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CORONARY HEART DISEASE: HIGH BLOOD CHOLESTEROL AS A RISK FACTOR

High blood cholesterol is one of the most known risk factors of coronary heart disease. Previously cholesterol was supposed to be the most important cause of heart artery blockages but with more and more research data coming in, it has become one of the first three risk factors.Cholesterol is a type of fat particle present in the blood in small quantities. This waxy particle is made up of a single chain of fatty acid with 27 carbon atoms. The structure is so complex that this fatty acid is rotated in four rings – in combination called cyclo-pentano-perhydro-phenantherene ring. It is one of the most decorated molecules known to medical science. Cholesterol has very important functions in the body as it forms a part of the cell wall, nerve coverings and the brain cells. We cannot imagine life without this molecule. So important is the requirement of cholesterol in the body that the liver has a manufacturing capacity of the minimum amount of cholesterol required by the body.But if this molecule is present in a high quantity in the body or blood, the excess can be deposited to create coronary blockages. Not only is the heart affected; high cholesterol can also get deposited inside the brain arteries, leg arteries and also in the skin below the eyes.Cholesterol carried in the blood is in free form, which is very dangerous and it can be also carried in combination of proteins (known as lipo-proteins). There is a strong relationship of blood level of free cholesterol and the rate of deposition of blockages in the heart arteries.Previously it was presumed that a cholesterol level of 250mg/100ml of blood was normal and safe. This was about 20 years back. After further research, it was found that a level less than 220mg/100ml was okay in the next ten years. But the latest scientific research has now proved that any level more than 200mg/100ml is definitely not good. The normal range of this fat is now considered between 130 and 200mg/100ml of blood. Blood levels of cholesterol are high in those people whose diet is rich in cholesterol. Foods that contain high cholesterol are egg yolk, meat of any kind (mutton, beef, chicken, pork – red meat and white meat, fish). Another rich source is milk and its products like ghee, cream, butter, ice cream, chocolates, paneer, curd etc. This becomes the culprit in vegetarians, who depend heavily on milk. Any other fat, especially the saturated fatty acids are used in the liver to manufacture cholesterol.Cholesterol is mostly deposited in the heart arteries, after it is converted into LDL cholesterol, the so-called bad ‘low density lipo-protein cholesterol’.It is recommended very low cholesterol (130-160mg/ 100ml) in the blood. The total intake of cholesterol in the diet of a person should be as low as l0 mg/day. A vegetarian on milk diet consumes as high as 200-500mg cholesterol while a non-vegetarian consumes as high as l000 mg per day.In most of the developed countries it is compulsory to put a display on the food labels – the exact content of cholesterol in every food. Regular physical exercise, stress management, stopping of smoking can also lead to lowering of the cholesterol in the blood, besides control of diet.*12/283/5*

SALT FOR HEALTHY BLOOD PRESSURE: SALT SENSITIVES, BEWARE

Some people can eat a bag of salty pretzels and their blood pressure remains normal; for others, just thinking about salt wreaks havoc with their blood pressure. An estimated 20 to 30 percent of people with hypertension have a condition called salt sensitivity, which means they have a severely pronounced response to sodium. Sodium restriction is extremely important for these people, as they not only have four times the risk of developing hypertension compared with people who respond normally to salt, but even small amounts of sodium can trigger a dramatic rise in blood pressure. Researchers are still looking into the mystery of salt sensitivity. Who gets it? What causes the condition? Is there a gene responsible? Although many theories exist, we still don’t know for sure. Some of the possible mechanisms include kidney insufficiency, adrenal sensitivity to angiotensin, hereditary causes, or a sensitivity to the chloride fraction of salt (sodium chloride).
When I see patients who have been told they have resistant hypertension (abnormally high blood pressure that does not come down despite treatment with at least three drugs), I always suspect salt sensitivity. I have found that resistant hypertension can often – though not always – be remedied by strictly curtailing dietary sodium and supplementing with extra potassium. To find out if you are salt sensitive, check with your doctor or simply monitor your blood pressure response to dietary sodium changes. If you are sensitive to salt, you’ll need to severely curtail your sodium intake and increase your potassium consumption.
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SALT FOR HEALTHY BLOOD PRESSURE: SALT SENSITIVES, BEWARESome people can eat a bag of salty pretzels and their blood pressure remains normal; for others, just thinking about salt wreaks havoc with their blood pressure. An estimated 20 to 30 percent of people with hypertension have a condition called salt sensitivity, which means they have a severely pronounced response to sodium. Sodium restriction is extremely important for these people, as they not only have four times the risk of developing hypertension compared with people who respond normally to salt, but even small amounts of sodium can trigger a dramatic rise in blood pressure. Researchers are still looking into the mystery of salt sensitivity. Who gets it? What causes the condition? Is there a gene responsible? Although many theories exist, we still don’t know for sure. Some of the possible mechanisms include kidney insufficiency, adrenal sensitivity to angiotensin, hereditary causes, or a sensitivity to the chloride fraction of salt (sodium chloride).When I see patients who have been told they have resistant hypertension (abnormally high blood pressure that does not come down despite treatment with at least three drugs), I always suspect salt sensitivity. I have found that resistant hypertension can often – though not always – be remedied by strictly curtailing dietary sodium and supplementing with extra potassium. To find out if you are salt sensitive, check with your doctor or simply monitor your blood pressure response to dietary sodium changes. If you are sensitive to salt, you’ll need to severely curtail your sodium intake and increase your potassium consumption.*64/313/5*

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