Health, Medicine & Nutrition
Surprising Physical Signs of Heart Disease PDF Print E-mail
News Releases - Health, Medicine & Nutrition
Written by Everyday Health   
Tuesday, 09 December 2014 15:32

By Chris Iliades, MD | Medically reviewed by Pat F. Bass III, MD, MPH 

Many people associate heart disease with obvious symptoms like chest pain. But there are some not-so-obvious connections, like swollen feet or bleeding gums, that should also merit a heart check from your doctor.

Heart disease symptoms in women or in men are indications that you feel or experience, while a sign of heart disease is something your doctor can see or find. Obvious heart disease symptoms include shortness of breath or chest pain. But your doctor may also look for some surprising heart disease signs during an examination.

Knowing the signs of heart disease is important because you may have them before you have any of the common heart disease symptoms. Letting your doctor know about these warning signs could help you get an early jump on heart disease.

Are you doing everything you can to manage your heart condition? Find out with our interactive checkup.

"Signs like ankle swelling or weight gain do not necessarily mean you have heart disease, but taken together with other symptoms of heart disease, laboratory studies, and family history, they are an important part of making a diagnosis of heart disease or heart failure," says Carl E. Orringer, MD, director of preventive cardiovascular medicine at the University Hospitals Case Medical Center in Cleveland.

Swelling of the Feet and Lower Legs

Retention of fluid in the feet and legs is known as peripheral edema. Edema may appear as "sock marks" at the end of the day. Mild peripheral edema is common. Your doctor may check for this sign by pressing a finger against your ankle or shin bone to see if a depression is left behind. This is called "pitting edema."

Edema may be a sign of heart failure because, when your heart is not pumping well, fluid from inside your blood vessels tends to leak out into surrounding tissues. The legs and ankles are common areas for edema because of the effects of gravity.

"Peripheral edema may be caused by a host of issues,” says Dr. Orringer. “The bottom line is that most people with peripheral edema do not have heart disease, but it could be an important sign if there are other signs and symptoms of heart failure."

Male Pattern Baldness

"If you watched any of the royal wedding, you might have noticed that Prince William is balding on the top of his head. This type of balding of the crown of the head in young men may be a sign of an increased risk for heart disease," says Orringer.

Several large studies have confirmed the link between baldness and heart disease. Compared to men with a full head of hair, men with crown loss have an increased risk of heart disease of about 23 percent. Men with complete loss of hair on the top of their head have an increased risk of 36 percent.

The combination of hair loss, high blood pressure, and high cholesterol pushes the risk even higher. This link may be due to too much of the male hormone testosterone, which interferes with hair growth on the head and causes hardening of the arteries. That doesn't mean you are doomed to heart failure if you are bald, but it does suggest you should be screened more carefully for other signs and symptoms of heart disease.

Yellow Bumps on the Skin

Xanthomas are deposits of fat that build up under the skin. They may appear as small yellow bumps or as flat, wide plaques on your elbows, knees, hands, feet, or buttocks. A type of xanthoma called "xanthelasma palpebra" appears on the eyelids. These yellow, fat deposits can potentially be signs of heart disease because they may indicate high levels of fats in the blood.

"Xanthomas may be a sign of a rare, inherited type of blood disorder in which high levels of triglycerides accumulate in the blood. Xanthomas may also be a sign of increased cholesterol and they may disappear once cholesterol levels are under control," says Orringer.

Gum Disease

Swollen, sore, or bleeding gums are usually a sign of poor oral hygiene, but may also be an important sign of heart disease. "The association between gum disease and heart disease is the real deal," says Orringer. "There is plenty of research available now that backs up this connection."

Gum disease and heart disease may be linked because they are both signs of poor circulation, or there could be common bacteria that are involved in both gum disease and plaque build-up inside coronary arteries. The link may also have something to do with the body's response to prolonged inflammation. In any case, taking better care of your teeth and gums is a good way to cut down your risk for heart disease.

Signs of Heart Failure

Heart failure means the heart is not functioning as well as it should. It doesn't mean the heart has failed. Another term for heart failure is congestive heart failure, or CHF. Heart failure gradually gets worse over time. Some early warning signs may include:

  • Weight gain. If your heart starts to fail and fluid starts to build up in your tissue, causing edema, you might see a sudden weight gain.
  • Frequent urination. Heart failure may cause decreased blood flow to the kidneys, which causes you to retain more fluid. One of the signs of this fluid may be frequent urination.
  • Cataracts. Although the exact connection is not known, studies show that people who have cataracts are at higher risk for heart disease, high blood pressure, and high cholesterol. "This link is probably more of an association than a sign of heart disease," says Orringer.
  • Nighttime cough. "One of the signs of heart failure may be the build-up of fluid in the chest and heart when lying flat at night. This pressure can cause a nighttime cough," explains Orringer.

Remember that all these heart disease signs may have many different causes. They do not mean you have or will get heart disease. But combined with other heart disease signs and symptoms, your blood tests, and your family history, they give your doctor the best chance to find heart disease early and keep you in good health.

15 Questions for Your Doctor About Type 2 Diabetes PDF Print E-mail
News Releases - Health, Medicine & Nutrition
Written by Everyday Health   
Tuesday, 09 December 2014 15:28
Once you’ve been diagnosed with type 2 diabetes, open communication with a doctor you trust will be key to managing your health. Now that you know what it means to have type 2 diabetes, you're ready to have a dialogue with your doctor about how you'll manage this disease — together. Here are 15 questions to get the conversation started.
  1. Do you have special training in diabetes? If not, can you refer me to a specialist?
  2. How many patients with type 2 diabetes do you see?
  3. What tests will you do at regular office visits? How often do I have to have the tests, and what will they tell you?
  4. Is there anything I need to do in advance of the tests? For example, do I need to fast if I’m going to have a blood-sugar test?
  5. Can you refer me to a diabetes educator or a registered dietitian?
  6. I have a family history of heart attack and/or stroke. Will my diabetes put me at greater risk for those problems?
  7. How can I tell if my blood sugar is too high or too low? What should I do about either high or low blood sugar?
  8. Will I have to test my own blood sugar at home every day?
  9. What are the best treatments for type 2 diabetes?
  10. Will I need to take pills or inject insulin? Will I ever be able to stop using them once I start?
  11. What are the risks of not treating type 2 diabetes?
  12. How will type 2 diabetes affect me over the long term?
  13. What should I do if my symptoms worsen or if I experience new symptoms?
  14. Is it possible for type 2 diabetes to go away on its own?
  15. Are my kids at greater risk for developing type 2 diabetes since I have it?

Type 2 Diabetes and Complications PDF Print E-mail
News Releases - Health, Medicine & Nutrition
Written by Dr. Sanjay Gupta   
Monday, 08 December 2014 12:55
For people with type 2 diabetes, uncontrolled blood sugar levels pose a serious health risk with a range of potential complications.

According to the U.S. Centers for Disease Control and Prevention, diabetes is the leading cause of kidney failure, new blindness, and leg and foot amputations unrelated to injury. It’s a major cause of heart disease, stroke, and nerve damage. Poor blood sugar control may also raise the risk for Alzheimer’s disease.

If you have type 2 diabetes, your body doesn’t use insulin properly to convert glucose into energy. As a result, blood sugar levels become elevated. This buildup of glucose, known as hyperglycemia, can damage blood vessels and vital organs. The A1C blood test is commonly used to see how well, on average, a patient’s blood sugar level has been managed over the past two to three months.

“A person’s A1C level is an excellent marker of complications,” said Joel Zonszein, MD, director of the Clinical Diabetes Center at Montefiore Medical Center in New York City. “If you have a lower number, you’ll be healthier.” The American Diabetes Association recommends an A1C of 7 percent, or an average glucose level of 145 milligrams per decileter (mg/dL).

The following are three common types of complications that can occur when diabetes isn’t properly controlled over time.

Eye Damage (Retinopathy)

Diabetic retinopathy is the leading cause of new-onset blindness in adults. It occurs when blood vessels of the retina swell and leak fluid into the macula, where focusing occurs. The result, known as macula edema, causes blurred vision. A more serious form of eye complication, called proliferative retinopathy, occurs when new blood vessels form in the retina to replace damaged ones. Scar tissue can develop and cause the retina to become detached.

Fortunately, “this kind of damage doesn’t happen overnight,” said Stephanie Marioneaux, an ophthalmologist in Chesapeake, Va., and a clinical spokesperson for the American Academy of Ophthalmology. Vision loss can be prevented if the blood vessel damage is caught early enough through regular eye exams.

“If we’re seeing damage in the retina that means their blood sugar has been elevated for a while,” said Dr. Marioneaux.

Nerve Damage (Neuropathy)

When hyperglycemia damages blood vessels that feed oxygen and nutrients to the nerves, it can result in nerve damage or neuropathy. Common signs include tingling, pain, or numbness in the feet and hands.

Patients may develop blisters or sores on their feet that can spread infection to the bone and cause tissue death. These infections are very hard to treat and can result in amputation.

“If people are experiencing the numbness and tingling, they should be checking their feet regularly for any sores or wounds and get them seen by a doctor before they get infected,” said Priscilla Hollander, MD, an endocrinologist at the Baylor Endocrine Center in Dallas.

While A1C is “a great tool,” Betul Hatipoglu, MD, an endocrinologist at the Cleveland Clinic, said it’s not a replacement for daily blood sugar monitoring. “Keeping it level can decrease chances of terrible complications that could potentially cause you to lose your limbs,” said Dr. Hatipoglu.

Kidney Disease (Nephropathy)

Diabetes is the leading cause of chronic kidney disease in the United States. “About 10 percent of people with type 2 diabetes will develop [it],” said Dr. Hollander.

High blood sugar levels compromise the kidneys’ ability to properly filter waste products in the blood. Protein that’s useful to the body leaks into the urine, while wastes start to collect in the blood. Left untreated, this can lead to kidney, or renal, failure requiring a machine to filter the blood (known as dialysis) or a kidney transplant.

According to Hollander, it usually takes about 10 years for diabetic kidney disease to manifest, and it can be caught in the early stages. A simple urine test can detect excess protein in the urine. Other signs to look for include frequent urination, weight gain, and ankle swelling.

“The incidence is improving,” said Hollander. “And we’ve made a lot of progress by controlling blood pressure, which plays a big role in furthering kidney damage.”

For anyone with type 2 diabetes, as Dr. Zonszein points out, “the sooner you can catch that your blood glucose hasn’t been under control, the better you can prevent these complications.”

Last Updated: 04/24/2014

What to Do If You Have Hyperglycemia PDF Print E-mail
News Releases - Health, Medicine & Nutrition
Written by Everyday Health   
Thursday, 04 December 2014 11:42

Hyperglycemia is the technical term for when blood-glucose levels (or blood-sugar levels) are too high because the body isn't properly using or doesn't make the hormone insulin. The symptoms of hyperglycemia develop slowly, over a period of hours or even days. Hyperglycemia doesn’t even cause symptoms until glucose levels are significantly high  — above 200 milligrams per deciliter (mg/dL), or 11 millimoles per liter (mmol/L). The longer blood-glucose levels stay high, the more serious the symptoms become.

Symptoms of hyperglycemia include:
  • Blood glucose over 200 mg/dL
  • More urine output than usual
  • Increased thirst
  • Dry skin and mouth
  • Decreased appetite, nausea, or vomiting
  • Fatigue, drowsiness, or lethargy

If hyperglycemia goes untreated, it can cause:

  • Fruity-smelling breath
  • Nausea and vomiting
  • Abdominal pain
  • Shortness of breath
  • Dry mouth
  • Weakness
  • Confusion
  • Buildup of toxic acids (called ketones) in your blood and urine
  • Coma

The dangerously high blood-glucose levels of hyperglycemia can result from:

  • Not taking enough insulin
  • An illness such as a cold or the flu
  • An infection
  • Eating too much
  • Excessive stress
  • Taking certain medications

How to Avoid Hyperglycemia

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To avoid episodes of hyperglycemia, take your usual insulin exactly as prescribed by your doctor (do not skip a dose!) and eat regular, balanced meals.

Next Step: How to Treat Low Blood Sugar

Profile by Sanford opens retail location in Davenport PDF Print E-mail
News Releases - Health, Medicine & Nutrition
Written by Shawn Neisteadt   
Wednesday, 03 December 2014 14:58

Program offers research-based method for weight management

DAVENPORT, Iowa – Profile by Sanford is now open at 3010 E. 53rd Street in Davenport. This is the second store Iowa.  The Hawkeye state’s first Profile store is in Clive and opened in July.

Profile launched in Sioux Falls, South Dakota, opening its first store front in November 2012. Today, it has 16 locations in five states with several more planned openings by the end of 2014.

Profile was designed using a large body of clinical research to ensure a sustainable means to healthy weight loss. A clinical and scientific advisory board comprised of Sanford Health physicians and researchers oversaw the development of the Profile system.  Sanford Health is the largest, rural, not-for-profit health care system in the United States.

“This state-of-the-art weight-loss system has brought clinically-proven results to communities across the Dakotas, Minnesota and Nebraska,” said local store manager Justin Roberson. “I’m eager to see the results this nutritional program will have here in Davenport.”

The rapidly growing Profile system utilizes meal-replacement products, nutritionally complete food and qualified health coaches. In addition to members consuming both Profile-produced and grocery-store food, coaches develop customized plans for their clients and offer advice on nutrition, exercise and behavior.

Profile continues to focus on program advancements through the launch of new food products, such as three new pizza varieties available this fall. Profile is also on the cutting edge of technology, expanding to better assist members with measuring daily activity. A new fitness tracker will provide additional measurable data that will be helpful to members and coaches in helping to monitor progress toward goals.

In addition to face-to-face meetings, coaches are able to efficiently track members’ progress through the use of smart wireless technology. Each member is outfitted with wireless devices to measure progress, including tools to track body weight, measurement and blood pressure. These devices automatically upload to a secure server, where members and coaches can monitor improvement on the web or mobile applications. Printed options are also available to members.

According to the Centers for Disease Control and Prevention, more than 60 percent of the U.S. population is considered overweight or obese.

To learn more, visit or call (877) 373-6069.

About Sanford Health
Sanford Health is an integrated health system headquartered in the Dakotas and is now the largest, rural, not-for-profit health care system in the nation with locations in 126 communities in nine states. In addition, Sanford Health is in the process of developing international clinics in Ghana, Mexico and China.

Sanford Health includes 43 hospitals, 140 clinic locations and 1,360 physicians in 81 specialty areas of medicine. With more than 26,000 employees, Sanford Health is the largest employer in North Dakota and South Dakota. The system is experiencing dynamic growth and development in conjunction with nearly $1 billion in gifts from philanthropist Denny Sanford. These gifts are making possible the implementation of several initiatives, including global children's clinics, multiple research centers and finding cures for type 1 diabetes and breast cancer. For more information, visit


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