If you listen to our radio program then you know I believe that your health is not your doctor's responsibility. It's also not your spouse's, or the government's responsibility. Your health is your responsibility.

I also believe, and this comes from practicing preventive medicine for more than 40 years, that with just some routine tests you can dramatically increase your chances of living a long and healthy life to the fullest.

At Cooper Clinic we specialize in prevention and early detection. On a routine basis we discover heart disease and cancer, which often times are completely asymptomatic. The good news is that in the majority of these cases we have caught the problem early enough so that it can be treated without significant consequences. I feel that everyone, especially anyone over 40 years of age, should have some sort of annual physical. The following is a list of what I strongly suggest you have completed annually:

1. Blood Profile.

This needs to include:

a. Total cholesterol, HDL, and LDL. Ideally your total cholesterol should be below 200 (180 if you have a family history of cardiovascular disease). The HDL (or "good") cholesterol should be above 40 for a man and above 45 for a woman. The LDL (or "bad") cholesterol should be below 100. The ratio, or atherogenic index (Total cholesterol divided by your HDL cholesterol) should be as low as possible, below 4.0 for a man and 3.5 for a woman).
b. Triglycerides. This is another measure of the fat in your blood. This should be below 125 mg/dL.
c. Homocysteine. Although this has been referred to as "the cholesterol of the 21st century, many doctors do not routinely measure homocysteine. That's a shame because elevated homocysteine has been linked to heart disease, stroke, colon cancer and just recently, to Alzheimer's disease. This level should be below at least 10 nmol/mL, and preferably 9 nmol/mL. The best way to lower homocysteine is with the proper combination of B vitamins, 25 mg of B6, 400 mcg of B12 and 800 mcg of folic acid.
d. C-reactive protein. Also known as CRP, this protein is a measure of inflammation in the system and has been directly linked to heart disease. Again, because much of what we know about CRP is fairly new, many doctors do not routinely have it measured. I suggest you insist on it. It should be below 0.3 mg/L.
e. Fasting Blood Sugar. This will show if you are diabetic. Diabetes, especially Type 2 or Adult Onset Diabetes, is on the rise and many Americans don't even know they have it. Ideally your fasting blood sugar level should be below 100 mg/dL.
f. Anemia. Again this often goes undiagnosed so make sure you are tested.
g. Uric Acid. This measures your metabolism of purine-containing foods and an elevation is associated with GOUT. The normal value is less than 8.0 mg/dL.

 
2. Urinalysis.

The urine needs to be evaluated for the presence of infection, an indication of diabetes or a malfunction of the kidneys.

3. Stool sample.

Colon cancer is a very prevalent cancer but is not deadly if caught early. An occult blood test is not expensive and can absolutely save your life.

 
4. Blood Pressure.

Again, a very simple test but millions of Americans are unaware they suffer from high blood pressure (hypertension). High blood pressure is known as the silent killer and is the leading cause of stroke. Ideal blood pressure is 120/80 but should be at least below 135/85. There are many ways to lower blood pressure naturally; the most effective is simply losing weight.

 
5. Maximal Stress Test.

Besides a laboratory test of oxygen consumption, this is the best measure of fitness and possibly the best detector of heart disease. Make sure your physician is qualified to perform a maximal stress test and that the test utilizes at least 10 leads. We highly recommend a maximal stress test at least every two years.

 
6. Resting Heart Rate, Max HR, and Recovery HR.

Your heart rate, or pulse, measures how many times a minute your heart beats. The average resting HR for a man is 72. For a women the average is about 76. As a general rule, the better shape you are in, the lower your resting heart rate will be. Your maximal HR and recovery HR will be determined as part of your stress test. The recovery HR is a great indicator of your "heart health." After a bout of intensive exercise, your heart rate should drop at least 12 beats/minute within the first minute. If not, you may have an underlying heart condition.

7. Body Mass Index and Percent Body Fat.

The Body Mass Index (or BMI) is what the government uses to measure appropriate height/weight ratios. An ideal BMI is between 18.5 and 24.9. Overweight is between 25 and 29.9. Obese is from 30.0 to 34.9, and clinically obese is anything over 35. Right now, 26% of adult Americans are obese and many experts expect that number to double by 2010. To calculate your BMI: take 703, multiply by your weight in pounds, then divide by your height, in inches, squared.
Percent body fat is another way to determine your ideal weight and can be measured in several different ways: the DEXA test, underwater weighing, or skin calipers. This is a great measure of your "leanness" or your "fatness." We encourage men to strive for a percent body fat between 15-19 while a woman's goal should be between 18-22.

8. Pulmonary function.

This measures your breathing and lung capacity. An easy test at home is to light a match, hold it 12 inches away from your mouth, and see if you can blow it out. If not, you could have a problem that needs attention.

9. Cancer Risk.

For women, this would include a pelvic exam on an annual basis. We also recommend that starting at 40, women get a mammogram every year. Starting at age 40, men should get their PSA (prostate specific antigen) tested every year, along with a digital rectal exam. Early detection of prostate cancer can easily mean the difference between life and death.

10. Bone density, calcium intake.

Osteoporosis is a huge problem now, and will only get worse with the aging of the baby boomers. The sad thing is, it is VERY preventable. The DEXA test measures bone density. At Cooper Clinic we test women starting at age 40, and men (at age 60. The majority of American adults and children are not getting enough calcium. For our recommendations of daily calcium consumption, click here: http://www.cooperaerobics.com/radio/BBSupplements.aspx.

11. Vision, glaucoma, and macular degeneration.

Obviously as we age our vision often fades. Regular eye exams can often catch problems while they are still correctable. Don't forget that diabetes can have a huge impact on your vision.

 
12. Hearing.

Again, regular checkups are vital if you want to avoid serious problems as you grow older.

So there is the list of the 12 things I feel that everyone needs to have checked on a regular basis.

Remember, your health is your responsibility, so don't be afraid to take charge. Be proactive with your medical care and hopefully you will be able to live a long and healthy life to the fullest. That should be everyone's goal.

 
Sincerely,
Ken Cooper, M.D., M.P.H.

To learn more about Dr. Cooper and The Cooper Aerobics Center, click here: Biographies.