2023-06-18 02:04:29
Once blood pressure, blood lipids, blood sugar and waist circumference are abnormal, it may eventually lead to metabolic syndrome. (Shutterstock)
The three highs (high blood pressure, high blood fat, and high blood sugar) are the culprits of cardiovascular and cerebrovascular diseases, and they are also causally related to diabetes. It means that people with three high problems have a higher chance of developing diabetes. People with diabetes It is also easier to have three highs and metabolic syndrome.
Once blood pressure, blood lipids, blood sugar and waist circumference are abnormal, it may eventually lead to Metabolic Syndrome. Metabolic Syndrome is a symptom and disease of comprehensive lifestyle and diet. It is also a collection of a series of cardiovascular disease risk factors, which can be regarded as kidney disease , outpost warning of cardiovascular and cerebrovascular diseases. It reminds us that we should pay more attention to physical symptoms immediately, do a good job in health management, diet control, and regular exercise, which can not only reverse metabolic syndrome, but also prevent diabetes, kidney and cardiovascular diseases.
According to statistics from the Ministry of Health and Welfare, if not treated and treated early, the risk of diabetes, high blood pressure, high blood fat, heart disease and stroke will be 2 to 6 times higher than that of ordinary people.
In addition, once you have diabetes plus the three highs, the probability of related complications will be greatly increased. If it is properly controlled, it can effectively reduce the incidence of kidney dialysis, stroke, and myocardial infarction.
In 2022, Taiwan’s hypertension treatment guidelines recommend that “home blood pressure monitoring (HBPM)” be used instead of outpatient blood pressure measurement. If the average blood pressure is higher than 130/80 mmHg, it is diagnosed as hypertension.
The American Diabetes Association recommends that blood pressure should be measured every time the outpatient visits follow up. Patients with hypertension and diabetes should also monitor blood pressure at home on weekdays.
▲ Defining standard value of metabolic syndrome
The following 5 components, if more than 3 items are met, are considered as metabolic syndrome:
| project | Symptoms and locations | Judgment Description |
| 1 | waistline | Abdominal obesity is defined as waist circumference ≥ 90 cm (35 inches) for men and ≥ 80 cm (31 inches) for women. |
| 2 | blood pressure | Systolic blood pressure ≥ 130 mmHg or diastolic blood pressure ≥ 85 mmHg is high. |
| 3 | fasting blood sugar | A fasting blood glucose value ≥ 100 mg/dL is considered high. |
| 4 | Triglycerides | Triglycerides ≥ 150 mg/dL are considered high. |
| 5 | HDL cholesterol | Men < 40 mg/dL, women < 50 mg/dL, sidi low. |
According to the results of the “2017-2020 National Nutrition and Health Status Change Survey”, it is estimated that regarding 5 million adults over the age of 18 in Taiwan suffer from hyperlipidemia, which means that 1 out of every 4 people has dyslipidemia!
Total cholesterol in the blood consists of triglycerides (TG) and other types of cholesterol. Among them, other types of cholesterol are divided into low-density lipoprotein cholesterol (Low-density lipoprotein cholesterol, LDL-C) and high-density lipoprotein cholesterol (High-density lipoprotein cholesterol, HDL-C).
HDL-C is also known as good cholesterol. It has the reputation of “vascular scavenger”. It can transport cholesterol in the whole body back to the liver for metabolism and keep blood vessels from being blocked; LDL-C is also called bad cholesterol. Excessive LDL-C will accumulate It can cause blockage in the blood vessel wall, accelerate arteriosclerosis, and increase the risk of stroke and myocardial infarction.
Diabetic patients are already at high risk of cardiovascular disease, so the recommended target value of LDL-C should be at least below 100 mg/dL, and if there are cardiovascular complications, it needs to be controlled in a lower range.
▲ Cholesterol goals for people with diabetes:
| main target | ||
| Low-density lipoprotein cholesterol (LDL-C) | All patients < 100mg/dL; those with cardiovascular disease < 70 mg/dL. | If the target is still not achieved following dietary intervention, cholesterol-lowering drugs can be used. |
| High-density lipoprotein cholesterol (HDL-C) | Male: >40 mg/dL
Female: > 50 mg/dL |
Lifestyle intervention is given priority, and exercise can increase HDL-C. |
| Triglycerides (TG) | < 150 mg/dL | Sugar control and weight loss can be improved. If ≥ 500 mg/dL, drug therapy is required. |
| secondary goal | ||
| non-HDL cholesterol | All patients < 130mg/dL; those with cardiovascular disease < 100 mg/dL. | Achieve the main goal first, and then evaluate the secondary goals. |
*Source: 2022 Type 2 Diabetes Clinical Care Guidelines.
▲ Relationship between three highs and diseases
Improve sleep apnea, high blood pressure can be cured without medicine?
“Doctor Wu Long, will I take high blood pressure medicine for a lifetime? Will it hurt my kidneys?” Outpatients often ask me this.
“Hypertension drugs usually protect the kidney function most! And most of the kidney diseases are caused by the failure to control high blood pressure. When the blood pressure is properly controlled, it can also delay the deterioration of kidney function!” I responded with a smile.
According to medical statistics, up to 90% of primary hypertension cannot find the cause, and 10% of secondary hypertension is caused by endocrine disorders (thyroid, adrenal disease, etc.).
Let’s not talk regarding high blood pressure for which there is no cause, but we can work on those parts that can be controlled, starting with adjusting our daily diet, exercising regularly, and losing weight. Therefore, instead of being afraid of taking medicine for life, it is better to start taking active actions now to keep yourself away from the risks of high blood pressure and diabetes as much as possible!
If you really want to reduce the frequency and quantity of taking medicine, you should start with living habits and weight loss control. In clinical practice, some patients have successfully lost 5 to 10 kilograms, so they can reduce the drugs for high blood pressure.
In addition, there is another controllable factor, that is, patients with sleep apnea, because the upper airway collapses or is easily blocked, resulting in hypoxia during sleep, long-term hypoxia leads to body inflammation, and is also prone to high blood pressure.
In the outpatient clinic, I once encountered high blood pressure that was difficult to control. Further examination found that the patient had sleep apnea. After wearing a respirator and improving sleep, the high blood pressure also stabilized. Some people even reduced the blood pressure medication. The frequency and quantity can be used to achieve the goal of gradually reducing and stopping the drug.⊙
<本文摘自《Treating Diabetes: Physician Wulong’s Antidiabetic Prescriptions, Clinical Cases and Medical Evidence》, provided by Booz Think Tank>
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Editor in charge: Wang Xiaoming
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