Latest news with #bloodpressure
Medscape
a day ago
- Health
- Medscape
Early, Aggressive BP Lowering Tied to Better ICH Outcomes
Initiating intensive blood pressure (BP) lowering within a few hours of intracerebral hemorrhage (ICH) was associated with better neurologic outcomes, fewer serious adverse events, and better mortality compared to the more conservative standard treatment, new research confirmed. Best results were found when treatment was administered within 3 hours of ICH symptoms, a pooled analysis of the four Intensive BP Reduction in Acute Cerebral Hemorrhage Trials (INTERACT1-4) showed. While current guidelines set a target systolic BP of < 180 mm Hg within 1 hour of ICH symptom onset, the intensive treatment systolic target is < 140 Hg within 1 hour. The new findings were published online on June 18 in The Lancet Neurology . Timing Dependent? In addition to evaluating the safety and efficacy of early intensive treatment for ICH, the investigators also aimed to assess the impact of treatment timing. The INTERACT1-3 studies included 10,269 adults with acute ACH who presented within 6 hours of symptom onset and had a systolic BP of > 150 mm Hg. INTERACT4 included 1043 patients with suspected acute stroke who had a systolic BP of ≥ 150 mm Hg within 2 hours of symptom onset. In addition, 1029 study participants had a hemorrhagic form of stroke. All were randomly assigned to receive either intensive or guideline recommended BP-lowering treatment with locally available BP drugs within 1 hour. Scores on the modified Rankin scale were used to determine functional recovery, the primary outcome measure for the pooled analysis. Additionally, a CT substudy of nearly 3000 INTERACT participants was conducted to measure hematoma volume. Mean systolic BP rates at 1 hour were significantly lower for the intensive treatment group compared to the guideline group (149.6 mm Hg vs 158.8 mm Hg, respectively; P < .0001). Poor physical function, defined as a modified Rankin scale score of 3-6 at the end of follow-up, was significantly less likely after intensive BP lowering (odds ratio [OR], .85; P = .0001). The intensive group also had reduced odds of neurologic deterioration within 7 days compared to the guideline group (OR, .76; P = .0002), as well as lower odds of any serious adverse event (OR, .84; P = .0003) or death (OR, .83; P = .002). CT substudy results showed no significant effect on either relative or absolute hematoma growth in the first 24 hours from intensive vs guideline treatment. However, when intensive BP lowering was initiated within 3 hours of symptom onset, functional recovery was improved and hematoma growth was reduced in almost 25% of the patients with serial CT scans, investigators noted. Patients with mild-to-moderate severity, as measured by ICH scores, had even greater reductions in hematoma growth after early intensive BP-lowering treatment. The new pooled analysis of all four INTERACT trials confirms findings from INTERACT4, presented at the 2024 European Stroke Organization Conference Annual Meeting and reported by Medscape Medical News . 'Time Is Brain' In an accompanying editorial, David J. Werring, PhD, Department of Translational Neuroscience and Stroke, University College London Queen Square Institute of Neurology, London, noted that several previous studies showed no benefit of BP lowering in acute ischemic stroke, 'probably because acutely elevated blood pressure has a role in maintaining brain perfusion.' However, the pathophysiology of stroke from ICH 'is different, with a major role for hematoma expansion within the first few hours, a therapeutic target which might be reduced' by intensive BP lowering, he wrote. Still, Werring noted that possible benefits need to be weighed against possible risks; and he pointed out several study limitations, such as the low severity of ICH overall and the inclusion of INTERACT3 data, which may have introduced confounding from BP lowering being just one component of its treatment 'bundle,' alongside strict glucose control and anticoagulant reversal. 'Notwithstanding these important limitations, the data presented make a compelling case for ultra-early intensive blood pressure reduction as a potentially useful intervention to improve outcomes in people with acute ICH,' he wrote, adding that more research is needed. 'Meanwhile, the clear message from this meta-analysis is that earlier treatment is better, meaning that, once again, time is brain for patients with ICH,' Werring concluded.
Yahoo
4 days ago
- Health
- Yahoo
10 ways to reduce your blood pressure
It's the thing we dread hearing at our midlife health check, but in fact an early diagnosis could prove a blessing. High blood pressure is often called 'the silent killer' because it may show no symptoms, making it all the more important to know your blood pressure numbers – and to check them regularly. Blood pressure is measured in millimetres of mercury (mmHg). The top number is 'systolic' – the pressure in your arteries when your heart beats. The bottom number is 'diastolic' – the pressure in your arteries when your heart rests between beats. 'Both are important, but for the over-50s, the top number is more important,' says Graham MacGregor, a professor of cardiovascular medicine and the chairman of Blood Pressure UK. 'An elevated systolic pressure in the over-50s shows a greater risk of stroke and heart disease than an elevated diastolic pressure.' 'Most people in the UK have blood pressure that's higher than the ideal, but as a general guide, normal blood pressure is considered to be between 90/60mmHg and 120/80mmHg,' says Prof MacGregor. So what are the proven ways of reducing blood pressure? The best methods to reduce blood pressure, according to the experts, are: Medication Cut back on salt Eat potassium Exercise more Lose weight Cut back on alcohol Quit smoking – and vaping Prioritise sleep Supplements Monitor your blood pressure at home Fortunately, we have very effective ways of reducing blood pressure with four main types of medicine. 'They reduce blood pressure through different mechanisms and that's important because your body will try to stop it working,' says MacGregor. 'One tablet might reduce the pressure through one mechanism, and then if your body manages to block it, you might be prescribed another pill that works through a different mechanism. If you're given two tablets that work in different ways, that's more effective than one, and if you're on three, that can be more effective than two.' The four main types are: Angiotensin-converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs) – both work by controlling the hormones that help relax and widen the blood vessels, which in turn lowers the pressure Thiazide diuretics – which removes excess fluid from the body Calcium-channel blockers (CCBs) – prevent calcium from entering the cells of the heart and arteries (since calcium causes them to contract more strongly), allowing blood vessels to relax and open. Side effects for some include dizziness and headaches. 'Some people won't have any side effects. It depends on the drug and the person, and also whether they are on any other medicines,' says Ruth Goss, a senior cardiac nurse with the British Heart Foundation. 'The long-term health consequences of uncontrolled high blood pressure are much worse. If you have any concerns about your medication, don't alter the dose or stop taking it. Talk to your GP,' she adds. This is absolutely key – the more salt you eat, the higher your blood pressure will be. Even if you are on blood pressure medication, a salty diet can make it work less effectively. Reducing your salt intake will have an impact quickly too – often within weeks. Though we need a small amount of salt to stay healthy – about 4 grams each day – we should eat no more than 6g, or one level teaspoon. Most of us eat too much. Roughly 75 per cent is from processed foods, 15 per cent is added during cooking or before eating (so remove the salt cellar from the table), and 10 per cent is found naturally in food. When it comes to processed foods, check labels carefully for salt or sodium – two loaves of bread or boxes of cereal made by the same company can contain wildly different quantities. 'When buying tinned fish, pulses or vegetables, opt for the ones in water over brine,' says Kate Llewellyn-Waters, author, nutritionist and resident expert on TV programme You Are What You Eat. Know your high-salt items, these are: Ketchup Soy sauce Gravy granules Pocessed meats Pickles Ready meals Takeaways Opting for unsalted butter is one example of a simple swap you can make. The FoodSwitch app allows you to scan the barcodes of food and drink and instantly see whether they are high, medium or low in salt. It also suggests healthier alternative products. 'When cooking, one of the most effective tips to retrain your taste buds is to add herbs or spices in place of salt,' says Llewellyn-Waters. Lemon juice, cumin, shallots and fresh or dried herbs will all add flavour.' The good news is that salt preference is an acquired taste that can be unlearned. It takes six to eight weeks to adjust to much lower quantities – after that, you'll never enjoy a pretzel again. 'Potassium is an important mineral that helps your body get rid of sodium and reduces pressure on your blood vessels,' says Llewellyn-Waters. 'Western diets tend to be high in sodium and low in potassium.' Foods that are rich in potassium include: Bananas Leafy greens Sweet potatoes Nuts (unsalted) Seeds Tomatoes Avocados Apricots Mushrooms Opt to get your potassium from these rather than potassium supplements. For those with kidney disease or taking certain blood pressure medication, a large increase in potassium could be harmful, so check with your doctor before making big changes. New research has found that eating bananas is more effective at lowering blood pressure than reducing salt intake. Another study tracked the fibre consumption of 200 people with hypertension and Type 2 diabetes. Their fibre intake was increased by about 20 to 25 per cent to 24 to 30g a day and they consumed 1,200-1,500 calories. After six months, researchers observed a 15 per cent reduction of systolic blood pressure. Another study tracked the fibre intake of more than 2,500 midlife women and found that fibre – especially from grains – contributed to a lower risk of hypertension. 'Your heart is a muscle. Regular exercise makes it stronger and able to pump blood with less effort, which brings down blood pressure,' says Ruth. 'Aim for 150 minutes of moderate exercise a week.' One meta-analysis of 270 randomised controlled trials compared five different forms of exercise – aerobic, weight training, a combination of both, high-intensity interval training and isometric exercise. All improved blood pressure but isometric exercise – such as planks, squats and wall sits – had the most pronounced effect. 'It's normal for blood pressure to rise after exercise and it should come back down when you stop,' says Goss. 'If your blood pressure is very high, speak to your GP or nurse before starting anything new.' 'If you're overweight, losing some pounds will lower your blood pressure as your heart won't need to work so hard to pump the blood around your body,' says Prof MacGregor. If you're overweight, even losing a moderate amount – 5 or 10 per cent of your body weight – can make a difference. As a general guide, blood pressure can go down by about 1mmHg with each kilogram (about 2.2lb) of weight lost. Your waistline is important too – research shows that carrying excess weight around your stomach may increase your risk of high blood pressure more than anywhere else on your body. 'We know that drinking alcohol in excessive amounts raises blood pressure,' says Prof MacGregor. 'Your blood pressure is pulled up when you experience a hangover.' Until recently, moderate drinking wasn't thought to be a risk factor, but newer data that spanned several decades and included 20,000 people has suggested that blood pressure increases in line with alcohol consumption, starting from as little as one glass of wine per day. Alcohol can also lead to weight gain – which raises blood pressure – and interfere with certain blood pressure medications. Still, it's too early for a change in guidelines, though Prof MacGregor advises those drinking above recommended levels to cut back. Smoking certainly causes a temporary rise in blood pressure by activating the sympathetic nervous system (SNS), which controls the body's response to danger and raises the heart rate and blood pressure. Researchers have also reported 'worrisome changes' in blood pressure and heart rates after vaping. Although experts disagree over the long-term effects of these temporary spikes, there's no doubt that smoking increases the build-up of fatty material in the arteries, reducing the space for blood flow. Quitting will significantly reduce your risk of stroke or heart disease. Blood pressure tends to lower by as much as 20 per cent when we sleep – known as 'nocturnal dipping'. There's a whole body of literature which suggests that regular sleep deprivation – less than five hours a night – as well as interrupted sleep is associated with higher blood pressure, particularly in women during middle age. Worrying about this certainly won't help you sleep better, but small steps to improve sleep hygiene are worth taking. This can include: Sleeping at a regular bedtime Daily exercise No devices in bedrooms Trying blackout blinds 'There are several supplements that may lower blood pressure, but it is vital to know that many supplements interact with medications, including blood pressure medication, so always check with your medical practitioner before taking any,' warns nutritionist Llewellyn-Waters. Supplements that may help lower blood pressure include: Potassium Magnesium Vitamin D Fish oil One 2022 study found that a daily dose of around 2-3g of omega-3 fatty acids (found in salmon, tuna and other oily fish) may be the optimal amount needed to help lower blood pressure. Garlic capsules have also shown effectiveness in reducing blood pressure, as well as improving cardiovascular health overall by reducing arterial stiffness, inflammation and elevated cholesterol levels. 'Everyone should have a blood pressure monitor,' says Prof MacGregor. 'Many people have scales to help them control their weight – even though we can tell by sight or how our clothes fit if we're overweight. We can't tell when our blood pressure is raised – the first sign might be a heart attack. Getting a blood pressure monitor could be the best thing you've ever done.' Monitoring at home will give you a more complete picture of day-to-day highs and lows, can motivate you to make changes and show you if those changes are working. Buy a monitor approved by the British and Irish Hypertension Society for home use and follow the instructions carefully, keeping still and quiet while you take your reading, taking two or three, one or two minutes apart (see a full how to below). Take the readings at the same time each day and always use the same arm, so you're comparing like with like. Keep a record of your readings. Hypertension is another term for high blood pressure and the point where it could be treated with medication. That's set at 140/90, although, says MacGregor, to some extent that's an arbitrary cut-off point. 'The risks from high blood pressure don't stop at a particular number. If you're below that threshold but it's still raised, you need to do something about it.' Hypertension carries no symptoms but it's a huge risk factor for the following: Stroke Cardiovascular disease Kidney disease Vision loss Vascular dementia It's not uncommon to hear someone attributing high blood pressure to stress. In truth, stress itself is unlikely to be the cause or the answer. 'If I pointed a machine gun at you, your blood pressure would go up, but the question is does stress cause a long-term rise in blood pressure? The evidence just isn't there,' says MacGregor. Stress only becomes a factor if it leads to an unhealthy lifestyle – like eating badly, smoking, drinking and losing sleep. 'It goes up as we get older, so if you haven't got high blood pressure now, you're probably going to get it,' warns MacGregor. 'In the UK, when you're 20, your risk is roughly 20 per cent, at 50, it's 50 per cent, at 80 years old, it's 80 per cent.' Diet is thought to be the critical cause here – age-related increases in blood pressure have been observed in almost every population except hunter gatherers and forage farmers. In fact, salt is believed to be the culprit. 'When you eat salt, you retain some in your body, which controls the amount of fluid in your blood,' MacGregor explains. 'Put simply, it's like adding fluid to a central heating system – it raises the pressure. There have been studies on communities who have no access to salt at all. Their blood pressure doesn't rise with age – their average blood pressure is 92/60 – the same as a gorilla or baboon.' For more information and resources, visit Blood Pressure UK Broaden your horizons with award-winning British journalism. 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The Verge
4 days ago
- Health
- The Verge
Putting on my ‘health tech wet blanket' hat because contactless blood pressure isn't really a thing yet.
It's been brought to my attention that the Trump Mobile Telehealth Information site seemingly claims contactless blood pressure are things you can get through its third-party Doctegrity services. This is a health tech red flag. While the other metrics mentioned are generally possible through a camera, contactless blood pressure is an emerging technology that hasn't been widely adopted. Most blood pressure tech still requires calibration with a cuff. I'm more inclined to think this is a marketing copy snafu.
Medical News Today
5 days ago
- Health
- Medical News Today
Hypertension: Flavonoid in tea and chocolate may lower blood pressure
A type of flavonoid found in chocolate and tea has been linked to lower blood pressure. Design by MNT; Photography by Johner Images/Getty Image & CatherineA new meta-study suggests that the flavan-3-ols, which are a type of plant-derived compound found in cocoa, tea, apples, and grapes, may be useful in managing high blood pressure. Specifically, they were found to be effective at improving endothelial function, which can significantly influence blood pressure. The authors of the meta-study suggest that flavan-3-ols may be considered as an addition to lifestyle changes and medication in treating hypertension. The flavan-3-ols in cocoa, tea, and some popular foods are so effective at improving endothelial function that they are worth considering in the management of high blood pressure, according to a new meta-study. Currently, lifestyle modification is the first method physicians recommend for patients who have high blood pressure. If this does not resolve the issue, the doctor will prescribe hypertension medications. In some of the 145 randomized controlled studies included in the meta-study's analysis, improvements in endothelial function were comparable to those achieved with hypertension medications. Flavan-3-ols are found in coffee, tea, dark chocolate, cocoa powder, apples, and grapes. Participants in the studies consumed cocoa, tea, apples, or grape extracts. The authors of the study are not suggesting that flavan-3-ols could replace medication. However, they do note that the ready availability and palatability of such foods may offer welcome additional support for a person hoping to manage hypertension, reducing the need for additional medication. The analysis found that the compounds successfully decreased blood pressure and improved endothelial functioning in healthy individuals and in people who had hypertension. Benefits to endothelial function were more consistently observed than reductions in blood pressure. Blood pressure was most often achieved in individuals who had high blood pressure at the beginning of the studies in which they participated. The study is published in the European Journal of Preventive Cardiology. The endothelium is a thin layer of cells lining the blood vessels. Its health, said cardiologist Jayne Morgan, MD of Hello Heart, 'is a reflection of the elasticity or stiffness and how well the arteries are performing in their vital role of maintaining a normal blood pressure.' The endothelium also, she noted, serves 'as a barrier to keep nutrients in and toxins out, reducing platelet adhesion and subsequent clot formation, and responding to injury.' Michelle Routhenstein, a registered dietitian who specializes in heart disease explained, endothelial function 'is measured by flow-mediated dilation (FMD), and even a small increase in FMD (about 1%) can reduce cardiovascular disease risk by 8– 13% .' 'As a dietitian focused on cardiovascular health, I see flavan-3-ols as an important part of a balanced heart-healthy diet,' said Routhenstein. Flavan-3-ols are a subclass of flavonoids. They are most available in unprocessed foods, such as dark chocolate and green or black teas, rather than in milk chocolate or flavored teas, since processing can damage or remove the compounds. Therefore, not just any chocolate or tea will do as a source of the compounds. 'When chocolate or tea goes through a lot of processing, like adding sugar, heating, or special treatments, it breaks down or removes these beneficial compounds,' Routhenstein cautioned. 'Milk chocolate, as well as instant or flavored teas, typically contain much lower levels of flavan-3-ols due to extensive processing and added ingredients.' Flavan-3-ols are not the only natural compound being investigated for their value in supporting cardiovascular health. Morgan noted several others: resveratrol, from grapes, may improve blood pressure control and vascular function. curcumin, from turmeric, is being investigated for its possible value in the reduction of arterial stiffness and plaque formation berberine, from various plants, may have lipid-lowering abilities Omega-3 fatty acids from fish, flaxseed, walnuts, and some other seeds, may reduce triglycerides, stabilize heart rhythms, and reduce cardiac death risk garlic extract and quercetin are being studied for possible effects on lowering blood pressure. Morgan warned, however: 'We should remember that 'natural' does not equal 'safe.' Berberine in particular can interfere with both anticoagulants and statins.' 'As a cardiovascular dietitian,' said Routhenstein, 'I believe this research highlights just how powerful food can be in improving blood-vessel health. In some cases, its effects can match or even exceed those of medications.' 'Food choices in general can both determine and in some cases drive, blood pressure, cholesterol levels, weight, blood sugar levels, and inflammation,' Morgan said. 'Diets high in saturated fats raise LDL (bad) cholesterol levels, salt raises blood pressure, trans fats raise cholesterol levels, and processed foods increase inflammation. Added sugars in sodas and cereal promote insulin resistance, diabetes, and obesity. Refined carbohydrates such as white bread, pastries, and pasta cause blood sugar spikes and inflammation.' — Jayne Morgan, MD 'Conversely, diets rich in whole foods, vegetables, fruits, whole grains, and magnesium and calcium work to promote healthy blood vessels. They decrease inflammation, and thereby promote healthy blood pressure and lower risk of heart disease and stroke,' Morgan said. 'I've seen firsthand,' said Routhenstein, 'how making the right dietary changes has helped many people lower their blood pressure enough to reduce or stop their medications.' 'It's something we don't talk about enough,' she added, 'but focusing on food should be a bigger part of how we prevent and manage heart disease and its complications.' Hypertension Cardiovascular / Cardiology Nutrition / Diet
News.com.au
5 days ago
- Health
- News.com.au
Why some spices could be doing more harm than good to your health
Welcome to Ask Doctor Zac, a weekly column from This week, Dr Zac Turner explores the truth about some common ingredients. QUESTION: Dear Dr Zac, I've been taking blood pressure medication for years without any issues – but I recently read that common spices I love and frequently use like ginger and black pepper can interfere with all types of medications. Now I'm starting to wonder: have my daily meals been affecting my meds this whole time? Or am I now just being paranoid to think my spice rack is doing more harm than good? – Warwick, 48, Canberra ANSWER: Dear Warwick, I've got some spicy news for you – you're not being paranoid. You may have been cooking up a storm, but some of your pantry favourites might have been quietly stirring up trouble in your bloodstream. This is one of those alarming but fascinating medical blind spots that very few people talk about. While your spice rack might look innocent, the truth is that many everyday spices pack serious pharmacological punch. That's right – your humble curry powder could be moonlighting as a biochemist, tweaking your enzyme levels while you're just trying to enjoy dinner. Let's break this down. Black pepper: The enzyme hijacker You know that satisfying little crack of the pepper mill? Behind that spicy pop is piperine, a compound that slows down enzymes responsible for breaking down medications. If you're on medications like propranolol or phenytoin, this could result in dangerously high drug levels in your system. While small amounts are usually safe, regularly consuming 2–4 tablespoons (yes, tablespoons!) of black pepper or popping high-dose pepper supplements can mess with your meds in a big way. Garlic: Blood pressure's double agent Garlic is known for helping lower blood pressure – but for people already on blood pressure meds, this can become a double whammy. Too much garlic can cause your BP to drop too low, leaving you dizzy, faint, or worse. It also acts as a blood thinner, making it a risky companion to Warfarin or Aspirin. Ginger, turmeric and friends: The bleeders Ginger and turmeric are the golden children of wellness influencers, but they too carry hidden dangers. Turmeric's curcumin and ginger's gingerols can thin your blood, interfere with how drugs are absorbed, and even raise levels of immune suppressants like tacrolimus. If you're on blood thinners, these spices could unintentionally supercharge your medication's effects – and not in a good way. Cinnamon, cloves and licorice: The silent saboteurs Cassia cinnamon, the kind most commonly found in your local supermarket, contains coumarin, which can damage the liver in large amounts. Cloves contain eugenol, which can also affect the liver and interfere with blood clotting. Licorice? That sweet little herbal tea ingredient can raise your blood pressure and cause fluid retention – definitely not ideal when you're on antihypertensives. So, should we all be terrified of tacos now? Absolutely not. Culinary doses – what you'd normally sprinkle into a stir-fry or curry – are almost always safe. It's when people start adding supplements, drinking litres of turmeric lattes, or chewing raw garlic like it's gum, that we start to see real medical consequences. Your best defence? Have a chat with your GP or pharmacist if you're on long-term medication. Ask whether any of your go-to herbs and spices might be interfering. And please, don't panic and toss your spice rack into the bin – just use your herbs with knowledge and care. Because while spices can heal, boost, and flavour our lives, taken the wrong way they can also sabotage our health quietly, slowly … and without us realising. So Warwick, your instincts were bang on. Your spice rack could be messing with your med -but now that you know, you can eat wisely and season with sense. Stay healthy (and mildly seasoned) – Dr Zac Dr Zac Turner is a medical practitioner specialising in preventative health and wellness. He has four health/medical degrees – Bachelor of Medicine/Bachelor of Surgery at the University of Sydney, Bachelor of Nursing at Central Queensland University, and Bachelor of Biomedical Science at the University of the Sunshine Coast. He is a registrar for the Australian College of Rural and Remote Medicine, and is completing a PhD in Biomedical Engineering (UNSW). Dr Zac is the medical director for his own holistic wellness medical clinics throughout Australia, Concierge Doctors.
