Tag Archive for: blood pressure

Blood Pressure: Getting It Right

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The change in the clinical guidelines for diagnosing high blood pressure, as described in Tuesday’s memo, requires that your BP reading is done correctly. That could be a problem.

In a JAMA Medical News report published in August, medical students were asked to take the BP of volunteers. Only one out of 159 got all the steps correctly. It’s not that they were poor at the actual mechanics of taking the BP, but they didn’t follow all 11 steps. Yes, 11 steps. Here they are:

  1. Five minutes of rest; that eliminates the rise in BP from getting to the office, checking in, getting weighed, etc. This is the step most often missed.
  2. The correct size cuff should be used. If your upper arms are large, and the nurse or doctor doesn’t use a large cuff, your BP reading will be higher. That’s because the bladder inside the cuff will have an artificially high pressure, which is reflected in the reading.
  3. The cuff should be placed over a bare arm, not over clothing. It’s your job to remember to wear something with a loose sleeve that won’t get in the way.
  4. The arm should be supported on a desk or a table, not hanging free.
  5. The patient should be asked not to talk. The doctor has to be able to hear the sounds clearly to get an accurate reading. This is not the time to discuss new restaurants.
  6. Legs should be uncrossed because that can affect blood flow.
  7. Feet should be flat on the floor.
  8. No reading or cell phones during measurement. There are a couple of reasons for this one. Holding the phone or book is an isometric contraction albeit a small one; nevertheless, it can raise the BP reading. The other reason is that if you’re checking email or something like that, it can affect your reading if your heart rate gets elevated.
  9. The BP in both arms should be checked.
  10. The arm with the higher reading should be noted.
  11. Finally, the physician should note in the records which arm is to be used in future readings.

Who knew taking a BP was so complicated? The photo above gets at least three steps wrong. Now that you know, you can make sure you do your part whether you’re told to or not.

But what’s going to happen if you hit higher numbers? I know many people suspect this is just a way to push more BP meds. We’ll look at treatment regulations on Saturday.

What are you prepared to do today?

Dr. Chet

 

Reference: JAMA Online. Abassi 08-30-2017.

 

Do You Have High Blood Pressure?

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On Monday November 13, you may have awakened with normal blood pressure, and by that afternoon, you may have joined the ranks of those with high blood pressure (HBP). That’s when the American Heart Association (AHA) released their new HBP clinical practice guidelines at their national conference. With the new guidelines, close to half of all adults will be diagnosed with HBP.

The guidelines are the topic for this week’s Memos. I downloaded the entire document—all 481 pages—and three important parts warrant discussion. The first is AHA’s new guidelines for diagnosing HBP, and those numbers are in the graphic above.

While there are numerous questions, the first one is this: is your BP being taken correctly? That’s the topic for Thursday’s Memo, and you’ll be surprised at how often it’s done poorly.

What are you prepared to do today?

Dr. Chet

 

Reference: Hypertension. 2017;00:e000-e000.

 

Research on Nature and Health

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I’m back on the deck to write today’s message about the benefits of spending time with nature (1). Researchers tested over 1,500 subjects who live in urban settings; they wanted to quantify visits to parks in cities with physical measures such as depression, blood pressure, social interactions, and physical activity (2). If you’re a long-time reader, you know I prefer studies with solid measurements such as body weight or cholesterol levels. Surveys and questionnaires are subject to how a person feels at any given moment, but these researchers used the best instruments available.

They found . . .

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Blood Pressure: Lifestyle First

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Today I’m going to share a caution from one of the lead authors in the Mayo Clinic arm of the study and tell you what I think is the biggest mistake the researchers made in announcing the preliminary results of the SPRINT Study.

The Mayo Clinic posted a video from Dr. William Haley, a lead researcher in the SPRINT Study; remember there were 102 different clinical sites that provided data for this study. What he said was significant. Here’s my interpretation: The results of a large study such . . .

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Blood Pressure: More Drugs

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Continuing our look at the SPRINT Study from Tuesday, the study showed a significant reduction in mortality from cardiovascular events such as heart attacks and strokes in subjects older than 50. I can’t argue that those are important results. The question is how did they do it? Here’s how: The group of subjects whose target systolic blood pressure (SBP) was less than 140 were treated with an average of two antihypertensive medications. What did they do with the group whose target SPB was less than . . .

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Blood Pressure: A Moving Target

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In a press release this past weekend, the National Institute of Health released preliminary results of the SPRINT Study (Systolic Blood Pressure Intervention Trial) sponsored by the National Heart, Lung, and Blood Institute. It reported that lowering the target systolic blood pressure (SBP) from 140 mm Hg to 120 mm Hg in people over 50 years old significantly reduced the death rate and cardiovascular events such as heart attacks and strokes.

The subjects were recruited from 102 clinical centers throughout the U.S. (1). The conditions for inclusion in the trial were that men and women must be 50 or . . .

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Drinking Your Phytonutrients: The Bottom Line

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To finish this series, I’ll briefly cover two recent research studies on coffee and tea, and then give you the bottom line and a recipe.
 
Research
Green Tea and Neuronal Mitochondria
The mitochondria are the powerhouses of the cells, and that includes brain cells. When they operate at peak activity, they provide our brains with the energy for learning and memory. The downside is that they produce many free radicals in the process, and if we don’t have antioxidants to quench those free radicals, it can cause a decline in mental function. Researchers have recently . . .

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Keeping Track of Life’s Simple 7

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To complete American Heart Month, here’s an easy way to track your heart health called Life’s Simple 7 (LS7), developed by the American Heart Association. LS7 has been around since 2010 but it escaped my attention until recently. For those of you who like to track your progress to see how you’re doing, this is a great tool; you may remember I mentioned it last month, but I think you need the details to really understand how LS7 can work for you.

There are seven different categories of variables to track, hence the name Life’s Simple . . .

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