Breast Cancer: Treatment and Prevention

Method of Treatment for  Breast Cancer

A multidisciplinary team will be involved in a breast cancer patient's treatment. The team may consists of an oncologist, radiologist, specialist cancer surgeon, specialist nurse, pathologist, radiologist, radiographer, and reconstructive surgeon. Sometimes the team may also include an occupational therapist, psychologist, dietitian, and physical therapist.

The team will take into account several factors when deciding on the best treatment for the patient, including:

1.The type of breast cancer

2. The stage and grade of the breast cancer - how large the tumor is, whether or not it has spread, and if so how far

3. Whether or not the cancer cells are sensitive to hormones

4. The patient's overall health

5. The age of the patient (has she been through the menopause?)

6. The patient's own preferences

The main breast cancer treatment options may include: 1-Surgery

2-Radiation therapy (radiotherapy)

3-Chemotherapy

4-Hormone therapy
5-Biological therapy (targeted drug therapy) 

1-Surgery:
Lumpectomy - surgically removing the tumor and a small margin of healthy tissue around it. In breast cancer, this is often called breast-sparing surgery. This type of surgery may be recommended if the tumor is small and the surgeon believes it will be easy to separate from the tissue around it. British researchers reported that about one fifth of breast cancer patients who choose breast-conserving surgery instead of mastectomy eventually need a reoperation. 


Mastectomy - surgically removing the breast. Simple mastectomy involves removing the lobules, ducts, fatty tissue, nipple, areola, and some skin. Radical mastectomy means also removing muscle of the chest wall and the lymph nodes in the armpit.


Sentinel node biopsy - one lymph node is surgically removed. If the breast cancer has reached a lymph node it can spread further through the lymphatic system into other parts of the body.


Axillary lymph node dissection - if the sentinel node was found to have cancer cells, the surgeon may recommend removing several nymph nodes in the armpit.


Breast reconstruction surgery - a series of surgical procedures aimed at recreating a breast so that it looks as much as possible like the other breast. This procedure may be carried out at the same time as a mastectomy. The surgeon may use a breast implant, or tissue from another part of the patient's body.

2-Radiation therapy (radiotherapy)

Controlled doses of radiation are targeted at the tumor to destroy the cancer cells. Usually, radiotherapy is used after surgery, as well as chemotherapy to kill off any cancer cells that may still be around. Typically, radiation therapy occurs about one month after surgery or chemotherapy. Each session lasts a few minutes; the patient may require three to five sessions per week for three to six weeks.

The type of breast cancer the woman has will decide what type of radiation therapy she may have to undergo. In some cases, radiotherapy is not needed.

Radiation therapy types include:
Breast radiation therapy - after a lumpectomy, radiation is administered to the remaining breast tissue


Chest wall radiation therapy - this is applied after a mastectomy


Breast boost - a high-dose of radiation therapy is applied to where the tumor was surgically removed. The appearance of the breast may be altered, especially if the patient's breasts are large.


Lymph nodes radiation therapy - the radiation is aimed at the axilla (armpit) and surrounding area to destroy cancer cells that have reached the lymph nodes


Breast brachytherapy - scientists at UC San Diego Moores Cancer Center revealed that patients with early-stage breast cancer in the milk ducts which has not spread, seem to benefit from undergoing breast brachytherapy with a strut-based applicator. This 5-day treatment is given to patients after they have undergone lumpectomy surgery. The researchers found that women who received strut-based breast brachytherapy had lower recurrence rates, as well as fewer and less severe side effects.

Side effects of radiation therapy may include fatigue, lymphedema, darkening of the breast skin, and irritation of the breast skin.

3-Chemotherapy

Medications are used to kill the cancer cells - these are called cytotoxic drugs. The oncologist may recommend chemotherapy if there is a high risk of cancer recurrence, or the cancer spreading elsewhere in the body. This is called adjuvant chemotherapy.

If the tumors are large, chemotherapy may be administered before surgery. The aim is to shrink the tumor, making its removal easier. This is called neo-adjuvant chemotherapy.

Chemotherapy may also be administered if the cancer has metastasized - spread to other parts of the body. Chemotherapy is also useful in reducing some of the symptoms caused by cancer.

Chemotherapy may help stop estrogen production. Estrogen can encourage the growth of some breast cancers.

Side effects of chemotherapy may include nausea, vomiting, loss of appetite, fatigue, sore mouth, hair loss, and a slightly higher susceptibility to infections. Many of these side effects can be controlled with medications the doctor can prescribe. Women over 40 may enter early menopause.

Protecting female fertility - Scientists have designed a way of aggressively attacking cancer with an arsenic-based chemo medication, which is much gentler on the ovaries. The researchers, from Northwestern University Feinberg School of Medicine in Chicago, believe their novel method will help protect the fertility of female patients undergoing cancer treatment.

The scientists say they also developed a way of rapidly testing existing chemotherapy drugs for their effect on ovarian function, so that doctors and patients can make decisions regarding treatment that minimize damage to ovaries.

They reported their findings in the journal PLOS ONE (March 2013 issue). The authors claim that the new nanoparticle chemo medication they designed is the first cancer drug to be tested during development for its impact on fertility using the new rapid toxicity test.

Although more cancer patients are surviving today thanks to the advances in cancer therapies, a significant number of female patients still face fertility loss after undergoing traditional chemotherapy.

Co-principal study investigator Teresa Woodruff, said "Our overall goal is to create smart drugs that kill the cancer but don't cause sterility in young women."

4-Hormone therapy (hormone blocking therapy)

Used for breast cancers that are sensitive to hormones. These types of cancer are often referred to as ER positive (estrogen receptor positive) and PR positive (progesterone receptor positive) cancers. The aim is to prevent cancer recurrence. Hormone blocking therapy is usually used after surgery, but may sometimes be used beforehand to shrink the tumor.

If for health reasons, the patient cannot undergo surgery, chemotherapy or radiotherapy, hormone therapy may be the only treatment she receives.

Hormone therapy will have no effect on cancers that are not sensitive to hormones.

Hormone therapy usually lasts up to five years after surgery.

The following hormone therapy medications may be used:
Tamoxifen - prevents estrogen from binding to ER-positive cancer cells. Side effects may include changes in periods, hot flashes, weight gain, headaches, nausea, vomiting, fatigue, and aching joints.

A biomarker in breast cancer patients who do not respond, or who have become resistant to Tamoxifen has been discovered by researchers at the University of Manchester, England. They say that their discovery will help doctors decide which patients are suitable or not for adjuvant (complementary) hormone therapy with Tamoxifen.


Aromatase inhibitors - this type of medication may be offered to women who have been through the menopause. It blocks aromatase. Aromatase helps estrogen production after the menopause. Before the menopause, a woman's ovaries produce estrogen. Examples of aromatase inhibitors include letrozole, exemestane, and anastrozole. Side effects may include nausea, vomiting, fatigue, skin rashes, headaches, bone pain, aching joints, loss of libido, sweats, and hot flashes.


Ovarian ablation or suppression - pre-menopausal women produce estrogen in their ovaries. Ovarian ablation or suppression stop the ovaries from producing estrogen. Ablation is done either through surgery or radiation therapy - the woman's ovaries will never work again, and she will enter the menopause early.

A luteinising hormone-releasing hormone agonist (LHRHa) drug called Goserelin will suppress the ovaries. The patient's periods will stop during treatment, but will start again when she stops taking Goserelin. Women of menopausal age (about 50 years) will probably never start having periods again. Side effects may include mood changes, sleeping problems, sweats, and hot flashes.

5.Biological treatment (targeted drugs)
Trastuzumab (Herceptin) - this monoclonal antibody targets and destroys cancer cells that are HER2-positive. Some breast cancer cells produce large amounts of HER2 (growth factor receptor 2); Herceptin targets this protein. Possible side effects may include skin rashes, headaches, and/or heart damage.


Lapatinib (Tykerb) - this drug targets the HER2 protein. It is also used for the treatment of advanced metastatic breast cancer. Tykerb is used on patients who did not respond well to Herceptin. Side effects include painful hands, painful feet, skin rashes, mouth sores, extreme tiredness, diarrhea, vomiting, and nausea.


Bevacizumab (Avastin) - stops the cancer cells from attracting new blood vessels, effectively causing the tumor to be starved of nutrients and oxygen. Side effects may include congestive heart failure, hypertension (high blood pressure), kidney damage, heart damage, blood clots, headaches, mouth sores. Although not approved by the FDA for this use, doctors may prescribe it "off-label". Using this drug for breast cancer is controversial. The FDA in 2011 said that Avastin is neither effective nor safe for breast cancer.

Swiss researchers found that Avastin offers only a modest benefit regarding disease progression in women with advanced stage breast cancer. They added that it has no impact on survival.


Low dose aspirin

Research carried out on laboratory mice and test tubes suggests that regular low-dose aspirin may halt the growth and spread of breast cancer.

Scientists from the Veterans Affairs Medical Center in Kansas City and the University of Kansas Medical Center explained that their tests on cancer lines and in mice showed that aspirin not only slowed the growth of cancer cells and shrank tumors considerably, but also stopped metastasis (cancer spreading to new sites).

Their research involved assessing aspirin's effects on two types of cancer, including the aggressive "triple-negative" breast cancer which is resistant to most current treatments.

Cancer campaigners cautioned that although the current results show great promise, this research is at a very early stage and has yet to be shown to be effective on humans.

Exercise and cancer survival rates - an report published in the Journal of the National Cancer Institute explained that physical activity is associated with lower rates of breast and colon cancer deaths.


Preventive ways for Breast Cancer

Some lifestyle changes can help significantly reduce a woman's risk of developing breast cancer.
1.Alcohol consumption - women who drink in moderation, or do not drink alcohol at all, are less likely to develop breast cancer compared to those who drink large amounts regularly. Moderation means no more than one alcoholic drink per day.


2.Physical exercise - exercising five days a week has been shown to reduce a woman's risk of developing breast cancer. Researchers from the University of North Carolina Gillings School of Global Public Health in Chapel Hill reported that physical activity - either mild or intense and before or after menopause - can lower breast cancer risk, but considerable weight gain may negate these benefits.


3.Diet - some experts say that women who follow a healthy, well-balanced diet may reduce their risk of developing breast cancer.


4.Postmenopausal hormone therapy - limiting hormone therapy may help reduce the risk of developing breast cancer. It is important for the patient to discuss the pros and cons thoroughly with her doctor.


5.Bodyweight - women who have a healthy bodyweight have a considerably lower chance of developing breast cancer compared to obese and overweight females.


6.Women at high risk of breast cancer - the doctor may recommend estrogen-blocking drugs, including tamoxifen and raloxifene. Tamoxifen may raise the risk of uterine cancer. Preventive surgery is a possible option for women at very high risk.


7.Breast cancer screening - patients should discuss with their doctor when to start breast cancer screening exams and tests.


8.Breastfeeding - women who breastfeed run a lower risk of developing breast cancer compared to other women.



Note :- Prevention is better than cure ! 

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Symptoms and Diagnosis of Breast Cancer

Sign and Symptoms of Breast Cancer

A symptom is only felt by the patient, and is described to the doctor or nurse, such as a headache or pain. A sign is something the patient and others can detect, for example, a rash or swelling.

The first symptoms of breast cancer are usually an area of thickened tissue in the woman's breast, or a lump. The majority of lumps are not cancerous; however, women should get them checked by a health care professional. A symptom is only felt by the patient, and is described to the doctor or nurse, such as a headache or pain. A sign is something the patient and others can detect, for example, a rash or swelling.

The first symptoms of breast cancer are usually an area of thickened tissue in the woman's breast, or a lump. The majority of lumps are not cancerous; however, women should get them checked by a health care professional.

1. A lump in a breast

2. A pain in the armpits or breast that does not seem to be related to the woman's menstrual period · Pitting or redness of the skin of the breast; like the skin of an orange

3.  A rash around (or on) one of the nipples

4. A swelling (lump) in one of the armpits

5. An area of thickened tissue in a breast

6. One of the nipples has a discharge; sometimes it may contain blood

7. The nipple changes in appearance; it may become sunken or inverted

8. The size or the shape of the breast changes The nipple-skin or breast-skin may have started to peel, scale or flake

Diagnosis of Breast Cancer

Women are usually diagnosed with breast cancer after a routine breast cancer screening, or after detecting certain signs and symptoms and seeing their doctor about them.

If a woman detects any of the breast cancer signs and symptoms described above, she should speak to her doctor immediately. The doctor, often a primary care physician (general practitioner, GP) initially, will carry out a physical exam, and then refer the patient to a specialist if he/she thinks further assessment is needed.

Below are examples of diagnostic tests and procedures for breast cancer:

1.Breast exam - the physician will check both the patient's breasts, looking out for lumps and other possible abnormalities, such as inverted nipples, nipple discharge, or change in breast shape. The patient will be asked to sit/stand with her arms in different positions, such as above her head and by her sides.


2.X-ray (mammogram) - commonly used for breast cancer screening. If anything unusual is found, the doctor may order a diagnostic mammogram.

Breast cancer screening has become a controversial subject over the last few years. Experts, professional bodies, and patient groups cannot currently agree on when mammography screening should start and how often it should occur. Some say routine screening should start when the woman is 40 years old, others insist on 50 as the best age, and a few believe that only high-risk groups should have routine screening.

In July, 2012, The American Medical Association said that women should be eligible for screening mammography from the age of 40, and it should be covered by insurance.

In a Special Report in The Lancet (October 30th, 2012 issue), a panel of experts explained that breast cancer screening does reduce the risk of death from the disease. However, they added that it also creates more cases of false-positive results, where women end up having unnecessary biopsies and harmless tumors are surgically removed.

Another study, carried out by scientists at the The Dartmouth Institute for Healthy Policy & Clinical Practice in Lebanon, N.H., and reported in the New England Journal of Medicine (November 2012 issue), found that mammograms do not reduce breast cancer death rates.

A team from the University of Copenhagen reported that women who have false-positive mammogram outcomes may suffer long-lasting stress and anxiety, in some cases this can last up to three years. They published their findings in Annals of Family Medicine (March 2013 issue).

Researchers from the Barbara Ann Karmanos Cancer Institute in Detroit, Michigan, found that breast cancer mortality was higher among older women whose time-lapses between their last mammogram and their breast cancer diagnosis were longer. They presented their findings at the American Association for Cancer Research (AACR) Annual Meeting 2013.

Team leader, Michael S. Simon, M.D., M.P.H., said "We found that for women age 75 and older, a longer time interval between the last mammogram and the date of breast cancer diagnosis was associated with a greater chance for dying from breast cancer."


3.2D combined with 3D mammograms - 3D mammograms, when used in collaboration with regular 2D mammograms were found to reduce the incidence of false positives, researchers from the University of Sydney's School of Public Health, Australia, reported in The Lancet Oncology.

The researchers screened 7,292 adult females, average age 58 years. Their initial screening was done using 2D mammograms, and then they underwent a combination of 2D and 3D mammograms.

Professor Nehmat Houssami and team found 59 cancers in 57 patients. 66% of the cancers were detected in both 2D and combined 2D/3D screenings. However, 33% of them were only detected using the 2D plus 3D combination.

The team also found that 2D plus 3D combination screenings were linked to a much lower number of false positives. When using just 2D screenings there were 141 false positives, compared to 73 using the 2D plus 3D combination.

Prof. Houssami said "Although controversial, mammography screening is the only population-level early detection strategy that has been shown to reduce breast cancer mortality in randomized trials. Irrespective of which side of the mammography screening debate one supports, efforts should be made to investigate methods that enhance the quality of, and hence potential benefit from, mammography screening.

We have shown that integrated 2D and 3D mammography in population breast-cancer screening increases detection of breast cancer and can reduce false-positive recalls depending on the recall strategy. Our results do not warrant an immediate change to breast-screening practice, instead, they show the urgent need for randomised controlled trials of integrated 2D and 3D versus 2D mammography."


4.Beast ultrasound - this type of scan may help doctors decide whether a lump or abnormality is a solid mass or a fluid-filled cyst.


5.Biopsy - a sample of tissue from an apparent abnormality, such as a lump, is surgically removed and sent to the lab for analysis. It the cells are found to be cancerous, the lab will also determine what type of breast cancer it is, and the grade of cancer (aggressiveness). Scientists from the Technical University of Munich found that for an accurate diagnosis, multiple tumor sites need to be taken. 


6.Breast MRI (magnetic resonance imaging) scan - a dye is injected into the patient. This type of scan helps the doctor determine the extent of the cancer. Researchers from the University of California in San Francisco found that MRI provides a useful indication of a breast tumor's response to pre-surgical chemotherapy much earlier than possible through clinical examination. 

( Source: http://www.medicalnewstoday.com/articles/37136.php)





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Breast Cancer In Women and Its Causes

What is breast Cancer ?

Breast cancer is a kind of cancer that develops from breast cells. Breast cancer usually starts off in the inner lining of milk ducts or the lobules that supply them with milk. A malignant tumor can spread to other parts of the body. A breast cancer that started off in the lobules is known as lobular carcinoma, while one that developed from the ducts is called ductal carcinoma. The vast majority of breast cancer cases occur in females. This article focuses on breast cancer in women.
Breast cancer is the most common invasive cancer in females worldwide. It accounts for 16% of all female cancers and 22.9% of invasive cancers in women. 18.2% of all cancer deaths worldwide, including both males and females, are from breast cancer.

Breast cancer rates are much higher in developed nations compared to developing ones. There are several reasons for this, with possibly life-expectancy being one of the key factors - breast cancer is more common in elderly women; women in the richest countries live much longer than those in the poorest nations. The different lifestyles and eating habits of females in rich and poor countries are also contributory factors, experts believe.

General breast cancer terms to be cleared about Breast Cancer

Here are some of the key words used to describe breast cancer.
Carcinoma

This is a term used to describe a cancer that begins in the lining layer (epithelial cells) of organs like the breast. Nearly all breast cancers are carcinomas (either ductal carcinomas or lobular carcinomas).
Adenocarcinoma

An adenocarcinoma is a type of carcinoma that starts in glandular tissue (tissue that makes and secretes a substance). The ducts and lobules of the breast are glandular tissues (they make breast milk), so cancers starting in these areas are often called adenocarcinomas.
Carcinoma in situ
This term is used for an early stage of cancer, when it is confined to the layer of cells where it began. In breast cancer, in situ means that the cancer cells remain confined to ducts (ductal carcinoma in situ). The cells have not grown into (invaded) deeper tissues in the breast or spread to other organs in the body. Carcinoma in situ of the breast is sometimes referred to as non-invasive or pre-invasive breast cancer because it might develop into an invasive breast cancer if left untreated. When cancer cells are confined to the lobules it is called lobular carcinoma in situ. 

Invasive (infiltrating) carcinoma

An invasive cancer is one that has already grown beyond the layer of cells where it started (as opposed to carcinoma in situ). Most breast cancers are invasive carcinomas—either invasive ductal carcinoma or invasive lobular carcinoma.
Sarcoma

Sarcomas are cancers that start in connective tissues such as muscle tissue, fat tissue, or blood vessels. Sarcomas of the breast are rare. 

Difference Between Invasive and Non invasive cancer 
Invasive breast cancer - the cancer cells break out from inside the lobules or ducts and invade nearby tissue. With this type of cancer, the abnormal cells can reach the lymph nodes, and eventually make their way to other organs (metastasis), such as the bones, liver or lungs. The abnormal (cancer) cells can travel through the bloodstream or the lymphatic system to other parts of the body; either early on in the disease, or later.

Non-invasive breast cancer - this is when the cancer is still inside its place of origin and has not broken out. Lobular carcinoma in situ is when the cancer is still inside the lobules, while ductal carcinoma in situ is when they are still inside the milk ducts. "In situ" means "in its original place". Sometimes, this type of breast cancer is called "pre-cancerous"; this means that although the abnormal cells have not spread outside their place of origin, they can eventually develop into invasive breast cancer.

Major Causes of Breast Cancer

Experts are not sure what causes breast cancer. It is hard to say why one person develops the disease while another does not. We know that some risk factors can impact on a woman's likelihood of developing breast cancer.
1. Getting older - the older a woman gets, the higher is her risk of developing breast cancer; age is a risk factor. Over 80% of all female breast cancers occur among women aged 50+ years (after the menopause).

2. Genetics - women who have a close relative who has/had breast or ovarian cancer are more likely to develop breast cancer. If two close family members develop the disease, it does not necessarily mean they shared the genes that make them more vulnerable, because breast cancer is a relatively common cancer.

The majority of breast cancers are not hereditary.

Women who carry the BRCA1 and BRCA2 genes have a considerably higher risk of developing breast and/or ovarian cancer. These genes can be inherited. TP53, another gene, is also linked to greater breast cancer risk.


3. A history of breast cancer - women who have had breast cancer, even non-invasive cancer, are more likely to develop the disease again, compared to women who have no history of the disease. Having had certain types of breast lumps - women who have had some types of benign (non-cancerous) breast lumps are more likely to develop cancer later on. Examples include atypical ductal hyperplasia or lobular carcinoma in situ.


4. Dense breast tissue - women with more dense breast tissue have a greater chance of developing breast cancer.


5. Estrogen exposure - women who started having periods earlier or entered menopause later than usual have a higher risk of developing breast cancer. This is because their bodies have been exposed to estrogen for longer. Estrogen exposure begins when periods start, and drops dramatically during the menopause.


6. Obesity - post-menopausal obese and overweight women may have a higher risk of developing breast cancer. Experts say that there are higher levels of estrogen in obese menopausal women, which may be the cause of the higher risk.


7. Height - taller-than-average women have a slightly greater likelihood of developing breast cancer than shorter-than-average women. Experts are not sure why.


8. Alcohol consumption - the more alcohol a woman regularly drinks, the higher her risk of developing breast cancer is.


9. Radiation exposure - undergoing X-rays and CT scans may raise a woman's risk of developing breast cancer slightly. Scientists at the Memorial Sloan-Kettering Cancer Center found that women who had been treated with radiation to the chest for a childhood cancer have a higher risk of developing breast cancer.


HRT (hormone replacement therapy) - both forms, combined and estrogen-only HRT therapies may increase a woman's risk of developing breast cancer slightly. Combined HRT causes a higher risk.


10. Certain jobs - French researchers found that women who worked at night prior to a first pregnancy had a higher risk of eventually developing breast cancer.

Canadian researchers found that certain jobs, especially those that bring the human body into contact with possible carcinogens and endocrine disruptors are linked to a higher risk of developing breast cancer. Examples include bar/gambling, automotive plastics manufacturing, metal-working, food canning and agriculture. They reported their findings in the November 2012 issue of Environmental Health.


11. Cosmetic implants may undermine breast cancer survival - women who have cosmetic breast implants and develop breast cancer may have a higher risk of dying prematurely form the disease compared to other females, researchers from Canada reported in the BMJ (British Medical Journal) (May 2013 issue).

The team looked at twelve peer-reviewed articles on observational studies which had been carried out in Europe, the USA and Canada.

Experts had long-wondered whether cosmetic breast implants might make it harder to spot malignancy at an early stage, because they produce shadows on mammograms.

In this latest study, the authors found that a woman with a cosmetic breast implant has a 25% higher risk of being diagnosed with breast cancer when the disease has already advanced, compared to those with no implants.

Women with cosmetic breast implants who are diagnosed with breast cancer have a 38% higher risk of death from the disease, compared to other patients diagnosed with the same disease who have no implants, the researchers wrote.

After warning that there were some limitations in the twelve studies they looked at, the authors concluded "Further investigations are warranted into the long term effects of cosmetic breast implants on the detection and prognosis of breast cancer, adjusting for potential confounders."

Source :- http://www.medicalnewstoday.com/articles/37136.php



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Diagnosis and Prevention of High Blood Pressure

Hypertension, or high blood pressure, is often called a "silent disease" because you usually don't know that you have it. There may be no symptoms or signs. Nonetheless, it damages the body and eventually may cause problems like heart disease.

Therefore, it's important to regularly monitor your blood pressure, especially if it has ever been high or above the "normal" range, or if you have a family history of hypertension. Because hypertension can cause heart disease, you may also need to be tested for heart disease. And do the following action to diagnose the High Blood pressure. 

Measuring Blood Pressure

You can get your blood pressure measured by a health care provider, at a pharmacy, or you can purchase a blood pressure monitor for your home.

Blood pressure is most often measured with a device known as a sphygmomanometer, which consists of a stethoscope, arm cuff, dial, pump, and valve.

Blood pressure is measured in two ways: systolic and diastolic.

• Systolic blood pressure is the maximum pressure during a heartbeat.

• Diastolic blood pressure is the lowest pressure between heartbeats.

* Blood pressure is measured in millimeters of mercury (mm Hg) and is written systolic over diastolic (for example, 120/80 mm Hg, or "120 over 80"). According to the most recent guidelines, a normal blood pressure is less than 120/80 mm Hg. Hypertension is blood pressure that is greater than 140/90, while pre-hypertension consists of blood pressure that is 120 to 139/80 to 89.

*  Blood pressure may increase or decrease, depending on your age, heart condition, emotions, activity, and the medications you take. One high reading does not mean you have high blood pressure. It is necessary to measure your blood pressure at different times, while you are resting comfortably for at least five minutes. To make the diagnosis of hypertension, at least three readings that are elevated are usually required.

* In addition to measuring your blood pressure, your doctor will ask about your medical history (whether you've had heart problems before), assess your risk factors (whether you smoke, have high cholesterol, diabetes, etc.), and talk about your family history (whether any members of your family have had high blood pressure or heart disease).

* Your doctor will also conduct a physical exam. As part of this exam, he or she may use a stethoscope to listen to your heart for any abnormal sounds and your arteries for a whooshing or swishing sound that may indicate that the artery may be partially blocked. Your doctor may also check the pulses in your arm and ankle to determine if they are weak or even absent.

* If you're diagnosed with high blood pressure, your doctor may recommend other tests, such as:

• Electrocardiogram (EKG or ECG): A test that measures the electrical activity, rate, and rhythm of your heartbeat via electrodes attached to your arms, legs, and chest. The results are recorded on graph paper.

• Echocardiogram: This is a test that uses ultrasound waves to provide pictures of the heart's valves and chambers so the pumping action of the heart can be studied and measurement of the chambers and wall thickness of the heart can be made.

Preventive Ways of High Blood Pressure
Below are eight main ways you can control your blood pressure.

They are:
1. Eat a better diet, which may include reducing salt
2.Enjoy regular physical activity
3. Maintain a healthy weight
4. Manage stress
5. Avoid tobacco smoke
6. Comply with medication prescriptions
7. If you drink, limit alcohol
8. Understand hot tub safety

Adopting a healthy lifestyle is critical for the prevention of HBP and an indispensable part of managing it. Think of these changes as a "lifestyle prescription" and make every effort to comply with them.

Whether you have been diagnosed with high blood pressure, also called hypertension, or are concerned because you have some of the risk factors for the disease, understand this: while there is no cure, high blood pressure is manageable.

By adopting a heart-healthy lifestyle, you can:
-Reduce high blood pressure
-Prevent or delay the development of HBP
-Enhance the effectiveness of blood pressure medications
-Lower your risk of heart attack, heart disease, stroke and kidney disease


How to do your part to balance  High Blood pressure ?

• Be informed

Of all people with high blood pressure, over 20 percent are unaware of their condition. This symptomless disease could leave them with substantial health consequences. Are you one of them? If you don't know, see a healthcare professional to be tested.

• Do your part to reach your treatment goals

Consider these statistics regarding those with known HBP:
-69.1 percent are under current treatment
-30.9 percent are not currently under treatment, even though they know their blood pressure is high

There is no healthy level of high blood pressure. Don't take life-or-death chances with this disease. Instead, take responsibility! Work with your healthcare professional to determine your treatment goals and map out your best action plan for HBP prevention and management.

•  Change your life and reduce your risks

Even if your blood pressure is normal (less than 120 mm Hg systolic AND less than 80 mm Hg diastolic) and your goal is prevention only, the lifestyle modifications provide a prescription for healthy living.

If your resting blood pressure falls in the pre-hypertension range (systolic - top- number between 120 and 139 mm Hg OR diastolic - bottom - number between 80 and 89 mm Hg), your doctor will recommend lifestyle modifications.

Lifestyle modifications are essential
These changes may reduce your blood pressure without the use of prescription medications.

• Take medication if it is prescribed for you

If your blood pressure is 140/90 or higher, your doctor will likely prescribe medication in addition to lifestyle modifications. Follow your healthcare professional's recommendations carefully, even if it means taking medication every day for the rest of your life. High blood pressure is a lifelong disease, and by partnering with your healthcare team, you can successfully reach your treatment goals and enjoy the benefits of better health.

Once your treatment program becomes routine, maintaining a lower blood pressure is easier. Remind yourself that by managing your blood pressure, you are lowering your risk of heart attack, hearat failure, stroke, peripheral artery disease and kidney disease. Death rates from these diseases have decreased significantly, thanks in part to earlier and better treatment of HBP.

Managing blood pressure is a lifelong commitment; make a pledge to do so starting today for yourself and for those you love. Listen to your doctor, read the sound medical information on this site, and act on the information to live a heart-healthier life. 

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Complications of High Blood Pressure

Complications of High Blood Pressure :

Hypertension places stress on several organs (called target organs), including the kidneys, eyes, and heart, causing them to deteriorate over time. High blood pressure contributes to 75% of all strokes and heart attacks.

Risk of complications or rapid progression of hypertension become more likely in the presence of other risk factors, including significant elevation of blood pressure, increasing age , smoking, abnormal cholesterol, family history of premature heart disease, obesity, diabetes, coronary artery disease, and other evidence of vascular disease.

Hypertension is a disorder characterized by chronically high blood pressure. It must be monitored, treated and controlled by medication, lifestyle changes, or a combination of both. There might be: 

1.Heart Complications

High blood pressure is a major risk factor for hypertensive heart disease, the leading cause of illness and death from high blood pressure. Hypertensive heart disease is a group of complications that include: 

  

Coronary Artery Disease. High blood pressure contributes to the thickening of the blood vessel walls, which can cause or worsen atherosclerosis (accumulated deposits of cholesterol in the blood vessels). The end result is coronary artery disease (CAD), also called ischemic heart disease, which increases the risk for angina (chest pain), heart attack, stroke, and death. High blood pressure is the most common risk factor for heart attack and stroke.

Heart Failure. High blood pressure increases the heart's workload. Over time, this can cause the heart muscle to thicken. As the heart pumps against elevated pressure in the blood vessels, the left ventricle becomes enlarged and the amount of blood pumped by the heart each minute (cardiac output) goes down, a condition called left ventricular hypertrophy (LVH). Without treatment, this can lead to heart failure.


Cardiac Arrythmias. High blood pressure increases the risk for cardiac arrhythmias (disturbances and irregularities in heartbeats). Arrhythmias include atrial fibrillation, premature ventricular contractions, and ventricular tachycardia.

2.Stroke
About two-thirds of people who suffer a first stroke have moderate elevated blood pressure (160/95 mm Hg or above). Hypertensive people have up to 10 times the normal risk of stroke, depending on the severity of the blood pressure in the presence of other risk factors. Hypertension is also an important cause of so-called silent cerebral infarcts, or blockages, in the blood vessels in the brain (mini-strokes) that may predict major stroke or progress to dementia over time. 

3.Diabetes and Kidney Disease

Diabetes. High blood pressure, and some of the medications used to treat it, can increase the risk for developing diabetes. There are strong biologic links between insulin resistance (with or without diabetes) and hypertension. It is unclear which condition causes the other.

People with diabetes or chronic kidney disease need to reduce their blood pressure to 130/80 mm Hg or lower to protect the heart and help prevent other complications common to both diseases. Up to 75% of cardiovascular problems in people with diabetes may be due to hypertension.

The United States Preventive Services Task Force recommends screening for type 2 diabetes in all patients with blood pressure higher than 135/80 mm Hg.

End-Stage Kidney Disease. High blood pressure causes 30% of all cases of end-stage kidney disease (medically referred to as end-stage renal disease, or ESRD). Only diabetes leads to more cases of kidney failure. Patients with diabetes and hypertension need to be monitored very closely for the development of kidney disease. 

 

4.Dementia

Isolated systolic hypertension may pose a particular risk for dementia (memory loss). 

5.Eye Damage

High blood pressure can injure the blood vessels in the eye's retina, causing a condition called retinopathy. 

 
6.Sexual Dysfunction

Sexual dysfunction is more common and more severe in men with hypertension and in smokers than it is in the general population. Although older drugs used to treat hypertension caused erectile dysfunction as a side effect, more recent evidence suggests that the disease process that causes hypertension is itself the major cause of erectile dysfunction. Oral phosphodiesterase type 5 (PDE5) inhibitors, such as sildenafil (Viagra), do not appear to pose a risk for most men who have both high blood pressure and erectile dysfunction. However, men who have uncontrolled or unstable hypertension should not take erectile dysfunction pills. Men who take nitrate medications for heart disease cannot take erectile dysfunction drugs. 

7.Pregnancy and High Blood Pressure

Many women who are likely to develop hypertension when they are older have their first elevated blood pressure readings during pregnancy. Elevated blood pressure readings generally show up early in pregnancy, before 16 - 20 weeks. (This condition is different than preeclampsia, described just below.) These women often require antihypertensive medications during pregnancy and closer monitoring of themselves and the fetus. Continued hypertension after the pregnancy is also not uncommon.

Severe, sudden high blood pressure in pregnant women is one component of a condition called preeclampsia (commonly called toxemia) that can be very serious for both mother and child. Preeclampsia occurs in up to 10% of all pregnancies, usually in the third trimester of a first pregnancy, and resolves immediately after delivery. Other symptoms and signs of preeclampsia include protein in the urine, severe headaches, and swollen ankles.

The reduced supply of blood to the placenta can cause low birth weight and eye or brain damage in the fetus. Severe cases of preeclampsia can cause kidney damage, convulsion, and coma in the mother and can be lethal to both mother and child. Women at risk for preeclampsia (particularly those with existing hypertension) are monitored carefully for its presence. Both mother and fetus are monitored closely after a diagnosis. Blood pressure medications may be required. Delivery is the main cure for preeclampsia. In severe cases, the obstetrician will need to induce pre-term birth.




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High Blood Pressure; Causes and Symptoms

What is High Blood pressure?

When your heart beats, it pumps blood round your body to give it the energy and oxygen it needs. As the blood moves, it pushes against the sides of the blood vessels. The strength of this pushing is your blood pressure. If your blood pressure is too high, it puts extra strain on your arteries (and your heart) and this may lead to heart attacks and strokes.

  Table of Categories  for Blood Pressure Measurement (mmHg)

Category	Systolic (top number)		Diastolic (bottom number)
Normal	Less than 120	And	Less than 80
Prehypertension	120–139	Or	80–89
High blood pressure
Stage 1	140–159	Or	90–99
Stage 2	160 or higher	Or	100 or higher

The ranges in the table apply to most adults (aged 18 and older) who don't have short-term serious illnesses.

What are the causes of high blood pressure?

1.Your Stressful Schedule
Chronic stress, like the kind you experience every day during your 9-to-5, can significantly increase your blood pressure.

2.Your Excess Baggage
Weight is one of the biggest contributors to high blood pressure. But then again, it differs from person to person. Some people can be extremely heavy and their blood pressure is normal, while others can gain just a little weight and their blood pressure goes through the roof.

3. Genes
Genetics certainly play a major role in your blood pressure, but that doesn’t mean one's fate is sealed if his old man had the condition. Even if someone have the genetic burden, he may be able to override it by leading an active lifestyle.

4.Your Lack of Exercise
Lack of activity doesn’t just contribute to your growing waistline—it greatly ups your risk for high blood pressure, too. 

Sign and Symptoms: Following are the common symptoms of high blood pressure.

1. Breathlessness
2. Headache
3. Bleeding from the nose (Also known as Epistaxis)
4. Fatigue and Sleepiness
5. Confusion
6. Tinnitus or ringing in the ears
7. Vomiting
8. Profuse sweating and
9. Blurred vision

Note :- Follow the ways of prevention and control to be safe from High Blood Pressure ! 

High Cholesterol: Causes, Symptoms and Prevention

What is cholesterol ?

Cholesterol is a waxy substance that's found in the fats (lipids) in your blood. While your body needs cholesterol to continue building healthy cells, having high cholesterol can increase your risk of heart disease. 
 

What may be the causes of cholesterol ?

Cholesterol is carried through your blood, attached to proteins. This combination of proteins and cholesterol is called a lipoprotein. There may be of different types of cholesterol, based on what type of cholesterol the lipoprotein carries. They are:
-Low-density lipoprotein (LDL). LDL, or "bad," cholesterol transports cholesterol particles throughout your body. LDL cholesterol builds up in the walls of your arteries, making them hard and narrow.
-Very-low-density lipoprotein (VLDL). This type of lipoprotein contains the most triglycerides, a type of fat, attached to the proteins in your blood. VLDL cholesterol makes LDL cholesterol larger in size, causing your blood vessels to narrow. If you're taking cholesterol-lowering medication but have a high VLDL level, you may need additional medication to lower your triglycerides.
-High-density lipoprotein (HDL). HDL, or "good," cholesterol picks up excess cholesterol and takes it back to your liver.

Sign and Symptoms of Cholesterol:

High cholesterol has no symptoms. A blood test is the only way to detect high cholesterol. Ask your doctor for a baseline cholesterol test at age 20 and then have your cholesterol retested at least every five years. If your test results aren't within desirable ranges, your doctor may recommend more frequent measurements. Your doctor may also suggest you have more frequent tests if you have a family history of high cholesterol, heart disease or other risk factors, such as smoking, diabetes or high blood pressure.

Test and Diagnosis:

A blood test to check cholesterol levels — called a lipid panel or lipid profile — typically reports:
-Total cholesterol
-LDL cholesterol
-HDL cholesterol
Triglycerides — a type of fat in the blood

For the most accurate measurements, don't eat or drink anything (other than water) for nine to 12 hours before the blood sample is taken.

Complication: High cholesterol can cause atherosclerosis, a dangerous accumulation of cholesterol and other deposits on the walls of your arteries. These deposits (plaques) can reduce blood flow through your arteries, which can cause complications, such as:

-Chest pain. If the arteries that supply your heart with blood (coronary arteries) are affected, you may have chest pain (angina) and other symptoms of coronary artery disease.

-Heart attack. If plaques tear or rupture, a blood clot may form at the plaque-rupture site — blocking the flow of blood or breaking free and plugging an artery downstream. If blood flow to part of your heart stops, you'll have a heart attack.

-Stroke. Similar to a heart attack, if blood flow to part of your brain is blocked by a blood clot, a stroke occurs.



Prevention and Control: Only heart-healthy lifestyle changes that can lower your cholesterol can help prevent you from having high cholesterol in the first place. To help prevent high cholesterol, you can:
-Lose extra pounds and maintain a healthy weight
-Quit smoking
-Eat a low-fat, low-salt diet that includes many fruits, vegetables and whole grains
-Exercise on most days of the week for at least 30 minutes
-Drink alcohol in moderation, if at all