatment guidelines for enrollees and doctors to view on their websites. The mantra for the 21rst century will be, "If
doctors don't educate themselves, patients will educate them".  Most people have a TV so what better place to start. In the future, computers will be in almost every home, too. With the Internet patients are able to access the same information as their doctor.

Providing educational materials that are easy to read and understand, i.e. at the lowest grade level possible, are essential, and key. This includes audio and visual learning - books, television, tapes, CDs, computer - as well as direct teaching. This is available
on the Internet with health sites just for kids like www.kidshealth.org and www.bam.gov . Health literacy systems can be of more use for distance learning technology via webcast teleconferences, and television programming. Learning in the home is effective and convenient.

Let your health home schooling begin!

*now Healthy People 2020

High Blood Pressure Home Remedies

Treating hypertension with lifestyle changes that promte good habits is key to staying 120/80, the normal blood pressure reading. Of course, maintainimg healthy weight for your height, eating the right foods, regular exercise, limited alcohol intake, avoidance of cigarettes and severe stress help. If these things fail to keep you 120/80 then you will need blood pressure medication prescribed by your primary care physician or cardiologist.

Many regimens start with a diuretic ("water pill") either alone or combined with any other medication groups like beta blockers, angiotensin converting enzyme inhibitors, calcium channel blockers, and more. Many of these have lots of side effects as well as create new medical problems (e.g. diuretics can cause loss of potasssium resulting in cramping, heart rhythm abnormalities; beta blockers can cause bradycardia, exacerbate asthma, COPD). When used in combination this can worsen. Home remedies may offer healthier and safer treatment.

Some high blood pressure home treatments include:
- honey and onion juice in equal amounts equal to 2 teaspoons daily
- garlic clove daily
- foods: fruits esp banannas, oranges, apples, watermelon. papaya; fish (less
red meat; vegetables especially carrots, spinach; whole grains; low fat
- apple cider vinegar 2 tablespoons daily
- aloe vera
- tea (black, green, hibiscus)
- coconut water ("noelani")

Many of these remedies also help other maladies, but more importantly they are natural, wholesome and inexpensive requiring no prescription. Remember to also halt the salt!

Best health!

Heart Screening Checklist

Check your heart list:
___Heart and vascular exam by health care provider
___Blood pressure, pulse, weight, height
___EKG

For further evaluation, especially if symptoms are present, and/ or if there is a strong family history of heart and vascular disease see a cardiologist.

Tests may include:
___Doppler echocardiogram (checks heart valves, size, etc.)
___Stress test - nuclear, doppler or exercise (heart function)
___Heart MRI scan (artery disease)
___Interventional studies like cardiac catherization, angiogram (checks artery blockage, valve function)

Heart health habits:

1. Maintain a healthy weight.
2. Eat healthy small portions.
3. Exercise regularly - every little bit counts! Just do it regularly.
4. Keep blood pressure under control.
5. Keep stress level low.
6. Get adequate sleep.
7. Take an aspirin a day if in a high risk group. Check with your health care provider.
8. Love, laugh, and let go!

Have a happy, healthy heart!

J.L. Richardson, MD, family medicine, is the author of the award winning Patient Handbook to Medical Care: Your Personal Health Guide.

www.mypatienthandbook.com

www.twitter.com/MD4U

www.twitter.com/drjfpmd

High Blood Pressure - Home Checks

High blood pressure, also called hypertension affects 1 in 4 adults. Do you know your numbers? do you what a normal reading is? A good normal reading is 120/80 with borderline at 130/85 to 140/90.

For more accurate measures of your blood pressure and what affects it consider home blood pressure monitoring. Buy a blood pressure monitor for home use. Wrist and arm monitors are available at Target, Walgreen's, CVS, Wal-Mart, and local medical supply stores. Shop on line by doing a search for "blood pressure monitor".

Record your blood pressure readings daily starting with morning, midday, and night. Make a note of your activity and how you are feeling. You may notice that extreme anxiety makes it go up. The correlation to your pressure will help you manage the things that make it go up. Share your results with your doctor so medication and lifestyle changes can be made if necessary.

You may find that while your blood pressure is high in the doctor's office, it may be normal in everyday activity. Remember, the doctor's result is a one time reading every one to four or more months. With normal home results, and high results at your doctor visits you may have "white coat" hypertension. There is much controversy over whether this should be treated. Check with your cardiologist.

If your blood pressure is borderline at 130/85, you want o start a low salt diet. The best is the DASH diet (http://bit.ly/hnbsL). Exercise, weight control, and stress reduction are other things to include in your treatment plan. For higher blood pressure readings over 140/90, medication may be necessary. Take your home blood pressure results in to your doctor. This will help in deciding on the best treatment for you.

Check out the American Heart Association http://hearthub.org/ for more information.

by J.L. Richardson, MD, author of the Patient Handbook to Medical Care: Your Personal Health Guide.

http://www.mypatienthandbook.com/
www.twitter.com/MD4U

Heart Valve Screening

Should screening for heart valve disease be routine? Should you wait until you have symptoms and need surgery?

Today it was reported that Robin Williams (the famous Mork) will be having surgery on his aortic heart valve. Yesterday former First Lady, Barbara Bush, had surgery for aortic valve disease. Both were reported as having shortness of breath. Mrs. Bush also had dizziness. Other signs and symptoms may include chest pain, fast heart beat, weakness, and leg swelling.

As with many conditions, there may not be any symptoms. This would be reason enough to consider routine preventive screening with an echocardiogram of the heart. This test shows the heart valves very well. It also assesses heart function. The echo, as it is called for short, is a great test for looking at the heart. It uses the same technique as a sonogram for pregnancy

The best news of all is that the ehco is noninvasive - no needles! It is done quickly in less than thirty minutes. It is also affordable.
These are supporting reasons for making this test a part of routine preventive screening. It is so easy!

Talk to your primary care physician and cardiologist. See what is best for you.

Heart Health Checklist

Check your heart list:
___Heart and vascular exam by health care provider
___Blood pressure, pulse, weight, height
___EKG

For further evaluation, especially if symptoms are present, and/ or a strong family history of heart and vascular disease see a cardiologist.

Tests may include:
___Doppler echocardiogram (checks heart valves, size, etc.)
___Stress test - nuclear, doppler or exercise (heart function)
___Heart MRI scan (artery disease)
___Interventional studies like cardiac catherization, angiogram (checks artery blockage, valve function)

Heart health habits:

1. Maintain a healthy weight.
2. Eat healthy small portions.
3. Exercise regularly - every little bit counts! Just do it regularly.
4. Keep blood pressure under control.
5. Keep stress level low.
6. Get adequate sleep.
7. Take an aspirin a day if in a high risk group. Check with your health care provider.
8. Love, laugh, and let go!

Have a happy, healthy heart!

J.L. Richardson, MD, family medicine, is the author of the award winning Patient Handbook to Medical Care: Your Personal Health Guide.

http://mypatienthandbook.com

Heart Health Month Tips

Check your heart list:

___Heart and vascular exam by health care provider
___Blood pressure, pulse, weight, height
___EKG


For further evaluation especially if symptoms are present, and/ or a strong family history of heart and vascular disease see a cardiologist. Tests may include:
___Doppler echocardiogram
___Stress test - nuclear, doppler or exercise
___Heart MRI scan
___Interventional studies like cardiac catherization


Heart health habits:
Maintain a healthy weight.
Eat healthy small portions.
Exercise regularly - every little bit counts! Just do it regularly.
Keep blood pressure under control.
Keep stress level low.
Get adequate sleep.
Take an aspirin a day if in a high risk group. Check with your health care provider.

Love, laugh, and let go! Have a happy, healthy heart!

Heart Disease Screening

EKG? Stress test? Echocardiogram? Nuclear stress test? Angiogram? CT scan? Which test is the best for checking for heart disease, also known as coronary artery disease (CAD)? The best way to look at the heart is directly. Short of an autopsy, there is no other way. So what do you do?

Thanks to modern medical technology a electron-beam computed tomography (EBCT) scan (also called fast CT) of the heart is able to show heart vessels coronary artery calcium (CAC), hard plaque that causes blockage. An angiogram/ cardiac catherization shows actual blockages. This is invasive requiring injection of dye into a main artery to view the coronary arteries, and is the gold standard for detecting CAD. The heart scans are noninvasive, and give a rather good look at CAC (hard plaque) in heart vessels which can also be a predict cardiac events like heart attacks.

The most current consensus document (2007) from the American
College of Cardiology Foundation and American Heart Association does not recommend the scan for asymptomatic people with a high risk of coronary artery disease, or for those at low risk, nor as a screening tool. It is considered reasonable in the asymptomatic with intermediate risk, and for the symptomatic person prior to an angiogram for definitive diagnosis.

The document also cites studies that compare fast CT with EKG stress test, nuclear perfusion scan, stress echocardiogram and angiogram. "The accuracy of fast CT was significantly higher than either treadmill testing or technetium stress in the diagnosis of obstructive CAD." Other studies included angiography (the gold standard), fast CT, EKG, and nuclear (with thallium and technetium) exercise stress testing. The fast CT correlated closer with the angiogram than the other tests especially if the CAC score from the fast CT was over 100. If arteries are occluded more than 50%, this will likely show on the fast CT. "Three studies have documented that CAC is a rapid and efficient screening tool for patients admitted to the emergency department with chest pain and nonspecific electrocardiograms."


So why are cardiologists continuing to pass on recommending the fast CT? Is it because it is more convenient for the doctor to do the other tests because they are more "readily available" like in the doctor's office or nearby hospital? It seems like a fast CT could be just as "readily available". Do they get paid more for these other tests that may yield less information like the specific areas where CAD may be localized?

The fast CT sounds too good to be true. Is it? Does it give more accurate information about heart vessel blockage in 10 minutes than the other tests mentioned, excluding the angiogram? I have been watching my vessels with fast CT for about 5 years now. I felt that my family history of heart disease and my risk factors warranted more than an EKG or stress test which have also been done. Both failed to correlate with the findings of the fast CT.