There is without a doubt that Mr. S is clearly unhealthy. Continuing to live the same lifestyle would not be beneficial for Mr. S. There is a combination of things that Mr. S could modify in his life that could better benefit him in the long run. Concerns with Mr. S health starts with his blood pressure of 142/88. His systolic pressure is stage 1 hypertensive while his diastolic pressure is pre-hypertensive. One of the biggest problems that Mr. S has is with his cholesterol. Serum cholesterol is beyond high, Mr. S owning up to 250mg/dl and a normal target cholesterol being around 200mg/dl. LDL and HDL cholesterol and triglyceride levels are all at extremely dangerous levels for a 48 year old man. Something that Mr. S has to consider is that smoking is a big risk to his health. A common misconception is that you have to be physically large to be unhealthy. His BMI is 25.76 kg/m^2 which is technically considered overweight, but barely makes the margin. Physically looking at him you would not suspect that there are a vast majority of health issues that could possibly be fatal if left alone. With all that at hand, there is without a doubt that Mr. S has significant coronary artery disease.
There are certain aspects of his life that Mr. S simply has no control over and cannot modify. Having been diagnosed with diabetes type 2, Mr. S can only act to assure that it does not progress or become more severe. There is nothing that Mr. S can do about being born a male, but because of that he is more susceptible to coronary heart disease. In addition, because his brother died of heart disease early in his life, it is then known that there is a chance that coronary heart disease runs in the family. However being that it is in the genetics, there is nothing that Mr. S can do to modify or reduce that particular risk. Mr. S has a personality that is easily stressed as demonstrated by the two and half pack of cigarettes each day. Although stress may not be a risk factor of heart disease it does contribute significantly to other risk factors.
Mr. S is definitely a patient to look at with extreme care. The first thing that has to be adjusted is Mr. S blood pressure. Hypertension is known as the silent killer which means that there are usually no physical symptoms. Diet, aerobic exercise, and quitting smoking are probably the best measures for Mr. S to take. I would not stress weight loss because he is not significantly overweight, and if he follows the plan for diet and aerobic exercise he will naturally lose weight.
The DASH diet has been proven successful in lowering blood pressure and cholesterol. The DASH diet is composed of “natural foods low in fats and rich in nutrients like potassium, calcium, and magnesium” (The DASH Diet Eating Plan). Reducing blood pressure is very promising with aerobic activity. A study was done where “hypertensive African American men were put on a 20-60 min, 3 times a week cycling routine for 16 weeks/4 months. Results showed that systolic pressure decreased by 7 mmHg and diastolic pressure was decreased byn 5 mmHg” (Effects of regular exercise on blood pressure and left ventricular hypertrophy in African-American men with severe hypertension). If we change the ethnicity from the study, the same results are likely.
Cholesterol is one of the biggest risk factors for coronary artery disease. Cholesterol builds plaque in the artery walls resulting in a decreased flow of blood thus leading to more complications. Cholesterol can also be lowered by the DASH diet and aerobic activity. Mr, S HDL cholesterol is also not where is should be. This can be increased with aerobic activity and a cessation in smoking. Men naturally have lower HDL so they have to work harder to raise it to a healthy standard which is around 40-60 mg/dl. “Within six months an increase in HDL can be expected if Mr. S implements a plan of a high intensity 45 minute workout for 5 days a week. A study where older men were put on that regiment