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What Food Can Be Consumed To Lower The Cholesterol Levels?
Question: what foods are good to lower my cholestol?
XXXXXXX is a 34 year old woman who comes to the clinic for an examination. She reports she has not seen a doctor since the birth of her last child 6 years ago. She has been well and is only at the clinic because her family has been insisting she needs a checkup. They are worried about her because her father suffered a fatal heart attack three months ago at age 54. She tells you she is confident she’s fine, even though she knows she’s a little overweight. Additional data collected is as follows:
T - 98F
P – 76, regular
R – 16
BP – 146/92 Right arm, 142/90 left arm
BMI – 34.5
Drinks 2 glasses of wine/day
Tobacco – 20 pack years, quit smoking 3 months ago
Medications (Prescribed, OTC, Herbal) – none
Physical exam - normal
Laboratory Data
RBC 4.2million/mm3 Total cholesterol 275mg/dL
Hgb 12.2g/dL HDL 31mg/dL
Hct 37% LDL 179mg/dL
Plt 235,000/mm3 Triglycerides 290mg/dL
Glucose, fasting 96mg/dL
Na 139meq/L
K 3.9meq/L
Cl 102meq/L
BUN 17
Cr 0.9mg/dL
1. What vital signs are significant in this case? Explain.
2. What laboratory data are significant in this case? Explain.
3. Explain short-term and long-term mechanisms in the body regulate blood pressure.
4. Does XXXXXXX XXXXXXX diagnostic criteria for hypertension? Why or why not?
5. What patient education would you provide to XXXXXXX and why?
6. Explain how untreated or poorly treated hypertension can cause damage to other organs of the body.
T - 98F
P – 76, regular
R – 16
BP – 146/92 Right arm, 142/90 left arm
BMI – 34.5
Drinks 2 glasses of wine/day
Tobacco – 20 pack years, quit smoking 3 months ago
Medications (Prescribed, OTC, Herbal) – none
Physical exam - normal
Laboratory Data
RBC 4.2million/mm3 Total cholesterol 275mg/dL
Hgb 12.2g/dL HDL 31mg/dL
Hct 37% LDL 179mg/dL
Plt 235,000/mm3 Triglycerides 290mg/dL
Glucose, fasting 96mg/dL
Na 139meq/L
K 3.9meq/L
Cl 102meq/L
BUN 17
Cr 0.9mg/dL
1. What vital signs are significant in this case? Explain.
2. What laboratory data are significant in this case? Explain.
3. Explain short-term and long-term mechanisms in the body regulate blood pressure.
4. Does XXXXXXX XXXXXXX diagnostic criteria for hypertension? Why or why not?
5. What patient education would you provide to XXXXXXX and why?
6. Explain how untreated or poorly treated hypertension can cause damage to other organs of the body.
XXXXXXX is a 38y old man who has had Diabetes Mellitus (DM) Type I since the age of 10. He uses an insulin pump to treat his Diabetes. He is married and has three daughters, ages 6, 4 and 15 months. His wife XXXXXXX prepares all the meals and is careful about the family’s diet, choosing healthy foods to keep in the home. With John’s new promotion to regional sales manager, he travels frequently for work and reports his diet isn’t as “good,” he’s been less vigilant with blood sugar testing and when he has tested his blood sugar, he’s noticed a lot more episodes when his blood sugar has been high. He also reports a 20lb weight gain in the past year and has recently noticed vision changes. He admits he’s worried about his health and is afraid of “ending up with kidney failure” or “going blind.”
Vital Signs are as follows: T – 97.9F, P – 66 and regular, R -14, BP – 132/84 R Arm, BMI – 24.2.
Laboratory Data
Glucose, fasting 200mg/dL
Na 141 meq/L
K 5.3 meq/L
Cl 115meq/L
BUN 21
Cr 1.5 mg/dL
GFR 54 mL/min/1.73m2
HgbA1c 7.7%
1. How are Diabetes Mellitus Type I and Type II similar? How are they different?
2. What is the value of testing HgbA1c in patients with Diabetes? How do you interpret John’s results?
3. Briefly explain chronic complications that can occur with Diabetes and the pathogenesis of these complications?
4. What data in this case supports John’s concerns about “going blind” or “ending up with kidney failure?”
5. Given John’s history, what type of acute complication is XXXXXXX most at risk for and why? Explain.
Vital Signs are as follows: T – 97.9F, P – 66 and regular, R -14, BP – 132/84 R Arm, BMI – 24.2.
Laboratory Data
Glucose, fasting 200mg/dL
Na 141 meq/L
K 5.3 meq/L
Cl 115meq/L
BUN 21
Cr 1.5 mg/dL
GFR 54 mL/min/1.73m2
HgbA1c 7.7%
1. How are Diabetes Mellitus Type I and Type II similar? How are they different?
2. What is the value of testing HgbA1c in patients with Diabetes? How do you interpret John’s results?
3. Briefly explain chronic complications that can occur with Diabetes and the pathogenesis of these complications?
4. What data in this case supports John’s concerns about “going blind” or “ending up with kidney failure?”
5. Given John’s history, what type of acute complication is XXXXXXX most at risk for and why? Explain.
Brief Answer:
Let us take one query at a time
Detailed Answer:
Hi XXXXX,
We generally give opinions to the patients who have an urgency as it helps them in decision making. I see multiple queries here. All of them seems to be of academic purposes. So I prefer to take only one query here. Please post your other query as separate question.
Now the query about Tina:
1) Blood pressure and BMI are significant vital signs here.
2) The Lipid profile is not good, it is considered to be dyslipidemic with raised total cholesterol, high LDL, high triglycerides and low HDL. Consider the possibility of familial hypertriglyceredemia.
3) We cannot explain the short and long term mechanism in this case. In general short term depends on blood vessel diameter, contractility of heart and heart rate whereas longterm depends on the blood volume precisely.
4) XXXXXXX meets diagnostic criteria for hypertension provided she records the BP over 140/90 for two more consecutive checks taken one week apart.
5) Who is XXXXXXX here she is not in the picture
6) Untreated hypertension can cause end organ damage to the vital organs like brain, heart, kidneys. The damage to kidney would potential raise the blood pressure again.
Hope this helps.
Let us take one query at a time
Detailed Answer:
Hi XXXXX,
We generally give opinions to the patients who have an urgency as it helps them in decision making. I see multiple queries here. All of them seems to be of academic purposes. So I prefer to take only one query here. Please post your other query as separate question.
Now the query about Tina:
1) Blood pressure and BMI are significant vital signs here.
2) The Lipid profile is not good, it is considered to be dyslipidemic with raised total cholesterol, high LDL, high triglycerides and low HDL. Consider the possibility of familial hypertriglyceredemia.
3) We cannot explain the short and long term mechanism in this case. In general short term depends on blood vessel diameter, contractility of heart and heart rate whereas longterm depends on the blood volume precisely.
4) XXXXXXX meets diagnostic criteria for hypertension provided she records the BP over 140/90 for two more consecutive checks taken one week apart.
5) Who is XXXXXXX here she is not in the picture
6) Untreated hypertension can cause end organ damage to the vital organs like brain, heart, kidneys. The damage to kidney would potential raise the blood pressure again.
Hope this helps.
Above answer was peer-reviewed by :
Dr. Aparna Kohli
Given these outcomes what are my short term and long term mechanisms in the body that regulate blood pressure??? Please explain in detail...
I'm 34 years old and am concerned because my dad had a fatal heart attack at age 54.
T - 98F
P – 76, regular
R – 16
BP – 146/92 Right arm, 142/90 left arm
BMI – 34.5
Drinks 2 glasses of wine/day
Tobacco – 20 pack years, quit smoking 3 months ago
Medications (Prescribed, OTC, Herbal) – none
Physical exam - normal
Laboratory Data
RBC 4.2million/mm3 Total cholesterol 275mg/dL
Hgb 12.2g/dL HDL 31mg/dL
Hct 37% LDL 179mg/dL
Plt 235,000/mm3 Triglycerides 290mg/dL
Glucose, fasting 96mg/dL
Na 139meq/L
K 3.9meq/L
Cl 102meq/L
BUN 17
Cr 0.9mg/dL
I'm 34 years old and am concerned because my dad had a fatal heart attack at age 54.
T - 98F
P – 76, regular
R – 16
BP – 146/92 Right arm, 142/90 left arm
BMI – 34.5
Drinks 2 glasses of wine/day
Tobacco – 20 pack years, quit smoking 3 months ago
Medications (Prescribed, OTC, Herbal) – none
Physical exam - normal
Laboratory Data
RBC 4.2million/mm3 Total cholesterol 275mg/dL
Hgb 12.2g/dL HDL 31mg/dL
Hct 37% LDL 179mg/dL
Plt 235,000/mm3 Triglycerides 290mg/dL
Glucose, fasting 96mg/dL
Na 139meq/L
K 3.9meq/L
Cl 102meq/L
BUN 17
Cr 0.9mg/dL
what patient education can you provide to me and why..Please explain in detail....
I'm a 34 year old woman went to the clinic for an examination. She reports she has not seen a doctor since the birth of her last child 6 years ago. She has been well and is only at the clinic because her family has been insisting she needs a checkup. They are worried about her because her father suffered a fatal heart attack three months ago at age 54. She tells you she is confident she’s fine, even though she knows she’s a little overweight. Additional data collected is as follows:
T - 98F
P – 76, regular
R – 16
BP – 146/92 Right arm, 142/90 left arm
BMI – 34.5
Drinks 2 glasses of wine/day
Tobacco – 20 pack years, quit smoking 3 months ago
Medications (Prescribed, OTC, Herbal) – none
Physical exam - normal
Laboratory Data
RBC 4.2million/mm3 Total cholesterol 275mg/dL
Hgb 12.2g/dL HDL 31mg/dL
Hct 37% LDL 179mg/dL
Plt 235,000/mm3 Triglycerides 290mg/dL
Glucose, fasting 96mg/dL
Na 139meq/L
K 3.9meq/L
Cl 102meq/L
BUN 17
Cr 0.9mg/dL
I'm a 34 year old woman went to the clinic for an examination. She reports she has not seen a doctor since the birth of her last child 6 years ago. She has been well and is only at the clinic because her family has been insisting she needs a checkup. They are worried about her because her father suffered a fatal heart attack three months ago at age 54. She tells you she is confident she’s fine, even though she knows she’s a little overweight. Additional data collected is as follows:
T - 98F
P – 76, regular
R – 16
BP – 146/92 Right arm, 142/90 left arm
BMI – 34.5
Drinks 2 glasses of wine/day
Tobacco – 20 pack years, quit smoking 3 months ago
Medications (Prescribed, OTC, Herbal) – none
Physical exam - normal
Laboratory Data
RBC 4.2million/mm3 Total cholesterol 275mg/dL
Hgb 12.2g/dL HDL 31mg/dL
Hct 37% LDL 179mg/dL
Plt 235,000/mm3 Triglycerides 290mg/dL
Glucose, fasting 96mg/dL
Na 139meq/L
K 3.9meq/L
Cl 102meq/L
BUN 17
Cr 0.9mg/dL
Brief Answer:
Few lifestyle and diet modifications required
Detailed Answer:
Hi,
As per the details given I would recommend the following for my patients with similar profile
1) Absolutely low salt diet (short term and long term BP control), less than 1tsp per day
2) Opt out of sugar (BP control) if there is a chance to avoid, please avoid. Salt and sugar are equally XXXXXXX
3) Stay away from white color diet. No polished rice, potato, refined flour.
4) Opt food closer to the nature like greens, dark colored vegetables and fruit at least to 6 servings a day (1 serving size is equal to half size of tennis ball)
5) Whole grains like whole wheat bread are better as their affect on the high cholesterol are little than the white or refined food. They damage the arteries and cause higher blood pressure and rupture of fatty plaques caused by high cholesterol
6) I would also refer you to a Cardiologist regarding the need to go on pills both for blood pressure and cholesterol. I would start with statins after checking liver function
7) At least 5 hours of moderate exercise per week or up to two and half hours of severe exercise per week with proper gear.
8) I recommend yoga and mediation sessions twice a week for one hour each. This is proven to relax the sympathetics which regulate blood vessels and cardiac output both the short term and long term.
Hope this helps.
Few lifestyle and diet modifications required
Detailed Answer:
Hi,
As per the details given I would recommend the following for my patients with similar profile
1) Absolutely low salt diet (short term and long term BP control), less than 1tsp per day
2) Opt out of sugar (BP control) if there is a chance to avoid, please avoid. Salt and sugar are equally XXXXXXX
3) Stay away from white color diet. No polished rice, potato, refined flour.
4) Opt food closer to the nature like greens, dark colored vegetables and fruit at least to 6 servings a day (1 serving size is equal to half size of tennis ball)
5) Whole grains like whole wheat bread are better as their affect on the high cholesterol are little than the white or refined food. They damage the arteries and cause higher blood pressure and rupture of fatty plaques caused by high cholesterol
6) I would also refer you to a Cardiologist regarding the need to go on pills both for blood pressure and cholesterol. I would start with statins after checking liver function
7) At least 5 hours of moderate exercise per week or up to two and half hours of severe exercise per week with proper gear.
8) I recommend yoga and mediation sessions twice a week for one hour each. This is proven to relax the sympathetics which regulate blood vessels and cardiac output both the short term and long term.
Hope this helps.
Above answer was peer-reviewed by :
Dr. Aparna Kohli
Hi I'm still waiting on a few open inquires will they be answered soon?
Brief Answer:
We do not leave any inquiry open
Detailed Answer:
Hi,
I prefer take only one question at a time, here we discussed about cholesterol and hypertension. You had posted multiple inquiries in a single discussion. As mentioned earlier please ask one question and related question in a single discussion here. Since you have a subscription you can post other unrelated queries as separate discussion for free. I can take that up or other doctors can take them whoever is available online. It will be easy working for the expert and the user.
Thanks
We do not leave any inquiry open
Detailed Answer:
Hi,
I prefer take only one question at a time, here we discussed about cholesterol and hypertension. You had posted multiple inquiries in a single discussion. As mentioned earlier please ask one question and related question in a single discussion here. Since you have a subscription you can post other unrelated queries as separate discussion for free. I can take that up or other doctors can take them whoever is available online. It will be easy working for the expert and the user.
Thanks
Note: For further queries related to coronary artery disease and prevention, click here.
Above answer was peer-reviewed by :
Dr. Aparna Kohli
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