Evidence suggests that excessive sitting and other behaviors that are low in

Evidence suggests that excessive sitting and other

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Evidence suggests that excessive sitting and other behaviors that are low in activity and energy expenditure may trigger unique cellular responses that contribute to the development of metabolic syndrome. [ 127 ] Sleep health Care should be taken to ensure that patients with metabolic syndrome practice healthy sleep behaviors. Even in patients who do not have sleep apnea or suspected sleep apnea, some studies have suggested a relationship between sleep deprivation or inadequate sleep time and metabolic syndrome. [ 129 ] Shift workers, who tend to have poor quality sleep, may also be at higher risk of developing metabolic syndrome. [ 130 ] Deterrence and Prevention In 2010, the American Heart Association-American Stroke Association (AHA-ASA) updated their guidelines for the primary prevention of stroke. These are described below. 128 ] Screening Hypertension Regular blood pressure screening , lifestyle modification, and drug therapy are recommended. A lower risk of stroke and cardiovascular events are seen when systolic blood pressure levels are less than 140 mm Hg and diastolic blood pressure is less than 90 mm Hg. In patients who have hypertension with diabetes or renal disease, the blood pressure goal is less than 130/80 mm Hg. However, the 2014 JNC-8 guidelines recommend more lenient targets (150/90 mm Hg in patients ≥60 y, and 140/90 mm Hg for most other populations). Diabetes Blood pressure control is recommended in types 1 and 2 diabetes. Hypertensive agents that are useful in the diabetic population include ACE inhibitors or ARBs. Treating adults with diabetes with statin therapy, especially patients with other risk factors, is recommended, and monotherapy with fibrates may also be considered to lower stroke risk. Taking aspirin is reasonable in patients who are at high cardiovascular disease risk. However, the benefit of taking aspirin in diabetic patients for the reduction of stroke risk has not been fully demonstrated. Dyslipidemia Statin therapy is recommended in patients with coronary heart disease and certain high-risk conditions for the primary prevention of ischemic stroke. In addition to statin therapy, therapeutic lifestyle changes and LDL-cholesterol goals are also recommended. Niacin may be used in patients with low HDL cholesterol or elevated lipoprotein (a), but its efficacy in preventing ischemic stroke is not established. Fibric acid derivatives, niacin, bile acid sequestrants, and ezetimibe may be useful in patients who have not achieved the target LDL-C level with statin therapy or who cannot tolerate statins; however, their effectiveness in reducing the risk of stroke has not been established. Physical activity Increases in physical activity are associated with a reduction in the risk of stroke. The goal is to engage in at least 30 minutes of moderate intensity activity on a daily basis
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  • Winter '19
  • Professor Robert
  • Nutrition, Atherosclerosis, Blood sugar

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