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Dr K K Aggarwal

Smoking makes you 5 years older

By Dr K K Aggarwal
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  • Men have a greater chance of dying than women, and smoking increases any adult’s risk of death just as if five years were suddenly added to their age.
  • For men who have never smoked, heart disease presents their greatest risk for death at any age, exceeding the odds of dying from lung, colon and prostate cancer combined.
  • Male smokers face a lung cancer risk that is greater than the odds of heart disease taking their lives after age 60, and is tenfold higher than the chance of dying from prostate and colon cancer combined.
  • The chances of dying from heart disease and breast cancer are similar for nonsmoking women until age 60, when heart disease becomes a greater risk.
  • For female smokers, dying from lung cancer or heart disease is more likely than dying from breast cancer after age 40.

Nine modifiable risk factors for heart attack

By Dr K K Aggarwal
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The majority of known risk factors for heart attack are modifiable by specific preventive measures.

The nine potentially modifiable factors include smoking, dyslipidemia, hypertension, diabetes, abdominal obesity, psychosocial factors, regular alcohol consumption, daily consumption of fruits and vegetables and regular physical activity. These account for over 90 percent of the population attributable risk of a first heart attack.

In addition, aspirin is recommended for primary prevention of heart disease for men and women whose 10-year risk of a first heart attack event is 6 percent or greater.

Smoking cessation reduces the risk of both heart attack and stroke. One year after quitting, the risk of heart attack and death from heart disease is reduced by one-half, and after several years begins to approach that of nonsmokers.

A number of observational studies have shown a strong inverse relationship between leisure time activity and decreased risks of CVD. Walking 80 minutes in a day and whenever possible with a speed of 80 steps per minute are the current recommendations.

Smoking makes you 5 years older

By Dr K K Aggarwal
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  • Men have a greater chance of dying than women, and smoking increases any adults risk of death just as if five years were suddenly added to their age.
  • For men who have never smoked, heart disease presents their greatest risk for death at any age, exceeding the odds of dying from lung, colon and prostate cancer combined.
  • Male smokers face a lung cancer risk that is greater than the odds of heart disease taking their lives after age 60, and is 10-fold higher than the chance of dying from prostate and colon cancer combined.
  • The chances of dying from heart disease and breast cancer are similar for nonsmoking women until age 60, when heart disease becomes a greater risk.
  • For female smokers, dying from lung cancer or heart disease is more likely than dying from breast cancer after age 40.

Sangat and smoking

By Dr K K Aggarwal
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Adi Shankaracharya described Sangat as the main force for living a spiritual life.

Sangat is the company of people you live with. Living in the company of good people makes one good and the reverse is also true.

The same is now being proved in the allopathic context. A new research published in the New England Journal of Medicine has shown that when one person quits smoking, than others are likely to follow. One person quitting can cause a ripple effect, making others more likely to kick the habit.

  1. If your spouse stops smoking, you’re 67 percent less likely to continue smoking.
  2. If your friend kicks the habit, it’s about 36 percent less likely that you’ll be smoking.
  3. When a sibling gives up cigarettes, your risk of smoking decreases by 25 percent.
  4. Your risk of smoking drops by 34 percent if a co–worker in a small office quits smoking. It’s sort of like watching dominoes. If one falls, it very quickly causes others to fall.

We should treat people in groups, rather than as individuals. Friends and family need to be involved. If you want to quit, try to get close friends and family to quit as well.

Quitting smoking may have the side benefit of improving social well–being, just as it improves physical health.

Stress may increase smoking habits

By Dr K K Aggarwal
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Stress increases the risk of heart attack by pushing people toward bad habits. A British study published in the Journal of the American College of Cardiology suggests that people with psychological stress had a 50% increased risk of a cardiovascular disease event over the follow–up period.

The reasons were higher smoking rates and low exercise levels of individuals who were stressed.

In the study over a 7-year follow–up period, incidence of cardiovascular events –– heart attacks, stroke, bypass surgery and the like –– was 50% higher among the people with a high level of depression and anxiety when compared to happier people. Smoking and lack of physical activity explained about 63% of the increase, with smoking alone responsible for 41%.

Alcohol intake explained less than 2% of the increase, with high blood pressure assigned 13% of the blame. All such patients should be treated with combined physiological approaches with intensive lifestyle changes to reduce modifiable risk.

Women above 65 should take extra care of their health

By Dr K K Aggarwal
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  • Women aged 65 and above should take low dose aspirin routinely to prevent heart attack and paralysis.
  • All women are urged to exercise a minimum of 30 minutes per day, but women who need to lose weight or maintain weight loss are now advised to engage in 60 to 90 minutes of moderate-intensity activity on most, or preferably all, days of the week.
  • A heart-healthy diet should be rich in fruits, whole grains and fiber foods with a limited intake of alcohol and sodium.
  • Saturated fat should be reduced to less than 7 percent of calories.
  • Women at very high risk for heart disease should try to lower their LDL (“bad”) cholesterol to less than 70 mg/dL.
  • Women aged 65 and over should consider taking low-dose aspirin on a routine basis, regardless of their risk. Aspirin has been shown to prevent both heart attacks and stroke in this age group.
  • The upper dose of aspirin for high-risk women is 325 mg per day.
  • Hormone replacement therapy, selective estrogen receptor modulators or antioxidant supplements such as vitamins C and E should be used to prevent heart disease.
  • Folic acid should also not be used to prevent cardiovascular disease.
  • Women should eat oily fish or some other source of omega-3 fatty acids at least twice a week.
  • Women should not only quit smoking but should use counseling, nicotine replacement or other forms of smoking cessation therapy.

Some tips on Multiple sclerosis from HCFI

By Dr K K Aggarwal
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  1. Eat a healthy diet with plenty of fruits and vegetables, lean protein, and omega-3 fatty acids
  2. Movement of the body is crucial in patients with MS at every stage. Regular exercise promotes better flexibility, boosts balance, and can also help with common MS complications.
  3. Practice good sleep hygiene by sticking to a consistent sleep schedule, keeping the room dark and cool, avoiding too many fluids before bedtime, and creating a relaxing bedtime routine.
  4. Get plenty of Vitamin D. As per a recent research, people with MS who are vitamin D deficient tend to suffer more significant progression of the disease.
  5. Smoking is a big risk factor for having MS as well as for the worsening of the disease. Quit this habit as well as drinking to help manage symptoms.
  6. Talk to your near and dear ones if you feel depressed. This will help you feel better and positive. Try meditating for some time during the day.

Hookah as bad as smoking

By Dr K K Aggarwal
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An hour of puffs from a hookah packs the same carbon monoxide punch as a pack-a-day cigarette habit. Hookahs have grown in popularity in recent years and Hookah bars have appeared in cities all over the world that allow people to smoke these water pipes. Users inhale tobacco smoke after it bubbles through water, a process that some people think filters toxins from the tobacco.

Hammond and a student, in a study published in the Journal of the American Medical Association, recruited 27 students who smoked water pipes for an hour on three different evenings in April 2006. Another five students did not smoke the hookahs but stayed in the room with those who did. The participants abstained from water pipe smoking for 84 hours before taking part in the study; the bowls of their water pipes were filled with water and 10 grams of Al Fakher muassal tobacco, and then heated with charcoal. Researchers monitored carbon monoxide in the breath of the participants both before and after the experiment using a machine designed to detect if people are smokers. The exhaled carbon monoxide in participants was an average of 42 parts per million, higher than that reported in cigarette smokers (17 parts per million). The study also found that carbon monoxide levels grew in the room where the subjects smoked hookahs and might reach environmentally unhealthy levels, as determined by the federal government, during longer sessions.

Smoking a water pipe for 45 minutes produces 36 times more tar than smoking a cigarette for five minutes.

Cycling can cause erectile dysfunction

By Dr K K Aggarwal
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Age, diabetes, hypertension, obesity, high lipids, smoking, drugs, heart disease, upright cycling for more than 3 hours a week can cause erectile dysfunction in males. For those who ride bicycles for more than 3 hours a week should do so in a reclining position and not upright position.

A man is considered to have erectile dysfunction when he cannot acquire or sustain an erection of sufficient rigidity for sexual intercourse. Any man may, at one time or another during his life, experience periodic or isolated sexual failures.

The term “impotent” is reserved for those men who experience erectile failure during attempted intercourse more than 75 percent of the time. Heart disease increases the risk for later erectile dysfunction. Erectile dysfunction may be an early warning sign of future heart disease. Men with erectile dysfunction without an obvious cause (e.g., pelvic trauma), and who have no symptoms of heart disease, should be screened for heart disease prior to treatment since there are potential cardiac risks associated with sexual activity in patients with heart disease.

Eight of the 12 most commonly prescribed medications list impotence as a side effect and it is estimated that 25 percent of cases of erectile dysfunction are due to drugs.

Depression, stress, or the drugs used to treat depression can result in erectile dysfunction.

Neurologic causes of erectile dysfunction include stroke, spinal cord or back injury, multiple sclerosis, or dementia. In addition, pelvic trauma, prostate. Surgery or priapism may cause erectile dysfunction.

Bicycling, less obvious, but of increasing importance, has been the possible association of erectile dysfunction with bicycling. Anything that places prolonged pressure on the pudendal and cavernosal nerves or compromises blood flow to the penile artery can result in penile numbness and impotence.

Cycling-induced impotence is primarily a problem of serious cyclists and has been reported to occur in Norwegian men competing in a 540 km bicycle race.

The penile numbness is attributed to the pressure on the perineal nerves whereas the erectile dysfunction is thought to be due to a decrease in oxygen pressure in the pudendal arteries.

Recreational cyclists, those who cycle for less than 3 hours per week and men who cycle in a reclining position avoid the sustained intense pressure on the penile nerve and artery and are less likely to experience sexual side effects. Continued cycling in a seated upright position can reduce the penile oxygen levels lasting 10 minutes.

Cycling can cause erectile dysfunction

By Dr K K Aggarwal
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Age, diabetes, hypertension, obesity, high lipids, smoking, drugs, heart disease, upright cycling for more than 3 hours a week can cause erectile dysfunction (ED) in males. Those who ride bicycles for more than 3 hours a week should do so in a reclining position and not upright position. A man is considered to have ED when he cannot acquire or sustain an erection of sufficient rigidity for sexual intercourse. Any man may, at one time or another during his life, experience periodic or isolated sexual failures. The term “impotent” is reserved for those men who experience erectile failure during attempted intercourse more than 75% of the time. Heart disease increases the risk for later ED; ED also may be an early warning sign of future heart disease. Men with erectile dysfunction without an obvious cause (e.g., pelvic trauma), and who have no symptoms of heart disease, should be screened for heart disease prior to treatment since there are potential cardiac risks associated with sexual activity in patients with heart disease. Eight of the 12 most commonly prescribed medications list impotence as a side effect and it is estimated that 25% of cases of ED are due to drugs. Depression, stress, or the drugs used to treat depression can result in ED. Neurologic causes include stroke, spinal cord or back injury, multiple sclerosis, or dementia. In addition, pelvic trauma, prostate. Surgery or priapism may cause ED. A less obvious, but of increasing importance, has been the possible association of ED with bicycling. Anything that places prolonged pressure on the pudendal and cavernosal nerves or compromises blood flow to the penile artery can result in penile numbness and impotence. Cycling-induced impotence, is primarily a problem of serious cyclists and has been reported to occur in Norwegian men competing in a 540 km bicycle race. The penile numbness is attributed to the pressure on the perineal nerves whereas the erectile dysfunction is thought to be due to a decrease in oxygen pressure in the pudendal arteries. Recreational cyclists, those who cycle for less than 3 hours per week and men who cycle in a reclining position avoid the sustained intense pressure on the penile nerve and artery and are less likely to experience sexual side effects. Continued cycling in a seated upright position can reduce the penile oxygen levels lasting 10 minutes.

5 ways to boost bone strength early

By Dr K K Aggarwal
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1. Monitor your diet. Get enough calcium and vitamin D ideally through the foods you eat. Although dairy products may be the richest sources of calcium a growing number of foods such as orange juice are calcium fortified. Fruits vegetables and grains provide other minerals crucial to bone health such as magnesium and phosphorus. 2. Maintain a reasonable weight. This is particularly important for women. Menstrual periods often stop in women who are underweight due to a poor diet or excessive exercise and that usually means that estrogen levels are too low to support bone growth. 3. Don t smoke and limit alcohol intake. Smoking and too much alcohol both decrease bone mass. 4. Make sure your workouts include weight bearing exercises. Regular weight bearing exercise like walking dancing or step aerobics can protect your bones. Also include strength training as part of your exercise routine. 5. Talk with your doctor about your risk factors. Certain medical conditions like celiac disease and some medications steroids and others can increase the chances that you will develop osteoporosis. It s important to talk with your doctor to develop a prevention strategy that accounts for these factors.

Sangat and smoking

By Dr K K Aggarwal
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Sewa, Simran and Sangat are the three principles of life as per the most Vedic literature. Even Adi Shankaracharya described Sangat as the main force for living a spiritual life. Sangat is the company of people you live with. Living in the company of good people makes one good and the reverse is also true. The same is now being proved in the allopathic context. A study published in the New England Journal of Medicine has shown that when one person quits smoking, than others are likely to follow. One person quitting can cause a ripple effect, making others more likely to kick the habit. 1. If your spouse stops smoking, you are 67% less likely to continue smoking. 2. If your friend kicks the habit, it’s about 36% less likely that you’ll be smoking. 3. When a sibling gives up cigarettes, your risk of smoking decreases by 25%. 4. Your risk of smoking drops by 34% if a coworker in a small office quits smoking. It is sort of like watching dominoes. If one falls, it very quickly causes others to fall. We should treat people in groups, rather than as individuals. Friends and family need to be involved. If you want to quit, try to get close friends and family to quit as well. Quitting smoking may have the side benefit of improving social well–being, just as it improves physical health.

Smoking leads to cardiovascular aging

By Dr K K Aggarwal
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Consuming tobacco can increase the cardiovascular age of a person, which can be much higher than the biological age. Cardiovascular aging in chronic smokers can be 10 years more than the biological age. This can be calculated by measuring the wall thickness of the carotid neck artery supplying blood to the brain. Apart from that, one can also measure the endothelial functions of the brachial artery supplying blood to the hand. Cardiac age of a person is calculated by measuring the relaxation functions of the heart. With advancing age the heart fails to relax properly. This relaxation abnormality usually comes after the age of 60. If the same is seen at the age of 40, one knows what the biological age and cardiac age is. The good news is that cardiovascular age of a person can be regressed by quitting smoking and tobacco along with adoption of a healthy lifestyle including diet and exercise. Graying of the hair may not be sufficient to know the age of a person. Today, it is the cardiovascular age which is important.

Cigarettes should be regulated

By Dr K K Aggarwal
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Electronic cigarettes are a new fad in the society. Not only adults, children too are getting hooked to them. They are easily available through Internet and can be ordered and purchased in Indian rupees. In its policy statement on e-cigarettes, published in the journal Circulation, the American Heart Association has asked the federal government to ban the sale of e-cigarettes to minors on the lines of the ban of cigarettes and smokeless tobacco products. The report has shown concern about the industries marketing and advertising e–cigarettes to children. In the US alone, there are 466 brands and 7764 unique flavors of e–cigarette products available. These flavors have been specifically designed to attract the youth. For the youth, an e-cigarette is high–tech, interesting and cool. In the US and in the west, an alarming number of middle and high school children are experimenting with e–cigarettes. It has also been seen that in experimental e–cigarette users, converting to regular smoking is very high. The efficacy of e–cigarettes as a primary smoking cessation therapy has not been established. A recent study published in the March 2017 of the journal JAMA Cardiology has shown an association of habitual e-cigarette use with increased cardiovascular risk.

Don’t ignore women’s health

By Dr K K Aggarwal
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Women are not diagnosed or treated as aggressively as men. Even though more women than men die of heart disease each year, women receive only 33% of all angioplasties, stents and bypass surgeries; 28% of implantable defibrillators and 36% of open–heart surgeries, according to the National Coalition for Women with Heart Disease.

Although the traditional risk factors for coronary artery disease — such as high cholesterol, high blood pressure and obesity — have a detrimental impact in men and women, certain factors play a bigger role in the development of heart disease in women.

• Metabolic syndrome — a combination of increased blood pressure, elevated blood glucose and triglycerides — has a greater impact on women than men. • Mental stress and depression affect women’s hearts more than they do men’s.

• Smoking is much worse for women than men.

• A low level of estrogen before menopause is a significant risk factor for developing microvascular disease.

• Though women will often have some chest pain or discomfort, it may not be the most prominent symptom. Diffuse plaques build–up and diseased smaller arteries are two reasons why symptoms can be different in women.

• In addition to chest pain, pressure or discomfort, signs and symptoms of heart attack in women include: Neck, shoulder, upper back or abdominal discomfort, shortness of breath, nausea or vomiting, sweating, light–headedness or dizziness and unusual fatigue.

• Endothelial dysfunction is more common in women. In this the lining of the artery does not expand (dilate) properly to boost blood flow during activity, which increases the risk of coronary artery spasm and sudden death.

• Results of the WISE study suggest that the commonly used treatments for coronary artery disease — angioplasty and stenting — are not the best options for women with more diffuse plaques.

• Typical tests for coronary artery disease — angiogram, treadmill testing and others — are not reliable in women.

• The WISE study showed that in some women, plaques accumulate as an evenly spread layer along artery walls, which is not visible using traditional testing methods.