Pharmahealthblog. Health and medical information

If you’re the kind of guy who has all kinds of extra memory on your computer or even a turbocharger on your riding lawn mower, you may be wondering, what’s the fuss about high blood pressure? Doesn’t higher pressure mean more power? And how in a man’s world could that ever be bad?

For one thing, high blood pressure makes you a prime candidate for a stroke, the third leading killer of men. In fact, the National Stroke Association says that between 40 and 90 percent of all stroke victims had high blood pressure before their strokes. “No question about it, high blood pressure leads the hit list,” says Ralph Sacco, M.D., director of the Northern Manhattan Stroke Study at Columbia-Presbyterian Medical Center in New York City and spokesperson for the National Stroke Association. What’s more, high blood pressure is the leading risk factor for congestive heart failure and has been linked to, among other things, heart disease, kidney disease, and an ominous-sounding problem called brain shrinkage.

If all this sounds fairly negative, you’re starting to get the picture. High blood pressure itself may not put you in a pine box – although about 40,000 Americans die from it each year – but it can sure help you along. “We’re talking about a problem that affects 50 million people,” says Eva Obarzanek, R.D., Ph.D., a research nutritionist at the National Heart, Lung, and Blood

Institute in Washington, D.C. “If we could lower people’s blood pressure, we could cut the number of serious diseases dramatically.”

A peek inside your cardiovascular system shows why.

Think of your heart as one incredibly well-built pump and your arteries, veins, and capillaries as a vast plumbing system of flexible, interconnected tubes carrying blood throughout your body. And when we say vast, we mean it: Stretched length-wise, the vessels of your circulatory system would measure an amazing 60,000 miles. In just one day, the average healthy adult heart pumps the equivalent of 2,100 gallons of blood.

The motor behind that movement is your heartbeat. For purposes of measuring the force your heart exerts, experts divide your heartbeat into two phases. When blood is squeezed out of your heart, that’s called your systolic pressure- the first number in your blood pressure equation. When your heart relaxes and refills with blood, that’s called diastolic pressure, the second number. A reading of 120/80 millimeters of mercury (120 over 80) is considered normal. Experts say that a reading above 140/90 should be of concern. And when your blood pressure is higher than 160/100, it’s definitely a problem, says Dr. Thomas Pickering of the Hypertension Center at New York Hospital.

Here’s where it gets weird. When that pressure rises higher than normal, the ever-protective lining of your arteries, called the endothelium, can’t keep plaque and other bits of blood debris from entering the vessel wall. The result: Before long, plaque starts to build up, clogging your arteries and blood vessels, says Dr. Robert DiBianco of Washington Adventist Hospital.

High blood pressure also strains your heart. Given the right stress- say, running or some other form of aerobic exercise -your heart will grow so that it can pump more blood. Not so when you have high blood pressure. Instead, your heart just gets thicker, which down the road can cause your heart to outgrow its blood supply. And this makes it more susceptible to narrowing of the arteries that supply blood to the heart, Dr. Pickering says.

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Smoking

Cigarette smoking is not only a risk factor for lung and cardiovascular disease. Chronic inflammation of the nasal passages and other components of the upper airway are more likely in smokers, having the same effect as other forms of upper respiratory tract obstruction. Smoking should be regarded as a risk factor for snoring.

Incidence

It wouldn’t be difficult to convince the average lay person that snoring is a common occurrence. We all know someone or have heard stories about someone who snores, but accurate estimates of the incidence of snoring are not easily established. Problems arise when we start asking questions about snoring. For a start, how do you get reliable information from people who sleep by themselves, and how do you classify the ones who snore “sometimes”? Despite these methodological problems, some impressive studies have been reported. A study in Italy involving about 6000 subjects showed that 20% of the selected population was habitual snorers with a further 15% being occasional snorers. A study in Toronto, Canada, collected data on 2629 subjects from a wide variety of ethnic and socioeconomic groups resulting in an overall snoring incidence of 42%. Detailed analysis of these and subsequent studies tells us a great deal about snoring in different age groups and the association with other medical complaints such as obesity, hypertension and heart disease. Several important trends emerge, particularly the higher incidence of snoring in males and the fact that we are more likely to snore as we get older.

Treatment

The demand for a snoring cure is evidenced by a proliferation of commercially available devices which claim to reduce or eliminate the problem. The techniques are various: hypnosis, designer pillows, electronic snore detectors and mouth appliances. Rather than present an evaluation of every one of these devices, it is intended to give an overview of current modes of treatment based on our understanding of the mechanisms of snoring.

Weight control

For the “uncomplicated” snorer, there are several approaches not requiring medical supervision. Overweight snorers, for example, will always be advised to lose weight regardless of other measures taken. Weight loss seems an absurdly simple way to reduce snoring, to the extent that many snoring patients are disappointed, if not offended, by the suggestion that their weight has anything to do with their nocturnal symptoms. Some recent work suggests that loss of weight is effective not merely because fatty impediments to the airway are removed, but because the function of the muscles supporting and controlling the pharyngeal area is improved.

There may well be both structural and functional reasons why weight loss decreases the likelihood of airway collapse during sleep, but regardless of the mechanisms, the importance of weight loss cannot be overemphasized. Weight loss, like alcohol avoidance, can only be achieved with appropriate education of the patient and a degree of self discipline. Unfortunately there are no diets designed specifically to meet the needs of snorers. Weight loss will follow when fewer calories are ingested, which for most people means a reduction in sweet and fatty foods. Consultation with a dietician is strongly recommended.

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First appointment

When you arrive at the clinic, you will be asked a few general questions about your health, and then shown into a cubicle to undress to the waist. It is easier if you wear trousers or a skirt rather than a dress. An X-ray of each of your breasts will then be taken, as described on p. 13. You should tell the radiographer if you are concerned about a lump, as you can be recalled for a clinical examination even if your mammogram does not show any abnormality.

Once both breasts have been X-rayed, you will be able to get dressed again while you wait a few minutes for the films to be developed, and for the radiographer to make sure that they are technically adequate. If you are asked to have a repeat X-ray at this stage, it will be for technical reasons or because a clear picture of the whole area of interest has not been obtained. The radiographer will not have made any medical judgment of your X-rays – only a technical one.

Receiving the results

During the next couple of weeks you and/or your GP should receive one of the following letters.

1    You are likely to receive a letter telling you that the mammogram showed no abnormality and that you will be called again for screening in 3 years time. This may be phrased as ‘no significant abnormality’ to take account of the fact that there is no real ‘normal’ standard as all women’s breasts are different.

2     You may receive a letter asking you to return for another mammogram because your X-rays were technically of poor quality. This may be because you moved slightly while the X-ray was being taken, or the developed film may not show enough of the breast area and armpit.

3     You may receive a letter asking you to return to the clinic for another assessment. This is the case for about 1 woman in 14, and can be because the X-rayed area needs to be examined more closely. Although you are bound to feel concern if this happens, bear in mind that there are numerous changes that occur in the breast tissue with age, some of which are quite normal and some of which may seem abnormal but are harmless.

Of the women who are recalled for further breast screening, 9 out of 10 are found not to have cancer. Most of the breast changes apparent on mammograms are not associated with any form of malignancy. Because of the importance of the early detection of breast cancer for successful treatment, the doctor examining your X-rays will err on the side of caution, and any unusual change in the tissue, or sign of any breast disease, will be examined further.

It may be helpful, while you wait for your second appointment, to make a note of any questions you think of, however trivial they may seem. Any doctor should be happy to explain points which are unclear and to discuss anything you are worried about.

Second appointment

All breast clinics are different, and each will have its own way of doing tests and investigations.

If you are asked to attend a second clinic, more X-rays will probably be taken, possibly from different angles, of one or both breasts. You may then be examined by a doctor, who will feel your breasts for any palpable lump or thickening of the tissue. If the doctor is able to feel anything, you may be given an ultrasound examination, the results of which may be discussed with you by the doctor at this visit or a subsequent one.

A fine needle aspiration biopsy may be done to remove a small sample of cells, or a small piece of tissue may be taken from a suspicious lump in your breast at a separate appointment using a general anesthetic. The cells or tissue sample will have to be examined under a microscope, so another appointment may have to be made for you to receive the results and discuss them with the doctor.

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Scarlet fever

In 1900 scarlet fever was so virulent that three out of every 100 children who caught it died. By 1973 there were only three deaths in 11,000 cases in the UK. Certainly children are better able to withstand the effects of the organism today but scientists are also sure that the organism itself has changed in some way.

Tuberculosis

In 185513 per cent of all deaths were caused by ÒÂ, and once again the young suffered most. ÒÂ is a classical example of a disease falling in the mortality league long before specific cures were available. Less overcrowding, better food, better personal hygiene and sanatorium treatment-all helped to reduce the illness and death from ÒÂ long before the drugs to cure it were discovered. Since the early 1950s, with mass X-rays, drugs and BCG vaccinations, there has been a rapid fall in the number of cases and deaths. New cases today are confined almost entirely to very old men and certain immigrants. But even today when the disease is virtually eradicated it causes the loss of 2.3 million working days a year in the UK. Just think what things were like a century ago!

Poliomyelitis

About thirty years ago polio reached its peak incidence. In 1947, 7,984 cases were recorded and 10 per cent of these died. Between 1952 and 1954 nearly another 1,000 died of the disease and many more were left paralysed. Today there are about 12,000 people in the UK suffering from the after-effects of polio.

The first vaccine was introduced in 1957. The result is that in the years 1972-4 only twenty-two cases of polio were reported in the UK and none died. But because not everywhere in the world has a similar record on this disease it still makes sense to be vaccinated before going abroad to certain countries.

Smallpox

Once the scourge of whole populations, this disease is now officially extinct in the world.

Maternal mortality

We have seen how the outlook has improved for babies and young children but so too has that of mothers during pregnancy and childbirth. A century ago maternal mortality in childbirth was at epidemic proportions, and even as recently as 1935 between forty and forty-five women died for every 10,000 pregnancies. This totalled about 2,500 women every year.

The establishment of the Royal College of Obstetricians and Gynecologists, and the Midwives Act of 1936 helped raise professional standards, and the care of pregnant women and the confinement in hospitals under specialist care has reduced the maternal death figures to one in every 10,000 births. There are suggestions that even this can be improved upon.

The history of preventive medicine, then, is largely that of public health, but now the challenges are different. Certainly we have combated the infectious illnesses to the point where they no longer pose a fraction of the threat they once did, but today we face new threats from degenerative diseases such as cancers, stroke, and heart disease-the big single killer of Western man.

Can modern preventive medicine do tor these diseases what public health so successfully did for the infections? The problems today are fundamentally different. The last century’s illness epidemics were caused by poverty and shortage. This century’s are being caused by wealth and excess. No one much minds giving up poverty and shortage but persuading people to give up ‘the good life’ is much more difficult.

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The benefits of the external use of herbs are greatly under estimated. Our skin is able to absorb the healing properties without having negative side effects on the digestive organs, when strong medicinal herbs or high dosages are used

To stimulate and treat a particular organ such as the stomach, liver or bladder, one can use a folded towel dipped in hot water placed on the area to be treated. Place a rubber water bottle, almost filled with hot water, on the wet towel, then wrap a towel around the body. A blanket to cover the patient is used as protection against cold air. Electric blankets should never be used to maintain the body temperature. Herbal extracts are used in hot compresses to amplify the treatment. This is the most commonly used pack. For treatments you use the same herbal tea as for baths. A cloth is dipped in herbal tea, .and wrung out, then placed on the problem area. A dry towel (bigger than the wet one) is then wrapped around for insulation and as an air barrier. Socks or compresses of wet socks should be linen or cotton, covered with dry woollen socks a bit longer than the wet socks. When applying wet socks or wet compresses one should make sure that all of the body is carefully covered with a blanket as a protection against cold.

You may alter or add to herbal compresses vinegar, Kombucha, clay, urine or only cold, warm or hot water depending on the treatment. You can find more detailed information in the book Water Medicine by Harald Tietze .

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