Health & Family

Get tested for diabetes if you have hypertension

Do you have high blood pressure, also known as hypertension? If so, you should be tested for diabetes.

That recommendation comes from the U.S. Preventive Services Task Force, an independent panel of experts. It reviews the evidence for prevention strategies like testing for diabetes or taking aspirin. The task force's recommendations usually become guidelines for primary care doctors and some specialists.

High blood pressure and diabetes often travel together. Treating them simultaneously is a win-win approach. Among people with diabetes, controlling blood pressure cuts in half the chances of having a heart attack or stroke or dying of heart disease. Among people with high blood pressure, controlling blood sugar reduces the chances of losing vision, losing feeling in the fingers or feet, losing a limb, and suffering kidney damage.

The diabetes test endorsed by the American Diabetes Association is the fasting blood sugar test. It involves having a small sample of blood drawn first thing in the morning before you have had anything to eat or drink. If your blood sugar is 126 milligrams per deciliter (mg/dL) or higher, and it's confirmed by a second test a few days later, you have diabetes. Some doctors check for diabetes by testing your blood sugar two hours after you drink a sugary beverage or by testing for the percentage of sugar-coated hemoglobin in the bloodstream (known as hemoglobin A1c).

Warfarin booklet

The blood thinner warfarin (Coumadin) can be a tricky medication to take. A new 20-page booklet from the federal Agency for Healthcare Research and Quality offers tips on what to expect, what to watch out for, and ways to stay safe while taking warfarin. You can get a free copy of “Your Guide to Coumadin/Warfarin Therapy” at www.health.harvard.edu/127 or by calling 800-358-9295.

Vitamins and air pollution

Sitting in traffic puts a strain on the heart. Living near it is even worse. In a new study of people with heart failure, those whose homes were close to a major roadway were more likely to have died over a five-year period than those who lived away from traffic.

In studies like this, it's hard to point the finger at any single culprit. Exhaust spewing from the tailpipes of cars, trucks and buses almost certainly plays an important role. It carries particles small enough to evade the lung's filters and get drawn deep into the lungs. Breathing in these particles can worsen heart failure or trigger heart attacks.

Getting enough vitamin B6, vitamin B12, and the amino acid methionine may somehow counteract the impact of these tiny particles. In a study of more than 500 elderly men, adequate intake of these nutrients offset air pollution's harmful effects on heart rate variability, a measure of heart health.

Since this is the first study to suggest that vitamin B6, vitamin B12 and methionine offer some protection against exhaust-related heart disease, don't rush out and buy megadoses of these nutrients. Instead, add to your daily diet heart-healthy foods that are also rich in these nutrients. Good sources include many ready-to-eat cereals (pick whole-grain kinds for an extra boost for the heart), shellfish, salmon, sardines, broccoli, avocados, mushrooms, sunflower seeds, pumpkin seeds, sesame seeds and lentils.

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