Health & Wellness

Folate and folic acid are forms of vitamin B9 used for deficiency and to prevent pregnancy complications. Many foods contain folate or have folic acid added.

Since 1998, folic acid has been added to cold cereals, flour, breads, pasta, bakery items, cookies, and crackers, as required by federal law. Foods that are naturally high in folate include leafy vegetables, okra, asparagus, certain fruits, beans, yeast, mushrooms, animal liver and kidney, orange juice, and tomato juice. Folic acid is also available as a supplement, and is often used in combination with other B vitamins.

Folic acid is used for preventing and treating low blood levels of folate (folate deficiency) and high blood levels of homocysteine (hyperhomocysteinemia). People who are pregnant or might become pregnant take folic acid to prevent serious birth defects such as spina bifida. Folic acid is also used for many other conditions including depression, stroke, decline in memory and thinking skills, and many others.

Uses & Effectiveness

Effective for

• Folate deficiency. Taking folic acid improves folate deficiency.

Likely Effective for

• High levels of homocysteine in the blood (hyperhomocysteinemia). This condition has been linked to heart disease and stroke. Taking folic acid by mouth lowers homocysteine levels in people with normal or high homocysteine levels and in people with kidney failure.
• Toxicity caused by the drug methotrexate. Taking folic acid by mouth seems to reduce nausea and vomiting from methotrexate treatment.
• Birth defects of the brain and spine (neural tube birth defects). Consuming folic acid 600-800 mcg by mouth daily during pregnancy reduces the risk of these birth defects. Folic acid can come from the diet or supplements. Some people who are at high risk should get 4000-5000 mcg daily.

Possibly Effective for

1. Decline in memory and thinking skills in older people. Taking folic acid by mouth, with or without other supplements, may improve memory and thinking skills in older people who have a larger decline in thinking skills than expected at that age. But it doesn't seem to work in older people who are experiencing the usual decline in thinking skills for their age.
2. Depression. Taking folic acid by mouth along with antidepressants seems to improve symptoms in some people with depression.
3. High blood pressure. Taking folic acid by mouth daily for at least 6 weeks reduces blood pressure in some people with high blood pressure who are not taking other blood pressure medications.
4. Gum enlargement caused by the drug phenytoin. Applying folic acid to the gums seems to prevent this issue. But taking folic acid by mouth doesn't seem to help.
5. Stroke. In areas of the world that don't add folic acid to grain products, taking folic acid supplements can reduce the risk of stroke. But supplements don't seem to be helpful for people who live in countries that do add folic acid to grain products.
6. A skin disorder that causes white patches to develop on the skin (vitiligo). Taking folic acid by mouth seems to improve symptoms of this condition.

Possibly Ineffective for

1. Low levels of healthy red blood cells (anemia) due to iron deficiency. Adding folic acid to an iron supplement does not help to treat anemia any better than taking an iron supplement alone.
2. Decline in memory and thinking skills that occurs normally with age. Taking folic acid by mouth doesn't seem to prevent a decline in mental function that occurs normally in healthy aging adults.
3. Cataracts. Taking folic acid by mouth with vitamin B6 and vitamin B12 does not prevent cataracts. In fact, it might increase the number of cataracts that need to be removed.
4. Diarrhea. Taking folic acid by mouth doesn't seem to prevent diarrhea in children who are at risk of malnutrition. In fact, it may even increase the risk of having diarrhea that lasts more than a few days.
5. Fall prevention. Taking folic acid by mouth with vitamin B12 does not seem to prevent falls in older people who are also taking vitamin D.
6. Male infertility. Taking folic acid by mouth, alone or with other ingredients, does not seem to improve male fertility.
7. Death of an unborn or premature baby. Taking folic acid by mouth during pregnancy does not seem to reduce the risk of a baby dying just before or after birth. But it does help prevent other health issues in the baby.
8. Cancer of the white blood cells (leukemia). Taking folate by mouth during pregnancy does not reduce the risk of this type of cancer in children.
9. Weak and brittle bones (osteoporosis). In elderly individuals with osteoporosis, taking folic acid by mouth with vitamin B12 and/or vitamin B6 does not seem to prevent broken bones.
10. Physical performance in elderly adults. Taking folic acid by mouth with vitamin B12 doesn't seem to help older people walk better or have stronger hands.
11. High blood pressure during pregnancy. High-dose folic acid supplements do not seem to reduce blood pressure during pregnancy, or the risk of developing a condition called pre-eclampsia.
12. Infection of the airways. Taking folic acid by mouth doesn't seem to prevent infections in the lungs in children at risk of malnutrition.

Reference:

• webmd.com/vitamins/ai/ingredientmono-1017/folic-acid

Anemia is a problem of not having enough healthy red blood cells or hemoglobin to carry oxygen to the body's tissues. Hemoglobin is a protein found in red cells that carries oxygen from the lungs to all other organs in the body. Having anemia can cause tiredness, weakness and shortness of breath.

Possible symptoms of anemia include:

• Tiredness.
• Weakness.
• Shortness of breath.
• Pale or yellowish skin, which might be more obvious on white skin than on Black or brown skin.
• Irregular heartbeat.
• Dizziness or lightheadedness.
• Chest pain.
• Cold hands and feet.
• Headaches.

There are many forms of anemia. Each has its own cause. Anemia can be short term or long term. It can range from mild to severe. Anemia can be a warning sign of serious illness.

Treatments for anemia might involve taking supplements or having medical procedures.

Eating a healthy diet might prevent some forms of anemia.

Types

1. Aplastic anemia
2. Iron deficiency anemia
3. Sickle cell anemia
4. Thalassemia
5. Vitamin deficiency anemia

Reference: mayoclinic.org/diseases-conditions/anemia/symptoms-causes/syc-20351360

Circulation problems signal that your blood isn’t flowing properly through your veins. The problem may be due to damage to the valves that control the blood flow within your veins. It may even be due to a plaque buildup that has caused a narrowing or partial blockage. These conditions reduce the amount of blood that flows in your veins.

While the sensation signals poor circulation, it may be a sign of a more serious medical condition, or it may be temporary, as from a sleeping position. Other symptoms associated with a lack of blood flow include:

• - Cold hands and feet even when it’s warm
• - Muscle pain and cramping when you exercise
• - Abdominal cramps, stomach pain, constipation or diarrhea
• - Brittle toenails caused by poor circulation in your feet
• - Hair loss on your feet or legs
• - Legs and feet that feel heavy
• - Pelvic pain or discomfort
• - Restless legs and feet
• - Numbness in your extremities
• - Swelling in your legs
• - Dizziness
• - Shortness of breath
• - Dry, itchy or blotchy skin
• - Change in skin tone or color
• - Headaches
• - Trouble remembering things
• - Erectile dysfunction
• - Lack of energy or concentration

Poor circulation is a serious condition and needs immediate medical attention. If you have any concerns with poor circulation in your feet contact one of our podiatrists of Instride Queen City Foot & Ankle Specialists. Our doctors will treat your foot and ankle needs.

Poor Circulation in the Feet

Poor blood circulation in the feet and legs is can be caused by peripheral artery disease (PAD), which is the result of a buildup of plaque in the arteries.

Plaque buildup or atherosclerosis results from excess calcium and cholesterol in the bloodstream. This can restrict the amount of blood which can flow through the arteries. Poor blood circulation in the feet and legs are sometimes caused by inflammation in the blood vessels, known as vasculitis.

Causes

Lack of oxygen and oxygen from poor blood circulation restricts muscle growth and development. It can also cause:

• Muscle pain, stiffness, or weakness
• Numbness or cramping in the legs
• Skin discoloration
• Slower nail & hair growth

Those who have diabetes or smoke are at greatest risk for poor circulation, as are those who are over 50. If you have poor circulation in the feet and legs it may be caused by PAD and is important to make changes to your lifestyle in order to reduce risk of getting a heart attack or stroke. Exercise and maintaining a healthy lifestyle will dramatically improve conditions.

Poor circulation in the hands may have different causes, including atherosclerosis and anemia. Poor blood flow in the hands can result in cold, numb, and painful fingers. Depending on the cause, other symptoms might also occur. eResearch by Navid Ajamin -- autumn 2023

Signs and symptoms of poor circulation in the hands include:

• Color: The fingernails appear pale or have a blue tint.
• Temperature: The fingers and hands feel cold to the touch.
• Swelling: The hands may swell and be painful.
• Numbness or tingling: The fingers might feel numb or have a tingling sensation.
• Blood refilling: Blood vessels may take longer to fill with blood. For example, after squeezing a finger, it may take longer than 3 seconds to refill with blood.
• Mobility: A person may have some difficulty moving the fingers.
• Pain: Severe pain in the hands and fingers may signal poor blood flow.

Other medical conditions linked to poor circulation include:

• Alopecia or hair loss, which may signal a lack of circulation to your scalp
• Arrhythmia, which is a heart condition
• Venous insufficiency
• Deep vein thrombosis
• A venous stasis ulcer
• Varicose veins or spider veins
• Raynaud’s disease

How to improve circulation at home

The best way to improve foot circulation is to treat any underlying conditions that may be causing it. If doctors cannot pinpoint a cause, however, several self-care strategies may help.

People can try:

• Any amount of walking is the number one recommendation for improving circulation: You can start small, taking short walks, even as little as five minutes daily. Studies indicate that even small increases in the amount of time you walk daily can have benefits.
• Move more: A 2020 study found that simple leg stretches can help improve vascular function after 12 weeks. The stretching regime made arteries less stiff, helping them dilate. If sitting for a long time, set reminders to get up and move around.
• Massage: Massaging the feet can stimulate circulation. People with Raynaud’s may also find it helps prevent or shorten attacks.
• Relaxation techniques: Breathing exercises, meditation, yoga, and tai chi can help manage unavoidable stress.
• Avoid caffeine, nicotine, and alcohol: Caffeine and alcohol can constrict blood vessels and exacerbate Raynaud’s.
• Wear compression socks: Compression socks apply pressure to the legs and feet, forcing blood to travel back toward the heart.
• Stay warm: If circulation problems worsen in cold conditions, keep the home at a comfortable temperature and wrap up in layers. Use hand or foot warmers when necessary.

Reference:

• astraveinvascular.com/circulation-problems
• henryford.com/blog/2020/10/how-to-boost-circulation
• queencityfootandankle.com/blog/symptoms-of-poor-circulation
• medicalnewstoday.com/articles/poor-circulation-in-hands#causes
• modernheartandvascular.com/improving-circulation-in-the-legs-naturally

The phrase “cold feet” doesn’t just refer to getting nervous before a big event like your wedding. Some people quite literally have cold feet, which either feel cold to them, cold to the touch, or both.

Many people will experience cold feet at some point in their lives.

Some causes are temporary and harmless, but others could indicate more serious health conditions.

What causes cold feet?

There are several different causes of cold feet. Sometimes, the simplest reason is a lack of warmth. If you’re in jeans and a t-shirt and your feet are bare, it makes sense that they may get cold first. However, there are other causes as well.

Poor circulation

This is one of the most common causes of cold feet. Poor circulation can make it difficult for enough warm blood to get to your feet regularly, keeping them cooler than the rest of your body.

Circulation problems can come as a result of a heart condition, where the heart struggles to pump blood through the body at a quick enough pace. Poor circulation can be the result of sitting too much from a sedentary lifestyle. If you sit at a desk all day for work, you may experience this. Smoking can also cause poor circulation.

Lack of iron in your diet. If you don’t consume and absorb enough iron, you may not have enough healthy red blood cells to transport oxygen around

Anemia

Anemia develops when you have a shortage of red blood cells. This is another common cause of cold feet, especially in severe cases of anemia. Iron-deficiency anemia can occur even in otherwise very healthy people. It can be treated relatively easily with changes in diet and by taking supplements.

Type 1 and type 2 diabetes

Diabetes can cause not only feet that are cold to the touch, but also feet that feel cold due to nerve damage. Other symptoms may include numbness or tingling in the feet. If you’re experiencing any symptoms of nerve damage in the feet, see your doctor, and take extra care to check them for cuts or injuries.

Hypothyroidism

This condition occurs when the thyroid is underactive and doesn’t produce enough thyroid hormone. This interferes with the body’s metabolism. Since metabolism controls both heartbeat and the body’s temperature, an underactive thyroid could contribute to reduced circulation and colder feet.

Other less common causes of cold feet include:

• peripheral vascular disease, or narrowing of the arteries due to plaques
• Raynaud’s phenomenon, where blood vessels spasm
• arteriosclerosis
• nerve damage from other causes

Vitamin B-12 deficiency

A vitamin B-12 deficiency can give you neurological symptoms including the feeling of cold hands and feet, numbness, or tingling.

Vitamin B-12 is found naturally in meat and dairy products, and is important for maintaining healthy red blood cells. Your body doesn’t make vitamin B-12, so you need to get it from the foods you eat.

Other symptoms of a vitamin B-12 deficiency include:

• fatigue
• movement and balance problems
• anemia
• pale skin
• shortness of breath
• mouth sores
• cognitive difficulties

What you can do

A blood test can indicate vitamin B-12 deficiency. Treatments can include your taking an oral supplement, receiving vitamin B-12 injections, and changes to your diet.

سردی پاها یکی از واکنش‌های طبیعی بدن به دمای پایین و هوای سرد است. وقتی بدن در یک محیط سرد قرار می‌گیرد، رگ‌های خونی درون "دوراندام‌هایی" از قبیل دست‌ها و پاها تنگ‌تر می‌شوند. این انقباض رگ‌ها باعث کاهش جریان خون به آن نواحی می‌شود که نتیجه‌ی آن کاهش میزان هدر رفت دمای بدن نیز است. بنابراین این اقدام یک اقدام ایمنی از سوی بدن است.

در توصیف "دوراندام" باید گفت: به بخش‌هایی از بدن گفته می‌شود که فاصله‌ی دورتری نسبت به ارگان‌های حیاتی بدن دارند. بنابراین کاهش جریان خون در دوراندام‌ها مثل پا و یا دست، به حفظ جریان خون و دما در ارگان‌های حیاتی و مهم‌تر کمک می‌کند.

البته این کاهش جریان خون اگر طولانی‌مدت شود، می‌تواند موجب کاهش اکسیژن در اندام مربوطه شود که شاید باعث تغییر رنگ آن عضو از بدن به رنگی متمایل به آبی شود. معمولاً این علائم در شرایط سرمای موقت، خطرناک نیستند و به‌محض افزایش دمای بدن دوباره به شرایط طبیعی بازمی‌گردند.

البته برخی افراد به سندروم رینود دچار هستند که در معرض سرما و یا استرس شدید قرار گرفتن،

موجب کاهش گردش خون بدن آن‌ها می‌شود و نتیجه آن تغییر رنگ، سرد شدن و یا بی‌حس شدن انگشتان دست یا پا است موضوعات مربوط به گردش خون نیز یکی از رایج‌ترین دلایل سردی پاها است. بدن افراد مبتلا به گردش خون ضعیف، همیشه در تلاش برای رساندن خون گرم کافی به دوراندام‌ها هستند و ممکن است مکرراً با سردی پاها و یا دست‌ها مواجه باشند.

سندرم رینود (Raynaud's Syndrome) یک اختلال عملکردی در سیستم گردش خون است که منجر به تنگی عروق خونی کوچک در نواحی انتهایی بدن، به‌ویژه انگشتان دست و پا، در واکنش به سرما یا استرس می‌شود. این واکنش باعث کاهش خون‌رسانی، تغییر رنگ پوست، درد، بی‌حسی یا سوزن‌سوزن شدن می‌گردد.

گردش خون ضعیف می‌تواند دلایل متفاوتی داشته باشد. داشتن سبک زندگی نشسته و نشستن‌های طولانی‌مدت می‌تواند منجر به کاهش گردش خون در پاها و حس سردی شود. همچنین استعمال مواد دخانی می‌تواند رسیدن خون به تمام نواحی بدن را با مشکلاتی مواجه کند. بنابراین احتمال سردی پاها در افرادی که مواد دخانی مصرف می‌کنند افزایش می‌یابد. کلسترول بالا می‌تواند باعث تشکیل پلاک‌ها در عروق خونی و متعاقباً منجر به کاهش گردش خون در بدن و پاها شود. این اتفاق نیز می‌تواند به احساس سردی پاها بیانجامد.برخی شرایط قلبی نیز ممکن است منجر به احساس سردی پاها شود بنابراین افرادی که دارای مشکلات قلبی هستند و یا در معرض بیماری‌ها و مشکلات قلبی قرار دارند و با سردی پا مواجه هستند بهتر است با پزشک خود در این زمینه صحبت کنند.

هنگام اضطراب، بدن هورمون آدرنالین را آزاد می کند. آدرنالین علاوه بر اینکه بدن را به حالت جنگ یا پرواز سوق می دهد، باعث می شود خون از قسمتهای کم اهمیت بدن مانند دست و پا برای محافظت از اندامهای اصلی شما دور شود. این ممکن است باعث احساس سرما در دست ها و پاهای شما شود.

بهترین گزینه برای درمان و پیشگیری از سردی پاها، مشورت با پزشک برای تشخیص عوامل و درمان مرتبط با مشکل است. البته برخی درمان‌های خانگی نیز برای سردی پاها وجود دارد که به بیان برخی از آن‌ها می‌پردازیم.

تحرک: یکی از ساده‌ترین راه‌ها بلند شدن و حرکت کردن است تا با این کار جریان خون به پاها افزایش یابد. افرادی که سردی پاهایشان ناشی از نشستن طولانی مدت است می‌توانند به راحتی با این روش پاهای خود را گرم کنند.

استفاده از جوراب یا پاپوش: استفاده از جوراب یا پاپوش در فضای داخلی می‌تواند یکی از راه‌های گرم کردن پا و جلوگیری از هدر رفتن حرارت پا به‌ویژه برای کسانی که در خانه خود فرش و یا سیستم گرمایش از کف ندارند باشد.

حمام پا: یکی از سریع‌ترین راه‌ها برای گرم کردن پاهای سرد این است که آن‌ها را داخل آب گرم بگذاریم. فرو بردن پاها در آب گرم به مدت ۱۰ الی ۱۵ دقیقه برای حفظ جریان خون گرم تازه برای پاها کافی به نظر می‌رسد. استفاده از این روش قبل از خواب به نظر بسیار مفید و کارآمد می‌آید و همچنین به کاهش تنش و آرامش عضلات نیز کمک می‌کند.

البته افرادی که دچار دیابت هستند و قند خون خود را به‌خوبی کنترل نمی‌کنند بهتر است از این روش استفاده نکنند چراکه ممکن است بی‌حسی در پاهای آن‌ها مانع حس دمای بالای آب و موجب سوختگی ناخواسته پاها شود.

پدهای گرم‌کننده و یا کیسه آب گرم: افرادی که به دلیل سردی پا نمی‌توانند بخوابند، می‌توانند از پدهای گرم‌کننده یا کیسه آب گرم در پایین تخت خواب خود استفاده کنند تا محیط گرمی به‌وسیله‌ی آن‌ها برای پای خود ایجاد کنند. از این روش برای تسکین درد عضلاتی که در طول روز فعالیت زیادی داشته‌اند نیز می‌توان استفاده کرد.

نکات اضافی برای رفع سردی پاها:

• هنگام نشستن روی صندلی اجازه ندهید که پاهایتان آویزان بماند.چهار پایه ای زیر پای خود بگذارید.
• فعالیت های هوازی مانند پیاده روی یا دوچرخه سواری را برای افزایش گردش خون مناسب و جلوگیری از سرد شدن پاها امتحان کنید.
• در فصول سرما جوراب های گرم و راحت بپوشید.
• اگر سیگاری هستید آن را ترک کنید زیرا ممکن است باعث ضعیف شدن گردش خون شود.
• به طور مداوم کلسترول ، فشار خون و قند خون خود را بررسی کنید.
• غذا های غنی از اسید های چرب امگا3 مانند ماهی سالمون، گردو، تخم کتان، دانه کدو تنبل را برای جلوگیری از عروق مسدود شده و گردش خون ضعیف مصرف کنید.
• از درمان هایی مانند یوگا و یا طب سوزنی نیز میتوانید استفاده کنید.
• شکلات تلخ سرشار از آنتی‌اکسیدان است که جریان خون را در دست ‌وپا افزایش می‌دهد.
• زنجبیل باعث افزایش گردش خون می شود و می تواند با سرما مبارزه کند. بعلاوه می تواند خطر لخته شدن خون را نیز کاهش دهد.

Reference:

• trevorlanepodiatry.com.au/what-can-cause-cold-feet
• healthline.com/health/cold-feet-and-hands#causes

Cortisol is a steroid hormone that regulates a wide range of processes throughout the body, including metabolism and the immune response. It also has a very important role in helping the body respond to stress.
As your body perceives stress, your adrenal glands make and release the hormone cortisol into your bloodstream. Often called the “stress hormone,” cortisol causes an increase in your heart rate and blood pressure. It's your natural “flight or fight” response that has kept humans alive for thousands of years.

Too much stress also can cause an irregular menstrual cycle and infertility in women, as well as a decreased libido in both men and women. Because stress also triggers mood swings and irritability, a hormone imbalance can lead to personal problems.

Normal levels of cortisol also are released when you wake up in the morning or exercise. These levels can help regulate your blood pressure and blood sugar levels and even strengthen your heart muscle. In small doses, the hormone can heighten memory, increase your immune system and lower sensitivity to pain.The danger of a fast-paced culture, however, is that many of us are constantly in high-stress mode. If your body experiences chronic stress, you may begin to feel unpleasant and even dangerous effects, such as:

• Fatigue
• Irritability
• Headaches
• Intestinal problems, such as constipation, bloating or diarrhea
• Anxiety or depression
• Weight gain
• Increased blood pressure
• Low libido, erectile dysfunction or problems with regular ovulation or menstrual periods
• Difficulty recovering from exercise
• Poor sleep

Cortisol is a steroid hormone, one of the glucocorticoids, made in the cortex of the adrenal glands and then released into the blood, which transports it all round the body. Almost every cell contains receptors for cortisol and so cortisol can have lots of different actions depending on which sort of cells it is acting upon.

These effects include controlling the body’s blood sugar levels and thus regulating metabolism, acting as an anti-inflammatory, influencing memory formation, controlling salt and water balance, influencing blood pressure and helping development of the foetus. In many species cortisol is also responsible for triggering the processes involved in giving birth.

Cortisol Production and Use by the Body

Think of cortisol as nature’s built-in alarm system. It’s your body’s main stress hormone. It works with certain parts of your brain to control your mood, motivation, and fear. eResearch by Navid Ajamin -- autumn 2020

Your adrenal glands -- triangle-shaped organs at the top of your kidneys -- make cortisol.

It’s best known for helping fuel your body’s “fight-or-flight” instinct in a crisis, but cortisol plays an important role in a number of things your body does. For example, it:

• Manages how your body uses carbohydrates, fats, and proteins
• Keeps inflammation down
• Regulates your blood pressure
• Increases your blood sugar (glucose)
• Controls your sleep/wake cycle
• Boosts energy so you can handle stress and restores balance afterward

How Does It Work?

Your hypothalamus and pituitary gland -- both located in your brain -- can sense if your blood contains the right level of cortisol. If the level is too low, your brain adjusts the amount of hormones it makes. Your adrenal glands pick up on these signals. Then, they fine-tune the amount of cortisol they release.

Cortisol receptors -- which are in most cells in your body -- receive and use the hormone in different ways. Your needs will differ from day to day. For instance, when your body is on high alert, cortisol can alter or shut down functions that get in the way. These might include your digestive or reproductive systems, your immune system, or even your growth processes.

Sometimes, your cortisol levels can get out of whack.

Cortisol level test: Purpose, procedure, and results

Too Much Stress

After the pressure or danger has passed, your cortisol level should calm down. Your heart, blood pressure, and other body systems will get back to normal.

But what if you’re under constant stress and the alarm button stays on?

It can derail your body’s most important functions. It can also lead to a number of health problems, including:

• Anxiety and depression
• Headaches
• Heart disease
• Memory and concentration problems
• Problems with digestion
• Trouble sleeping
• Weight gain

Too Much Cortisol

A nodule (mass) in your adrenal gland or a tumor in the brain’s pituitary gland can trigger your body to make too much cortisol. This can cause a condition called Cushing syndrome. It can lead to rapid weight gain, skin that bruises easily, muscle weakness, diabetes, and many other health problems.

Too Little Cortisol

If your body doesn’t make enough of this hormone, you have a condition doctors call Addison’s

disease. Usually, the symptoms appear over time. They include:

• Changes in your skin, like darkening on scars and in skin folds
• Being tired all the time
• Muscle weakness that grows worse
• Diarrhea, nausea, and vomiting
• Loss of appetite and weight
• Low blood pressure

If your body isn’t making enough cortisol, your doctor may prescribe dexamethasone, hydrocortisone, or prednisone tablets.

Ways to Manage Stress

Becoming aware of when and why you’re feeling stressed is the first step to addressing a stress-induced hormone imbalance. By learning how to stay calm during tense situations, you’ll be able to better control your reactions to external stimuli.

Some great ideas for reducing stress and eliminating a hormone imbalance include:

• Adopting a regular exercise routine
• Practicing daily meditation, mindfulness and/or deep breathing exercises
• Improving your sleep hygiene
• Minimizing your consumption of caffeine and alcohol
• Establishing and maintaining a healthy diet
• Evaluating and adjusting your work-life balance
• Seeking out emotional support from family and friends

Enlisting the help of a therapist, psychologist or other mental health professional also may help you better manage your stress and improve your health.

There is no dearth of indoor exercises that you can do from the comfort of your home like brisk walking, skipping, zumba, pilates or Yoga.(Pixabay)

- Cortisol increases the activity of the sebaceous glands, so we produce more oil which can cause infection and lead to breakouts, disrupt the natural skin barrier and the skin microbiome.

- Cortisol causes increased oil production in your skin glands, which can lead to clogged pores and acne breakouts. Chronic stress leads to constant increased levels of these hormones and can have a negative effect on your skin health.

- Too much cortisol can cause some of the hallmark signs of Cushing syndrome — a fatty hump between your shoulders, a rounded face, and pink or purple stretch marks on your skin. Cushing syndrome can also result in high blood pressure, bone loss and, on occasion, type 2 diabetes.

- Stress can increase the level of the hormone cortisol, increasing inflammation in your body, which can lead to hives, acne, eczema and hair loss among other symptoms.

Reference:

• yourhormones.info/hormones/cortisol
• webmd.com/a-to-z-guides/what-is-cortisol#1
• premierhealth.com/your-health/articles/women-wisdom-wellness-
• winniepalmerhospital.com/content-hub/can-stress-upset-my-hormones

See also:

• Low stress hormones linked to low sexual desire in women
• How Too Much Stress Can Cause Weight Gain

What are blood lipids?

"Blood Lipids" is the term used for all the fatty substances found in the blood, including cholesterol and triglycerides. Some people have too much cholesterol (fat) in their blood and this increases their chances of having a heart attack.

Hyperlipidemia (high cholesterol) is an excess of lipids or fats in your blood. This can increase your risk of heart attack and stroke because blood can't flow through your arteries easily. Adding exercise and healthy foods can lower your cholesterol. Some people need medication as well. Managing your cholesterol is a long-term effort.

What is dyslipidemia vs. hyperlipidemia?

They’re mostly interchangeable terms for abnormalities in cholesterol. Your cholesterol can be “dysfunctional” (cholesterol particles that are very inflammatory or an abnormal balance between bad and good cholesterol levels) without being high.

Both a high level of cholesterol and increased inflammation in “normal” cholesterol levels put you at increased risk for heart disease. Your providers may use both terms to refer to a problem with your cholesterol levels, and both mean that you should do something to bring the levels down.

What is cholesterol?

Cholesterol is a fatty substance which is mainly made in the body when the liver breaks down saturated fats in food. This cholesterol then passes into the blood.

Cholesterol travels in the bloodstream in two forms:

• 'Low Density Lipoprotiens' (LDLs) - this is often called 'bad cholesterol' as it helps to deliver cholesterol to the body through the bloodstream.
• 'High Density Lipoproteins' (HDLs) - this is often called 'good cholesterol' as it helps to take bad cholesterol out of the bloodstream from parts of the body.

What are triglycerides?

Triglycerides are another type of fat found in the blood which mainly come from food. After you eat, fats in your food are broken down in the liver into triglycerides. The liver can also convert excess calories (e.g. from drinking too much alcohol, sugar drinks, or eating too much fatty foods or meat) into triglycerides. These fatty triglycerides are released into your blood and are then transported through your body and used as energy or stored as fat.

Why are blood lipids a risk factor for Coronary Heart Disease?

Having high levels of fat in you blood can lead to fatty deposits in the blood vessels in the body, including the coronary arteries (the blood vessels which supply the heart muscle with blood). This leads to the narrowing or hardening of the coronary arteries. There is more information in the 'what is coronary heart disease (CHD)' section.

The goal is therefore to aim to have:

• low levels of total fat in your blood
• low levels of LDL cholesterol
• high levels of HDL cholesterol
• low levels of triglycerides

How are blood lipids measured?

Blood lipids (cholesterol and triglycerides) are measured by a simple blood test. Your nurse or Doctor will take a sample of your blood. If you are having your triglyceride levels measured, you will be asked not to eat anything, and to drink only clear water, for about 12 hours before your blood is taken.

Blood lipids (cholesterol and triglycerides) are measured in units called millimols per litre of blood, usually shortened to 'mmol/l'. Your target is to have:

• a total cholesterol level under 5mmol/l
• an LDL level under 3mol/l
• a HDL level above 1mmol/l
• a triglyceride level under 2mmol/l

This may all seem quite confusing - but don't worry. If you have had a heart attack or if you have angina, your GP or Practice Nurse should check your blood lipid level every year. If your total cholesterol is over 5mmol/l then you should be on cholesterol-lowering medication - usually a statin (e.g. Simvastatin, Atrovastatin) if you have angina or have had a heart attack. If you are not on these medicines, ask your doctor or nurse about them.

What can I do to help to lower my blood lipids?

There are many things that you can do to help lower the levels of fat in your blood:

• try to eat less fatty foods, especially foods with lots of saturated fat
• if you are overweight then losing a bit of weight can help lower your cholesterol. Try to loose at least a half to one lb (0.5kg) a week. This might not seem much but over a few weeks it will mount up.
• try to be a bit more active - this will also help you to lose weight
• take the correct medicines e.g. cholesterol lowering drugs (if your doctor thinks you need them).

The Living with heart disease section provides more information on healthy eating, physical activity . You could also ask your GP or Practice Nurse for more advice.

What causes cholesterol to get high?

Various hyperlipidemia causes include:

• Smoking.
• Drinking a lot of alcohol.
• Eating foods that have a lot of saturated fats or trans fats.
• Sitting too much instead of being active.
• Being stressed.
• Inheriting genes that make your cholesterol levels unhealthy.
• Being overweight.

Lipid Profile and Cholesterol Test

Lipid profile (also known as Lipid Panel or Coronary Risk Panel) is the type of screening that can assess the level of fats and fatty substances found in the blood. It measures the following parameters:

Total Cholesterol eResearch by Navid Ajamin -- summer 2020

This test measures all kinds of cholesterol in all lipoprotein surfaces: LDL, HDL, and VLDL.

Less than 200 mg/dL Desirable
200-239 mg/dL Borderline
240 mg/dL High

HDL level (good cholesterol)

HDL is considered a “scavenger” that cruises along the blood stream and removes bad cholesterol. Having a high HDL decreases the risk of developing heart diseases.

less than 40 mg/dL (1.04 mmol/L) Increased risk of heart disease
between 40 and 45 mg/dL (1.04-1.17 mmol/L) Borderline
greater than 45 mg/dL (1.17 mmol/L) Acceptable

LDL level (bad cholesterol)

LDL is usually founds as blobs of fats that adhere on the walls of the blood vessels, thereby constricting the normal flow of the blood. When this happens, it has a significant negative impact on the heart, which can lead to heart attack or stroke due to the formation of a blood clot.

Less than 100 mg/dL (2.59 mmol/L) Optimal
100-129 mg/dL (2.59-3.34 mmol/L) Near Optimal/Above Optimal
30-159 mg/dL (3.37-4.12 mmol/L) Borderline
160-189 mg/dL (4.15-4.90 mmol/L) High
Greater than 189 mg/dL (4.90 mmol/L) Very High

A level between 70-180 mg/dL is predominant among individuals aged 40-75 years old who have diabetes and are potential candidates for having a heart disease.

VLDL (very low-density lipoprotein)

This is a type of bad cholesterol that is responsible for the building up of cholesterol on the walls of the blood vessels.

Normal level is between 2 and 30 mg/dl.

Triglyceride level

Triglycerides are a type of fat that the body uses for storing energy. They are responsible for giving energy to the muscles. Having a high triglyceride level along with high LDL can increase the risk of developing a heart disease.

Less than 150 mg/dl Normal
150 to 199 mg/dl Borderline
200 to 499 mg/dl High
500 or more Very High

Ratio of total cholesterol to HDL

Determining the ratio allows the doctor to determine if the individual is at high risk of having a heart disease or not.

To calculate, divide the HDL value to the total cholesterol level. If the ratio is between 3.5 to 1, then it is at an optimal level. A higher ratio means a higher risk of heart disease.

Ratio of LDL to HDL

To calculate, subtract the LDL value to the HDL value. A value of less than 30 mg/dl is optimal, while any value greater than that increases the risk of heart disease.

Lipids are an integral part of cells responsible for keeping the body to work normally. They are found in blood and are stored in tissues. A healthy level of lipid should be maintained in staying healthy.

High cholesterol level is a lipid disorder that increases the risk of life-causing diseases, such as coronary artery disease, heart attack or stroke. Accordingly, as part of a regular health examination or evaluation, the doctor uses the results of the cholesterol test as a basis for preventing or diagnosing a medical condition.

Reference:

• my.clevelandclinic.org/health/diseases/21656-hyperlipidemia
• nhsggc.org.uk/your-health/health-services/hsd-patient-carers/heart-disease
• confirmbiosciences.com/knowledge/blog/industry-news-understanding-lipid-profile-cholesterol-test

According to the blood-type diet, there are 4 blood types:

• Type O - the oldest blood type
• Type A - agrarian
• Type B - nomadic
• Type AB - modern

Food Groups and Blood Type          eResearch by Navid Ajamin -- spring 2014

Type O should eat lean meat, poultry , fish, fruits and vegetables, limit grains and dairy, and exercise vigorously.

Type A should eat soy foods, grains, organic vegetables and do more gentle exercise.

Type B should eat dairy foods, meat, produce, corn or wheat and do moderate exercise. No beans.

Type AB should eat seafood, tofu, dairy, produce, limit chicken, beef, pork and do calming exercise.[1]

Type O blood: A high-protein diet heavy on lean meat, poultry, fish, and vegetables, and light on grains, beans, and dairy. D'Adamo also recommends various supplements to help with tummy troubles and other issues he says people with type O tend to have.

Type A blood: A meat-free diet based on fruits and vegetables, beans and legumes, and whole grains -- ideally, organic and fresh, because D'Adamo says people with type A blood have a sensitive immune system.

Type B blood: Avoid corn, wheat, buckwheat, lentils, tomatoes, peanuts, and sesame seeds.  Chicken is also problematic, D'Adamo says. He encourages eating green vegetables, eggs, certain meats, and low-fat dairy.

Type AB blood: Foods to focus on include tofu, seafood, dairy, and green vegetables. He says people with type AB blood tend to have low stomach acid. Avoid caffeine, alcohol, and smoked or cured meats.[2]

Reference:

1.doctoroz.com 2.webmd.com

Video: BLOOD TYPE DIET FOOD LISTS

Oncology (from the Ancient Greek onkos (ὄγκος), meaning bulk, mass, or tumor, and the suffix -logy (-λογία), meaning "study of") is a branch of medicine that deals with cancer. A medical professional who practices oncology is an oncologist. 

eResearch by Navid Ajamin -- summer 2013

Anemia goes undetermined in many people, and symptoms can be minor or vague. The signs and symptoms can be related to the underlying cause or the anemia itself.

Most commonly, people with anemia report feelings of weakness, or fatigue, generalmalaise, and sometimes poor concentration. They may also report dyspnea (shortness of breath) on exertion. In very severe anemia, the body may compensate for the lack of oxygen-carrying capability of the blood by increasing cardiac output. The patient may have symptoms related to this, such as palpitations, angina (if pre-existing heart disease is present), intermittent claudication of the legs, and symptoms of heart failure.

1. What causes anemia?

   There are more than 400 types of anemia, which are divided into three groups:

   • Anemia caused by blood loss
   • Anemia caused by decreased or faulty red blood cell ...

   read full answer on webmd.com

   The three main causes of anemia are:

   • Blood loss
   • Lack of red blood cell production
   • High rates of red blood cell destruction ...

   read full answer on nih.gov

   Anemia occurs when your blood doesn't have enough red blood cells. This can happen if:

   • Your body doesn't make enough red blood cells
   • Bleeding causes you to lose ...

   read full answer on mayoclinic.com

    

   آزمایش شمارش سلول‌های خون یا همان CBC چیست؟
   در این آزمایش انواع سلول‌های خون و تعداد آنها بررسی می‌شود. CBC می‌تواند برای کمک به تشخیص بیماری به کار رود یا به عنوان یک آزمایش غربالگری از جانب پزشک درخواست شود.
   
   چند نوع سلول در خون داریم؟
   سلول‌های قرمز خون (RBC): غذا و اکسیژن را در سراسر بدن حمل کرده و به بافت‌ها می‌رسانند و مواد زاید را از بافت‌ها می گیرد. سلول‌های قرمز خون حاوی هموگلوبولین (HBGG) هستند

    

   سلول‌های سفید خون (WBC): در برابر میکروب‌ها و عوامل بیماری‌زا از بدن دفاع می‌کنند. در پیشگیری و درمان بیماری‌ها نقش دارند. خود سلول‌های سفید خون، چندین نوع مختلف دارند.

   پلاکت‌ها (Platelets): در انعقاد و لخته شدن خون نقش دارند. کاهش تعدا پلاکت‌ها (ترومبوسیتوپنی) می‌تواند علل مختلفی داشته باشد. از علل ترومبوسیتوپنی می‌توان به موار زیر اشاره نمود:
   کاهش تولید پلاکت در برخی بیماری‌ها و بدخیمی‌ها (معمولاً در این موارد تعداد RBC و WBC نیز غیرطبیعی است)، عفونت‌های ویروسی مانند اوریون، سرخک، آبله‌مرغان،‌هپاتیت C، ایدز و ...، آنمی آپلاستیک، شیمی‌درمانی، مصرف برخی داروها، سرطان مغز استخوان مانند لوکمی یا لنفوما،‌ مصرف زیاد و طولانی‌مدت الکل، کمبود ویتامین B12 و اسیدفولیک، افزایش تخریب پلاکت‌ها مثلاً در بیماری ITP و TTP ، ...
    

   به جز تعداد سلول‌ها دیگر چه مواردی در آزمایش CBC مورد بررسی قرار می‌گیرند؟
   هموگلوبولین (HBG): هموگلوبولین همان ماده‌‌ای است که به گلبول‌های قرمز رنگ می‌دهد. هموگلوبولین اکسیژن را از ریه‌ها به بافت‌های بدن حمل می‌کند و دی‌اکسیدکربن را از بافت‌های بدن می گیرد و به ریه‌ها می‌آورد.
   
   هماتوکریت (HCT): هماتوکریت بیان کننده‌ی درصد سلول‌های قرمز خون نسبت به کل حجم خون است.
   
   MCV: بیان کننده‌ی اندازه‌ی متوسط (میانگین) سلول‌های قرمز است. وقتی MCVبیش از حد طبیعی باشد، یعنی سلول‌های قرمز خون از حدطبیعی بزرگتر هستند (مثلاً در کم‌خونی ناشی از کمبود ویتامین B12 یا اسیدفولیک) و وقتی MCV کمتر از حد طبیعی است یعنی به سلول‌های قرمز خون کوچک‌تر از حد طبیعی هستند (مثلاً در کم‌خونی ناشی از فقر آهن). در تالاسمی نیز MCV کاهش می‌یابد.
   
   MCH: نشان‌دهنده‌ی میزان هموگلوبین‌های حمل کننده‌ی اکسیژن در خون است. 
   
   MCHC: نشان‌دهنده‌ی غلظت هموگلوبولین در درون سلول‌های قرمز خون است. وقتی میزان MCHC پایین است،‌ یعنی غلظت هموگلوبولین در گلبوبول قرمز کاهش یافته است، برای مثال این مورد در کم خونی فقر آهن دیده  می‌شود.  

   میزان طبیعی موارد فوق چیست

   نرمال CBC گزارش
   نرمال		TEST	آزمایش
   40- 51درصد	مردان	HCT	هماتوکریت
   37- 46 درصد	زنان	HCT	هماتوکریت
   31- 43 درصد	کودکان	HCT	هماتوکریت
   13.2 - 16.5	مردان	HB	هموگلوبین
   12-15.2	زنان	HB	هموگلوبین
   11-14.3	کودکان	HB	هموگلوبین
   4.3 - 6.2میلیون	مردان	RBC	شمارش گویچه های قرمز
   3.8- 5.5میلیون	زنان	RBC	شمارش گویچه های قرمز
   3.7- 5.3 میلیون	کودکان	RBC	شمارش گویچه های قرمز
   هزار 10 - 4.1	-	WBC	شمارش گلبولهای سفید خون
   N=50 -70 L=25- 40 M =3 - 8 E =1- 4 B =0-1	بزرگسالان	D.WBC	شمارش افتراقی گویچه ای سفید
   هزار 450 - 140		PLT	شمارش پلاکت ها
   82 - 102	مردان	MCV	میانگین حجم یک گویچه قرمز
   78 -101	زنان	MCV	میانگین حجم یک گویچه قرمز
   27- 31	-	MCH	غلظت هموگلوبین یک گویچه قرمز
   31- 35	-	MCHC	میانگین هموگلوبین یک گویچه قرمز
   11.5-14درصد	-	RDW	گستره تغییرات اندازه گویچه های قرمزآنیزوسیتوز

    

    

    بیماری‌ها چه اثراتی بر آزمایش خون دارند؟
   بیماری‌های مختلف می‌توانند بر شکل، تعداد و عملکرد سلول‌‌های خونی اثر بگذارند. در جدول‌های زیر به برخی علل این تغییرات اشاره می‌کنیم.
   
   دلایل کاهش تعداد سلول‌های قرمز خون
   - از دست دادن خون
   - کم‌خونی
   - خونریزی
   - اختلالات مغز استخوان (برای مثال، آسیب حین پرتودرمانی، سموم، فیبروز، تومور)
   - کاهش هورمون اریتروپوئیتین به علت مشکلات کلیوی
   - همولیز (تخریب گلبول‌های قرمز)
   - لوکمی (نوعی سرطان خون)
   - مولتیپل میلوما (نوعی سرطان خون)
   - بالا بودن میزان آب بدن
   
   دلایل افزایش سلول‌های قرمز خون
   - کاهش فشار اکسیژن در خون
   - بیماری‌های مادرزادی قلب
   - فیبروز ریوی
   - پلی‌سیتمیِ وِرا
   - کاهش آب بدن
   - بیماری‌های کلیوی همراه با افزایش هورمون اریتروپوئیتین
   - کورپولمونل (بیماری‌های قلبی ـ ریوی)
   
   دلایل کاهش تعداد سلول‌های سفید خون
   - اختلالات مغز استخوان (مثلاً بر اثر وجود تومور و بدخیمی یا فیبروز)
   - وجود موادی که اثر سمی بر سلول‌ها دارند (سایتو‌توکسیک‌ها)
   - بیماری‌های کلاژن ـ عروقی (مانند لوپوس)
   - بیماری‌های کبد یا طحال
   - قرار گرفتن در معرض پرتوها
   
   دلایل افزایش سلول‌های سفید خون
   - بیماری‌های عفونی
   - بیماری‌های التهابی
   - لوکمی (نوعی سرطان خون)
   - فشار‌های شدید روحی ـ روانی
   - تخریب بافتی (مثلاً در سوختگی‌ها)
   
   دلایل کاهش میزان هماتوکریت (HCT)
   - انواع کم‌خونـــــی 
   - از دست دادن خون
   - آسیب و اختلال در مغز استخوان
   - لوکمی
   - همولیز (تخریب سلول‌های قرمز خون)
   - تغذیه‌ی نامناسب یا کمبد برخی مواد غذایی مشخص
   - مولتیپل میلوما
   - افزایش آب بدن
   - رماتیسم مفصلی
   
   دلایل افزایش هماتوکریت (HCT)
   - کم آبی بدن
   - سوختگی‌ها

   - اسهال
   - اکلامپسی
   - پلی‌سیتمی‌ورا
   - شوک

Reference:

• wikipedia.org/wiki/Anemia
• wikipedia.org/wiki/Oncology

See Also:

• Iron-deficiency Anemia What Causes Anemia?

• Diagnosing Anemia in Children

• the importance of anemia diagnosis and treatment -- google search

اندازه گیری فشار خون: در سال ۱۹۰۵ Korotkoff روش سمعی اندازه گیری فشارخون را ارائه نمود.

Nikolai Sergeyevich Korotkov (also romanized Korotkoff; Russian: Никола́й Серге́евич Коротко́в) (26 February [O.S. 14 February] 1874 – 14 March 1920) was a Russian Empire surgeon, a pioneer of 20th-century vascular surgery, and the inventor of auscultatory technique for blood pressure measurement.

What is Korotkoff blood pressure?

Korotkoff sounds are produced underneath the distal half of the blood pressure cuff. The sounds appear when cuff pressures are between systolic and diastolic blood pressure, because the underlying artery is collapsing completely and then reopening with each heartbeat. eResearch by Navid Ajamin -- summer 2012

تعریف فشار خون: عبارت است از فشاری که از طرف جدار بطن چپ به خون وارد می شود و این جریان خون فشاری بر دیواره رگ ها وارد می کند که در اصطلاح فشار خون می گویند. فشار خون از دو جزء اساسی فشارخون سیستولیک و فشار خون دیاستولیک تشکیل می شود.

What is high blood pressure

There are 3 levels of hypertension:

• mild – blood pressure between 140/90 and 149/99mmHg (millimetres of mercury); may be checked regularly but does not usually need treatment
• moderate – blood pressure between 150/100 and 159/109mmHg
• severe – blood pressure of 160/110mmHg or higher

  

You might be more at risk if you:

1. are overweight
2. eat too much salt and do not eat enough fruit and vegetables
3. do not do enough exercise
4. drink too much alcohol or coffee (or other caffeine-based drinks)
5. smoke
6. do not get much sleep or have disturbed sleep
7. are over 65
8. have a relative with high blood pressure
9. are of black African or black Caribbean descent
10. live in a deprived area

Making healthy lifestyle changes can sometimes help reduce your chances of getting high blood pressure and help lower your blood pressure if it's already high.

What is considered high blood pressure?

Definitions of high blood pressure vary slightly depending on where you live.

In the U.S., healthcare providers define high blood pressure (hypertension) as:

• A top number (systolic blood pressure) of at least 130 mmHg, and/or
• A bottom number (diastolic blood pressure) of at least 80 mmHg.

In Europe, healthcare providers define hypertension as:

• A top number of at least 140 mmHg, and/or
• A bottom number of at least 90 mmHg.

In about 1 in 20 cases, high blood pressure happens as the result of an underlying health condition or taking a certain medicine.

Health conditions that can cause high blood pressure include:

1. kidney disease
2. diabetes
3. long-term kidney infections
4. obstructive sleep apnoea – where the walls of the throat relax and narrow during sleep, interrupting normal breathing
5. glomerulonephritis – damage to the tiny filters inside the kidneys
6. narrowing of the arteries supplying the kidneys
7. hormone problems – such as an underactive thyroid, an overactive thyroid, Cushing's syndrome, acromegaly, increased levels of the hormone aldosterone (hyperaldosteronism), and phaeochromocytoma
8. lupus – a condition in which the immune system attacks parts of the body, such as the skin, joints and organs
9. scleroderma – a condition that causes thickened skin, and sometimes problems with organs and blood vessels

Medicines that can increase your blood pressure include:

1. the contraceptive pill
2. steroids
3. non-steroidal anti-inflammatory drugs (NSAIDs) – such as ibuprofen and naproxen
4. some pharmacy cough and cold remedies
5. some herbal remedies – particularly those containing liquorice
6. some recreational drugs – such as cocaine and amphetamines
7. some selective serotonin-noradrenaline reuptake inhibitor (SSNRI) antidepressants – such as venlafaxine

In these cases, your blood pressure may return to normal once you stop taking the medicine or drug.

How can I lower my blood pressure quickly during pregnancy?

Walking is the most accessible cardiovascular exercise for women during pregnancy. If you are wondering how to lower diastolic blood pressure fast, know that walking briskly for up to 45 minutes each day can achieve this.

فشارخون سیتولیک: به حداکثر فشار ایجاد شده از طرف قلب گویند که بر دیواره آئورت وارد می آید و چون گرفتن آئورت دشوار بوده و با توجه به اینکه فشار در امتداد یک سطح یکسان است فشار را در سطح آئورت و در ناحیه بازو اندازه گیری می کنند.سیستول (به انگلیسی: Systole ) به فرایند انقباض قلب گفته می‌شود. این اصطلاح درحقیقت مربوط به انقباض بطن چپ می‌باشد. در جریان سیستول٬ لایهٔ ماهیچه قلب (میوکارد) بر اثر دریافت پیام‌های الکتریکی سامانهٔ عصبی خودگردان٬ پاسخ خود را به شکل انقباض بیان می‌کند. به حالت انبساط قلب، دیاستول گفته می‌شود.

فشار خون دیاستولیک: به حداقل فشار ایجاد شده از طرف قلب به دیواره آئورت را گویند که این حالت در زمان استراحت قلب ایجاد می شود.بنابراین فشار سیستولیک حداکثر فشار وارد ه بر عروق و فشار دیاستولیک حداقل فشار وارده بر عروق محسوب شده و به صورت کسر بیان می گردد، مثل ۱۲۰ بر روی ۷۵ (۱۲۰/۷۵) میلی متر جیوه.

فشار خون به کمک دستگاه فشارسنج (Sphygomanometer) و گوشی پزشکی (Stetehescope) انجام می گیرد. دستگاه فشارسنج خود به سه اندازه بزرگ، متوسط و کوچک تقسیم می گردد که بزرگ برای افراد چاق و متوسط برای استفاده عموم و کوچک برای کودکان استفاده می گردد.

دستگاه فشار سنج خود از عملکرد به سه نوع دیجیتالی، جیوه ای و عقربه ای تقسیم می شوند:

1. کار با دستگاه فشار سنج دیجیتالی راحت بوده و معمولاً نیازی به گوشی پزشکی جهت گرفتن فشار ندارد. این خود به دو نوع مچی و بازویی تقسیم شده که معمولاً بازویی آن مطمئن تر می باشد.
2. دستگاه فشارسنج جیوه ای فشار خون را بر روی ستون جیوه نمایش می دهد و یکی از بهترین وسایل اندازه گیری فشار خون به حساب می آید. تنها مشکل این دستگاه بزرگ بودن آن است.
3. دستگاه فشار سنج عقربه ای که فشار خون را بر روی ستون درجه عقربه ای که متصل به یک فنر است می سنجد. قیمت پایین و راحتی در حمل از ویژگی های این دستگاه است ولی باید مرتب از نظر دقت چک گردد.

   

روش اندازه گیری فشارخون: بازوبند فشارسنج را به دور بازوی راست بیمار ببندید (در مورد بیشتر موارد بستن بازوبند فشارسنج را دور بازوی راست بیمار پیشنهاد می کنند. در صورتی که دور بازوری سمت چپ بیمار می بندید به یاد داشته باشید که ۵ میلی متر جیوه نسبت به سمت راست بیشتر نشان خواهد داد)، به نحوی که قسمت قابل اتساع کاف در سطح قدامی داخلی بازوقرار بگیرد و لبه پایینی کاف نیز۲ سانتی متر از چین آرنج فاصله داشته باشد. کاف فشار سنج نباید خیلی سفت یا خیلی شل بسته شود.با دست راست خودساعد بیمار را نگهدارید یا آنرا روی میر مناسبی بگذارید. گوشی را در حفره جلوی آرنج بگذارید و فشار بدهید و کیسه را آنقدر باد کنید تا نبض از بین برود (معمولاً تا ۲۰۰ میلی متر جیوه). سپس به آهستگی فشار را کم کنید، بتدریج که سطح جیوه پایین می آید، به آن نقطه ای که ضربانات قابل سمع می گردند، توجه کنید: این همان فشار سیستولی است. با ادامه پائین آمدن سطح جیوه، صدای ضربانات بلندتر می شود، سپس بتدریج کاهش می یابد، تا مرحله ای که شدت آن به ناگهان کاهش واضحی پیدا می کند، ضربانات ضعیف چند لحظه ای دیگر به گوش می رسد و سپس بکلی ناپدید می شود. این همان فشار دیاستولی است (نقطه ناپدید شدن صدا). فشار خون بازوی چپ را نیز به همین طریق اندازه می گیرند.

مراحل فشار خون Blood pressure stages

• در بعضی از بیماران فشار خون دیاستولی به ظاهر قابل اندازه گیری نمی باشد، پر واضح است بیماری که فشار خون سیستولیک دارد حتماً فشار خون دیاستولیک نیز خواهد داشت. این اشتباه ناشی از این است که که در هنگام تعیین فشار خون دیاستولی، به نقطه ای که شدت صدا به ناگهان تغییر می کند، توجه ای نمی شود. این حالت در بیماران مبتلا به نارسائی آئورت، و هیپرتیروئیدی و در موارد نادر در افراد سالم نیز دیده می شود.
• معمولاً بین فشار خون سیستولی که با دو روش سمعی و لمسی گرفته می شود. اختلاف جزئی وجود دارد در این حال ملاک فشار خون، فشاری است که لمس می شود نه شنیده می شود.
• در موارد نادری که فشارسنج ۲۰۰ میلی متر جیوه را نشان می دهد، می توان نبض را لمس کرد ولی در همین زمان صدائی به گوش نمی رسد، مگر اینکه سطح جیوه فشار سنج به ۱۶۰ تا ۱۷۰ میلی متر جیوه سقوط کند. در این حال فشار خون بیمار ۲۰۰ میلی متر جیوه است نه ۱۶۰ یا ۱۷۰ میلی متر جیوه.
• برعکس این حالت نیر ممکن است پیش آید یعنی گاهی در ۲۰۰ میلی متر جیوه صداهای نبض به گوش می رسد ولی نبض لمس نمی شود مگر آنکه فشار به ۱۶۰ میلی متر جیوه سقوط کند در این حال ملاک فشار خون لمس شده می باشد.
• چون امکان اشتباه در اندازه گیری فشار خون سیستولی در روش سمعی بیشتر است، روش لمسی از این نظر معتبرتر می باشد، ولی تسلط بر این روش تمرین بیشتری لازم است. راه صحیح آن است که هر دو روش را بکار ببریم و در موارد اختلاف یافته های لمسی را معتبرتر بدانیم.

در موراد زیر در اندازه گیری فشارخون با روش سمعی اشتباه بوجود می آید:

1. آویزان بودن دست
2. باد کردن آهسته بازوبند
3. بادکردن مجدد بازوبند بدون آنکه کاملاً خالی شده باشد

There are instances in which the BP-measurement accuracy is affected by patients’ habits or behaviors.

Acute meal ingestion, caffeine or nicotine use can all affect BP(Blood Pressure) readings, leading to errors in measurement accuracy. If the patient has a full bladder, that can lead to an error in systolic BP of up to 33 mm Hg, and the white-coat effect can have an error of up to 26 mm Hg.

It is important for the patient to rest comfortably in a quiet environment for five minutes in a chair. The patient should also have an empty bladder and not have eaten, ingested caffeine, smoked or engaged in physical activity at least 30 minutes before the measurement.

Inaccuracies in BP measurement can also occur due to errors related to the procedure. For example, having the patient’s arm lower than heart level can lead to an error of 4 mm Hg up to 23 mm Hg. Procedure related error might also occur if the patient’s legs are crossed at the knees or if talking occurs during BP measurement. A fast cuff deflation rate also can contribute to inaccuracy.

Your systolic and diastolic pressures change depending on your activity level, stress, fluid intake, and other factors.

It's important to limit how these other factors might change your pressure when you're taking a blood pressure reading.

For the most accurate reading, follow these steps when checking your blood pressure:

• Rest quietly for at least five minutes.
• Sit in a calm, warm space.
• Relax, with your arms at your sides, and the cuff at about the level of your heart.
• Keep your legs uncrossed.
• Your bladder should be empty.

Reference:

• bupa.co.uk
• elmcroft.com
• rokhshad.com
• fa.wikipedia.org/wiki
• nhs.uk/conditions/high-blood-pressure-hypertension/causes
• verywellhealth.com/systolic-and-diastolic-blood-pressure-1746075
• nhs.uk/pregnancy/related-conditions/complications/high-blood-pressure
• my.clevelandclinic.org/health/diseases/4314-hypertension-high-blood-pressure
• ama-assn.org/delivering-care/hypertension/4-big-ways-bp-measurement-goes-wrong-and-how-tackle-them
• toplinemd.com/trogolo-obstetrics-and-gynecology/pregnancy-hypertension-how-to-lower-blood-pressure-naturally

See also:

• Intro to Blood Pressure
• Understanding Blood Pressure (BP) Readings
• Blood Pressure in Infants, Children and Adolescents