Author of this article:Hu DayiChief Physician of the Department of Cardiovascular Medicine at Peking University People's Hospital and Director of the Institute of Cardiovascular Disease at Peking University People's HospitalNowadays, there are more and more medical examination institutions in China, and the variety of medical examinations is also endless.
Author of this article:Hu DayiChief Physician of the Department of Cardiovascular Medicine at Peking University People's Hospital and Director of the Institute of Cardiovascular Disease at Peking University People's Hospital
Nowadays, there are more and more medical examination institutions in China, and the variety of medical examinations is also endless... Some medical examinations even cost tens of thousands of yuan at a time.
Physical examination is important, but I think there should be a personalized scheme for physical examination. It varies from person to person, that is, according to age and gender, whether there is overweight, obesity or emaciation, whether there is hypertension, diabetes and dyslipidemia, whether smoking and heavy drinking, and other factors, a targeted physical examination scheme should be designed.
Don't pursue high prices
Physical examination should be targeted
Many middle-aged and elderly people go for the so-called "deep examination", and find that there are carotid atherosclerotic plaques and coronary artery stenosis. Once the stenosis exceeds 70%, they are likely to accept the stent that should not be placed.
This year (2022), I am 76 years old and have never had a coronary artery CT or carotid artery ultrasound. Why? Do I have any risk of atherosclerotic cardiovascular disease (including stroke) at the age of 76? There must be, age is the biggest risk that cannot be changed. So how to avoid or prevent risks?
I think we should strive to defend two lines of defense:
1Healthy lifestyle. I never smoke, and now I insist on not getting drunk; Persist in exercise; Regularly schedule and go to bed at ten o'clock on time; Maintain a good mindset and mood; Eat reasonably.
2Control risk factors, such as hypertension, hyperglycemia, and hyperlipidemia.
Traveling ten thousand steps a day, I have been like a day for 22 years. I have walked in the desert and Gobi, walked along the Ancient Tea Horse Road, entered Xizang 20 times, and walked on the Ali Plateau 8 times without angina. This suggests that there may be two situations for me:
1Coronary artery stenosis is not severe enough to cause myocardial ischemia and angina;
2The coronary artery may have stenosis, but it establishes good collateral circulation, so there is no need for stents or bypass grafting.
What do I check for every year's physical examination?
What do I do for my annual physical examination? Go to see a general practitioner first and discuss the necessary and optional items with him. The items that must be checked every year include:
(1) Weight
(2) Body fat
(3) Blood pressure
(4) Fasting blood glucose and glycated hemoglobin
(5) Four items of blood lipids (total cholesterol, triglycerides, low-density lipoprotein cholesterol, and high-density lipoprotein cholesterol)
(6) Hematuria and stool routine (including fecal occult blood)
(7) Digital examination of the anus
In 2020, my physical examination revealed positive stool occult blood and positive Helicobacter pylori test. So I went for a painless gastroscopy and used systematic medication to eradicate Helicobacter pylori.
Earlier, during my on-the-job physical examination at Peking University People's Hospital, I found that my postprandial blood sugar was high and my fasting blood sugar was normal. Therefore, I started to "eat 80% full and walk ten thousand steps a day". My weight decreased from 93 kilograms to 72 kilograms, and my blood sugar remained normal for many years. In 2015, I found that glycated hemoglobin was 6.5 and fasting blood sugar was normal. I started using acarbose and later switched to metformin sustained-release tablets, taking one tablet per day; Simultaneously using lipid-lowering drugs for a year, the low-density lipoprotein cholesterol was reduced to around 2.0 mmol/L.
In 2022, during a physical examination, the blood pressure was 146-154/90-100 millimeters of mercury, so we scheduled for ambulatory blood pressure monitoring and began taking antihypertensive drugs. After taking the medication, I self measure my blood pressure daily and maintain it below 130/80 millimeters of mercury.
Currently, many medical examination centers only check and ignore. The deeper and more comprehensive the investigation, the more clinically insignificant but unsettling results will be identified. For example, mild mitral and tricuspid valve regurgitation, left ventricular diastolic dysfunction, atrial or ventricular premature beats, short-term atrial tachycardia, ventricular premature beats, as well as pulmonary nodules, carotid artery plaques, and varying degrees of coronary artery stenosis.
These examination results can cause extreme anxiety among the subjects, worry about the detachment of carotid artery plaques and blockage of cerebral blood vessels, worry about myocardial infarction and heart accidents, and worry about the canceration of nodulesSubjects who did not feel unwell before the physical examination are actually in great pain after reading the examination report, and are prone to excessive medical treatment. This is currently a very common problem. Here, I emphasize once again that physical examinations should be personalized, targeted, and more moderate.
Source: Famous Chinese Medicine Masters
Editor: Xiang Yanhong
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