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Dr K K Aggarwal

Cholesterol tips

By Dr K K Aggarwal
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Blood lipid levels may exhibit mild seasonal variation with a drop in the summer and total cholesterol levels peaking in the winter. The variation can be up to 5 mg/dL.

Serum total and HDL-cholesterol can be measured in fasting or non-fasting individuals. There are only small clinically insignificant differences in these values when measured in the fasting or non-fasting state.

The total cholesterol can vary by 4 to 11 percent within an individual due to multiple factors including stress, minor illness and posture. Values may also vary between different laboratories, with data suggesting that a single measurement of serum cholesterol can vary as much as 14 percent. Therefore in an individual with “true” serum cholesterol concentration of 200 mg/dL, the range of expected values is 172 to 228 mg/dL.

More than one measurement of total cholesterol should therefore be obtained when treatment considerations demand a precise determination. Measurement of serum HDL-C and triglycerides may demonstrate even greater variability.

A standard serum lipid profile consists of total cholesterol, triglycerides, and HDL-cholesterol. Lipid profile should be performed after 12 to 14 hours of fasting to minimize the influence of postprandial hyperlipidemia. One can use either plasma or serum specimen. The serum cholesterol is approximately 3 percent lower than the plasma value.

Healthy obesity does not exist

By Dr K K Aggarwal
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New research published online in the Annals of Internal Medicine suggests that individuals cannot be simultaneously overweight and physically fit.

As BMI rose, so did blood pressure, waist circumference and insulin resistance. As BMI increased, levels of HDL cholesterol, thought to protect against heart attack and stroke, decreased.

While participants who were either overweight or obese “may not yet have reached the points that define metabolic illness, they appeared to be on that road as their weight” increased.

Heart disease starts in youth

By Dr K K Aggarwal
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Autopsy studies of young people who died in accidents have shown that by the late teens, the heart blockages, the kind of lesions that cause heart attacks and strokes are in the process of developing The best opportunity to prevent heart disease is to look at children and adolescents and start the preventive process early. More than a third of children and adolescents are overweight or obese. The first signs that men are at higher risk of heart disease than women appear during the adolescent years despite the fact that boys lose fat and gain muscle in adolescence, while girls add body fat. Between the ages of 11 and 19, levels of triglycerides, a type of blood fat associated with cardiovascular disease, increase in the boys and drop in the girls. Levels of HDL cholesterol, the “good” kind that helps keep arteries clear, go down in boys but rise in girls. Blood pressure increases in both, but significantly more in boys. Insulin resistance, a marker of cardiovascular risk, which is lower in boys at age 11, rises until the age of 19 years. Any protection that the young women have for cardiovascular protection can be wiped out by obesity and hence obesity in girls at any cost should be handled on priority.

Healthy obesity does not exist

By Dr K K Aggarwal
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A recent research published online in the Annals of Internal Medicine suggests that individuals cannot be simultaneously overweight and physically fit. As BMI rose, so did the blood pressure, waist circumference and insulin resistance. As BMI increased, levels of HDL cholesterol, thought to protect against heart attack and stroke, decreased.

While participants who were either overweight or obese “may not yet have reached the points that define metabolic

Cholesterol tips released

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Blood lipid levels may exhibit mild seasonal variation with a drop in the summer and total cholesterol level peaking in the winter. The variation can be up to 5 mg/dL, said Padma Shri & Dr. BC Roy National Awardee, Dr. KK Aggarwal, President Heart Care Foundation of India & National Vice President Elect IMA.

Serum total and HDL-cholesterol can be measured in fasting or non-fasting individuals. There are only small clinically insignificant differences in these values when measured in the fasting or non-fasting state.

The total cholesterol can vary by 4 to 11 percent within an individual due to multiple factors including stress, minor illness and posture. Values may also vary between different laboratories, with data suggesting that a single measurement of serum cholesterol can vary as much as 14 percent. Therefore in an individual with “true” serum cholesterol concentration of 200 mg/dL the range of expected values is 172 to 228 mg/dL.

More than one measurement of total cholesterol should therefore be obtained when treatment considerations demand a precise determination. Measurement of serum HDL-C and triglycerides may demonstrate even greater variability.

A standard serum lipid profile consists of total cholesterol, triglycerides, and HDL-cholesterol. Lipid profile should be performed after 12 to 14 hours of fasting to minimize the influence of postprandial hyperlipidemia. One can use either plasma or serum specimen. The serum cholesterol is approximately 3 percent lower than the plasma value.

Turmeric can prevent heart failure

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Traditional Indian turmeric prevents heart failure, lowers cholesterol, prevents cancers and gall stones and augments scar formation in a wound.

Studies from the University of Toronto’s Cardiology Division and published in The Journal of Clinical Investigation have shown that Curcumin, an ingredient in the curry spice turmeric, when given orally to a variety of mouse models with enlarged hearts (hypertrophy), could prevent and reverse hypertrophy, prevent heart failure, restore heart function and reduce scar formation.

In the studies, curcumin was given to rats, who then underwent surgery or received drugs designed to put them at risk of heart failure. The rats that received curcumin showed more resistance to heart failure and inflammation than comparison groups of rats that did not get curcumin.

Curcumin treatment also reversed heart enlargement. Curcumin short–circuited the heart enlargement process, though it’s not clear how it did that.

The healing properties of turmeric have been well–known. The herb has been used in traditional Indian medicine to reduce scar formation. For example, when there is a cut or a bruise, the home remedy is to reach for turmeric powder because it can help to heal without leaving a bad scar.

Curcumin has come under the scientific spotlight in recent years, with studies investigating its potential benefits for reducing cholesterol levels, improving cardiovascular health and fighting cancer.

As an herb, turmeric should to be taken 300 mg thrice–daily with meals. It has useful actions like antioxidant, anti–inflammatory, anti rheumatic; lowering cholesterol, anti cancer and prevention of gall stones. It is also found to be useful in situations like dysmenorrhea, dyspepsia, HIV, muscle soreness, peptic ulcer disease, scabies and uveitis.

Curcuminoids, act as free radical scavengers. They also inhibit leukotrienes and synthesis of prostaglandins. The anti–inflammatory activity has been claimed to be comparable to NSAIDs (such as indomethacin).

Curcuminoids lower blood lipid peroxides, decrease total cholesterol and LDL cholesterol, and increase HDL cholesterol. Turmeric has also been claimed to inhibit platelet aggregation.

In people with type 2 diabetes, intensive drug therapy can significantly lower bad LDL cholesterol and reduce the thickness of the neck carotid arteries supplying oxygen to the brain.

A study published in Journal of the American College of Cardiology has shown that every effort should be made to bring down the bad LDL cholesterol to less than 80mg/dL.

The Stop Atherosclerosis in Native Diabetics Study (SANDS) trial tested the value of aggressively lowering bad LDL cholesterol to 70 mg/dL or lower, and non HDL cholesterol to 100 mg/dL.

The standard treatment group had standard goals (100 mg/dL for LDL and less than 130 mg/dL for non HDL Cholesterol).

The study involved 427 type 2 diabetic Native Americans who were aged 40 or older and who had no history of heart attack or other heart-related event. There were 204 people in the standard treatment group and 223 in the aggressive treatment group. Ultrasound tests showed that neck artery thickness got worse, or progressed, in the standard treatment group and regressed in the aggressive treatment groups.

The test called intima media thickness of the carotids is the only cost-effective test to know whether or not the heart blockages are shrinking or progressing as the thickening in carotids goes hand in hand with the thickening in the heart arteries.