Could it be a tool to detect 'masked hypertension?'
As we have recently reported, cardiologists are increasingly concerned about a condition known as "masked hypertension."
That's when a patient shows a normal blood pressure reading the one or two times a year it is taken at the doctor's office but has above normal readings during much of his or her daily routine. Doctors have said regular blood pressure checks are one way to identify patients who unknowingly suffer from high blood pressure.
Back in May, the Food and Drug Administration (FDA) issued 510(k) clearance for a new medical device that might prove to be a useful tool in this effort. CareTaker Medical says its Wireless Continuous Non-Invasive “Beat-by-Beat” Blood Pressure (“cNIBP”) and Heart Rate Monitor can provide constant blood pressure monitoring.
The device uses a low-pressure finger cuff that is attached to a small device worn on the wrist. It measures the heart rate on a remote display. It was designed for use in hospitals and during patient transit, but the company says it can also be used after a patient is discharged.
A game changer
“CareTaker is a real game changer, allowing physicians to remotely monitor medical-grade Continuous Blood Pressure and Heart Rate from anywhere, using only a patient friendly-finger cuff” said Dr. Jay Sanders, an adjunct professor of medicine at Johns Hopkins and President Emeritus of the American Telemedicine Association.
In the past, he says most doctors had to settle for intermittent blood pressure readings using arm cuffs, which he says which can produce misleading results.
"In remote monitoring settings, the ability to gather continuous blood pressure and vital sign data from such an integrated easy-to-use device will provide better information and improve patient compliance while reducing cost and workload,” Sanders said.
The company says its device provides "ICU quality" continuous readings without catheters or cumbersome wires that were typically part of previous continuous blood pressure reading devices. In an email to ConsumerAffairs, the company said the device is not a pulse transit time method, "but instead a completely new way of tracking blood pressure."
Researchers at Stony Brook and Columbia universities used 24-hour ambulatory blood pressure monitors to conclude that as many as 17.1 million people might suffer from masked hypertension.
As we have recently reported, cardiologists are increasingly concerned about a condition known as "masked hypertension."That's when a patient shows a n...
February is a good month to check your blood pressure
High blood pressure can cause strokes or heart attacks, but it's easily treated
As you will undoubtedly hear several times over the next couple of weeks, February is National Heart Month, and there will be plenty of tips for staying healthy.
So here's one. Get your blood pressure checked.
High blood pressure is called "the silent killer" because many people don't know they have it. There really are no symptoms.
But when blood pumps through veins and arteries with too much pressure, it can weaken the walls of those blood vessels, increasing the chance that there will be a break at some point, causing a stroke. When the heart works too hard to pump blood, the organ can become enlarged, causing heart problems later on.
29% know they have it
A Harris Poll conducted on behalf of the American Academy of Family Physicians (AAFP) found that nearly three in 10 people said they had been diagnosed with high blood pressure. That's in line with estimates by the Centers for Disease Control and Prevention (CDC).
A more disturbing statistic is only 54% say their blood pressure is under control. And maybe even more disturbing -- we're only talking about people who are aware that their blood pressure is outside the normal range. Many others may be blissfully unaware.
"This finding is concerning because we know that high blood pressure and heart attacks or chronic heart failure are so closely related," said Dr. John Meigs, Jr., president of the AAFP. "According to the CDC, seven out of 10 people who have a first heart attack have high blood pressure. Seven out of 10 people who develop chronic heart failure have high blood pressure. So it's important that people know what their blood pressure is and work with their family physician to treat it."
The good news is that high blood pressure is easily treated. First and foremost, a healthy diet and lifestyle will help keep your blood pressure in check. Tobacco and too much alcohol, along with a sedentary lifestyle, are major contributors to hypertension.
However, there can be other contributors to high blood pressure that can affect even the healthiest of people. But prescription medication is available that can keep your blood pressure in a healthy range.
And just what is that range? Well, that's been the subject of some recent debate. While the medical community in recent decades settled on 120/80 as the ideal reading, in late 2013 a medical panel issued new guidelines suggesting patients over 60 were fine with a blood pressure reading of 150/90. Blood pressure goals were also eased for adults with diabetes and kidney disease.
However, not everyone in medicine agrees, so it's a good idea to consult with your healthcare provider.
"Get your blood pressure checked," Meigs said. "If you have high blood pressure, work with your doctor to treat it and lower your risk factors."
At the same time, Meigs says it's a good idea to have your blood cholesterol levels checked as well.
As you will undoubtedly hear several times over the next couple of weeks, February is National Heart Month, and there will be plenty of tips for staying he...
Researchers say one in eight Americans suffer from the condition
Hypertension, or high blood pressure, is called "the silent killer." Elevated blood pressure can eventually lead to heart attack and stroke, and millions of people with hypertension don't know it.
There is very effective medication to control blood pressure -- and a healthy lifestyle also helps -- but first you have to know that your blood pressure is too high.
As we first reported back in early December, doctors have begun to worry about what they call "masked hypertension." A patient goes to the doctor and his blood pressure reading is a perfectly acceptable 129/82.
But then he goes about his daily life -- going to work, picking up the kids, cleaning out the garage, and while he's doing all that his blood pressure might be an unhealthy 147/96. He doesn't know, of course, because he doesn't have a blood pressure cuff at home to measure it.
Numbers are alarming
Researchers at Stony Brook and Columbia universities have studied this phenomenon by attaching 24-hour ambulatory blood pressure monitors to subjects in their study. They now say that not only is the condition real, the numbers associated with it are alarming.
They found 12.3% of people display a normal blood pressure reading in the clinic, are not taking blood pressure lowering medicines, have never had a heart attack or stroke, but have high blood pressure during their daily activities. This amounts to about one in eight adults over age 21 -- approximately 17.1 million people in the U.S.
Lead investigator Joseph Schwartz of Stony Brook says the study is breaking new ground in estimating the size of the problem. He says it could lead to new guidelines to help identify patients with high blood pressure and improve hypertension preventive methods.
What to do
Until then, it is helpful to know the hypertension risk factors. People over age 50 are at risk of developing hypertension. So are those who are overweight or obese, or have a sedentary lifestyle with little physical exercise.
Diet can also be a big risk factor. Eating unhealthy foods, especially those high in sodium, can increase the risk for hypertension. African-Americans are at a higher risk than other races.
If you think you might fall into one of those risk categories, consider investing in a home blood pressure monitoring cuff and learn how to properly use it.
Measuring your blood pressure two or three times a week, at different times of the day, might let you know if you are suffering from "masked hypertension," even though your readings at the doctor's office look just fine.
Hypertension, or high blood pressure, is called "the silent killer." Elevated blood pressure can eventually lead to heart attack and stroke, and millions o...
Medical researchers worry about 'masked' hypertension
Blood pressure levels found to be higher than during doctors' office visits
Hypertension, or high blood pressure, is a growing health concern in the U.S., mainly because of lifestyle factors. A poor diet, lack of exercise, and obesity are all contributing factors.
High blood pressure is easily treatable, but first you have to know if you are affected by it. Blood pressure is measured using a cuff that applies pressure to your arm or wrist. Unless you have one of these cuffs at home, the only time you take a reading is when you visit a healthcare provider.
Researchers at Stony Brook University and Columbia University wondered if occasional measurements at a doctor's office provided an accurate determination of whether someone suffered from high blood pressure.
They enlisted a group of patients who had normal readings on their infrequent measurements in a clinical setting and placed wearable monitors on them to measure blood pressure around the clock. They say they discovered that for some subjects, their blood pressure was outside the normal range during daily activities, even though it seemed normal at the doctor's office.
Reverse of 'white coat hypertension'
The researchers say it's the reverse of so-called “white coat hypertension,” when the slight stress of being in a doctor's office results in higher blood pressure readings. When blood pressure spikes during normal day-to-day activities, the researchers call it “masked hypertension.”
The only way to uncover masked hypertension is with around the clock monitoring, using a wearable device. The researchers say that compared to blood pressure measured infrequently in a clinic, ambulatory blood pressure is a better predictor of future heart disease.
In the study, nearly 16% of patients with normal clinic blood pressure were found to have “masked hypertension.” It was more common in men than women. Interestingly, it also affected younger, normal weight participants more than those who were older and overweight.
Debunking a widely held belief
“These findings debunk the widely held belief that ambulatory blood pressure is usually lower than clinic blood pressure,” said lead author Dr. Joseph Schwartz.
Schwartz said healthcare providers need to know that there appears to be a tendency for blood pressure during normal activities to be higher than clinic blood pressure in healthy patients who are being evaluated for high blood pressure during well-patient visits.
It's an important issue because high blood pressure, left untreated, can lead to more serious health conditions, such as heart attack and stroke.
Hypertension, or high blood pressure, is a growing health concern in the U.S., mainly because of lifestyle factors. A poor diet, lack of exercise, and obes...
Is there an alternative to blood pressure medicine?
Scientists in the UK say a surgical procedure could help many patients
Consumers with high blood pressure spend billions of dollars each year on prescription medication to keep it in check.
But what if there were a medical procedure that made that unnecessary? Researchers at the University of Bristol in the UK say there may be.
The scientists have concluded that carotid bodies, a small cluster of nerves and cells next to the carotid artery, are a cause of high blood pressure. This revelation, they say, offers a new target for treatment.
The research team says removing one carotid body from some patients with high blood pressure caused an immediate and sustained drop in blood pressure.
“The falls in blood pressure we have seen are impressive – more than you would see with pharmacological medication – and demonstrate the exciting potential there now is for targeting the carotid body to treat hypertension,” said Dr. Angus Nightingale, of the Bristol Heart Institute.
The theory goes like this: the carotid bodies monitor levels of oxygen in the blood. When oxygen levels fall they sound the alarm, instructing the brain to step up the level of breathing and blood pressure.
But in some cases, the monitored fall in oxygen level is a false reading. The way the scientists explain it, it's like the thermostat on your furnace being set too high.
Professor Julian Paton, one of the researchers, says it's a novel approach but one that could potentially be a game-changer for the treatment of high blood pressure. Currently, he says, medication only treats the symptoms of high blood pressure. Removing the corotid bodies, he says, gets at the root cause.
Wouldn't help in every case
Nightingale makes clear the procedure would not be the answer for every case, but also says that the research team has developed some tests that would help identify patients for whom it would be effective. But that's not to say there isn't a role for drugs.
“Although this surgical approach to controlling high blood pressure was successful, we don’t think this will be the solution in the long term,” Nightingale said. “We now need to find a drug that dampens down an overactive carotid body and resets the blood pressure thermostat to a normal level.”
Hypertension is one of the leading causes of death worldwide and a major contributor to strokes. The Centers for Disease Control and Prevention (CDC) estimates 70 million Americans have high blood pressure, the treatment of which cost $46 billion in health care services, medications, and missed days of work in 2011.
Consumers with high blood pressure spend billions of dollars each year on prescription medication to keep it in check.But what if there were a medical...
Johns Hopkins researchers say aggressive standards may be damaging the heart
Millions of Americans take medication to lower their blood pressure and combat hypertension. Now, some doctors worry their colleagues are using drugs to drive blood pressure too low.
Specifically, researchers at Johns Hopkins have focused on diastolic blood pressure, a measure of pressure in arteries between heartbeats when the heart is resting. It's the bottom number in a blood pressure reading, such as 130 over 85. In such a reading, the 85 is the diastolic pressure.
Amid rising obesity and diabetes, high blood pressure has become an increasing health threat, increasing the risk of heart attack and stroke. Doctors have responded with new and powerful drugs to maintain pressure at lower rates.
After analyzing medical records gathered over 30 years of federal health studies, the Johns Hopkins researchers say they have found evidence that pushing blood pressure too low can damage the heart.
The numbers are linked
Hopkins heart specialist William McEvoy say the problem is doctors' focus on driving the top number – the systolic pressure – to a maximum of 120. Since the top and bottom numbers are linked, that often pushes the diastolic pressure below 80.
"Our key finding suggests that for some patients, there should perhaps be modification of intensive anti-hypertensive treatment recommendations issued last year as a result of the SPRINT trial, and that physicians shouldn't look at driving down the top blood pressure number in isolation without considering implications of lowering the bottom number," McEvoy said.
There has been a lot of debate in medical circles in recent years about what a healthy blood pressure number should be. Medical authorities have consistently pushed the standard lower – to 120 over 80 – meaning more people would need prescription medication to reach and maintain that level.
Another look at goals
In 2013 an American Medical Association (AMA) panel on hypertension made a few waves when it suggested blood pressure goals had been set too low. It suggested patients over 60 were fine with a blood pressure reading of 150 over 90.
Many health professionals have questioned that finding, but it is also interesting that a Duke University study the following year determined that under the revised guidelines, the number of patients requiring prescription drugs to meet their target blood pressure was reduced by 5.8 million people.
“Raising the target in older adults is controversial, and not all experts agree with this new recommendation,” lead author Ann Marie Navar-Boggan, a cardiology fellow at Duke University School of Medicine, said at the time. “In this study, we wanted to determine the number of adults affected by these changes.”
Based on their study, the Duke researchers estimated the proportion of U.S. adults in need of hypertension treatment would decrease from 40.6% under the old guidelines to 31.7% under the new recommendations, resulting in a pretty big hit for drug companies.
If you are currently taking prescription drug medication, you should continue doing so until you can have a discussion with your health care provider about your health situation and what your target blood pressure should be.
Millions of Americans take medication to lower their blood pressure and combat hypertension. Now, some doctors worry their colleagues are using drugs to dr...
High blood pressure readings aren't always an emergency
The trend of measuring blood pressure at home has led to a dramatic increase in ER visits
If you’re one of the millions of people in the U.S. with high blood pressure, you may have heard one or two lectures from your doctor about how dangerous it can be. If left untreated, high blood pressure can have a profound negative impact on your heart; it can lead to serious issues like heart attack, heart disease, and congestive heart failure, to name a few.
However, a new study suggests that not every high blood pressure reading is cause for panic. In fact, researchers say that the trend of monitoring your blood pressure from home is actually leading consumers to go to the emergency room too much, especially when other emergency symptoms are not present.
“We encourage patients to monitor their blood pressure at home if they have been diagnosed with hypertension, but not every high blood pressure reading is an emergency,” said lead author Dr. Clare Atzema.
“Some of the increase in emergency visits is due to the aging of our population, but we suspect that recent public education campaigns recommending home blood pressure monitoring may have inadvertently contributed to the rise in visits for hypertension,” she added.
Hospital visits increase
For the purposes of the study, Atzema and her colleagues analyzed changes in the number of annual visits that Ontario emergency departments had for cases of hypertension. They found that the number of visits increased by 15,793 to 25,950 per year.
Inversely, they found that the number of patients admitted to the hospital following these visits decreased from 9.9% to 7.1%, suggesting that not every case warranted a trip to the ER.
The researchers also note that mortality incidences were very low for cases related to hypertension; they found that less than 1% of patients died within 90 days of going to the emergency room and 4.1% died within two years of their visit.
Better safe than sorry
The researchers advise consumers to go to the emergency room for blood pressure-related concerns only if a reading coincides with other emergency symptoms.
“Patients should be aware that unless their high blood pressure coincides with symptoms of medical emergency, such as chest pain, severe headache, nausea or shortness of breath, they probably do not need to visit the ER,” said Atzema.
However, she cautions that too much prudence can also be a bad thing when it comes to medical emergencies.
“We of course encourage them to follow up as soon as possible with their regular physician. If there is any doubt, come to the emergency department: we would rather have you come without an emergency than stay home with one.”
While not exactly controversial, what your blood pressure should be has become a topic of debate within the medical community.
It started in 2013, when an American Medical Association panel on hypertension issued new guidelines, suggesting patients over 60 were fine with a blood pressure reading of 150/90. Blood pressure goals were also eased for adults with diabetes and kidney disease.
The following March researchers at Duke University ran an analysis and determined that an estimated 5.8 million adults no longer needed blood pressure medicine under the new guidelines.
Since then, opposing views advocating the lower 120/80 blood pressure benchmark have been heard loud and clear. The latest is a new study conducted by the University of Utah, University of Alabama at Birmingham, and Columbia University. If found that 16.8 million Americans could potentially benefit from lowering their systolic blood pressure – the top number – to 120, much lower than current guidelines of 140 or 150.
The scientists reached their conclusions based on results from the Systolic Blood Pressure Intervention Trial (SPRINT). Their initial analysis, reported back in September, showed that using medications to reach a lower target of 120 mmHg could greatly reduce risk for heart failure, heart attack, and death, compared to a target of 140 mmHg.
“SPRINT could have broad implications,” said lead author Adam Bress, of the University of Utah College of Pharmacy. “Millions of Americans whose blood pressure is under control according to current guidelines may be considered uncontrolled if new guidelines adopt the intensive target of less than 120 mmHg studied in SPRINT.”
The research carries two implications that health care providers must weigh. It suggests 16.8 million Americans could be at risk. It also suggests that same number almost certainly would need to be on prescription medication to reach the lower blood pressure goal.
In other words, it's not only a matter of life and death – billions of dollars are at stake.
“Physicians are going to need to decide how far outside the SPRINT inclusion criteria to go,” said co-author Rachel Hess, a professor of internal medicine and population health sciences at the University of Utah School of Medicine. “It’s going to be a tough decision.”
What to do
If you are concerned about your blood pressure levels, have a frank discussion with your healthcare provider. Make sure he or she is aware of the current debate over safe blood pressure levels and discuss where your levels should be.
Lifestyle factors can also have a large influence on blood pressure. Eating a nutritious, balanced diet low in sodium, getting plenty of exercise, maintaining a normal weight, and avoiding tobacco and excessive alcohol have all been shown to help promote healthy blood pressure.
While not exactly controversial, what your blood pressure should be has become a topic of debate within the medical community.It started in 2013, when ...
Too many young people have elevated blood pressure
Scientists think too much time online isn't helping
High blood pressure was once just a concern for people entering their middle-aged years. Now, with an epidemic of obesity and increasing cases of diabetes, it's a problem for young people too.
A recent federal study determined that having even slightly elevated blood pressure when you are young can lead to serious heart problems in middle age.
Persistently elevated blood pressure, or hypertension, is one that tops 140/90, a reading that measures the force of pressure in the heart as it contracts and as it relaxes between contractions. Hypertension has been long implicated as a risk factor in a range of cardiovascular diseases.
But the recent study suggests that pressure just below that threshold -- or high normal pressure -- begins to fuel heart damage in people as young as 20 and can lead to changes in heart muscle function in as little as 25 years.
One in 25 teens
According to the Nemours Foundation, a non-profit children's health organization, about one in 25 teenagers has elevated blood pressure. The foundation says there can be many reasons, but most have to do with an unhealthy lifestyle – a bad diet, excess weight, stress, and too little physical activity.
One risk factor for high blood pressure in teens may be spending hours each day on the Internet.
Researchers at Henry Ford Hospital in Detroit discovered teens who spend at least 14 hours a week on the Internet had an increased risk of elevated blood pressure. When they examined 134 teens who fit the category of heavy Internet users, 26 of them had higher than normal blood pressure.
These findings add to other research that seems to suggest an association between heavy Internet use and a number of health risks like addiction, anxiety, depression, obesity, and social isolation.
Dial it back
Andrea Cassidy-Bushrow, the study’s lead author, says the take-home message for teens and parents is moderation.
“Using the Internet is part of our daily life but it shouldn’t consume us,” she said. “In our study, teens considered heavy Internet users were on the Internet an average of 25 hours a week.”
Cassidy-Bushrow urges young people to take regular breaks from their computer or smartphone and engage in some form of physical activity. She also recommends parents place limits on their children’s’ time at home on the Internet.
“I think two hours a day, five days a week is good rule of thumb,” she said.
The study estimates teens spend an average of 15 hours a week online, either at school or at home. Forty-three percent of heavy Internet users were considered overweight compared to 26% of light Internet users.
High blood pressure was once just a concern for people entering their middle-aged years. Now, with an epidemic of obesity and increasing cases of diabetes,...
Federal study urges lower blood pressure targets for seniors
In most cases, medication would be required to meet the lower target
There is no debate over the danger of high blood pressure. It's a killer. The debate is over what constitutes high blood pressure.
A series of studies has set different benchmarks, with different levels of risk. The latest study –this one produced by a branch of the National Institutes of Health (NIH) – could add to the confusion.
In what's being called a landmark clinical trial, researchers monitored the blood pressure of thousands of patients. In particular, they paid attention to systolic pressure – the top number in a blood pressure reading.
The study found that patients over age 50 who used medication to achieve a systolic reading of 120 reduced their rates of cardiovascular events, such as heart attack and heart failure, as well as stroke, by almost a third. They reduced the risk of death by almost a quarter, as compared to the target systolic pressure of 140. That's a significant reduction in risk.
“This study provides potentially lifesaving information that will be useful to health care providers as they consider the best treatment options for some of their patients, particularly those over the age of 50,” said Gary H. Gibbons, M.D., director of the National Heart, Lung, and Blood Institute (NHLBI).
But it isn't the only study out there. In 2014 an AMA panel of experts issued its Evidence-based Guideline for the Management of High Blood Pressure in Adults, determining that physicians were shooting too low, especially when they insisted their older patients achieve a blood pressure of 120/80. The panel said patients over 60 were fine with a blood pressure reading of 150/90. Blood pressure goals were also eased for adults with diabetes and kidney disease.
As expected, this was controversial. A month later researchers at Duke University added to the controversy when they proclaimed that there were 5.8 million Americans taking blood pressure medication who really didn't need the pills.
Based on the study sample, the researchers determined that the proportion of U.S. adults considered eligible for hypertension treatment would decrease from 40.6% under the old guidelines to 31.7% under the new recommendations. In other words, a lot fewer patients need to be taking drugs for high blood pressure.
What is normal?
The fact is, if you are 60 years old and in excellent physical condition, with regular exercise and a healthy lifestyle, you might be able to achieve a systolic reading of 120 without the aid of medication. But if you are a few pounds overweight and spend most of your time at a desk or in a chair, chances are good that you'll need a pill or two to get to 120/80.
So whether a normal blood pressure is easy or difficult to maintain without medication is of enormous importance – to drug manufacturers.
The sale of medication to control blood pressure is a huge part of the pharmaceutical industry. The government reports that in 2010, more than 58 million adults were treated for hypertension and spent more than $20 billion on medication to control blood pressure. According to Statista, the top five selling prescription blood pressure medications brought in $5.27 for pharmaceutical companies in 2011.
And there has been research suggesting that, in the end it might not matter all that much. As we reported in June, researchers at the University of Alabama Birmingham concluded that once you develop hypertension, even if it is eventually controlled with medication, it significantly increases the chance of having a stroke. In addition, the reearchers contend the risk of stroke went up 33% with each blood pressure medicine required to treat blood pressure to goal.
What to do
That doesn't mean that if you have elevated blood pressure you should ignore this latest study, but you probably shouldn't take it at face value either. Instead, have an informed conversation with your health care provider.
Make sure he or she is aware of the 2014 Evidence-based Guideline that raised blood pressure targets for older adults and discuss this latest research as well.
Over the years ConsumerAffairs has reported extensively on blood pressure research. Check out our articles here.
There is no debate over the danger of high blood pressure. It's a killer. The debate is over what constitutes high blood pressure.A series of studies h...
Why young adults need to be checking their blood pressure
Elevated, but 'normal' blood pressure could be dangerous for young people in middle age
In recent years doctors have determined that older adults can enjoy health with higher elevations of blood pressure than had previously been considered normal.
In 2013 a medical panel on hypertension, or high blood pressure, issued guidelines suggesting patients over 60 were fine with a blood pressure reading of 150/90. Blood pressure goals were also eased for adults with diabetes and kidney disease.
In March 2014 researchers at Duke University ran an analysis and determined that an estimated 5.8 million adults no longer needed blood pressure medicine under the new guidelines.
Sub-clinical heart damage
But researchers are careful to point out that the same cannot be said for young adults. In fact, a federal study led by Johns Hopkins researchers says mild elevations in blood pressure considered to be in the upper range of normal during young adulthood can lead to sub-clinical heart damage by middle age, a condition that could lead to full-blown heart failure.
Elevated blood pressure is one that tops 140/90, a reading that measures the force of pressure in the heart as it contracts – that's the top number – and as it relaxes between contractions, the bottom number. High blood pressure has been long implicated as a risk factor in a range of cardiovascular diseases.
What is different about the new study is its suggestion that pressure just below that threshold, what is called high normal pressure, begins to fuel heart damage in people as young as 20 and can lead to changes in heart muscle function in as little as 25 years.
Investigators are especially troubled because their findings come from a group of patients, most having had no hypertension. They are concerned that a pattern of high normal blood pressure in early adulthood could be indicators of 2 forms of heart failure, a condition marked by the progressive weakening heart muscle and the organ's gradual loss of blood-pumping ability.
“Our results suggest the heart muscle may be more exquisitely sensitive to the effects of even subtle elevations in blood pressure than we thought,” said principal investigator Joao Lima.
To review, the most recent clinical guidelines issued by the Joint National Committee in 2014 define hypertension as blood pressure above 140/90, which is higher than it has been in recent years. The guidelines also call on clinicians and patients to aim for a pressure below 150/90.
The Johns Hopkins team says these guidelines are not “one size fits all.” They do not apply to all ages, and what constitutes normal should probably change with age, they say.
“Our results suggest that 'high-normal' blood pressure may be too high and far from normal for some people,' said lead author Satoru Kishi, M.D., a cardiologist at Mitsui Memorial Hospital in Tokyo who worked on the study as a research fellow at the Johns Hopkins University School of Medicine. “A concerning number of young adults with pressures in the high-normal range develop insipient heart dysfunction in middle age.”
Young people may suffer from elevated blood pressure because of lifestyle issues. Diet and body mass are big influencers.
Young people who are overweight or obese, eat an unhealthy diet and get little exercise may experience elevated blood pressure levels. In the past these levels were seen as fairly normal. The Hopkins team says now they should be cause for concern.
In recent years doctors have determined that older adults can enjoy health with higher elevations of blood pressure than had previously been considered nor...
The researchers followed up with participants in a major blood pressure study for more than 6 years. Three-quarters of the participants' blood pressure was controlled by medication. The remain quarter had uncontrolled hypertension. At the end of the 6 years more than 800 had suffered a stroke.
The researchers conclude that the harder hypertension is to control, the more likely the patient is to eventually suffer a stroke, even if medication returns blood pressure to normal levels.
Stroke risk rises with each pill
Dr. George Howard, a professor in the Department of Biostatistics in the UAB School of Public Health, found the risk of stroke went up 33% with each blood pressure medicine required to treat blood pressure to goal.
People with normal blood pressure without having any kind of treatment are two and a half times less likely to have a stroke than people on three or more blood pressure medications.
That's bad news for people who have suffered hypertension for years but have finally reduced their blood pressure to normal levels with the help of multiple pills.
“You’re in as much trouble by the time you are on three medications that achieve excellent control as you are when you have hypertension and it is untreated, which is amazing,” Howard said.
False sense of security
Howard's point is this: relying on medication to control blood pressure presents a false sense of security.
The way to reduce strokes, he says, is to prevent hypertension in the first place. His four steps for preventing high blood pressure are:
Taking part in moderate physical activity
Keeping weight in normal rages
Reducing salt intake
Eating a diet rich in fruits, vegetables and low-fat dairy products and reduced in saturated and total fat.
“It’s everything we know we should be doing,” Howard said. “And over the past 14 years, stroke deaths are down 42%, likely because of this general shift of everybody in the population working toward having lower blood pressures.”
Drug sales booming
But the sale of medication to control blood pressure is a huge part of the pharmaceutical industry. The government reports that in 2010, more than 58 million adults were treated for hypertension and spent more than $20 billion on medication to control blood pressure.
Last year researchers at Duke University irked the phamaceutical industry when they suggested millions of Americans are taking blood pressure medication they don't need.
That's because health guidelines had just raised what was considered normal blood pressure. The Eighth Joint National Committee said adults over 60 could be healthy with blood pressure readings of 150/90 instead of the previous 140/90.
“As individuals, we need to take the right actions for our health,” Howard said. “Individuals and society need to work together to keep people from becoming hypertensive.”
In other words, we need to address what is causing our blood pressure to rise to unhealthy levels, not lower it with drugs.
Millions of people take medication that successfully controls their blood pressure. But new research suggests they haven't eliminated their risks of suffer...
Two foods that may improve blood pressure readings
Blueberries and beet juice both appear to have medicinal effects
Doctors aren't completely sure what can lower your blood pressure but they know of a lot of thing that can raise it – being overweight, consuming too much sodium and not getting enough exercise.
Scientists now say they have additional data suggesting two foods can help lower blood pressure – one that you might like eating, the other perhaps not so much.
Researchers at Florida State University say just one cup of blueberries each day could be important in reducing blood pressure and reducing arterial stiffness.
Perhaps not quite as appetizing is beet juice. But British scientists say drinking a cup of it each day has been shown to significantly lower blood pressure among patients with high blood pressure.
Blueberries or beet juice?
Probably for most consumers, the blueberry option is preferable.
“Our findings suggest that regular consumption of blueberries could potentially delay the progression of prehypertension to hypertension, therefore reducing cardiovascular disease risk,” said Sarah A. Johnson, assistant director of the Center for Advancing Exercise and Nutrition Research on Aging (CAENRA) and postdoctoral fellow in the Department of Nutrition, Food and Exercise Sciences at Florida State University (FSU).
The team of FSU nutrition and exercise scientists published their findings in the Journal of the Academy of Nutrition and Dietetics.
Johnson started her project because of her interest in functional foods — foods that have a positive impact on health beyond basic nutrition. She found that many of these foods can prevent and reverse negative health outcomes, especially for postmenopausal women.
“Cardiovascular disease is the leading cause of death in the United States,” she said. “Once women go through menopause, this puts them at an even greater risk for it. Our findings suggest that the addition of a single food, blueberries, to the diet may mitigate the negative cardiovascular effects that often occur as a result of menopause.”
In her study participants who received blueberry powder – the equivalent of a cup of blueberries a day – experienced a 5% decrease in systolic blood pressure. They saw an even greater decrease in diastolic pressure.
Previous studies on blueberries have shown positive effects on cardiovascular risk factors including blood pressure, but they all included large amounts of blueberry powder consumption, anywhere from 50 grams to 250 grams. In the case of 250 grams, that would translate to more than 11 cups of fresh blueberries, which may not be realistic for people to consume on a regular basis.
Scientists at Queen Mary University of London say a daily 250ml glass of beet juice also contributes to a significant drop in blood pressure. They say beet's high content of inorganic nitrate is what provides the medicinal effect.
While previous studies have suggested blueberries have a positive effect on blood pressure, the researchers says this is the first to indicate dietary nitrate supplementation from beet juice has a similar effect.
Doctors aren't completely sure what can lower your blood pressure but they know of a lot of thing that can raise it – being overweight, consuming too much ...
New high blood pressure treatment could be in the works
Preventing leptin from getting to the brain may be the key
For years doctors have known that obesity is a strong link to cardiovascular disease, and with it conditions like hypertension, or high blood pressure.
Now, doctors are learning more about why carrying too much weight contributes to high blood pressure, a major risk for stroke and heart attack.
An international team of health researchers has published findings that focus on the role of leptin, a substance produced by fat cells.
Leptin is key
It turns out that leptin levels in the body are significantly elevated following weight gain. The increase in leptin acts in the brain to increase blood pressure.
The researchers reached their conclusion when they ran a series of experiments on both animal and human subjects. First, they set up roadblocks in the brain to keep the leptin signals from getting through. They even went so far as to remove leptin receptors from the brain.
Interrupting that communication had a dramatic effect. It reduced both high blood pressure and obesity.
80% of hypertension cases
The research team maintains as much as 80% of common hypertension is linked to excess body fat. This study breaks new ground because it describes how obesity raises blood pressure.
More importantly, it could lead to new approaches for treating both conditions.
"Our data suggest that pharmacological approaches based on altering the effect of leptin in the dorsomedial hypothalamic region of the brain, could potentially represent a therapeutic target for the treatment of obesity induced hypertension and potentially could be exploited to alleviate the incidence of obesity induced cardiovascular diseases," said Professor Michael Cowley, of Australia's Monash University.
Translated, that means it may be possible to produce a drug that would stop leptin from telling the brain to raise the body's blood pressure. If so, it would come as welcome news to millions of Americans.
Epidemic of hypertension
The Centers for Disease Control and Prevention (CDC) estimates some 67 million American adults – about 31% of the adult population – have high blood pressure and only about half of them have their condition under control.
The condition affects men and women more or less equally over their lifetimes. However, for people younger than 45 years old, the condition affects more men than women. For people 65 years old or older, high blood pressure affects more women than men, the CDC says.
Because it is so closely linked to heart disease and stroke, more than 348,000 American deaths in 2009 included high blood pressure as a primary or contributing cause, working out to about 1,000 deaths a day.
In addition to heart-related illness high blood also pressure increases your risk for kidney disease.
High blood pressure is usually treated with medication but changes in lifestyle are also very effective in bringing it under control. A healthy diet, regular exercise and maintaining a normal weight will do as much as anything to keep your blood pressure under control.
How high is high blood pressure? Recently, there has been some disagreement about that in medical circles. We recently looked into that question here.
For years doctors have known that obesity is a strong link to cardiovascular disease, and with it conditions like hypertension, or high blood pressure....
High blood pressure is falling but irregular heartbeats increasing
According to the cardiac researchers presenting at last weekend's American Heart Association Scientific Sessions, we're making progress in some areas of heart health but stepping back in others.
First, the good news. Since the Baby Boom population first entered middle-age and obesity has become more common, hypertension – or high blood pressure – has been a growing problem. But those dangerous blood pressure readings appear to be coming down.
Dropping blood pressure
Findings presented over the weekend show that more than half of those diagnosed with hypertension are now getting readings below 140/90 millimeters of mercury (mm Hg), which is considered safe.
A reading of 120/80 is considered optimal and the findings show that between 2003 and 2012, the percentage of hypertension patients able to achieve that rose from 13% to 27%.
"This is definitely good news," the researchers conclude.
That's because hypertension is linked to heart attack and stroke. As fewer people have high blood pressure, that risk has declined.
But the percentage of patients with high blood pressure that remains uncontrolled remains high, at 48%. The federal Healthy People 2020 initiative has a goal of reducing that to 38%. High blood pressure affects about 1 in 3 adults in the United States.
Irregular heart beats jump
While there was good news on the blood pressure front, doctors report emergency room visits for irregular heartbeat surged in recent years and are currently creating a major health care burden.
Atrial fibrillation (AF), the most common kind of arrhythmia or irregular heartbeat, can lead to blood clots, stroke, heart failure and other heart-related complications.
When they studied the data, researchers found that 65% of those making a trip to the ER for an irregular heartbeat ended up in the hospital. It has increased in later years, rising from 62.5% in 2006 to 67% in 2011.
The rate of AF emergency room visits steadily increased 24%, from 133 visits per 100,000 persons in 2006 to 165 visits per 100,000 persons in 2011.
When you add it all up, more than 2.7 million Americans were admitted for AF between 2006 and 2011.
The one bright spot was the decrease in in-hospital death rates after a patient was admitted with AF.
There were some common characteristics of patients who were admitted with AF. They tended to be elderly, female, had Medicare or Medicaid insurance and lived in areas with low median income.
According to the American Heart Association an irregular heartbeat can produce a wide range of symptoms. They include fatigue, dizziness, lightheadedness, fainting, chest pain, shortness of breath and a rapid heartbeat.
The Association says that while most cases are harmless, some arrhythmias are extremely dangerous and require treatment and management.
According to the cardiac researchers presenting at last weekend's American Heart Association Scientific Sessions, we're making progress in some areas of he...
Emergency visits to treat hypertension spiked 25% over 5 years
There are many reasons people go to a hospital emergency room and in recent years, spiking blood pressure has become a fairly common one.
Data presented at the American Heart Association's High Blood Pressure Research Scientific Sessions earlier this month showed the number of ER cases of essential hypertension, high blood pressure with no known cause, increased by 25% over a 5-year period.
That means a lot of people who suddenly discover their blood pressure is dangerously high are seeking immediate medical attention. Dr. Sourabh Aggarwal, M.D., Chief Resident in the Department of Internal Medicine at Western Michigan University School of Medicine in Kalamazoo, says there's a clear takeaway from this development.
What it shows
"This shows we are not doing a good job in controlling high blood pressure in the outpatient setting," she said. "We need better high blood pressure care in this setting."
When patients go to the ER for treatment of high blood pressure, they are less likely than in the past to be admitted. This may have to do with more effective treatments, including medications. Researchers reached their conclusion after collecting data on about 3.9 million ER visits from 2006 to 2011 in which high blood pressure was the first listed diagnosis.
The research does not show what specifically sent the people to the hospital but the American Heart Association recommends going to the ER if you have blood pressure above 180/110 mm Hg, which is considered a hypertensive crisis.
High blood pressure, often called a silent killer because it typically has no symptoms, affects 76.4 million U.S. adults. It's a major risk factor for stroke, heart attack and heart failure.
It's also on the increase, as more Americans are overweight and sedentary. While high blood pressure can have many causes, those 2 are among the most common.
Small weight gain
The American Heart Association event produced other significant new information about hypertension. Researchers said they found that gaining as little as 5 pounds can raise the blood pressure of otherwise healthy adults.
“To our knowledge, for the first time, we showed that the blood pressure increase was specifically related to increases in abdominal visceral fat, which is the fat inside the abdomen,” said Naima Covassin, Ph.D., the study’s lead author and a research fellow at the Mayo Clinic in Rochester, Minn. “Our research suggests that healthy people who are more likely to gain weight in the stomach area are also more likely to have their blood pressure increased.”
The study found that test subjects who gained weight increased the systolic blood pressure by 4 points compared to test subjects who didn't gain weight. Where the weight was gained was also a factor.
People who added fat in the stomach area had the greatest increase in their blood pressure. While the small weight gain did increase blood pressure, it didn't have any effect on insulin or blood sugar levels.
“The public awareness of the adverse health effects of obesity is increasing; however, it seems most people are not aware of the risks of a few extra pounds,” Covassin said. “This is an important finding because a 5 to 7 pound weight gain may be normal for many during the holiday season, the first year of college or even while on vacation.”
And as you get older, it gets harder to shed pounds, even as few as 5. Better to avoid gaining it in the first place, if possible.
There are many reasons people go to a hospital emergency room and in recent years, spiking blood pressure has become a fairly common one....
High-protein diet can lower blood pressure, study finds
It may be time to revise dietary recommendations, researchers say
A new study finds that adults who consume a high-protein diet may be at a lower risk for developing high blood pressure, and researchers involved in the study say the results suggest it's time to take a new look at dietary recommendations.
"These results provide no evidence to suggest that individuals concerned about the development of HBP (high blood pressure) should avoid dietary protein. Rather, protein intake may play a role in the long-term prevention of HBP," said Lynn Moore, associate professor of medicine at the Boston University School of Medicine. "This growing body of research on the vascular benefits of protein, including this study, suggest we need to revisit optimal protein intake for optimal heart health," she added.
In the latest study, published in the American Journal of Hypertension, researchers found participants consuming the highest amount of protein (an average of 100 g protein/day) had a 40% lower risk of having high blood pressure compared to the lowest intake level.
The researchers analyzed protein intakes of healthy participants from the Framingham Offspring Study and followed them for development of high blood pressure over an 11-year period.
Overweight and normal
They found that adults who consumed more protein, whether from animal or plant sources, had statistically significantly lower systolic blood pressure and diastolic blood pressure levels after four years of follow-up. In general, these beneficial effects were evident for both overweight and normal weight individuals.
They also found that consuming more dietary protein was associated with lower long-term risks for HBP. When the diet also was characterized by higher intakes of fiber, higher protein intakes led to 40%–60% reductions in risk of HBP.
One of three U.S. adults has hypertension and 78.6 million are clinically obese, a risk factor for the development of hypertension. Because of the strain that it puts on blood vessel walls, High blood pressure is one of the most common risk factors of stroke and an accelerator of multiple forms of heart disease, especially when paired with excess body weight.
A new study finds that adults who consume a high-protein diet may be at a lower risk for developing high blood pressure, and researchers involved in the st...
Size matters when it comes to blood pressure cuffs
Is that monitoring kiosk at the grocery store for you?
You see them everywhere: the supermarket, drug stores, discount superstore. It's those blood pressure monitoring kiosks where you stick your arm in the cuff and get a reading.
But here's something to keep in mind: The next time you do that, you could get an inaccurate reading unless the cuff is your size.
Correct cuff size is a critical factor in measuring blood pressure. Using a too-small cuff will result in an artificially high blood pressure reading; a too-large cuff may not work at all or result in an inaccurately low blood pressure reading.
The Food and Drug Administration (FDA) wants you to know that blood pressure cuffs on public kiosks don’t fit everyone -- and might not be accurate for every user.
“They are easily accessible and easy to use,” says Luke Herbertson, PhD, a biomedical engineer at FDA. “But it’s misleading to think that the devices are appropriate for everybody. They are not one-size-fits-all.”
Blood pressure is an important indicator of cardiovascular health. High blood pressure (hypertension) is called a “silent killer” because it may not show any symptoms. It increases the risk of stroke, heart attack, heart failure, kidney failure and death. The higher the blood pressure, the greater the risk.
Hypertension affects nearly one in three adults in the United States, and in most patients, it is found only when they have their blood pressure checked.
The need for accuracy
In a clinic or a medical office, this is done by using blood pressure cuffs of various sizes to ensure the reading is accurate. For example, a toddler’s blood pressure is checked by using an extra-small children’s cuff, but a football lineman’s arm may require an extra-large adult cuff.
Not so at kiosks. Most have just one fixed-size cuff that fits arms of only a certain size. The blood pressure reading is reliable only if the user’s arm is within the range that has been validated for that cuff size. Moreover, not all kiosks have the same size cuff. There is no such thing as a “standard” cuff to fit a “standard” arm.
If the cuff doesn’t fit your arm properly, your reading won’t be accurate.
“Different kiosks have different cuff sizes that will fit different people -- so it’s important to know the circumference of your upper arm because not all devices are alike,” says Stephen Browning, a biomedical engineer at FDA. “Many people will be outside the arm size range for a particular kiosk, and the information from that kiosk won’t be reliable for them.”
Other factors, including how someone uses a device, might cause an inaccurate reading. “The user might not have placed the cuff on his arm properly or might not be sitting properly. These things will affect accuracy,” Herbertson says.
That’s why people shouldn’t overreact to any one reading from a kiosk.
“Hypertension isn’t diagnosed solely based on one reading. Inaccurate blood pressure measurements can lead to the misdiagnosis of hypertension or hypotension (low blood pressure), and people who need medical care might not seek it because they are misled by those inaccurate readings,” Browning says.
“Next time you see your doctor, get his or her opinion about whether blood pressure kiosks are right for you and if so, learn to use them properly—using the right size cuff so you can get accurate readings,” Herbertson advises.
What to do
Consumers use kiosks for various reasons. They might have been advised by their doctor to monitor changes to their health. They may be concerned about hypertension. Or they may just be curious about their blood pressure.
Health care providers diagnose hypertension based on several blood pressure measurements over a period of time. Remember that one measurement -- from a kiosk or other device -- doesn’t a diagnosis make.
Like your heart rate, your blood pressure can change quickly. It might be higher during a stressful meeting, after a brisk walk or because you’re sick. Those variations are normal. That’s why people with hypertension monitor their blood pressure frequently. And health care providers often depend on the patient’s own readings to augment the reading in a doctor’s office, so kiosks can be useful in many circumstances.
Although blood pressure kiosks have their limitations, they can provide valuable information when used properly and under the guidance of a health care provider.
You see them everywhere: the supermarket, drugs stores, discount superstore. It's those blood pressure monitoring kiosks where you stick your arm in the c...
Growing research suggests it can be higher than current guidelines
All of a sudden, the medical community is second guessing the recent low benchmarks for “safe” blood pressure. In short, some are suggesting “the lower the better” approach might not be the right one after all.
The latest questions appear in a study published in the online edition of JAMA Internal Medicine. Researchers at Wake Forest Baptist Medical Center report that lowering systolic blood pressure below 120 does not appear to provide additional benefit for patients.
Systolic pressure is the top number in a standard blood pressure reading such as 120/80.
“Frequently we treat patients’ blood pressure to the lowest it will go, thinking that is what’s best,” said Carlos J. Rodriguez, M.D., associate professor of public health sciences at Wake Forest Baptist and lead author of the study.
Lower not necessarily better
But the researchers found that pushing blood pressures to the lowest levels possible didn't provide any benefit to patients with risk of dangerous events like heart attack, heart failure and stroke.
“This calls into question the notion that lower is better,” Rodriquez said.
Previous studies had claimed a progressive rise in heart disease risk as systolic blood pressure (SBP) rose above 115. According to the Mayo Clinic, normal blood pressure is below 120/80, which is often difficult to achieve without medication.
However, that's a relatively recent change. Until 2003 most doctors considered 120/80 an ideal blood pressure and a systolic reading up to 140 to be satisfactory.
But a report that year from the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure warned that blood pressure needed to be lower. It said systolic pressure as low as 120 might be risky. For millions of patients, that meant taking medication.
Drug industry influence?
It has to be asked what role the pharmaceutical companies might have played in developing these new standards. A 2005 investigation by The Seattle Times alleged 9 of the 11 authors of the new guidelines had drug company ties.
A new panel on hypertension issued new guidelines last December, suggesting patients over 60 were fine with a blood pressure reading of 150/90. Blood pressure goals were also eased for adults with diabetes and kidney disease.
In March researchers at Duke University ran an analysis and determined that an estimated 5.8 million adults no longer needed blood pressure medicine under the new guidelines.
“Raising the target in older adults is controversial, and not all experts agree with this new recommendation,” said lead author Ann Marie Navar-Boggan, a cardiology fellow at Duke University School of Medicine. “In this study, we wanted to determine the number of adults affected by these changes.”
Based on their study, the Duke researchers estimated the proportion of U.S. adults in need of hypertension treatment would decrease from 40.6% under the old guidelines to 31.7% under the new recommendations, resulting in a pretty big hit for drug companies.
More bad news for drug companies
The new Wake Forest study is likely to be seen as more bad news in the pharmaceutical industry. It found that among people with high blood pressure, once SBP is below 140, lowering it below 120 did not reduce heart risks.
“Our study found that the optimal blood pressure range for people with hypertension is 120-139, which significantly reduces the risk of stroke, heart attack or heart failure,” Rodriguez said. “These findings suggest that you don’t need to go lower than that to have the benefits.”
If you are currently taking medication for high blood pressure, you should continue to do so. Never make changes in your medication based on news stories. However, you should discuss these new guidelines with your healthcare provider for advice about whether you need to stay on the medication.
All of a sudden, the medical community is second guessing the recent low benchmarks for “safe” blood pressure. In short, some are suggesting &l...
It's a grown-up affliction but an alarming number of children are beginning to feel its effects: hypertension, or high blood pressure.
The typical person suffering from high blood pressure is middle aged, stressed out and overweight. However, the average age of people with hypertension is steadily declining.
More than 50 million Americans are now believed to suffer from hypertension, putting them at increased risk for cardiovascular disease, end-stage renal disease, and cerebrovascular accidents.
And now doctors estimate that nearly 5% of the pediatric population has unhealthy levels of blood pressure.
Hypertension can have many causes but it is primarily influenced by lifestyle factors. Being overweight, not eating properly and getting little or no exercise can all be contributors.
That may be why so many children are now affected. The rise in childhood hypertension coincides with the rise in childhood obesity.
“Hypertension puts a strain on the cardiovascular system, and makes children at risk for heart disease and chronic kidney disease later in life,” said Dr. Robert Woroniecki,of Stony Brook Children’s Hospital. “Conversely, sometimes chronic kidney disease leads to high blood pressure. Whatever the cause, the effects can dramatically influence a child’s health.”
High blood pressure poses a different sort of problem for children's health, but it poses a problem nonetheless. In adults, high blood pressure can mean the patient is at short-term risk of a heart attack or stroke.
Not so with children but hypertension can still cause changes in your child’s body, putting them at risk for future complications. Once they reach middle age, these children may have even more severe health problems than do adults diagnosed during middle age.
High blood pressure has no symptoms, leading it to be sometimes called “the silent killer.” But being overweight or obese are big risk factors.
Woroniecki says children who meet this physical description should get regular blood pressure readings. Until recently pediatricians were not all that likely to screen their young patients for high blood pressure because it was so rare.
Difficult to diagnose
Diagnosing high blood pressure in children is more difficult than in adults. According to the Mayo Clinic, pediatric hypertension is defined as “blood pressure that's the same as or higher than 95% of children who are the same sex, age and height as your child.”
There isn't a simple target blood pressure reading the problem in all ages for children, because what's considered normal blood pressure changes as children grow.
But the condition in children can occur for the same reasons it shows up in adults -- being overweight, eating a poor diet and not exercising.
While hypertension can be addressed in these children by having them make lifestyle changes, some cases are more complicated and may require medication. For example, the Mayo Clinic notes that high blood pressure in children under 10 is usually caused by an underlying medical condition.
For adolescents, the American Heart Association says age, body size and the degree of sexual maturation are major factors in determining blood pressure levels. Heavier and more sexually mature teenagers tend to have higher blood pressure.
The group cites research suggesting teens who are obese and have high blood pressure may develop thicker arteries by age 30. Fatty buildups in artery walls can lead to a variety of health problems including heart disease and stroke.
It's a grown-up affliction but an alarming number of children are beginning to feel its effects: hypertension, or high blood pressure.The typical person ...
Researchers: neighbor's foreclosure may spike your blood pressure
Researchers continue to find contributors to hypertension
Smoking can cause high blood pressure. So can drinking too much alcohol. Being overweight and consuming too much sodium also greatly increases your risk.
Beyond that, doctors have been puzzled when hypertension shows up in people who don't smoke, drink, or have poor diets. But gradually new potential triggers are emerging.
Researchers publishing their results in the American Heart Association journal Circulation have advanced the theory that living on a street with a foreclosed home can cause your blood pressure to rise.
Specifically, the researchers say that a foreclosed property may cause a neighbor's systolic blood pressure, the top number in a blood pressure reading, to rise.
Stressing over the neighborhood
Stress has always been a hypertension risk factor but the study takes health in a new direction. Instead of blood pressure being influenced by an individual's personal behavior, the researchers suggest that environmental factors play a bigger role that previously believed.
It may have taken the 2008 housing collapse to bring it to light. Because of the massive scale of the U.S. housing crisis public health officials have tried to reach a better understanding of how foreclosure activity might impact health.
The number of foreclosures spiked in the United States in 2007-10 when more than 6 million homeowners fell behind on their mortgages and banks took ownership of the homes, or foreclosed.
Researchers looked at data from 1,740 participants in 1987-2008 who were part of the Framingham, Mass., Heart Study. They distinguished between bank-owned foreclosures that typically sit vacant and foreclosures purchased by third-party buyers, which are generally put into productive use.
They found that for every vacant foreclosed property within 328 feet of a participant's home there was an average increase of 1.71 mm Hg in systolic blood pressure. If a property was purchased and occupied there was no difference.
The findings have renewed focus on the role that stress plays in hypertension.
"The increases in blood pressure observed could be due in part to unhealthy stress from residents' perception that their own properties are less valuable, their streets less attractive or safe and their neighborhoods less stable," said Mariana Arcaya, study lead author and Yerby Postdoctoral Research Fellow at the Harvard Center for Population and Development Studies. "Safety could also be a concern that affects their ability to exercise in these neighborhoods."
Increased awareness needed
The takeaway from this, according to Arcaya, is that healthcare providers should be aware of real estate trends in the areas they serve. Patients living in neighborhoods still recovering from the housing crisis may need extra monitoring.
High blood pressure, often called “the silent killer, affects nearly 76 million people in the United States. It's a major contributor to heart disease and stroke.
While stress is a risk factor that should get more attention, doctors continue to link the condition lifestyle choices, particularly diet.
Scientists in Austria recently identified a hormone, FGF23 (Fibroblast Growth Factor 23), as a trigger for elevated blood pressure. When the level of FGF23 is raised, as through a high phosphate diet, calcium and sodium accumulate, putting strain on the cardiovascular system.
Foods that are rich in phosphate – things like cheese, Parmesan, cola, baking powder and most processed foods – are triggers for FGF23.
When large quantities of phosphates are consumed, production of the FGF23 hormone is stimulated, which has a negative effect on the cardiovascular system.
Reinhold Erben, the head of the Unit of Physiology, Pathophysiology and Biophysics at the Vetmeduni Vienna, says consumers should control their phosphate consumption, since it is now shown to be important to health.
Smoking can cause high blood pressure. So can drinking too much alcohol. Being overweight and consuming too much sodium also greatly increases your risk....
Blood pressure goes down and the heart works more easily after a watermelon snack
You might think of watermelon as a summertime treat but a new study finds it's a beneficial snack year-round, especially for obese people with high blood pressure.
The study by Florida State University Associate Professor Arturo Figueroa, published in the American Journal of Hypertension, found that watermelon could significantly reduce blood pressure in overweight individuals both at rest and while under stress.
“The pressure on the aorta and on the heart decreased after consuming watermelon extract,” Figueroa said.
The study started with a simple concept. More people die of heart attacks in cold weather because the stress of the cold temperatures causes blood pressure to increase and the heart has to work harder to pump blood into the aorta. That often leads to less blood flow to the heart.
Thus, people with obesity and high blood pressure face a higher risk for stroke or heart attack when exposed to the cold either during the winter or in rooms with low temperatures.
So, what might help their hearts? It turned out that watermelon may be part of the answer.
Figueroa’s 12-week study focused on 13 middle-aged, obese men and women who also suffered from high blood pressure. To simulate cold weather conditions, one hand of the subject was dipped into 39 degree water (or 4 degrees Celsius) while Figueroa’s team took their blood pressure and other vital measurements.
The results showed that consuming watermelon had a positive impact on aortic blood pressure and other vascular parameters.
Notably, study participants showed improvements in blood pressure and cardiac stress while both at rest and while they were exposed to the cold water.
“That means less overload to the heart, so the heart is going to work easily during a stressful situation such as cold exposure,” Figueroa said.
You might think of watermelon as a summertime treat but a new study finds it's a beneficial snack year-round, especially for obese people with high blood p...
Studies suggests we might not need all that medication
Lifestyle changes may improve both blood pressure and erectile dysfunction
Consumers spend billions of dollars a year on prescription medication to treat all sorts of conditions. But are some of us taking pills – and spending money – needlessly?
A couple of recent studies suggest we may be. The separate research projects, released late last week, studied prescription medications for high blood pressure and those treating erectile dysfunction. They may cause some heartburn at drug companies.
In February the Eighth Joint National Committee voted to relax the blood pressure goal in adults 60 years and older to 150/90, instead of the previous goal of 140/90.
The Duke researchers analyzed a number of previous studies of hypertension patients and their blood pressure readings to reach the conclusion that many who are now taking medication don't need it. But that doesn't mean you should throw away your pills. The researchers make clear they aren't advocating that.
“Raising the target in older adults is controversial, and not all experts agree with this new recommendation,” said lead author Ann Marie Navar-Boggan, a cardiology fellow at Duke University School of Medicine. “In this study, we wanted to determine the number of adults affected by these changes.”
The Duke study, in collaboration with McGill University, reviewed a database with more than 16,000 participants whose blood pressure measurements were listed. Based on the sample, the researchers conclude the proportion of U.S. adults who should be treated for high blood pressure would decrease from 40.6% under the old guidelines to 31.7% under the new recommendations.
“The new guidelines do not address whether these adults should still be considered as having hypertension,” Navar-Boggan said. “But they would no longer need medication to lower their blood pressure.”
Discuss it with your doctor
Whether a patient needs to continue taking medication is a decision to be made only after discussing it with a doctor. But if millions of people now paying for prescription medication no longer had to, that could be very bad news for the pharmaceutical industry, not to mention very good news for consumers.
The news may be equally as bad for the makers of drugs to treat erectile dysfunction. A new report in the Journal of Sexual Medicine suggests men can reverse their erectile dysfunction by lifestyle changes without relying completely on medication.
Gary Wittert, head of the Discipline of Medicine at the University of Adelaide, in Australia, says his research team found a large number of men in their study were naturally overcoming erectile dysfunction issues without taking medication.
“The remission rate of those with erectile dysfunction was 29%, which is very high,” he said. “This shows that many of these factors affecting men are modifiable, offering them an opportunity to do something about their condition."
The researchers found that even in cases where medication was required to treat erectile dysfunction, it was more effective if the men adopted improved lifestyle behavior.
Lifestyle changes include losing weight, getting more exercise, drinking less alcohol, eating a more nutritious diet and getting a good night's sleep.
Treating both high blood pressure and erectile dysfunction are profitable businesses. According to the Agency for Healthcare Research and Quality, Americans spent $20.4 billion in 2010 to treat high blood pressure.
According to government statistics, worldwide sales of the three most popular drugs to treat erectile dysfunction total $1 billion per year.
It bears repeating that no one who is currently taking prescription medication should stop on their own. But it might be a question to raise with your health care provider.
Consumers spend billions of dollars a year on prescription medication to treat all sorts of conditions. But are some of us taking pills – and spendin...
Knowing these five sets of numbers may reduce heart risk
You don't have to like math to help your heart
Numbers are a big part of health. Height, weight, pulse, blood pressure – doctors can tell a lot about how we are doing physically by the numbers assigned to these properties and functions. And at least one doctor thinks you should know these numbers too.
Dr. Martha Gulati, director of preventive cardiology and women’s cardiovascular health at The Ohio State University Wexner Medical Center, says five sets of numbers in particular can help individuals know if they are in danger of developing heart disease.
Body mass index
The first number is your body mass index, or BMI. When the Wexner Medical Center commissioned a survey, it found nearly two thirds of the public not only didn't know their number, but didn't know what BMI was. So, what is it?
“Basically, it's calculating the amount of weight you're carrying for your body surface area,” Gulati told ConsumerAffairs.
In simple terms, it's a number that tells you how fat you are. When you enter your weight and height into a calculator like this one, you arrive at a number. A number below 25 is considered normal weight. Twenty-five to 30 is overweight and a BMI of 30 or above is considered obese. Gulati says a BMI is just a way to get a difficult conversation started.
“A lot of women don't like to talk about their weight and believe it or not, a lot of doctors don't talk about weight because they don't want to embarrass their patient,” Gulati said. “But if you can't talk about it in a doctor's office, where can you talk about it?”
The second number is blood pressure, measured using two numbers. The systolic pressure – the pressure when you heart is pushing blood through your veins – and the diastolic pressure, when your heart is at rest, is displayed as 120/80, which is considered a normal blood pressure.
Readings up to 140/90 are considered pre-hypertension and are usually addressed through diet and exercise. Readings over 140/90 usually are treated with medication.
The third number is your cholesterol. It's a natural substance produced in your body. Unfortunately, you can get too much cholesterol from food. Some people actually produce too much cholesterol on their own and getting it from food just adds to the problem.
Over time cholesterol can clog arteries, bringing on heart disease and sometimes a heart attack. High cholesterol can be treated with medication but Gulati says it’s important to know your total cholesterol number and your low-density lipoprotein, or LDL, number – the so-called “bad cholesterol” that can cause problems. A healthy cholesterol number is below 200. A healthy LDL number is below 100.
People with diabetes have to constantly keep up with their blood sugar number. That's an indicator of how much glucose is in the blood and too much causes diabetes.
But even if you don't have diabetes you need to be aware of this number, especially if you are overweight. But it's not an easy number to access.
“A lot of times physicians are checking these numbers but not always telling their patients what they are,” Gulati said. “They may say 'your blood work is normal,' but it's not enough to know it's normal, you really need to know what the numbers are.”
A healthy fasting blood sugar number is under 100 after not eating for eight hours.
Finally, you should know the number of inches around your waist. But not the area where your belt goes. No, a more accurate measure of your gut is putting the tape measure across your belly button. Gulati says physicians should be measuring it on a more regular basis but concedes it's rarely done.
“What we're doing is measuring for central obesity,” she said. “If you carry your weight in the center of your abdomen instead of your hips, being an apple shape instead of a pear shape, that tells me you are pre-disposed to developing diabetes and heart disease.”
Knowing these numbers, of course, is only half the battle. Then you have to do something about it. Fortunately, there's a lot you can do.
A careful diet, keeping track of calories – numbers again – and getting regular exercise will help maintain a healthy weight and cardiovascular system.
Numbers are a big part of health. Height, weight, pulse, heart rate – doctors can tell a lot about how we are doing physically by the numbers assigne...
Blood pressure should be measured in both arms: study
Different pressure between arms may foretell cardiovascular problems
Most of us have two arms, so why is it that blood pressure is generally measured in only one arm? It's a good question and, in fact, a new study finds that it would be better to measure the pressure in both arms.
Why? Research published in the March issue of The American Journal of Medicine suggests that there is an association between a difference in interarm systolic blood pressure and a significant increased risk for future cardiovascular events -- heart attacks and the like.
A link between interarm blood pressure differences and cardiovascular risk has been long suspected, but little data existed to support the hypothesis until now.
This new study examined 3,390 participants aged 40 years and older from the Framingham Heart Study. All subjects were free of cardiovascular disease at baseline, but investigators found that participants with higher interarm systolic blood pressure differences were at a much higher risk for future cardiovascular events than those with less than a 10 millimeters of mercury (mmHg) difference between arms.
"In this large prospective, community-based cohort of middle-age men and women free of cardiovascular disease, an increased interarm systolic blood pressure difference was found to be present in nearly 10% of individuals and is associated with increased levels of traditional cardiovascular risk factors," explains lead investigator Ido Weinberg, MD, Institute for Heart Vascular and Stroke Care, Massachusetts General Hospital, Boston.
Researchers also found that participants with elevated interarm blood pressure difference were older, had a greater prevalence of diabetes mellitus, higher systolic blood pressure, and a higher total cholesterol level.
According to these findings, investigators suggest practitioners should consider including blood pressure readings in both arms in order to get the most accurate readings possible and detect any differences in interarm blood pressure.
"Even modest differences in clinically-measured systolic blood pressures in the upper extremities reflect an increase in cardiovascular risk," says Weinberg. "This study supports the potential value of identifying the interarm systolic blood pressure difference as a simple clinical indicator of increased cardiovascular risk."
New study presents evidence that blood pressure should be measured in both armsDifference in interarm blood pressure linked to greater risk of future car...
Report: high blood pressure rivals HIV as health threat
Response is too little, too late researchers say
British researchers have sounded an alarm over the growing threat of hypertension, or high blood pressure, comparing it to the HIV epidemic that exploded two decades ago.
Their report, in the International Journal of Epidemiology, suggests high blood pressure could be as devastating to global health as HIV. Peter Lloyd-Sherlock of the University of East Anglia, Shah Ebrahim and Heiner Grosskurth of the London School of Hygiene and Tropical Medicine (LSHTM), find another similarity. They say the response of most governments to high blood pressure is little better than the reaction to HIV/AIDS 20 years ago – too little, too late.
High blood pressure is not an infectious disease – you don't get it from human contact. But like HIV, the researchers say, it can lead to fatal and disabling illness. They estimate that the number of world-wide deaths attributable to hypertension over the next 20 years may substantially exceed the number resulting from HIV/AIDS.
Despite those numbers, the three researchers say there is “denial” and misunderstanding about the impact of hypertension, despite the two conditions having a number of things in common. Though they have different origins, both diseases can be treated and managed as chronic conditions through a combination of drug treatment and lifestyle changes.
“It has been suggested that valuable lessons for hypertension could be taken from HIV/AIDS policies,” the researchers write. “Yet there is little indication that these are being taken on board. Our response to the global epidemic of hypertension seems little better than our response to HIV/AIDS two decades ago: too little too late. Can we not wake up earlier this time, before millions have died?”
High blood pressure is a condition in which the heart uses excess force to pump blood through the circulatory system. It can lead to coronary heart disease, heart failure, stroke, kidney failure and other health conditions.
The excessive pressure of the blood moving through the system can weaken artery walls, leading to a rupture and causing a stroke.
According to the National Heart, Lung and Blood Institute, part of the National Institutes of Health, about one in three adults in the U.S. suffers from high blood pressure. Since there are no signs or symptoms, you can have it for years without knowing it.
Blood pressure is measured using a cuff device that records the higher systolic pressure – when the heart is pushing blood through the body – and lower diastolic pressure – when the heart is at rest between beats. A reading of 120/80 or lower is considered normal.
High blood pressure is often caused by lifestyle factors. Smoking, unhealthy foods, being overweight or obese, too little exercise and too much alcohol are all factors that can raise blood pressure. Stress is another factor that can significantly raise risks.
Because high blood pressure is largely behavior-influenced, the researchers speculate government officials are reluctant to spend taxpayer funds to help people “who eat and drink too much.”
“HIV was faced with political denial and public misunderstanding in the early years of the pandemic, especially in some poorer countries,” the researchers write. “There is a similar pattern of denial with hypertension.”
The denial, they claim, is misguided, especially the view that hypertension does not affect poorer social groups. They say there is substantial evidence that hypertension is highly prevalent among poorer groups and that they are less likely to have access to effective treatment.
British researchers have sounded an alarm over the growing threat of hypertension, or high blood pressure, comparing it to the HIV epidemic that exploded t...
Researchers looked at results from 13 studies on the effects of physical activity on blood pressure. The studies involved 136,846 people in the United States, Europe or East Asia who initially had healthy blood pressure. More than 15,600 developed high blood pressure during follow-up periods ranging from two to 45 years.
Bettering your odds
However, those who exercised more than four hours per week in their leisure time had a 19% lower risk of high blood pressure than those who exercised less than one hour per week. People who had one to three hours per week of leisure exercise had an 11% lower risk than those with under an hour of activity.
This suggests that more is better: The more recreational physical activity you get, the more you are protected from developing high blood pressure.
Almost 78 million U.S. adults have high blood pressure, defined by the American Heart Association as blood pressure readings at or above 140 millimeters of mercury for the upper number or 90 or higher for the bottom number. Because it typically has no symptoms, the condition goes undetected or untreated in many people.
"Hypertension is a risk factor for cardiovascular and kidney disease -- thus, it is important to prevent and control hypertension," said Wei Ma, M.D., Ph.D., study co-author and associate professor at the Shandong University School of Public Health in Jinan, China. "To try to lower your risk of high blood pressure, you should exercise more in your leisure time."
Work vs. fun
Researchers didn't find a solid link between physical exertion at work and risk of high blood pressure. Health guidelines urging people to get more exercise don't distinguish between activity at work and for leisure, said Bo Xi, M.D., Ph.D., lecturer at the Shandong University School of Public Health in Jinan, China, and a co-author with Ma. But, "given the new findings, perhaps they should."
Physical activity on the job, such as farm or industrial work, can involve exertion like heavy lifting, prolonged standing and repetitive tasks.
Recreational exercise may affect several factors tied to high blood pressure -- helping people keep off extra pounds, improving poor insulin sensitivity or reducing the blood vessels' resistance to blood flow, Ma said.
Although the new research linked recreational exercise and lower blood pressure, it didn't show that the exercise prevents the condition. People who exercise for fun may just have healthier lifestyles, Xi said.
A lot of people look for reasons to avoid physical activity. But here's a good reason to seek it out. New research in the American Heart Association journ...
Study finds little benefit from aliskiren in preventing heart disease
Study followed 613 patients, found similar outcomes with aliskiren and a placebo
In a new study, the drug aliskiren did not slow the development of high blood pressure and coronary artery disease compared to a placebo.
Aliskiren inhibits the production of renin, an enzyme secreted by the kidneys that can cause tightening of the arteries, which in turn contributes to high blood pressure. But in a study of 613 patients, no significant improvement was seen, according to a study published by JAMA. The study is being released early online to coincide with its presentation at the European Society of Cardiology Congress 2013.
“These findings do not support the use of aliskiren for regression or prevention of progression of coronary atherosclerosis,” the authors conclude.
No significant difference
Aliskiren is commonly used in patients who show early signs of high blood pressure and coronary heart disease, in an effort to slow the progression of disease. Guidelines generally recommend reducing blood presure to 140/90.
Stephen J. Nicholls, M.B.B.S., Ph.D., of the South Australian Health and Medical Research Institute, Adelaide, Australia, and colleagues conducted a study to determine if renin inhibition with aliskiren would slow progression of coronary atherosclerosis in patients whose blood pressure was considered optimally controlled to current treatment targets.
The randomized, multicenter trial compared aliskiren with placebo in 613 participants with coronary artery disease, systolic blood pressure between 125 and 139 mm Hg (prehypertension range), and 2 additional cardiovascular risk factors. The trial was conducted at 103 academic and community hospitals in Europe, Australia, and North and South America.
The researchers found that there was no significant difference between the treatment groups.
In a related editorial, Jean-Claude Tardif, M.D., and Jean Gregoire, M.D., of the Montreal Heart Institute, Montreal, Canada, comment on the findings and discuss two other trials in which aliskiren was not effective in improving clinical outcomes in patients with cardiovascular disease.
They suggest that, pending further study, "the role of renin inhibition in this context should be limited."
"Because aliskiren does reduce blood pressure, perhaps this agent could be reserved for use in patients with coronary disease and hypertension who cannot tolerate ACE inhibitors and angiotensin receptor blockers,” they suggested.
What to do
If you are taking aliskiren, talk with your physician about this study. While it was not shown to prevent the progression of heart disease, aliskiren does reduce high blood pressure.
Consumers should never self-diagnose or self-treat based on a single research study or, for that matter, any information they find on the Internet. Only your physician can diagnose and treat illness.
In a new study, the drug aliskiren did not slow the development of high blood pressure and coronary artery disease compared to a placebo.Aliskiren inhibi...
It's been said that the eyes are the windows to the soul. Now, some doctors believe that the eyes may also be a window to a person's stroke risk.
Researchers who took part in a study reported in the American Heart Association journal Hypertension believe retinal imaging may someday help assess if you're more likely to develop a stroke -- the nation's No. 4 killer and a leading cause of disability.
"The retina provides information on the status of blood vessels in the brain," said Mohammad Kamran Ikram, M.D., Ph.D., lead author of the study and assistant professor in the Singapore Eye Research Institute, the Department of Ophthalmology and Memory Aging & Cognition Centre, at the National University of Singapore. "Retinal imaging is a non-invasive and cheap way of examining the blood vessels of the retina."
Hypertension the key
High blood pressure is the single most important risk factor for stroke worldwide. However, it's still not possible to predict which high blood pressure patients are most likely to develop a stroke.
Researchers tracked stroke occurrence for an average 13 years in 2,907 patients with high blood pressure who had not previously experienced a stroke. At baseline, each had photographs taken of the retina, the light-sensitive layer of cells at the back of the eyeball. Damage to the retinal blood vessels attributed to hypertension -- called hypertensive retinopathy -- evident on the photographs was scored as none, mild or moderate/severe.
During the follow-up, 146 participants experienced a stroke caused by a blood clot and 15 by bleeding in the brain.
Finding a link
Researchers adjusted for several stroke risk factors such as age, sex, race, cholesterol levels, blood sugar, body mass index, smoking and blood pressure readings. They found the risk of stroke was 35 percent higher in those with mild hypertensive retinopathy and 137 percent higher in those with moderate or severe hypertensive retinopathy.
Even in patients on medication and achieving good blood pressure control, the risk of a blood clot was 96 percent higher in those with mild hypertensive retinopathy and 198 percent higher in those with moderate or severe hypertensive retinopathy.
"It is too early to recommend changes in clinical practice," Ikram said. "Other studies need to confirm our findings and examine whether retinal imaging can be useful in providing additional information about stroke risk in people with high blood pressure."
It's been said that the eyes are the windows to the soul. Now, some doctors believe that the eyes may also be a window to a person's stroke risk. Research...
More doctors are beginning to emphasize lifestyle changes
Hypertension, or high blood pressure, has been called the silent killer because many who have it are unaware they have a condition that can shorten their life. Recognizing that you have the condition, however, is just the first step. Next, you have to treat it.
First, let's define our terms. When we say “high blood pressure” we are talking about a blood pressure reading above 140/90 – the 140 being the systolic number, which measures the the pressure in the arteries when the heart beats. The 90 is the diastolic number, which measures the pressure between beats.
Adopting a healthy lifestyle is an effective first step in both preventing and controlling high blood pressure. If lifestyle changes alone are not effective in keeping your pressure controlled, it may be necessary to add blood pressure medications. In fact, most people with high blood pressure take one or more prescription medications.
One of the older class of medications is the beta blocker. Beta blockers reduce nerve impulses to the heart and blood vessels, slowing the heart, so it doesn't work as hard.
Angiotensin converting enzyme, or ACE, inhibitors prevent the formation of a hormone called angiotensin II, which can cause blood vessels to narrow. The ACE inhibitors cause the vessels to relax and blood pressure goes down.
Angiotensin antagonists shield blood vessels from angiotensin II. As a result, the vessels become wider and blood pressure goes down. Calcium channel blockers, or CCBs, keep calcium from entering the muscle cells of the heart and blood vessels. This causes the blood vessels to relax and pressure goes down.
Alpha blockers reduce nerve impulses to blood vessels, which allows blood to pass more easily, causing the blood pressure to go down. Alpha beta blockers work the same way as alpha blockers but also slow the heartbeat, as beta blockers do. As a result, less blood is pumped through the vessels and the blood pressure goes down.
Cheap and under-used
Perhaps the simplest drug is a diuretic, also called a water pill. It works in the kidneys and flushes excess water and sodium from the body. It's cheap and, according to one blood pressure expert, under-used. In 2012 Dr. Samuel J. Mann, a nationally-known hypertension specialist at New York-Presbyterian Hospital/Weill Cornell Medical Center, questioned the widespread use of today's most popular hypertension drugs.
"Despite their best intentions many physicians continue to place their hypertensive patients on blood pressure medications, drug combinations or doses that may not be the best treatment available to them, Mann said. "I believe that with the medications we have, we can do much better than we are doing.
Mann's view may be gaining wider acceptance. Many physicians are now emphasizing a healthy diet, reducing sodium consumption, maintaining a healthy weight and reducing alcohol use.
If you are currently taking blood pressure medication, don't stop taking it without consulting with your doctor first. Even if you continue to take medication, making lifestyle changes to promote a normal blood pressure can only improve your health.
Hypertension, or high blood pressure, has been called the silent killer because many who have it are unaware they have a condition that can shorten their l...
Obesity and poor eating habits are likely responsible
It isn't just older folks who should be worried.
New research in the American Heart Association journal Hypertension finds the risk of elevated blood pressure among children and adolescents rose 27 percent during a thirteen-year period.
The culprits may be higher body mass, larger waistlines and eating too much sodium or salt.
High blood pressure is a risk factor for stroke, heart disease and kidney failure and accounts for about 350,000 preventable deaths a year in the U.S.
"High blood pressure is dangerous in part because many people don't know they have it," said Bernard Rosner, Ph.D., lead author of the study and professor of medicine at Harvard Medical School. "It's a very sneaky thing. Blood pressure has to be measured regularly to keep on top of it."
In adults age 20 and older, blood pressure should normally be less than 120/80 mm Hg. However, among children and teens blood pressure norms vary according to age, sex and height.
While the researchers noted "elevated" readings, the children could not be called hypertensive because blood pressure readings must be high three times in a row for an official diagnosis.
Researchers compared more than 3,200 children ages 8-17 in the National Health and Nutrition Examination Survey (NHANES) III in 1988-1994 with more than 8,300 in NHANES in 1999-2008. They accounted for differences between the two groups in age, sex, race/ethnicity, body mass, waistline and sodium intake.
Boys were more likely to have elevated blood pressure, but the rate increased more markedly in girls from the first study to the second.
More children were overweight in the second study, and both sexes -- especially girls -- had bigger waistlines.
Children whose body mass or waistline measurements were in the top 25 percent for their age group were about twice as likely to have elevated blood pressure as children with measurements in the bottom 25 percent.
Black children had a 28 percent higher risk of elevated blood pressure than non-Hispanic white kids.
In both studies, children with the greatest sodium intake were 36 percent more likely than those with the lowest intake to have elevated blood pressure.
More than 80 percent of children in both studies had a daily sodium intake above 2,300 milligrams; however, fewer children in the later study had an intake above 3,450 milligrams.
"Everyone expects sodium intake will continue to go up," Rosner said. "It seems there's been a little bit of listening to dietary recommendations, but not a lot."
What to do
Americans eat an average 3,400 milligrams of sodium daily -- more than twice the 1,500 or less that the American Heart Association recommends. Two-thirds of sodium intake is from store-bought foods and one-quarter from restaurant offerings.
Studies have linked excessive sodium in the diet to high blood pressure, and have suggested reducing sodium intake in children's and adolescents' can lower average systolic (top number) blood pressure by 1.2 mm Hg and average diastolic (bottom number) pressure 1.3 mm Hg.
It isn't just older folks who should be worried. New research in the American Heart Association journal Hypertension finds the risk of elevated blood pres...
Blood pressure, cholesterol control could cut heart disease risk
Close attention to both may provide long-term benefits
It sounds so simple, yet fewer than one in three people manage to do it.
According to new research in the American Heart Association journal Circulation, you might be able to cut your risk for heart disease by half or more by simultaneously controlling your high blood pressure and high cholesterol.
Researchers also found that prescribing medications to better manage blood pressure and cholesterol would greatly benefit people who are older, diabetic, have cardiovascular disease or are Hispanic or black. And they say going to the doctor at least twice a year could help.
Undertreated high blood pressure and cholesterol affect millions, posing a major public health threat, said Brent M. Egan, M.D., lead study author and a professor of medicine and pharmacology at Medical University of South Carolina in Charleston, S.C.
"The reality is, we know more than enough to prevent 75% of heart disease and strokes, but we're not doing everything we could be doing or even doing it at a reasonable level," he said. "We've made some gradual improvements over the years, but there is still a lot of progress to be made."
High blood pressure affects about 33% of the U.S. adult population and doubles the risk for heart disease. About 32 million people have dangerously high total blood cholesterol levels of 240 mg/dL or higher. Previous research indicates that treating high blood pressure reduces the risk of heart disease by 25% and treating high cholesterol in hypertensive patients can lower the risk by more than 35%, researchers said.
Cholesterol readings need closer attention, Egan said. "If patients' cholesterol tests show a good high-density lipoprotein (HDL) level, which is the healthy, protective cholesterol, then the low-density lipoprotein (LDL) number might get overlooked. Unfortunately, not all HDL is equally protective and some people with a normal HDL are at high risk. In those patients, there might be a false sense of assurance that cholesterol really isn't a problem.
“But LDL and non-HDL readings are the ones to really watch,” he notes. “Patients seeing their doctors for blood pressure treatment should ask about their LDL and non-HDL levels and make sure both are under control at the same time."
The findings are based on data of more than 17,000 adults who participated in the National Health and Nutrition Examination Surveys during in 1988-94, 1999-2004 and 2005-10.
In addition to reviewing patients' blood pressure and cholesterol levels, researchers considered race, age, insurance status, whether patients smoked, had diabetes, had diagnosed heart disease and/or chronic kidney disease, and if they visited a doctor every year.
It sounds so simple, yet fewer than one in three people manage to do it. According to new research in the American Heart Association journal Circulation,...
Research continues to suggest its importance to a healthy circulatory system
Consumers spend billions of dollars on medication to control high blood pressure but getting plenty of vitamin D might help too. Research continues to suggest that the vitamin, present in dairy foods and sunlight, has benefits for the circulatory system.
In March researchers at Boston's Brigham and Women's Hospital conducted a study that suggested moderate amounts of vitamin D supplements could reduce high blood pressure. Since African Americans tend to have high higher incidence of hypertension, the study followed 250 African American adults.
"We found that vitamin D supplementation modestly but effectively lowered blood pressure," said Dr. John Forman, who led the research team. "And people who were taking a placebo had a slight increase in their blood pressure."
Vitamin D has long been thought to have some benefits when it comes to blood pressure. Some previous students on animals achieved that result, though the findings have not been universally accepted.
“In population studies, people with low levels of vitamin D seem to have a high risk of developing high blood pressure than those with higher levels of vitamin D,” according to researchers at the University of Maryland Medical Center. “However, there's no proof that low levels of vitamin D cause high blood pressure in healthy people.”
Dr. Sheldon G. Sheps, of the Mayo Clinic, agrees that the role too little vitamin D plays in developing high blood pressure is not exactly clear. But he says a vitamin D deficiency may be linked to heart disease and a higher risk of high blood pressure. It's too early to know, he says. More research is needed.
However, there appears to be a growing consensus that it could be beneficial. Researchers at Edinburgh University in the UK are so convinced that vitamin D is effective in reducing high blood pressure, as well as heart attack and stroke risk, that they suggest getting vitamin D from sunlight has benefits that may far outweigh skin cancer risks. Their research focuses on ultra violet (UV) rays, which reportedly release a compound in the body that lowers blood pressure.
High blood pressure is a growing threat, especially to the aging population. While being overweight, getting little exercise and consuming excessive levels of sodium are all contributors, not all of its causes are understood.
High blood pressure occurs when the heart has to work harder to move blood through veins and arteries, usually because of rigidity in the blood vessels. Prolonged high blood pressure can cause the heart to enlarge. The high pressure of the blood flowing through the veins can eventually cause a blood vessel to break, causing a stroke.
If increasing vitamin D intake can be shown to prevent high blood pressure, it could provide an easy and effective treatment. It might also save money on prescription medications.
What to do
There are many sources of vitamin D that could probe healthy in other ways, even if it doesn't reduce high blood pressure. Spending time outdoors, with exposure to the sun, is one way but should be measured against the risk of skin cancer.
Some foods also are rich sources of vitamin D. Dairy products, like milk, cheese and yogurt are good sources. You can also get vitamin D from salmon, tuna, flounder, cereal, pork, eggs, mushrooms and liver.
Vitamin D is also available in supplements. Popular brands cost about $25 for 120 capsules, a four month supply. As with any health or diet issue, discuss the role of vitamin D in your diet, and as a tool to control blood pressure, with your physician.
Consumers spend billions of dollars on medication to control high blood pressure but getting plenty of vitamin D might help too. Research continues to sugg...
Are beta blockers effective against Alzheimer's disease?
Blood pressure drug reduced brain shrinkage in study
Among the types of medication people take for high blood pressure are beta blockers, which are a class of drugs that reduce stress levels within the body.
If you take one, you might be reducing your risk of Alzheimer's disease. A study involving autopsies of 774 elderly Japanese-American men, most of whom had suffered from high blood pressure, yielded interesting results.
Only 15 percent of the men had been taking beta blockers for their high blood pressure. Their autopsies revealed they suffered the least amount of brain damage.
The researchers found that all types of blood pressure treatments were clearly better than no treatment. However, men who had received beta blockers as their only blood pressure medication had fewer abnormalities in their brains compared with those who had not been treated for their hypertension, or who had received other blood pressure medications.
Less brain shrinkage
The brains of participants who had received beta blockers plus other medications showed an intermediate reduction in numbers of brain abnormalities. Study participants who had taken beta blockers alone or in combination with another blood pressure medication had significantly less shrinkage in their brains.
“With the number of people with Alzheimer’s disease expected to grow significantly as our population ages, it is increasingly important to identify factors that could delay or prevent the disease,” said study author Lon White, MD, of the Pacific Health Research and Education Institute in Honolulu. “These results are exciting, especially since beta blockers are a common treatment for high blood pressure.”
Beta blockers questioned as blood pressure treatment
In October researchers at the NYU Langone Medical Center questioned whether beta blockers were an effective means of combating high blood pressure. They studied patients taking the drugs and concluded they weren't helping -- at least they weren't lowering blood pressure.
Sripal Bangalore, MD, assistant professor in the Department of Medicine and leader of the research team, suggested the current use of beta blockers to treat high blood pressure is based on old studies.
“Our results found none of the patient populations studied showed benefit from taking beta-blockers, including patients with a history of heart attack,” Bangalore said in October, when his study was released. “This is concerning in light of current treatment patterns and reveals a need for more education among practitioners who treat patients at risk for heart attack and stroke.”
This latest study, however, supported by the National Institutes of Health, might have found an additional use for the drugs. But beta blockers are known to have side effects, which include increases in cholesterol levels, weight gain, upset stomach and headaches.
If you think you are at risk of developing Alzheimer's disease you should discuss beta blockers with your doctor to determine if it is medication you should be taking.
Among the types of medication people take for high blood pressure are beta blockers, which are a class of drugs that reduce stress levels within the body....
Low wages linked to higher risk of high blood pressure
Women and younger workers appear to be most affected
Besides high unemployment, the U.S. is experiencing high rates of under-employment, with more people working part-time and earning less than they need to sustain themselves and their families.
Besides the economic ramifications, researchers at the University of California (UC) Davis say there appear to be health consequences as well. They found that employees earning the lowest wages have a higher risk of hypertension than workers with the highest wages, even if the high-wage jobs carry a lot of stress. The correlation between wages and hypertension was especially strong among women and workers under 45.
“We were surprised that low wages were such a strong risk factor for two populations not typically associated with hypertension, which is more often linked with being older and male,” said J. Paul Leigh, senior author of the study and professor of public health sciences at UC Davis. “Our outcome shows that women and younger employees working at the lowest pay scales should be screened regularly for hypertension as well.”
New focus of research
The study, published in the December issue of the European Journal of Public Health, is believed to be the first to isolate the role of wages in hypertension, which occurs when the force of circulating blood against artery walls is too high. According to the Centers for Disease Control and Prevention (CDC), hypertension affects approximately 1 in 3 adults in the U.S. and costs more than $90 billion each year in health-care services, medications and missed work days. It also is a major contributor to heart disease and stroke, both of which are leading causes of death and disability.
What's surprising is that hypertension has previously been assumed to afflict the stressed-out corporate executive, faced with the responsibilities of meeting profit projections or bearing other stressful burdens. But the UC study suggests it is the people working for them who are feeling the effects of the stress.
While there is a known association between lower socioeconomic status and hypertension, determining the specific reason for that association has been difficult, according to Leigh. Other researchers have focused on factors such as occupation, job strain, education and insurance coverage, with mixed results. Leigh’s study was the first to focus on wages and hypertension.
The role of wages
“By isolating a direct and fundamental aspect of work that people greatly value, we were able to shed light on the relationship between socioeconomic status and circulatory health,” said Leigh. “Wages are also a part of the employment environment that easily can be changed. Policymakers can raise the minimum wage, which tends to increase wages overall and could have significant public-health benefits.”
Leigh is not the first researcher to express concern that young people, especially, are not being adequately screened for high blood pressure. In November research presented at the American Heart Association's Scientific Sessions 2012 found that adults 18-24 years old with high blood pressure were 28 percent less likely to be diagnosed during doctor visits than those 60 and older.
"These young patients come to the clinic and their blood pressure is recorded," said Heather Johnson, M.D., lead researcher of the study. "They have high blood pressure, but there's no documentation of a diagnosis."
High blood pressure is a major risk factor for heart attack and stroke. While more prevalent in older Americans, about 29 percent of all U.S. adults have hypertension, according to American Heart Association statistics. About 11 percent of men and 7 percent of women 20-34 years old have high blood pressure.
Besides high unemployment, the U.S. is experiencing high rates of under-employment, with more people working part time and earning less than they need to s...
High Blood Pressure in Young Adults Likely to Go Undiagnosed
Researchers are at a loss to explain the disparity in diagnosis
What is it about young adults, their doctors and high blood pressure?
According to findings presented at the American Heart Association's Scientific Sessions 2012 that adults 18-24 years old with high blood pressure were 28 percent less likely to be diagnosed during doctor visits than those 60 and older.
"These young patients come to the clinic and their blood pressure is recorded," said Heather Johnson, M.D., lead researcher of the study. "They have high blood pressure, but there's no documentation of a diagnosis. We wanted to find out why."
Ignoring the obvious?
Researchers examined electronic health records of 13,593 men and women who were at least 18 years old. All had visited their doctor at least twice within the previous three years in an outpatient, non-urgent care setting, and had multiple elevated blood pressures that met guideline criteria for a hypertension diagnosis.
Yet, after four years of visiting their doctors and accounting for other factors:
67 percent of 18- to 24-year-olds remained undiagnosed compared with 54 percent of people 60 and older.
65 percent of 25- to 31-year-olds were undiagnosed.
59 percent of 32- to 39-year-olds were still living with undiagnosed high blood pressure.
Furthermore, young adults were less likely to be diagnosed if they actively smoked and if they had a mild stage of hypertension, said Johnson, an assistant professor of medicine in the division of cardiology at the University of Wisconsin School of Medicine and Public Health in Madison.
Conversely, a high blood pressure diagnosis was more likely for minorities, young adults with diabetes, severe high blood pressure, and who made more clinic visits to primary care and specialty providers.
Family practice physicians were less likely to diagnose high blood pressure than Internal Medicine physicians; however, female doctors were more likely to diagnose high blood pressure in young adults.
High blood pressure is a major risk factor for heart attack and stroke. While more prevalent in older Americans, about 29 percent of all U.S. adults have hypertension, according to American Heart Association statistics. About 11 percent of men and 7 percent of women 20-34 years old have high blood pressure.
A controllable condition
"We know that once high blood pressure is diagnosed and young adults receive the treatment they need, they can achieve pretty high control rates," Johnson said. Because researchers examined patient records from a large academic group practice in the Midwest, some of the predictors may vary among different healthcare systems and geographic regions, Johnson said.
Nevertheless, multiple factors must change. "Patient factors play a role, provider factors play a role, along with the healthcare system," she said. "You can't blame one component. They all must work together to diagnose and manage high blood pressure in young patients."
Johnson said she hopes the findings will "guide both patient and provider to make elevated blood pressure one of the key things to focus on during the visit."
What is it about young adults, their doctors and high blood pressure? According to findings presented at the American Heart Association's Scientific Sessi...
Consumer Group Calls for Warnings on Widely Used Blood Pressure Drugs
Public Citizen says a Black Box Warning is needed the labels of 19 meds
Mixing your meds can often do more harm than good -- especially if you're taking blood pressure drugs.
That's why Public Citizen has sent a petition calling on the U.S. Food and Drug Administration (FDA) to place a black box warning on three classes of medications used to treat high blood pressure (hypertension).
The drugs, known as angiotensin-converting enzyme (ACE) inhibitors, angiotensin II receptor blockers (ARBs) and aliskiren, are commonly used to treat high blood pressure. Several ACE inhibitors and ARBs also are approved for -- and effective when used separately in -- slowing the progression of other chronic illnesses, such as heart and kidney disease that afflict millions of people.
ACE inhibitors and ARBs are among the top-selling medications in the country. In 2011, 164 million ACE inhibitor prescriptions (fifth most of any drug class) and 86 million ARB prescriptions (16th most) were dispensed (in addition to 2.4 million aliskiren prescriptions). ARBs alone generated $7.6 billion in revenue in 2011.
Drugs in combination
The use of ACE inhibitors and ARBs in combination has become commonplace in recent years due to a theoretical belief that such combination use would confer an added benefit over the use of the drugs individually. However, Public Citizen contends, this theory has been unequivocally disproven in two large studies involving tens of thousands of patients with heart disease and diabetes that failed to show any clinical advantage of combination therapy.
On the contrary, the studies showed a higher rate of several life-threatening side effects, such as low blood pressure, kidney failure and dangerously high blood potassium levels, in patients taking the drugs together compared with patients on only one of the medications.
A third study involving the combined use of the new drug aliskiren with ACE inhibitors and ARBs in patients with diabetes and kidney disease was halted early for identical reasons: a higher rate of the same serious side effects with no added benefit with combination use. An aliskiren/ARB combination drug, Valturna, was withdrawn from the market shortly thereafter.
Failure to respond
Despite this wealth of data, FDA has failed to respond by adequately warning doctors and patients of the clear danger of the combined use of ACE inhibitors, ARBs and aliskiren, Public Citizen said in the petition. Critical safety information to this effect does not appear in a black box warning at the top of any of the drugs’ labels, and for most of the drug labels, there is no mention anywhere of the dangers of combined use.
“There are few cases in medicine that have such a vast body of evidence all pointing in the same direction,” said Dr. Sammy Almashat, researcher with Public Citizen’s Health Research Group. “This is a classic case of theory not translating into clinical significance. Patients with serious conditions, such as heart and kidney disease, should never be exposed to life-threatening side effects, unless the benefits outweigh the risks. This is clearly not the case here. The FDA must act accordingly and alert the medical community and the users of these drugs of this critical danger.”
Public Citizen calls on the FDA to add a black box warning to the labels of all 18 ACE inhibitor and ARB medications, as well as aliskiren, indicating the increased risk of serious side effects with no added benefit when using the drugs in combination.
The group also is petitioning the agency to require an FDA-approved medication guide to be distributed to all patients prescribed these drugs, as well as a “Dear Doctor” letter to physicians, warning them of the dangers of combination therapy.
Mixing your meds can often do more harm than good -- especially if you're taking blood pressure drugs That's why Public Citizen has sent a petition calling...
Millions of Americans take a prescribed medication to control their blood pressure, some of which are very expensive. And some of which do very little at all to help.
So says Dr. Samuel J. Mann, a nationally-known hypertension specialist at New York-Presbyterian Hospital/Weill Cornell Medical Center and professor of clinical medicine at Weill Cornell Medical College.
"Despite their best intentions many physicians continue to place their hypertensive patients on blood pressure medications, drug combinations or doses that may not be the best treatment available to them, Mann said. "I believe that with the medications we have, we can do much better than we are doing.
On drugs needlessly
Mann has put his concerns in a new book, Hypertension and You: Old Drugs, New Drugs and the Right Drugs for Your High Blood Pressure. In it, he suggests many people on blood pressure medication don't even have high blood pressure.
He blames incorrect blood pressure measurement, both at the doctor's office and at home, for the mistaken impressions. According to the Mayo Clinic, a normal blood pressure is 120/80 or below.
Mann said he wants consumers to understand the shortcomings of current treatment approaches and present new and better approaches that can help improve blood pressure control, reduce side effects of medications and lower health care costs.
For example, he thinks beta blockers, which slow down the heart to reduce blood pressure, have too many side effects, responsible for what he calls an “epidemic” of fatigue and, in some cases, can cause cognitive impairment.
While doctors prescribe many new, expensive drugs Mann says they virtually ignore many older, cheaper drugs that may be more effective. As an example he cites diuretics, which he calls effective and inexpensive but are widely underused and underdosed, resulting in inadequate blood pressure control, unneeded multi-drug regimens and avoidable costs.
And then there are causes of high blood pressure that aren't physical in nature but rather psychological. Hypertension linked to psychological factors, Mann says, responds to a different set of blood pressure drugs than other cases of hypertension.
The bottom line, Mann says, is that blood pressure medications are currently failing millions of people who, despite taking the drugs, are still at increased risk for heart attack and stroke.
Millions of Americans take a prescribed medication to control their blood pressure, some of which are very expensive. And some of which do ...
How to Eat, Live and Be Healthy With High Blood Pressure
Professor Joan Salge-Blake provides some great tips to manage hypertension.
According to the Centers for Disease Control and Prevention (CDC) nearly 1 in 3 U.S. adults have high blood pressure, which equates to about 68 million people.
Managing hypertension can simultaneously be easy and difficult, depending on several factors like health coverage, finances, and getting the knowledge of how to do it.
And when it comes to eating right for both preventing and managing high blood pressure it can be a challenge to develop proper eating habits as well as maintain dietary consistency.
To get some eating tips for managing high blood pressure we reached out to author and registered dietician Joan Salge-Blake, who is also a nutrition professor at Boston University. Professor Salge-Blake previously spoke to us about her take on the organic food debate.
Salge-Blake says when it comes to high blood pressure, a big misconception is that people diagnosed with it have to stay away from salt altogether.
“They [high blood pressure patients] don’t have to avoid it, they just have to get it down,” she told ConsumerAffairs. “The problem is that the majority of the foods and the sodium that we take in is from processed foods, so the consumer doesn’t really have control over that. The good news is that Kraft, General Mills and many big corporations are committed over the next several years to reducing the amount of sodium in their products."
"They’re working to do that, because really as a consumer who uses these products we’re just held basically to whatever is available out there. So that has to happen for the American public to get their sodium down,” she says.
Supermarket "pretty healthy"
Salge-Blake also points out that most grocery stores already provide enough food items for consumers to avoid a great deal of sodium. She says anything in the produce section is okay and if we’re able to select foods grown and made naturally, it makes the average supermarket still a pretty healthy place to shop.
“Anything from Mother Nature, fruits and vegetables are naturally low in sodium,” she says. "The whole grains are going to be just fine, I wouldn’t worry about the sodium in lean dairy products, and by itself lean meat, fish or poultry. So if you can get away from buying things more processed it would be better.”
“For example, the whole grains in brown rice are very low in sodium," she adds. "Now if you get seasoned brown rice or one of those little packets, the sodium goes up. But the good news is there’s plain brown rice and the sodium is low, so what the consumer can do is just use a nutrition label -- to see in the category in which they're buying -- which one would be lower in sodium, and typically it’s the ones that are not seasoned,” she said.
But can one lower their blood pressure by simply eating healthy foods? I mean, is prescription medicine always the first line of defense when you’re first diagnosed with hypertension?
“There are many lifestyle habits that can help you lower your blood pressure should it be high,” says Salge- Blake. "One of the first things you should do is look at your weight and if you’re overweight, you should think about trying to get some weight off because we know that even by losing 10 percent of your body weight can have a dramatic effect on lowering your blood pressure."
"So you want to get more potassium-rich foods in your diet, and believe it or not, those are fruits and vegetables and lean dairy, so going back to Mother Nature again that would be a really, really good thing to do."
“You want to be exercising, and you want to watch your alcohol intake should you consume alcohol. Consume small amounts because it could increase your blood pressure, so you want to keep it to a more moderate amount,” Salge-Blake warns.
Not always enough
But sometimes eating right and exercising just aren't enough, as many people live a healthy lifestyle but still have high blood pressure, and for them, prescription medicine is typically the way to go. However, the risks of being on such medicines can easily lure one towards a level of complacency after seeing their blood pressure numbers drop to healthier levels.
Some may think, "Hey my blood pressure counts are good now, I guess I can ease up on the exercising and all that healthy eating for a while," which is a dangerous form of logic, says Salge-Blake.
“That’s the magic of the medicine,” she said. “It’s beautiful because for some people they may not be able to control it with diet alone. Some people may say, ‘gee, I’ll just take the hypertension pill and not worry about it’. But what you want to think about is not just hypertension, when you’re eating a well-balanced diet, you’re also fighting heart disease which is the number one killer of Americans."
“We’ll also be getting a diet that would be best in preventing diabetes. Typically if you have high blood pressure, you [should] say ‘Let me start now to see if I can change my diet to get that lower, and guess what, I may help myself reduce the risk of Type-2 diabetes later in life. That’s the way you have to look at it.'"
"You have to look at it like ‘This [high blood pressure] is the first signal that what I’m eating may not be good for my health’, and correct it before another signal, i.e. your glucose starts to get a little bit too high and you start developing a risk for Type-2 diabetes,” she says.
Prescription may be needed
Salge-Blake also said high blood pressure patients may not be able to pinpoint and cure the condition from proper diet and exercise, but they’ll be able to manage it better, while also diminishing the chances of getting another condition and taking yet another type of medication.
She also states that once you’re diagnosed with hypertension, your first line of defense should be trying to lower your blood pressure on your own, and if that doesn’t work talk to your doctor about getting the right prescription.
But once you start taking medication, don’t stop exercising or eating right, because if you continue to live the same type of lifestyle, you may eventually have to increase the strength of your medicine. She also says that just because you’re on a high blood pressure medication doesn’t mean you’ll necessarily be on it for the rest of your life.
“I’ve had clients, who have come to me on hypertension medication, and through their diet they lost weight, and made changes and they were able to lower their dose and get off it [the medication]. So not necessarily is it something that you’ll stay on for the rest of your life,” she says.
According to the Center for Disease Control and Prevention nearly 1 in 3 U.S. adults have high-blood pressure, which equates to about 68 million people.M...
The program, “Team Up. Pressure Down.,” includes educational videos, a blood pressure control journal, and wallet card to track medication use.
The blood pressure initiative, part of the Million Hearts health education program, was developed by the Centers for Disease Control and Prevention (CDC) with practicing pharmacists and national pharmacist groups. The initiative’s tools will help pharmacists talk about current medications and ways in which patients can use the medications most effectively. The goal of Million Hearts is to prevent 1 million heart attacks and strokes by 2017.
“This valuable Million Hearts initiative will prevent heart attacks and strokes by bringing pharmacists into the care team to help patients control their blood pressure,” said Surgeon General, Regina M. Benjamin, MD. “Pharmacists are able to talk to patients and families about using medication to manage, high blood pressure, and they can also help patients address barriers to taking their medication.”
In May, the Community Preventive Services Task Force, an independent, nonfederal, uncompensated body of public health and prevention experts, whose members are appointed by the Director of CDC, recommended team-based care uniting the efforts of physicians, pharmacists, nurses, and other health care professionals -- to improve blood pressure control. Its recommendation followed a review of evidence from more than 70 scientific publications.
“More than 36 million Americans, or more than half of those with hypertension, don’t have their blood pressure under control and every single day, more than one thousand Americans have a heart attack or stroke,” said Janet Wright, M.D., a board-certified cardiologist and executive director of Million Hearts. “Through the ``Team Up. Pressure Down.’’ educational program for pharmacists, we are taking the first step in helping many more Americans achieve blood pressure control.”
“Our organization trains the next wave of young pharmacists who are committed to making a difference in patients’ lives,” said William Lang, M.P.H., vice president for policy and advocacy, American Association of Colleges of Pharmacy. “`Team Up. Pressure Down.’ recognizes and supports the critical role of pharmacists in improving blood pressure control through team-based care.”
“`The Team Up. Pressure Down’. program will help pharmacists in any setting talk to their patients about the importance of staying on blood pressure medications and coach them on how to control hypertension,” said Carolyn C. Ha, Pharm.D., director, professional affairs, National Community Pharmacists Association.
The materials can be tailored for any pharmacy setting. Continuing pharmacy education credit is available for pharmacists who participate.
Customers at drugstores around the nation can get help to improve blood pressure control, through a collaboration among pharmacists, the U.S. Department of...
Non-Alcoholic Red Wine May Help Reduce High Blood Pressure
Increasing levels of nitric acid helps decrease both blood pressure numbers
Men with high risk for heart disease had lower blood pressure after drinking non-alcoholic red wine every day for four weeks, according to a new study in the American Heart Association journal Circulation Research.
Non-alcoholic red wine increased participants' levels of nitric oxide, which helped decrease both systolic and diastolic blood pressure, researchers said. Nitric oxide is a molecule in the body that helps blood vessels relax and allows more blood to reach your heart and organs.
Researchers studied 67 men with diabetes or three or more cardiovascular risk factors who ate a common diet plus one of the following drinks: about 10 ounces of red wine, non-alcoholic red wine or about 3 ounces of gin. All of the men tried each diet/beverage combination for 4 weeks.
It appears to be the alcohol
The red wine and nonalcoholic wine contained equal amounts of polyphenols, an antioxidant that decreases blood pressure.
During the red wine phase, the men had very little reduction in blood pressure and there was no change while drinking gin. However, after drinking non-alcoholic red wine, blood pressure decreased by about 6mmHg in systolic and 2mmHg in diastolic blood pressure -- possibly reducing the risk of heart disease by 14 percent and stroke by as much as 20 percent.
Researchers concluded that the alcohol in red wine weakens its ability to lower blood pressure. But polyphenols -- still present after alcohol is removed from wine — are likely the beneficial element in wine.
Men with high risk for heart disease had lower blood pressure after drinking non-alcoholic red wine every day for four weeks, according to a new study in t...
Serious health risk isn't getting enough attention, CDC finds
About 1 in 3 American adults -- 67 million of us -- have high blood presure but more than half of us don't have it under control, a new report finds.
“We have to roll up our sleeves and make blood pressure control a priority every day, with every patient, at every doctor’s visit,” said Thomas R. Frieden, M.D., M.P.H., the director of the Centers for Disease Control and Prevention. “With increased focus and collaboration among patients, health care providers and health care systems, we can help 10 million Americans’ blood pressure come into control in the next five years.”
Frieden cited a CDC report that found the majority of people with high blood pressure are being treated with medicine and have seen a doctor at least twice in the past year, yet their condition is still not under control. Millions more are either aware they have high blood pressure but aren’t getting treated with medicine or don’t even know they have it, the report says.
Key facts in theVital Signs report about those affected:
About 67 million adults have high blood pressure.
More than half (36 million) have uncontrolled high blood pressure.
Nearly 22 million know they have high blood pressure, but don’t have it under control.
16 million take medicine, but still don’t have their blood pressure under control.
Major risk factor
High blood pressure is a major risk factor for heart disease and stroke, the first and fourth leading causes of death in the United States, leading to nearly 1,000 deaths a day.
High blood pressure is defined as blood pressure greater than or equal to 140/90 mm- Hg. High blood pressure’s direct health care cost is almost $131 billion annually.
Pharmacists, nurses, dietitians, and community health workers can support doctors in identifying and treating patients with high blood pressure. This team-based approach is a way to provide patient support and follow-up care, manage medicines, and help patients stick to a blood pressure control plan. In addition, patients should be counseled to make important lifestyle changes that affect blood pressure, including eating a healthy, low sodium diet, exercising, maintaining a healthy weight and not smoking.
About 1 in 3 American adults -- 67 million of us -- have high blood presure but more than half of us don't have it under control, a new report finds.&ldq...
Researchers say a healthy lifestyle will keep blood pressure in a healthy range
If you ask your doctor the cause of high blood pressure, she'll probably tell you that there's no way to know for sure. But researchers increasingly say there are things you can do to reduce your risks of developing it.
A healthy lifestyle -- getting exercise, maintaining a healthy weight, avoiding tobacco, using alcohol in moderation and eating a balanced diet -- reduces the risk of hypertension by two-thirds, according to research by Professor Pekka Jousilahti from the National Institute for Health and Welfare, in Helsinki, Finland.
High blood pressure, or hypertension, has increased with obesity. According to the World Health Organization, hypertension is the leading cause of death in the world. It now contributes to over seven million deaths a year.
Alcohol, activity, vegetables and body weight
The study examined people who were assigned to one of four different categories, based on their level of healthy living. Those categories were made of moderate alcohol consumption, leisure time physical activity at least three times per week, daily consumption of vegetables, and normal body weight.
Smoking was not included in the analysis because Jousilahti said it was not associated with the development of hypertension in the team's analyses.
"The risk of hypertension was only one-third among those having all four healthy lifestyle factors compared to those having none," said Jousilahti. "Even having one to three healthy lifestyle factors reduced the risk of hypertension remarkably. For example having two healthy lifestyle factors reduced the risk of hypertension by nearly 50 percent in men and by more than 30 percent in women."
Bigger impact on men
Jousilahti said the study suggests that maintaining a healthy lifestyle may have more of an impact on risk of hypertension in men than women.
"This could be because of the stronger association of obesity and alcohol consumption with the risk of hypertension in men than in women," he said.
While consumers spend billions of dollars each year on medication to control blood pressure, Jousilahti says the control may be within the grasp of each individual, at much less cost.
"Four modifiable lifestyle factors: alcohol consumption, physical activity, consumption of vegetables and keeping normal weight have a remarkable effect on the development of hypertension," he said. "Lifestyle modification has a huge public health potential to prevent hypertension."
If you ask your doctor the cause of high blood pressure, she'll probably tell you that there's no way to know for sure. But researchers increasingly say th...