Ways to Lower your High Blood Pressure

Doctors have long known that systolic blood pressure below 120 was considered normal and meant a lower risk of heart disease and kidney problems. But they would often only treat patients if that top number crept above 140, the threshold for officially having high blood pressure.

Recent findings from a large National Institutes of Health study now suggest that it’s worth treating patients in that prehypertension gray area of 120 to 140, in order to bring them down into the normal range.

The findings, which have not yet been published and are still preliminary, found lower rates of heart attack, stroke and death among people with high blood pressure who brought that top number down to 120. In order to reach that goal, study participants in the 120 group took an average of three blood pressure medications, whereas the 140 group took two medications.

“This is notable because there (are) a lot of people out there with blood pressure in the 130s that we might previously have left alone, but if the results of this trial (are) as we think they are, it might be reason to try to get them to 120,” said Dr. John D. Bisognano, professor of medicine at the University of Rochester Medical Center and president-elect of the American Society of Hypertension.

The final results of the NIH study will arrive in the coming months, but “it has changed in my practice. Like if I have someone in the low 140s, I no longer say that’s sort of close. … I try to push them down into the mid-130s if they are nondiabetic,” Bisognano said. (Although this strategy might also help people with diabetes, Bisognano added, the NIH study only looked at people over 50 who did not have diabetes.)

The focus is on the top number in a blood pressure reading because it’s a better predictor of heart attack and stroke than the bottom number, the diastolic pressure, Bisognano said.

So how can patients take their blood pressure down to 120?

If that becomes the new goal, many people will probably need to start a blood pressure medication or add another to their current regimen, Bisognano said. But there are also a number of lifestyle interventions they may be able to tap into instead of taking a new drug. Here are their options:

Medicate

Many people have to take blood pressure medication just to stay close to the 140 mark, Bisognano said. Some may even run marathons and lead otherwise healthy lives, but just can’t get down in the normal range, possibly because they are genetically predisposed to high blood pressure.

To get down to 120, these people may have to take more blood pressure medication. The most common, Bisognano said, are the “ABCDs”: ACE inhibitors, beta blockers, calcium channel blockers and diuretics. Typically, patients who need more than one medication would take one from each of these classes.

 

Although the ABCDs can lead to side effects, such as dehydration, headache and weakness, most people can tolerate them and the problems are usually not severe, Bisognano said. In addition, “we are in a golden age of hypertension treatment, where almost all of the drugs are cheap,” he said.

A medium dose of one of these medications usually brings systolic blood pressure down by about 10 points, said Dr. Karen Margolis, director of clinical research at HealthPartners Institute for Education and Research.

Lose weight

Weight loss can lower blood pressure about as much as taking a single blood pressure medication, Margolis said. Research suggests that losing about 9 pounds could reduce systolic blood pressure by 4.5 points, and one study found that maintaining weight loss of about 7 pounds for a year could even bring it down by 11 points.

It is not clear why weight loss is so beneficial for blood pressure, Bisognano said. It may lead to changes in circulation, or it may be because of the dietary changes that can accompany weight loss, such as eating less salt. “(However) we have to appreciate how difficult it is to lose weight,” especially if you are busy, Bisognano said. “Sometimes you can do it and sometimes you cannot.”

Exercise

Along with weight loss, exercise is probably the best way to lower blood pressure without the possible side effects of medication, Bisognano said. It makes arteries more flexible and better able to dilate, which directly reduces systolic blood pressure, he said.

The American College of Cardiology and the American Heart Association recommend 2½ hours a week of medium intensity physical activity, such as jogging, swimming and dancing. One study found that 10 weeks of moderate exercise, such as walking and cycling, for an hour three times a week reduced systolic blood pressure in sedentary older adults by 5 points.

For some people, however, the slog of going to the gym after a long work day may be worse than the side effects of medication, Bisognano said. But even being a “weekend warrior” can help. “Then, when your life permits you to do something once or twice a week, you’ll be in physical shape to do that,” Bisognano said.

Scale back the salt

One of the most important dietary changes some people can make to lower blood pressure is reducing salt intake, Bisognano said. Many of us consume 9 to 12 grams of salt a day, but the American Heart Association recommendation is 3 or 4 grams. In one study, scaling back daily salt levels from 8 grams to 4 grams was associated with a drop of 6.7 points in systolic blood pressure.

 

But only people whose blood pressure is affected by salt may reap this kind of blood pressure-lowering benefit. “If you don’t have salt-sensitive hypertension, it will not do much,” said Dr. Samuel Joseph Mann, professor of internal medicine at New York-Presbyterian Hospital Weill Cornell Medical College.

About half of black people and a quarter of white people have salt-sensitive hypertension, and the numbers are higher in older people, Mann said. You can see if your hypertension is affected by salt by reducing your intake for four or five days, such as by cutting out soups and processed foods and not eating out, and measuring your blood pressure at your drugstore before and after, Mann added.

Eat more fruits and vegetables

If reducing salt is not enough, people with high blood pressure have an entire diet designed for them. Dietary Approaches to Stop Hypertension, or DASH, was developed by the National Institutes of Health and has been voted one of the best overall diets.  The DASH diet is high in fruits, vegetables and fiber, and low in sodium. It may further reduce systolic blood pressure by about 3 points compared with a regular low-sodium diet, according to a trial of DASH.

However, a drawback of the DASH diet is that it’s high in carbohydrates. This can stimulate the appetite and make it harder for people to lose weight, Bisognano said. If you are trying to lose weight and lower blood pressure, diets such as Zone and South Beach, which balance carbs with protein and fat, may be easier to stick with for six months or so, he added.

Snack on chocolate

Not every tasty treat is bad for your blood pressure. Research suggests that people who ate more dark chocolate over a period of two to eight weeks had lower systolic blood pressure by about 2 points. Antioxidants in cocoa, called flavanols, may help dilate arteries.  Although this reduction in blood pressure is relatively small, it may complement other interventions. However, Bisognano said, “if you have 400 calories of dark chocolate, you don’t get to have 400 calories of something else.”

Don’t binge drink

High blood pressure is another reason not to binge drink. Studies suggest that alcohol reduction interventions can reduce systolic blood pressure by about 4 points among people who consume between 30 and 60 drinks a week. The American Heart Association recommends that women stick to an average of one alcoholic drink a day and men to two.

Meditate

It may not come as a surprise that meditation practices that aim to improve focus and reduce anxiety may also lower your blood pressure. An analysis of studies of transcendental meditation using a short mantra found it could reduce systolic blood pressure by nearly 5 points more than those who did not meditate or used other relaxation techniques.  We know that transcendental meditation, and other relaxation techniques such as yoga, definitely work if done regularly. The question is, can people do it regularly?” Bisognano said.

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OnSeptember 22, 2015, posted in: Latest News by

The Man Who Saved 2 Million Lives

On the surface, James Harrison is just an average guy. He loves his daughter and grandchildren, collects stamps, and goes for walks near his home on Australia’s central coast. But it’s what’s under the surface that makes him extraordinary — specifically, what’s flowing in his veins.

Known as “The Man with the Golden Arm,” nearly every week for the past 60 years he has donated blood plasma from his right arm. The reasons can be traced back to a serious medical procedure he underwent as a child.

“In 1951, I had a chest operation where they removed a lung — and I was 14,” recalls Harrison, who is now aged 78.

“When I came out of the operation, or a couple days after, my father was explaining what had happened. He said I had (received) 13 units (liters) of blood and my life had been saved by unknown people. He was a donor himself, so I said when I’m old enough, I’ll become a blood donor.”

Soon after Harrison became a donor, doctors called him in. His blood, they said, could be the answer to a deadly problem.

“In Australia, up until about 1967, there were literally thousands of babies dying each year, doctors didn’t know why, and it was awful,” explains Jemma Falkenmire, of the Australian Red Cross Blood Service. “Women were having numerous miscarriages and babies were being born with brain damage.”

It was the result of rhesus disease — a condition where a pregnant woman’s blood actually starts attacking her unborn baby’s blood cells. In the worst cases it can result in brain damage, or death, for the babies.

Rhesus disease happens when a pregnant woman has rhesus-negative blood (RhD negative) and the baby in her womb has rhesus-positive blood (RhD positive), inherited from its father. If the mother has been sensitized to rhesus-positive blood, usually during a previous pregnancy with an rhesus-positive baby, she may produce antibodies that destroy the baby’s “foreign” blood cells.

Harrison was discovered to have an unusual antibody in his blood and in the 1960s he worked with doctors to use the antibodies to develop an injection called Anti-D. It prevents women with rhesus-negative blood from developing RhD antibodies during pregnancy.

“Australia was one of the first countries to discover a blood donor with this antibody, so it was quite revolutionary at the time,” says Falkenmire.

Harrison’s blood is precious. He and Anti-D are credited with saving the lives of more than 2 million babies, according to the Australian Red Cross blood service: That’s 2 million lives saved by one man’s blood.

“Every bag of blood is precious, but James’ blood is particularly extraordinary,” says Falkenmire. “His blood is actually used to make a life-saving medication, given to moms whose blood is at risk of attacking their unborn babies. Every batch of Anti-D that has ever been made in Australia has come from James’ blood.

“And more than 17% of women in Australia are at risk, so James has helped save a lot of lives.”

One of those lives is that of baby Samuel, who is just five weeks old. His mother, Kristy Pastor, first received the Anti-D injection during her second pregnancy. With Harrison’s antibodies in her blood, little Samuel is her fourth happy and healthy baby.

“They just said you needed the vaccine,” she said. “I didn’t think about it any further, and then looking into it a bit more, I found out about James and how amazing he is and how many donations he’s made, and that it was all because of him.

“I’m grateful and I think James is really selfless to continue to donate, so that we can keep having this vaccine.”

Doctors still aren’t exactly sure why Harrison has this rare blood type but they think it might be from the transfusions he received when he was 14, after his lung surgery. He’s one of no more than 50 people in Australia known to have the antibodies, according the Australian Red Cross blood service.

“I think James is irreplaceable for us,” says Falkenmire.

“I don’t think anyone will be able to do what he’s done, but certainly we do need people to step into his shoes,” she adds. “He will have to retire in the next couple years, and I guess for us the hope is there will be people who will donate, who will also … have this antibody and become life savers in the same way he has, and all we can do is hope there will be people out there generous enough to do it, and selflessly in the way he’s done.”

Harrison is considered a national hero, and has won numerous awards. He’s now donated his plasma more than 1,000 times, but no matter how many times he’s given blood there’s one thing that will never change: “Never once have I watched the needle go in my arm,” he says.

“I look at the ceiling or the nurses, maybe talk to them a bit, but never once have I watched the needle go in my arm. I can’t stand the sight of blood, and I can’t stand pain.”

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OnJune 9, 2015, posted in: Latest News by

How to Beat Negative Thoughts

Candy Barone, 41, can’t remember her late twenties.

It was during the worst part of what she describes as self-sabotaging behaviors that consumed her life from her early 20s to early 30s: emotional binge-eating, working out for hours at a time, drinking and compulsive shopping.

But she does remember the childhood that would set her on this destructive path. Her father, a social alcoholic who “couldn’t coexist with other people” without a drink in his hand, was mentally, emotionally, and at times, physically abusive toward Barone, her mother and brother, but not her little sister.

Barone would position herself in front of her mother and brother, trying to draw her father away from them. This would cause Barone to put herself in toxic environments and relationships later in life because she believed, “if I can survive this, I’ll be tougher.”

Early on, she was taking on a protective parental role in place of her childhood. Her parents divorced when she was 12. Barone’s mother, suffering from depression, put herself in the hospital when Barone was 15.

After that, Barone never stopped working. She was determined to put herself through school, and worked full time through her teens. Toward the end of her college years, while she was working three jobs, Barone looked back on her life with anger. She felt like her childhood had been taken away.

But once she graduated and took a job in the corporate world, Barone had extra income for the first time in years. She could do what she wanted. That’s when her dangerous cycles of self-sabotaging behaviors began.

In order to achieve instant gratification and make herself feel better, Barone would indulge with food, eating an entire pizza in one sitting. Then, out of guilt, she would hit the gym for an intense, three-hour workout. After three weeks of working out for three hours nonstop each day, the gym wouldn’t let her check in. They were concerned that she could harm herself with such intense behavior.

“I didn’t want to take responsibility for anything,” she said. “Instead of dealing with all of the fear and the stress I was feeling, I was overcompensating and looking for satisfaction through these behaviors.” Her weight waxed and waned as a result of her behavioral cycle. When her weight would balloon, Barone turned to fat burners and detox supplements, overusing them at times.

She was also shopping all the time, whether it was online or walking in a store and spending $500. Her shoe addiction was out of control. “Yet, the more I gave into the compulsions, the emptier I felt,” she said.

The stress of her job, which was demanding 80- to 100-hour workweeks, mounted on top of her compulsions until Barone found herself in the hospital with severe chest pains. Her massive anxiety had triggered a sliding hiatal hernia. After increasing weight gain and five surgeries while going to graduate school, Barone had finally had enough. At 35 she decided to take stock of her life and turn things around.

She began to ask herself questions: “Why do I want this? Is it just a craving or is this coming from an emotional place? How will I feel about this later?”

The litany of questions guided her through her behaviors and Barone really started getting to know herself for the first time: who she was, what she really wanted in life, how she had created her habits.

Barone left the corporate world and its stresses behind. She started eating a healthy diet that would fuel her energy and positivity. She trained and exercised to achieve her best fitness level without resorting to extremes.

Over the course of her career, Barone had found comfort in working with youth programs. The idea had never left her entirely. She knew there were other people out there like her who found it hard to stop the cycle of self-sabotaging behaviors. By sharing her story, maybe she could help others.

Now, Barone has her own business. You Empowered Strong helps others identify their goals, knock down internal barriers and “destroy the noise” of negative self-talk and fears. She has transformed herself into a certified master coach, CEO, trainer, speaker and author.

But when it comes to overcoming the behaviors that had such control over her life for so many years, Barone said the struggle isn’t over. “I still have to be present and honest with myself to avoid these,” she said. “I call myself a recovering perfectionist and control freak.”

Taking charge and helping others has helped Barone achieve a place where she feels like she’s living her best life. Her friends have also noticed the shift. Lisa Goodpaster, who has known Barone for 30 years, is happy to see that her friend has more peace on the inside these days.

 

“Candy has always been very intelligent, and what one might refer to as a type A personality: very organized, very passionate and knew what she wanted,” she said. “I think the Candy of today is still very much all of those things, but she has used these traits in a positive way to move herself forward, instead of working against herself and self-sabotaging. She now isn’t just as successful on the outside, as she always was, but her success is coming from a deeper place on the inside as well.”

Sarah Koenig, who became fast friends with Barone when they began working together in 2008, was a witness to Barone’s transformation. Before Barone published her children’s book, “Dream Star,” based on a story she used to tell her sister, Koenig was reading a copy of it to her daughter.

“When you are with Candy, she is energy,” Koenig said. “She has harnessed that energy and is doing so much with it to inspire others. The energy was always there, sometimes working for her, sometimes against her. But once she cleared the noise and eliminated the self-sabotage, she harnessed that energy and now uses it in ways that truly serve her community, herself, her clients, family, friends. It’s a powerful, positive force.”

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OnJune 5, 2015, posted in: Latest News by

Statins May Reduce Strokes in Low Risk Elderly Users

Cholesterol-lowering drugs such as statins may reduce the risk of stroke in low-risk elderly patients, a French study suggests.

People who took statins or fibrates, another type of cholesterol-lowering medicine, were 34 percent less likely to have a stroke than those who didn’t, researchers report.

“If confirmed, these results are compatible with the view of keeping elderly individuals on lipid-lowering drugs for longer periods of time,” senior study author Christophe Tzourio, an epidemiology professor at the National Institute of Health and Medical Research and the University of Bordeaux in France, said by email.

Millions of people worldwide take statins to help reduce their blood levels of low-density lipoprotein, known as bad cholesterol because it builds up in blood vessels and can lead to atherosclerosis, clots and heart attacks.

Unless patients have damaged arteries, many doctors recommend against statin use for people over 75 because the benefits are less clear for the elderly and the pills have been linked to side effects including diabetes, cognitive impairment, and liver injury.

Because statins are still widely used among the older patients, Tzourio and colleagues set out to see if they could shed light on the potential benefits of treatment later in life.

They analyzed data from interviews with 7,500 elderly residents of three French cities starting in 1999. At the start of the study, participants were at least 65 years old, with an average age of 74. They had no history of vascular disease or stroke.

About 27 percent of the people in the study took either statins or fibrates to lower cholesterol. These participants were more likely to be female, younger and less educated.

During an average follow up of about nine years, 292 people had a stroke and 440 experienced other cardiovascular events. Strokes were more common among men and participants who were older or had other risk factors such as diabetes, obesity or high blood pressure.

Taking cholesterol pills didn’t lower the risk of vascular events or heart disease, but it did lower the odds of a stroke and death from all causes.

The study doesn’t prove the pills prevent strokes, the researchers acknowledge in the British Medical Journal. Participants in the study were richer, better educated and followed healthier diets than the typical French person, the authors note.

It’s possible that factors other than the drugs helped lower the risk of strokes, said Dr. Francine Welty, a cardiologist at Beth Israel Deaconess Medical Center and Harvard Medical School in Boston who wasn’t involved in the study.

While the current study focused on healthier elderly people who had no prior strokes, it’s possible that the findings might be similar for people who’ve already had at least one stroke, Welty said in an email. Previous research in younger adults has shown statins may prevent a repeat stroke, she said.

“I would expect a similar reduction in older adults because their risk for recurrent stroke may be even higher,” said Welty. “However, until a randomized trial is done in older adults, we don’t know for sure.”

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OnMay 20, 2015, posted in: Latest News by

Concern Over Gardasil Grows Amid Growing Numbers of Adverse Reactions

Numerous reports are appearing across the country of adverse affects of the vaccine Garasil, after it was fast-tracked through the FDA.   A few of the stories that describe this concern are listed below.

 

 

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OnApril 16, 2015, posted in: Latest News by

Why French Kids Don’t Have ADHD

 

In the United States, at least 9% of school-aged children have been diagnosed with ADHD, and are taking pharmaceutical medications. In France, the percentage of kids diagnosed and medicated for ADHD is less than .5%. How come the epidemic of ADHD—which has become firmly established in the United States—has almost completely passed over children in France?

Is ADHD a biological-neurological disorder? Surprisingly, the answer to this question depends on whether you live in France or in the United States. In the United States, child psychiatrists consider ADHD to be a biological disorder with biological causes. The preferred treatment is also biological–psycho stimulant medications such as Ritalin and Adderall.

French child psychiatrists, on the other hand, view ADHD as a medical condition that has psycho-social and situational causes. Instead of treating children’s focusing and behavioral problems with drugs, French doctors prefer to look for the underlying issue that is causing the child distress—not in the child’s brain but in the child’s social context. They then choose to treat the underlying social context problem with psychotherapy or family counseling. This is a very different way of seeing things from the American tendency to attribute all symptoms to a biological dysfunction such as a chemical imbalance in the child’s brain.

 

French child psychiatrists don’t use the same system of classification of childhood emotional problems as American psychiatrists. They do not use the Diagnostic and Statistical Manual of Mental Disorders or DSM.  According to Sociologist Manuel Vallee, the French Federation of Psychiatry developed an alternative classification system as a resistance to the influence of the DSM-3. This alternative was the CFTMEA (Classification Française des Troubles Mentaux de L’Enfant et de L’Adolescent), first released in 1983, and updated in 1988 and 2000. The focus of CFTMEA is on identifying and addressing the underlying psychosocial causes of children’s symptoms, not on finding the best pharmacological bandaids with which to mask symptoms.

To the extent that French clinicians are successful at finding and repairing what has gone awry in the child’s social context, fewer children qualify for the ADHD diagnosis. Moreover, the definition of ADHD is not as broad as in the American system, which, in my view, tends to “pathologize” much of what is normal childhood behavior. The DSM specifically does not consider underlying causes. It thus leads clinicians to give the ADHD diagnosis to a much larger number of symptomatic children, while also encouraging them to treat those children with pharmaceuticals.

The French holistic, psychosocial approach also allows for considering nutritional causes for ADHD-type symptoms—specifically the fact that the behavior of some children is worsened after eating foods with artificial colors, certain preservatives, and/or allergens. Clinicians who work with troubled children in this country—not to mention parents of many ADHD kids—are well aware that dietary interventions can sometimes help a child’s problem. In the United States, the strict focus on pharmaceutical treatment of ADHD, however, encourages clinicians to ignore the influence of dietary factors on children’s behavior.

And then, of course, there are the vastly different philosophies of child-rearing in the United States and France. These divergent philosophies could account for why French children are generally better-behaved than their American counterparts. Pamela Druckerman highlights the divergent parenting styles in her recent book, Bringing up Bébé. I believe her insights are relevant to a discussion of why French children are not diagnosed with ADHD in anything like the numbers we are seeing in the United States.

From the time their children are born, French parents provide them with a firm cadre—the word means “frame” or “structure.” Children are not allowed, for example, to snack whenever they want. Mealtimes are at four specific times of the day. French children learn to wait patiently for meals, rather than eating snack foods whenever they feel like it. French babies, too, are expected to conform to limits set by parents and not by their crying selves. French parents let their babies “cry it out” (for no more than a few minutes of course) if they are not sleeping through the night at the age of four months.

French parents, Druckerman observes, love their children just as much as American parents. They give them piano lessons, take them to sports practice, and encourage them to make the most of their talents. But French parents have a different philosophy of discipline. Consistently enforced limits, in the French view, make children feel safe and secure. Clear limits, they believe, actually make a child feel happier and safer—something that is congruent with my own experience as both a therapist and a parent. Finally, French parents believe that hearing the word “no” rescues children from the “tyranny of their own desires.” And spanking, when used judiciously, is not considered child abuse in France. (Author’s note: I am not personally in favor of spanking children).

As a therapist who works with children, it makes perfect sense to me that French children don’t need medications to control their behavior because they learn self-control early in their lives. The children grow up in families in which the rules are well-understood, and a clear family hierarchy is firmly in place. In French families, as Druckerman describes them, parents are firmly in charge of their kids—instead of the American family style, in which the situation is all too often vice versa.

 

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OnJanuary 22, 2015, posted in: Latest News by

Bad Flu Season Expected

(CNN)The flu season is at the midway point, and it’s shaping up to be a difficult one, according to the Centers for Disease Control and Prevention.

At a press conference Friday in Atlanta, CDC Director Dr. Tom Frieden said the season has been particularly bad for people 65 and older.

Frieden also said that five more children have died sincethe CDC last reported figures, bringing the number of pediatric deaths up to 26 since the flu season began in the fall. The deaths, however, are believed to be higher due to delays in reporting.

Adult deaths are not tracked, but the CDC said that the elderly and people with underlying health conditions are vulnerable to this strain of the flu.

Frieden advises doctors to treat people who are sick with the flu with anti-viral medications. Anti-viral medications are dramatically under prescribed and could prevent thousands of hospitalizations and may even save people from death, he said.

But pediatrician Lisa Thebner cautions that “not everyone needs antivirals.” She said, “They are mostly recommended for those who are most at risk for complications,” meaning the very young or old.

Frieden said some doctors don’t think the medications work, but if given early, they help ease some of the symptoms of the flu.

The CDC had predicted the season would be a bad one after most of the samples taken from people with the flu tested positive for the H3N2 strain. That strain of virus is “nastier,” according to Frieden, and generally makes people sicker and results in more hospitalizations and deaths.

The CDC reports that most states are seeing widespread cases of flu. In states where the flu season started earlier, it may be slowing down, but there are still weeks of flu left. The flu season usually lasts into the spring.

With that in mind, Frieden suggests to go get a flu shot if you haven’t been vaccinated.

The flu shot this year is not a perfect match for the virus that mutated, but it is the best protection available for people and can lessen the severity of the illness.

 

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OnJanuary 14, 2015, posted in: Latest News by