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Navigating the Levels and Varieties of High Blood Pressure

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Knowing how to interpret your blood pressure readings, especially if you’re over 50, can be pivotal to your health. Distinguishing between the different stages and types of hypertension might seem daunting, but demystifying the numbers can empower you to take the necessary precautions and actions.

The American College of Cardiology/American Heart Association (AHA) marked a turning point in 2017 when it updated its guidelines to classify hypertension as a blood pressure reading of 130/80 mm Hg or higher. This update signalled a new health risk for a significant proportion of the population, particularly older adults.

With age, the major arteries in our bodies can stiffen. This hardening of arteries can result in high blood pressure, a condition that can cause severe complications if left unchecked or unmanaged. Heart disease, stroke, kidney disease, eye problems, and even cognitive decline are potential outcomes. Therefore, a shocking 46% of adults in the U.S., according to AHA estimates, are categorized as having high blood pressure.

Being aware of your blood pressure levels is the first step. If your systolic pressure stands between 120-129 mm Hg and your diastolic pressure is under 80 mm Hg, you fall into the elevated range. Risk factors at this stage typically include inactive lifestyle, poor diet, and family history. Proactive lifestyle changes at this stage can prevent further progression.

Jordana Cohen, M.D., an associate professor of medicine at the Hospital of the University of Pennsylvania, advises that patients over the age of 75, smokers, or those with risk factors for diabetes, kidney disease, high cholesterol, or heart disease should consider a reading of 130/80 mm Hg as a signal to speak with a doctor.
“On the other hand, under the age of 75 and [with] no other risk factors, 140/90 is when we really start treatment,” she counsels.

Moving up the scale, a systolic pressure of 130-139 mm Hg or a diastolic pressure of 80-89 mm Hg indicates stage 1 hypertension. Those over 50 in this stage face higher risk of cardiovascular diseases. It’s vital at this point to monitor regularly and make lifestyle changes like reducing sodium intake and increasing physical activity.

Benjamin Galper, M.D., a cardiologist at Kaiser Permanente, underscores the importance of managing blood pressure effectively, particularly for those above 50.
“For my patients, I recommend starting medication if their blood pressure reaches stage 1 … and lifestyle changes, including exercise and nutrition adjustments, are not allowing them to reach their goal.”

The highest level, stage 2 hypertension, is marked by a systolic pressure of 140 mm Hg or higher or a diastolic pressure of 90 mm Hg or above. This stage puts individuals at a high risk for heart attacks, strokes, and kidney damage, necessitating immediate medical intervention and lifestyle adjustments.

To ensure that your blood pressure readings are accurate, Dr. Cohen suggests taking readings about 30 seconds to a minute apart, twice daily – once in the morning and once before bed, ideally an hour after dinner. This should be done at least three days per month.

Hypertensive urgency, or uncontrolled hypertension as Dr. Cohen terms it, arises when blood pressure exceeds the 180/120 mark without causing symptoms of damage to vital organs like the heart, brain, kidneys or eyes. In case of seeing these numbers, it’s critical to double-check the reading and seek immediate medical assistance to adjust the treatment plan and avert potential damage.

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Sleep Alert: How One Habit May Increase Heart Attack and Stroke Risk by 26%

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As children, many of us had set bedtimes dictated by our parents, ensuring we got the rest we needed. However, as adults, we have the freedom to choose our own sleep schedules. Despite this autonomy, maintaining a consistent sleep routine might be more beneficial than we realize. A recent study suggests that varying your sleep and wake times could significantly increase your risk of serious cardiovascular issues, such as heart attacks and strokes.

The study, published in the Journal of Epidemiology & Community Health, investigated the sleep patterns of 72,269 individuals aged 40 to 70. These participants were part of the UK Biobank study and wore activity trackers for a week to monitor their sleep. The data collected was used to calculate each participant’s Sleep Regularity Index (SRI) score, which measures the consistency of sleep-wake patterns across consecutive days.

Participants were categorized based on their SRI scores: those scoring over 87 were considered regular sleepers, scores between 72 and 87 indicated moderately irregular sleepers, and scores below 72 were classified as irregular sleepers. Interestingly, regular sleepers were more likely to achieve the recommended seven to nine hours of sleep per night for adults under 65, and seven to eight hours for those over 65.

Over the following eight years, researchers compared these sleep regularity scores with the incidence of cardiovascular events and related deaths. The findings were striking. Irregular sleepers had a 26% increased risk of experiencing major cardiovascular events compared to their regular sleeping counterparts. Even those who were moderately irregular faced an 8% higher risk.

The study authors noted, “Our results suggest that sleep regularity may be more relevant than sufficient sleep duration in modulating MACE [major adverse cardiovascular event] risk.” This implies that even if one gets the recommended amount of sleep, irregular sleep patterns can still pose a significant health risk.

In a press release, the researchers emphasized the importance of sleep consistency in public health guidelines and clinical practices, highlighting its potential impact on cardiovascular health. Lead study author Jean-Philippe Chaput, PhD, from the University of Ottawa, shared with CNN that while exact sleep and wake times aren’t necessary, staying within 30 to 60 minutes of your usual schedule is beneficial.

“Small variations are fine, but consistent sleep patterns improve sleep quality, boost mood and cognitive function, and lower the risk of health issues like heart disease and diabetes,” Chaput explained.

Despite its compelling findings, the study did have limitations. The authors pointed out that it was observational, meaning it could not establish a direct cause-and-effect relationship. Sleep was only monitored for one week, which might not provide a complete picture of long-term patterns. Additionally, the data may not fully represent the broader UK population, and the activity trackers used could not distinguish between quiet wakefulness and sleep or account for napping in the SRI scores.

Overall, this research underscores the importance of maintaining a regular sleep schedule for cardiovascular health, suggesting that consistency in sleep might be as crucial as the amount of sleep itself.

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Heart Medications That May Protect Your Brain and One to Watch Out For

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As we continue to explore ways to protect our cognitive health as we age, a new study highlights the potential role of common heart medications in reducing dementia risk. While lifestyle changes like diet and exercise have long been recommended, this research suggests that certain medications could provide additional benefits. However, not all heart drugs are created equal, and one in particular might even increase the risk of dementia. Let’s take a closer look at these findings.

Diuretics

Diuretics, commonly known as water pills, are often used to manage blood pressure by helping the body eliminate excess fluid. The study indicates that these medications could also play a role in reducing dementia risk. Researchers suggest that diuretics might “exert antioxidant and neuroprotective effects” by preserving potassium or uric acid levels. This protective mechanism could contribute to the lower risk of dementia observed in those who use these drugs long-term.

Renin-Angiotensin System (RAS)-Acting Agents

RAS-acting agents are another class of drugs used to treat high blood pressure. According to the study, these medications may specifically help ward off Alzheimer’s disease by safeguarding certain brain mechanisms. The researchers noted, “We can see a clear link between long-term use—five years or more—of these drugs and reduced risk of dementia in older age.” This suggests that maintaining consistent use of these medications could be beneficial for cognitive health.

Cholesterol-Lowering Drugs

Cholesterol-lowering medications, such as statins, are known for their role in managing heart health. The study found that these drugs might also lower the risk of dementia by preventing plaque buildup in blood vessels, which can impede blood flow to the brain. The combination of cholesterol-lowering drugs and blood pressure medications was particularly effective, further reducing dementia risk. “Previous studies have focused on individual drugs and specific patient groups but in this study, we take a broader approach,” explained Alexandra Wennberg, PhD, co-lead study author.

Combination Therapy

The study highlights the benefits of using a combination of the aforementioned drugs. Individuals taking two to three different treatments experienced a significant reduction in dementia risk, with a decrease of 27 to 30 percent. This suggests that a multi-faceted approach to managing heart health could also support cognitive well-being.

Antiplatelet Drugs

While many heart medications show promise in reducing dementia risk, antiplatelet drugs, such as aspirin, may have the opposite effect. These medications are used to prevent strokes by stopping platelets from clumping together. However, the study found that they might increase the risk of microbleeds in the brain, which is linked to cognitive decline. People taking these drugs had a 13 to 25 percent higher risk of developing dementia.

This study sheds light on the complex relationship between heart medications and dementia risk. While certain drugs show promise in reducing the likelihood of cognitive decline, others may pose a risk. It’s important for individuals to consult with healthcare professionals to determine the best course of action for both heart and brain health.

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Expert Reveals Top 3 Gut Health Mistakes to Avoid

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The intricate world of gut health is gaining increasing attention as researchers uncover its profound influence on our overall well-being. The gut microbiome, a complex ecosystem of over 100 trillion microbes, including bacteria, fungi, yeast, and viruses, plays a crucial role in how our body functions. This collection of microorganisms is so influential that experts often refer to it as the “second brain,” according to registered dietitian Kristian Kirkpatrick, RD.

Endocrinologist and researcher Max Nieuwdorp, PhD, emphasizes the importance of maintaining a healthy gut microbiome for balanced hormone levels. In his book, *The Power of Hormones*, Nieuwdorp details how gut microbes are instrumental in the release and production of hormones, impacting critical processes like metabolism and mood. He shares three key things to avoid for optimal gut health.

One major dietary change Nieuwdorp recommends is reducing red meat consumption. During an interview with Business Insider, he explained that red meat can alter the gut microbiome’s composition by producing “dangerous” metabolites during digestion.

“I try to not eat meat every day,” Nieuwdorp said.

While protein is essential, a diet heavily reliant on red meat can increase the risk of various health issues, including diabetes, heart disease, stroke, and colorectal cancer. Red meat is also known for its high cholesterol, saturated fats, and sodium content.

Ultra-processed foods are another group Nieuwdorp steers clear of. These include sweetened breakfast cereals, processed meats, sodas, and some frozen meals. Instead, he opts for fresh foods without preservatives or additives.

Gastroenterologist Preeya Goyal, MD, highlights the dangers of ultra-processed foods, noting, “Ultra-processed foods contain large quantities of saturated fat and trans-fat, added sugar, salt, and food additives that seriously affect the gut and physical health.”

Finally, Nieuwdorp is cautious about antibiotics, using them only when absolutely necessary. He warns, “They drive dysbiosis in the gut.”

Dysbiosis, as explained by the Cleveland Clinic, is an imbalance in the diversity of gut microorganisms, making individuals more susceptible to infections and disrupting essential functions normally provided by a healthy microbiome. This imbalance can also adversely affect hormone function.

By avoiding these common pitfalls, Nieuwdorp advocates for a balanced gut microbiome, which in turn supports overall health and well-being.

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