When you have type 2 diabetes, your cells don't get enough glucose, which may cause you to lose weight. Also, if you are urinating more frequently because of uncontrolled diabetes, you may lose more calories and water, resulting in weight loss, says Daniel Einhorn, MD, medical director of the Scripps Whittier Diabetes Institute and clinical professor of medicine at the University of California in San Diego.
In the 19th and 20th centuries, before effective pharmacological treatment for hypertension became possible, three treatment modalities were used, all with numerous side-effects: strict sodium restriction (for example the rice diet[152]), sympathectomy (surgical ablation of parts of the sympathetic nervous system), and pyrogen therapy (injection of substances that caused a fever, indirectly reducing blood pressure).[152][158]
The first WHO Global report on diabetes demonstrates that the number of adults living with diabetes has almost quadrupled since 1980 to 422 million adults. Factors driving this dramatic rise, which is largely on account of type 2 diabetes, include overweight and obesity. The new report calls upon governments to ensure that people are able to make healthy choices and that health systems are able to diagnose, treat and care for people with diabetes.

 Again, the answer to why has already been discovered! We have a 24hr clock in our body, known as the circadian rhythm. This rhythm controls what hormones are released and when, it controls our wake sleep rhythm and when working properly signals what physiological processes happen during the day and at night. When you think about it, it is a pretty simple concept that we should be eating during the day and not eating during our biological night. People who are ‘night owls’ often eat during their biological night and it has been shown that the insulin and glucose response to a meal eaten at night is that of a DIABETIC! I was shocked when I first discovered this! This means that even a ‘healthy’ thin person is predisposed to weight gain and gets stuck in fat storage mode if they eat all night long. This is aggravated in people who are predisposed to insulin resistance and metabolic hormone chaos!

Let’s be real. Metabolic Resistance Training is numero uno for a reason; it’s a nearly perfect method for losing fat. If you’re looking for something more in-depth, Jen Sinkler’s Lift Weights Faster 2 has over 180 metabolic workouts. ONE HUNDRED EIGHTY of them! You’ve got workouts for the next year, and that’s if you train every other day and don’t repeat any.
Now for the big surprise cause. There is another set of signaling molecules that have a huge impact on metabolic compensations during dieting. These compounds are present in your fat cells, and when fat is burned, they are released in significant concentrations. The shocking thing about these compounds is they did not come from your body. They are man made chemicals that you eat, put on your skin, drink in your water, and inhale through the air.

Monitor your blood pressure at home. Home blood pressure monitoring can help you keep closer tabs on your blood pressure, show if medication is working, and even alert you and your doctor to potential complications. Home blood pressure monitoring isn't a substitute for visits to your doctor, and home blood pressure monitors may have some limitations. Even if you get normal readings, don't stop or change your medications or alter your diet without talking to your doctor first.
This could be considered the "corollary" to #2.  Doing a set of 100 barbell snatches is absurd, as technique breaks down, and the amount of weight an athlete can use is almost too trivial to even call it metabolic RESISTANCE training.  Plus, it would likely take about 2-3 minutes to complete, which means that you're getting much more aerobic, even if an athlete is "working hard."  My feeling is that you use your work bouts to challenge anaerobic systems, and your recovery period to condition the aerobic energy system.  Let's be honest: most strength training enthusiasts care more about the aerobic system for recovery than actual aerobic exercise performance, anyway.
Bhasin et al, as part of the Framingham Heart Study, found that sex hormone-binding globulin is independently associated with the risk of metabolic syndrome, whereas testosterone is not. Age, body mass index (BMI), and insulin sensitivity independently affect sex hormone-binding globulin and testosterone levels. [48] More recent studies have raised the possibility of an association between testosterone deficiency and metabolic syndrome. [49]
What if there was a way that you could combine muscular and cardiovascular benefits of exercise without sacrificing lean muscle tissue or lowering your metabolism as is usually the case? Well, there is, but it takes a special way to organize your workout and to perform it. The days of long slow cardio are GONE! Not only is that ineffective, but it has a high injury rate too. Don't do that to yourself. Read this book and learn how to get the most from you routine without injury.

Out of this whole article this quote from a participant was the thing that drove my emotions. For anyone who struggles with weight loss resistance this will stab you in the heart. It is so incredibly true. There is nothing quite like feeling like your body is failing you and that even starving yourself, restricting every delicious food and exercising to the max is not enough.
MRT should be a total-body routine that works all the major muscles each session. Since the metabolic cost of an exercise relates directly to the amount of muscle worked, incorporate multi-joint exercises whenever possible.[3] Involve more muscle, and you expend more energy. Opt for compound movements: squats, rows and presses will work the muscles of the torso and thighs. Reserve single-joint movements for the arms and calves. Train three, non-consecutive days per week (i.e. Monday, Wednesday, Friday) to allow for adequate recuperation.
Exposure to certain viral infections (mumps and Coxsackie viruses) or other environmental toxins may serve to trigger abnormal antibody responses that cause damage to the pancreas cells where insulin is made. Some of the antibodies seen in type 1 diabetes include anti-islet cell antibodies, anti-insulin antibodies and anti-glutamic decarboxylase antibodies. These antibodies can be detected in the majority of patients, and may help determine which individuals are at risk for developing type 1 diabetes.
Serum creatinine is measured to assess for the presence of kidney disease, which can be either the cause or the result of hypertension. Serum creatinine alone may overestimate glomerular filtration rate and recent guidelines advocate the use of predictive equations such as the Modification of Diet in Renal Disease (MDRD) formula to estimate glomerular filtration rate (eGFR).[27] eGFR can also provide a baseline measurement of kidney function that can be used to monitor for side effects of certain anti-hypertensive drugs on kidney function. Additionally, testing of urine samples for protein is used as a secondary indicator of kidney disease. Electrocardiogram (EKG/ECG) testing is done to check for evidence that the heart is under strain from high blood pressure. It may also show whether there is thickening of the heart muscle (left ventricular hypertrophy) or whether the heart has experienced a prior minor disturbance such as a silent heart attack. A chest X-ray or an echocardiogram may also be performed to look for signs of heart enlargement or damage to the heart.[23]

During Induction you were consuming about 20 grams of carbs per day. The carbohydrate level was extremely low to demonstrate that it's possible for virtually everybody to experience lipolysis—from the person who can lose weight quite easily on almost any program to the hardest case, the person who, until doing Atkins, thought that losing weight was almost impossible.
* Some examples of agents that induce hypertension include nonsteroidal anti-inflammatory drugs (NSAIDs) and cyclooxygenase-2 (COX-2) inhibitors; illicit drugs; sympathomimetic agents; oral contraceptive or adrenal steroid hormones; cyclosporine and tacrolimus; licorice; erythropoietin; and certain over-the-counter dietary supplements and medicines, such as ephedra, ma huang, and bitter orange. Drug-related causes of hypertension may be due to nonadherence, inadequate doses, and inappropriate combinations.
Monitoring your caloric intake may be helpful if you’re overweight, but everyone with type 2 diabetes should track how many carbs they’re taking in. That can be tricky because carbs are in many of the common foods you may already eat, but there are both good and bad sources of carbs. Fruits and vegetables, for example, are good sources, while pretzels and cookies are bad sources. (29)
Current strategies for controlling cardiovascular disease (CVD) risk factors, such as high blood pressure and high cholesterol, are not widely used as standard practice. CDC developed this guide to provide health professionals with evidence-based strategies for effective and sustainable CVD prevention, including health and economic impact and potential for reducing health disparities.
Leading a healthy lifestyle now can reduce your risk of developing the health risks associated with metabolic syndrome as you get older. Effective prevention includes eating a healthy diet by following Canada's Food Guide and exercising for 150 minutes every week. Seeing your doctor for routine check ups and checking your blood glucose levels, blood pressure, blood cholesterol, and weight will help you monitor your health.

* The average person can expect to lose 1-2 lbs. per week. Results may vary. Weight loss is influenced by exercise, food consumed and diet.* FREE 1-3 Day Shipping on Orders Over $99 from Shop.Atkins.com. ©2017 Atkins Nutritionals, Inc.Disclaimer: Nothing contained on this Site is intended to provide health care advice. Should you have any health care-related questions, please call or see your physician or other health care provider. Consult your physician or health care provider before beginning the Atkins Diet as you would any other weight loss or weight maintenance program. The weight loss phases of the Atkins Diet should not be used by persons on dialysis. Individual results may vary.

Nope! Just as Time agreed, other research has shown that the low fat craze directly coincides with the increasing obesity epidemic. As you may have noticed above, fat is not on the list of insulin stimulating foods.. but sugar is! And sugar is just the thing that is added to low fat foods to make them taste better. So not only do you get a heightened insulin response to these low fat, low calorie foods leaving you in fat storing mode, but you are get an altered satiety response. That is right, fat is critical for the regulation of gut hormones and also the hormones that make you feel full after a meal and keep you feeling full between meals.
Usually, there are no immediate physical symptoms. Medical problems associated with the metabolic syndrome develop over time. If you are unsure if you have metabolic syndrome, see your healthcare provider. He or she will be able to make the diagnosis by obtaining the necessary tests, including blood pressure, lipid profile (triglycerides and HDL), and blood glucose.
^ Brunner EJ, Hemingway H, Walker BR, Page M, Clarke P, Juneja M, Shipley MJ, Kumari M, Andrew R, Seckl JR, Papadopoulos A, Checkley S, Rumley A, Lowe GD, Stansfeld SA, Marmot MG (November 2002). "Adrenocortical, autonomic, and inflammatory causes of the metabolic syndrome: nested case-control study". Circulation. 106 (21): 2659–65. doi:10.1161/01.cir.0000038364.26310.bd. PMID 12438290.

Forouzanfar MH, Alexander L, Anderson HR, et al, for the GBD 2013 Risk Factors Collaborators. Global, regional, and national comparative risk assessment of 79 behavioural, environmental and occupational, and metabolic risks or clusters of risks in 188 countries, 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet. 2015 Dec 5. 386 (10010):2287-323. [Medline].
It has not been contested that cardiovascular risk factors tend to cluster together; the matter of contention has been the assertion that the metabolic syndrome is anything more than the sum of its constituent parts. Phenotypic heterogeneity (for example, represented by variation in metabolic syndrome factor combinations among individuals with metabolic syndrome) has fueled that debate. However, more recent evidence suggests that common triggers (for example, excessive sugar-intake in the environment of overabundant food) can contribute to the development of multiple metabolic abnormalities at the same time, supporting the commonality of the energy utilization and storage pathways in metabolic syndrome.
Hypertension (HTN or HT), also known as high blood pressure (HBP), is a long-term medical condition in which the blood pressure in the arteries is persistently elevated.[10] High blood pressure typically does not cause symptoms.[1] Long-term high blood pressure, however, is a major risk factor for coronary artery disease, stroke, heart failure, atrial fibrillation, peripheral vascular disease, vision loss, chronic kidney disease, and dementia.[2][3][4][11]
Although many processes are involved in this, your thyroid is one of them. The thyroid is a small gland at the front of the neck that releases hormones that control your metabolic rate and the functions of nearly every cell in the body. Going low calorie is a great way to make you feel cold, tired, constipated and frumpy because your brain uses your thyroid to slow everything down!
Patients with metabolic syndrome can have several disorders of coagulation that make it easier for blood clots to form within blood vessels. These blood clots are often a precipitating factor in developing heart attacks. Patients with metabolic syndrome should generally be placed on daily aspirin therapy to help prevent such clotting events. You should speak to a doctor, of course, before starting any new medication regimen.

By the end of the book, you'll be able to create your own safe, effective, and efficient training program best suited to you. Or just choose from one of our 10 general or specialized HIT routines contained in the book. You'll develop the knowledge to change and make it a sustainable effort over time to keep you consistent. You'll be able to adapt to the ever changing dynamic situation that is a progressive training program.

Kids who have a family history of heart disease or diabetes are at greater risk for metabolic syndrome. But, as with many things in life, the lifestyle habits a child adopts can push things in one direction or another. So kids who are active, fit, and eat a lot of fruits and vegetables may drastically decrease their chances of developing metabolic syndrome — even if a close relative already has it.
^ Sacks, F. M.; Svetkey, L. P.; Vollmer, W. M.; Appel, L. J.; Bray, G. A.; Harsha, D.; Obarzanek, E.; Conlin, P. R.; Miller, E. R. (2001-01-04). "Effects on blood pressure of reduced dietary sodium and the Dietary Approaches to Stop Hypertension (DASH) diet. DASH-Sodium Collaborative Research Group". The New England Journal of Medicine. 344 (1): 3–10. doi:10.1056/NEJM200101043440101. ISSN 0028-4793. PMID 11136953.
^ Jump up to: a b Gatta-Cherifi, Blandine; Cota, Daniela (2015). "Endocannabinoids and Metabolic Disorders". Endocannabinoids. Handbook of Experimental Pharmacology. 231. pp. 367–91. doi:10.1007/978-3-319-20825-1_13. ISBN 978-3-319-20824-4. PMID 26408168. The endocannabinoid system (ECS) is known to exert regulatory control on essentially every aspect related to the search for, and the intake, metabolism and storage of calories, and consequently it represents a potential pharmacotherapeutic target for obesity, diabetes and eating disorders. ... recent research in animals and humans has provided new knowledge on the mechanisms of actions of the ECS in the regulation of eating behavior, energy balance, and metabolism. In this review, we discuss these recent advances and how they may allow targeting the ECS in a more specific and selective manner for the future development of therapies against obesity, metabolic syndrome, and eating disorders.
Although treatment of sleep apnea with continuous airway positive pressure (CPAP) would logically seem to improve CV outcomes and hypertension, studies evaluating this mode of therapy have been disappointing. A 2016 review of several studies indicated that CPAP either had no effect or a modest BP-lowering effect. [29] Findings from the SAVE study showed no effect of CPAP therapy on BP above usual care. [30] It is likely that patients with sleep apnea have other etiologies of hypertension, including obesity, hyperaldosteronism, increased sympathetic drive, and activation of the renin/angiotensin system that contribute to their hypertension. Although CPAP remains an effective therapy for other aspects of sleep apnea, it should not be expected to normalize BP in the majority of patients.
In people aged 18 years or older hypertension is defined as either a systolic or a diastolic blood pressure measurement consistently higher than an accepted normal value (this is above 129 or 139 mmHg systolic, 89 mmHg diastolic depending on the guideline).[5][7] Other thresholds are used (135 mmHg systolic or 85 mmHg diastolic) if measurements are derived from 24-hour ambulatory or home monitoring.[79] Recent international hypertension guidelines have also created categories below the hypertensive range to indicate a continuum of risk with higher blood pressures in the normal range. The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation and Treatment of High Blood Pressure (JNC7) published in 2003[27] uses the term prehypertension for blood pressure in the range 120–139 mmHg systolic or 80–89 mmHg diastolic, while European Society of Hypertension Guidelines (2007)[86] and British Hypertension Society (BHS) IV (2004)[87] use optimal, normal and high normal categories to subdivide pressures below 140 mmHg systolic and 90 mmHg diastolic. Hypertension is also sub-classified: JNC7 distinguishes hypertension stage I, hypertension stage II, and isolated systolic hypertension. Isolated systolic hypertension refers to elevated systolic pressure with normal diastolic pressure and is common in the elderly.[27] The ESH-ESC Guidelines (2007)[86] and BHS IV (2004)[87] additionally define a third stage (stage III hypertension) for people with systolic blood pressure exceeding 179 mmHg or a diastolic pressure over 109 mmHg. Hypertension is classified as "resistant" if medications do not reduce blood pressure to normal levels.[27] In November 2017, the American Heart Association and American College of Cardiology published a joint guideline which updates the recommendations of the JNC7 report.[88]
The blood vessels and blood are the highways that transport sugar from where it is either taken in (the stomach) or manufactured (in the liver) to the cells where it is used (muscles) or where it is stored (fat). Sugar cannot go into the cells by itself. The pancreas releases insulin into the blood, which serves as the helper, or the "key," that lets sugar into the cells for use as energy. http://www.sandysidhumedia.com/wp-content/uploads/2012/12/quotecaroline.jpg

Both numbers in a blood pressure reading are important. But after age 50, the systolic reading is even more significant. Isolated systolic hypertension is a condition in which the diastolic pressure is normal (less than 80 mm Hg) but systolic pressure is high (greater than or equal to 130 mm Hg). This is a common type of high blood pressure among people older than 65.
^ Aronow WS, Fleg JL, Pepine CJ, Artinian NT, Bakris G, Brown AS, Ferdinand KC, Ann Forciea M, Frishman WH, Jaigobin C, Kostis JB, Mancia G, Oparil S, Ortiz E, Reisin E, Rich MW, Schocken DD, Weber MA, Wesley DJ, Harrington RA, Bates ER, Bhatt DL, Bridges CR, Eisenberg MJ, Ferrari VA, Fisher JD, Gardner TJ, Gentile F, Gilson MF, Hlatky MA, Jacobs AK, Kaul S, Moliterno DJ, Mukherjee D, Rosenson RS, Stein JH, Weitz HH, Wesley DJ (2011). "ACCF/AHA 2011 expert consensus document on hypertension in the elderly: a report of the American College of Cardiology Foundation Task Force on Clinical Expert Consensus Documents developed in collaboration with the American Academy of Neurology, American Geriatrics Society, American Society for Preventive Cardiology, American Society of Hypertension, American Society of Nephrology, Association of Black Cardiologists, and European Society of Hypertension". J Am Soc Hypertens. 5 (4): 259–352. doi:10.1016/j.jash.2011.06.001. PMID 21771565.
These diabetes complications are related to blood vessel diseases and are generally classified into small vessel disease, such as those involving the eyes, kidneys and nerves (microvascular disease), and large vessel disease involving the heart and blood vessels (macrovascular disease). Diabetes accelerates hardening of the arteries (atherosclerosis) of the larger blood vessels, leading to coronary heart disease (angina or heart attack), strokes, and pain in the lower extremities because of lack of blood supply (claudication).
MRT, a.k.a. "metabolic resistance training," might as well be called "madman training." It's no-holds-barred, haul-ass, maximum-effort, build-muscle, heave-weight, torch-fat, absolutely insane huff-n-puff training. It'll spike your metabolism, crush calories like beer cans, lift your lactate threshold, boost your ability to make muscle, and maximize your body's capacity for change.

After reading a recent Time article entitled “The Weight loss trap” I quite literally jumped off of my office chair, frustrated, angry and delighted. (I also lit up my husband’s phone with a thousand messages). I am so over misinformation in the weight loss space, but even more, it kills me that people are made to feel out of control and hopeless in their own bodies. Why delighted? Well, I was not quite ready to announce my upcoming book but I just could not give up this opportunity to share with you all of the reasons why Time has great points, but doesn’t tell the whole story. You can finally overcome weight loss resistance!

Hypertension is the most important modifiable risk factor for coronary heart disease (the leading cause of death in North America), stroke (the third leading cause), congestive heart failure, end-stage renal disease, and peripheral vascular disease. Therefore, health care professionals must not only identify and treat patients with hypertension but also promote a healthy lifestyle and preventive strategies to decrease the prevalence of hypertension in the general population. (See Treatment.)
Creatinine is a chemical waste molecule that is generated from muscle metabolism. Creatinine is produced from creatine, a molecule of major importance for energy production in muscles. Creatinine has been found to be a fairly reliable indicator of kidney function. As the kidneys become impaired the creatinine level in the blood will rise. Normal levels of creatinine in the blood vary from gender and age of the individual. https://s10721.pcdn.co/wp-content/uploads/2009/05/when-meditation-gets-hard.jpg
After reading a recent Time article entitled “The Weight loss trap” I quite literally jumped off of my office chair, frustrated, angry and delighted. (I also lit up my husband’s phone with a thousand messages). I am so over misinformation in the weight loss space, but even more, it kills me that people are made to feel out of control and hopeless in their own bodies. Why delighted? Well, I was not quite ready to announce my upcoming book but I just could not give up this opportunity to share with you all of the reasons why Time has great points, but doesn’t tell the whole story. You can finally overcome weight loss resistance!
Dietary changes: The conventional medical recommendation of a low-fat, high-carbohydrate diet to lower triglycerides and bring down cholesterol is dead wrong in his opinion. Eating a diet high in the wrong kinds of carbohydrate and fat may actually elevate triglycerides and cholesterol. Instead, Dr. Weil recommends following an anti-inflammatory diet. This is a not a diet in the popular sense – it is not intended as a weight-loss program (although people can and do lose weight on it), nor is it an eating plan to stay on for a limited period of time. Rather, it is way of selecting and preparing foods based on scientific knowledge of how they can help your body remain optimally healthy. Along with influencing inflammation, this diet will provide steady energy and ample vitamins, minerals, essential fatty acids and dietary fiber. The following suggestions incorporate the principles of this way of eating:
Optimally, the management approach results in weight loss based on a healthy diet and regular physical activity, which includes a combination of aerobic activity and resistance training, reinforced with behavioral therapy. Metformin, an insulin sensitizer, or a thiazolidinedione (eg, rosiglitazone, pioglitazone) may be useful. Weight loss of ≈ 7% may be sufficient to reverse the syndrome, but if not, each feature of the syndrome should be managed to achieve recommended targets; available drug treatment is very effective.
Cataracts and glaucoma are also more common among diabetics. It is also important to note that since the lens of the eye lets water through, if blood sugar concentrations vary a lot, the lens of the eye will shrink and swell with fluid accordingly. As a result, blurry vision is very common in poorly controlled diabetes. Patients are usually discouraged from getting a new eyeglass prescription until their blood sugar is controlled. This allows for a more accurate assessment of what kind of glasses prescription is required.
Ariana Shakibinia decided to study public health in large part because she lives with T1D. She had always been interested in public policy, but she says living with this disease has made her more vested in the healthcare conversation. “I am living with what is essentially a pre-existing condition. I’m fortunate enough to have good health insurance, but it makes the potential financial burden of T1D management much more visible and relatable.”
Exogenous administration of the other steroids used for therapeutic purposes also increases blood pressure (BP), especially in susceptible individuals, mainly by volume expansion. Nonsteroidal anti-inflammatory drugs (NSAIDs) may also have adverse effects on BP. NSAIDs block both cyclooxygenase-1 (COX-1) and COX-2 enzymes. The inhibition of COX-2 can inhibit its natriuretic effect, which, in turn, increases sodium retention. NSAIDs also inhibit the vasodilating effects of prostaglandins and the production of vasoconstricting factors—namely, endothelin-1. These effects can contribute to the induction of hypertension in a normotensive or controlled hypertensive patient.
Whelton, P. K., Carey, R. M., Aronow, W. S., Casey, D. E., Collins, K. J., Dennison Himmelfarb, C., ...Wright, J. T. (2017, November 13). ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the prevention, detection, evaluation, and management of high blood pressure in adults. A report of the American College of Cardiology/American Heart Association Task Force on clinical practice guidelines. Hypertension. Retrieved from http://hyper.ahajournals.org/content/early/2017/11/10/HYP.0000000000000065
When there is excess glucose present in the blood, as with type 2 diabetes, the kidneys react by flushing it out of the blood and into the urine. This results in more urine production and the need to urinate more frequently, as well as an increased risk of urinary tract infections (UTIs) in men and women. People with type 2 diabetes are twice as likely to get a UTI as people without the disease, and the risk is higher in women than in men.

In hypertensive emergency, there is evidence of direct damage to one or more organs.[27][28] The most affected organs include the brain, kidney, heart and lungs, producing symptoms which may include confusion, drowsiness, chest pain and breathlessness.[26] In hypertensive emergency, the blood pressure must be reduced more rapidly to stop ongoing organ damage,[26] however, there is a lack of randomized controlled trial evidence for this approach.[28]
The prevailing opinion is that all of these markers are signs of insulin resistance, meaning the diminished ability of a given amount of insulin to exert its normal effect. When insulin resistance develops, it can impact metabolic processes in many ways, resulting in the specific markers listed above. However, different individuals respond to insulin resistance in different ways. Also, the time frame in which certain signs develop varies. This variability makes defining—and treating—metabolic syndrome tricky.
In most people with established essential hypertension, increased resistance to blood flow (total peripheral resistance) accounts for the high pressure while cardiac output remains normal.[52] There is evidence that some younger people with prehypertension or 'borderline hypertension' have high cardiac output, an elevated heart rate and normal peripheral resistance, termed hyperkinetic borderline hypertension.[53] These individuals develop the typical features of established essential hypertension in later life as their cardiac output falls and peripheral resistance rises with age.[53] Whether this pattern is typical of all people who ultimately develop hypertension is disputed.[54] The increased peripheral resistance in established hypertension is mainly attributable to structural narrowing of small arteries and arterioles,[55] although a reduction in the number or density of capillaries may also contribute.[56]