Body mass index « ThePclinic

Atherosclerosis: Thickening of Arterial Wall

Some years back, one of my friends asked me that a person known to him is having pain in the left arm while walking, compelling him to take a break; and gets back the pain sometimes after resuming his walk. I suggested an electrocardiogram (ECG), and as expected by me a coronary artery disease was diagnosed. This symptom is somewhat a tale tell story of angina pain of heart. In my childhood, I have seen dancing of some superficial arteries of old aged persons and surprised over it; now, I am clear about its cause i.e. it is due to thickening of wall of peripheral arteries from atherosclerosis. In atherosclerosis; there occurs deposit of cholesterol, calcium, some blood cells and some other components in the inner layer of blood vessels called intima. This is equally seen larger as well as smaller blood vessels in the body. Smoking is an important cause of atherosclerosis.

Recently, researchers have found out the role of immune cells in the formation of atheroma after triggering an inflammation in the intima of blood vessels. Drugs targeting these cells also cause harm to useful effects of these cells. So, now they are targeting research, how to destroy the bad effect of cells leaving ahead the good effects. They also found out one molecule that switches on the harmful effect of these immune cells. The new research will be focusing more on blocking the action of the molecule.

Pot bellied persons due excess abdominal fat; the apples are prone to develop atherosclerosis than the pears; persons having fat deposit around hip, researchers say. Smoking, alcohol, sedentary life style and more saturated fat consumption are some of the contributing factors for atherosclerosis. Measurements of waist circumference (WC), waist to hip ratio (WHR) and Body mass index (BMI) are some of predictors of risk of heart attack. Waist circumference >32 inches in female and >37 inches in male have the risk of heart attack. Persons having WHR > 0.7 and BMI >30 are at the risk of developing atherosclerosis.

Filed under: atherosclerosis — Tags: Add new tag, Angina pectoris, Artery, atherosclerosis, Body mass index, Cardiovascular Disorders, Conditions and Diseases, Health, Heart disease — Dr.Prahallad @ December 28, 2009 7:01 pm

Preliminaries In Treatment of Idiopathic Hypertension.

: Image by Getty Images via Daylife

Sometimes cases are noticed, where drug treatment is started straight in the first visit of a newly diagnosed patient of hypertension. I, somehow could not digest this. If it is too high when first noticed drug treatment may be started but with mild to moderate rise in pressure, some other things should be tried first. Researchers also agree to it. It may have a cause to be designated as secondary hypertension. When a cause is not found it is termed as idiopathic or primary hypertension. However many theories are advanced to explain it.

Atherosclerosis is the main contributing factor. Here fat plaques form on the inner layer of the blood vessels, thereby narrowing the lumen. That gives resistance to flow of blood and the pumping force of heart has to increase to maintain adequate flow. So, the result is increased pressure.
Stress and strain induces a variety of endocrine hormones such as corticosteroids and adrenaline play a major role in sustaing it.
Rennin, angiotensin and aldosterone axis also plays a major role.
Obesity is a major cause of it. It is measured by what is called body mass index (BMI), which is arrived at by the formula body weight in kgs/body surface in square meter. If it is more than 30 the person is obese. And around 25 is normal

Blood pressure has two components namely systolic and diastolic. Systolic is the pressure when the heart pumps blood and diastolic is the pressure when the heart receives blood from vein and getting filled. Normally systolic blood pressure ranges from 90 mm. to 130 mm. of mercury and diastolic pressure ranges from 60 mm. to 90 mm. of mercury. When its value exceeds 130/90 mm. it is termed as hypertension. However, the patient should not be stamped as hypertensive right in the first visit, because simple tension of being examined may raise the blood pressure of a person. We usually take three recordings in three different occasions to confirm the disease.
Relevant investigations for diabetes mellitus, lipid profile, ECG, ultrasonogram, kidney profile and urine examination are to be done to exclude any other cause for it or to find out associated diseases. If no specific cause is found it is termed as idiopathic and presumed to be due to atherosclerosis.
The hierarchy of treatment should be as follows.

Life style modification. Patients leading a sedentary life should be encouraged to go for physical exercise. That will give relaxation, reduce weight, mobilize fat and keep the arteries clean from the deposits of atheromatous plaques. That will streamline blood flow and reduce hypertension.
Restriction of salt intake will go a long way in reducing the hypertension influencing the rennin-angiotensin-aldosterone axis.
Meditation will give relaxation and reduce stress which in turn will reduce the steroid hormone level to facilitate reduction of blood pressure.
Taking a few petals of garlic is said to have positive health benefits,as well as Yogic practices.
Thereafter, comes the role of drugs and first being a diuretic. And there is a long list of drugs which are to be prescribed by the expert physician.

Therefore, hypertension should be treated in a planned way. If pre-drug treatment practices are followed a number of patients may not require medications at all.