understand high blood pressure diabetes and heart disease one of the key things that i dread doing some research for this show doctor that i came across some of diseases source i heard that hypertension which is also known as high blood pressure is called a silent killer and it's because so often we're walking around there's no warning signs or anything cause of death in the united states over six hundred thousand americans die of heart disease each year so the topics that we're going to be talking about today are really really really serious especially when we would be what so many of us are walking around that time bomb hospital those are the people who take care of and the nutrition aspect comes in when i was training my critical care training at that time there was no one actually feeding the patient and when i grew up in my house you had to eat and if you didn't eat my father used to say if you don't eat you don't stay here and so it it was it was just confusing to me that the sickest patients we were not feeding wow you know so i did an extended fellowship at the university of have blood pressure well basically what it what we're seeing now is that normal blood pressure is one hundred twenty over eighty let's think of it this way with high pipe blood pressure the heart  ventricle is that chamber that pushes blood into the body all right into our arteries and once that blood is pushed into the arteries a pressure is generated that top number is the number that we it when it's filling the brain the pleasure pressure in the blood actually decreases that pressure that's still lower number and that's the diastolic that's to eighty so it's one twenty over eighty that's normal now high blood pressure is once you get in there is a range that we don't walk around with one twenty over eighty or they say right now that we get upset we yell at the kids you know that kind of stuff all of a sudden my blood pressure is up to the moon and that happens we are fluctuate but then we can get to an area of constant if you're over one forty with the with the top number and over ninety with the lower number on a continuous basis then that's high proper escher and it's very disturbing because it's a chronic disease and there's so many effects on the body over time if you have blood pressure at that level isn't there isn't the reason why we it's hard to detect this because again we have our emotions and all these these things that keep keep it happening right you know our bodies i mean we're doing so much we're touching we're feeling we're walking we're we're communicating so we really don't take time to actually notice you know i just don't feel right or i'm not concentrating maybe i'm hungry or what there those signs though that we can we can look for meaning that you can have headaches and that's that an important one and a regular basis well yeah you come in go for a every day i wake up with a headache or boy this headache wouldn't go  your that's one of the key sites actually just a diverse just for a second i had a patient in the office just monday and she was talking about her husband she's an elderly lady and she said her husband died at thirty eight  at the age of thirty eight and i said that's kind of young she's like you know he had high blood pressure but we didn't know it well and he went to work that day and that morning and you know he's a truck driver luckily he didn't drive the truck that morning but  had the boss called her and he had a massive cerebral haemorrhage because of his blood pressure wow yeah so that is one of the things that we worry about we worry about the fact that it is the type of thing where we get headaches all the time already usually we're we're talking about people that are forty fifty sixty years old ok that have that have that that most of the time those are patients that we will find that have high blood pressure ok  once you're over sixty to sixty years or it's significant that if i could wait for you'll find a large portion of the population has high blood pressure and these patients you know they should be going to their doctor they should be evaluated they should be on their medications there and they should stay on their medications is not the type of medication i could take today and i may skip it tomorrow and it's something that you really should be regimented about yes that's that's good to know and i said  hypertension diabetes heart disease people of color poor it's almost like we have a you know or a ticket for you know what i mean like they're like we have a special number to get these diseases it is and i think it or there are many reasons it's cultural i think it's what we eat i think it means sometimes lack of exercise it you know the stress of the day there are so many reasons that you have these particular disease but diseases what high blood pressure is one that we definitely definitely have a lot well let's move on a little bit to our next next culprit vs for diabetes or and all of these are chronic diseases and it's not like you have hypertension you have diabetes i'm going to give you goes way right none of these are chronic disease once diagnosed you have to take care of it as you know life long so let's look at diabetes diabetes is our body this ability to handle sugar ok or glucose as we say now when there are certain ela well put it this way diabetes can be broken up into two to four i think it be type one diabetes or type two type one is usually called juvenile diabolical because that's the one that you would get or you can find in children or young adults ok all right usually there is a decrease the amount of insulin secreted by the body so you actually need insulin replaced ok type two diabetes is adult onset diabetes usually has an adult will come and that is the type of diabetes that it's called resistant never some reason that insulin is beyond secreted but it's resistant the cells aren't using it appropriately so you have to help it out so there are medications that you can take that may help it out and you probably won't need until now also with diabetes you can have other other causes such like medications can cause diabetes steroids induced diabetes many of us on steroids for many different reasons it's an anti inflammatory so we use it for many different diseases but one of the side effects can be diabetes and you can of a new term over the last ten or fifteen years pre diabetics well that that patient who are not classifying them as diabetics but they have the potential right they need to start talking careful there should be presumed preventive action should should come about at that time you know and then once over one thirty then we're classing for you as a diabetic and most likely the doctor will prescribe something at that right you know my ex husband you know you love this the sweets and it seems that when you're a diabetic and correct me if i'm wrong it seems that that amplifies that you just crave that sugar sugar carbohydrates and it just seems as though the brain just needed to a certain degree and it's very easy to overdo those particular and the problem is the one thing that we are craving that's what the body is having the most problem and now metabolizing and dealing with the other thing that's important about this is that the secondary problems of hypertension and diabetes can be dramatic really dramatic i mean we're talking about things like a real but we know disease or kidney disease and into the point where you actually have dialysis you know you actually lose the function of your kidneys talk about eyesight diabetic retinopathy i mean there are so many peripheral vascular disease meaning that the blood vessels can't get blood to the to the history of the exterminations and there that's where you get the of the toes you you lose the feeling the rapa three and your toes in your fingers there are so many side effects or effects that diabetes cause that it's the type of disease that you really have to stay on t that never stops working oh really starks you're in trouble exactly when they get so unique or going to really years and heart disease is something that we have to really think about because there are secondary diseases like for instance diabetes and high hypertension of course they cause heart disease all right there are certain things that the heart just cannot tolerate obviously the glucose in the vessels go are affected just like any other vessels and what hypertension that pressure going trying to push that pressure out it affects the ventricle it really damages the heart the most important thing the two things number one is that we look at the heart as that it has its own separate vascular system that supplies blood and oxygen so the muscle can work appropriately right all right those vessels can get clogged up and that's the problem and if the heart muscle is not being in bed oxygen appropriately and there's going to be called this something occurs called askin me in a schema is a decreased heart that actually to a certain degree doesn't quite die but it almost dies i mean it really is bruised to the point that it doesn't function appropriately there are other aspects it's called  push the blood out over time it gets larger in the heart it's larger well you would think that a large heart would be a stronger however you know just the opposite while an enlarged heart is a weaker heart believe it or not so he then it comes to the point where that left ventricle is having a hard time pushing the blood out there because it's always pushing against a resistance so now you have a problem there so cardiomyopathy or a corner we call the current area artery disease where the arteries are a little clogged but those little cholesterol droplets and those are the two primary one said i'll talk about that most people hear about but there are valuable heart disease problems and things like that that can that can cause dysfunction as far as the heart is concerned as well but wow wow yeah so when so as as a people just people in general and i'm having these three what are some of the key things that we need to do to actually you talked about earlier in terms of the high blood pressure or you know some of the things that we could science so in terms of let's talk about what their heart disease are what it's not the signs that something maybe are ok if you're if your activity ok you're having you know if you're if you're doing something and say walking up the stairs and all the sudden now you're becoming short of breath like i used to be able to do three three flights of no problem now i'm only diabetes and you have to be careful with that because the diabetics they don't have the nerves aren't as reactive so they may not get the feeling of the chest pain order to going that's one thing i just want to go back  congestive heart failure there are many things that number one can cause it and many symptoms that you can get secondary to and we talk about a diabetes two what are some of the said although we said that many people walk around having carbohydrates number one number two it could be weight gain or weight loss a lot of times there is most of the time it's we gain urinating frequently that's one and just the fact that  have a thirst thirst you're always thirsty and you're always want to drink drink water those are those are usually the ones that we think of as someone who comes to the office and said who are you know always going to the bathroom if it's a male the first thing i think of his prostate and the second thing is you may have some diabetes going on you know something like that always thirsty are some blurred vision there just so many things that you can think about but those are the main ones so let's talk about checked once a year because you know there are certain things that we can't do anything about because we are who are parents were so the first thing i would say is you know understand your family history you know we are really truly or what our parents are so if if mom and dad had diabetes then even if you don't have it at this particular point you know at some point in your life you do it's a good chance you will develop diabetes the other thing is that going to the doctor definitely at least once a year to get a basic checkup even if you're feeling great because you just never know you know especially and another thing smoking cigarettes and yes if you're a smoker please get a chest x ray on a yearly body mass index is eighteen to twenty five and you're in a normal weight that is for your height weight sex and at that particular point and you can go in to any of the weight loss or weight programs on the internet and put that information between that are right twenty five to thirty that would be overweight ok so so what is it mentoring though the time it's about it it's actually measuring your weight for your height ok all right see because our bodies are built to how should i say this i want to put it in a way you'll understand our bodies are built to carry a certain amount of weight if you're five foot two   pounds on to that one hundred twenty pounds or whatever but the thing of it is that that kind of gives you a range for your height how much you should carry and now if you're carrying two hundred pounds at five foot or two hundred fifty five foot two then basically what you're saying is that your care you're having your body work twice as hard for all of those years so if we really look at our health and weight and and and things like that basically what you're saying is you're you're going against the natural functions of the body from all of that time i look at it in the i c u all the time i see patients come in there are either overweight or obese and they have these secondary problems and their secondary problems because of the overweight is is worse than someone who's thin so that they're someone who's them if they may have diabetes but it may be a mild in someone who's overweight their diabetes may send them to the emergency room and they may be in the i c u so it's a different level so i liken it to this if you buy a new car and you drive it one hundred miles an hour from the david you board it until the people you sell it i would not want to buy that car there right now if you have your body and its body frame that carries one hundred twenty pounds and you have it well you know well you have three hundred pounds or two hundred pounds or whatever it is for the rest of so many years ten twenty thirty years then you're going to have secondary problem because of the weight and the problems of dramatic as we get older the truck problems even become more significant and you see that in the hospital all the time but i've never heard it being explained that way and it's really really really like you know yeah that's what i talk to my patients of like do you know i don't test ties and we we talk like good friends really you know but that's the best way because as i was telling you earlier that i had the unfortunate situation to be in the hospital visiting a family member and the doctor came in and was speaking to my best and not really asking questions to get not only better understanding of their situation but also taking on a ship and maybe even questioning some of the things that made me because i think also that sometimes when you go to the doctor the doctor you're giving him you're giving him x amount of information and he's making that decision based on that information true so it's so important for you have to have that dialogue or occasion you know the most important thing for physician is history most of the time the diagnosis that i make is from the history itself just listening to the patient listening to the symptoms listening to the time period just a varity of the symptoms what they took it what worked what didn't work and then i said ok i think i know what's going on but from very good the physician should explain his thoughts to the patient i think we should we as people including myself as a patient as people should be better health care consumers all right number one we should choose a doctor that you know sort of that we can get along just like anybody you know i mean that understand us as a person will take time with us we'll we'll explain it in a way that i can understand that's very very important i feel that if a patient understands their medications understand some and have on some understanding of the disease that they have and what they should do about it which they shouldn't do how things are then it's a better chance that they will maintain a better control of that disease if it's someone who doesn't understand why they're taking the medication what the name of the medications is what the side effects to look for to it you know the likelihood that they're going to be compliant d dramatically right so they should we should be better health care consumers truly that's so true and it is so especially you know in terms of insurance sometimes you know i think the time crunch is there that you know we have to see x amount of people are you know if the time frame is not there for a term sometimes to x the questions that we really need to ask because again the bottom line it's our own health right true true you know it's all about it's all about longevity but the most important thing is to be healthy as long as you live you know i don't want to be you know sixty years old and then you know i'm going to live to eighty but from from sixty to eighty i was in a nursing home right now a lot of life is on