High blood pressure: About 1 in 2 (46.73%) adults have hypertension or high blood pressure, American Heart Association, 2023. And, 1 in 3 (33%) adults in the United States have the common cardiovascular complication- heart attack (which may present as chest pain), stroke (which may subtly present as precipitous memory loss or cognitive declines), and heart failure (which may present as easy fatigability). What can we do about it? Low salt intake and increased fruits and vegetables with whole grains (dietary approaches to stop hypertension) and exercise would be a good start. Our primary care providers would be excited to take it from here.

High blood sugar: Slightly above 1 in 10 (10.5%) adults have sufficiently elevated blood sugar for the diagnosis of diabetes mellitus. Aside from heart attack, stroke, kidney, and heart failure, other serious complications associated with diabetes include damage to the blood vessels in the retina that can lead to vision loss or blindness; nerve damage that can cause pain, tingling, or numbness in the hands and feet, as well as problems with digestion, sexual function, and urinary function; and damage to the blood vessels and nerves in the feet that can cause foot ulcers, infections, and in severe cases, amputation. How can we help ourselves?

The key to optimum management of diabetes mellitus is prompt diagnosis because there are primarily two types of diabetes mellitus: insulin-dependent & non-insulin dependent. Excessive urination, thirst and appetite should necessitate immediate appointment with your health care provider.

High lipids or cholesterol and/or triglycerides: About 12 in 100 (12.1%) adults have high cholesterol and/or triglycerides, AHA, Circulation, 2019. It causes narrowing and hardening of blood vessels resulting in reduced blood flow to the body (tissues and organs). This leads to complications such as heart attack, stroke, erectile dysfunction, and intermittent leg pain among others. Important mitigating factors or activities are lifestyle modifications (including diet and exercise) and medications. Please, see your primary care provider for evaluation including risk stratification for appropriate/adequate management.

Asthma: About 1 in 13 (7.8%) people in the US have recurrent episodes of shortness of breath or difficulty with breathing per 2020 CDC (Center for Disease Control and Prevention) estimate. This is close to 1 in 9 (11%) in those below 100% of the poverty threshold. The complications of asthma include asthma attack or exacerbations of shortness of breath (often due to airway secretions and narrowing) which may be severe enough to result in death. It’s important for asthma patients to always have their rescue (such as albuterol) inhalers at hand and avoid symptom triggers as much as possible. Regular healthcare check-up is key to optimum wellbeing.

Chronic Obstructive Pulmonary Disease (COPD): About 1 out of 10 adults have COPD according to the Global Initiative for Chronic Obstructive Lung Disease (GOLD), 2023 Report. In the US, it ranges between about 3 out of 100 in Hawaii and 12 out of 100 in West Virginia per 2020 CDC age-adjusted data. The complications include recurrent lung infections, depression, right-sided heart failure, lung damage, respiratory/breathing failure, lower or higher number of oxygen-carrying cells in the blood and lung cancer that may result in significant incapacity and even death.

The avoidance of environmental exposure to toxic fumes prevents COPD and significantly delays its occurrence in those vulnerable, such as individuals with alpha-1 antitrypsin (which protects the body tissues from immune agents) deficiency. It is important for people with COPD to avoid smoking that worsens the condition and consult with a primary care provider or specialist for a plan to optimize breathing and prevent complications.

Depression is persistent sadness which results in social and occupational dysfunction. Individuals affected may experience reduced energy, low mood, feel anxious, loss of or increased appetite, sleep disturbance, poor concentration, excessive guilt, and thoughts of suicide among others (American Psychiatric Association. Diagnostic and statistical manual of mental disorders, 5th ed.). 1 in 12 adults have depression. It is more common in females (1 in 10) and young adults (1 in 6) per 2020 SAMHSA data.

The complications of depression include risk of self-injury and suicide. Depression gets better or responds to medication but there are other treatment modalities. Psychotherapy and other activities including exercise have been effective.

If interference in function from depression and/ or anxiety lasts for two weeks or more or is more than usual, please see a primary care provider or a specialist before situations get worse. A stitch in time saves nine!

Osteoarthritis is due to the deterioration or loss of the cartilage that covers and cushions the ends of the adjacent or articulating bones, and/ or small, abnormal bony outgrowths in the affected joint(s) especially the large ones such as the knee and hip joints. It presents with joint ache, stiffness, and reduced motion and/or function. About 1 in 10 adults (although more common with increasing age) are affected per 2020 CDC estimate.

The complication centers on loss of function resulting in inability to perform activities of daily living. However, treatment related complications such as kidney dysfunction and peptic ulcer disease from the use of NSAIDs such as ibuprofen are not uncommon. It is in this light that individuals with osteoarthritis should meet their primary care providers and come up with a plan of care including medication(s), exercise programs and involve physical and occupational therapists to preserve function for as long as possible.

Chronic pain is often defined as pain that persists for 3 or more months. It affects about 1 out of 5 adults (MMWR Morb Mortal Wkly Rep., 2018). Poorly managed pain may result in disability/loss of ability to function, inability to focus and medication/drug dependence. It is possible to be productive, happy and enjoy life with appropriate plan of care which may involve pain management specialist and a primary care provider.

Primary Care nuggets

Primary care nuggets