Category Archives: high blood pressure

Beating Hypertension-the Silent Killer

One in three American adults has hypertension (high blood pressure). And, because hypertension causes few obvious symptoms, many people with high blood pressure don’t even know it. What’s more, only about half of all diagnosed individuals are controlling their blood pressure adequately. This condition is a primary or contributing cause in more than 1,000 deaths each day and costs the nation $48.6 billion each year, according to the Centers for Disease Control and Prevention. But, straightforward lifestyle changes can both prevent and treat this common and devastating “silent killer.”

What is Blood Pressure? “Blood pressure is the force the blood exerts on the walls of the arteries,” says Sondra M. DePalma, DHSc, PA-C, a cardiology PA with PinnacleHealth CardioVascular Institute at UPMC Pinnacle and an author of the American Heart Association’s 2017 Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults. The top number (the systolic pressure) is the force exerted on the artery wall with each beat (contraction) of the heart. The bottom number (the diastolic pressure) is the force when the heart is at rest (between beats). If readings rise above 120 systolic and 80 diastolic, risks begin to rise. Treatment through lifestyle changes and/or medication is recommended if numbers rise over 130 or over 80. [For more information on blood pressure readings, see Blood Pressure by the Numbers.

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Diet and Alzheimer’s – Tufts

Herewith another entry in our arsenal against that destroyer of lives – Alzheimer’s Disease, from the Tufts Health & Nutrition Letter.

Alzheimer’s disease accounts for 60 to 80 percent of the loss of memory and other cognitive abilities collectively known as dementia. There is no known food or diet that can prevent or cure Alzheimer’s dementia, but diet may help delay onset and slow progression.

What sets Alzheimer’s apart from other forms of dementia is the excessive buildup of beta-amyloid protein fragments into plaques, as well as defective tau proteins that form tangles in the brain. These changes lead to the death of the nerve cells responsible for everything from memory to movement. There are currently no known dietary factors that can impact the formation of these plaques and tangles, but diet may act in other ways to influence Alzheimer’s and other forms of dementia.

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Heart Attacks Striking Younger Women

Being a senior citizen I have to admit that I fall prey to accepting the cliche that you youngsters don’t have any physical problems. However, this item from Johns-Hopkins says otherwise.

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Younger women are having more heart attacks, says a recent study. Researchers were surprised to find that while the heart attack rate has decreased among older adults, it’s risen among those ages 35-54, especially women. The Atherosclerosis Risk in Communities study reviewed more than 28,000 hospitalizations for heart attacks in four cities.

“This observational study found a trend in young women,” says Virginia Colliver, M.D., cardiologist with Johns Hopkins Community Physicians-Heart Care in Bethesda, Maryland. “But the research doesn’t provide insight into why the uptick in heart attacks is happening to younger people. I suspect it has to do with more people having risk factors for heart disease at an earlier age.”

Heart Attack Risk Factors for Women

There are several factors that increase your chance of developing heart disease. Almost 50% of all Americans have at least one of three major risk factors for the condition: Continue reading

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Myths about high blood pressure – Rush

Blood pressure is like what Mark Twain said about the weather, “Everybody talks about it, but nobody does anything about it.” Well almost. I have found that blood pressure is one of those subjects that is widely and wildly misunderstood. I used to think it was like grey hair on old people. Everybody has it. I was dead wrong.

Few assumptions are more dangerous than this one: If you have high blood pressure, you know it.

Doctors refer to high blood pressure, or hypertension, as a silent killer because it rarely produces warning signs.

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“When symptoms do occur, such as headache, nosebleeds or blurry vision, high blood pressure may have already reached severe and possibly life-threatening levels,” says Daniel Pohlman, MD, a primary care doctor at Rush University Medical Center. Continue reading

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Lowering blood pressure could help prevent cognitive impairment – Study

Significant reductions in the risk of mild cognitive impairment (MCI)*, and the combination of MCI and dementia**, have been shown for the first time through aggressive lowering of systolic blood pressure in new research results from the federally-funded SPRINT MIND Study reported at the Alzheimer’s Association International Conference (AAIC) in Chicago.

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“This is the first randomized clinical trial to demonstrate a reduction in new cases of MCI alone and the combined risk of MCI plus all-cause dementia,” said Jeff D. Williamson, MD, MHS, Professor of Internal Medicine and Epidemiology and Chief, Section on Gerontology and Geriatric Medicine at Wake Forest School of Medicine. Williamson reported these results at AAIC 2018.

The results of this large-scale, long-term clinical trial provide the strongest evidence to date about reducing risk of MCI and dementia through the treatment of high blood pressure, which is one of the leading causes of cardiovascular disease worldwide.

“This study shows more conclusively than ever before that there are things you can do — especially regarding cardiovascular disease risk factors — to reduce your risk of MCI and dementia,” said Maria C. Carrillo, PhD, Alzheimer’s Association Chief Science Officer. “To reduce new cases of MCI and dementia globally we must do everything we can — as professionals and individuals — to reduce blood pressure to the levels indicated in this study, which we know is beneficial to cardiovascular risk.”

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Study finds 500 more genes that affect blood pressure

Blood pressure is the force of the blood pushed against the the wall of the arteries …

Over 500 new gene regions that influence people’s blood pressure have been discovered in the largest global genetic study of blood pressure to date, led by Queen Mary University of London and Imperial College London.

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Involving more than one million participants, the results more than triple the number of blood pressure gene regions to over 1,000 and means that almost a third of the estimated heritability for blood pressure is now explained.

High blood pressure is a major risk factor for stroke and heart disease and was responsible for an estimated 7.8 million deaths worldwide in 2015. While lifestyle risk factors are relatively well-known and include obesity, smoking, alcohol and high salt-intake, high blood pressure is also highly heritable through genetics. Prior to this study however, the genetic architecture of blood pressure had not been well understood. Continue reading

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It’s official – spending time outside is good for you – Study

One of my favorite songs as a kid in the 1940’s was “Don’t fence me in.”
Here are some of the lyrics:
Oh, give me land, lots of land under starry skies above
Don’t fence me in
Let me ride through the wide open country that I love
Don’t fence me in

It appears I still feel that way, particularly when it comes to exercise. Working out in the health club really turns me off.

A new report reveals that exposure to green space reduces the risk of type II diabetes, cardiovascular disease, premature death, preterm birth, stress, and high blood pressure.

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Populations with higher levels of green space exposure are also more likely to report good overall health – according to global data involving more than 290 million people. Continue reading

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Biking linked to lower cardiovascular disease risk – AHA

Can I get an Amen?

People who bike regularly, either for pleasure or as a way to commute, appear to have a lower risk of cardiovascular disease, according to two separate studies published simultaneously in the American Heart Association’s journal Circulation and Journal of the American Heart Association, the AHA/ASA’s Open Access Journal.

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My dog and me rounding a turn on Northerly Island, just south of the Chicago Loop.

While structured cycling as part of a formal workout routine is already known to guard against cardiovascular illness, little is known about the effects of habitual biking done for leisure or as a way to commute. Together, the findings from the newly published studies suggest that leisure and commuter biking may be an important public health strategy in large-scale efforts to reduce cardiovascular risk.

In the Circulation study, 45,000 Danish adults (aged 50 to 65) who regularly biked for recreation or to commute had between 11 percent and 18 percent fewer heart attacks during a 20-year follow-up (1993-2013).

The analysis showed that as little as half an hour of biking per week provided some protection against coronary artery disease. Additionally, people who took up biking during the first five years the authors followed them had about a 25 percent lower risk of developing heart disease, compared with those who remained non-bikers in the subsequent 15-year period.

Researchers caution that their findings do not prove definitively that riding a bike for leisure or to and from work can prevent heart attacks. However, they say, the lower number of cardiovascular events observed among those who biked on a regular basis is a strong indicator that such activity can boost cardiovascular health.

“Finding time for exercise can be challenging for many people, so clinicians working in the field of cardiovascular risk prevention should consider promoting cycling as a mode of transportation,” said Anders Grøntved, M.Sc., M.P.H., Ph.D., senior study author and associate professor of physical activity epidemiology at the University of Southern Denmark.

Researchers also tracked participants’ overall exercise habits, activity levels and frequency of bicycle riding, along with heart disease risk factors, such as blood pressure, weight, cholesterol, smoking, diet and alcohol consumption. Participants were asked to provide information about cycling habits at the onset of the study and once more in five years.

In all, there were 2,892 heart attacks during the 20-year follow-up. Researchers estimate that more than 7 percent of all heart attacks could have been averted by taking up cycling and keeping it up on a regular basis.

“Because recreational and commuter biking is an easy way to make physical activity part of one’s routine in a non-structured and informal fashion, based on the results, public health authorities, governments and employers ought to consider initiatives that promote bicycle riding as a way to support large-scale cardiovascular disease prevention efforts,” said Kim Blond, M.Sc, lead author and research assistant at the University of Southern Denmark.

The Journal of the American Heart Association study revealed that middle-aged and older Swedish adults who biked to work were less likely than non-bikers to be obese, have high cholesterol, high blood pressure or pre-diabetes — all critical drivers of cardiovascular risk.

Researchers followed more than 20,000 people in their 40s, 50s and 60s over 10 years and monitored their commuting habits, weight, cholesterol levels, blood glucose and blood pressure.

At the beginning of the study, active commuters (biked to work) were 15 percent less likely to be obese, 13 percent less likely have high blood pressure, 15 percent less likely to have high cholesterol and 12 percent less likely to have pre-diabetes or diabetes, compared with passive commuters (used public transportation or drove to work).

During a follow-up exam 10 years later, the portion of study participants who switched from passive commuting to active commuting also had an improved risk profile. They were less likely to be obese, have diabetes, hypertension or elevated cholesterol, compared with non-bikers.

Collectively, at the 10-year follow-up, those who maintained biking or took up biking at some point had a 39-percent lower risk of obesity, 11 percent lower risk of high blood pressure, 20 percent lower risk of high cholesterol and 18 percent lower diabetes risk.

“We found active commuting, which has the additional advantages of being time-efficient, cheaper and environmentally friendly is also great for your health,” said Paul Franks, Ph.D., senior study author, professor in the Department of Clinical Sciences at Lund University in Sweden and guest professor at Umeå University in Sweden. “The multiple advantages of active commuting over structured exercise may help clinicians convey a message that many patients will embrace more readily than being told to join a gym, go for a jog or join a sports team.”

Researchers noted that there was no minimum amount of time or distance required to reduce one’s risk, even though people who biked longer or more often experienced small additional gains in risk reduction.

Because the study was observational, it is difficult to establish a cause-and-effect relationship between improved cardiovascular health and commuter biking, but the findings do indicate a strong cardio-protective effect from cycling.

Based on their findings, researchers also estimated that maintaining biking habits or switching from passive commuting to biking may have prevented 24 percent of obesity cases, 6 percent of hypertension diagnoses, 13 percent of high cholesterol diagnoses, and 11 percent of the cases of diabetes.

“The really good news here is that it’s never too late to benefit from an active lifestyle,” Franks said. “People who switched from passive to active commuting saw considerable gains in their cardiovascular health.”

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Heart attacks often follow dramatic changes in outdoor temperature

As regular readers know I pretty much ride my bike every day here in Chicago. I say ‘pretty much’ because several  years ago, my doctor told me that I shouldn’t be doing my big rides in high temperatures. I said that I felt I was in great shape and my body could handle it. She answered that she said the same thing to her 40-year-old patients. Extreme heat puts the body under special stress and it is not wise to actively exercise in those conditions.

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Here I am riding with my dog in the annual Bike the Drive ride in Chicago down Lake Shore Drive. As a Memorial Day ride, the temps rarely hit high extremes.

Now, it seems that now only high temp extremes, but also large intra-day changes can be damaging, according to a study being presented at the American College of Cardiology’s 67th Annual Scientific Session. It states that large day-to-day swings in temperature were associated with significantly more heart attacks in a study being presented at the American College of Cardiology’s 67th Annual Scientific Session.

Regarding extreme weather events, Hedvig Andersson, MD, a cardiology researcher at the University of Michigan and the study’s lead author, said, “Our study suggests that such fluctuations in outdoor temperature could potentially lead to an increased number of heart attacks and affect global cardiac health in the future.”

There is a large body of evidence showing that outdoor temperature affects the rate of heart attacks, with cold weather bringing the highest risk, but most previous studies have focused on overall daily temperatures. This new study is among the first to examine associations with sudden temperature changes. Continue reading

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Caution advised about recent U.S. advice on aggressively lowering blood pressure

Medical researchers at Trinity College Dublin, Ireland, are advising caution when treating blood pressure in some older people — after results from a study contrasted with recent advice from the U.S. to attempt to aggressively lower blood pressure in all adults to targets of 120mmHg.
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Researchers from the Irish Longitudinal Study on Ageing (TILDA) at Trinity College Dublin, in collaboration with Beaumont Hospital, Dublin, have recently published the findings in the Journal of the American Medical Association (JAMA Internal Medicine).

A large randomized blood pressure trial led by U.S. investigators — the Systolic blood Pressure Intervention Trial (SPRINT) — demonstrated that lowering systolic blood pressure to levels of 120mmHg or less compared with 140mmHg or less in adults (over 50 years with cardiovascular risk) significantly reduced death (from all causes and from heart failure and heart attacks). The study also reported that common side effects of low blood pressure such as falls, injuries, blackouts, and drops in blood pressure after standing were not increased by aggressive treatment — even in people over 75 years old.

Because the latter findings were clinically counter intuitive, the TILDA team tested whether they held true outside of a trial setting. Focusing on people in Ireland over 75 years, they examined rates of falls, injuries, blackouts and excessive drops in standing blood pressure in those who met the criteria for the treatment proposed in SPRINT and were followed up with for 3½ years — the same time period as SPRINT.

The researchers reported starkly contrasting results — falls and blackouts were up to five times higher than reported in SPRINT and drops in blood pressure on standing were almost double that reported in SPRINT. Therefore, in people over 75 years, intensive lowering of blood pressure to 120mmHg could result in harm and TILDA researchers recommend that a better understanding of who, over 75 years, will or will not benefit, is necessary before widespread adaptation of the SPRINT results.

The TILDA team is now assessing how best to determine which people may benefit from SPRINT, and which people are more at risk from aggressive blood pressure lowering.

First author of the journal article, Research Fellow at TILDA, Dr. Donal Sexton, said: “SPRINT was a landmark study of hypertension treatment. While the benefits of lowering blood pressure seen in this study are not in dispute, we are highlighting to physicians that we need to be cognizant of the fact that the trial was not powered for adverse events such as falls causing injury. Physicians ought not to expect a similarly low rate of adverse events in clinical practice as was observed in the trial when lowering blood pressure in older people. Overall what we are saying is that the risks and benefits of lowering blood pressure should be individualized for each patient.”

Professor Rose Anne Kenny, founding Principal Investigator with TILDA and lead author of the journal article commented: “Our work and that of other groups has shown that low blood pressure and particularly drops in standing blood pressure are linked not only to falls, fractures and fall- and blackout-related injuries, but also to depression and possibly other brain health disorders.”

“These outcomes can seriously impact on independence and quality of life and we advise caution in applying the SPRINT recommendations to everyone over 75 years without detailed assessment of an individual’s risk versus possible benefit until such a time as we can provide more clarity re treatment.”


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Home blood pressure monitors inaccurate 70 percent of the time: Study

What to watch out for when choosing and using your own device

Advances in technology have made it possible for us to take measurements of our body that previously we had to rely on doctor visits to get done. This is a positive development that saves us time and money – on the assumption that we can do as accurate a measurement as the hospital. Seems that is not necessarily the case with home blood pressure monitors.

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Seventy per cent of readings from home blood pressure monitors are unacceptably inaccurate, which could cause serious implications for people who rely on them to make informed health decisions, new UAlberta research reveals.

“High blood pressure is the number one cause of death and disability in the world,” said medical researcher Jennifer Ringrose, who led the research study. “Monitoring for and treating hypertension can decrease the consequences of this disease. We need to make sure that home blood pressure readings are accurate.” (my emphasis)
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Healthy arteries may be possible with aging – AHA

As a 77 year old, I was heartened to learn that a lot of the damage expected by aging could be controlled by attention to the American Heart Association’s (AHA) seven steps in yesterday’s post.

Study Highlights

  • High blood pressure and increased blood vessel stiffness are often considered common parts of aging.
  • Having healthy arteries into one’s 70s and beyond is challenging and depends on modifiable lifestyle factors, not necessarily genetics.

Having the blood vessels of a healthy 20-year-old into one’s 70s is possible but difficult in Western culture, according to new research in the American Heart Association’s journal Hypertension.

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“For the most part, it’s not genetic factors that stiffen the body’s network of blood vessels during aging. Modifiable lifestyle factors – like those identified in the American Heart Association’s Life’s Simple 7 –  are the leading culprits,” said study author Teemu J. Niiranen, M.D., research fellow at Boston University School of Medicine, Framingham Heart Study, Framingham, Massachusetts. Continue reading

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Some fruit and veggies may lower blood pressure

Here is yet another reason to be sad about the SAD – Standard American Diet.

A new study by  Keck School of Medicine of the University of Southern California researcher links increased dietary potassium with lower hypertension.

Consuming potassium-rich foods like sweet potatoes, avocados, spinach, beans, bananas — and even coffee — could be key to lowering blood pressure, according to a USC researcher.

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“Decreasing sodium intake is a well-established way to lower blood pressure,” said Alicia McDonough, professor of cell and neurobiology at the Keck School of Medicine of USC, “but evidence suggests that increasing dietary potassium may have an equally important effect on hypertension.” Continue reading

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Rapid middle age blood pressure drops linked to dementia in old age – Study

Regular readers know how much I follow developments in the study of the brain. Here is some fresh fascinating info from Johns Hopkins.

Summary: Researchers report orthostatic hypotension could cause lasting damage to the brain because it can reduce blood flow to the brain.

Middle-aged people who experience temporary blood pressure drops that often cause dizziness upon standing up may be at an increased risk of developing cognitive decline and dementia 20 years later, new Johns Hopkins Bloomberg School of Public Health research suggests.

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The findings, being presented March 10 at the American Heart Association’s EPI|LIFESTYLE 2017 Scientific Sessions in Portland, Ore., suggest that these temporary episodes – known as orthostatic hypotension – may cause lasting damage, possibly because they reduce needed blood flow to the brain. Previous research has suggested a connection between orthostatic hypotension and cognitive decline in older people, but this appears to be the first to look at long-term associations. (my emphasis)

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Poor sleep may raise risk for irregular heart rhythms – AHA

Regular readers know that I feel strongly that sleep is one of the cornerstones of good health. You can check out my Page – How important is a good night’s sleep? for more details.

According to the American Heart Association (AHA):
• Poor sleep – even if you don’t have sleep apnea – may be linked to higher risks of developing an irregular heartbeat.
• In addition, getting less rapid-eye movement (REM) sleep may also be linked to higher atrial fibrillation risks.

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Disruptions in sleep may be raising your risks of an irregular heartbeat, known as atrial fibrillation (AF), according to preliminary research presented at the American Heart Association’s Scientific Sessions 2016. Continue reading

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What is High Blood Pressure?

Blood pressure is one of the critical and least understood aspects of our health. For that reason, I am reblogging this post I wrote five years ago. This is a perfect example of ‘what you don’t know can hurt you.’

Tony

One Regular Guy Writing about Food, Exercise and Living Past 100

Blood pressure is the force of the blood pushed against the the wall of the arteries, according to Nurse Practicioner Deborah Bergman, MS, RN, speaking to the Northwestern Memorial Healthy Transitions Program®.

Bergman explained that blood pressure depends on the strength of the heartbeat, thickness and volume of the blood, the elasticity of the artery walls and general health. It is the arterial pressure of the circulation. It is a dynamic process and fluctuates all day.

She said that blood pressure (BP) varies between a maximum (systolic) pressure – working phase. And the minimum (diastolic) pressure – the resting phase. Average blood pressure decreases as the blood moves away from the heart through the arteries. It drops most rapidly around the small arteries and continues to decrease as it moves through the capillaries and back to the heart through the veins.

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