Cycle: Evaluation of the subject
treatment of obesity and overweight in two stages: the assessment phase and the phase of the intervention.
evaluation is needed to determine the status of absolute risk of the subject, it is done through:
A) Calculating BMI;
B) Measurement of waist circumference;
C) Verification of the presence of risk factors for concurrent cardio-vascular or comorbidities.
(For points A and B see the link .
As far as point C, it is known that some obesity-associated diseases (comorbidity) and some risk factors, place the subject in a class of very high mortality risk.
These people must be treated not only to lose weight, to modify the risk factors and to manage the disease.
associated diseases are:
- Coronary heart disease (history of myocardial infarction, history of angina pectoris, history of surgical procedures on the coronary arteries, angioplasty);
- Presence of other forms of atherosclerosis (peripheral arterial disease, abdominal aortic aneurysm ; symptomatic carotid artery disease);
- Type II diabetes;
- sleep apnea.
Other disorders associated with (which does not give effect to the level of mortality, but must be treated) are:
- Clinical obstetrics and gynecology;
- osteo-articular
- gallstones and its complications;
- Stress.
risk factors that place the subject in the group with a high absolute risk (it takes at least 3) are:
- Smoke;
- Hypertension (P systolic> 140 mmHg or diastolic pressure P> 90 mm Hg or Treatment with antihypertensive drugs);
- Excess LDL (> 160 mg / dl. A borderline value of 139-159 mg / dl associated with 2 other risk factors, confers high risk);
- Lack of HDL (< 35 mg/dl);
- Impaired fasting glucose (IFG) (110-125 mg / dl);
- Family history of premature coronary artery disease (before age 55);
- Age (> 45 years in men,> 55 years in women) .
Other risk factors (which increase the need to lose weight) are:
- Physical inactivity (leading to increased risk of cardiovascular disease and type II diabetes. exacerbates the severity of other risk factors);
- Hypertriglyceridemia.
If a person falls into the category of high risk, antihypertensive and cholesterol-lowering treatment should be done intensively.
0 comments:
Post a Comment