Tag: North America

Blood Test To Predict Risk Of Heart Disease For Diabetics

Diabetes has long been regarded as a risk factor of heart disease. The specific relationship between the two was unclear although diabetes is known to double the risk of heart disease. As a result, many people living with diabetes have to monitor their health for well-known risk factors for heart disease, such as obesity, cholesterol levels and blood pressure. Despite the fact that the role of blood sugar levels in managing their risk of developing cardiovascular disease remains as a big unknown, diabetics are still advised to achieve a well-controlled level of blood sugar.

In 2004, researchers from United States revealed that a new blood test (at that time) can predict risk of developing heart disease for people with diabetes.

Two separate studies had suggested that people with both Type 1 and Type 2 diabetes should regularly take the hemoglobin A1c test, on top of their regular checks of blood sugar. The HA1c test looks for glycated hemoglobin, also called glycosylated hemoglobin, and is a measure of how well blood sugar is controlled.

In one study, the researchers at Johns Hopkins University in Baltimore reanalyzed the data from 13 studies involving nearly 10,000 people from North America and Europe, and found that those with higher levels had much higher risks of heart and artery disease.

Being published in the Annals of Internal Medicine, the research reported that 1 percent point increase in HA1c predicted an 18 percent increase in risk for total cardiovascular disease and a 28 per cent risk for peripheral vascular disease (clogged arteries in the legs).

Similar results were found in the second study. The researchers from the Cambridge University and Britain’s Medical Research Council studied 10,030 people aged between 45 and 79 for 6 years. They found that a 21 percent increase in cardiovascular events such as heart attack, for every 1 percent point increase in hemoglobin A1c above 5 percent. Persons with HA1c concentrations less than 5 percent had the lowest rates of cardiovascular disease and mortality. This was true even when patients were older and fatter and regardless of blood pressure or cholesterol levels.

In conclusion, the 2 studies clearly prove that the glycosylated hemoglobin level is an independent progressive risk factor for incident cardiovascular events, regardless of diabetes status. Glycosylated hemoglobin level can be added to the list of other clearly established indicators of cardiovascular risk, such as blood pressure and cholesterol level.

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Arthritis – A Deadly Disease

Arthritis is the disease basically associated with the old people but the children may be affected by this disease. People of the age group 65 are mostly affected by arthritis in North America and they together constitute 70% of the total population. Women are at the major risk of getting affected by arthritis as compared to the men and this disease is more prevalent in the women of all ethnic races and cultures. According to an estimate about 46 million of people USA are suffering from this disease and the number increases every year. About one million people are admitted to the hospital just because of the problems they face because of arthritis.

Recital

All the persons suffering from arthritis complain the problem of extreme pain. The pain may be different according to the location and the individual. Rheumatoid arthritis is very worse in the morning and is characterized by stiffness. In the earlier stages the symptoms cannot be easily recognized. In the old individuals and the children pain may not be the major diagnostic feature as the old people move little and the children refuse to move the limb when it is paining. Important features of arthritis include speed and time of onset, pattern of joint movement, symmetry of symptoms, early morning stiffness, locking with inactivity, tenderness and other systemic factors. Physical examination and the radiography may be helpful in the diagnosis of the disease. Arthritis has been known from prehistoric times. Extra articular features of arthritis or joint disease include cutaneous nodules, oedema, ocular inflammation, diarrhea, bursitis, lymphadenopathy and urethritis. Blood tests indicate the presence of rheumatoid factor, antinuclear factor (ANF) and extractable nuclear antigen.

Malady

In USA arthritis is the major cause of disability among the individuals and 20 million people are dependent upon the doctors and the physicians for their survival. It has been found that the 50% of an individual’s salary who is suffering from arthritis is lost in the treatment of arthritis. The ability of a person to remain active is lost completely. Some also suffer from obesity, high cholesterol and risk of heart disease. Depression may also be found in such individuals.

Indications

Apart from the type of arthritis the common symptoms are pain, joint stiffness and swelling and a persisting pain around the joints. Other symptoms include inability to walk and move hands, malaise and feeling of tiredness, fever, weight loss, poor sleep, muscle ache, tenderness and difficulty in moving the joints.

Types

Rheumatoid Arthritis

It is a disorder where the body starts destroying its own tissues for some unknown reasons. The attack is not only restricted to the joints but also to other parts of the body. The major damage is caused to the lining of the joints and the cartilage resulting in the erosion of two opposing bones. The joints of the fingers, knee, wrists and elbows are affected in the rheumatoid arthritis. The disease is having symmetry and causes severe deformity in few years. It basically affects the people of age group 20 or more. This disorder in children causes pain, fever, skin rashes and limitations on the day to day activities. Actual cause rheumatoid arthritis is not known till present but the scientists are very actively engaged in finding out the treatments as possible for this disorder. The drugs that are administered against rheumatoid arthritis include intravenous injections of either corticosteroids or monoclonal antibodies. Remicade is a drug which is presently being used for the treatment of rheumatoid arthritis and can be effective for short term only. Surgery can be done to replace the affected joint but there is no complete cure of the disorder. Other dangerous symptoms can also develop in later stages which include heart problems, gait abnormality and skin nodules.

Osteoarthritis

It affects the larger joints of the body like that of the back, hip or the knees. This is generally the result of the wear and tear of the joints. It begins in the cartilage and results in the erosion of two opposing bones. It starts with a minor pain which is experiences while walking and the pain becomes continuous during the night. The pain causes hindrance in the daily activity of the individual. It is basically a disorder very common among the old people especially the women of the age group 65. Osteoarthritis cannot be cured but can be prevented from becoming worse. Weight loss is the most common feature of this disease. Physical therapy of the joints may be helpful in getting some relief. Joint replacement may be of little help.

Severe Arthritis

Arthritis is a dangerous disease and in more intense cases it can result in severe deformities. The majority of the individuals suffering from the rheumatoid arthritis have deformed fingers. The deformity may also be seen in the wrist joint so it cannot be moved properly. Other problems include appearance of carpal tunnel syndrome due to nerve entrapment. In later cases the sensation of the fingers also gets lost. Infectious arthritis is another form of severe arthritis. It is characterized by appearance of sudden chills, fever and joint pain. This condition may be caused by bacteria. This disease can be easily diagnosed and prevented from becoming intense. Psoriasis is another form of arthritis. In this case first the patient develops skin problems followed by arthritis. Symptoms include joint pain, stiffness and swelling. There is no cure for this disease and this occurs on a small scale. Lupus is a collagen vascular disorder that can be frequently found associated with arthritis. The symptoms of lupus include skin rash, extreme photosensitivity, hair loss, kidney problems, lung fibrosis and constant joint pain. Another problem that has been found associated with arthritis is gout which arises due to the deposition of uric acid crystals in the joints leading to inflammation. The joints lose their activity and often swell.

Inhibition

Rheumatoid and the osteoarthritis are not curable but one can prevent himself from being affected by physical therapy, losing weight and eating healthy. The individuals who feel pain in the joints must immediately consult the physicians so that the treatment can be started as soon as possible in order to prevent the disorder from becoming intense.

Ministration

Once arthritis is diagnosed treatments are available for a number of symptoms that are frequently experienced. Rheumatoid and osteoarthritis are not curable. The treatments used against them can help in relieving pain for a short period but complete relief is not possible. Treatments include physical therapy, changing the lifestyle, orthopedic bracing, medications and dietary supplements. Arthroplasty also called joint replacement surgery can also be performed. Physical exercise has given better results in treatment of arthritis.

Medications

Physicians generally start the treatment with the use of drugs. The first choice of drugs is the non-steroidal anti-inflammatory drugs (NSAIDs). Ibuprofen and tramadol are the general pain killers which are basically used. The drugs although effective are also associated with a number of side-effects like the abdominal pain, bleeding, liver and kidney damage and ulcers. The non-steroidal anti-inflammatory drugs cannot be used for prolonged periods without the prescription of the physician. Corticosteroids are presently being used for the treatment of arthritis. They help in reducing the inflammation and also prevent the joint damage. Corticosteroids are associated with a number of side effects like ulcers, hypertension, cataracts, diabetes, skin bruising, and weight gain. Disease modifying antirheumatic drugs (DMARDs) is generally used for the treatment for the rheumatoid arthritis as they are helpful in preventing the joint damage. The commonly used DMARDs are methotrexate, hydrochloroquineand minocycline. They are also having many side effects in the form of liver and kidney damage, bone marrow suppression and possibility of other infections.

Immunosuppressants like cyclosporine and cyclophosphamide can be taken for getting relief from inflammation. These drugs make an individual more prone to other infections. Tumor necrosis factor inhibitors have been used for getting relief from inflammation and joint pain. They are also having some side effects as a person becomes susceptible to the risk of heart disease and other infections.
Occupational therapy and the physical therapy can help the people suffering from arthritis. Physical therapy can teach an affected individual how to relax the limb without damaging the joints. It can also provide splint and braces for the joints. Physical therapy also teaches how to drive the car, take bath and perform household work. Occupational therapy teaches how to reduce on the joints and perform the daily activities. Physical therapy also makes use of ice, heating pads and ultrasound guided massage therapy. Both these therapies help an individual to remain free from some of the difficulties of arthritis.

It can be concluded that arthritis is a very painful disease affecting the joints and there no complete cure for it only one can practice the use of physical and occupational therapy. Drugs can be helpful but are at risk and make an individual more prone to other infections.

Obesity and Heart Disease

We only have to look at a Titian painting to recognize that at one point in the history of Western culture, fat was considered beautiful. Before the 20th Century, corpulence was touted as a sign of wealth and luxury, largely because most people were barely surviving on a meager existence.

Ironically, now in our era of affluence and plenty, we have to contend with the health and economic problems of obesity. We have a population in North America that is more than 55% overweight. More than 20% of those overweight are considered obese, a situation which proves to be an economic burden on our Health Care system because of the coronary risk factors associated with obesity. In 2004, total national health expenditure in the USA was $1.9 Trillion or $6,280 per person.

Why is obesity a risk factor for heart disease?

Among obese individuals, triglyceride levels are unusually high, while HDL levels tend to be low; both of these situations are risk factors for heart disease .A recent study involving tissues collected from autopsies of 3000 men (15-34 years old) who had died of external causes (not heart related) identified an association between obesity and coronary atherosclerosis.

Abdominal fat which characterizes obese individuals is also an area of concern. A study of 1300 Finnish men (42-60 years old) suggests that abdominal fat is an independent and major risk factor for coronary events. Several reasons have been suggested for this: a) stomach fat is continually released into the bloodstream in the form of artery-clogging fatty acids; b) abdominal fat also releases compounds that facilitate risk factors such as atherosclerosis, metabolic syndrome and inflammation; c) abdominal fat initiates biochemical events that lead to insulin resistance, a precursor of Type 2 diabetes and heart disease.

Obesity is often a precursor to metabolic syndrome, a dangerous health situation that is manifested through a cluster of symptomsexcess body fat, insulin resistance, low HDL cholesterol, high triglyceride levels and high blood pressureall risk factors for coronary events. People with metabolic syndrome release immune system messengers called cytokines into their bloodstream. Cytokines lead to a communication breakdown between body cells and insulin which leads to excessive insulin production by the pancreas, creating a situation that is a literal time bomb for heart disease . In addition, this excessive insulin production can raise fibrinogen concentrations in the bloodstream, thus allowing blood to clot more easily, a situation that is a direct risk factor for heart attacks and strokes.

Because of their size, obese individuals are more often than not sedentary in lifestyle. Inactivity in and of itself is also a coronary risk factor. Data from more than 88,000 women in the Nurses Health Study shows that a lean sedentary woman had 1.48 greater risks for coronary heart disease than a slightly heavier but physically active woman.