Goal oriented medicine
What are the results (biophysical measurements & laboratory results) everyone should strive to achieve?
- Blood Pressure: Maintain Blood Pressure readings between 110-135 / 60-85
- Heart Rate: Maintain Heart Rate between 50 to 100
- Body Mass Index: BMI equal to or less than 26
- Glucose (blood sugar readings): Before meal readings of 80-120 / 2 hours after meal readings of less than 200
- HgbA1C: Measurement of long term (one to three months of glucose control) readings of less than 8.0
Lipid Profile
Cholesterol Less than 200mg/dl if no Cardiac/Coronary Heart Disease Risk Factors
Cholesterol Less than 180mg/dl if Cardiac/Coronary Heart Disease Risk Factors or Disease present or in personal past
LDL Cholesterol Less than 130mg/dl if no Cardiac/Coronary Heart Disease Risk Factors
LDL Cholesterol Less than 100mg/dl if Cardiac/Coronary Heart Disease Risk Factors or Disease present or in personal past
Triglycerides Less than 130mg/dl if no Cardiac/Coronary Heart Disease Risk Factors
Triglycerides Less than 100mg/dl if Cardiac/Coronary Heart Disease Risk Factors or Disease present or in personal past
HDL Cholesterol Greater than 45mg/dl if no Cardiac/Coronary Heart Disease Risk Factors and male
HDL Cholesterol Greater than 50mg/dl if no Cardiac/Coronary Heart Disease Risk Factors and female
Homocysteine Levels and Lipoprotein (a)
Homocysteine levels should be less than 8. If levels are > 12 should consider this a High Risk Factor for coronary artery disease and should seek to have Lipids at lower goal levels. Cholesterol < 180, LDL < 100, HDL > 45 (Men), > 50 (Women), with Triglycerides < 100.
Elevated Homocysteine levels get treated with Folic Acid in doses of 1-3mg per day, and additional B-Complex Vitamins, primarily B1, B6 and B12.
Lipoprotein (a) levels should be less than 30. If levels are > 30, this should be considered as an indicator for High Risk for coronary artery disease and cerebrovascular disease.
This also puts you at high risk for Heart Attacks (Myocardial Infarction) and Strokes (Cerebrovascular Accident, CVA). Should therefore seek to have Lipids at lower goal levels. Cholesterol in the 140-160 range, LDL in the 60-80 range, HDL > 45 (Men), HDL > 50 (Women) > 50, with Triglycerides in the 50-80 range.
