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 Your Health

As your physician, I want to help you lead a long, healthy life. I would like to take this opportunity to share with you the preventative measures that need to be taken to maintain the QUALITY of life you lead. Heart Disease and Cancer are the leading causes of death in the United States1. By simply choosing a healthy lifestyle and having necessary tests performed at the appropriate times you can drastically reduce the impact of these diseases in your life!

Leading a Healthy Lifestyle:

Committing to a healthy lifestyle is the first step to preventing cancer and heart disease. Follow these 3 simple steps to a healthier you:

1.    Stop Smoking:  Quitting is hard to do, but living with cancer or chronic heart disease is tougher!  There are a lot of resources that can help you with this difficult task. Please talk to me about this today!
Great resource: www.smokefree.gov
Quick Fact: Smokers have more than twice the risk of heart attack as non-smokers2!

2.   Get some Physical Activity every day: Aim for 30 minutes of exercise every day...and remember, every little bit counts! Walk the dog, take the steps instead of the elevator, vacuum the house...do anything, just get moving!

3.   Maintain a Healthy Diet: Eat balanced meals that are low in sodium, saturated fats and cholesterol and make sure to include a variety of fruits and vegetables, whole grains, and low-fat or fat-free dairy products.

There are lots of resources available to assist you in these areas - please ask me about them today and commit to making these 3 simple lifestyle changes! You will not only significantly reduce your chances of heart disease and cancer, but you will improve the overall quality of your life! You will feel better physically and mentally. Start today!

Heart Disease:
Heart disease is the #1 cause of death for men and women in the United States! But, even that statistic doesn't tell the whole story...millions of patients each year experience dramatically changed lives after the heart attack or stroke that didn't take their life. Prevention is vital to make sure you don't become a statistic! The American Heart Association now recommends that heart attack prevention begin by age 202. The first step is modifying your lifestyle. In addition to the lifestyle changes mentioned above, limiting alcohol intake, reducing stress, lowering high blood pressure, managing diabetes and reducing blood cholesterol are critical!

Did you know that people with diabetes are 2 to 4 times more likely to develop cardiovascular disease2? Needless to say, managing diabetes plays a significant role in reducing the number of heart disease related deaths. Starting at 45 years of age, either a fasting plasma glucose test (FPG) or a level drawn two hours after a meal. (Note: Pre-diabetes is when blood glucose levels are higher than normal but not high enough to be diabetic and these individuals are at greater risk of developing diabetes.)

  FPG Target Values                          OGTT Target Values
Normal:              < 100 mg/dL          Normal:              < 140 mg/dL
Pre-Diabetes:      100 - 125 mg/dL     Pre-Diabetes:      140 -199 ng/dL
Diabetes:            > 125 mg/dL          Diabetes:           > 199 mg/dL

In addition to your total cholesterol there are 3 values that you need to know and understand: LDL, HDL, and triglycerides. Your HDL is your "good" cholesterol because it helps to carry the bad cholesterol away from the arteries. Your LDL is your "bad" cholesterol since as it flows through the blood stream it builds up on the arterial walls forming plaques that eventually lead to blockages. Triglycerides are a normal component in your bloodstream. After you eat, your body digests the fats in your food and releases triglycerides into your bloodstream. They are transported throughout your body to give you energy or to be stored as fat4. Keeping these within healthy ranges are vital for a heart healthy life. So what is healthy?

Total CholesterolTriglyceridesHDL Target Ranges
Desirable:< 200 mg/dLNormal:< 150 mg/dLMen:40-50 mg/dL
Borderline:200-239 mg/dLBorderline:150-199 mg/dLWomen: 50-60 mg/dL
High risk:> 239 mg/dLHigh:200-499 mg/dL  
  Very high:> 499 mg/dL  

LDL is the primary target for lipid management and requires a little bit more information. Target levels depend on family history and how many of the following risk factors you have: smoker, blood pressure > 140/90, currently on an antihypertensive medication, HDL < 40 mg/dL, family history of premature Coronary Heart Disease (CHD), men > 45 years, or women > 55 years5.

Risk                                                                                                                   LDL Goal
A patient with CHD, Diabetes, or any other Atherosclerotic Disease----------------------- < 70 mg/dL
2+ Risk Factors   --------------------------------------------------------------------------------------------- < 130 mg/dL
0-1 Risk Factors  --------------------------------------------------------------------------------------------- < 160 mg/dL

Cancer Prevention6:
Prevention and early detection are the keys to a cancer free life! Leading a healthy lifestyle is half of the battle early detection is critical! Whether it's cancer of the breast, prostate, colon, or cervix - simple tests are available to help you.

Breast cancer is the second leading cause of cancer death in women, after lung cancer3. Starting when a woman is in their 20's and 30's, self breast exams should be done on a monthly basis and a clinical breast exam should be done about every 3 years. Starting at the age of 40, clinical breast exams and mammograms should be done yearly. For women with a family history, it may be necessary to begin mammograms earlier and/or additional tests may be recommended. Please talk to us today if there is any family history and about resources that are available.

Prostate cancer is the third leading cause of cancer death in men, after lung cancer and colorectal cancer3. If treated early, you can significantly reduce the probability of it spreading. For this reason, starting at the age of 50, all men need to have yearly prostate screenings. This includes a digital rectal examination and a Prostate Specific Antigen (PSA) test. (For African-American men with a family history, the recommendation is to start at 40 years of age.)

Colon cancer is the second leading cause of cancer death in men and third in women3. Beginning at age 50, both men and women should have a flexible sigmoidoscopy every 5 years. Please bring to our attention any personal history of colorectal cancer, adenomatous polyps, chronic inflammatory bowel disease, cancer or polyps in a first-degree relative younger than 60, or two first-degree relatives of any age. These patients may need to start screening earlier and/or have them performed more often. Should any positive test result, it needs to be followed up with a colonoscopy.

The Pap smear is a simple test performed during an annual exam that screens for cervical cancer. All women should begin getting tested within 3 years after starting to have intercourse, but no later than 21 years of age.  Beginning at age 30, women who have had 3 normal Pap test results in a row may get screened every 2 to 3 years.  Women 70 years of age or older who have had 3 or more normal Pap tests in a row and no abnormal Pap test results in the last 10 years may choose to stop Pap smears. Women who have had a total hysterectomy (removal of the uterus and cervix) may also choose to stop having cervical cancer screening, unless the surgery was done as a treatment for cervical cancer or pre-cancer. Women who have had a hysterectomy without removal of the cervix should continue to follow the guidelines above. Women who have certain risk factors such as diethylstilbestrol (DES) exposure before birth, HIV infection, or a weakened immune system due to organ transplant, chemotherapy, or chronic steroid use should continue to be screened annually or as long as they are in good health. A new immunization is available for all women >9 years old to prevent Human Papilloma Virus (HPV), which is now considered the primary cause of cervical cancer.

Thank you for taking the time to read and review this material that will help you understand the steps that need to be taken to ensure you lead a long and healthy life. Please carefully consider each of the recommendations listed. It's not only your best defense against heart disease and cancer; it's also your responsibility2.

Sources:

1: National Center for Health Statistics
Health, United States, 2005
With Chartbooks on Trends in the Health of Americans
Hyattsville, Maryland: 2005 

2: American Heart Association Inc. www.americanheart.org 

3: American Cancer Society Inc.; www.cancer.org

4: www.merckmedicus.com 

5: NCEP III Guidelines 

6: Smith RA, Cokkinides V, Eyre HJ. American Cancer Society guidelines for the early detection of cancer, 2006. GA Cancer J Glin. 2006; 56:11-25 

Albert J. Weisbrot, M.D. and Associates, Inc.
7451 Mason Montgomery Rd.
Mason Ohio 45040
Phone: 513-770-0330
Fax: 513-770-2106

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Copyright 2008 Albert J. Weisbrot, M.D. and Associates, Inc.
Last modified: 05/06/08