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Control your blood pressure, cholesterol and blood glucose

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Keeping your blood pressure, cholesterol and blood sugar levels down could cut obesity-related risk of heart disease and stroke by 50%, according to a new study.

Scientists studied information on 1.8 million people, which came from an analysis of 97 studies from around the world. Their work showed that high blood pressure, the levels of cholesterol in your blood, and blood glucose account for up to half of the increase in risk for heart disease, and three quarters of the increased risk of stroke among overweight or obese people.

High blood pressure presents the biggest risk of these three factors. On its own it accounts for 31% of the increased risk of heart disease, and 65% of the increased risk of stroke.

“This is a very good scientific paper and has looked at a huge number of studies,” says Professor Graham MacGregor, professor of cardiovascular medicine at Barts and the London Hospitals (CHECK sp), and Chair of Blood Pressure UK. “This isn’t a new message but there is now a lot more evidence for it than there was previously.”

“What this is showing is that most of the risk of being overweight is accounted for by the raised blood pressure, raised cholesterol, and blood sugar. So this is an important message for people who are overweight. Ideally, of course, the best thing to do is to lose weight, and that would help correct the risk. But as they acknowledge in the study, it’s very difficult for people to lose weight.”

“At the same time the research team stresses the importance of measures for the population. Even if you can’t stop people becoming obese, you must reduce salt intake, saturated fat and transfat intake. You also need to increase fruit and vegetable consumption and reduce refined carbohydrate consumption. It’s still important that we do all these things.”

Obesity is a growing problem for our health. An earlier study by this research team found that obesity has almost doubled globally since 1980. More than 1.4 billion adults aged 20 and over are overweight or obese. It’s well known that being overweight raises your risk of the two leading causes of death worldwide, heart disease and stroke. It also increases your risk of diabetes and some types of cancer. Past research by the same team estimated that every year 3.4 million deaths are caused by overweight and obesity.

“Our results show that the harmful effects of being overweight or obese on heart disease and stroke partly occur by increasing blood pressure, serum cholesterol and blood glucose. Therefore, if we control these risk factors, for example through better diagnosis and treatment of hypertension, we can prevent some of the harmful effects of being overweight or obese,” said senior author Goodarz Danaei, HSPH professor of global health.

“Large, long-term population studies like this one are a very powerful tool, allowing researchers to disentangle individual factors and understand how they each contribute to our risk of disease,” explains Professor Stephen Hill, Chair of the Medical Research Council’s Molecular and Cellular Medicine Board, which part-funded the work.

“It’s interesting that, even when blood pressure, blood sugar and cholesterol are brought under control, obese individuals are still at higher risk of heart attack and stroke. This suggests that other factors might be at play, which is likely to be of interest for future research into the consequences of obesity.”

The study was carried out by a worldwide research consortium, and is published in The Lancet. It was led by scientists from Harvard School of Public Health (HSPH), Imperial College London, and the University of Sydney.
About blood pressure

A normal, or ideal blood pressure is below 120 over 80 (120/80). At this level you have a much lower risk of heart disease or stroke. According to Blood Pressure UK, most adults in the UK have readings between 120/80 and 140/80. This isn’t classed as high blood pressure (also known as hypertension), but you should still try to bring it down, or at least, stop it rising any further.

Cholesterol

Cholesterol

If your blood pressure is 140/90 or more, with readings taken over a few weeks, then you probably do have high blood pressure. It is important to bring your blood pressure down, as high blood pressure puts extra strain on your heart and blood vessels. This increases your risk of heart attack or stroke. And as this study shows, reducing your blood pressure is one of the best ways to reduce this risk.

Talk to your GP, and see what they advise. They may prescribe medication to reduce your blood pressure. Your GP is also likely to suggest changes to your diet and lifestyle. For example, eating less salt and more fruit and vegetables helps to reduce your blood pressure. The same goes for losing weight (if you are overweight), drinking less alcohol, and being more active.


About cholesterol

We make cholesterol in our bodies (specifically, in the liver), and it’s vital for healthy cells. Your blood carries this waxy substance around your body. There is cholesterol in some of the food we eat, but you really need to watch out for the amount of saturated fat in your diet.

When cholesterol and protein combine, they are called lipoproteins. There are two types of lipoprotein, the ‘good’, HDL (high density lipoprotein), which helps to keep us healthy, and the ‘bad’, LDL (low density lipoprotein), which can clog up our arteries, leading to disease.

Some people inherit a condition called Familial Hypercholesterolaemia (or FH). This means you have very high levels of cholesterol, sometimes as much as four times the amount most people have.

If you have concerns about your cholesterol levels, talk to your GP. They may recommend a blood test. Treatment for high cholesterol levels includes medication. Statins are the most common, but you may be prescribed aspirin.

Eating a healthy diet, low in saturated fats may be the first approach your GP advices. This would include avoiding foods such as fatty meat and meat products, butter, lard and ghee, cream, iced cream and crème fraiche.

The Food Standards Agency states that the average man should have no more than 30g of saturated fat a day. The average woman should have no more than 20g of saturated fat a day.


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