September 27th, 2008
Many people are ready and willing to have their blood pressure checked regularly, but they are uncertain about where to go to have it measured. If you visit your doctor a few times each year, you shouldn’t have any trouble monitoring your blood pressure. Most doctors will check your blood pressure at every office visit.
Many doctors even encourage their patients to stop by the office for
blood pressure measurements anytime during office hours without having to make an appointment. The nurse can take your blood pressure and record it on your chart. However, not everyone has a family doctor or goes to a doctor regularly. Fortunately, you don’t need to go to a doctor’s office every time you want to measure your blood pressure.
Many sports centers, pharmacies and supermarkets have blood pressure monitoring machines that you can use free of charge. It only takes a minute or two to get your blood pressure reading.
Although these devices might not be quite as accurate as the blood pressure cuff at your doctor’s office, they work fine for a rough estimate. Try one the next time you visit your pharmacy or supermarket.
In addition to supermarkets and pharmacies, many fire stations have personnel and equipment for measuring blood pressure. The firemen or emergency medical technicians are usually more than happy to measure your blood pressure. In fact, some fire stations actually advertise this service to the public and encourage anyone to stop by for a quick check. County health departments also are perfect places for regular blood pressure measurements for anyone in the county. These services are usually free of charge for county residents.
People with busy schedules or strange work shifts often find it difficult to make special trips for blood pressure readings. In those cases, it might be easier or more practical to purchase a blood pressure device to use at home. Your doctor or pharmacist can tell you where you can buy a standard sphygmomanometer for home blood pressure measurements.
Most medical supply stores even carry electronic blood pressure devices. These electronic measuring devices are usually battery operated and are a bit easier to operate than the standard sphygmomanometers.
With electronic devices, you don’t have to inflate and deflate the cuff and try to listen with the stethoscope all at the same time. The machine does all that for you. Either way, standard or electronic, home devices allow the convenience of quick and frequent blood pressure checks without ever having to leave your home.
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September 24th, 2008
Measuring your own blood pressure has become convenient. You can do it on a coin operated machine in some stores or purchase a device like the one your doctor uses or one of the new electronic, battery-operated devices. The device for measuring blood pressure is called a sphygmomanometer.
Measuring blood pressure is simple. You wrap a band (the cuff) around your arm and stop all blood flow. Then, just below the band, you listen with a stethoscope to an artery and slowly release the band. As the blood starts flowing, the left ventricle or the systolic pressure comes through (the high number). As the lower pressure comes through, the beats stop, and the second sound is steady; that’s the background pressure or the diastolic pressure (the low number).
The cuff is hooked to a pressure-sensing device, which is activated by pumping up the cuff. In the doctor’s office, mercury is used to measure pressure, but many newer electronic devices are calibrated against a standard column of mercury and are almost as accurate. The electronic sphygmomanometer has a sound-sensing device more sensitive and objective than the human ear, so there’s no need for a stethoscope.
It is suggested that you purchase one of the newer battery operated, electronic sphygmomanometers that give you your systolic and diastolic blood pressures and pulse rate in one reading. They are sold in most drugstores, some discount and health stores, through mail order catalogs, and over the Internet. The sphygmomanometer you purchase will have directions on its use.
Here are a few commonalities that apply to all of them:
1. Wrap the cuff snugly but not tightly.
2. Pump the pressure in the cuff sufficiently to stop blood flow; about 200 to 225 millimeters is enough. When you’re back in shape, 150 will be plenty.
3. Let the air drain from the cuff slowly and steadily. Many devices do this automatically.
4. Do not take only one measurement; use several measurements.
5. Always measure with your elbow resting on a table at about the level of your heart, or midchest.
The battery-operated devices don’t always give consistent measurements when used repeatedly in succession due to current surges and charge buildup. Inaccurate readings can also result from low batteries. If you opt for this type, be sure the batteries are good and always allow a few minutes between measurements.
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September 20th, 2008
Of all the issues related to high blood pressure, none is more controversial than salt, more specifically the sodium in salt. Since the 1970s, health organizations have advised Americans - especially those with high blood pressure - to limit their intake of sodium. The recommendation stems from studies showing that a reduction in sodium can lower your blood pressure if you’re “sodium-sensitive.” But what if you’re not sodium-sensitive? And how should you interpret more recent studies suggesting that your weight and other aspects of your diet may be more important than limiting sodium?
Sodium is an essential mineral. Its main role is to help maintain the right balance of fluids in your body. It also helps transmit nerve impulses that influence contraction and relaxation of your muscles. You get sodium from the foods you eat. Many foods naturally contain some sodium. However, most sodium comes from sodium compounds added to food during commercial processing and meal preparation at home.
Salt (sodium chloride) is the most common source of sodium. It’s made up of 40 percent sodium and 60 percent chloride. You need a minimum of 500 milligrams (mg) of sodium each day. That’s a little more than teaspoon of salt. However, most Americans consume 3,000 to 4,000 mg of sodium daily.
Your kidneys regulate the amount of sodium in your body. When your sodium levels are low, they conserve sodium. When your levels are high, they excrete the excess amount in your urine. Sometimes your kidneys can’t eliminate enough sodium. Extra sodium starts to accumulate in your blood, and because sodium attracts and holds water, your blood volume increases. Your heart has to work harder to move the increased volume of blood through your blood vessels, increasing pressure on your arteries. Heart, kidney, liver and lung disease can all lead to an inability to regulate sodium. In addition, some people are simply more sensitive to the presence of high levels of sodium in their blood.
How people react to sodium varies. Some people, both healthy adults and people with high blood pressure, can consume as much sodium as they like and it has no or little effect on their blood pressure. For others, too much sodium quickly leads to an increase in blood pressure, often triggering the development of high blood pressure. This condition is referred to as sodium or salt sensitivity.
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September 19th, 2008
Everyone wants a strong heart. But sometimes it can grow too strong for its own good. When your blood pressure rises, your heart must work extra hard to pump blood. The heart reacts by growing bigger - just as your biceps would if you started lifting weights. Unfortunately, bigger isn’t better where your heart is concerned. If the heart wall grows too large, it reduces the space inside your left ventricle (that’s the chamber within the heart that pumps blood into the bloodstream). This condition is known as left ventricular hypertrophy.
The enlarged heart muscle now needs additional blood to keep itself healthy. But because hypertension can lead to hardening of the arteries—especially the arteries in the heart itself—the muscle sometimes can’t get enough blood. The heart then becomes weaker, not stronger, since it can’t feed itself properly.
The result is a host of problems, ranging from chest pain called angina to irregular heartbeats, heart attack, and heart failure. Left ventricular hypertrophy occurs more often in men and overweight people, both of whom are more prone to heart disease to begin with. But when women develop the disorder, the results can be deadly. Researchers have discovered that women with left ventricular hypertrophy may be four times more likely to die of any cause (even those not related to heart problems) than women without the condition.
Reducing high blood pressure may stop dangerous growth of the heart muscle and may even reduce the muscle’s size. So it’s essential that you work to lower your pressure to avoid further problems from left ventricular hypertrophy.
An enlarged heart is not the only possibility of damage. Your eyes also can be affected. Your eyes are very sensitive to hypertension, since they have extremely fine arteries feeding blood to them. Left unchecked, high blood pressure can greatly damage these delicate blood vessels. The walls of the arteries grow thicker so that they can handle the additional pressure from the bloodstream. This in turn causes the arteries to narrow. When this happens, blockages can occur - or the arteries may hemorrhage, causing blood to leak into the eyes. Either way, this can harm the optic nerves and cause partial loss of vision.
The higher your blood pressure and the longer it’s left untreated, the higher the possibility of eye damage. Fortunately, lowering your pressure can actually help reverse some of the harm. Be sure to tell your eye doctor about your condition, so he can monitor your eyes for signs of damage.
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September 14th, 2008
What’s so bad about high blood pressure? Oh there is plenty! Your heart, kidneys, and other organs, as well as your blood vessels, simply aren’t designed to handle constant pressure. They need to relax at lower pressure levels to stay healthy. Over time, hypertension can lead to serious health problems, including the following:
Hypertension is the leading cause of stroke. That’s because high blood pressure can cause atherosclerosis (also known as hardening of the arteries), a condition in which sticky stuff called plaque attaches itself to the inside walls of arteries and slows the flow of blood. Doctors aren’t quite sure how this happens. They believe that high blood pressure might injure the cells that line your arteries. This may lead to chemical reactions that make the cholesterol flowing through your blood attach to artery walls. Over time, this can cause plaque deposits.
When an artery feeding your brain gets too narrow because of plaque, you’re at risk of what’s called an ischemic stroke, in which a blood clot gets stuck in the narrowed section of the blood vessel. Suddenly, blood can’t flow to the brain. Without blood, brain cells can’t get oxygen and may start to die. A full-blown ischemic stroke can be fatal.
A burst blood vessel in the brain can cause a very serious type of stroke called a hemorrhagic stroke. Unlike an ischemic stroke, which is caused by a blockage, a hemorrhagic stroke occurs when blood from the broken artery spills into the brain, causing pressure to build up in the skull. This can deprive parts of the brain of vital oxygen. The result can be irreversible brain damage. People with hypertension are far more likely to suffer hemorrhagic strokes than people with normal blood pressure.
People with hypertension also are more likely to experience transient ischemic attacks, or mini-strokes. These are like ischemic strokes, except that the blockage either isn’t complete or eventually opens up. While not always as serious as ischemic strokes, mini-strokes can cause permanent damage to the brain over time. Depending on where the blockage occurs, you could lose control over parts of your body, have difficulty with speech, or develop any number of other problems.
Hypertension also increases your chances of developing an irregular heartbeat. One type of irregular heartbeat is called atrial fibrillation. This jumpy heartbeat can force a blood clot out of the heart and into the body. If the clot finds its way to the brain, it can cause a stroke. Men with high blood pressure are 50 percent more likely to develop atrial fibrillation than men with normal pressure. Women with high blood pressure have a 40 percent greater risk than women with normal pressure.
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September 13th, 2008
Approximately 40 percent of people with high blood pressure are sodium sensitive. In addition, people with diabetes tend to be more sensitive to high levels of sodium. Exactly what causes sodium sensitivity is not known. Genetics may play a role in some cases. There’s no easy way to tell if you’re sodium-sensitive other than to limit your consumption of sodium and see if doing so lowers your blood pressure. Medical tests can pinpoint your response to varying levels of sodium, but testing isn’t practical or necessary.
If you’re sensitive to sodium, following a low-sodium diet will likely produce a noticeable reduction in your blood pressure. If you have high blood pressure, your doctor also may recommend a diuretic medication that eliminates excess fluid from your blood. Even if you take a diuretic, you still need to avoid too much sodium. If you don’t, the drug may cause you to lose excessive amounts of other essential minerals, such as potassium and magnesium.
The National High Blood Pressure Education Program, sponsored by the National Institutes of Health, recommends that all Americans limit sodium to 2,400 mg a day. That’s equivalent to about a teaspoon of salt. Many health professionals and organizations, including doctors in Mayo Clinic’s Division of Hypertension, support this recommendation. Here’s why:
* If you have high blood pressure and you’re sodium-sensitive, reducing sodium can lower your blood pressure. Limiting sodium in combination with other lifestyle changes, such as following a healthful diet and increasing your activity level, may be enough to keep you from having to take medication to control your blood pressure.
* If you’re taking blood pressure medication, limiting sodium can help increase the effectiveness of the drug.
* If you’re at risk for high blood pressure, limiting sodium along with other lifestyle changes may help prevent development of the disease.
* If you’re healthy, limiting sodium as part of a healthful diet is safe and reasonable. In addition, it may keep you from becoming at risk for the disease as you get older, when high blood pressure is more prevalent and your sensitivity to sodium often increases.
Although it hasn’t been proven that reducing sodium will reduce your risk for high blood pressure, large population studies show that when people cut back on sodium their blood pressures decrease. There are also fewer deaths from heart attack and stroke. This suggests that the average person, especially one with a family history of high blood pressure, may benefit from reducing sodium.
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September 9th, 2008
What do a stick of butter and a bottle of olive oil have in common? They’re both fat and provide 9 calories per gram or 252 calories per ounce - about 85 calories per tablespoon. But olive oil is much better for you than butter.
Most animal fat, for example butter or the white fat around beef, is solid at room temperature. In contrast, vegetable fat, more specifically vegetable oil, is liquid at room temperature. It’s obvious why nutritionists call animal fat “hard fat” and vegetable oil “soft fat.”
Saturated and unsaturated fats differ in their chemical structure. The terms saturated and unsaturated refer specifically to their chemical structure or molecular configuration. Chemists tell us the structure of highly saturated or hard fat is dense and uniform because the molecular linkages holding the carbon atoms together are all used up. In contrast, vegetable oils are not dense and uniform. The linkages holding their carbon atoms together are not used up. The spaces in their molecular structure are open and reactive. When you see “hydrogenated vegetable oil” on a label, it means hydrogen was added to those open spaces, which turns the oil into a solid fat. Olive oil, a monounsaturated fatty acid (MFA), is an excellent example of an oil that has only one open space. MFA oils are liquid at room temperature, tend to be amber in color, and are somewhat thick or moderately viscous.
Beef lard is a saturated fatty acid (SFA). SFAs are not liquid at room temperature; they are white and hard. This is true of most animal fat.
Sunflower oil is a polyunsaturated fatty acid (PUFA) - an oil that has many open spaces. PUFA oils vary in their degree of saturation. The more unsaturated they are, the lighter in color and the more fluid they are. Some are nearly as clear as water.
PUFAs help keep blood pressure normal. In fact, some of these oils can help reduce blood pressure. Vegetable oil supplies linoleic acid, a plant oil essential for health. Linoleic acid is the raw material for prostaglandin number 2 (PG2), a substance the body produces. PG2 and other materials produced from it are important in the relaxation and contraction of the muscles that line the arterioles. Therefore, linoleic acid has a metabolic effect that helps to maintain normal blood pressure.
PUFAs also reduce blood pressure by reducing blood viscosity. Remember that reduced viscosity decreases total peripheral resistance to blood flow, and decreased resistance means lower blood pressure.
Saturated fats have a tendency to increase blood pressure by increasing blood viscosity. Increased viscosity contributes to total peripheral resistance, and that increases blood pressure. Obviously, the dietary objective should be to reduce saturated fat; emphasize the unsaturated fat in the diet; and obtain sufficient amounts of a special PUFA, called the omega-3 oils, from fish and vegetable sources. These changes are achieved by shifting emphasis from meat and butter to foods that contain unsaturated fats.
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September 2nd, 2008
Plenty of drugs are on the market that actually raise blood pressure on their own or because they block the action of a drug that lowers blood pressure. If you can possibly avoid them, do so. Sometimes, however, the problem that makes you need the other drug is so severe that you can’t avoid it. You then have to use the drugs for high blood pressure to overcome the blood pressure elevation of the essential drug.
Monitor your blood pressure whenever you start or stop a drug. The new drug may raise the blood pressure or block your own blood pressure drugs. A drug that you were taking and are now stopping may also have interacted with your blood pressure medication in some way, so that your pressure was under control when you used the drug but will rise when you stop it.
Many cold medications contain drugs that cause constriction of arteries and elevation of blood pressure. You need to read the label on any cold medication that you plan to use. The label should say clearly that it contains medications that should not be taken by a person who has high blood pressure. If uncertain, check with your doctor before you use it.
Of the drugs that your doctor may prescribe for you, many steroids, such as cortisone or prednisone, raise blood pressure. Several of the antidepressant drugs, particularly trimipramine and venlafaxine, have caused sustained increases in blood pressure. Other antidepressant drugs from the class called monoamine oxidase inhibitors raise blood pressure by preventing the breakdown of epinephrine. Drugs in this class include phenylzine and tranylcypromine. Any of the nonsteroidal anti-inflammatory agents also raise blood pressure.
Certain drugs that fight against your blood pressure medications make your blood pressure medication less effective. Numerous drugs fall into this category, some of which you can’t avoid if you have certain problems. For example, if you have kidney disease, you may have to take erythropoietin to combat anemia. As much as you don’t need another way for your blood pressure to elevate, erythropoietin will do it. But you have to take it because it’s the only way to increase your blood count, besides transfusions, which don’t tend to keep your count higher for very long.
Colestipol, a drug for lowering cholesterol, is another one that fights against blood pressure medications. Fortunately, the choices for treating cholesterol are numerous, so this drug can be stopped, if necessary. Cholestyramine is also a cholesterol-lowering drug with the same tendency to raise blood pressure.
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September 1st, 2008
Besides lowering blood pressure, all antihypertensive drugs can produce undesirable side effects. This is not surprising, since they alter basic body functions not only in the blood vessels but in the nervous system and kidneys as well. Since they alter basic functions, all drugs must have several effects. Even if a drug acts on only one type of molecule in the body, because all systems in the body are interconnected it almost certainly will produce other effects.
As examples, by limiting the ability of the heart to beat faster, beta blockers reduce the ability of a person to exercise, and thiazide diuretics produce abnormal changes in the composition of body fluids, including blood cholesterol. So by altering basic bodily functions, drugs affect the ability of the body to adapt to different situations.
Typical side effects of some of the more commonly used antihypertensive drugs include urinary loss of potassium, fatigue, gastric irritation, nausea, vomiting, abdominal cramps, diarrhea, dizziness, headache, rash, weakness, nasal congestion, impotence (loss of sex drive), congestive heart failure, mental depression, short-term memory loss,12 and in the case of beta blockers, reduction of ability to exercise. In fact, the reduction in blood pressure is associated not with improvement in the function of the cardiovascular system, but rather with a suppression of cardiac function. Sometimes other drugs are added to treat these side effects. In addition, antihypertensive drugs may adversely affect other diseases.
How common are complications due to these drugs? Well, in a government sponsored study of over five thousand patients being treated with drugs for high blood pressure, it turned out that the drug-treated group had fewer strokes, but a worse outcome in coronary disease. In fact, after ten years of treatment, death due to coronary heart disease was significantly greater in the drug-treated group than in the untreated group. However, no significant effect upon overall rate of death was observed.
Altogether, these studies were seen to justify the assumption that antihypertensive drug treatment saves lives and reduces fatal and nonfatal complications of this threat to health. So in spite of the fact that some physicians had begun to worry about the increasing number of totally unexpected adverse effects for the last forty-five years almost all people diagnosed as having primary hypertension have faced the prospect of a lifetime of treatment with drugs.
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