Low-Carb Diet Effective in Lowering Blood Pressure

A new study initiated by researchers at Veterans Affairs Medical Centre and Duke University Medical Centre, reveals that a low-carbohydrate diet is equally effective for weight loss as the weight loss drug orlistat, but in a surprising twist, a low-carbohydrate diet proved more advantageous in lowering blood pressure, as well than the weight-loss medicine.

Researcher William S. Yancy, Jr., MD, an associate professor of medicine at Duke University Medical Centre, says, “If people have high blood pressure and a weight problem, a low-carbohydrate diet might be a better option than a weight loss medication”.

The study, published in the Archives of Internal Medicine, involved 146 obese or overweight adults who were randomly segregated into two groups. Among them many were suffering from high blood pressure or diabetes.

A low-carbohydrate was imposed on the first group while the second group received the weight loss drug orlistat thrice a day.

The results revealed weight loss was similar in the two groups. The low-carb diet group lost an average of 9.5% of their body weight and the orlistat group lost an average of 8.5%. However, those in low-carbohydrate group witnessed a fall in their blood pressure, compared to only 21% of those in the orlistat group.

Researchers say weight loss itself typically produces a healthy reduction in blood pressure, but it appears that a low-carbohydrate diet has an additional blood pressure-lowering effect that merits further study.

Source: topnews.us

Use of Hypertension Drugs Leads to Hip Bone Loss in Older Men

Powerful diuretics, commonly prescribed drugs for heart failure and hypertension, can also steal calcium from the bones and cause significant bone loss in men taking them, study finds.

Between 2000 and 2002, Dr. Lionel S. Lim of Griffin Hospital, in Derby, Connecticut and colleagues tested the bone mineral density levels of 3,269 men older than age 65. Patients received follow-up examinations about 4.6 years later. The researchers collected data on medication use and found that 84 men were continuous users of loop diuretics, 181 were intermittent users and 3,004 were non-users.

At the end of the study, the researchers found that the average annual rate of decline in total hip bone mineral density was -0.78 among continuous users, -0.58 among intermittent users and -0.33 among nonusers.

“Compared with rates of hip bone loss among non-users of diuretics, adjusted rates of loss were about twofold greater among intermittent loop diuretic users and about 2.5-fold greater among continuous loop diuretic users,” wrote Dr. Lim and colleagues in the study.

These findings come to reinforce previous studies, which have found an association between the use of powerful diuretics and increased risk of fractures.

“We conclude that loop diuretic use in older men is associated with increased rates of hip bone loss. Our findings suggest that health care providers should take into account loop diuretic use when evaluating older men for risk factors for bone loss and fracture risk,” the study wrote.

The findings were similar for change at the femoral neck and trochanter, the researchers said.

The study, supported by the national Institute of Health, was published in the April 14 issue of the Archives of Internal Medicine.

Source: eFluxMedia.com

Hypertension Prevents Migraines

Despite being the cause of many serious health problems, high blood pressure seems to have great benefits when it comes to migraines, as new research showed.

Dr. Eling Tronvik of the Norwegian National Headache Center at Trondheim University Hospital in Norway and his colleagues found that high blood pressure seems to reduce the chances of migraine, besides decreasing the quantum of chronic pain in other parts of the body.

It was long believed that migraines and other types of headaches are more common among people with high blood pressure, but studies conducted in the 1990s did not support this belief.

“This is a paradox. Several earlier studies have linked increasing blood pressure to a decrease in chronic pain in general, and this study suggests that the same is true for migraines,” Dr. Tronvik told WebMD.

The study’s data included information on blood pressure, use of blood pressure medications and headache frequency for 51,353 adults living in Norway in the 1980s and 1990s.

The biggest benefit was found in people with the highest pulse pressure, a measurement of the difference between the diastolic and systolic pressure at the moment the heart beats. They had up to 50 percent fewer headaches.

People with high systolic pressure also appeared to do better.

Things looked differently for people who took medicine to control their blood pressure, even though these drugs are often given to migraine sufferers.

“Higher pulse was linked to up a 50 percent reduction in the amount of headache and migraine for both men and women. The finding was not as strong, however, for people who were taking blood pressure medication, which are sometimes used to treat migraines,” Dr. Tronvik said.

How is that possible? Dr. Tronvik explained that high systolic blood pressure and pulse pressure are related to stiff arteries, which affect something called baroreflex arch.

“Both animal and human studies suggest that stimulation of the baroreflex arch can inhibit pain transmission. So changes in blood pressure may affect headache and migraine.”

However, Dr. Tronvik said, no matter how well high blood pressure prevents headaches, people should not abandon their hypertension medications. “High blood pressure is a huge problem in this country, and far too few people are controlling it as they should.”

The findings of the study were published in Tuesday’s issue of Neurology.

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High Blood Pressure on Increase Among American Women

Uncontrolled hypertension rates are on the increase among American women, and the prevalence of this major risk factor for heart disease and stroke among American men is still not as low as it should be, a new survey shows.

"Blood pressure that is higher than optimal is among the leading two or three risks for cardiovascular disease, if not the leading one," said Majid Ezzati, an associate professor of international health at the Harvard School of Public Health and lead author of the report in the Feb. 12 issue of Circulation.

About one in five American adults has "uncontrolled high blood pressure," defined as a systolic pressure - the higher number of the 140/90 reading - above 140, according to the state-by-state survey. Data from two major ongoing studies, the National Health and Nutrition Examination Survey and the Behavioral Risk Factor Surveillance System, was used in the survey.

The incidence of uncontrolled high blood pressure had been declining steadily for decades into the 1990s, the researchers found. The decline has continued for American men, with the rate dropping from 19 percent to 17 percent in the early 2000s. But the incidence among American women increased from 17 percent to more than 22 percent during that same period.

There are big state-by-state differences, with the incidence of hypertension highest in southern states and the District of Columbia and lowest in Northeastern and Midwestern states such as Vermont, Connecticut, Minnesota, New Hampshire, Iowa and Colorado.

"We also found that in every state in the United States, women have higher uncontrolled hypertension prevalence rates than men do," Ezzati said in a statement. "The difference between men and women is as low as 4 percent and as high as 7 percent."

"We need to look nationally, but also especially focus on those states with the highest hypertension prevalence and emphasize interventions to do better than last decade's trends," Ezzati said.

The persistent incidence of hypertension is "principally a failure of our health-care delivery system," said Dr. Dan Jones, president of the American Heart Association. "Certainly physicians have some fault, patients have some fault, and biology plays a role. But in our current health-care system, high blood pressure is treated as part of a visit with a primary-care physician that may take only five to 15 minutes. It may be one of five or six problems that the patient has and may be the least symptomatic of those problems, so it doesn't get the attention it should."

Even when the problem is detected and hypertension medication is prescribed, "patients need to take the medicine on a regular basis, and simply fail to do so," Jones said.

Measures other than drug treatment can keep blood pressure under control, Ezzati added. "Lowering salt intake, including regulation in packaged and prepared foods, and regular testing should both be effective, as would, of course, more exercise and lower weight," he said.

"We've got to make hypertension a high priority in the treatment of patients," Jones said.

Source: www.forbes.com

Diuretics Best for Hypertension and Metabolic Syndrome

Diuretics appear to be as good or better than other blood pressure drugs for treating hypertension in patients with metabolic syndrome, especially black patients, according to a U.S. study.

People with hypertension and metabolic syndrome are at high risk for complications of cardiovascular disease.

Researchers at Case Western Reserve University and University Hospitals Cases Medical Center in Cleveland analyzed data from the Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT).

It included 42,418 people with hypertension and at least one other risk factor for cardiovascular disease who were randomly assigned to take either the diuretic chlorthalidone (15,255), the calcium channel blocker amlodipine besylate (9,048), the alpha-blocker doxazosin mesylate (9,061), or the ACE inhibitor lisinopril (9,054).

Each drug was used to start treatment, and other drugs were added if necessary to control blood pressure. The majority of patients were followed for an average of 4.9 years, but the alpha-blocker part of the trial was halted after an average of 3.2 years due to increased rates of cardiovascular disease.

Among the patients in the study, 23,077 met the criteria for metabolic syndrome, which is defined as hypertension plus at least two of the following factors: diabetes or pre-diabetes; a body-mass index (BMI) of at least 30; high triglyceride levels; or low levels of high-density lipoprotein ("good" cholesterol).

"No differences were noted among the four treatment groups, regardless of race or metabolic syndrome status for the primary end point (nonfatal myocardial infarction [heart attack] and fatal coronary heart disease)," the study authors wrote.

Among patients with metabolic syndrome, those taking the diuretic had a lower rate of heart failure than those taking the other three drugs. Patients who took the ACE inhibitor and the alpha-blocker also had an increased risk of combined cardiovascular disease.

"The lack of benefit of the agents with the most favorable metabolic profile [i.e., ACE inhibitors and alpha-blockers] was especially marked in black participants with metabolic syndrome," the researchers wrote.

"The magnitude of excess risk of end-stage renal [kidney] disease [70 percent], heart failure [49 percent] and stroke [37 percent] and the increased risk of combined cardiovascular disease and combined coronary heart disease strongly argue against the preference of ACE inhibitors over diuretics as the initial therapy in black patients with metabolic syndrome. Similar high risk was noted for those randomized to the alpha-blocker versus the diuretic."

The researchers concluded that the findings "fail to provide support for the selection of alpha-blockers, ACE inhibitors, or calcium channel blockers over thiazide-type diuretics to prevent cardiovascular or renal outcomes in patients with metabolic syndrome, despite their more favorable metabolic profiles."

Source: www.washingtonpost.com

High Blood Pressure May Vary By Season

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Study Shows Higher Doses Of Medication May Be Needed In Winter

If you're being treated for hypertension, take note: Your blood pressure is more likely to return to normal levels in summer than in winter, a new study shows.

The findings suggest that people with high blood pressure may need higher doses of medication or even different drugs in the winter months, says researcher Ross D. Fletcher, MD, chief of staff at the VA Medical Center in Washington, D.C.

The researchers analyzed the electronic health records of 443,632 veterans with high blood pressure treated at 15 VA hospitals throughout the U.S. over a five-year period.

Blood pressure was nearly 8 percent less likely to return to normal in the winter than in the summer, the study showed.

"In all cities, there was a seasonal variation that didn't seem to be related to outside temperature," Fletcher says.

Whether you're in San Juan, Puerto Rico, or Anchorage, Alaska, "every summer it gets better and every winter it gets worse," he tells WebMD.

One hopeful trend: In each of the 15 cities studied, the number of people with hypertension whose levels returned to normal rose an average of 4 percent per year, Fletcher says.

The findings were reported at the American Heart Association's Scientific Sessions 2007.

Understanding Your Blood Pressure Reading

"Normal" blood pressure is a measurement of less than 120/80; pre-hypertension is a blood pressure reading in which the top number is in the range of 120-139 and the bottom number is in the range of 80-89.

In the study, people with readings of more than 140 over 90 on three separate days were considered to have high blood pressure.

Explaining the Seasonal Gap

Fletcher says that weight and exercise may play a role in the seasonal variations. "People gain weight in the winter and lose weight in the summer. People tend to exercise more in the summer and less in the winter," he says.

Blood pressure rises with weight gain and falls with weight loss, says American Heart Association spokesman Jonathan Halperin, MD, a cardiologist at Mount Sinai Medical Center in New York.

Halperin notes that other studies have shown that blood pressure and heart disease rates can vary over the course of a day.

Heart attacks, for example occur more commonly in the morning, he says, while blood pressure tends to drop at night. "But to my knowledge, this study is the first to show seasonal variations," Halperin tells WebMD.

Blood Pressure in Summer and Winter

Halperin advises doctors and patients to be more attentive to blood pressure in winter months.

"If a person has borderline readings in the summer, he should think about being screened again in six months to make sure blood pressure hasn't dropped further," he says.

If blood pressure does dip in the winter, a more potent treatment regimen should be considered, Fletcher says.

"Our goal is to get as many people to below 140 over 90 as possible," he says.

The other 13 VA hospitals studied were in Baltimore, Boston, Chicago, Fargo, N.D., Honolulu, Houston, west Los Angeles, Miami, Minneapolis, New York, Philadelphia, Portland, Ore., and Washington, D.C.

Hypertension Drugs May Prevent and Treat Alzheimer’s, Study Finds

Drugs commonly used to treat hypertension, may be successful in preventing Alzheimer’s disease, according to a new study published in The Journal of Clinical Investigation.

In the study, researchers at the Mount Sinai School of Medicine found that geriatric patients who are being treated for high blood pressure with hypertenstion drugs may cut their risks of developing Alzheimer’s disease.

The researchers studied more than 1,500 drugs currently available to treat other disorders to determine the effectiveness of the drugs in preventing Alzheimer’s. They found that of the 55 drugs studied, seven drugs used to treat hypertension were the most effective.

Researchers found that the drugs prevented beta-amyloid production, a fragment of protein in the brain that is usually eliminated but forms a kind of plaque, or blockage, in the brain of Alzheimer’s patients.

The drugs may also prevent further deterioration in those who are already afflicted with Alzheimer's, according to the study. One drug, Valsartan, was given to Alzheimer’s diseased mice, at a three or four times lower than the normal dosage for humans, and the drug still prevented further production of this blockage in the brain.

The effectiveness of hypertension drugs in preventing this blockage in the brain may help identify future treatments that can prevent cognitive deterioration and dementia in Alzheimer’s patients, according to researchers. However, studies on human patients is necessary.

"The use of these drugs for their potential anti-Alzheimer’s disease role is still highly experimental, and at this stage we have no clinical data beyond phenomenological observation in humans" said Dr. Pasinetti, director of the Center of Excellence for Research in Complementary and Alternative Medicine in Alzheimer's disease at Mount Sinai. "We need to complete preventive and therapeutic clinical trials in the near future if we are to identify certain anti-hypertensive drugs with anti beta-amyloid antioligomeric activities, which will need to be prescribed at dosages that do not interfere with blood pressure in normotensive Alzheimer’s disease patients."

Take a siesta to reduce your blood pressure

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A new study has found that expecting an afternoon nap could reduce blood pressure, consequently cutting down the risk of heart attacks.

Researchers at the Liverpool John Moores University in Liverpool, U.K., have discovered that the time just before one falls asleep in the afternoon is the most beneficial in reducing blood pressure and lessening the risk of cardiovascular diseases.

Afternoon naps, or siestas are typically short naps or rest periods of no more than an hour that are taken in the afternoon.

While earlier studies on siestas have found that this practice may slightly increase the risk of heart attack, the new study has shown an inverse relationship between siesta taking and fatal heart attacks.

According to the researchers, change in blood pressure is the key factor linking afternoon naps to cardiovascular function. Some researchers hypothesize that the lower blood pressure reduces strain on the heart and decreases the risk of a fatal heart attack.

The current study provides a detailed description of changes in cardiovascular function of daytime sleep in healthy individuals, comparing napping with other daytime activities such as standing and lying down without going to sleep.

For the study, the researchers tested nine healthy volunteers (eight men, one woman) who did not routinely take afternoon naps. The volunteers wore equipment that checked blood pressure, heart rate, and forearm cutaneous vascular conductance (which determines dilation of blood vessels).

During one afternoon session, the volunteer spent an hour resting, lying face-up in bed. During another session, the volunteer spent an hour relaxed, but standing. And in one session, the volunteer was allowed an hour to sleep, lying face-up. During the sleep stage, the researchers measured the volunteer's different stages of sleep.

After analysis, researchers found a significant drop in blood pressure during the sleep trial, but not during the resting or standing trials. Besides, this drop in blood pressure occurred mostly after lights out, just before the volunteer fell asleep.

According to the John Moores team, this fall in blood pressure may be one explanation for the lower cardiovascular mortality that some studies have found among people who habitually take siestas. On the other hand, some studies of nocturnal sleep have shown that blood pressure rises when we awake and that more cardiac deaths occur in the mornings.

Hence, the team will next look at blood pressure during the waking portion of the afternoon nap to see if this period may also pose an increased danger of coronary mortality.

The study entitled, 'Acute Changes in Cardiovascular Function During the Onset Period of Daytime Sleep: Comparison to Lying Awake and Standing,' is published in the online edition of the Journal of Applied Physiology, published by The American Physiological Society.

Weight Loss Can Normalize Blood Pressure

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By Charles Bankhead

At least half of overweight patients with stage I hypertension can normalize their blood pressure with modest weight loss, Italian investigators reported here.

After six months on a reduced-calorie diet, supplemented by a lipase inhibitor in some cases, about half of 210 patients lost more than 5% of their body weight, which was associated with about a 5% reduction in blood pressure, Roberto Fogari, M.D., of the University of Pavia, reported at a conference of the American Heart Association's Council for High Blood Pressure Research.

The results demonstrated not only that weight loss alone can normalize hypertension but also that many overweight hypertensive patients have been misdiagnosed as having essential hypertension. The results emphasize the importance of initiating dietary intervention in overweight patients with high blood pressure before resorting to drug treatment, said Dr. Fogari.

"This is important because it means that in these patients with elevated blood pressure who were overweight, the blood pressure is not a form of essential hypertension but was hypertension secondary to body weight," said Dr. Fogari.

"These findings apply to western societies in general, but only to overweight patients, not to obese patients, with high blood pressure," he added.

The study involved men and women ages 29 to 65 and who had a body mass index of 25 to 29 kg/m2, defining them as overweight but not obese. All the patients had stage I hypertension, reflected in a systolic blood pressure of 140 to 159 mm Hg and a diastolic pressure of 90 to 99 mm Hg. None of the patients had a history of antihypertensive therapy.

Upon entry to the study, each patient consulted with dietary authorities who developed individualized reduced-calorie food plans that reflected a patient's food preferences. About half the patients also received the lipase inhibitor orilistat (Xenical) as an aid to weight loss and weight maintenance.

"We gave orilistat only when diet alone was not able to achieve the appropriate reduction in body weight," said Dr. Fogari.

After six months of follow-up, 49% of the women and 53% of the men had lost more than 5% of the baseline bodyweight. The 5% reduction in blood pressure that accompanied the weight loss was sufficient to normalize blood pressure in many patients.

There was a significant reduction in plasma leptin (from 17.3±4.4 to 10.9±3.2 ng/mL, P<0.01), active renin (from 12.9±6.8 to 9.1±5.2 pg/mL P<0.05), and aldosterone (from 71.8±28.4 to 59.7±23.5 P<0.01).

Forty-eight percent of the those with bodyweight loss of 5% or more achieved a normal BMI (< 25 Kg/m2) and 53% showed a BP blood pressure normalization (< 140/90 mmHg). Plasma leptin, active renin and aldosterone decreases were not different than those of the 25 patients who did not achieve the blood pressure normalization despite the BMI normalization.

The study will continue until all patients have been followed for a year.

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Sleep Deprivation Can Lead To Hypertension Risk in Women

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by Anna Boyd

A new study by British researchers shows that women who deprive themselves of sleep may be more likely to die of heart disease.

Warwick Medical School researchers from the University of Warwick published their study this week in the journal Hypertension. The authors write that women who slept five hours or less were twice as likely to suffer from high blood pressure (hypertension) than women who slept seven hours or more a night.

They found no difference between men sleeping less than five hours or more than seven hours each night.

“Sustained sleep curtailment, ensuing excessive daytime sleepiness and the higher cardiovascular risk are causes for concern,” lead author Prof. Francesco Cappuccio from the University of Warwick's Warwick Medical School, said in a statement.

“Emerging evidence also suggests a potential role for sleep deprivation as a predictor or risk factor for conditions like obesity and diabetes,” he added.

Cappuccio and his colleagues analyzed data pertaining to more than 6,500 participants, more than 4,000 men and more than 1,500 women. All were volunteers from 20 civil service departments based in London.

The researchers established hypertension as blood pressure equal to or higher than 140/90 mm Hg within their sample, or if the participant regularly required blood pressure medications.

Cappuccio said lack of sleep had been linked to a higher risk of developing high blood pressure but also to increased death from cardiovascular cause. “It is a stark finding but the results are highly suggestive of a causal link,” the Daily Mail quotes him as saying.

He will present his research later this month at the British Sleep Society's annual meeting in Cambridge, according to the Daily Mail.

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Children eat too much salt, risk high blood pressure

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By Anna Boyd

British researchers warn that a diet with high levels of salt can raise children’s blood pressure, increasing the risk of cardiovascular disease later in life.

A study published in the Journal of Human Hypertension shows that children’s favorite supermarket foods and snacks contain higher levels of salt than those recommended by health experts.

Researchers with the Department of Health looked at 2,127 British children aged 4 to 18, monitoring their daily salt intake. This did not include salt added in cooked meals or at the table.

The specialists found that the average four-year-old consumed 4.7g of salt a day, when only 2-3g of salt is recommended for this age group, the Journal of Human Hypertension reports.

The researchers showed in their study that each extra gram of salt eaten raised blood pressure significantly, increasing the risk of heart disease and stroke during adulthood. The children who ingested the highest amounts of salt also had the highest levels of blood pressure.

The Food Standards Agency in the UK is once again urging consumers to read products’ labels and check the levels of salt, even in products such as corn flakes, where one would not expect to find salt.

Earlier this year, the agency released the results of tests conducted on more than 1,000 adults, which showed that British adults consume an average 9g of salt each day. The FSA recommends a maximum of 6g per day.

At the time, FSA chairperson Dame Deirdre Hutton said the general population needed to reduce its salt intake in order to prevent serious health problems. High blood pressure is at least partly to blame for 170,000 deaths in England each year, the FSA report said.

The agency recommends that younger children receive less salt than older ones. Babies under 6 months should receive less than 1 g of salt daily, while babies 7 to 12 months should receive a maximum of 1g.

Children 1 to 3-years-old should have a maximum of 2g per day, while 4 to 6-year-olds 3g, 7 to 10 year-olds 5g and 11 to 14-year-olds a maximum 6g.

Excessive salt consumption has been linked to conditions such as asthma, osteoporosis, stomach cancer and hypertension (high blood pressure).

Jo Butten of Consensus Action on Salt and Health said of the recent study: “The message for parents is to check labels, especially on foods such as breakfast cereals and snack products, which they may not expect to contain high levels of salt, and choose the lower salt options.

“It may be difficult for parents to tell their children they can't have crisps every day, or that they need to eat a different breakfast cereal, or that some instant noodles should be avoided completely, but surely it's a small price to pay to reduce their risk of having a heart attack or stroke when they are older?”

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