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Dr K K Aggarwal

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)

Sodium in drugs can be dangerous

By Dr K K Aggarwal
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Using effervescent, dispersible or soluble drugs on a regular basis leads to greater risk for heart attacks, strokes, and other cardiovascular events.

Regular use of prescribed effervescent and other sodium–containing drugs have a 16% greater risk for nonfatal stroke, nonfatal myocardial infarction (MI), and vascular death (P<0.01), compared with regular users of low or no–sodium versions of the same drug as per Dr Jacob George, at the University of Dundee in Scotland who write in BMJ.

Taking the maximum daily dose of drugs like effervescent aspirin or acetaminophen may exceed the recommended daily limit of sodium. Effervescent paracetamol 500 mg can contain 18.6 mmol of sodium in each tablet.

Sodium–loaded effervescent, soluble or dispersible tablets should be avoided in patients at risk of hypertension.

Current U.S. guidelines recommend that people at low risk for CVD events limit their sodium intake to no more than 2,300 mg (1 teaspoon or 100 mmol/L) per day.

Certain populations, including people over 50, African Americans, diabetics, and people with high blood pressure or chronic kidney disease, should limit their daily sodium intake to 1,500 mg.

American Heart Association recommends intake of less than 1,500 mg of sodium a day for everyone. World Health Organization (WHO) recommendations call for limiting daily sodium intake to no more than 2,000 mg per day.

All will not benefit by reducing sodium

By Dr K K Aggarwal
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A new analysis from the large international PURE trial has reopened the debate over the link between sodium and blood pressure. Presenting PURE SODIUM at the European Society of Cardiology 2013 Congress, Dr Andrew Mente (McMaster University, Hamilton, ON) and colleagues found that only certain subgroups would actually experience blood–pressure benefits from restricting their sodium consumption.

Ayurveda has been talking about it for some time. People with Kapha and pitta personalities would benefit and not those with vata personality

Heart Patients Beware of Summer

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Dehydration can precipitate heart attack in susceptible individuals. Dehydration can be dangerous in patients with uncontrolled blood pressure or diabetes. In these patients, dehydration can make the blood thicker and precipitate heart attack.

Dehydration is common in summer, and with the rising temperatures, chances of a person developing dehydration increase. A person, therefore, needs to increase fluid intake during summer.

The normal fluid requirement is 30 ml per kg weight, but the same needs to be increased in the summer because of the loss of fluid from sweating. Apart from water, sodium (Na) or salt is also lost.

Walking is a necessity for heart patients and it should be continued even during peak summer but the peak heat periods should be avoided. One can walk early in the morning or late in the evening.