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Know your health numbers

Dr. Drew Werner

EAGLE COUNTY – Do you know your number? No, I’m not talking about your sleep number. I don’t mean your telephone number or your spouse’s cell phone, either. I don’t mean your Social Security number or your nine-digit Zip code. I don’t even mean your license plate number, checking account balance or even your credit card’s available line of credit.Dear Doc: I recently had my blood tested and was glad to hear that everything was the same as last year. Even my blood pressure was within a point or two. Then my doctor told me everything was too high! What is up with that!- Thought I was doing well in Vail.Dear Doing Well: Like many numbers they are meant to change. We want our new car to have a few more horsepower and get a few more miles to the gallon too. At the end of the year, we’d like a raise and see our bank accounts grow. We’d like to pay less in taxes (I won’t even get started in that election year thing). Our numbers change because our expectations change. Medicine is the same. We certainly want what is best for your health. So the goals we set change, too.Fifteen years ago, when I started in practice, 240 was a reasonable cholesterol level and no one was even worried about your HDL (high density lipoprotein) or LDL (low density lipoprotein). A fasting blood sugar of 150 was only something to watch and if your blood pressure was 160/90, you were doing just fine. How times have changed.In order to obtain some good standards we need good data. Going a step farther, why worry about something that cannot be treated? Therein lie the clues to why medical standards have dropped so much in the last 15 and particularly the last five years.As blood pressure medications have become better tolerated, with fewer side effects, it has become easier to treat hypertension. At the same time the risks of hypertension – such as heart attack, kidney failure and stroke – have been more clearly identified. The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC7) was published in 2003. Those guidelines recommend that all healthy adults have a blood pressure less than 140/90. For adults with heart or kidney disease those numbers are lowered to130/80. Equally importantly, JNC7 identifies those healthy adults with a blood pressure between 120-139/80-89 as having prehypertension which requires closer monitoring.Cholesterol guidelines have changed, too. The Adult Treatment Panel (ATP) is the body of experts from the National Cholesterol Education Program, which establishes our optimal cholesterol numbers. They recently came out with their third set of recommendations, ATP III, which focuses not on treatment of cholesterol related disease but lowering cholesterol in order to prevent cholesterol related complications. Now your LDL (Low Density Lipoprotein), or the “bad” cholesterol, should be below 100. An LDL of 129 to 130 is considered borderline and should be treated if you have other risk factors, including heart disease and diabetes. ATP III also lowered triglyceride guidelines to 150 or less as normal and recommends consideration of treatment above 200. Finally, the guideline for HDL (High Density Lipoprotein), or the “good cholesterol,” is to have it above 40. Previously 35 was considered acceptable.Last but not least is your blood glucose, or blood sugar. Previously, either you had diabetes or you did not. A blood sugar greater than 140 was a concern. Recently, however, the goal of a normal blood sugar was 126 or below. That made a large number of previously normal individuals diabetics. Within the past year it has been recognized that most diabetics have “prediabetes” for months to years before developing diabetes. The recommendation for a normal fasting blood sugar then is below 100. Previously it was 115.So I encourage you to really get to know your numbers. I’ll talk in more detail about cholesterol, high blood pressure and diabetes in future weeks. Please keep your questions coming in!Dr. Drew Werner of the Eagle Valley Medical Center writes a weekly column for the Daily. He encourages health questions. Write him by e-mail to editor@vaildaily.com or c/o Editor, Vail Daily, P.O. Box 81, Vail, 81658.Vail, Colorado


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