Saturday, 28 April 2012

Stroke: Major causes


An ischemic stroke is caused by blockage of blood flow to the brain by a blood clot. The accumulation of plaque on artery walls (atherosclerosis or "hardening of the arteries" in common parlance) is an underlying cause of many ischemic strokes.

Atherosclerosis is a process in which fatty deposits (atherosclerotic plaque) invade the inside of blood vessels, particularly the carotid arteries on either side of the neck arteries supplying the heart and legs. Atheromatous plaque may cause stroke either by blocking blood flow, either by standing out (and be an embolus) that migrates into the blood, sometimes to the brain.

A hemorrhagic stroke is caused by bleeding in the brain (intracerebral hemorrhage) or bleeding around the brain (subarachnoid hemorrhage) resulting from a ruptured blood vessel. Sometimes cerebral hemorrhages are attributable to high blood pressure uncontrolled and, in some cases, anomalies that are within the structure of blood vessels (eg. Aneurysms or vascular malformations).

Many risk factors can cause a stroke.

Of these, there are factors you can not change, including:
  •     age - the risk of stroke increases as you get older;
  •     ethnicity - a larger percentage of First Nations people of African descent, Hispanic and South Asian high blood pressure and diabetes. These disorders increase the risk of stroke;
  •     family history - the risk of stroke may increase if a parent, brother or sister had a stroke before age 65;
  •     gender - men are at greater risk of stroke than women who are not yet menopausal;
  •     history of stroke or transient ischemic attack (TIA) - it is estimated that up to 30% of people who have suffered a stroke or TIA will make another stroke within 5 years after.
Among the factors that you can support include:
  •     high blood pressure;
  •     heart disease or atrial fibrillation (irregular heart beat);
  •     smoking;
  •     diabetes;
  •     a high cholesterol;
  •     physical inactivity;
  •     a heavy drinking (more than 2 drinks daily);
  •     stress.
Other factors can cause a stroke, including:
  •     other medical conditions such as amyloid angiopathy and antiphospholipid antibody syndrome;
  •     the use of illicit drugs such as cocaine or LSD;
  •     taking drugs such as tamoxifen *, phenylpropanolamine, and thrombolytics.
Other factors such as the use of oral contraceptives, hormone replacement or pregnancy and childbirth for women with preexisting medical conditions can increase the risk of stroke in certain circumstances. Talk to your doctor about risk factors that are relevant to your case and may affect your risk of stroke.

Stroke : Description



A stroke is characterized by a sudden loss of brain function due to an interruption of blood flow to the brain after an ischemic stroke (caused by the formation of a blood clot) or cerebrovascular bleeding (caused by the rupture of a vessel and subsequent bleeding into or around the brain).

The interruption of blood flow to the brain causes the destruction of nerve cells (neurons). The effects of a stroke vary depending on the part of the brain that was injured and extent of damage that results. About 80% of strokes are ischemic and 20% are hemorrhagic.

Stroke is a leading cause of disability globally and in Canada, approximately 300,000 people live with the consequences of a stroke. It is also the third leading cause of death in the country. Approximately 60% of people who have a stroke are dealing with a form of impairment such as paralysis, sensory loss, memory lapses, speech disorders and sight while some people may also suffer a depression or other emotional problems.

It is possible to minimize the risk of stroke by modifying risk factors, by using drugs and, in certain circumstances, surgery.

Friday, 27 April 2012

Cholesterol: Should you be tested? How often?



Canadian guidelines for the most recent support of the recommended cholesterol cholesterol test in the following cases:
  •     men 40 years or more;
  •     women 50 years or more;
  •     postmenopausal women (any age);
  •     people with diabetes;
  •     obese (BMI [body mass index] of 27 or more);
  •     smokers;
  •     people with hypertension;
  •     People with strong family history, that is to say which members of the immediate family (such as parents, siblings) had heart disease at a relatively young age (under 60);
  •     people with physical signs of high cholesterol, such as yellow lesions under the skin or a grayish circle around the cornea (transparent layer that covers the eye);
  •     patients with atherosclerosis (narrowing and hardening of the arteries);
  •     men with symptoms of erectile dysfunction (difficulty getting or maintaining an erection);
  •     People with chronic kidney disease;
  •     people infected with HIV receiving antiretroviral therapy (HAART);
  •     people with lupus erythematosus, rheumatoid arthritis or psoriasis;
  •     children with a family history of hypercholesterolemia.
For persons belonging to groups above, it appears advisable to cholesterol testing at intervals of 1 to 3 years, or sooner, if values ​​are abnormal or if treatment is started. Even if you're not part of these groups, your doctor may choose to measure your cholesterol levels it considers appropriate.

Your doctor will schedule for the determination of cholesterol depending on your age, your general health and whether or not you take cholesterol (medication to reduce your cholesterol).

Your doctor will check your cholesterol usually 6 weeks after initiation of treatment with a new drug or after a change in dose. Once the appropriate dose is reached, the tests will be every 6 to 12 months.

The cholesterol test will help you and your doctor to estimate your risk of heart disease, to determine your expectations for treatment and to evaluate the success of it. Ask your doctor if your cholesterol levels should be measured and, if so, what should your cholesterol targets.

What is a determination of hsCRP and should I suffer?


What is a determination of hsCRP?

C-reactive protein (CRP) is a protein that produces the liver when there is inflammation in the body. That's why they say it is a marker of inflammation. Because C-reactive protein can be measured by a method "highly sensitive", sometimes used the abbreviation hsCRP, but you can also simply use the abbreviation CRP. Inflammation is a way the body uses to protect themselves from injury or infection and can be caused by smoking, high blood pressure or high blood sugar. Excessive inflammation has been linked to heart disease.

Thursday, 19 April 2012

Am I at risk for heart disease?



High cholesterol is a major risk factor for heart disease. Risk factors are often classified into two categories: non-modifiable factors and modifiable factors or treatable.

Non-modifiable factors:
  •     age and sex (women over 55 and men over age 45 have a higher risk);
  •     ethnicity (people from Africa, South Asia and the descendants of First Nations have a higher risk);
  •     family history (including those family members have suffered a stroke or heart attack before age 60, suffer or have suffered from angina or are prone to hypertension or the hypercholesterolemia are at increased risk).
Factors modifiable or treatable:
  •     hypercholesterolemia;
  •     hypertension;
  •     elevated levels of hsCRP (C-reactive protein [CRP]: protein produced by the body in the presence of inflammation);
  •     a sedentary lifestyle (lack of exercise);
  •     obesity (overweight);
  •     smoking;
  •     excessive consumption of alcohol (more than 2 drinks per day for men and more than one drink per day for women);
  •     stress;
  •     diabetes;
  •     metabolic syndrome (group of risk factors for heart disease that tend to occur together, they include: a large waist circumference, high triglycerides, low levels of HDL cholesterol and a blood pressure and a high blood sugar, so if you have a large waist circumference plus two (or more) of these risk factors, your doctor may diagnose metabolic syndrome).
Concerned about your risk of heart disease? You can calculate your risk here and ask your doctor what you can do to reduce your risk.

The link between high cholesterol and heart disease


The higher your cholesterol, the higher your risk of heart disease increases. High cholesterol is one of many risk factors for heart disease. By controlling your cholesterol, you can reduce your risk of dying from heart disease. Effective treatment can save your life!

Whatever your level of risk, you should make changes in your lifestyle, such as improving your diet and exercising more, to better control your cholesterol. Some people have a risk level that may also require medication. Whatever your level of risk, the objective is to lower your bad cholesterol (LDL) cholesterol and increase your good cholesterol (HDL). The more you can lower your LDL cholesterol, the better.

Ask your doctor about your risk of heart disease, what treatment is best for you, how you set goals for your treatment and how to evaluate the success of it.

Saturday, 14 April 2012

Should you be tested for cholesterol? How often?



Canadian guidelines for the most recent support of the recommended cholesterol cholesterol test in the following cases:
  •     men 40 years or more;
  •     women 50 years or more;
  •     postmenopausal women (any age);
  •     people with diabetes;
  •     obese (BMI [body mass index] of 27 or more);
  •     smokers;
  •     people with hypertension;
  •     People with strong family history, that is to say which members of the immediate family (such as parents, siblings) had heart disease at a relatively young age (under 60);
  •     people with physical signs of high cholesterol, such as yellow lesions under the skin or a grayish circle around the cornea (transparent layer that covers the eye);
  •     patients with atherosclerosis (narrowing and hardening of the arteries);
  •     men with symptoms of erectile dysfunction (difficulty getting or maintaining an erection);
  •     People with chronic kidney disease;
  •     people infected with HIV receiving antiretroviral therapy (HAART);
  •     people with lupus erythematosus, rheumatoid arthritis or psoriasis;
  •     children with a family history of hypercholesterolemia.
For persons belonging to groups above, it appears advisable to cholesterol testing at intervals of 1 to 3 years, or sooner, if values ​​are abnormal or if treatment is started. Even if you're not part of these groups, your doctor may choose to measure your cholesterol levels it considers appropriate.

Your doctor will schedule for the determination of cholesterol depending on your age, your general health and whether or not you take a cholesterol (medication to reduce your cholesterol).

Your doctor will check your cholesterol usually 6 weeks after initiation of treatment with a new drug or after a change in dose. Once the appropriate dose is reached, the tests will be every 6 to 12 months.

The cholesterol test will help you and your doctor to estimate your risk of heart disease, to determine your expectations for treatment and to evaluate the success of it. Ask your doctor if your cholesterol levels should be measured and, if so, what should your cholesterol targets.

What should your target cholesterol levels?


Your cholesterol target depends on your risk of heart disease. Your doctor will calculate this risk based on your age, your gender, your cholesterol levels and your overall health. You can also determine your own risk of heart disease with our calculator target cholesterol levels and heart disease risk. 

Regardless of your level of risk of heart disease, the goal is to reduce your LDL ("bad" cholesterol) at least 50%. Your doctor can determine the target values ​​that are appropriate for you.

To learn more about cholesterol targets and values
​​that you should aim, see Setting goals. The target cholesterol levels are an important way to verify the effectiveness of your treatment. Ask your doctor what you can expect from your treatment against cholesterol and how to know if it works.


Friday, 13 April 2012

Why is this important?

Why is it so important to reach your target cholesterol levels? Because an effective reduction in cholesterol levels can save lives! Lowering cholesterol helps reduce the risk of heart disease or certain complications of heart disease (heart attacks and deaths from heart disease). Leading cause of death in Canada, heart disease accounts for one third of all deaths.

For each decrease of 1.0 mmol / L of your blood LDL-C, you decrease from 20 to 25% your risk of heart attack or dying from heart disease. Therefore, it is important to minimize your LDL cholesterol: the higher your rate is low, the better!

How far to go for reducing LDL cholesterol? Read the section Setting goals should be to find out what your cholesterol target. Talk to your doctor about your treatment goals and ask how to evaluate the success of your treatment.

Thursday, 12 April 2012

Adopt a healthy lifestyle


What are the benefits of lifestyle changes?

Changes in lifestyle are an important part of the management of cholesterol and the risk of heart disease. Adopting a healthy lifestyle can help reduce a high cholesterol. In some people, these changes will be sufficient to maintain healthy cholesterol levels, others will also need medication.

Even if you take medication to lower your cholesterol, do not forget that the change in lifestyle is still important. Think of your medication as a component of a health program also includes a diet and exercise.

Continue reading to learn more about changes in lifestyle that can help control cholesterol levels and learn tips to help you accomplish these changes.
 
Healthy Weight

The new Canadian guidelines on cholesterol management recommend maintaining a healthy weight to help control cholesterol. You can tell if you have a healthy weight by calculating your BMI (body mass index). Overweight or obesity (especially if you have a large waist circumference) are important risk factors for heart disease for which you can act. Under the guidelines, a large waist circumference varies by ethnic groups:
  •  for people of European origin, Saharan, or populations of the eastern Mediterranean or the Middle East: more than 94 cm (37 inches) for men and more than 80 cm (31.5 inches) for women;
  •  for people of South Asian, Chinese or Japanese: more than 90 cm (35.4 in.) for men and more than 80 cm (31.5 inches) for women.

Canadian guidelines on cholesterol management recommend maintaining a BMI below 25 and aim for a BMI less than 23 for people of Asian origin.

The best way to maintain a healthy weight is to eat a healthy diet and exercise. 

Diet and nutrition

By supplying more healthily, you can improve your cholesterol and reduce your risk of heart disease and stroke.

Here are some tips:
  •  Eat foods low in fat. Replace harmful fats with healthier fats. Saturated fats, trans fats and cholesterol are unhealthy fats. The healthier fats include polyunsaturated and monounsaturated fats and omega-3. Opt for low fat dairy and lean meats that have a total content of fat and lower also contain less saturated fat. When cooking, use oils containing healthy fats such as olive, sunflower, safflower and corn.
  •     Eat more fruits and vegetables, from 7 to 10 servings a day.
  •  Increase the amount of soluble fiber you eat. Foods such as oat bran, oatmeal, high fiber cereals, legumes (eg. Beans, peas and lentils) and fruits high in pectin (eg. Strawberries, oranges, apples and grapefruit) Good sources of soluble fiber.
  •   Try to eat fewer desserts such as cookies and cakes.
  •  Ask your doctor or dietitian to help you adopt healthy eating habits and perhaps even determine how many calories you should consume each day to maintain a healthy weight.
  •  When eating out, choose if possible "healthy choice", for example, the food steamed, baked or grilled.

Avoid fried foods, fried or breaded and the dishes with creamy sauces. Choose dressings or sauces, low fat and ask for them on the side. Do not hesitate to inform you of how to prepare food or make a special request. Finally, beware the portions that are served. Many restaurants serve more food than you need for one meal. Do not feel compelled to eat everything on your plate. Ask for a smaller portion, share your meal with a friend or bring the leftovers home for another meal.

It may be difficult to change your eating habits. The key to success lies in the "moderation in all things." You can offer occasional sweet or fatty foods, but do not make a habit. Ask your doctor and your dietitian what changes would be beneficial in your diet.

Exercise

Exercising regularly helps you lose weight and control your cholesterol.

Wondering where to start? Here are some tips on exercise:

    Set your goal to do 30 to 60 minutes of moderate intensity physical activity (brisk walking) to high (jogging) on
​​most days of the week. Physical activities that you could include in your routine are swimming, walking, jogging or cycling. Remember that you are not obliged to do all your exercise at once. If you can reserve a block of 30 minutes in your schedule, three sessions of 10 minutes will give you the same benefits.
  •  If you are having trouble getting motivated, try to train with a friend or join a group. Choose activities that will please you.
  •  You should be comfortable and able to talk while you're exercising. Stop when you feel dizzy, faint or breathless, or if you feel pain.
  •  There are other simple ways to increase your physical activity level. You can for example take the stairs or parking your car further away than usual. Gardening, yard work and household chores you are also exercising.
Consult your doctor before starting any exercise program, especially if you suffer from heart disease or are taking medication. Start slowly by you setting realistic goals and gradually increase the frequency and intensity of exercise as your fitness improves.

Quit Smoking

Smoking can increase your triglyceride levels and lower your HDL cholesterol. Smokers have a risk of heart disease 70% higher than non-smokers. Quitting smoking can also help people with metabolic syndrome to reduce their risk of heart disease.

Tips to quit smoking:
  •  The benefits of quitting smoking are felt first 24 hours after the last cigarette.
  •  There are several methods to quit smoking, including nicotine replacement products, prescription drugs, support programs and stop "brutal". Each person is unique and must find the method that suits him best. Ask your doctor or pharmacist to advise you on the most appropriate method for you.
  •  Visit the Health Canada Web site to find other web links where you can get information on various programs and tips for quitting.

  • If you have already tried unsuccessfully to quit, do not worry! It usually takes several attempts before successfully quitting for good. Each test brings you closer to your goal.
Moderate alcohol consumption

Excessive consumption of alcohol can increase your triglyceride levels and blood pressure.

Here are some tips to make your drinking does not harm your heart health:

    Limit the amount of alcohol you take in one drink per day for women or two drinks per day for men.
    Remember that one drink equals:
  •         355 mL (12 oz) of beer - about a bottle of beer, or
  •         150 ml (5 oz) of wine - about one small glass of wine, or
  •         45 mL (1.5 oz) of distilled spirits at 40% (hard liquor) - about a shot glass.
  •     Avoid situations that lead you to drink too much. Ask family and friends to support you, and tell them you are trying to reduce your drinking.
If your drinking is a concern, talk to your doctor

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Tuesday, 10 April 2012

How my high cholesterol can be harmful for me?


Hypercholesterolemia is a disease usually "silent", that is to say, it does not normally cause any signs or symptoms that you can feel. Laboratory analysis is the primary means of screening for high cholesterol. For more information on screening for high cholesterol, see the section called Cholesterol.

Why can it be cholesterol harm me? High levels of LDL ("bad") cholesterol and total cholesterol, and low levels of HDL ("good cholesterol") in the blood have been linked to atherosclerosis, a buildup of plaque (a deposit hard of cholesterol and other substances from the blood) on the blood vessel walls, making them stiffer and stronger. Plaques can also rupture, which increases the risk of clots that can clog blood vessels. It follows an increased risk:

  •     heart attack: when blood vessels supplying the heart are blocked by a clot, some parts of the heart muscle may die due to lack of oxygen and nutrients.
  •     stroke (CVA): when blood vessels supplying the brain are blocked by a clot, brain tissue may die or be injured due to lack of blood supply.
  •     angina: When blood vessels supplying the heart are constricted, which causes the heart to receive all the oxygen it needs (but sufficient for it to not die), chest pain may occur .
  •     peripheral vascular disease (circulation problems), also called peripheral arterial disease: when the blood vessels supplying the arms and legs are narrowed or blocked, there may be pain when the limb is used.
Untreated, high cholesterol can lead to serious complications and even death. It is therefore important to check your cholesterol levels as often as your doctor recommends. Lower your cholesterol can save your life. Therefore, if your cholesterol is high, ask your doctor what you can do to lower it.

Monday, 9 April 2012

Cholesterol



 What is cholesterol?

Essentially, high cholesterol means the cholesterol in the blood is too high, which increases your risk of heart disease. To learn more about high cholesterol, see when cholesterol is it considered too high? and Setting Goals.

Where does cholesterol stays?

The liver manufactures about 80% of the cholesterol found in blood, the rest from our diet.

Many foods contain small amounts of cholesterol, but the data suggest that saturated fats and trans fats found in our diet have the greatest impact on blood cholesterol levels. Saturated fats are typically found in meat and dairy products. It is therefore important to monitor not only the cholesterol content of foods, but also the amount of saturated fat they contain.

Although a small number of people can eat a diet rich in saturated fat without having adverse effects on cholesterol levels, most people should eat foods lower in fat to maintain a healthy cholesterol level.

The production of cholesterol in the liver is influenced by family history (genetics) and how the liver works. This means that your diet and lifestyle are not the only factors responsible for high cholesterol. The risk of high cholesterol increases with age.

Cholesterol! Is it all bad?

Your body needs a certain amount of cholesterol to function properly. It is essential to the manufacture of cells and hormones. Hormones are chemical messengers that allow cells to communicate. Thus, sex hormones, estrogen and testosterone, are made in the body from cholesterol.

How many people suffer from high cholesterol?

Nearly 40% of the adult Canadian population shows high cholesterol. Do you belong in? Ask your doctor to check your cholesterol and if you were to have other tests to assess your risk of heart disease.

Saturday, 7 April 2012

Setting Goals


You and your doctor will determine your treatment goals set against cholesterol. Clearly defined objectives will assess more easily the success of your treatment.

Your main objectives will be therapeutic to target your target cholesterol levels. The target values
​​determined depend on the level of your baseline and your risk of heart disease. Your doctor will calculate your risk of heart disease, or you can calculate it yourself here. Whatever your level of risk of heart disease and how you treat your high cholesterol, the goal for everyone is to reduce LDL ("bad" cholesterol) at least 50%.

Here are the usual targets of cholesterol:


If your risk of heart disease over the next 10 years is ... You'll need to start treatment ... And your cholesterol targets are ...
Moderate risk (10-19%) For most people:

when LDL-C is greater than 3.5 mmol / L, or

when the ratio CT / HDL-C is greater than 5.

Among men over 50 and women over 60 years:
when hsCRP *** is greater than 2.0 mg / L (regardless of whether the LDL-C is high).
Lowering LDL-C at least 50%, or

Reach a level of LDL-C below 2.0 mmol / L, or

Achieve a rate of apo B * less than 0.8 g / L.
High risk ** (20% or more) Immediately Lowering LDL-C at least 50%, or

Reach a level of LDL-C below 2.0 mmol / L, or

apo B Less than 0.8 g / L
* Apo B = apolipoprotein: protein part of LDL-C and VLDL, which can cause inflammation in blood vessels.

** The high risk group also includes people with diabetes or a disease related to atherosclerosis (eg. Heart disease, stroke, peripheral vascular disease).

*** CRP (CRP) is a protein that produces the liver when there is inflammation in the body. That's why they say it is a marker of inflammation. The C-reactive protein can be measured by assaying the rate of hsCRP (C-reactive protein high sensitivity), also called hsCRP assay.

The targets set out in the table above are only recommendations - your doctor may recommend that you aim for even lower values
​​(eg, a reduction of over 50% in LDL-C). With respect to LDL cholesterol, the general rule is "the higher the rate is lower, the better." For each reduction of 1.0 mmol / L LDL cholesterol, your risk of certain complications associated with heart disease (cardiac death and heart attack) decreases from 20 to 25%.

Although LDL cholesterol is the most important target, your doctor may establish other targets "secondary", especially when you reach your goal LDL-C, for example:

Secondary targets Usual targets
Ratio CT/C-HDL less than 4.0
Triglycerides less than 1.7 mmol / L
hsCRP less than 2.0 mg / L
Non-HDL cholesterol (HDL-C less than CT) less than 3.5 mmol / L
Ratio apo B / apo AI (apo B is part of the LDL-C and VLDL-C and apo AI is part of HDL-C) less than 0.80

Although triglyceride levels be measured during the determination of cholesterol, the Canadian guidelines for the management of cholesterol does recommend more valuable therapeutic target for triglycerides. However, a triglyceride level of 10.0 mmol / L or higher requires treatment because of the increased risk of pancreatitis (inflamed pancreas). Triglyceride levels should ideally be below 1.5 mmol / L.

Your doctor may also recommend other therapeutic purposes, for example:
  •     achieve and maintain a healthy weight;
  •     quit smoking;
  •     control your blood pressure;
  •     control your blood sugar.

Friday, 6 April 2012

Cholesterol

What should your target cholesterol levels?

Your cholesterol target depends on your risk of heart disease. Your doctor will calculate this risk based on your age, your gender, your cholesterol levels and your overall health. You can also determine your own risk of heart disease with our calculator target cholesterol levels and heart disease risk. Regardless of your level of risk of heart disease, the goal is to reduce your LDL ("bad" cholesterol) at least 50%. Your doctor can determine the target values
​​that are appropriate for you.

To learn more about cholesterol targets and values
​​that you should aim, see setting goals. The target cholesterol levels are an important way to verify the effectiveness of your treatment. Ask your doctor what you can expect from your treatment against cholesterol and how to know if it works.