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Dr K K Aggarwal

Can blood pressure be higher in one arm?

By Dr K K Aggarwal
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A small difference in blood pressure readings between arms is normal. However, a difference of more than 20 mmHg for systolic pressure (top number) or more than 10 mmHg for diastolic pressure (bottom number) can be a sign of an underlying narrowing of the main arteries to that arm.

A difference of 10 to 15 mmHg for upper systolic pressure that shows up repeatedly is a risk marker for vascular disease and future heart attacks.

Always have your doctor check blood pressure in both your arms and use that arm, with higher reading, for future blood pressure readings.

Keeping blood pressure in the safe zone

By Dr K K Aggarwal
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Keeping your BP below 120/80 is the ideal goal to avoid a host of afflictions, including heart disease, kidney failure and erectile dysfunction. When lifestyle changes fail to fix the problem, doctors tend to reach for the prescription pad and add medication.

  • Reduce sodium intake. DASH diet keeps sodium to 2,300 mg per day (about one teaspoon of salt). Cutting it to 1,500—not easy, but doable—works even better. The DASH diet can lower your systolic pressure (upper number) by 10 points or more.
  • Monitor your pressure at home. This can give you instant feedback on the benefits of diet and exercise and give you and your doctor a more accurate picture of your blood pressure. This is valuable, because some people experience “white coat hypertension,” in which blood pressure spikes higher than normal when measured at the doctor’s office.
  • Limit your alcohol intake. For men, the suggested limit is 1 to 2 alcoholic drinks per day, defined as 1.5 ounces (1 shot glass) of 80–proof spirits, a 5–ounce serving of wine, or a 12–ounce serving of beer. (For women it’s no more than one drink a day.)
  • Take more meds if you need to—but take the right ones.

(Healthbeat)

Predicting sudden cardiac death

By Dr K K Aggarwal
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  • Normally people can walk a distance of 400-700 meters in 6 minutes.
  • A 6-minute walking distance of less than 300 meter is a simple and useful predictor of sudden cardiac death in a patient with mild to moderate heart failure.
  • Patients with interstitial lung disease who can cover less than 200 meters during 6-minute walk test are 4 times more likely to die than those who can walk greater distance.
  • People who can cover a distance of 200-300 meters need further evaluation.
  • A fall of SpO2 of more than 4% ending below 93% suggests significant desaturation.
  • An improvement of more than 70 meters or 10% in distance walked can make all the difference.
  • An improvement of 30 meters in any distance walked is the minimally important difference in any treatment.
  • Sudden cardiac death is linked to 15% of total urban mortality.
  • Risk factors for sudden cardiac death include abnormal lipid level, high blood pressure, cigarette smoking, physical inactivity, diabetic, obesity and family history of premature heart disease or heart attack.
  • Binge alcoholism can cause sudden cardiac death (6 or more drinks per day or five drinks in one session)
  • Risk of sudden cardiac arrest is transiently increased for up to 30 minutes after strenuous exercise (1/1.5 million of episode of exercise)
  • If you are at low risk for having a heart problem, you do not need a regular treadmill test.

Can blood pressure be higher in one arm?

By Dr K K Aggarwal
Filed Under Wellness | Tagged With: , | | Comments Off on Can blood pressure be higher in one arm?

A small difference in blood pressure readings between arms is normal. However, a difference of more than 20 mmHg for systolic pressure (top number) or more than 10 mmHg for diastolic pressure (bottom number) can be a sign of an underlying narrowing of the main arteries to that arm.

A difference of 10 to 15 mmHg for upper systolic pressure that shows up repeatedly is a risk marker for vascular disease and future heart attacks.

Always have your doctor check blood pressure in both your arms and use that arm, with higher reading, for future blood pressure readings.

Can blood pressure be higher in one arm?

By Dr K K Aggarwal
Filed Under Wellness | Tagged With: , , | | Comments Off on Can blood pressure be higher in one arm?

A small difference in blood pressure readings between arms is normal. However, a difference of more than 20 mmHg for systolic pressure (top number) or more than 10 mmHg for diastolic pressure (bottom number) can be a sign of an underlying narrowing of the main arteries to that arm.

A difference of 10 to 15 mmHg for upper systolic pressure that shows up repeatedly is a risk marker for vascular disease and future heart attacks.

Always have your doctor check blood pressure in both your arms and use that arm, with higher reading, for future blood pressure readings.

Blood pressure can be higher in one arm

By Dr K K Aggarwal
Filed Under Wellness | Tagged With: , , | | Comments Off on Blood pressure can be higher in one arm

A small difference in blood pressure readings between arms is normal. However, a difference of more than 20 mm Hg for systolic pressure (top number) or more than 10 mm Hg for diastolic pressure (bottom number) can be a sign of an underlying narrowing of the main arteries to that arm.

A difference of 10 to 15 mm Hg for upper systolic pressure that shows up repeatedly is a risk marker for vascular disease and future heart attacks.

Always have the doctor check both your arms for blood pressure, and whichever is higher, use that arm for future blood pressure readings.

Man Vachan Kaya

By Dr K K Aggarwal
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Man Vachan Kaya are the three fundamental principles used to define non–violence (ahimsa) and truthfulness (satya).

Being truthful means what you think, speak and do, are the same. You should be one in whatever you think, do or speak.

Ahimsa is the fundamental principle of Jainism, which means that you should be non–violent not only in your actions but also in your speech and thoughts. Being truthful makes you Satyugi. Only in certain circumstances, you may differ in your thinking, speech and actions. For example, you cannot tell a patient he is going to die in the next week. Here your mind may be saying something, your speech and actions will be something else.

Any discordance in Man, Vachan and Kaya ends up with guilt and suppress emotions, which later on can cause blood pressure, diabetes and heart disease.

(Disclaimer: The views expressed in this write up are my own).

5 steps to lower Alzheimers risk

By Dr K K Aggarwal
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  1. Maintain a healthy weight
  2. Check your waistline
  3. Eat mindfully
  4. Exercise regularly
  5. Keep an eye on important health numbers (cholesterol, triglycerides, blood pressure, blood sugar)

(Source: Harvard Healthbeat)

Air pollution can raise blood pressure

By Dr K K Aggarwal
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Breathing polluted air for even 2 hours can increase blood pressure, potentially raising the risk of cardiovascular disease in those exposed to smog.

In susceptible patients this small increase may actually be able to trigger a heart attack or stroke. In a study, which appeared in the journal Hypertension, researchers tested 83 people as they breathed levels of air pollution similar to those in an urban city near a roadway. The air pollution caused diastolic pressure (lower number in a blood pressure reading) to rise within 2 hours. Blood vessels were impaired for as long as 24 hours. Tests showed that microscopic particles in the air, rather than ozone gases, caused the rise in blood pressure and impaired blood vessel function. If air pollution levels are forecasted to be high, those with heart disease, diabetes or lung disease should avoid unnecessary outdoor activity.

Blood vessels were impaired for as long as 24 hours. Tests showed that microscopic particles in the air, rather than ozone gases, caused the rise in blood pressure and impaired blood vessel function. If air pollution levels are forecasted to be high, those with heart disease, diabetes or lung disease should avoid unnecessary outdoor activity.

Blood pressure drugs should be taken at night

By Dr K K Aggarwal
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Uncontrolled blood pressure can lead to heart attacks, paralysis and heart failure. Most such attacks occur in the early morning hours. Pulse, blood pressure and thickening of platelets are all higher in the early morning hours.  Controlling early morning blood pressure can reduce cardiovascular mortality. According to a study published in the Journal of the American Society of Nephrology, among patients with chronic kidney disease and high blood pressure, taking at least one antihypertensive drug at bedtime significantly improves blood pressure control, with an associated decrease in risk for cardiovascular events.  The study included 661 patients with chronic kidney disease who were randomly assigned either to take all prescribed anti BP drugs on awakening or to take at least one of them at bedtime. Patients were followed for a median of 5.4 years; during that time, patients who took at least 1 BP–lowering drug at bedtime had approximately one third of the cardiac risk compared with those who took all medications on awakening. A similar significant reduction in cardiac deaths, heart attacks and paralysis was noted with bedtime dosing. Patients taking their medications at bedtime also had a significantly lower mean BP while sleeping. For each 5 mmHg decrease in mean sleep–time systolic upper BP, there was a 14% reduction in the risk for cardiovascular events during follow–up. Potential explanation for the benefit of night time treatment may be associated with the effect of night time treatment on urinary albumin excretion levels. Urinary albumin excretion is significantly reduced after bedtime, but not morning, treatment.

Can blood pressure be higher in one arm?

By Dr K K Aggarwal
Filed Under Wellness | Tagged With: , , , , | | Comments Off on Can blood pressure be higher in one arm?

A small difference in blood pressure readings between arms is normal. However, a difference of more than 20 mm Hg for systolic pressure (top number) or more than 10 mm Hg for diastolic pressure (bottom number) can be a sign of an underlying narrowing of the main arteries to that arm.

A difference of 10 to 15 mm Hg for upper systolic pressure that shows up repeatedly is a risk marker for vascular disease and future heart attacks.

Always have your doctor check both your arms for blood pressure and which of the two is higher, use that arm for future blood pressure readings.

5 Steps to Lower Risk of Alzheimer�s disease

By Dr K K Aggarwal
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  • Maintain a healthy weight
  • Check your waistline.
  •  Eat mindfully. Emphasize on colorful, vitamin–packed vegetables and fruits; whole grains; fish, lean poultry, tofu, and beans and other legumes as protein sources plus healthy fats. Cut down on unnecessary calories from sweets, sodas, refined grains like white bread or white rice, unhealthy fats, fried and fast foods, and mindless snacking. Keep a close eye on portion sizes, too.
  • Exercise regularly. Aim for 2½ to 5 hours weekly of brisk walking. Or try a vigorous exercise like jogging for half that time.
  • Keep an eye on important health numbers. In addition to watching your weight and waistline, keep a watch on your cholesterol, triglycerides, blood pressure and blood sugar numbers.

Blood pressure drugs should be taken at night

By Dr K K Aggarwal
Filed Under Wellness | Tagged With: , , , , , , | | Comments Off on Blood pressure drugs should be taken at night

Uncontrolled blood pressure can lead to heart attacks paralysis and heart failure. Most such attacks occur in the early morning hours. Pulse blood pressure and thickening of platelets are all higher in the early morning hours. Controlling early morning blood pressure can reduce cardiovascular mortality. According to a study published in the Journal of the American Society of Nephrology among patients with chronic kidney disease and high blood pressure taking at least one antihypertensive drug at bedtime significantly improves blood pressure control with an associated decrease in risk for cardiovascular events. The study included 661 patients with chronic kidney disease who were randomly assigned either to take all prescribed anti BP drugs on awakening or to take at least one of them at bedtime. Patients were followed for a median of 5.4 years during that time patients who took at least 1 BP lowering drug at bedtime had approximately one third of the cardiac risk compared with those who took all medications on awakening. A similar significant reduction in cardiac deaths heart attacks and paralysis was noted with bedtime dosing. Patients taking their medications at bedtime also had a significantly lower mean BP while sleeping. For each 5 mmHg decrease in mean sleep time systolic upper BP there was a 14 reduction in the risk for cardiovascular events during follow up. Potential explanation for the benefit of night time treatment may be associated with the effect of night time treatment on urinary albumin excretion levels. Urinary albumin excretion is significantly reduced after bedtime but not morning treatment.

Keep your kidneys healthy

By Dr K K Aggarwal
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We all want our kidneys to last for a lifetime. We all should show our love for kidneys by adopting a 10-step program for protecting kidney health. Begin with monitoring blood pressure and controlling weight and then move on to the rest of the kidney-healthy tips. 1. Monitor blood pressure and cholesterol. 2. Control weight. 3. Don’t overuse over-the-counter (OTC) painkillers. 4. Monitor blood glucose. 5. Get an annual physical exam. 6. Know if chronic kidney disease (CKD), diabetes or heart disease runs in your family. If so, you may be at risk. 7. Don’t smoke. 8. Exercise regularly. 9. Follow a healthy diet. 10. Get tested for chronic kidney disease if you are at risk.

Working hard when tired not good for the health

By Dr K K Aggarwal
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Doing mental or physical work while exhausted may harm your health, according to a study from University of Alabama at Birmingham and published in International Journal of Psychophysiology.

In the study, fatigued people had bigger spikes in blood pressure compared to well–rested people while doing a memorization test. When fatigued people regard a task as worthwhile and achievable, they increase their effort to compensate for their diminished capability. As a result, the blood pressure of a tired person increases and remains elevated until the task is completed or the person gives up. In this study, the researchers told 80 volunteers that they could win a modest prize by memorizing 2 to 6 nonsense trigrams (meaningless, three–letter sequences) within two minutes. Compared to volunteers with low levels of fatigue, those with moderate fatigue had stronger blood pressure while doing the two–trigram memorization task.