Preventing and detecting common health problems
Tests, tests, tests. Sometimes, it can seem like everyone is telling you to have one medical test or another. But which tests deserve space on your to-do list? There are plenty of reasons to know the answer to this question. Routine tests or screening exams are the best method for catching many conditions in the early stages — when the odds for successful treatment are greatest. Regular preventive exams also help assess your overall health and risk factors.
Perhaps, most important is screening for diseases or conditions which may serve as a wake-up call if your daily lifestyle or habits appear to be impacting important health measurements, such as your blood pressure, cholesterol levels or weight.
Still, knowing which screening exams and tests are appropriate for you can be confusing. Today’s column discusses which ones you may need, why you need them, and when they should be done. It also explains how specific tests are performed and how you should prepare for them.
The recommendations in this article are for people with average risks of common diseases and conditions. They shouldn’t replace the advice of your doctor, particularly if you’re at higher risk for certain health problems.
High Blood Pressure (Hypertension)
Blood pressure is determined by the amount of blood your heart pumps and the amount of resistance to blood flow in your arteries. Narrowed or hardened arteries limit the flow and can cause high blood pressure. The longer hypertension goes undetected and untreated, the higher your risk of heart attack, stroke, heart failure, and kidney damage. A 2007 national survey of the Philippine Heart Association found that there are 10.5 million Filipinos with hypertension and that 16 percent of them are not even aware that they have the condition.
Recommended exams: A blood pressure measurement often is done when you see a doctor for any reason. However, recommendations call for an initial blood pressure measurements to be taken at age 21 and then at least every two years thereafter.
What’s involved: An inflatable cuff is wrapped around your upper arm to measure your systolic pressure (the amount of pressure your heart generates when pumping blood through the arteries) and your diastolic pressure (the amount of pressure in the arteries when your heart is at rest between beats). A blood pressure reading below 120/80 mmHg is considered normal. A reading of 140/90 mmHg or higher is considered high blood pressure.
Diabetes
Diabetes is a chronic condition that affects the way your body metabolizes sugar (glucose). It is estimated that there are currently 3.3 million Filipinos who are diabetic but that this figure will rise to 7.8 million by 2030. In fact, many of these people do not even know they have the disease. Type 2 diabetes can be easy to ignore, especially in the early stages when you’re feeling fine and have no symptoms. But diabetes that remain untreated or isn’t controlled can affect almost every major organ in your body, including your heart, nerves, eyes and kidneys.
Recommended exams: Many people just learn they have type 2 diabetes after a blood test is done for another condition or as part of a routine physical exam. But to catch undetected cases of diabetes, the American Diabetes Association recommends that every adult have a fasting blood sugar test at 45. If your results are normal, the test can be repeated at three- to five-year intervals. However, more frequent testing may be recommended if you’re at high risk of diabetes because of obesity, a history of gestational diabetes, or a family history of the disease. If your results indicate you’re at increased risk for diabetes, it’s recommended that you have a fasting blood sugar test every year.
What’s involved: For a blood sugar test, blood is drawn from a vein in your arm and sent to a laboratory for analysis. This is usually done after you’ve fasted overnight or for at least eight hours. If your fasting blood sugar measures 126 mg/dL or higher, your doctor may recheck the test. If the results of the second test are the same, you likely will be diagnosed with diabetes (see table).
How to prepare: Don’t eat or drink anything except water for eight to 12 hours before the test. You also should avoid alcohol and high-sugar and high-fat foods the evening before the test.
High Blood Cholesterol
The higher your level of low-density lipoprotein (LDL or “bad”) cholesterol and the lower your level of high-density lipoprotein (HDL or “good”) cholesterol, the greater your risk of a heart attack, stroke, kidney disease and dementia.
Recommended exams: A blood test measuring your lipid levels is recommended every five years, or more often if your results are abnormal. If you’re at high risk of heart disease, this test may begin as early as 20. In other cases, your doctor may not recommend this test until your mid-30s or mid-40s. This test measures total cholesterol as well as LDL cholesterol, HDL cholesterol and triglycerides.
What’s involved: Blood is drawn and is analyzed in a laboratory. An LDL level below 100 mg/dL for adults at average risk of heart disease or below 70 mg/dL for adults at a higher risk of heart disease is considered most desirable. Other desirable cholesterol levels include a total cholesterol value under 200 mg/dL, an HDL level of 50 mg/dL or higher, and a triglyceride level below 150 mg/dL.
How to prepare: Don’t eat or drink anything except water for nine to 12 hours before the test.
Weight Problems
The World Health Organization says more than a billion adults around the world are overweight and 300 million of them are obese, putting them at a much higher risk of diseases such as diabetes, heart problems, high blood pressure, stroke, and some forms of cancer. The number of overweight or obese Filipinos has been steadily increasing in years.
Recommended exams: A few evaluations can help you determine if you need to lose weight for medical reasons. One is a body mass index (BMI), which is a formula that uses weight and height to estimate body fat. Another is a waist circumference measurement, which is used to see if you carry most of your fat around your waist or upper body. These are evaluated along with your medical history, physical exam and other screening tests to determine your level of certain health risks.
What’s involved: For a BMI, you will be weighed and have your height measured, and these figures will be used in a calculation. BMI is weight (in kg) divided by height (in meters squared). If your BMI is between 19 and 24, you’re considered in a healthy weight range for your height. If your BMI is between 25 and 29, you’re considered overweight. If the figure is 30 or greater, you’re considered obese. A waist circumference measurement greater than 35 inches for women and 40 inches for men pose increased health risk.
How to prepare: Talk with your doctor openly and honestly about your weight and how an unhealthy weight affects your health.
Screening exams play an important role in protecting your health. As the old saying goes, “An ounce of prevention is better than a pound of cure!”
* * *
Next week, we will continue the discussion on screening tests for common health problems, including hearing loss, periodontal disease, vision changes, skin cancer, and others.
