HYPERTENSION

DIABETES
ARTHRITIS
and other health concerns...
BY: DR. GARY S. SY
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DR. GARY S. SY
Diplomate in Geriatric Medicine
Health Columnist, TV & Radio Host
Multi-Awarded Medical Practitioner
 HYPERTENSION
The Silent Killer
As your heart pumps blood through
your arteries, the force of the blood
flow exerts pressure on the arterial
walls, just as air pumped into a tire
exerts pressure on its lining and sur-
face. And just as too much air pres-
sure is bad for the life of the tire, so
too much blood pressure eventually
damages your arteries. If your heart
pumps blood through your circulatory
system most of the day with a force
that is much greater than necessary
to maintain a steady flow, you have
hypertension, or high blood pressure
that never returns to normal range.
Two types of pressure, systolic and di-
astolic, are measured. Systolic pres-
sure is the peak pressure at the mo-
ment when your heart contracts and
pumps out the blood into the arteries.
Diastolic pressure is the lowest pres-
sure in the arteries just before the next
contraction of the heart. Therefore,
the systolic figure, which represents
the moment of greatest pressure, is
always higher than the diastolic fig-
ure. If someone tells you that your
blood pressure is 120 over 80, this
means that your systolic is 120 milli-
meters of mercury (mmHg), and your
diastolic is 80 mmHg. Those figures
are within normal range for a healthy
young adult.
But for instance, if you are over 40
and your blood pressure reading is
140 over 90 mmHg, your physician
may consider this to be normal pres-
sure for you, since blood pressure
tends to rise slightly with age.
There are actually two types of high
blood pressure, essential or primary
and secondary or non-essential hy-
pertension. Primary hypertension is
high blood pressure that is not due to
another underlying disease. The pre-
cise cause is unknown, but a num-
ber of definite risk factors have been
identified and these include heredity,
cigarette smoking, stress, obesity, ex-
cessive use of stimulants such as cof-
fee or tea, drug abuse, high sodium
(salt) intake, and use of oral contra-
ceptives. In secondary hypertension,
the cause of the disorder has been
identified by your physician. Some
possible causes are kidney disease,
hormonal disorders and aldoster-
onism. A person may also have sec-
ondary hypertension because the
blood vessels are chemically con-
stricted or have lost elasticity from a
build up of fatty plaque on the inside
walls of the blood vessels, a condition
known as atherosclerosis.
What are the symptoms?
High blood pressure is almost always
a symptom less disease. If you have
hypertension, you may feel fine, with-
out the slightest indication of physical
problems.
Such symptom as severe headache,
nape pain, blurring of vision, palpita-
tions, shortness of breath, chest dis-
comfort, and a feeling of ill health
usually occur only when some dam-
age has already taken place from
the hypertension in your retinas, brain,
heart or kidneys. So it is risky to wait for
treatment until symptoms develop.
What should be done?
While medical advances have
helped, much of the credit goes to
lifestyle changes, such as quitting
smoking and changing diet to lower
blood pressure and cholesterol lev-
els.
For normal individuals, have your
blood pressure checked once a
year and remember what your blood
pressure is. Even if you show signs of
high blood pressure during a first ex-
amination, your physician may want
to check your pressure a couple of
times before treating you.
What is the treatment?
Self help: In many cases, changes
in your weight, diet, and lifestyle can
lead to satisfactory lowering of the
blood pressure without the use of
drugs. Here are some suggestions of
how to change your life-style.
If you smoke, quit! There’s a direct
correlation between cigarettes
and high blood pressure, by giving
up smoking you can reduce the risk
instead of increasing it.
If you are overweight, choose a
sensible weight loss diet, stick to
it until you reach an appropriate
weight for your age, sex, height,
and then try to maintain it.
Do not add salt to your food.
Try to make your work schedule
and recreation less demanding.
Avoid stress.
Try to avoid using alcohol. Alcohol
consumption can increase blood
pressure and can interact with
blood pressure medications.
Very mild hypertension can often
be treated without drugs.
Professional help:
If self-help does not lower your blood
pressure to a normal range, you need
drug treatment. The drugs used to
treat high blood pressure must always
be administered under the supervi-
sion of a physician. Your physician
will base the decision in choosing
the best medications on a number
of considerations, such as your age,
general state of health and sex. When
the decision on which medications
to try has been made, it is important
that you and your physician agree to
the treatments and that you follow his
or her instructions carefully and com-
pletely.
Always remember, your own heart’s
health depends on you – the choices
you make, the habits you create, and
the lifestyle you adopt.
 Herbal Remedy for Hypertension

Serpentina
* Helps regulate blood pressure
* Soothens the muscles and blood vessels
Sambong
* Helps maintain good blood circulation
* Diuretics
Garlic
* Helps lower blood cholesterol
* Has anti-bacterial & anti-viral properties
Periwinkle
* Natural relaxant and has anti-stress property
* Has calming effect for better sleep
Goto Cola
* Helps in the production of collagen that
strengthens blood vessels

The five herbs mentioned are now available in capsule form under the brand-
name ALIVIO Herbal Dietary Supplement.

Recommended Use:
One (1) capsule twice a day after meal.

Available at all leading drugstores nationwide.

 DIABETES
MELLITUS
elevated blood sugar leads to nar-
Diabetes Mellitus is a disease in
rowing and hardening of the blood
vessels, which impairs circulation and
which blood sugar (glucose) levels
damages tissues. These complica-
are abnormally high because the
tions are even more likely in people
body does not produce enough of
who smoke or have high blood pres-
the hormone insulin or the body fails
sure and high cholesterol levels, both
to respond to insulin.
of which often accompany diabetes.
Fortunately, many complications can
When sugar from food is absorbed
be prevented by quitting smoking
into the bloodstream, the pancreas
and by taking steps to control blood
responds by producing insulin. Insulin
pressure and cholesterol levels as well
plays a key role in moving the sugar
as blood sugar levels.
from the bloodstream into the cells,
where it is then converted into energy.
Causes of Diabetes
The body uses this energy to function;
sugar is the fuel on which the body
Diabetes is categorized as Type I or
runs. If the body cannot adequately
Type II, each with a different cause.
produce or respond to insulin, sugar
Type II diabetes is the main form of di-
cannot enter the cells, instead, sugar
abetes among older people. Obese
accumulates in the blood, and the
older people with a family history of
cells must turn to other sources for en-
diabetes have the highest risk of de-
ergy.
veloping type II diabetes which ac-
counts for 90% of the entire diabetes
Diabetes is extremely common in
population worldwide.
older people, of whom about 15 to
In type I diabetes, the type that usu-
25% have the disease. Statistically,
ally becomes evident in childhood
there are about 500 daily diagnosed
or young adult, the pancreas can-
cases of diabetes in the Philippines .
not produce insulin or produce tiny
Diabetes can lead to such compli-
amount of insulin. Symptoms include
cations as chest pain (angina pec-
intense thirst, frequent urination, ex-
toris) and heart attacks, heart failure,
treme hunger, and rapid weight
stroke, kidney failure, erectile dysfunc-
loss. It can be controlled by regular
tion, blurred vision and blindness, pain
lifetime doses of insulin in the proper
and loss of sensation in the hands
amounts. Keeping the balance be-
and feet, and amputation. Many of
tween insulin dose and sugar intake
these complications arise because
is one of the major challenges faced
by people with Type II diabetes, also
known as adult-onset diabetes usually
doesn’t appear until the early to mid
forties. In most cases, the problem is
not a simple lack of insulin, but a de-
fect in the receptors for insulin in the
cell walls. The body does not respond
normally to the insulin produced by
the pancreas. Long term complica-
tions of Type II diabetes are similar to
those of Type I, but include higher in-
cidence of heart disease, high blood
pressure, and stroke. So it’s worth it to
have blood sugar monitoring regu-
larly.
The main risk factor for Type II diabe-
tes is obesity. Obesity causes insulin
resistance, possibly by increasing the
blood levels of building blocks of fats
and certain proteins that interfere with
the action of insulin.
Aging itself puts people at higher risk of
developing diabetes. As people age,
insulin secretion tends to decrease
slightly and insulin resistance tends to
increase slightly, even among people
without obesity or diabetes.
Heredity is a risk factor as well.
Signs and Symptoms
People with Type II diabetes may
have no symptoms for months or
even years before the disease is di-
agnosed. When the blood sugar
level raises too high, sugar spills into
the urine. The kidneys then must ex-
crete additional water to dilute the
sugar. Therefore, a person with high
blood sugar urinate large volumes
(Polyuria). The loss of water due to ex-
cessive urination also creates abnor-
mal thirst (Polydipsia). Also, the body
cannot use sugar as energy, a per-
son with diabetes may experience
excessive hunger and thus eat more
(Polyphagia) and yet still lose weight.
Other symptoms include blurred vi-
sion, drowsiness, light headedness,
irritability, fatigue and weakness, de-
creased endurance during exercise,
numbness in the hands and feet,
body itchiness, hard to heal wounds,
frequent vaginal discharges, recur-
ring skin infections, hard to maintain
or achieve an erection in men.
Diagnosis and Screening
A simple blood test called Fasting
Blood Sugar (FBS) or Glucose test is
most commonly used to make a di-
agnosis. The level of sugar (glucose)
in the blood is measured, usually af-
ter the person has fasted for at least
8 hours. Sometimes the blood sugar
level is measured randomly without
regard to when the person last ate,
but this is not as accurate.
In a person who does not have dia-
betes, blood sugar levels after fasting
range from 70 to 110 milligrams per
deciliter (mg/dl) of blood. Diabetes is
the likely diagnosis if the blood sugar
level is 126 mg/dl or higher if the per-
son fasted before the test or 200 mg/
dl or higher if the test was performed
at random.
People who have two or more fast-
ing blood sugar levels between 110
to 125 mg/dl (a condition called im-
paired fasting glucose) should repeat
the test yearly.
The diagnosis of diabetes mellitus is
confirmed if any one of the following
results is obtained:
Two fasting levels are 126 mg/dl
or higher
Two random levels are 200 mg/
ml or higher
Fasting level of 126 mg/dl or high-
er and a random level of 200
mg dl or higher.
Prevention
Diabetes often can be prevented.
Losing weight through dietary chang-
es, increased physical activity, or both
is a very effective measure. Brisk walk-
ing for 30 minutes daily is one type of
beneficial physical activity.
Treatment
The goal of treatment is to maintain
blood sugar levels within the nor-
mal range so as to prevent or con-
trol symptoms and reduce the risk
of complications. There are mainte-
nance drugs that could help control
blood sugar levels but these are not
substitute for proper diet, exercise
and weight reduction.
Drug Treatment
Insulin
Function: Control blood sugar levels
in people with Type I diabetes and
some Type II diabetes. Side effects:
overused can raise cholesterol levels,
blood pressure and increase body
fat.
Oral Hypoglycemic Drugs (Sulfony-
lureas)
Function: lower blood sugar levels by
stimulating cells in the pancreas to re-
lease more insulin. Side effects: with
long-term use, increased risk of death
from heart attack.
Biguanides
Function: increase insulin’s activity in
muscle and fat tissue and prevent
the liver from releasing extra glucose
into the blood stream. Side effects:
nausea, diarrhea, loss of appetite,
and abdominal discomfort.
Thiazolidinediones
Function: counteract insulin resistance
by increasing the activity of receptors
in the liver, muscle, and fat cells. Side
effect: not common.
Glucosidase inhibitors
Function: prevent blood glucose
from rising after ingestion of com-
plex carbohydrate when used with a
starchy, high-fiber diet. Side effects:
gas, bloating and poor absorption of
nutrients.
Interestingly, before the advent of in-
sulin and oral hypoglycemic drugs,
herbal medicines were often used to
help treat diabetes. There are many
safe botanical medicines that are
helpful in managing Type I and II dia-
betes. But it doesn’t mean that you
can discontinue insulin or other drugs
without consulting your doctor.
 Herbal Remedy for Diabetes
1. Gymnema (Gymnema sylvestre)
This Ayurvedic remedy is probably one of the most com-
mon herbs used to treat diabetes. Gymnemic acid, a
component of the herb, acts directly on the tongue to
block its ability to sense sweetness. This action can help
you for go the sweet treats that may be aggravating the
condition.

2. Eugenia Jambolana (Jambul)

The fresh seeds found to be effective for diabetic people
as they quickly reduce sugar in the urine which is known as
glucosuria. Jambolana regulates the diabetes-inducing
conversion of starch into sugar in case of an increased in
production of glucose.

3. Fenugreek (Trigonella foenum-grecum)

Modern research has shown that fenugreek seeds not only
lower blood glucose levels but also total cholesterol, and
triglycerides while increasing HDL, the good cholesterol.
Fenugreek seed also contains fiber that help slows down
the rate at which food is emptied from the stomach. This
in turn delays the absorption of glucose from the small in-
testine, resulting in lower blood sugar.

4. Bitter melon (Momordica charantia)

Also known as bitter gourd or balsam pear is widely used
in folk remedy. Clinical studies have verified its benefits.
Bitter melon contains compounds that are close chemi-
cal relatives of insulin, polypeptide-P, which lowers blood
sugar level.

The four herbs mentioned above are available in capsule form under the
brand name “DIABETROL”. Its recommended dosage is 1-2 capsule twice
daily after meals . For weight reduction, DIABETROL can be taken three times
a day, 1 capsule 30 minutes before each meal. DIABETROL, from the words
“Diabetes Control”, is now available at all leading drugstore nationwide.

Always remember : Your best assurance for maximum health and an active life comes
from your own responsible attitude and from following the advice you get from physician.
Plant-based therapy should not be used by itself. Proper and effective natural treatment of
diabetes and hypoglycemia requires careful integration of diet, proper exercises, lifestyle
modification, nutritional supplements and prescribed medication.
 OSTEOARTHRITIS
Osteoarthritis is a
common degen-
erative disease of the
joints. Also known as
the wear and tear dis-
ease, it is characterized
by areas of destruction of
articular cartilage, sclero-
sis of the underlying bone
and hypertrophy of soft tissues.
This type of arthritis affects more peo-
ple than any other type. Patients usu-
ally know this disease best as old age
arthritis.
Why does Osteoarthritis occur?
In a normal joint a smooth, elastic
material called cartilage covers the
ends of your bones where they meet.
Cartilage enables the bones to glide
smoothly across each other and
gives joints their flexibility. When the
cartilage wears away, it becomes
painful to move the joint. The ends
of the bones may develop spurs
or outgrowths, and ligaments and
membranes around the bones may
thicken. It usually becomes apparent
in older people, in the larger, weight-
bearing joints including the hips,
knees, and spine.
What are the symptoms?
Episodes of pain, swelling and stiff-
ness in the affected joint occur at in-
tervals of months or years. The major
symptom is pain, in and around the
joints. In different individuals the type
of pain varies. It may be a constant
aching, a feeling of soreness, or a
more severe pain when you move
your joints. The pain occurs because
the pressure is placed on the nerve
endings due to the deterioration of
the smooth cartilage between the
bones. Tense muscles may radiate to
other muscles that seem unrelated to
your sore joint.
How is Osteoarthritis diagnosed?
Often if a person complains of pains
in joints, the physician will order x-rays
because damage to a joint may be
seen that way. However, x-rays are
only part of the procedure to diag-
nose Osteoarthritis. The history of your
symptoms and the findings of the
complete physical examination also
will be valuable factors in the diagno-
sis. Your explanation of how you feel
will be very important. For example,
persons with Osteoarthritis usually do
not have a feeling of being ill, do not
experience severe weight loss, and
do not have poor appetite or fever.
Also, the pain in the involved joint is
usually maximal with activity (walking;
etc.) and decreased by rest in pa-
tients with Osteoarthritis.
How is Osteoarthritis treated?
There is no cure for Osteoarthritis. The
goal of therapy is to control the dis-
ease and possibly slow its progress by
keeping the affected joints mobile,
preventing further disability, and re-
lieving pain.
In some cases special exercise,
rest and heat therapy are effective.
Resting decreases stress on the sore
joints, and relieves pain and swelling.
Pain relievers such as paracetamol and non-steroidal anti-inflammatory drugs
(NSAIDs) are commonly used to relieve pain and inflammation. However, oral
pain reliever has its side effects particularly in the gastrointestinal system
If you are over-weight, your physician will probably suggest a weight-reducing
diet. Reducing weight will help reduce strain on your joints, particularly if your
Osteoarthritis is in the hips or knees.

Natural Remedy for Osteoarthritis

Glucosamine hydrochloride
- one of the important ingredient which repair the damaged cartilage. The
hydrochloride of glucosamine is the purest, highest and 20% more active
than sulfate form.

Chondroitin
- for better absorption of glucosamine in our body.

Methylsulfonylmethane (MSM)
- helps relieve the pain and soreness caused by osteoarthritis.

The three natural ingredients mentioned are now available in capsule form
under the brandname OSTEOFLEX Dietary Supplement.

Recommended use:
One (1) capsule twice a day after meal or as prescribed
by your healthcare professionals.

Available in all leading drugstores nationwide.

PROPER
EXERCISE & DIET
SITTING AND STRETCHING Neck/Spine Stretch
The following exercise should be done Sit up straight, pull your shoulders
while sitting in a straight-backed chair back, tuck your chin in, and imag-
with a firm seat and no arms (i.e. ine someone is pulling on a string at-
kitchen chair that does not swivel). Sit tached to the top your head.
with your buttocks against the back of
the chair.

This exercises should be

done while sitting in a
chai r.

Neck Bend
Look straight ahead. Bend your left
ear to your left shoulder. Then bend
your right ear to your right shoulder
and lift your head up to the center.
Hands Behind
Put your hands behind your head and
pull your elbows back. Then return
your arms to your sides. Now put your
hands behind your back and slide
your thumbs up as high as you can.

Neck Turn
Turn your head left so that you are
looking over your left shoulder, then
turn it right to look over your right shoul-
der, then turn back to the center.
Shoulder Lift
Sit with head facing forward. Lift your
left shoulder up while keeping your left
arm by your side. Then drop your left
shoulder down, lift your right shoulder
up and drop it down.

Cation
Avoid putting your neck in the either the flexed (chin to
chest) or extended (tilting head back) position.
Frontward Arm Lift
Start with both arms straight down by
your sides. Keep your palms toward
your sides with thumbs up. Lift your
arms forward and up to your ears.
Then slowly lower them back to your
sides.
Outward Arm Lift
Start with with both arms straight down
at your sides, palm facing down. Lift
your arms out to the sides (as high as
your shoulders). Then turn your palms
up and lift your arms up above your
head.
Now slowly return your arms to the
height of your shoulders. Turn your
down palms down and bring your
arms back to your sides.
Elbow Bend
Start your arm straight down at your
side. Bend your elbow, bring your
hand up so your fingers can touch
your shoulder. Then slowly lower your
arm back to your side.
Elbow Roll
Start with your elbow bent at 90 de-
grees and tucked into your side. Point
your thumb toward the ceiling. Now
roll your thumb to the outside (palm
face up) as far as you can. Then roll
your palm down so that it faces the
floor. Finally, roll your palm back to
the starting position.
Wrist Cycle
Keep your elbow tucked into your
side and your hand out in front of
you, fingers straight. Do not move
your forearm (hold forearm still with
other hand). With your hand, draw the
largest circles you can in the air, first
going one way then the other way -
remember only your wrist should be
moving.
Wrist Bend
Have your elbow bent and tucked
into your side, with your palm towards
the floor. Bend from the wrist and
point your fingers down to the floor.
Then bend from the wrist and point
your fingers up to the ceiling, pulling
back as far as you can.
Finger Curl
Gently tuck the tips of your fingers into
their inside base. Keep your knuckles
straight, making sure that they do not
move. Then stretch them back out.
Loose Fist
Start with your fingers extended, then
gently tuck them into the palm of
your hand. Close your hand to make
a loose fist. Then slowly stretch your
fingers back out straight.
Finger Touch
Touch your thumb to the tip of each
finger of your hand.
Thumb Stretch
Stretch your thumb as far away from
your finger as possible and then re-
lax.
Finger Slide
Start with your hand flat on a surface,
thumb and fingers together and
straight. Slide thumb away from fin-
gers. Then slide index finger toward
thumb, long finger index (keeping the
rest of your hand still). Slide your ring
finger to the long finger and baby fin-
ger over to the right finger. Then re-
lax.
Ankle Bend and Stretch
With your leg in a position most com-
fortable for you (relaxed, or extended,
or anywhere in between), point your
toes down as far as possible (feel the
pull on your ankle). Then pull up and
point your toes toward your head.
Hip Bend
Start with your hands resting on your
lap and your back straight. Lift your
knee to your chest as far as possible.
Then slowly lower your leg and put
your foot back on the ground.
Knee Stretch
Lift your foot up as high as your knee,
keeping your toes pointed at the
ceiling and your leg as straight as
you can. Hold this position and try to
straighten a little more. Now bend
your knee and pull your foot back as
far as possible under your chair.
Ankle Circle
Draw a circle in the air with your big
toe. Be sure to keep your leg still and
move only your ankle. Repeat circling
in the opposite direction.

FOODS ACCORDING TO PURINE CONTENT

GROUP I GROUP II GROUP III
Select from these foods: Use these foods in moderation: Avoid this foods
Beverages Fats Mussels (tahong)
Butter, margarine Fish Meat extracts
Bread (except those listed under Group III) Gravies (sarsa)
Cereals and cereal products Legumes Patis
(beans, lentils)
Cheese Yeast (beer)
Meat
Eggs Anchovies
Meat soup and broth (dilis and bagoong)
Fruits
Oatmeal Internal Organs
Gelatin
Poultry (as liver, brains, kidney & pancreas)
Milk
Seafoods Sardines
Sugar and syrups (crabs,eel, shrimps) Herring
Tea and coffee Vegetables (tamban, tawilis, tunsoy, lapad,
Vegetables (asparagus, spinach, mushroom & silinyasi)
cauliflower) Mackerel
(alumahan, hasa-hasa, tanigue)
Sweetbreads
(mulyehas)
 www.geriatricaph.com
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Phone: (632) 635-7724 • Telefax: (632) 635-7721 • Mobile No.: 0920-9828888