Cholesterol is a fatty, waxy substance found naturally in the blood. Cholesterol is also known as a lipid. Lipids are essential in maintaining good health and normal bodily functions. However, when the levels of cholesterol in the blood become too high, it can have a negative effect on our health. If cholesterol levels in the blood are too high then it can stick and build up in the artery walls. This build up can start to restrict the blood flow through the arteries, potentially starving the heart, brain and rest of the body of blood supply and hence, oxygen. This restriction can lead to heart disease, such as a heart attack or stroke.
Cholesterol is transported around the body by proteins in your blood. Combined they are called lipoproteins. The two main types of lipoproteins are known as:

• Low-density lipoprotein (LDL) – LDL is sometimes referred to as ‘bad cholesterol’. This is because the LDL carries cholesterol away from the liver, delivering it to the cells that require it. If there’s an excess amount for the cells to use then the remaining cholesterol begins to build up in the artery walls, leading to disease of the arteries.
• High-density lipoprotein (HDL) – HDL is also known as ‘good cholesterol’. This is because HDL carries cholesterol away from the cells and back to the liver. After being taken to the liver it will either be broken down or removed from the body as a waste product.

High cholesterol (which actually refers to high levels of LDL) can be caused by a number of factors. These include:

• Eating an unhealthy diet
• Being physically inactive or over weight
• Smoking
• Drinking too much alcohol
• Family medical history
• Having diabetes or high blood pressure
• Age

Keeping a healthy lifestyle is a key way of preventing or reducing high cholesterol. There are a number of changes you can make:

• Diet – improving your diet can reduce the amount of cholesterol that comes into your body from the food you eat. Try to follow a balanced diet, whilst reducing your intake of saturated fat.
• Exercise – aim to do some type of physical activity every day
• Stop smoking – this can improve your cholesterol levels and have many other health benefits at the same time. For more information on how to stop smoking you can speak to your GP, visit https://www2.hse.ie/living-well/quit-smoking/
• Alcohol – try to reduce your alcohol consumption or keep consumption within the recommended limits.

High blood pressure is also known as hypertension. Having high blood pressure means that your blood pressure is consistently higher than it should be. It is important to reduce high blood pressure because it puts a strain on your blood vessels and heart.

Over time, this can lead to serious problems such as heart attacks, strokes, kidney disease, heart disease and heart failure. It is thought that globally, around 25% of adults have hypertension.

When you have a blood pressure check it records two figures. The higher number is the systolic pressure and the lower number is the diastolic pressure. The systolic pressure measures when your heart beats and contracts to pump blood around the body. The diastolic pressure measures the resistance to blood flow in the vessels when your heart relaxes.

High and healthy blood pressure might be slightly different for different people. As a general guide, healthy blood pressure is between 90/60mmHg and 120/80mmHg. A blood pressure reading above 120/80mmHg and below 140/90mmHg could indicate you are at risk of hypertension. A consistent blood pressure reading above 140/90mmHg is usually considered to be high blood pressure/hypertension.
Unless someone has very high blood pressure (hypertensive crisis), there are usually no high blood pressure symptoms. The only way to find out whether you have hypertension is to have a blood pressure test. This can be done at your GP surgery or at your local pharmacy. BP monitors are also available to buy to use at home.

Often, there is no obvious cause of hypertension but there are a number of risk factors that are known to increase your risk. Some of these factors are things you cannot change. For example, a family history of hypertension, age, living in a deprived area, and being of black African or black Caribbean descent.

There are some lifestyle factors that increase the risk of hypertension. These factors include:

• Being overweight or obese
• Not exercising regularly
• Smoking
• Drinking too much alcohol
• Eating too much salt

Lifestyle changes can reduce your risk of high blood pressure or lower your blood pressure if it is already high.

Asthma is a condition that affects the airways- the small tubes that carry air in and out of the lungs. In asthma, the airways become over-sensitive; meaning that they react to things that wouldn’t usually cause a problem, such as cold air or dust.

When the airways react to a substance, the muscles of the tube walls tighten up, making them narrow and leaving little room for air to flow in and out. The lining of the airways then gets swollen (just like your nose during a cold) and sticky mucus is produced which clogs up the breathing passages.

With so little space in the airways, it becomes difficult for air to move in and out and the chest has to work much harder to breathe. Tightening of the muscles around the airways can happen quickly; this is the most common cause of mild asthma symptoms.

Thankfully, this tightness can be relieved quickly with a reliever inhaler (usually blue). However, the swelling and mucus happen more slowly and need a different treatment. This usually is usually a preventer inhaler which is taken daily to allow the effect to build up over time.

The majority of people with asthma are prescribed a daily preventer inhaler to protect against an asthma attack and a reliever inhaler to use when symptoms occur. It is extremely important that preventer medication is taken regularly, as prescribed and even when asthma symptoms are not present.

The symptoms of asthma include experiencing breathlessness, a tightness of the chest, having a cough or making a wheezing. There is great variation in how many symptoms a person may experience, and while some may only have one symptom others may experience several symptoms.

An individual will experience symptoms of asthma when he or she is exposed to so-called triggers, which irritate the person’s lungs leading to the airways becoming narrow, the muscles around the airways tightening and an increase in the production of mucus (phlegm).

It is important to be aware of the triggers so that they then can be avoided. There is a great variation in triggers and they can be related to weather conditions, exercise, allergens, medication, foods, and airborne irritants. Some common triggers include cigarette smoke, the use of certain pain killers (aspirin and ibuprofen), cold air, sudden changes in temperature, and from consuming food that contains sulphites.

The aim of asthma treatment is to maintain good control as good control can prevent damage caused to your lungs by frequent asthma attacks and flare ups.
Good control of your asthma is:

• Not experiencing daytime or night time symptoms from you asthma
• Not being prevented from doing things (such as exercising) by your asthma
• Not needing to use your reliever inhaler (normally blue – salbutamol)
• Not experiencing asthma attacks

If you don’t think your asthma is well controlled a face to face appointment with your primary doctor is the best way to address this

Useful link: Asthma Society of Ireland: www.asthma.ie

Gout is a form of arthritis that causes severe pain, swelling and tenderness in one or more joints. The most common place to get gout is where the joint of the big toe meets the foot. Around 56-78% of people with the condition will experience gout in this joint. However, any joint can be affected such as the ankle, knee, fingers, wrist, and elbow.

People will often experience sudden and intense swelling and pain in and around the joint known as a gout attack. People will often describe gout pain as feeling like the area is on fire. During this time, movement or any weight on the area can be excruciating. It can also cause the skin around the swollen joint to become hot and red.

The condition comes and goes meaning it will go through periods when the condition is active, known as a gout flare, and periods when there are no symptoms. An attack usually lasts around 5 to 7 days before improving. When there are no symptoms it’s important that you implement strategies to prevent flares. Gout is more common in men and becomes more common with increasing age.

Gout is caused by the accumulation of uric acid crystals in the joints. This happens because of a build-up of uric acid in the blood. Uric acid can accumulate in and around a joint, leading to sharp and painful uric acid crystals. Uric acid is a normal waste product the body produces when it breaks down purines, a common substance in many foods.

Uric acid will normally be removed from the blood by the kidneys, however, when high levels of purine-rich foods are eaten, the body can struggle to remove the uric acid from the blood before it crystallises in a joint causing gout.

Foods that are high in purines include offal (like liver and kidney), game (such as pheasant and venison), sugary soft drinks, seafood, and alcohol.

Not everyone who has high blood levels of uric acid, or a diet high in purines, will develop the condition. Other factors increase your risk such as a family history of gout, being overweight, kidney problems, a high alcohol intake, and taking certain medicines.

Your lifestyle choices are one of the most important factors in preventing gout. The gout diet is often adopted by those with the condition as it can often limit purine intake enough to prevent flares.

The diet involves avoiding foods and drinks that are high in purines or result in an increased risk of a flare-up.

A healthy diet and exercise, in general, can improve your condition by limiting excess weight as a risk factor as well as potentially improving other risk factors such as diabetes, high blood pressure and high cholesterol. You should speak to your doctor or dietician about ways to assist with a diet and exercise plan for you and your conditions.