The heart is a muscular organ that functions like a pump by moving blood through a fine, interconnected network of blood vessels. One set of blood vessels collect oxygen-rich blood from various parts of the body and gets it to the heart. It is then sent to all parts of the body through another separate channel of vessels.

The blood also transports various nutrients to the different body parts. Fat molecules or cholesterol is one of them. In fact, with changing diet patterns, there are more of fat molecules. They are heavier than the other particles, and so tend to settle down along the walls. This is known as plaque formation. This attracts more fat molecules to settle down and gradually forms a larger mass of fat cells. It also reduces the diameter of the vessel, thereby lowering the amount of blood that reaches the target organs.

Another effect it has is that it encourages the heart to exert extra pressure to push the blood through the vessels. There are simple ways to reduce blood pressure (BP), and some of these are listed below.

Eat healthy: Avoid processed and/or packaged foods. Increase the intake of fresh foods with lots of grains, vegetables, fruits, and dairy products. Include antioxidants like flaxseed, olive oil and omega-3 fatty acids to improve heart health. Avoid foods rich in calcium, sodium and magnesium. Increase consumption of potassium, which is good for heart.
Exercise regularly: Exercising has multiple benefits, and one of them is to improve heart health. It improves circulation, keeps the heart muscles active and strong and helps them pump blood better throughout the body.
Quit smoking: Smoking has severe effects on the overall health of an individual and heart health in particular. So quitting smoking can be hugely beneficial for the heart. It reduces the rate of plaque build-up and also helps in reversal.
Practise weight management: An increasing waistline is definitely not good for your heart, so watch your weight and keep your body mass index (BMI) in check. Watch what you eat, work out, and get your weight under control.
Follow stress management: The effect that stress has on our health cannot be underrated. Be it yoga, music, meditation, exercise or spending time with family/friends, choose what works best for you and learn to relax and manage stress.
Reduce alcohol consumption: More than two drinks per day can increase blood pressure significantly. So if you can t control, just quit.
Increased blood pressure is more rampant than what it was a few decades back. The age of onset is also reduced, with people in 30s now having hypertension. Making the above lifestyle changes can help lower your BP. Lifestyle diseases are now starting early in child hood. It is important to allow them to eat healthy food and physical activity. Smoking etc starts in school and need to be prohibited.

6 Simple Things That Can Help Lower Your Blood Pressure

Dialysis is a very important and life-saving procedure. It is performed to replace kidney function in case of renal failure. Wastes and extra fluids in the blood are filtered out during this process. To be able to perform Dialysis, the connection between the patient s bloodstream and the equipment for performing Dialysis (dialyzer) outside the body is established. This connection is created through Dialysis Access Surgery. It is a type of Vascular Surgery which forms the vascular opening for access during Dialysis. Thus, Dialysis Access Surgery is the lifeline for the survival of the patient.

Types of Vascular Access for Dialysis- 
There are three types of Vascular Access for Dialysis: Arteriovenous (AV) Fistula, Arteriovenous (AV) Graft, and Venous Catheter.

  Arteriovenous (AV) fistula is a surgical connection of an artery to a vein. An AV fistula is usually placed in the upper arm or in the forearm. It causes extra blood to flow into vein making it grow large. A larger vein hence provides easy access to blood vessels. An AV fistula is preferred over other methods as it lasts longer than other methods of access and provides a good flow of blood. Moreover, it is less prone to infection and blood clots than other methods. Before an AV Surgery, a Vessel Mapping Test is sometimes performed for assessing the blood vessels most suitable for Dialysis. An AV fistula is performed under local anaesthesia and requires two to three months for maturation before hemodialysis. If it fails to mature, the procedure is repeated.

  Arteriovenous (AV) graft is performed when AV fistula fails to mature. It is hence the second most preferred choice for long-lasting access to vascular tissues for Dialysis. An AV graft is a looped plastic tube which establishes a connection between an artery and a vein. Like AV fistula, AV graft is also performed under local anaesthesia. It is slightly more difficult to maintain than an AV fistula.

  A venous catheter is used for short- term hemodialysis. It is a tube which is inserted into chest, neck, leg, or near groin for vascular access. After exiting the body, the tube splits into two halves. In the case where a renal disease has made quick progression leaving little or no time for the AV fistula or AV graft to mature, a venous catheter is used to establish the required vascular connection. This procedure is also performed under local anaesthesia. It is a tool for emergencies but is not suited for long- term use. It can cause narrow vein due to an infection,
scarring, or blood clot. If long- term venous catheter is used, it is tunnelled under the skin which has fewer problems associated with it and is more comfortable. 

How to Care for a Vascular Access?
  Get checked for infections and other problems before each hemodialysis session;
  Use the operated site for access only for the intended use;
  Always keep the access clean;
  Prevent cutting or bumping the access;
  Check for thrill/ vibration in the access and inform the doctor if any;
  Do not put pressure on the access site;
  Do not put blood pressure cuff around the access arm;
  Do not wear jewellery or tight-fitting garments over the site;
  Do not lift a weight.

Take Away-
Vascular Surgery for Dialysis is performed to provide vascular access for the procedure. AV fistula is the most preferred type followed by an AV graft. A venous catheter is recommended to be used only in case of an emergency when there is not much time left for the other two options to mature.

Vascular Surgery - Can It Help For Dialysis?

Coronary artery disease is characterized by accumulation of plaque in the coronary artery that chokes blood supply to the heart. This plaque buildup usually starts with cholesterol accumulation and gradually other particles such as calcium and lipoproteins get deposited as well. Over time, the plaque accumulates, making the blood vessels narrow and choking the supply of blood. In some cases, if the plaque ruptures, it may lead to formation of blood clots resulting in stroke.

The symptoms of coronary artery disease are:

1. Breathing difficulties: This disorder may lead to shortness of breath as the blood pumping mechanism of the heart is impaired; this usually results in fatigue and exertion. It is advised to avoid advanced cardio exercises such as the high intensity interval training.

2. Chest pain: Stress related activities may cause intense pressure or tightness in your chest, resulting in pain in the middle or left portion of your chest. If you discontinue the activity, the pain would usually subside. In some cases, you may feel the pain in the arm and the neck.

3. Heart attack: If the level of plaque accumulation is excessive, then it may result in a heart attack. It is characterized by breathing difficulties, pain, tightness in the chest and sweating. You may also experience pain in the neck and the jaw.

The causes of coronary artery disease are:
1. Smoking and alcohol consumption
2. Leading a sedentary lifestyle ups the risk of coronary artery disease
3. Hypertension
4. High cholesterol levels in the body
5. Blood sugar problems

Treatment
1. Get your blood pressure under control: If you suffer from high blood pressure, then it is recommended to get it under control to prevent coronary artery disease.
2. Quit smoking: If you are a habitual smoker, then it is time to nip the habit in the bud. Smoking is known to constrict blood vessels as it is a vasoconstrictor.
3. Eat healthy: Eat a well balanced diet consisting of vegetables and fruits so that your body receives the essential nutrients to function well.
4. Beat stress: You need to control your stress levels through exercise or meditation. Take time off work and do activities that make you happy.

Coronary Artery Disease: Causes and Treatment

For a long time cholesterol in totality was seen as a bad thing for your body although the truth was a little more complicated than that. Cholesterol primarily is divided into two types, one of which can be categorized as bad cholesterol and the other as good cholesterol. Let's have an in-depth look at both the categories.

Ldl or low density lipoprotein aka bad cholesterol: cholesterol is a wax like chemical which is found all over the body and it has important functions to perform. Cholesterol is carried all over the body by lipoproteins. The low density lipoproteins are denoted as bad cholesterol as they can accumulate on the walls of the blood vessels and cause blockages resulting in many ailments. Ldl levels of 190 and above are considered dangerous. 

Some of the risks associated with it are:
1. Heart disease
2. Stroke
3. Atherosclerosis
4. Peripheral artery disease among many others

Hdl or high density lipoprotein aka good cholesterol - this is a form of cholesterol which is usually desired in higher quantities as it removes ldl from the system by dislodging it from the arteries and then carrying it through the bloodstream into the liver. The liver then breaks it down and removes it from the body. Thus, higher number of hdl cholesterol is always desirable. Some of the ideal numbers for hdl cholesterol within the body are:

For women - ideal: 60 mg/dl, dangerous: 50 mg/dl or lower
For men - ideal: 60 mg/dl, dangerous: 50 mg/dl lower

The role of triglycerides
Good and bad cholesterol levels also depend on the levels of triglycerides within the body and not just ldl or hdl cholesterol. Triglycerides are another type of fat which are used to store energy within the body, but can also affect your health. It is most associated with atherosclerosis when the levels of triglycerides are high within the body. 

Some habits that contribute to high levels of it are
A. Lack of physical activity
B. Obesity or being overweight
C. Excesses in alcohol consumption
D. Smoking
E. Bad diet and others

Thus the good cholesterol vs bad cholesterol war also includes other factors, most of which can be easily changed by making subtle changes in lifestyle and incorporating healthier habits. This will increase the good cholesterol and the other relevant elements and reduce the bad.

Good Cholesterol Vs Bad Cholesterol

Angioplasty is the procedure of opening a coronary artery blockage with the help of wire balloon and stent. This procedure is done to open the blocked coronary arteries if they are causing symptoms or acute heart attacks.

HOW IT IS DONE?

The procedure is usually done in local anaesthesia. A wrist artery (radial) or a groin artery (femoral) is used to gain access to the coronary artery as is done in angiography. A hollow tube called a catheter is passed upto heart artery and through this, a guidewire is passed across the blockage and over this wire balloon is passed and blockage dilated.

After this balloon is removed and the metallic stent is passed over this wire. The stent is then inflated and it takes its shape of the hollow tube so that the flow in the coronary artery is restored.

WHAT ARE INDICATIONS OF ANGIOPLASTY AND STENTING:

An acute Heart attack is the most definite indication of angioplasty and stenting. At the time of the heart attack, there is an urgent need to restore the blood flow of block coronary artery which is usually not possible with medicines alone. Angioplasty is the most effective and definite way of opening the artery urgently in such situation.

SHOULD ALL BLOCKAGES BE OPENED UP BY ANGIOPLASTY AND STENTING?

NO, all blockages do not warrant this procedure. There is some amount of risk involved in the angioplasty procedure itself. When the risk of blockage is considered more than the risk of opening the artery then the procedure is indicated. Patients who are doing good on medicines may be followed up without angioplasty.

All About Angioplasty!

Cholesterol is one of those terminologies that need a clear and fresh understanding, right from scratch. It is nothing but obvious and common for you to primarily know about the ill effects of cholesterol and what it does to your body; from increasing the risks of cardio-vascular diseases to adding to your waistline. However, it is time we all got a fresh perspective on what cholesterol is.

So, to start off, what is actually cholesterol?
It is waxy substance produced by the liver which plays an important role in the proper functioning of the cells, digestive process and synthesis of Vitamin D in the body. As cholesterol is a fat based substance that does not dissolve in blood, it is transported, throughout the body, by a protein called the  lipoprotein . The lipoproteins that carry cholesterol are of two types: Low-Density 

Lipoprotein (LDL) and High Density Lipoprotein (HDL)

Why is LDL  bad ?
LDL is known as  bad  cholesterol as it is responsible for plaque formation that reduces flexibility of the arteries and tends to clog them.

Why is HDL  good ?
HDL is known as the  good  cholesterol because it gets rid of excessive LDL from the arteries and transports them to the liver where they can be broken down. Too much of bad cholesterol in the body can lead to clogged arteries that may result in stroke or a heart attack. Now that you know that too much LDL cholesterol is bad for you, you need to keep it under control while raising the good cholesterol (HDL) levels. In order to do that, you need to make certain modifications in your lifestyle.

Some of them can be:

Eat foods that are good for the heart: Avoid eating saturated fats and trans-fats as they raise LDL levels in the body. Instead, choose foods that are rich in the heart healthy monounsaturated fats such as almonds and olive oil. Also, include foods that are rich in Omega-3 fatty acids such as fish oil; these fatty acids increase HDL levels in the blood.
Exercise regularly: Exercise not only helps you to lose calories but also increases the good cholesterol levels in the body. Aim for 20-30 minutes of cardiovascular exercises in the form of brisk walking, running or cycling to keep your heart muscles healthy.
Stop smoking: Smoking can cause the blood vessels to narrow down, thus increasing blood pressure, owing to the constriction of the blood vessels. Quit smoking right away and your ticker will thank you for it. Remember to limit alcohol consumption as well.
Maintain optimal weight levels: It s time to get rid of all the excess fat from the body, especially the visceral fat (abdominal fat). Obesity increases the risk of heart diseases and also has a negative effect on the cholesterol levels.

Cholesterol - Lifestyle Habits That Help Control it!

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