Tag Archives: high blood pressure

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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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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Clinic readings may underestimate blood pressure during daily activities – AHA

Ignorance about blood pressure is widespread.

Harvard Medical School reports “Blood pressure has long been one of the best markers of your health. It is a number you can remember and monitor. High blood pressure (hypertension) is linked to a greater risk of heart attacks and strokes.

“About one out of three adults has high blood pressure, which is usually defined as a reading of 140/90 millimeters of mercury (mm Hg) or higher.”

You can have high blood pressure, or hypertension, and still feel just fine, according to the National Institute on Aging (NIA). That’s because high blood pressure often does not cause signs of illness that you can see or feel. But, high blood pressure, sometimes called “the silent killer,” is very common in older people and a major health problem.

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Study Highlights
•    24-hour ambulatory, or around-the-clock monitoring, during daily activities revealed undetected high blood pressure among otherwise healthy adults who had normal readings in the clinic.
•    Healthcare providers should be aware that normal blood-pressure tests in the clinic may not rule out high blood pressure among otherwise healthy patients. Continue reading

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Heart disease and brain health linked – Harvard

I have written time and again about the link between exercise and brain health. The Harvard Heart Letter has a nice post on how heart disease and brain health are tied together.

“Just like in the rest of your body, advancing years can take a toll on your brain function. Much of this slowing down is predictable and can be chalked up to normal aging. However, when thinking skills become increasingly fuzzy and forgetfulness gets to be a way of life, an early form of dementia known as mild cognitive impairment may be setting in,” so writes Julie Corliss, Executive Editor, Harvard Heart Letter.

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“Often, the first reaction is to attribute these changes to the beginning of Alzheimer’s disease. But blood flow problems may be to blame, as well. “An estimated one-third of all cases of dementia, including those identified as Alzheimer’s, can be attributed to vascular factors,” says Dr. Albert Hofman, chair of the department of epidemiology at the Harvard T.H. Chan School of Public Health. Continue reading

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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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High Blood Pressure May Impair Cognitive Function and Pose Risk for Alzheimer’s

My family history of Alzheimer’s Disease and dementia popped this news item up onto my radar screen.

Before considering problems with high blood pressure, let’s understand what it is. Blood pressure is the force of the blood pushed against the the wall of the arteries. It 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, a dynamic process that fluctuates all day.

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Normal BP is 120/80, systolic/diastolic. Prehypertensive is 120-139 over 80-89. Stage one hypertension is 140-159 over 90 – 99. Stage two hypertension reads 160 -179 over 100 – 109.

Some of the causes of high blood pressure include smoking, overweight, lack of physical activity, too much salt, too much alcohol, stress, older age, genetics. Continue reading

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Harvard on Understanding Blood pressure

As a senior citizen, I know that high blood pressure is very widespread. I used to think it was about the same as having grey hair. But, I was wrong.

Harvard Medical School reports “Blood pressure has long been one of the best markers of your health. It is a number you can remember and monitor. High blood pressure (hypertension) is linked to a greater risk of heart attacks and strokes.

“About one out of three adults has high blood pressure, which is usually defined as a reading of 140/90 millimeters of mercury (mm Hg) or higher.

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“The first, or upper, number (systolic pressure) represents the pressure inside the arteries when the heart beats, and the second, or lower, number (diastolic pressure) is the pressure between beats when the heart rests.

“Blood pressure rises with age because of increasing stiffness of large arteries, long-term buildup of plaque, and the effects of other diseases involving the heart and blood vessels. Typically, more attention is given to the diastolic reading as a major risk factor for cardiovascular disease. Continue reading

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What about your blood pressure? – NIH

You can have high blood pressure, or hypertension, and still feel just fine, according to the National Institute on Aging (NIA). That’s because high blood pressure often does not cause signs of illness that you can see or feel. But, high blood pressure, sometimes called “the silent killer,” is very common in older people and a major health problem. If high blood pressure isn’t controlled with lifestyle changes and medicine, it can lead to stroke, heart disease, eye problems, kidney failure, and other health problems. High blood pressure can also cause shortness of breath during light physical activity or exercise. My emphasis

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What Is Blood Pressure?
Blood pressure is the force of blood pushing against the walls of arteries. When the doctor measures your blood pressure, the results are given in two numbers. The first number, called systolic blood pressure, is the pressure caused by your heart pushing out blood. The second number, called diastolic blood pressure, is the pressure when your heart fills with blood. The safest range, often called normal blood pressure, is a systolic blood pressure of less than 120 and a diastolic blood pressure of less than 80. This is stated as 120/80.

Do You Have High Blood Pressure?
One reason to have regular visits to the doctor is to have your blood pressure checked. The doctor will say your blood pressure is high when it measures 140/90 or higher at two or more checkups. He or she may ask you to check your blood pressure at home at different times of the day. If the pressure stays high, even when you are relaxed, the doctor may suggest exercise, changes in your diet, and medications.
The term “prehypertension” describes people whose blood pressure is slightly higher than normal—for example, the first number (systolic) is between 120 and 139, or the second number (diastolic) is between 80 and 89. Prehypertension can put you at risk for developing high blood pressure. Your doctor will probably want you to make changes in your day-to-day habits to try to lower your blood pressure.

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What if Just the First Number Is High?
For older people, the first number (systolic) often is 140 or greater, but the second number (diastolic) is less than 90. This problem is called isolated systolic hypertension. It is the most common form of high blood pressure in older people and can lead to serious health problems. Isolated systolic hypertension is treated in the same way as regular high blood pressure but often requires more than one type of blood pressure medication. If your systolic pressure is 140 or higher, ask your doctor how you can lower it. Continue reading

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Heart Health and Brain Health Linked – AA

Regular readers know that I am strongly concerned about my health, both physical and mental. At least two of my family members have suffered from Alzheimer’s and dementia. So, I was thrilled to learn that the Alzheimer’s Association thinks there are links between heart health and brain health.

IMG_7718“Growing evidence suggests a close link between the health of the heart and the health of the brain. The brain is nourished by one of the body’s richest networks of blood vessels. With every beat, the heart pumps about 20 to 25 percent of the blood to the head, where brain cells use at least 20 percent of the food and oxygen carried by the blood in order to function normally. As a result, many factors that damage the heart or blood vessels may also damage the brain – and may increase the risk for developing Alzheimer’s disease and other dementias”, according to the Alzheimer’s Association (AA).

“Some autopsy studies show that as many as 80 percent of individuals with Alzheimer’s disease also have cardiovascular disease. This may be a key to understanding why some people who develop plaques and tangles on the brain – the hallmark of Alzheimer’s disease – do not develop the symptoms of Alzheimer’s. Autopsy studies suggest that plaques and tangles may be present in the brain without causing symptoms of cognitive decline unless the brain also shows evidence of vascular disease.”

Some of the factors for which there may be a heart-brain health connection include:
Smoking: There is fairly strong evidence that current smoking increases the risk of cognitive decline and possibly also dementia, and that quitting smoking may reduce the associated risk to levels comparable to those who have not smoked.
Diabetes: Diabetes is associated with lower cognitive performance, and there appears to be strong, 
but not conclusive, evidence for an association between diabetes and dementia.
Obesity: Mid-life obesity increases the risk of cognitive decline and may also be associated with an 
increased risk of dementia.
High Blood Pressure: High blood pressure, or hypertension, especially in midlife, has been shown 
to be associated with a higher risk of cognitive decline. Some evidence has also shown that medi- cine for treating high blood pressure may be effective in reducing the risk of decline.

“What’s good for your heart may in fact be good for your brain, too. Physical activity is one such factor that not only protects the heart but improves cognitive function and may also protect against dementia. And, some emerging evidence suggests that consuming a heart-healthy diet may also protect the brain.

“Many cardiovascular disease risk factors are modifiable – that is, they can be changed to decrease the likelihood of developing cardiovascular disease. Many experts believe that controlling cardiovascular risk factors may be the most cost-effective and helpful approach to protecting brain health. In fact, some researchers have suggested that the improved cardiovascular health of the population in the last 25 years has had a spillover effect by also reducing the incidence of dementia. Thus, reducing the burden of diabetes, cardio- vascular disease, and obesity may help protect against Alzheimer’s disease and other dementias. By including brain health promotion messages in existing heart-health campaigns, the public health community may help reduce both the incidence of chronic cardiovascular conditions and future cognitive decline.”

To read further on this check out my Page – Important Facts About Your Brain (and Exercise).

Tony

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Some People with High Blood Pressure May Have Early Brain Damage – AHA

A new imaging technique found that some people with high blood pressure also have damage to nerve tracts connecting different parts of the brain, according to a study presented at the American Heart Association’s (AHA) 2015 High Blood Pressure Conference.

The area of brain damage detected is linked to difficulties in certain cognitive skills, decision-making, and the ability to regulate emotions.

IMG_7718“We already have clear ways to explore the damage high blood pressure can cause to the kidneys, eyes, and heart. We wanted to find a way to assess brain damage that could predict the development of dementia associated with vascular diseases,” said Daniela Carnevale, Ph.D., the study’s senior author and assistant professor at Sapienza University of Rome, based in Neuromed Institute.

While there has been a lot of research on hypertension-related brain changes in the grey matter, Carnevale proposed that a look into the brain’s white matter could tell if high blood pressure was having an effect even earlier than what is known.

Researchers used diffusion tensor imaging (DTI), an enhancement of magnetic resonance imaging (MRI), to evaluate and compare the structural and functional properties of the main connections between different brain regions. Fifteen participants were on medication for moderate to severe high blood pressure and 15 participants had normal blood pressure. Participants were also given a cognitive assessment.

The brain imaging found that, while none of the participants showed abnormalities on a standard MRI, the more advanced DTI revealed that participants with high blood pressure had damage to:
•    brain fibers that affect non-verbal functions;
•    nerve fibers that affect executive functioning and emotional regulation; and
•    limbic system fibers, which are involved in attention tasks.

In addition, imaging and laboratory tests indicated damage to the heart and kidneys from high blood pressure.

Researchers also found those with high blood pressure performed significantly worse on two different assessments of cognitive function and memory. However, there were no differences in tests evaluating verbal function or ability to perform daily activities.

“DTI provides a way to evaluate pre-symptomatic brain damage in people with high blood pressure in order to identify possible therapies to help control brain damage and reduce the eventual development of dementia. It is generally accepted that not all available medications have the same impact on different kinds of organ damage,” Carnevale said.

DTI, also called tractography, is not performed in routine medical practice, but the researchers suggest that physicians should start to consider potential brain damage as they treat patients with high blood pressure.

To read further on high blood pressure check out my posts:

What is High Blood Pressure?

What You Need to Know About High Blood Pressure

Leisure Time Activity Could Lower Your Risk of High Blood Pressure

Tony

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The Result of Eating Too Much Salt Can be Measured in Blood Pressure

More than 75 percent of sodium in the U.S. diet is found in the salt added to processed food. In the United States, about 9 of every 10 people consume too much sodium. The Salty Six foods – breads and rolls, cold cuts and cured meats, pizza, poultry, soup and sandwiches – are the leading sources of overall sodium in the U.S. diet.

Because of this it is really important to beware of eating processed food. Lots of folks cut down on their table salt, but that isn’t the real culprit in the sodium problem. They need to beware of the stealth sodium in the processed foods they eat.

Here are a few of the posts I have written on salt:

High Salt Diet Doubles Thread of Cardiovascular Disease in People with Diabetes

How Much Salt is Too Much Salt?

Some Sneaky Salt Statistics

Where Does All the Salt in our Diet Come From?

Tony

Cooking with Kathy Man

People who gradually increase the amount of salt in their diet and people who habitually eat a higher salt diet both face an increased risk of developing high blood pressure, according to a study published in the Journal of the American Heart Association.

In a Japanese study of more than 4,000 people who had normal blood pressure, almost 23 percent developed high blood pressure over a three year period. Those who ate the most salt were the most likely to have high blood pressure by the end of the study. Participants who gradually increased their sodium intake also showed gradually higher blood pressure.

The researchers estimated the amount of salt an individual was consuming by analyzing the amount of sodium in the urine of people who were visiting their healthcare provider for a routine check-up, and conducted follow-up urine analysis for approximately three years.

At the conclusion of the study…

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More than half the packaged food you buy in grocery stores has too much salt – The Washington Post

The Washington Post seems to do a good job of looking out for healthy ideas for us. I think everyone needs to understand that they are getting TOO MUCH salt from the packaged foods they buy. A lot of folks cut down on table salting their food, not realizing how much they get in their processed foods.

Please check out the following to read more on salt: High-Salt Diet Doubles Threat of Cardiovascular Disease in People with Diabetes
How Much is Too Much Salt?
Some Sneaky Salt Statistics
Where Does All the Salt in Our Diet Come From?

Tony

Learn about nutrition with me!

By Lenny Bernstein April 2

More than 90 percent of us consume too much salt (guilty!), which, as you know, contributes to high blood pressure. For some reason, blood pressure varies noticeably by region of the country, so a team of researchers from the Centers for Disease Control and Prevention decided to determine whether there also are regional variations in the amounts of salt in the packaged foods we buy at the supermarket.

They didn’t find any. But what they did find, according to a report released Thursday, is a bit sobering: More than half of what we buy contains more than the recommended amount of salt for each serving we consume. Meat and pasta mixed dishes (I assume they’re talking about frozen meals and the like; I’m still seeking an explanation) were the top culprits, with better than 80 percent of each containing too much salt in the three…

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Ability to Balance on One Leg May Reflect Brain Health and Stroke Risk

Researchers found that the inability to balance on one leg for longer than 20 seconds was associated with cerebral small vessel disease, namely small infarctions without symptoms such as lacunar infarction and microbleeds.

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Struggling to balance on one leg for 20 seconds or longer was linked to an increased risk for small blood vessel damage in the brain and reduced cognitive function in otherwise healthy people with no clinical symptoms, according to new research in the American Heart Association’s journal Stroke.

“Our study found that the ability to balance on one leg is an important test for brain health,” said Yasuharu Tabara, Ph.D., lead study author and associate professor at the Center for Genomic Medicine at Kyoto University Graduate School of Medicine in Kyoto, Japan. “Individuals showing poor balance on one leg should receive increased attention, as this may indicate an increased risk for brain disease and cognitive decline.”

The study consisted of 841 women and 546 men, average age of 67. To measure one-leg standing time, participants stood with their eyes open and raised one leg. The maximum time for keeping the…

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Hypertension Self-Management Program Helps Reduce Blood Pressure For High-Risk Patients

“This trial has shown for the first time, to our knowledge, that a group of high-risk individuals, with hypertension and significant cardiovascular comorbidity, are able to self-monitor and self-titrate antihypertensive treatment following a pre­specified algorithm developed with their family physician and that in doing so, they achieved a clinically significant reduction in systolic and diastolic blood pressure without an increase in adverse events,” the authors write. “This is a population with the most to gain in terms of reducing future cardiovascular events from optimized blood pressure control.”

Cooking with Kathy Man

Among patients with hypertension at high risk of cardiovascular disease, a program that consisted of patients measuring their blood pressure and adjusting their antihypertensive medication accordingly resulted in lower systolic blood pressure at 12 months compared to patients who received usual care, according to a study in the August 27 issue of JAMA.

Data from national and international surveys suggest that despite improvements over the last decade, significant proportions of patients have poor control of their elevated blood pressure. Self-monitoring of blood pressure with self-titration (adjusting) of antihypertensives results in lower blood pressure in patients with hypertension, but there are no data about patients in high-risk groups, according to background information in the article.

Richard J. McManus, F.R.C.G.P., of the University of Oxford, and colleagues randomly assigned 552 patients with hypertension and a history of stroke, coronary heart disease, diabetes, or chronic kidney disease to self-monitoring of blood pressure combined…

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What are Some Good Reasons to Use Apple Cider Vinegar? – Infographic

Apple cider vinegar is one of those foods that “a little goes a long way.” If you want to include it in your diet, a simple way is to mix a tablespoon of it with a tablespoon of honey and add to water or drink like that.

Mr. Lazy Cook includes an ounce in his daily morning smoothie.

Last, but not least, apple cider vinegar helps to suppress appetite and can assist in weight loss.

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Tony

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