When a patient receives the lab results, they are most interested in whether their blood sugar or cholesterol levels are above or below the limit, and also in blood pressure measurements. Dr. Gábor Simonyi, head of the Department of internal and Lipidology Department of Ferenc Flór, Pest County Hospital, was asked about the target values. Who sets the limit values and how?Limit values for blood sugar, fats and blood pressure are established on the basis of recommendations from international and domestic professional associations. The recommendations shall be updated periodically on the basis of the results of the latest studies. In Hungary, the two-yearly consensus conferences are presented and the limits of the different fields are adopted.
What are the targets for blood pressure, blood sugar and cholesterol?
Blood pressure limits or targets also depend on diseases associated with high blood pressure. Generally, blood pressure below 140/90 mmHg should be sought. The goal is to maintain blood pressure below 130/80 mmHg in patients with diabetes or metabolic syndrome and cardiovascular disease. It is important to note that in coronary heart disease blood pressure should not be lowered below 120/70 mmHg. In diabetic patients, fasting blood glucose should not exceed 6 mmol/l and glucose levels should be 7,5 mmol/l after a meal. Patients with diabetes must achieve HbA1c below 7.0%, but nowadays, especially in elderly people and patients with a number of complications, a slightly higher level is allowed. The situation is a little more complicated from the point of view of blood fats because they provide a number of target values depending on the risk categories. At very high risk, the maximum levels are the highest, where total cholesterol below 3,5 mmol/l and LDL-cholesterol below 1,8 mmol/l are the recommended target values. At high risk the target is total cholesterol below 4.5 mmol/l and LDL cholesterol below 2,5 mmol/l, while in patients who have not yet developed cardiovascular disease (asymptomatic high risk condition) the limit is 5 mmol/l for total cholesterol and 3,0 mmol/l for LDL cholesterol. In addition, in the last two categories, triglycerides below 1,7 mmol/l and HDL-cholesterol values above 1,0 mmol/l (men) and 1,3 mmol/l (women) are desirable.
A lot of people think that a little higher value is not a problem. Why is persistently high value harmful?
The highest risk of persistent high blood pressure, blood sugar and fat levels is that for a long time there are virtually no symptoms. However, the abnormal values that have existed for many years have, unfortunately, been damaging from the very first moment. Later, they can cause a number of diseases (e.g. myocardial infarction, brain softening, lower limb vascular diseases, heart failure, kidney disease, plaque formation in different veins, blindness, atherosclerosis resulting in amputation, etc.) When diet and lifestyle changes are sufficient and when to take medication For example, in case of slightly elevated cholesterol or blood glucose levels, lifestyle changes should first be initiated, only after failure of these changes should be switched to medication. However, there are conditions (e.g. blood pressure > 180/110 mmHg or HbA1c > 8-8.5%) in which immediate medical treatment is required.What if someone’s values are too low? Is low blood pressure/blood sugar / cholesterol what to do?
Too low values can cause symptoms of blood pressure or blood sugar.
Low blood pressure may be associated with dizziness, headache, severe transient unconsciousness, and with low blood sugar levels, the body may start a series of warning signs: you may feel tortured hunger, heart palpitations, sweating, tremor. There is also nervousness and irritability. If the diabetic cannot eat carbohydrate food at this time, the symptoms may worsen. Headache, dizziness, loss of concentration and confusion. In severe conditions, convulsions and coma may occur. If someone experiences something like this, they should urgently seek help in the early stages of symptoms. In the case of blood fats, the opposite is the case, and the large studies have shown that the lower this value, the lower the risk of cardiovascular disease. We are also well aware that cholesterol levels are very low in natural people and in the case of newborns, and that, in essence, the effects of civilisation are the main reason for the current average values in the population, which are much higher than desired. What does too much abdominal circumference suggest? Does that have a goal? What are these?
Abdominal volume increases with body weight.
The abdominal type (Apple type) obesity is more dangerous in this respect than the iliac type (pear type). Because Apple-type obesity causes metabolic changes in the body that have a number of adverse effects later on. For men, the abdominal circumference above 102 cm is high and a moderate risk between 94 and 102 cm. In women, a value above 88 cm represents a high risk and a moderate risk is within the range of 80-88 cm. What intervals should the target values be checked? The different target values can often only be achieved by long treatment. There are patients who may need a variety of medicines to do this. Therefore, patients should show up for more checks and controls. The frequency of checks depends on the target values to be achieved and whether they have been achieved. The desired targets are beneficial in the long term and therefore it is important to keep them. Who checks or initiates the examinations of the general practitioner or specialist? Control is a multi-level task. The role of a general practitioner is very important, as patients first come to them with their health problems. In general, the general practitioner initiates the various tests, and it is often possible to achieve target values at this level. If this fails, you will refer the patient to the appropriate specialist. Long-term follow-up of the patient may require the cooperation of the general practitioner and specialist.