Dr KK's Formula of Eighty For Living Upto Eighty

To live above the age of eighty one needs to have ideal health parameters and ideal lifet style and the same can be remembered by the formula of "eighty". One should keep fasting blood sugar (mg%), fasting LDL bad cholesterol (mg/dL), lower blood pressure (mm Hg) and abdominal circumference (cm) all below 80. Most people will cross hundred if they reach eighty without an illness.

Abdominal (Waist) circumference

Increasing central adiposity is associated with an increased risk of morbidity and mortality. Therefore, in addition to measuring body mass index, waist circumference should be measured to assess abdominal obesity. Patients with abdominal obesity (also called central adiposity, visceral, android, or male-type obesity) are at increased risk for heart disease, diabetes, hypertension, and dyslipidemia.

Although computed tomography (CT) and magnetic resonance imaging (MRI) are more accurate than waist circumference for assessing the distribution of body fat, they are too expensive to be performed for this purpose alone. Measurement of the waist-to-hip ratio provides no advantage over waist circumference alone. The waist circumference is measured with a flexible tape placed on a horizontal plane at the level of the iliac crest as seen from the anterior view. In adults with a BMI of above 23 kg/m2, a waist circumference greater than 80 cm is associated with a greater risk of hypertension, type 2 diabetes, and dyslipidemia, and heart disease.

Blood pressure

Lower blood pressure should be kept lower than 800 mm Hg. If the lower blood pressure is between 80-90 mm hg it is called pre hypertension and if above 90 mm Hg is called hypertension. A person with pre-hypertension, is more than three times likely to have a heart attack and 1.7 times more likely to have heart disease than a person whose lower blood pressure is lower than 80 mmHg. Diastolic or lower blood pressure is the pressure when the heart is at rest between the heart beats. If pre-hypertension is aggressively treated 45% of all heart attacks can be prevented.

The 2007 United States Preventive Services Task Force (USPSTF) guidelines recommend screening every two years for persons with lower pressures below 80 mmHg, and yearly for persons with a lower blood pressure of 80 to 89 mmHg. Patients with pre hypertension have a greater prevalence of traditional cardiovascular risk factors than those with normal blood pressures. Presence of at least one adverse risk factor (above-normal cholesterol levels, overweight/obesity, and diabetes mellitus) is significantly more likely among pre hypertensive than normotensive individuals.

There is an association between pre hypertension and microalbuminuria, a risk factor for cardiovascular disease and early cardiovascular mortality.

Blood Sugar

Normal fasting blood sugar is 60-90 mg%. Any fasting sugar of over 126  mg% increases the risk for both macrovascular and microvascular disease and above 90 mg% increases the risk of macrovascular disease (myocardial infarction, stroke, peripheral vascular disease), but not for microvascular disease (retinopathy, neuropathy and nephropathy). For cardiovascular protection the blood sugar should be lower 80 mg% or lower. 

Diabetes risk factors are age ≥45 years, overweight (body mass index ≥23 kg/m2), family history diabetes mellitus in a first-degree relative, habitual physical inactivity, history of delivering a baby weighing >4.1 kg (9 lb) or of gestational diabetes mellitus, hypertension (blood pressure ≥140/90 mmHg), dyslipidemia defined as a serum high-density lipoprotein cholesterol concentration ≤35 mg/dL (0.9 mmol/L) and/or a serum triglyceride concentration ≥250 mg/dL (2.8 mmol/L), previously identified impaired glucose tolerance or impaired fasting glucose, polycystic ovary syndrome and history of vascular disease.

Cholesterol (LDL Bad)

The optimal value for LDL bad cholesterol in both men and women is <100 mg/dL in normal population but lower than 80 mg% in patients with heart disease or at risk of heart disease ( being an Indian is a risk factor). A one standard deviation (38.5 mg/dL) LDL increase is associated with an age adjusted relative risk for heart disease of 1.42 for men and 1.37 for women. Being an India is a risk factor for heart disease.

Heart disease equivalents, that is, risk factors that place the patient at similar risk for heart disease as a history of heart disease itself, are identified as diabetes mellitus, symptomatic carotid artery disease, peripheral arterial disease, abdominal aortic aneurysm, multiple risk factors that confer a 10-year risk of heart disease >20 percent and chronic renal insufficiency (defined by a plasma creatinine concentration that exceeds 1.5 mg/dL or an estimated glomerular filtration rate that is less than 60 mL/min per 1.73 m2).

Patients at very high risk for heart disease might also be expected to benefit from more intensive lipid lowering therapy. Such patients should be treated with the lowest dose of a statin that reduces their LDL-C below 80 mg/dL.

Diet

Eating fewer calories has been shown to reduce chances of heart attack. One gram of food contains 6 calories on an average. One should not eat more than 80 grams of food in any meal.

Exercise

·     Cardiovascular training exercise involves walking 80 steps a minute.

·     Cardiovascular exercise involves attaining 80% of target heart rate (220- age is 100 % target heart rate).

·     Adequate walking cum exercise duration per day is 80 minutes a day.

·     80 km running per week is associated with an elevation in serum HDL-cholesterol levels and significant reductions in adiposity and serum triglycerides [Arch Intern Med 1997; 157:191].

·     The recommended recreational (non sporting) activity duration is 80 minutes thrice a week.

·     The recommended regular walking duration is 80 minutes in 2 days.

Pranayama

One should do 80 alternate nostril pranayama a day.

Or one should do 80 UMMMMM chanting a day.

Alcohol

·     For health reasons, for those who consume social drinks: social drinking when not contraindicated in males is taking 80 grams in one week (10 grams is 30 ml 80 proof whisky). In women it is 80 grams in two weeks.

·      One should not take more than 80 ml of whisky in one day.

About the author: Padmashri & Dr. B.C. Roy National Awardee, Dr. KK Aggarwal is a Senior Consultant, Physician, Cardiologist at Delhi based Moolchand Medcity; President Heart Care Foundation of India; Chairman Ethical Committee Delhi Medical Council and has served as the Research and Academic Wing Heads of National Indian Medical Association.  [emedinews@gmail.com, www.heartcarefoundation.org, www.emedinews.in]