Home blood pressure monitors can help keep your blood pressure in check

Home blood pressure monitors can help people keep their blood pressure in check and possibly cut down on medication -- as long as the patients and their doctors put those home readings to good use, a new research review finds.

The analysis, of 37 international clinical trials, found that on average, adults with high blood pressure who were assigned to use home monitors shaved a few points off their blood pressure compared with counterparts who stuck with doctor's office measurements alone.

The home monitor users were also twice as likely to reduce the number of blood pressure medications they needed.

Researchers say the findings, reported in the journal Hypertension, should encourage people with high blood pressure to invest in a home monitor. The devices generally range in cost from about $25 to more than $100, depending on the features.

"Everyone who wants to know how well (their) blood pressure is controlled should monitor blood pressure at home," the study's lead author, Dr. Rajiv Agarwal of the Indiana University School of Medicine in Indianapolis, said.

He also likened blood pressure monitors to exercise treadmills, though. People may buy them with good intentions, but how they use them is what matters.

In their study, Agarwal and his colleagues found that home monitoring tended to work better when it was part of a general plan to adjust medications in response to the home readings.

The conventional way to do that is to bring your blood pressure readings to your doctor at each visit; some home monitors have memory storage that automatically records each reading and allows you to print out the information.

A few of the studies Agarwal's team reviewed tested so-called telemonitoring, in which wired or wireless technology is used to automatically send blood pressure readings to the doctor's office. Those studies tended to show greater effects on blood-pressure control than studies without telemonitoring.

Right now, though, telemonitoring is not commonly used for managing high blood pressure and studies are still investigating its value.

The findings are based on 37 clinical trials that included a total of 9,446 men and women with high blood pressure. In each, researchers randomly assigned some patients to use home blood pressure monitors and the rest to stay with office-based measurements. Most of the studies followed the participants for a few months to one year.

Overall, study participants using home monitors saw their blood pressure dip by 2 to 3 points, and most of the studies came out in favor of home monitoring over office-based measurements alone -- though the differences were generally small.

Patients with home monitors were also more likely to be able to cut down their drug regimen. In one of the larger trials, for example, 51 of 203 home-monitor patients reduced their number of medications, versus 22 of 197 patients without home monitors.

That, according to Agarwal's team, may be because home monitoring helps detect the "white coat effect" -- when a person's blood pressure spikes in the doctor's office.

Dr. Giuseppe Mancia, who co-wrote an editorial published with the study, agreed that home monitors are a good investment.

"I definitely believe that all (high blood pressure) patients should be advised by their physician to use a home BP monitor," Mancia, of the University of Milano-Bicocca in Italy, said.

He also pointed out, however, that patients should use the monitors only as often as their doctors recommend, and not become obsessive about checking their numbers. Obsessive checking could just spur anxiety, which could, in turn, boost blood pressure.

Mancia said people should also be sure to choose monitors that have been validated for accuracy according to international criteria. Certain professional groups, like the British Hypertension Society and the Association for the Advancement of Medical Instrumentation, test blood pressure monitors' reliability and maintain lists of validated monitors on their websites.

Daily orange juice could lower diastolic blood pressure

Drinking orange juice every day may have important heart health benefits.  A recent study published online in the American Journal of Clinical Nutrition found that consuming about two cups of 100 percent orange juice every day for one month significantly lowered diastolic blood pressure among men who were slightly overweight, but otherwise healthy.(1) Improvements also were seen in other indicators of cardiovascular health, notably better functioning of the inner lining of blood vessels.

These results were observed when men drank 100 percent orange juice, as well as when they consumed a control drink plus purified hesperidin. Hesperidin, which is naturally found in oranges and orange juice, is a plant flavonoid, a member of the polyphenol family of plant compounds, which may have beneficial effects on human health.

"The main result of this study is that orange juice and hesperidin appear to promote a decrease in blood pressure, particularly diastolic blood pressure. This likely is the result of improved blood flow induced by a better functioning of the blood vessels. At the anatomical level, these beneficial effects on blood circulation could be due to a positive effect of orange juice and hesperidin on blood vessel dilatation and vessel resistance," said Christine Morand, lead author of the study from the French National Institute for Agronomic Research. "While the benefits were seen with both orange juice and hesperidin, results were most significant for orange juice, indicating that other properties in orange juice may be playing additional beneficial roles."

Study Highlights

In this randomized, controlled, cross-over study, 24 healthy overweight men, aged 50 to 65 years, consumed three different four-week dietary treatments, with a three-week 'wash-out' period between each treatment:

1. 500 milliliters a day of 100 percent orange juice, which is equivalent to 17 ounces or about 2 cups of orange juice;
2. 500 milliliters a day of a control drink plus a capsule of 292 milligrams of hesperidin, which was equivalent to the amount naturally found in the 500 milliliters of orange juice provided and;
3. 500 milliliters a day of a control drink plus a placebo.

Significant benefits seen from both the consumption of 100 percent orange juice and the purified hesperidin include:

• Improvements in blood pressure: Diastolic blood pressure (DBP), the bottom number in a blood pressure reading, significantly decreased by an average of 5.5 mmHg when the 100 percent orange juice group was compared to the placebo control group and by an average of 3.2 mmHg when the hesperidin group was compared to the placebo control group.  DBP is the pressure on artery walls when the heart relaxes between beats. DBP values are an important cardiovascular health indicator: the higher the diastolic blood pressure, the greater the risk for heart attacks, strokes and kidney failure.
• Improvements in blood vessel function: The inner lining of blood vessels demonstrated a significantly better ability to widen (called "vasodilation") immediately following both the orange juice and hesperidin treatments, with orange juice having a more significant effect. When blood vessels widen, there is less resistance to blood flow which leads to a decrease in blood pressure. This reduces the heart's workload, and serves as an important indicator of overall cardiovascular health.

Heart Health Benefits of 100 Percent Orange Juice

This study supports a larger body of epidemiologic evidence that has shown citrus fruit consumption is associated with a number of cardiovascular benefits including a lower risk of acute coronary events and stroke. (2),(3)

 Note: The research was supported by a grant from the Florida Department of Citrus (FDOC). FDOC's role was limited to the provision of orange juice and the analysis of orange juice components. FDOC had no role in study design, data collection, data analysis, decision to publish or preparation of the manuscript.  

Reduce your risk of stroke by 80% - lifestyle change matters!

A person who opts for healthy lifestyle choices can have an 80% lower risk of first time stroke compared to individuals who do not, scientists have revealed in an article in the medical journal Stroke. Of the 795,000 strokes that occur in the USA, over 77% are first events, the authors explain. After heart disease and cancer, stroke is the biggest cause of premature death in America. It is a major cause of disability.  New stroke prevention guidelines, which had previously been updated in 2006, are being issued.

The researchers say two factors can significantly reduce the incidence of first time strokes:

• Health lifestyle choices
• Emergency room interventions

Larry B. Goldstein, M.D., director of the Duke Stroke Center in Durham, N.C., said:

"Between 1999 and 2006, there's been over a 30 percent reduction in stroke death rates in the United States and we think the majority of the reduction is coming from better prevention."  Up to 1999 stroke incidence had been on the rise. There had been a 39% increase in hospitalizations due to stroke from 1988 through 1997.

The authors say the stroke rate in America will rise because people are living longer.

This time the stroke prevention guidelines address the condition as a broad continuum of related events, including ischemic stroke, non-ischemic-stroke and TIA (transient ischemic attack).

A stroke is a condition in which a blood clot or ruptured blood vessel interrupts the flow of blood to a specific area of the brain. Lack of glucose and oxygen flowing to the brain results in the death of brain cells and subsequent brain damage. The patient may have problems with speech, memory and movement. There are two main types of stroke:

• Ischemic stroke - represent about 87% of all strokes. A thrombus (blood clot) forms, blocking blood flow to a part of the brain. Sometimes the clot can form in another part of the body, becomes dislodged and free-floating (an embolus). The embolus can make its way through the bloodstream to the brain where it can cause an ischemic stroke.

• Hemorrhagic stroke (non-ischemic stroke) - a blood vessel ruptures. The leaking blood fills the space between the brain and skull (subarachnoid hemorrhage). Can also occur if a defective artery in the brain bursts and fills the surrounding tissue with blood (cerebral hemorrhage). In both cases there is poor bloodflow to the brain, plus the accumulation of leaking blood places excessive pressure on the brain.

• A transient ischemic attack (TIA), also known as a mini-stroke, is a temporary interruption of blood flow to a part of the brain. TIA symptoms may be similar to a stroke, however they last for a shorter time and do not leave noticeable permanent damage. TIAs are considered major risk factors for a later, larger stroke.

Highlighted below are some major updates in the new stroke prevention guidelines:

Healthy lifestyle choices - don't smoke, follow a healthy low fat diet with plenty of fruits and vegetables, if you consume alcohol do so in moderation, keep your body weight within normal limits, and exercise regularly. People who adopt ALL these lifestyle choices can have an 80% lower risk of developing a stroke.

Source: MedNews Today

Race, gender and where you live strongly affect your risk for high blood pressure

A new study finds that race, gender and where you live strongly affect your risk for high blood pressure, which is a major risk factor for heart disease and stroke.  Deaths from heart disease and stroke in the United States decreased 65 percent overall between 1968 and 2006, but rates of cardiovascular death are still higher in the southeastern United States, in blacks compared to whites, and in men compared to women.

Study author Dr. Deborah A. Levine and colleagues suspected high blood pressure may play a role in these differences. They examined data from 3,436 people in Birmingham, Ala., Chicago, Minneapolis and Oakland, Calif., who took part in the Coronary Artery Risk Development in Young Adults (CARDIA) study.

The participants were aged 18 to 30 when they enrolled in the study and none of them had high blood pressure. After 20 years of follow-up, high blood pressure had been diagnosed in:

• 37.6 percent of black women
• 34.5 percent of black men
• 21.4 percent of white men
• 12.3 percent of white women.

• 33.6 percent of Birmingham residents
• 27.4 percent in Oakland, Calif.
• 23.4 percent in Chicago
• 19 percent in Minneapolis.

After they adjusted for a number of risk factors, the researchers concluded that living in Birmingham significantly increased the risk of developing high blood pressure.

"In addition, independently of where they live, blacks -- especially black women -- are at markedly higher risk of hypertension even after we took into account factors that are known to affect blood pressure, such as physical activity and obesity," Levine, an assistant professor of internal medicine at the University of Michigan Medical School, said in an American Heart Association news release.

Further research is needed to learn more about how race, gender and geography affect high blood pressure risk, she added.

The study appears in the Dec. 6 online issue of the journal Hypertension.

Lizard venom could open up new areas for treatment of high blood pressure

Scientists have discovered five new types of lizard venom which could prove a goldmine for researchers working on the next generation of blood pressure and heart disease medication.

The results of a wide-ranging four-year study, led by University of Melbourne venom expert Bryan Fry, also found some lizard species thought not to be venomous actually were.

''Their venom is unlike anything we've ever seen,'' Dr Fry said. ''These are brand-spanking new toxin classes, completely unique.''

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Of the five new classes of venom discovered, three already show huge potential for drug design and development because of the small size of their compounds. ''You want to start with something small,'' Dr Fry said. ''If you start with something big then there is a greater chance of the immune system reacting violently to it … we have found three that aren't going to be picked up by the immune system at all.''

Dr Fry said the next step was to ''reinvent the wheel'' and make an artificial version of the venom. The aim would be to make it more potent and stable than the naturally occurring venom and also to extend its life in the human body.

The study involved collecting and analysing the venom of 25 lizards from around the world including the monitor, North American alligator lizard and European legless lizard. These lizards belong to a group of venomous lizards called anguimorphs which have, scientifically speaking, been an untapped resource.

However, Dr Fry said it was possible that ''obscure little lizards'' could hold the key to the next wonder drug - and this being the case, it was vital that their habitat was preserved.

Historically, reptile venom has proved a handy tool for scientists developing drugs for high blood pressure. ''But these three [toxins] are completely different, which is important because they hit the blood pressure system completely differently,'' Dr Fry said. ''Basically, we now have three more opportunities for treating high blood pressure.''

The findings have been published in this month's edition of theJournal of Molecular and Cellular Proteomics.

Institute of Medicine increases RDA for Vitamin D

The recommended dietary allowance for vitamin D in the USA and Canada have been increased - the guidelines were issued today by the Institute of Medicine (IoM). For the last ten years people have been reading conflicting reports on what their vitamin D intake should be, as well as calcium intake. Consequently, the US and Canadian governments asked the IoM to examine data and health outcomes linked to vitamin D and calcium consumption, and to produce new DRIs (Dietary Reference Intakes).

The new recommendations for daily vitamin D intake are (upper level):

• 1000 IU - infants up to 6 months of age
• 1,500 IU - ages 6 months to 12 months
• 2,500 IU - ages 1 to 3 years
• 3,000 IU - ages 4 to 8 years
• 4,000 IU - 9 years and older

The new recommendations for daily calcium intake are (upper level):

• 1,000 milligrams - infants up to 6 months of age
• 1,500 milligrams - ages 6 months to 12 months
• 2,500 milligrams - ages 1 to 8 years
• 3,000 milligrams - ages 9 to 18 years
• 2,500 milligrams - 19 years to 50
• 2,000 milligrams - 51 years and older

Vitamin D has historically been associated with healthy bones, however new research has revealed other benefits, including cancer and diabetes prevention. Vitamin D has also been found to reduce the risk of hypertension (high blood pressure).

Professor of foods and nutrition, James C. Fleet, from Purdue University, said:

"There is a consensus among most experts that many people have low serum of vitamin D levels, an indicator of vitamin D status, but there is disagreement on how high those levels need to be and how much is needed to raise vitamin D to a healthy level.

Some believe that vitamin D has incredible benefits and the recommended amount should be even higher than the new recommendation. However, research does not yet mirror those beliefs, so there is more work to be done."  Prof. Fleet studies how vitamin D controls calcium metabolism, as well as its role in prostate and colon cancer prevention. He adds that the new recommendations will help federal guidelines for various nutrition programs, including the food stamp program, the WIC (Woman, Infants and Children) program, and school lunch programs.

Vitamin D helps transport calcium and phosphorous through the digestive system - it is a cholecalciferol. Bone health does not only depend on adequate levels of calcium, but also phosphorous. Phosphorous is vital for cell strength and energy production.

Although sunlight is a good source of vitamin D, in that it stimulates the skin to synthesize the vitamin, it may also raise the risk of skin cancer. Sun exposure needs to be carefully measured, the amount depends on several factors, including which part of the world you live in, the season, and your type of skin. Some medications can also make the skin more sensitive to the negative effects of sunlight.

Prof. Fleet said:

"For most people, and assuming they live somewhere there is ample sunlight, it really doesn't take much sun to make adequate levels of vitamin D. However, that said, the dermatology community believes that there is no such thing as safe sun, so people need to get vitamin D from supplements or their diet."

Salmon, sardines, shrimp and eggs are rich in vitamin D. It is commonly added to breakfast cereals, orange juice and milk.

Fleet explains that most people do not consume enough vitamin D foods for their daily requirements. Vitamin supplements can be used to fill any dietary shortfalls.

People over 9 years of age should not receive over 4,000 IUs daily, Fleet adds. This is higher than the previous 2,000 limit. Those taking more than the recommended limit should check with their doctor.

Fleet said:  "Several groups need to especially pay attention to their vitamin D levels. For example, people with dark skin or those who cover up can't make vitamin D in their skin. Also, we lose the ability to make vitamin D in the skin as we age. At the same time, older adults' bones are becoming weaker, especially for postmenopausal women, so it is critical that vitamin D is consumed adequately to preserve bone health."

"Dietary Reference Intakes for Calcium and Vitamin D"

Source: Medical News Today / Christian Nordqvist