Understanding Blood Pressure

The top number (Systolic reading) is the measure of pressure in the arteries when the heart contracts.  The bottom number (Diastolic reading) is the pressure in the arteries when the heart muscle is resting between beats, filling back up with blood.  To get an accurate BP, it should be taken multiple times at different points of the day for several days and averaged.

The Body Mass Index (BMI) is a measure of proper weight to height ratio.  Elevated readings coincide with the incidence of: high blood pressure, heart disease, stroke, gallbladder disease, sleep apnea, osteoarthritis, varicose veins, liver disease, cancers, back pain, fatigue, and shortened life span.  A healthy score ranges from 18-25.  The formula to calculating your BMI is as follows:

Body Weight / Height (in inches) squared X 703 = BMI

Important Note:  BMI does not differentiate between body fat and muscle mass.  So, there are exceptions to the measure.  BMI should not be applied to children, those with physical diabilities, pregnant and lactating women, and supreme athletes.




 The lists below explain tests run during routine blood work and extras, give normal value ranges, and even details the numbers of a urinalysis exam. 

Blood and Serum

·         Acid phosphatase- found in the serum and prostate, it is released into the blood and lymph in metastatic prostatic cancer, a normal range is measured in .5-2.0 Badansky units.

·         Albumin/globulin ratio (total protein)- sampled in serum, amino acids are converted into albumin and globulin in the liver. The kidney would normally prevent these proteins from being excreted.  Normal a/g ratio is 2:1 or 2.5:1.

·         Alkaline phosphatase- sampled in serum, normals range between 2.0 - 4.5 Badansky units, or an increase suggests bone growth and disease, liver disease, bile duct obstruction, Paget’s disease; while a decrease suggests growth retardation.

·         Amylase- sampled in serum, this enzyme produced by the pancreas and parotid gland, normals range from 4-25 u/ml, an increase suggests acute pancreatitis.

·         ANA (anti-nuclear antibodies)- sampled in blood in autoimmune disease, antibodies form to the nuclear material of the host cells.  If normal it would not be present.  It would be present in lupus, rheumatoid arthritis and scleroderma.

·         ASO titer- increased in rheumatic fever.

·         Bilirubin (bile pigment)- released into blood as a result of red blood cell       breakdown then conjugated (combined) with glucuronic acid in the liver.  Increased in hepatitis, duct obstruction or hemolytic disease.

·         BST (bromsulthalein)- this injected dye should be removed in the liver.  If increased, this would suggest liver disease.

·         BUN (blood urea nitrogen)- urea is the end product of protein metabolism.  This would be increased in renal damage or in urinary tract obstruction.  While a decrease would suggest hepatic failure or pregnancy.

·         Calcium (in serum)- this maintains proper neuromuscular excitability and clotting controlled by the parathyroid hormone.  An increase in this suggests hyperparathyroidism, hypothyroidism, and excess vitamin D and bone metastases.  A decrease suggests the opposite plus possible malabsorption, renal insufficiency or pancreatitis.

·         CO2 (carbon dioxide) (serum)- because it is converted to carbonic acid this helps regulate acidosis or alkalosis.

·         Creatine/Creatinine- creatine forms creatine phosphate, the storage form of energy in muscle.  In the presence of CPK, creatine phosphate combines with ADP to form ATP, leaving creatinine as a waste product eliminated by the kidneys. Increased creatine suggest muscular dystrophy, kidney disease, or obstruction.

·         CPK (creatine phosphokinase)- an increase in CPK suggest myocardial infarct (heart attack).  Measured at leased 4 hours after symptoms and peaking at 36 hours.  Also, an extreme increase in this would suggest the presence of muscular dystrophy.

·         ESR (erythrocyte sedimentation rate)- when blood is mixed with an anticoagulant the red blood cells settle out.  This is increased in advanced malignancy, tissue necrosis or inflammatory disease.

·         Blood glucose (found in serum)- this is increased in diabetes and Cushing’s disease, and will be decreased in hypoglycemia and Addison’s disease.

·         Heterophil (Paul-Bunnel)- found in blood, in certain diseases the titer of       antibodies to sheep red blood cells rises.  An increase in this suggests the presence of mononucleoses.

·         IBC (iron binding capacity)- transferrin picks up iron and transports it to the bones.  An increase in IBC suggests hepatitis, blood loss or anemia.

·         IDH (isocitric dehydrogenase)- found in serum, it is the enzyme of citric acid in  the liver.  If increased, it will suggest viral hepatitis or liver metastases.

·         Iron- measured in serum, it forms hemoglobin, it is increased in acute liver       disease and hemolytic disease. It will be decreased in the presence of iron deficiency, anemia and bleeding.

·         LAP (luecin aminopeptidase)- measured in serum this enzyme active with liver alkaline phosphatase, will be increased in liver cancer.

·         LDH (lactic dehydrogenase)-measured in serum, it is the Krebs cycles active enzyme in liver and muscle, this will be increased in the presence of myocardial infarct.

·         Lipase- found in serum this fat digesting enzyme is produced by the pancreas.  This will decrease in acute pancreatitis, cancer of the pancreas and obstruction of the pancreatic duct.

·         Lipids- measured in the serum, they're freely circulating sources of energy. 

Total lipids = 450-1000mg %

Cholesterol =150-280mg %

Phospholipids = 9-16mg %

Total fatty acids = 190-420mg %

Triglycerides = 40-150mg %

Lipids in the serum suggest an increase in atherosclerosis and hyperlipidemia.

·         Phosphorus- this is measured in serum and is regulated by parathyroid hormone, vitamin D and the kidneys.  An increase in phosphorus suggests severe kidney disease, hyporparathyroidism and hypervitaminosis (D).  A decrease is seen with hyperparathyroidism, vitamin D deficiency, malabsorption and osteomalacia.

·         Potassium- exchanged for sodium in the kidney, measured in serum, an increase suggests renal insufficiencies or Addison’s’s disease.  A decrease in potassium suggests chronic renal disease, use of insulin or excess glucose, and diuretics.

·         SGOT (serum glutamic oxalacetic transaminase)- this is an enzyme present in the muscle and liver.  Increase in SGOT is seen in heart disease and in muscular dystrophy, as well as liver disease. 

·         SGPT (serum glutamic pyruvic transaminase)- this enzyme in large amounts in the muscle and liver.  An increase in SGPT suggests acute hepatitis.

·         Sodium- this is measured in serum, sodium maintains osmotic pressure and acid-base balance.  An increase in sodium is suggestive of Cushing’s disease, while a decrease in sodium may suggest Addison’s disease.

·         Uric Acid- measured in serum, this is the end product of purine metabolism.  This will be increased in gout and decreased in acute hepatitis.

Complete Blood Count (CBC)

·         White Blood Count (leukocytes)- bacteriocidal, main defense against invading microorganisms.  An increase in WBC suggest infections, blood disorders, emotional upset, while a decrease in WBC is seen in diminished immunity due to exhaustion.

·         Red Blood Count (RBC) - red blood cells will be increased in polycythemia and decreased with anemia.

·         Hemoglobin- oxygen transport, this will increase in dehydration and polycythemia  while it will be reduced in all anemias and in late pregnancy.

·         Hematocrit (volume of settled RBC’s per 100 ml of blood)- hematocrit will be increased in polycythemia and decreased in anemia.

·         Indices (mean corpuscular volume or MCV) (mean corpuscular hemoglobin or MCH)-these will be increased in macrocytic anemia and will be decreased in microcytic anemia (mean corpuscular hemoglobin concentration or MCHC) this will be decreased in microcytic anemia.

·         Platelet count- primary in coagulation and vessel wall strength, this will be increased in trauma and blood loss, while decreased in the presence of anemia.

White Blood Count (WBC):

·         Neutrophils- increased in bacterial infection and necrosis.

·         Lymphocytes- increase in viral infection, lymphocytic leukemia and decreased in Hodgkin’s’s disease and pyogenic infection.

·         Eosinophils- increased in allergies and paracystic infection.

·         Monocytes- increase in chronic infection and Hodgkin’s disease.

·         Basophils- increase in myeloid leukemia and decreased in acute infections.

·         Reticulocyte- increased in pernicious anemia, hemorrhage, while decreased in aplastic anemia.

Urinalysis

·         Aldosterone- increased in hypertension and disfunction of the adrenal cortex.

·         Bence Jones protein- present in multiple myeloma and osteosarcoma.

·         Catecholamines- compounds produced in the adrenal cortex (epinephrine/ norepinephrine) increased in pheochromocytoma- a benign neoplasm affecting the tissues of the adrenal medulla.

·         HCG (human chorionic gonadotropin)- this is present during pregnancy.

·         Phenylalanine- present in phenylketonuria (PKU), which is seen in mental retardation.

·         PSP (phenolsulfonphthalein)- this is decreased in kidney disfunction.

·         17 Ketosteroids- excretion products of androgenic hormones, this will increase in the presence of Cushing’s disease and decreased in the presence of Addison’s disease.