nraonm - healthfair 2017 · colon cancer screening: colonoscopy at age 55 for normal risk . stool...
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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?