Khaas Baat : A Publication for Indian Americans in Florida
Health & Wellness

Strengthening your Self-Defense against Diseases – Part v

Dr. M. P. Ravindra Nathan

By M. P. Ravindra Nathan,

Ever since medicine has moved into the age of science, laboratory tests and values have become just as important as clinical examinations. There are many diseases that gain a foothold in your body and stealthily progress for weeks, months or years before they come to light. Examples are plenty in every physician’s practice. One of my patients who presented to the emergency room with a mini stroke was found to have significant hypertension previously unrecognized. Now you know why “hypertension” is called “silent killer.” And the 64-year-old man who came to my clinic recently with a toe nail infection turned out to have undiagnosed diabetes.

To avoid these complications and maintain good health, it’s important to know certain parameters about ideal health – what we call normal range of values. This will help you in early detection, prompt treatment and prevention of serious complications. Some of the key numbers you have to remember are given below. United Healthcare, the largest medical insurance company in United States, says, “Know these numbers and you can make changes to improve your health and reduce the risk of heart disease, diabetes and other illnesses.”

BMI or Body Mass Index: Normal: <25, Overweight: 25 – 29.9, Obesity: 30 or over. Morbid Obesity > 40

Your body mass index (BMI) measures your weight in relation to your height and is a universally accepted index for evaluation of body obesity. You can refer a BMI chart to get your number quickly. Overweight and obesity contribute to many diseases and hence you must try to keep your BMI below 25. For Indians, 23 or below would be ideal.

Blood Pressure (BP). Normal: 120/80 or below. Pre-hypertension: 120 – 139/ 80 – 89 Hypertension: Stage 1: 140 - 159/90 – 99, Stage II: 160 – 179/ 100 – 110, Stage III: 180/ 110 or above.

“Aggressive treatment of high blood pressure can sharply cut the risk of heart attacks, strokes and deaths in people 50 and older,” according to a landmark federal study released recently and was flagged on the front pages of most newspapers. Nearly 1 out of 3 adults in the U.S. has high BP. If you find out you are one of them, don’t panic, but do see a doctor to get the proper advice.

Fasting Blood Sugar and HbA1c. Normal FBS: 100 mg/ dl or below, Pre- Diabetes: 101 -125. Diabetes: >125. Your post-prandial blood sugar should be < 180, ideally < 150. Hb A1C: Normal: 5.7 – 6.4 and above 6.4 is consistent with Diabetes Mellitus (DM).

These measurements are for early detection of (DM) that can often antedate clinical appearance by months or years. So beware. HbA1C represents average plasma glucose concentration over prolonged periods of time, hence useful in deciding the control of DM in a patient. A preventable disease to a great extent, DM is common among Indians. According to a newly released report in Circulation: Cardiovascular Quality and Outcomes,“10 percent of patients who presented with acute heart attack at 24 hospitals in the United States during a three-year study had unrecognized diabetes!” Now that’s serious!

Lipid (Cholesterol) Profile: Normal Cholesterol: <200 mg/dl. LDL (Low-density lipoproteins or bad cholesterol: 100 mg or less especially for high risk patients. HDL (High-density Lipoproteins or good cholesterol): 45 or above for males and 50 or above for females. Triglycerides: Another fatty element in the blood should be 150 mg/dl or less.

While some cholesterol is needed for our body to function normally, excess cholesterol becomes the fatty substrate that contributes to vascular atherosclerosis responsible for heart attacks, strokes and peripheral vascular disease. There are no definite symptoms related to high cholesterol, so it's important to know your numbers and discuss the results with your doctor.

Waist circumference: Males: 40 inches or less. Females: 35 inches or less. Anything above is considered unhealthy.

Measured around the abdomen, just above the top of the hip bone, roughly at the area of umbilicus, waist circumference is unique indicator of body fat distribution, which can identify patients who are at increased risk of obesity-related cardiometabolic disease and resultant heart disease, above and beyond the measurement of BMI. It is also used to assess the central fat distribution and abdominal obesity; the latter considered to be highly atherogenic resulting in heart disease.

PSA (Prostate Specific Antigen): Normal: 1 – 4 ng/ml.

PSA is tested only in males and may be elevated in conditions like benign enlargement, inflammation or cancer of the prostate gland. Certain prostate cancers, especially below the age of 70, can be aggressive and PSA measurement is beneficial in early detection and therapy.

To be a smart patient, you should keep track of all these numbers. Physicians would like every patient to be involved with his or her own care.

M.P. Ravindra Nathan, M.D., is a cardiologist and Emeritus Editor of AAPI Journal. His book “Stories from My Heart” was recently released. (www.amazon.com or www.bn.com).

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