NRAO-NM HEALTH FAIR 2017

ALLEN BASSLER, MD

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

Recommendations for Adult Periodic Health Screening

Target Population

<120/80: every 2 years120-139/80-90: yearly

Screening Test

Blood Pressure

Cholesterol

Obesity

Begin screening at 35(males) or 45 (females); younger if high riskStarting at age 6

Thyroid disease, anemia, kidney/liver disease, PSAinsufficient or negative evidence for screening

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

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 2018.Recommended at age 50+. Has 90+% efficacy

Blood Sugar Classifications

Fasting Blood Glucose Levels

60-100=Normal

>100-125=Prediabetes

>125=DiabetesTwo Hour Glucose Tolerance Test

140-199=Prediabetes

>200=Diabetes

Body Mass Index(BMI)Tool for Categorizing Desirable Weight

Formula : Weight/Height2 (kg/m2)

Categories

Healthy: 18.5-24.9

Overweight: 25.0-29.9

Obese: 30.0-39.9

Morbidly Obese: 40+

BMI>30 intensive behavioral interventions

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

Tests forPrediabetes/Diabetes

Fasting Blood Sugar Test

Done after at least 8-hour fast

>100-125 is classified as prediabetes

>125 is diabetes

A1c Test

A1c 5.7%-6.4%: classified as prediabetes

A1c >6.4%: classified as diabetes

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

Classification & Management of Blood Pressure

Prehypertension:Systolic 120-139 mmHg or diastolic 80-89 mmHgIs 130/80 really hypertension?

Hypertension:

Stage 1: systolic 140-159 mmHg or diastolic 90-99 mmHg

Stage 2: systolic >/=160 or diastolic >/=100mmHg

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

Lipid Levels (Cholesterol)Total Cholesterol

<200 Desirable

200-239 Borderline

>240 High

LDL (Bad) Cholesterol – Primary Target of Therapy

<100 Optimal

100-129 Near Optimal

130-159 Borderline High

160-189 High

>190 Very High

HDL (Good)

Cholesterol

<40 Low

>60 High

AHAGuidelinesTwo 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

Thyroid-Stimulating Hormone(TSH)

A test for TSH is done to find out whether the thyroid glandis 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 0.40-4.0

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

Therapeutic Lifestyle Changes(TLC)

Exercise, Exercise, Exercise!

30 minutes ~ four times a weekAttend free NRAO yoga and aerobics classes!

Behavior/Habits

No tobacco

Limited alcohol (max two drinks a day)

Family, friends, & fun!

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

Questions?