Wellness Blog: Thomas Sbarra, MD, FACC

Hypertension

Thomas Sbarra, MD, FACC — Tue, 15 Apr 2008 12:50:15 GMT

Blood pressure (BP) as measured by a blood pressure cuff is an estimate of the blood pressure in the large blood vessels in your chest. It is a combination of the force generated by the pumping action of the heart and the resistance provided by the stretch on the blood vessels. In general terms, the more resistance to stretch of these vessels (the stiffer they are) the higher the pressure. Studies have shown that the lower the blood pressure the better but the benefits are less pronounced below 130/80* so that becomes the maximum blood pressure target. Above this number the chance of heart attack and stroke rises steeply. Blood pressure varies from minute to minute and can vary by 50-80 mm with stress or activity. Our goal is to sense what your average blood pressure is and react accordingly.

Exercise

Thomas Sbarra, MD, FACC — Tue, 15 Apr 2008 12:47:22 GMT

Use it or lose it! The activity people do as part of their daily routine has diminished greatly over the last 100 years. Estimates are that the average person is now less than half as active as their great grandparents. All animals need exercise to stay healthy and we are just not getting enough. Combined with the omnipresence of food in the society, this is a toxic scenario and a large contributor to the epidemic of heart disease and diabetes.

Diabetes

Thomas Sbarra, MD, FACC — Tue, 15 Apr 2008 12:46:24 GMT

9% of Americans have diabetes. Perhaps another 25% have 'pre diabetes' or what is now called "the metabolic syndrome". The incidence has been rising alarmingly over the last 30 years associated with decreasing activity and increasing abundance of food in the society. It is now seen in 16% of children! Americans now eat between 250 and 350 more calories a day than they did 25 years ago and exercise 30% less. This 'toxic environment' as it has been called by Walter Willet of the Harvard School of Public Health, is driving us to cardiovascular ruin..

High Cholesterol

Thomas Sbarra, MD, FACC — Tue, 15 Apr 2008 12:46:00 GMT

Medically speaking: "Dyslipidemia", literally abnormal forms and quantities of several kinds of fatty molecules that can be found in your blood stream. The usual determinants include: HDL, LDL and Triglycerides*. But there are actually several more that can be measured, and have clinical significance including, VLDL and VLDL 'remnants'.

Our Sedentary Society

Thomas Sbarra, MD, FACC — Tue, 15 Apr 2008 12:43:26 GMT

Residents of all western countries and particularly Americans have experienced a gradual but marked decline in physical activity beginning around 1900. This trend has accelerated and has been particularly rapid in the last 30 years. Directly related to convenience items and mechanical devices (remote controls and snow blowers, etc) and to reduction in physical labor requirements (less farmers and more lawyers). Additionally, the flight to the suburbs that occurred in the past 60 years was supposed to get us more access to clean air and open spaces but it has had the unintended consequence of increasing our dependence on the automobile. Today, paradoxically, due to traffic congestion and parking issues, the city folk now walk more than the country dwellers. (Although we could argue that the air is better here)