Questions about your general advise on screening

Medical Q&A [Moderated]
1

Dear Drs.,

I’ve recently become an even more dedicated listener to your podcasts, and I must say, the content is truly remarkable and very helpful.

As I became 40 last year I started to become a bit more health conscious overall and I realized that thrice a week strength training may not be enough to max out in terms of “health gainz”. Your insightful discussions finally made me incorporate some light to moderate intensity cardio a couple of times a week in addition to the 10k+ steps I am trying to collect.

Your advice on regular health screenings caught my attention, particularly focusing exclusively on blood pressure, blood lipids, and a once-in-lifetime L(a) measurement. I’ve was wondering about two aspects: 1. Considering the rising concern around (pre-)diabetes, wouldn’t it be prudent to include regular blood sugar measurements? My last HbA1c reading was 5.5%, nearing the upper limit of normal. To counter this, I’ve successfully reduced my waist circumference to 87-88 cm from its original 95+ cm. Shouldn’t an annual check of my blood sugar levels be appropriate?
2. Getting my blood pressure checked in a clinical setting seems close to impossible to me since I seem to have a severe white coat syndrome. When I measure at home my readings range between optimal and normal while it shoots up to severely elevated when I get it checked in a doctor’s office. Should I be worried about that or just rely on the normal at-home data. Thanks You!

2

Torsten,

Thanks for the post and congrats on making some healthy behavior changes. To your questions:

  1. Yep, screening for diabetes is recommended for those with overweight or obesity and/or other predisposing factors via fasting blood sugar or HbA1c. The interval of testing depends on the result, e.g. with normal levels you can space it out to every few years and with abnormal levels, repeat testing will be on the order of months (or sooner with various interventions).

  2. White coat hypertension has a number of different definitions, but management typically involves at-home monitoring using an appropriate device (https://www.validatebp.org/) or 24-hour ambulatory blood pressure monitoring. Ideally, your physician would work with you to ascertain whether or not you have white coat hypertension and if not, what to do about it.

-Jordan

3

Thank you Jordan for your helpful answer.

My physician advised me to monitor my bp at home for a while and when I showed her my readings the following week she told me everything appears to be okay. Curiously, I read that people white coat hypertension tend to be at greater cardiovascular risk even when their at-home measuremnts are normal.

Another thing I always found funny is that to be more healthy you should be as active as possible engaging in a lot of endevours which actually raise the bp (if only for the time o activity) :slight_smile:

Please keep up the great work!