MILWAUKEE – It isn’t easy to be patient when you can’t work and you’re in pain, as Christine Morgan knows all too well.
Her chronic pain comes from fibromyalgia. Morgan, 60, also has spinal stenosis, a narrowing of the spaces within the spine that pinches the nerves, most often in the lower back and neck. To top it off, she is diabetic, has kidney disease, high blood pressure and depression.
Yet Morgan has been turned down for Social Security Disability Insurance – twice. “They sent me a letter that said I wasn’t disabled,” she said.
There are marked gender differences in what drives blood pressure in middle-age in adulthood, suggesting the need for gender-specific treatments for high blood pressure, according to research presented today at the American Heart Association (AHA) Council on Hypertension, AHA Council on Kidney in Cardiovascular Disease, American Society of Hypertension Joint Scientific Sessions 2017, in San Francisco.
“Blood pressure is determined mainly by three factors: heart rate; stroke volume, which is the volume of blood pumped by the heart; and the resistance to blood flow through the vessels, called total peripheral resistance. An increase in any one of the three factors can lead to an increase in blood pressure,” said study author Catriona Syme, Ph.D., postdoctoral fellow at The Hospital for Sick Children (SickKids) in Toronto, Ontario, Canada. “The key takeaway from this study is that, for young and middle-aged women, stroke volume was the main determinant of blood pressure, while, in men, vascular resistance was the main determinant of blood pressure.”
Young adults, particularly men, lag behind middle-aged and older adults in awareness and treatment of high blood pressure, putting this population at an increased risk for heart attack and stroke, according to new research in the American Heart Association’s journal Hypertension.
High blood pressure is a leading risk factor for heart attack and stroke and is also a significant public health burden, costing the United States about $110 billion in direct and indirect costs in 2015, according to American Heart Association estimates. American Heart Association guidelines define blood pressure as normal at less than 120/80 and high blood pressure as 140/90 or above.
Is being born in states with high stroke mortality associated with dementia risk in a group of individuals who eventually all lived outside those states?
A new article published by JAMA Neurology reports the results of a study that examined that question in a group of 7,423 members of the integrated health care delivery system Kaiser Permanente Northern California.
A band of states in the southern United States is known as the Stroke Belt because living there has been associated with increased risk of a number of conditions, including high blood pressure, diabetes, stroke and cognitive impairment.
A large, long-term study suggests that middle aged Americans who have vascular health risk factors, including diabetes, high blood pressure and smoking, have a greater chance of suffering from dementia later in life. The study, published in JAMA Neurology, was funded by the National Institutes of Health (NIH).
“With an aging population, dementia is becoming a greater health concern. This study supports the importance of controlling vascular risk factors like high blood pressure early in life in an effort to prevent dementia as we age,” said Walter J. Koroshetz, M.D., director of NIH’s National Institute of Neurological Disorders and Stroke (NINDS), which partially funded the study and created the Mind Your Risks® public health campaign to make people more aware of the link between cardiovascular and brain health. “What’s good for the heart is good for the brain,” he added.
Americans of South Asian descent are twice as likely as whites to have risks for heart disease, stroke and diabetes, when their weight is in the normal range, according to a study headed by Emory University and UC San Francisco.
Similarly, Americans of Hispanic descent were 80 percent more likely than whites to suffer from so-called cardio-metabolic abnormalities that give rise to heart disease, stroke and diabetes, compared with 50 percent more likely for those who were Chinese and African-American.
These risks include high blood pressure (hypertension), elevated glucose, low HDL, the “good cholesterol,” and high triglycerides, a fat found in blood. In the study, participants who were aged between 45 and 84, were classified as having cardio-metabolic abnormalities if they had two or more of these four risk factors.
An analysis of the records of UK patients who had experienced a stroke has found that over half of those who should get drugs to prevent strokes were not prescribed them.
Across the UK, that amounts to 33% of all stroke and ‘mini-stroke’ (transient ischaemic attack, or TIA) patients having a ‘missed opportunity’ for preventative treatment.
Three types of patients are recommended to have drugs to prevent strokes; patients with high blood pressure, patients who are at high risk of a stroke, and patients with an irregular heartbeat — called atrial fibrillation.
High blood pressure in middle age can lead to impaired cognition and is a potential risk factor for Alzheimer’s disease, according to a statement from the American Heart Association co-authored by Loyola Medicine neurologist José Biller, MD.
Dr. Biller is a member of the multidisciplinary panel of experts that wrote the statement, published in the heart association journalHypertension. Dr. Biller is chair of the department of neurology of Loyola University Chicago Stritch School of Medicine. The panel is chaired by Constantino Iadecola, MD, of Weill Cornell Medicine and co-chaired by Kristine Yaffe, MD, of the University of California San Francisco.
Dementia affects an estimated 30 to 40 million people worldwide, and the number is expected to triple by 2050 due to an aging population and other factors.
Visits to emergency departments for patients with hypertension increased by 64 percent between 2002 and 2012 while hospitalizations for those visits declined by 28 percent. A study published online in Annals of Emergency Medicine suggests that aggressive home monitoring of blood pressure may be driving patients to emergency departments despite the lack of other emergency conditions, such as stroke (“A Population-Based Analysis Of Outcomes In Patients With A Primary Diagnosis Of Hypertension In The Emergency Department”).
“We encourage patients to monitor their blood pressure at home if they have been diagnosed with hypertension, but not every high blood pressure reading is an emergency,” said lead study author Clare Atzema, MD, an emergency physician at Sunnybrook Health Sciences Centre and a scientist at the Institute for Clinical Evaluative Sciences in Toronto, Ontario, Canada. “Some of the increase in emergency visits is due to the aging of our population, but we suspect that recent public education campaigns recommending home blood pressure monitoring may have inadvertently contributed to the rise in visits for hypertension.”
Scientists from Queen Mary University of London and Barts Health NHS Trust have successfully improved blood pressure control among patients with severe intolerance to antihypertensive medication — by using medicines in unconventional ways and treating patients with a ‘stepped care’ approach (where the most effective yet least intensive treatment is delivered to patients first).
The study, which is published today in the Journal of Clinical Hypertensionand is supported by Barts Charity, devised a novel treatment strategy for 55 patients, involving fractional dosing with tablets (halving or quartering pills), liquid formulations of antihypertensive drugs and patch formulations of antihypertensive drugs — plus use of unlicensed drugs that lower blood pressure.
Blood pressure was significantly reduced among patients after just six months on the novel treatment strategy, and the results were sustained. Significantly, the patients experienced no debilitating side effects.