You might have these three conditions without knowing it! High blood pressure, high blood sugar and high blood cholesterol can all have serious health consequences, but symptoms can take up to 20 years to manifest! Here, we explain how you can identify and treat these conditions early to maximize your chances of a long and healthy life.
1. High Blood Pressure
What is blood pressure?
When your heart beats, it pumps blood around your body to give it the energy and oxygen it needs. As the blood moves, it pushes against the sides of the blood vessels. The strength of this pushing is your blood pressure. Blood pressure is taken using two measurements: systolic (measured when the heart beats, when blood pressure is at its highest) and diastolic (measured between heart beats, when blood pressure is at its lowest). Blood pressure is written with the systolic blood pressure first, followed by the diastolic blood pressure (for example 120/80). Blood pressure is measured in the unit mmHg (millimeters mercury).
What is HIGH blood pressure?
High blood pressure is a medical condition also called hypertension (1): Normal blood pressure is lower than 120/80mmHg. While elevated blood pressure is between 120/80 and 130/90 mmHg, hypertension is defined as either:
• Stage 1 – Between 130/90 and 140/90
Whether this should be considered hypertension of simply elevated blood pressure is, however, debated, and European health professionals generally don’t regard it as hypertension, whereas Americans do. (2)
• Stage 2 – Higher than 140/90
If there is a disparity in category between the systolic and diastolic pressures, the higher value determines the stage. So a blood pressure of 125/105 would be classified as hypertension because the diastolic pressure of 105 is above the limit of 90, even is 125 is below the limit of 130-140 mmHg. (2)
Keep in mind that your blood pressure varies A LOT during te day, and that it’s your RESTING blood pressure that determines whether or not you have the medical condition. Your blood pressure is SUPPOSED to increase in certain siutations to provide a steady flow of blood to tissues that need it.
For example, during the leg press, your blood pressure can increase to an average of 320/250! (3) If it didn’t, no blood would reach the cells in your flexed quads!
What are the symptoms of high blood pressure?
There are no symptoms that with certainty can diagnose hypertension. Blood pressure rises slowly over time and your body adapts to this, making it a symtom-free, but serious condition!
For diagnosis, blood pressure needs to be measured at least 2-3 times to make sure that temporary elevations don’t lead to a misdiagnosis.
Your doctor is ultimately the one who should make the diagnosis, but you can aid in the diagnosis by providing blood pressure values measured when you are in a relaxed state at home (with at least 10 minutes of rest before measuring). You can do this using an automatic blood pressure measurer in your home. Bring these values to your doctor to discuss whether or not you have hypertension.
For example, some people may experience „white coat hypertension” which means that the blood pressure is consistently elevated in clinics but not outside the clinic.
What causes hypertension?
The exact cause of hypertension is not clear yet. Doctors consider it a multifactorial disease. So let’s talk about risk factors (i.e. people who tend to have higher blood pressures)…
- Age – Advancing age is associated with increased blood pressure, particularly systolic blood pressure
- Obesity – Obesity and weight gain are major risk factors for hypertension and are also determinants of the rise in blood pressure that is commonly observed with aging.
- Family history – Hypertension is about twice as common in subjects who have one or two hypertensive parents
- Race – Hypertension tends to be more common, be more severe, occur earlier in life, and be associated with greater target-organ damage in blacks
- Kidney conditions
- High-sodium diet
- Excessive alcohol consumption
- Physical inactivity
There are a lot of other risk factors, including side effects from drugs, genetic conditions, hormonal diseases and the list goes on.
How does HIGH blood pressure affect me?
Hypertension affects many organs and is actually the BIGGEST modifiable risk factor for early death in the west.
It affects all organs slowly over time, particularly your heart and kidneys:
● Your left heart will grow to be able to keep pumping blood, and can eventually stop working properly (heart failure).
● You have a much higher risk of getting a stroke och brain bleed
● You have a much higher risk of getting a heart attack
● Your kidneys gradually become worse at filtering your blood from waste products and you end up with chronic kidney disease.
Hypertension is the most important risk factor for early heart disease, being more common than cigarette smoking, high blood cholesterol or diabetes, which are the other major risk factors.
For every 20 mmHg higher systolic and 10 mmHg higher diastolic blood pressure, the risk of death from heart disease or strokes doubles. (2) Remember though, that your absolute risk in the end depends on many factors including age and genetics.
How can I prevent high blood pressure?
Dietary and lifestyle modifications have been evaluated in a number of studies for the prevention rather than treatment of hypertension. As illustrated by the following observations, the optimal effect on blood pressure is achieved with correction of multiple contributors to hypertension, including salt intake, obesity, and excess alcohol intake. (4)
The relative efficacy of such interventions can be illustrated by the results of two randomized trials and a large observational study:
● Losing excess weight and reducing excess salt lowers blood pressure: The Trials of Hypertension Prevention, phase II randomized 2382 men and women (aged 30 to 54 years) with a BP (blood pressure) <140/83-89 who were 110 to 165 percent of ideal body weigh. The patients were randomly assigned to usual care, salt restriction, weight reduction, or both. They lost more weight with the combined therapy than the usual care. The combined therapy proved more beneficial than the salt restriction and weight reduction individually.
● The findings have been replicated: Another trial evaluated 975 older people (aged 60 to 80 years) who had a BP <145/<85 mmHg; 585 were obese. The patients were randomly assigned to usual care or to salt restriction, weight loss (in obese patients), or both. Results were almost similar as the first study.
● Daily exercise, the DASH diet, and folate rich-foods also help: The importance of risk factors for primary hypertension in women was evaluated in a prospective cohort study of 83,882 adult women who did not have a history of hypertension, heart disease, or diabetes. Six lifestyle and dietary factors were independently associated with a lower risk of developing hypertension during 14 years of follow-up: body mass index of less than 25 kg/m2, a daily mean of 30 minutes of vigorous exercise, adherence to the Dietary Approaches to Stop Hypertension (DASH) diet, modest alcohol intake, infrequent use of nonnarcotic analgesics, and intake of 400 mcg/day or more of folate. The presence of all six factors was associated with a marked decrease in the risk for hypertension.
Just to state the obvious, a healthy lifestyle and regular physical activity are the most important factors that protect us against hypertension.
How can I treat high blood pressure?
Of course there are traditional ways to treat hypertension with medicines, but the first line of treatment is actually diet and lifestyle change. The following lifestyle changes can reduce hypertension. Keep in mind that these effects aren’t necessarily additive. (5)
- Eating fresh fruit and vegetables daily for at least 5 portions, each portion >70 grams, can lower blood pressure by 8-14 mmHg.
- Maintaining normal weight (BMI between 20-25) can lower blood pressure by 5-10 mmHg per 10 kg weight lost.
- Pulse raising exercise (brisk walking) >30 min/day can lower blood pressure by 4-9 mmHg (weightlifting also helps, but is not priotized).
- Limiting salt intake to < 6 g NaCl per day can lower blood pressure by 2-8 mmHg.
- Limiting alcohol intake to below 9 standars units per week for women and below 14 standard units per week for men can lower blood pressure by 2-4 mmHg (1 unit = 12 grams of alcohol, found in a 33 cl bottle of beer or a 10-15 cl glass of wine or a 4 cl short of liquer).
Our recommendation is to check your blood pressure on a regular basis and consult with your doctor if you observe any anomalies. For your general health live a balanced life without any excess and exercise regularly.
It is important to know that, for some people, blood pressure will remain elevated DESPITE a perfectly managed lifestyle (age and genetics can play a big role here). In these cases, we absolutly suggest using medication to achieve optimal blood prssure if you are interested in preventing long-term organ damage from hypertension.
- High blood pressure is a serious condition that needs treatment
- High blood pressure can be prevented
- High blood pressure doesn’t have any symptoms at first
- You can measure you own blood pressure and keep track of it
- A healthy life is the number one change you can make and it will help you enormously
- Once your lifestyle is optimized, we still recommend medication if blood pressure remains elevated.
2. High Blood Sugar Levels
What is high blood sugar?
When we talk about blood sugar, we are actually referring to high blood glucose levels, also called hyperglicemia.
The hormone insulin should stop your blood glucose levels from getting too high by allowing your muscle, liver and fat cells to store and glucose. When the body can’t produce insulin or insulin isn’t working properly, blood glucose can rise, damaging your blood vessels over time. This is a major concern that affects people with both type 1 or type 2 diabetes.
As you know, high blood sugar is not good news. There are many types of hyperglicemia. Some of them are permanent, like in diabetes. Some of them are transient: after you eat or after a heart attack.
There are two options to measure the level of glucose in the blood:
- Basal blood sugar which means the level in the morning, before you eat or drink anything.
- Postprandial blood sugar which means that you ate during before the procedure.
If the value of the basal blood sugar is between 100-126mg/dl (or 6.1-6.9 mmol/l) then you have impaired fasting glucose (IFG) also called prediabetes. This is a sign of insulin resistance in your liver.
If the basal blood sugar level is greater than 126mg/dl (or 7.0 mmol/l) at multiple blood tests than your doctor will probably diagnose you with diabetes.
If the value of the postprandial blood sugar level is greater than 200mg/dl (or 12.2 mmol/l) than you probably have diabetes.
If the value is between 140-199mg/dl (8-12.1 mmol/l) than you probably have impaired glucose tolerance (IGT), another form of pre-diabetes This type of pre-diabetes represents insulin resistance in your muscles.
It is important to know you blood sugar level in order to prevent the onset of any diseases. In order to do that we recommend you consult your doctor to perform a routine check-up and see if everything is ok every year.
How does high glucose level affect me?
Diabetes affects people in many ways and it is a factor that reduces the quality of life. As stated above, high blood sugar levels damage your blood vessels. Damanged blood vessels means that the organs recieving the blood also will be damaged, including eyes, kidney, nerves and brain.
The disease is very dangerous if we think about the complications (1):
- People with diabetes have a higher-than-average risk of having a heart attack or stroke
- High blood pressure
- Nerve damage (neuropathy): About half of all people with diabetes have some form of nerve damage.
- Eye complications
- Kidney disease
- Mental health: anger, depression, etc
- Ketoacidosis is a serious condition that can lead to diabetic coma (passing out for a long time) or even death. When your cells don’t get the glucose they need for energy, your body begins to burn fat for energy, which produces ketones. Ketones are chemicals that the body creates when it breaks down fat to use for energy. The body does this when it doesn’t have enough insulin to use glucose, the body’s normal source of energy. When ketones build up in the blood, they make it more acidic. They are a warning sign that your diabetes is out of control or that you are getting sick.
- Skin complications
- Foot complications
- Stomach emptying problems (gastroparesis)
As you can see the list is pretty long and it’s not complete. It is much easier to prevent these complications than treat them so let’s head to the next idea->
What are the symptoms of high blood sugar?
Pre-diabetes generally has no symptoms. If you are overweight or have a lot of diabetes in your family (genetics), you risk developing diabetes which will eventually give you symptoms of high blood sugar. Early symptoms of high blood sugar include:
- Thirst (high sugar means your body thinks its dehydrated)
- Frequent urination (high sugar brings more water with it into your bladder)
- Blurred vision (sugar gets stored in your lens)
- Fatigue and weight loss (your cells aren’t getting glucose and are thus “starving”)
- Dry skin and fungal skin infetions
- Muscle cramps
How can I prevent high blood sugar?
Individuals at high risk, including those with impaired fasting glucose (IFG), impaired glucose tolerance (IGT), obesity, close relatives with type 2 diabetes, or who are members of certain ethnic groups (Asian, Hispanic, African American), are appropriate candidates for preventive interventions). Even if you are not at risk you should take into consideration the following.
All people should be provided with a comprehensive lifestyle modification program that includes:
● Behavior modification
● Dietary therapy
● Physical activity
● Smoking cessation
The goal of the lifestyle intervention is weight loss with return to normal glycemia. (2)
Some clinical trials state that regular exercise and living a healthy lifestyle reduced the weight of the people at risk and managed to lower blood sugar levels. (2) No surprise these changes will always have a good impact for everyone, not only the persons at risk.
The genetic factor plays an important part only if you let it. Start by changing the way you eat, the way you treat yourself and start exercising regularly.
If you are pregnant then you should consult with your doctor about the risks of gestational diabetes.
How can I treat high blood sugar?
As we said
before at the treatment of hypertension, your doctor will treat you
accordingly. But one recommendation we can make is to change your lifestyle and
live healthier because it will only help you. Do routine check-ups and blood
tests every year in order to keep an eye on your health and if you notice any
differences go consult your doctor.
If you want to know our general recommendation for how to eat healthy, we’ve put all the info in our ebook Diet Like a Doctor.
- High blood sugar is a condition which precedes diabetes
- High blood sugar can be prevented
- High blood sugar is a medical condition which can still be cured but diabetes is not
- You can measure your blood sugar with routine check-ups and then consult with your doctor
- A healthy life is the number one change you can make and it will help you enormously
- American Diabetes Association – Living with diabetes – Complications
- Prevention of type 2 diabetes mellitus – K McCulloch, MDR Paul Robertson, MD; UpToDate
3. High Cholesterol Levels
What is cholesterol?
Cholesterol is a substance found in the blood. Everyone has some. It is needed for good health. Some people have too much cholesterol and these people have a higher risk of heart attacks, strokes, and other health problems. The higher your cholesterol, the higher the risk of these problems. (1)
There are different types of cholesterol:
● Total cholesterol
● LDL cholesterol – Also called “bad” cholesterol because having high LDL raises your risk of heart attacks, strokes, and other health problems
● HDL cholesterol – Also called “good” cholesterol because people with high HDL tend to have a lower risk of heart attacks, strokes, and other health problems
● Triglycerides – Triglycerides are not cholesterol. They are another type of fat. But they often get measured when cholesterol is measured.
How does high cholesterol affect me?
In general, people without heart disease and under 50 years old should aim for:
● Total cholesterol below 200 mg/dL (or 5.2 mmol/L)
● LDL cholesterol below 130 mg/dL (or 3.4 mmol/L) – or much lower, if at risk of heart disease
● HDL cholesterol above 60 mg/dL (or 1.6 mmol/L)
● Non-HDL cholesterol below 160 mg/dL (or 4.1 mmol/L) – or lower, if they are at risk of heart disease
● Triglycerides below 150 mg/dL (or 1.7 mmol/L)
These values are a general recommendation but depending on if your risk for heart disease is low, medium, high of very high, you might want to be more/less aggressive with your cholesterol targets. Your doctor is the best person to make this judgement.
Likewise, many people who cannot meet their goals can thus still have a low risk of heart attacks and strokes. (1) High cholesterol, by itself, is not always a reason to worry. It’s just a part of what causes heart disease. Other factors that increase your risk include:
● Cigarette smoking
● High blood pressure
● Genetics: If you have a parent, sister, or brother who got heart disease at a young age (before age 55 for men and age 60 for women) we still don’t know all the genes to be able test for heart disease genetics which is why you need to check your family history instead
● Unhealthy diet: A “heart-healthy” diet includes lots of fruits and vegetables, and foods that provide fiber and healthy fats (fish and certain oils). It also means limiting sugar and unhealthy fats.
● Older age
If you are at high risk of heart attacks and strokes, having high cholesterol is a problem. (2)
How can I prevent high cholesterol levels?
You can lower your cholesterol somewhat if you start:
● Avoiding red meat, butter, fried foods, cheese, and other foods that have a lot of saturated fat.
● Losing weight (if you are overweight).
● Being more active.
Even if these steps do little to change your cholesterol, they can improve your health in many ways.
No surprise here that living a healthy life will keep your cholesterol levels normal and you will have a lot of benefits.
How can I treat high cholesterol levels?
It’s not up to us to recommend you a treatment. We can say that the first step in order to treat this is to change your lifestyle. For some, medication with so-called “statins” can be an option.
Check your cholesterol levels regularly and consult your doctor to decide the best treatment for you
- High cholesterol level is a serious medical condition that can lead to heart attack or stroke
- High cholesterol level can be prevented
- High cholesterol level can be treated but is harder that preventing it
- High cholesterol level can be measured with routine check-ups and keep track of it
- A healthy life is the number one change you can make and it will help you enormously
- Patient education: High cholesterol (The Basics) – Written by the doctors and editors at UpToDate
- Suggested in 2017 by the American College of Cardiology/American Heart Association (ACC/AHA)
Article by Team EBT Member Vlad Radulescu, edited by M.D Artin Entezarjou