NRAO-NM HEALTH FAIR 2017 ALLEN BASSLER, MD

Transcription

1 NRAO-NM HEALTH FAIR 2017 ALLEN BASSLER, MD

2 Recommendations for Adult Periodic Screenings and Vaccinations Body Mass Index (BMI) Blood Sugar (glucose), single value Hemoglobin A1C (average blood sugar over 2-3 months) Classification and Management of Blood Pressure Lipid Levels and Classifications Therapeutic Lifestyle Changes

3 Recommendations for Adult Periodic Health Screening Screening Test Blood Pressure Cholesterol Obesity Target Population <120/80: every 2 years /80-90: yearly Begin screening at 35 (males) or 45 (females); younger if high risk Starting at age 6 Thyroid disease, anemia, kidney/liver disease, PSA insufficient or negative evidence for screening

4 Recommendations for Adult Periodic Health Screenings Beyond Scope of Health Fair Tests for Women: Breast Exams Mammography Pap smears: updated recommendations Bone density screening (DEXA or similar) Colon cancer screening: Colonoscopy at age 55 for normal risk Stool occult blood HIV (AIDS): all adults age 18-65, once unless high risk Hepatitis C: once for all adults born between 1945 and 1965

5 Recommendations for AdultVaccinations Influenza : yearly Tdap : tetanus, diphtheria, and acellular pertussis (whooping cough). Once for every adult. Tetanus every 10 years Pneumococcal vaccine : once after age 65, earlier for high risk patients Shingles (Herpes Zoster) vaccine : once after age 59. New vaccine called Shingrix will be available in Recommended at age 50+. Has 90+% efficacy

6 Blood Sugar Classifications Fasting Blood Glucose Levels =Normal > =Prediabetes >125=Diabetes Two Hour Glucose Tolerance Test =Prediabetes >200=Diabetes

7 Body Mass Index(BMI) Tool for Categorizing Desirable Weight Formula : Weight/Height 2 (kg/m 2 ) Categories Healthy: Overweight: Obese: Morbidly Obese: 40+ BMI>30 intensive behavioral interventions

8 Blood Sugar/Hemoglobin a-1-c (Glycohemoglobin) Hemoglobin a-1-c correlates to the average blood sugar over 2-3 months Used to diagnose diabetes and prediabetes Used to monitor adequacy of diabetic control

9 Tests forprediabetes/diabetes Fasting Blood Sugar Test Done after at least 8-hour fast > is classified as prediabetes >125 is diabetes A1c Test A1c 5.7%-6.4%: classified as prediabetes A1c >6.4%: classified as diabetes

10 High-Sensitivity C-Reactive Protein (hs-crp) Screens for Inflammation Used to evaluate risk of developing coronary artery disease and possibly cancer Inflammation helps fight injury and disease, but it also causes tissue to break down faster which can cause disease

11 Classification & Management of Blood Pressure Prehypertension: Systolic mmhg or diastolic mmhg Is 130/80 really hypertension? Hypertension: Stage 1: systolic mmhg or diastolic mmhg Stage 2: systolic >/=160 or diastolic >/=100mmHg

12 Classification & Management of Blood Pressure (Part Two) Goals for blood pressure depend on other risk factors Heart disease Diabetes Diagnosis is made after two or more subsequent elevated blood pressures on separate occasions Influence of pain, white coat hypertension

13 Lipid Levels(Cholesterol) Total Cholesterol <200 Desirable Borderline >240 High LDL (Bad) Cholesterol Primary Target of Therapy <100 Optimal Near Optimal HDL (Good) Cholesterol <40 Low Borderline High High >190 Very High >60 High

14 AHA Guidelines Two Categories High Risk for atherosclerotic cardiovascular disease Diabetes LDL>190 All other patients: base on 10-year cardiovascular risk >7.5% statin therapy <7.5% reassess every 4-6 years

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16 Thyroid-Stimulating Hormone(TSH) A test for TSH is done to find out whether the thyroid gland is working properly An underactive thyroid can cause symptoms such as weight gain, tiredness, dry skin, constipation, a feeling of being too cold, or irregular menstrual periods An overactive thyroid can cause symptoms such as weight loss, rapid heart rate, nervousness, diarrhea, a feeling of being too hot, or irregular menstrual periods A normal TSH test result is

17 Prostate-Specific Antigen (PSA) The US Preventive Services Task Force and the AAFP recommend AGAINST screening for asymptomatic prostate cancer Grade D: harms outweigh the benefits

18 Therapeutic Lifestyle Changes(TLC) Exercise, Exercise, Exercise! 30 minutes ~ four times a week Attend free NRAO yoga and aerobics classes! Behavior/Habits No tobacco Limited alcohol (max two drinks a day) Family, friends, & fun!

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20 TLC Choose Healthy Foods Fruits and veggies Fish and chicken > red meats Snack on nuts & fruit (almonds, walnuts, pecans) Reduced fat dairy, milk, yogurt, & cheese Mono-saturated oils: olive, canola

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22 Questions?

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