Managing High Blood Pressure

While many consumers may enjoy an afternoon nap, the results from a recent American Heart Association study shows that they might be bad for your health. The study showed that taking frequent naps during the day may increase the risk of high blood pressure and stroke. 

“This may be because, although taking a nap itself is not harmful, many people who take naps do so because of poor sleep at night,” said researcher Michael A. Grandner, Ph.D.

“Poor sleep at night is associated with poorer health, and naps are not enough to make up for that. This study echoes other findings that generally show that taking more naps seems to reflect increased risk for problems with heart health and other issues.” 

Heart health risks

The researchers analyzed data from more than 500,000 people between the ages of 40 and 69 who were enrolled in the U.K. Biobank. The participants were surveyed four times between 2006 and 2019 about their napping habits. They also gave saliva, blood, and urine samples over the course of the study. 

The team learned that regular daytime nappers were nearly 25% more likely to have a stroke and 12% more likely to have high blood pressure. Younger participants who napped frequently had a 20% higher risk of high blood pressure compared to those under 60 who never napped. 

The researchers found that napping more often could worsen heart health. Those who increased their napping in any way – even jumping from rarely napping to sometimes napping – were 40% more likely to have high blood pressure. The team hopes these findings highlight some of the heart health risks associated with regularly napping. 

“These results are especially interesting since millions of people might enjoy a regular, or even daily nap,” said researcher Dr. E. Wang. 

A new study conducted by the American Heart Association explored how women’s exposure to per- and polyfluoroalkyl substances (PFAS) may impact their heart health. According to their findings, women with the highest traces of the chemicals in their blood may be more than 70% as likely to develop high blood pressure. 

“PFAS are known as ‘forever chemicals’ because they never degrade in the environment and contaminate drinking water, soil, air, food, and numerous products we consume or encounter routinely,” said researcher Ning Ding, Ph.D. “One study estimated that two of the most common ‘forever chemicals’ are found in most household drinking water and are consumed by more than two-thirds of Americans. 

“Women seem to be particularly vulnerable when exposed to these chemicals. Our study is the first to examine the association between ‘forever chemicals’ and hypertension in middle-aged women. Exposure may be an underappreciated risk factor for women’s cardiovascular disease risk.” 

Blood pressure risks

For the study, the researchers analyzed data from over 1,000 women between the ages of 45 and 56 who were enrolled in the Study of Women’s Health Across the Nation-Multi-Pollutant Study (SWAN-MPS). All of the women had healthy blood pressure levels at the start of the study, and the researchers followed up with them on a yearly basis from 1999 through 2017 to measure their blood pressure and take blood samples.

The researchers learned that women who had the highest concentrations of PFAS in their blood were at a higher risk of high blood pressure. The study looked at several different types of PFAS, and the researchers learned that some of them posed a bigger risk than others to the women’s blood pressure. Three of the chemicals stood out as having a more than 40% higher risk of high blood pressure: perfluorooctane sulfonic acid (PFOS), perfluorooctanoic acid (PFOA), and 2-(N-ethyl-perfluorooctane sulfonamido) acetic acid.

“It’s important to note that we examined individual PFAS as well as several PFAS together, and we found that the combined exposure to multiple PFAS had a stronger effect on blood pressure,” said researcher Kyun Park. “Some states are beginning to ban the use of PFAS in food packaging and cosmetic and personal care products. Our findings make it clear that strategies to limit the widespread use of PFAS in products need to be developed. Switching to alternative options may help reduce the incidence of high blood pressure risk in midlife women.”  

Overall, women with the highest levels of all seven PFAS had a more than 70% higher risk of developing high blood pressure. 

“We have known for some time that PFAS disrupts metabolism in the body, yet we didn’t expect the strength of the association we found,” said Park. “We hope that these findings alert clinicians about the importance of PFAS and that they need to understand and recognize PFAS as an important potential risk factor for blood pressure control.” 

While recent studies have found that blood pressure readings may vary depending on where they’re taken, a new study conducted by researchers from the American Heart Association focused on the risks associated with higher blood pressure when consumers stand up. 

According to their findings, consumers who experience a spike in blood pressure when they go from sitting to standing may have a higher risk of having a heart attack. 

“This finding may warrant starting blood pressure-lowering treatment including medicines earlier in patients with exaggerated blood pressure response to standing,” said researcher Dr. Paolo Palatini. 

Long-term heart attack risk

For the study, the researchers analyzed data from over 1,200 people enrolled in the HARVEST study. This Italy-based dataset started in 1990, and collected information on adults between 18 and 45 who were diagnosed with – but not being treated for – stage 1 hypertension. All of the participants had their blood pressure taken in six positions lying down and six positions standing up. The team then followed their health outcomes over the course of nearly 20 years. 

The researchers found an interesting relationship between blood pressure upon standing and the risk of a heart attack. The study identified a group of participants who experienced a significant increase in systolic blood pressure upon standing; on average, blood pressure shot up 11.4 mm Hg. Participants in this group were nearly twice as likely to have a heart attack despite showing no other cardiovascular-related health concerns at the start of the study. 

“The results of the study confirmed our initial hypothesis – a pronounced increase in blood pressure from lying to standing could be prognostically important in young people with high blood pressure,” Dr. Palatini said. “We were rather surprised that even a relatively small increase in standing blood pressure (6-7 mm Hg) was predictive of major cardiac events in the long run.” 

Aside from this pattern with standing blood pressure, the researchers found that participants in this group showed favorable health outcomes. They had better cholesterol levels than other study participants, exhibited comparable physical activity levels, had no family history of cardiovascular issues, and had healthy BMIs. 

However, the study showed that these participants were more likely to be smokers than those without this sharp uptick in blood pressure upon standing. This group also had higher overall blood pressure readings over the course of 24 hours. 

The researchers hope these findings identify patients who may have a higher risk of serious heart health issues – particularly those who are younger and may not present with any other major cardiovascular risks. 

“The findings suggest that blood pressure upon standing should be measured in order to tailor treatment for patients with high blood pressure, and potentially, a more aggressive approach to lifestyle changes and blood-pressure-lowering therapy may be considered for people with an elevated [hyperreactor] blood pressure response to standing,” Dr. Palatini said. 

As recent studies have highlighted the ways that consumers’ food choices may impact their blood pressure, a new study conducted by the American Heart Association looked closely at how protein may affect health outcomes. 

According to the findings, eating a variety of different protein sources may help lower the risk of developing high blood pressure. 

“The heart health message is that consuming a balanced diet with proteins from various different sources, rather than focusing on a single source of dietary protein, may help to prevent the development of high blood pressure,” said researcher Dr. Xianhui Qin. 

Protein variety improves blood pressure

For the study, the researchers analyzed data from nearly 12,200 adults enrolled in the China Health and Nutrition Survey from 1997 through 2015. Participants took the survey every two to four years and reported on everything they ate in three 24-hour periods for each survey. The group also reported on their health outcomes related to blood pressure, including being diagnosed with high blood pressure or being prescribed medication for high blood pressure throughout the survey. 

Ultimately, the researchers learned that the variety of proteins the participants consumed played a role in their blood pressure outcomes. Those who regularly ate four or more different kinds of proteins were 66% less likely to develop high blood pressure when compared to those who regularly ate less than two different kinds of protein. 

While protein variety was beneficial for blood pressure readings, the quantity of protein consumed played a cautionary role for the participants. Those who ate the largest quantities of protein and those who ate the smallest quantities of protein were at a higher risk of developing high blood pressure. 

The researchers hope these findings encourage consumers to consider their diets and what changes they can make to improve their health outcomes. 

“Nutrition may be an easily accessible and effective measure to fight against hypertension,” said Dr. Qi. “Along with fat and carbohydrates, protein is one of the three basic macronutrients.” 

A new study conducted by researchers from Cedars-Sinai Medical Center revealed that hospital visits related to high blood pressure have been increasing over the last decade. According to their findings, more consumers are going to the hospital for hypertensive crises, which increase the risk for a heart attack or stroke. 

“Although more people have been able to manage their blood pressure over the last few years, we’re not seeing this improvement translate into fewer hospitalizations for hypertensive care,” said researcher Dr. Joseph E. Ebinger. “We need more research to understand why this is happening and how clinicians can help patients stay out of the hospital.” 

Gender plays a role in blood pressure health

For the study, the researchers analyzed data from the National Inpatient Sample between 2002 and 2014. They tracked hospitalizations across the country and evaluated the frequency with which consumers were seeking emergency care due to blood pressure concerns. 

Over the course of the study, there were nearly 920,000 people admitted into hospitals for hypertension concerns. However, the researchers found that the number of hospitalizations for blood pressure issues more than doubled between 2002 and 2014. 

The team explained that several factors could come into play here. For instance, lifestyle factors such as smoking, diet, and exercise can all negatively impact consumers’ heart health and blood pressure levels. Additionally, though many consumers take medication to maintain healthy blood pressure levels, if they aren’t taking the proper dosage or if their finances have prevented them from obtaining the drugs, they may have a higher risk for complications. 

The researchers found that men were more likely to be hospitalized for blood pressure concerns than women. However, the researchers learned that the mortality rate of these cases was similar for both groups. This means hypertension may pose a greater risk for women’s long-term health.

“These findings raise the question: Are there sex-specific biologic mechanisms that place women at a greater risk for dying during a hypertensive crisis?” said researcher Dr. Susan Cheng. “By understanding these processes, we could prevent more deaths among women.” 

A new study conducted by researchers from Rutgers University explored one of the biggest factors impacting the maternal death rate. According to their findings, chronic hypertension was responsible for the rise in maternal death. 

“Overall hypertension-associated deaths declined in the U.S. over the last 40 years, but this decline is restricted to women who have preeclampsia/eclampsia as the cause,” said researcher Cande V. Ananth. 

“If you isolate the data on women who have chronic hypertension, which is defined as a preexisting hypertensive condition or hypertension diagnosed within the first 20 weeks of pregnancy, as a cause, mortality rates have increased quite substantially – on average, by about 9.2% per year over the last 40 years. So it is the chronic hypertension that has really driven the maternal mortality trends in the U.S. over the last 40 years.” 

Racial and age-related disparities in heart health 

For the study, the researchers analyzed the health outcomes of women who gave birth in the United States between 1979 and 2018. They looked at factors such as race, age, and history with hypertension before, during, and after pregnancy. 

Over the course of the study, the maternal mortality rate was 2.1 per 1,000,000 births. However, the researchers learned that the same figure was nearly four times higher for Black women than white women. Experts say risk factors related to high blood pressure, as well as limited access to health care, may be the reason behind this racial disparity. 

“Black women were anywhere from three- to four-fold increased risk of dying from a hypertension-related cause compared to White women in the United States, and this disparity has persisted for the last 40 years,” Ananth said. 

The study also showed that age may play a role in the maternal death rate. When older women gave birth and were also in poor health, the risk of death related to high blood pressure was higher. 

Finding better treatments for women

The goal moving forward is to better identify, monitor, and treat women who may be at a higher risk of developing chronic hypertension. The team says lifestyle interventions – such as following healthier diets, consuming less alcohol, and eliminating smoking – and the use of blood pressure medications may be necessary to see results. 

“We have gotten much better at treating women with preeclampsia/eclampsia during pregnancy, which has undoubtedly contributed to the decline in maternal death rates, but we haven’t done as good a job in treating women with chronic hypertension,” said Ananth. “Part of that is because many of these women come in undiagnosed, and it’s often problematic to treat women with drugs to reduce their blood pressure, particularly early in pregnancy, so there’s a conflict of what’s the right approach.

“Women who have any obstetrical complications, particularly hypertension-related complications, should be monitored very closely during the course of pregnancy and delivery, as well as in the postpartum period,” he added. “Following these women after pregnancy is crucial.” 

A new study conducted by researchers from the American Heart Association explored the safety of blood pressure treatments for pregnant women. According to their findings, these treatments not only help maintain healthy blood pressure levels, but they can also improve pregnancy and delivery outcomes.

“For decades, the benefits of blood pressure treatment for pregnant women were unclear,” said researcher Dr. Vesna D. Garovic. “And there were concerns about fetal well-being from exposure to antihypertensive medications. 

“Through our comprehensive review of the existing literature, it is reassuring to see emerging evidence that treating high blood pressure during pregnancy is safe and effective and may be beneficial at lower thresholds than previously thought. Now, we have the current statement focused on hypertension during pregnancy to help inform optimal treatment and future research.” 

Keeping mothers and babies healthy

The researchers analyzed several earlier studies that evaluated the safety of different blood pressure treatments for pregnant women. Previous findings suggested that some treatments could compromise fetuses’ health, but the researchers noted that addressing hypertension is also important for mothers’ long-term health.

Ultimately, their work showed that blood pressure treatments – such as prescription medications and lifestyle habits like consistent exercise and healthy diets – are important for the health of mothers beyond their pregnancies. The team found that engaging in these habits both before and during pregnancy is key to keeping blood pressure in a healthy range. Pregnant women who exercised were 30% less likely to develop high blood pressure and 40% less likely to develop preeclampsia. 

Left untreated, high blood pressure can increase the likelihood of health risks for both mothers and infants, including low infant birth weight and preterm delivery. The researchers said when women have high blood pressure at the time of delivery, they have a higher risk of heart health complications down the road.

Moving forward, the researchers hope more work is done to better understand women’s heart health before, during, and after pregnancy. 

“Future clinical trials are needed to address questions about when to begin treatment for high blood pressure during pregnancy,” said Dr. Garovic. “Also, close collaboration between the American Heart Association and American College of Obstetricians and Gynecologists will be instrumental in optimizing diagnosis and treatment of hypertension during pregnancy and in improving immediate and long-term outcomes for many women who develop hypertension during pregnancy.” 

A new study conducted by researchers from the University of Eastern Finland explored potential risk factors for cardiovascular disease in young adulthood. Their study showed that adolescents with arterial stiffness were more likely to develop hypertension and obesity by the time they reached young adulthood. 

For the study, the researchers tracked more than 3,800 17 year-olds enrolled in the Avon Longitudinal Study of Parents and Children for seven years. They measured the participants’ arterial stiffness at the start of the study and then tracked their health outcomes over nearly a decade. 

The researchers learned that arterial stiffness at the start of the study was linked with a higher risk of high blood pressure and obesity seven years later. Diastolic blood pressure doubled as a result of arterial stiffness, while systolic blood pressure went up by 20% over the course of the study. Arterial stiffness was also linked with a 20% increase in overall obesity by the time the participants were 24.  

Measuring arterial stiffness could help predict health problems

The study also showed that higher arterial stiffness was linked to poorer health outcomes among participants. Compared to those with high arterial stiffness, those with mild artery stiffness experienced half as big of a change to their blood pressure. 

While diet and exercise remain important components of long-term heart health, the researchers also hope these findings emphasize the benefits associated with monitoring children’s arterial stiffness. 

“...Our novel findings are significant clinically and for population health, in that future hypertension and obesity prevention and treatment strategies may now consider reducing arterial stiffness, particularly from adolescence,” said researcher Andrew Agbaje. 

A new study conducted by the American Heart Association explored how consumers’ hormone levels may affect their heart health. 

According to the study's findings, elevated levels of stress hormones may increase the long-term risk of high blood pressure and cardiovascular disease. 

“Previous research focused on the relationship between stress hormone levels and hypertension or cardiovascular events in patients with existing hypertension,” said researcher Dr. Kosuke Inoue. “However, studies looking at adults without hypertension were lacking. It is important to examine the impact of stress on adults in the general population because it provides new information about whether routine measurement of stress hormones needs to be considered to prevent hypertension and CVD events.” 

Managing stress levels

For the study, the researchers analyzed data from more than 6,000 participants enrolled in the Multi-Ethnic Study of Atherosclerosis (MESA). Over the course of three months, the team tracked the participants’ stress hormones -- norepinephrine, epinephrine, dopamine, and cortisol -- through urine samples. The team followed up with medical exams for several years to better understand how the participants’ stress hormones impacted their heart health long term. 

Ultimately, the researchers learned that elevated stress hormone levels can have long-term effects on consumers’ heart health. 

The biggest health risks occurred as hormone levels doubled. Each doubling of cortisol increased the risk of cardiovascular events -- like heart attack and stroke -- by 90%, whereas each time all four stress hormones doubled, the risk of high blood pressure increased as much as 31%. 

“The stress hormones norepinephrine, epinephrine, dopamine, and cortisol can increase with stress from life events, work, relationships, finances, and more,” said Dr. Inoue. “And we confirmed that stress is a key factor contributing to the risk of hypertension and cardiovascular events.” 

Moving forward, the researchers hope that these findings lead to more consumers receiving the proper testing and prevention measures to identify those who may be at the highest risk of high blood pressure and heart disease. 

“The next key research question is whether and in which populations increased testing of stress hormones could be helpful,” said Dr. Inoue. “Currently, these hormones are measured only when hypertension with an underlying cause or other related diseases are suspected. However, if additional screening could help prevent hypertension and cardiovascular events, we may want to measure these hormone levels more frequently.”

A new study conducted by researchers from the University of Colorado at Boulder explored a new technique that may help consumers lower their blood pressure. 

According to their findings, a five-minute breathing exercise known as High-Resistance Inspiratory Muscle Strength Training (IMST), which requires consumers to breathe through a device that provides resistance, can lower blood pressure and benefit heart health.

“There are a lot of lifestyle strategies that we know can help maintain cardiovascular health as they age,” said researcher Daniel Craighead. “But the reality is, they take a lot of time and effort and can be expensive and hard for some people to access. IMST can be done in five minutes in your own home while you watch TV.” 

Blood pressure benefits

For the study, the researchers had 36 adults with high systolic blood pressure between the ages of 50 and 79 involved in the study. Over the course of six weeks, half of the group performed IMST regularly and the other half used a placebo breathing device. The researchers monitored the participants’ blood pressure to track any changes. 

The team learned that using the IMST device six days a week for 30 inhalations per day was associated with lower systolic blood pressure readings -- even six weeks after the participants stopped using it. Ultimately, the systolic reading dropped by as much as 9 points, which the researchers explained can be significant in terms of consumers’ long-term health. 

The findings were also positive because those who used the IMST device were consistent with the treatments 95% of the time. This is important because staying on top of the breathing exercise can yield the best health outcomes for consumers. 

“We have identified a novel form of therapy that lowers blood pressure without giving people pharmacological compounds and with much higher adherence than aerobic exercise,” said researcher Doug Seals. “That’s noteworthy.” 

The researchers believe that IMST can help relax the blood vessels, which is what ultimately helps lower blood pressure. Moving forward, the team hopes to make IMST devices more widely available to consumers. 

“It’s easy to do, it doesn’t take long, and we think it has a lot of potential to help a lot of people,” said Craighead. 

Several studies have analyzed the ways that air pollution can pose a threat to children’s physical health, mental health, and brain development. 

Now, a new study conducted by researchers from the American Heart Association has found another way that air pollution can be damaging to children’s short- and long-term health. According to their findings, exposure to air pollution may increase the risk of kids developing high blood pressure both during childhood and adulthood. 

“Our analysis is the first to closely examine previous research to assess both the quality and magnitude of the associations between air pollution and blood pressure values among children and adolescents,” said researcher Dr. Yao Lu. “The findings provide evidence of a positive association between short- and long-term exposure to certain environmental air pollutants and blood pressure in children and adolescents.” 

Monitoring blood pressure

To understand the impact that air pollution can have on kids’ blood pressure, the researchers analyzed 14 earlier studies that included data on more than 350,000 children between the ages of five and 13. They focused on exposure to pollutants such as nitrogen dioxide and both coarse and fine particulate matter (PM2.5). The team also analyzed the length of time that children were exposed to the various pollutants and what role they played in their health outcomes. 

Ultimately, the researchers learned that any kind of exposure to air pollution was associated with an increased risk of high blood pressure in kids. Systolic blood pressure readings were impacted by long-term exposure to all three pollutants and short-term exposure to coarse particulate matter (PM10). On the other hand, the diastolic reading increased most often when there was long-term exposure to both fine and coarse particulate matter. 

The researchers explained that more work needs to be done in this area to better understand how different kinds of pollutants can impact kids’ heart health and blood pressure. However, these findings highlight the ways that many young people are already being affected by short- and long-term exposure to air pollution. Moving forward, the researchers hope these findings lead to changes in air pollution regulations.

“To reduce the impact of environmental pollution on blood pressure in children and adolescents, efforts should be made to reduce their exposure to environmental pollutants,” Dr. Lu said. “Additionally, it is also very important to routinely measure blood pressure in children and adolescents, which can help us identify individuals with elevated blood pressure early.” 

A new study conducted by researchers from the American Heart Association discovered a unique association between dental hygiene and blood pressure.

Their findings showed that consumers with severe gum disease (periodontitis) may have an increased risk of developing high blood pressure. The team hopes these findings encourage consumers to pay closer attention to their dental habits because they could have long-term impacts on heart health. 

“Patients with gum disease often present with elevated blood pressure, especially when there is active gingival inflammation, or bleeding of the gums,” said researcher Eva Muñoz Aguilera, DDS. “Elevated blood pressure is usually asymptomatic, and many individuals may be unaware that they are at an increased risk of cardiovascular complications. We aimed to investigate the association between severe periodontitis and high blood pressure in healthy adults without a confirmed diagnosis of hypertension.” 

The link between oral health and heart health

To understand how dental hygiene can affect blood pressure, the researchers evaluated results from past studies that included data on 250 adults with severe gum disease and 250 adults with healthy gums. Over the course of nearly two decades, the participants gave blood samples, had their blood pressure measured, and underwent dental exams to assess the severity of their gum disease. 

Though none of the participants had any health issues when the study began, the researchers noted a clear correlation between those who had severe gum disease and poorer heart health. Participants with active gum inflammation and severe gum disease were more likely to have high blood pressure, which the researchers defined as having 50 percent or more of the teeth infected. 

Ultimately, severe periodontitis made participants two times more likely to have high blood pressure. Bad dental health was also linked with lower good cholesterol levels, higher glucose levels, and higher bad cholesterol levels. Overall, gum disease -- because of the inflammation it causes -- can significantly impact consumers’ heart health. 

“This evidence indicates that periodontal bacteria cause damage to the gums and also triggers inflammatory responses that can impact the development of systemic diseases including hypertension,” said researcher Francesca D’Aiuto, DMD. “This would mean that the link between gum disease and elevated blood pressure occurs well before a patient develops high blood pressure. Our study also confirms that a worryingly high number of individuals are unaware of a possible diagnosis of hypertension.” 

The researchers say it’s important for dentists and primary care physicians to identify risk factors and recommend patients for further testing and observation. Consumers can do their part by practicing healthy dental habits.

“Oral health strategies such as brushing teeth twice daily are proven to be very effective in managing and preventing the most common oral conditions, and our study’s results indicate they can also be a powerful and affordable tool to help prevent hypertension,” Dr. D’Aiuto said. 

A new study conducted by researchers from Murdoch Children’s Research Institute explored some of the best practices and risks related to taking kids’ blood pressure readings.

According to the team, it’s important for health care professionals to measure kids’ blood pressure in both arms to get the best accuracy. 

They explained that just taking the reading on one arm can misdiagnose kids’ risk of having high blood pressure; however, after reading both arms, doctors can make a clearer assessment of kids’ health. 

“Misdiagnosis could occur when the blood pressure difference is greater than about 5 mmHg, but one in seven healthy children had a difference greater than 10 mmHg, which could lead to a failure to identify stage one or two hypertension,” said researcher Melanie Clarke. 

“Given blood pressure measured in a child’s right and left arm are often different, it’s important to take measurements in both arms to make a correct diagnosis,” she said. “Accurate blood pressure assessment in kids is critical for identifying the potential risk for damage to the heart and blood vessels, which can lead to early-onset cardiovascular disease.” 

Making a correct diagnosis

The researchers had 118 kids between the ages of seven and 18 participate in the study. The team measured the participants’ blood pressure in both arms, analyzed the differences in the readings, and then focused on the significance behind those differences. 

The study showed that 25 percent of the kids involved in the study with no previous heart conditions showed a significant difference in their blood pressure readings between their two arms. This is important because if a doctor only measures one arm, they’re not getting the complete picture. Kids who have high blood pressure, or who are at risk of having high blood pressure, could be missed because if doctors don’t get all the data that’s available to them.

“There are good clinical reasons for measuring blood pressure in both arms in children and adolescents in the evaluation of hypertension and this study provides clear support for this approach,” said researcher Gary Jennings. 

The researchers also learned that the difference in readings was even more common in kids who had a history with heart concerns. This makes it all the more necessary for doctors to check both of kids’ arms to ensure that they’re delivering the most accurate course of treatment. Having high blood pressure during childhood can often lead to high blood pressure in adulthood, so it’s important for parents, kids, and their doctors to know the risks.

“We know high blood pressure is common in adults but many people don’t realize how common it is in kids too,” said Mynard. “More work needs to be done to draw attention to the problem of childhood hypertension and its long-term consequences.”