My Doctor Online The Permanente Medical Group
Are you having back pain with any of the following?
- Severe pain, weakness or tingling in your leg(s).
- Difficulty stopping urination or loss of control of bladder or bowels.
- Unexplained fever, nausea or vomiting.
- A history of cancer or unexplained weight loss.
We understand that you are experiencing one or more of the health issues that might be impacting your back pain.
We recommend that you discuss these health issues with your doctor before proceeding with this program.
Once you are cleared by your doctor to do this program, we hope it helps you find relief from your back pain.
Healthy Heart
It's important to eat a healthy diet, manage conditions like high cholesterol or high blood pressure, and lead an active lifestyle to keep your heart healthy. You can improve your overall heart health and reduce your risk of having a heart attack.
A Heart Healthy Lifestyle [Read/Print full article]
Overview
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Some people are at a greater risk for heart disease than others. Some risk factors for heart disease cannot be changed, like your age, your gender, or your family history of heart disease. Other risk factors can be managed with changes to your health and lifestyle.
Eating a healthy diet, managing conditions like high cholesterol or high blood pressure, and leading an active lifestyle can improve your overall heart health and reduce your risk of having a heart attack.
Control Your Cholesterol
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Cholesterol is a fatlike substance made by the body that is found naturally in animal-based foods. It is needed for hormone and vitamin production and to support brain function. The levels in your blood are determined by family genetics and by your diet and lifestyle.
There are two main types of cholesterol:
- Low-density lipoprotein (LDL), often called "bad" cholesterol
- High-density lipoprotein (HDL), often called "good" cholesterol
When "bad" LDL cholesterol levels are too high or when "good" HDL levels are too low, fats can build up in the blood vessels. This can decrease your blood flow to vital organs such as the heart and brain.
There is an additional type of fat found in your blood, called triglycerides. Triglycerides differ from cholesterol, but they can also lead to heart and blood vessel problems. Both cholesterol and triglyceride levels are measured by simple blood tests.
What you can do
The best ways to keep your cholesterol and triglyceride levels in the healthy range are diet, exercise, and maintenance of a healthy weight. In addition to these lifestyle changes, some people need medications to lower their cholesterol.
Target ranges for healthy levels of cholesterol are:
- Total cholesterol: Less than 200.
- LDL cholesterol: Less than 130. However, the goal is between 70 and 100 if you have a history of heart attack, diabetes, stroke, bypass surgery, or peripheral arterial disease.
- HDL cholesterol: More than 45.
- Triglycerides: Less than 150.
Additional References:
- PDF Link to High Cholesterol - Here's What You Can Do
Control Your Blood Pressure
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Blood pressure is the force of your blood on the walls of your blood vessels. This force, or pressure, enables blood to pump throughout your body. When the force of blood against your artery walls is too strong, your heart has to work too hard to send blood throughout your body. This is called high blood pressure or hypertension, and it can damage your blood vessels over time. Lowering your blood pressure can take some of this extra demand off your heart and blood vessels.
How blood pressure is measured
Blood pressure is measured in ranges:
- Normal blood pressure: 119/79 or lower (stated as "119 over 79")
- Prehypertension: 120/80 to 139/89
- High blood pressure: 140/90 or higher
The top number of your blood pressure measurement is the systolic pressure. This is the force of blood against your arteries when your heart is sending blood to your body.
The lower number is the diastolic pressure. This is the force of blood against your arteries while your heart relaxes between beats. Both numbers are important and need to be normalized to prevent damage to blood vessels and major organs.
How to lower your blood pressure
You can make changes that will lower your blood pressure and improve your health. Making healthy choices like eating right and increasing your activity level, as well as taking medication to lower your blood pressure if you need to, will lessen your risk of having serious health problems.
- Quit smoking. This will help lower your blood pressure. It is the single most important change you can make to improve your health and feel better.
- Make time for regular physical activity. Aim for 30 to 60 minutes most days of the week.
- Maintain a healthy weight. If you are not at a healthy weight, losing 5 to 10 percent of your body weight by eating less fat and smaller portions can help reduce your risk.
- Manage your stress. Reducing your stress can help you make (and maintain) other lifestyle changes that can help you lower your risk of heart disease. Choose a stress-reducing activity that you think you would enjoy, such as walking, dancing, Tai Chi, yoga, or meditation.
- Make smart food choices, including choosing whole grains, vegetables, fruits, low-fat or nonfat milk products, lean meat, and beans.
- Limit salt (sodium) to 1500 mg to 2000 mg per day. Read food labels to select foods lower in sodium.
- Limit alcohol to 1 drink per day if you are a woman and no more than 2 drinks per day if you are a man. One drink equals 4 to 5 ounces of wine, 12 ounces of beer, or 1½ ounces of liquor.
Additional References:
Manage Your Diabetes
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By taking care of diabetes, you can stay well and reduce the chance of developing complications such as a heart attack, stroke, or kidney problems.
Hemoglobin A1c and estimated average glucose (eAG) are blood tests that measure your average blood sugar during the past 2 to 3 months. These tests help us understand how well you are able to keep your diabetes under control. We recommend a hemoglobin A1c blood test at least every year and possibly more often if we are adjusting your treatment plan.
Talk with us about your personal target for A1c and eAG. Typical ranges are:
| A1c target (%) | eAG target (mg/dL) | |
| Most people | Below 7 | Below 150 |
| People older than 65 or with additional health conditions | Below 8 | Below 180 |
Additional References:
Get Moving
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Exercising just 30 minutes a day decreases your risk for heart disease. Exercise strengthens your heart muscle, improves circulation throughout your body, helps maintain a healthy weight, improves your cholesterol and blood sugar levels, and decreases your stress level.
- Choose an activity that you enjoy. This is different for everyone: A salsa dance class could be your first choice, or it could be a quiet walk around your neighborhood in the evening.
- Have a specific goal in mind. Maybe you'd like to walk a half-marathon, be able to swim 2 miles without stopping, or regularly exercise 3 times a week.
- Schedule time to exercise every week. Sometimes it helps to put aside time in your daily schedule for a trip to the gym or a yoga class. Exercise during your lunch hour or invite your family to join you for exercise after work.
- Chart your progress. Many people find it helpful to see their progress over time. Write down the activity you do each day of the week in a notebook or electronic journal. Keep track of your distance, how long your activity lasted, and how you felt before and afterwards.
- Find a partner to exercise with you. This may help keep you motivated and provide support.
Additional References:
Lose a Little Weight
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Losing as little as 10 pounds can lower your risk for heart disease and improve your cholesterol, blood pressure, and blood sugar.
When you weigh too much, your heart has to work harder, your blood pressure goes up, your cholesterol levels are worse, and it is more likely that you will develop diabetes.
Your body mass index (BMI) is a measurement based on your height and weight that helps you to take into account any risks you may have for medical problems due to excess body weight. If your BMI is 25 or higher, you are at higher risk for a heart attack or stroke. Asian Americans are at higher risk for diabetes, heart attack, or stroke at a lower BMI.
By eating healthier and becoming more active, you take the first step toward losing the weight you want. Think about taking a nutrition or exercise class to get you started.
Additional References:
Take a Deep Breath
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Strong, stressful emotions like anxiety, depression, and anger can affect your heart by temporarily raising your blood pressure. These strong emotions might make it less likely that you'll follow through on many of your lifestyle goals, like getting regular exercise and eating a healthy diet. Find strategies that are effective in reducing your stress.
- Cut down on caffeine. Caffeine can make anxious feelings worse and keep you from getting a good night's sleep.
- Do not use alcohol, drugs, or tobacco to cope with stress. Even a little bit can make you feel worse.
- Get moving. Exercise can help you reduce your stress.
- Do deep breathing to relax. When you're feeling anxious, take slow, deep breaths for a few minutes. Count to 4 as you breathe deeply into your belly through your nose. Now breathe out even more slowly through your nose for 6 to 8 seconds.
Call us if your stress is keeping you from doing your daily activities or is causing discomfort despite home treatment.
Additional References:
Don't Use Tobacco
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If you smoke or use tobacco, quitting is one of the best things you can do for your health. In the first year after you quit, your risk of heart disease will be half of what it was when you still smoked.
Using tobacco increases your risk of heart disease by:
- Decreasing the amount of oxygen to your heart
- Raising your blood pressure and pulse rate
- Causing blood to clot more easily
- Damaging the cells that line arteries in your heart
If you are thinking about quitting tobacco now or sometime in the future, we can help. We have many resources that can help you quit successfully and ease the cravings and other symptoms you might feel as your body withdraws from nicotine.
Here are a few tips to help you quit smoking:
- Write down your reasons for quitting and read them over a number of times each day.
- Set a quit date and start getting ready for that day.
- Find others who will support you. Consider attending a class, ask a friend or family member, or talk to a former smoker about how he or she quit.
- Consider medications to help you quit. Medications can help reduce cravings after you quit.
- Plan healthy things to do for those times when you would usually have a cigarette.
Related Health Tools:
If you have an emergency medical condition, call 911 or go to the nearest hospital. An emergency medical condition is any of the following: (1) a medical condition that manifests itself by acute symptoms of sufficient severity (including severe pain) such that you could reasonably expect the absence of immediate medical attention to result in serious jeopardy to your health or body functions or organs; (2) active labor when there isn't enough time for safe transfer to a Plan hospital (or designated hospital) before delivery, or if transfer poses a threat to your (or your unborn child's) health and safety, or (3) a mental disorder that manifests itself by acute symptoms of sufficient severity such that either you are an immediate danger to yourself or others, or you are not immediately able to provide for, or use, food, shelter, or clothing, due to the mental disorder.
This information is not intended to diagnose health problems or to take the place of specific medical advice or care you receive from your physician or other health care professional. If you have persistent health problems, or if you have additional questions, please consult with your doctor. If you have questions or need more information about your medication, please speak to your pharmacist. Kaiser Permanente does not endorse the medications or products mentioned. Any trade names listed are for easy identification only.