Blood Pressure Archive

In the journals

Age may not be a factor when it comes to who can benefit from statins. A study published online July 7, 2020, by JAMA found that people who started taking the cholesterol-lowering medication in their mid-70s or later had fewer heart-related problems and lived longer than non-users.

Researchers looked at 326,981 mostly male veterans, ages 75 and older, who were free of cardiovascular disease and did not take statins. Over the next 10 years, more than 57,000 began statin therapy.

People who take frequent saunas or hot baths may lower their risk of heart problems. But be cautious if you have low blood pressure.

Soaking in a bathtub or basking in a sauna can be a pleasant way to relax. Done on a regular basis, both habits may also help prevent heart attacks and strokes, according to several studies.

"The high temperatures in a warm tub or sauna cause your blood vessels to dilate, which lowers blood pressure," says Dr. Adolph Hutter, professor of medicine at Harvard Medical School. The volume of blood your heart pumps will also rise, especially in a hot tub. That's a result of the pressure of the water on the body, which increases the heart's workload, he explains.

For monitoring conditions that contribute to heart attack and stroke, virtual doctor visits are much more convenient than in-person appointments. Where is this trend headed?

Virtual doctor visits — when you talk to a physician on a video call instead of during an in-person office exam — have been available in certain places for years. But they never really caught on until the pandemic hit earlier this year. Almost overnight, virtual care became an indispensable tool for managing coronavirus infections and other health conditions during the crisis.

In 2019, virtual visits accounted for fewer than 1% of the appointments at Mass General Brigham, a large health care system founded by Harvard-affiliated Brigham and Women's Hospital and Massachusetts General Hospital (MGH). "But during the peak of the coronavirus surge in Boston, 80% of all visits were done virtually," says Dr. Lee Schwamm, director of the Center for TeleHealth at MGH and vice president of virtual care at Mass General Brigham.

Yes, but only under very unusual circumstances. Unless you have a rare inherited heart condition, consider these examples as curiosities rather than cause for concern.

If you take a statin, you've probably noticed the bright yellow sticker on the back of the prescription bottle warning you to avoid grapefruit and grapefruit juice. This tangy citrus fruit contains compounds that interfere with enzymes that break down various medications, including statins. This can boost blood levels of the drug, which could increase the risk of side effects.

It turns out that grapefruit also contains a substance called naringenin that can cause subtle changes in the heart's carefully choreographed timing. It does this by slightly prolonging what's known as the QT interval (see "What is long QT syndrome?"). To be clear, this phenomenon only happened in some volunteers after they drank about four cups of grapefruit juice. But a handful of other substances can have a similar effect, as described in an article about these so-called arrhythmogenic foods in the July 2020 issue of Trends in Cardiovascular Medicine.

Many provide links to published research about these heart -protecting drugs. Others mention personal beliefs about statins, some of which are inaccurate.

Statins are among the most frequently prescribed medications in the United States. These cholesterol-lowering drugs help reduce the risk of heart attacks and strokes, especially for people who've already had one of those life-threatening events. But many people stop taking their statins or don't take them as prescribed, a phenomenon doctors refer to as nonadherence.

Hoping to gain some insight into this trend, researchers analyzed 11,852 posts that mentioned statins on Twitter over a five-year period. About a quarter of Americans use Twitter, which is one of the most popular social media platforms. Although many of the tweets featured ads or financial market information, nearly half were related to health issues associated with statins. Of these, more than a third provided resource information, such as a link to a published study. About 20% included personal beliefs or attitudes about statins, which proved to be quite polarized. Some people described statins as lifesaving, while others referred to them as poisonous or deadly, according to the researchers, whose study was published June 25, 2020, in JAMA Network Open.

More than 10 million adults in the US have hypothyroidism — when the thyroid gland fails to produce enough thyroid hormone to meet the body’s needs — but the vast majority of these cases are considered mild. Whether or not to treat mild hypothyroidism is an ongoing debate. There is a possible link between mild hypothyroidism and coronary artery disease, but researchers found that treating it in older people did not provide any benefit.

News briefs

Here's a finding worth toasting if you're partial to a tipple: a study published online June 29, 2020, by JAMA Network Open linked low-to-moderate alcohol drinking in middle age with better cognitive (thinking) skills in older age. Researchers analyzed the health data of about 20,000 adults (average age 61) who took part in cognitive screenings every few years during a nine-year period and reported how much alcohol they drank each week. Men who had fewer than 15 drinks per week, and women who had fewer than eight drinks per week, were considered moderate drinkers. And they're the ones who appeared to have better word recall and vocabulary over time, and slower rates of cognitive decline, compared with people who never drank. The study is observational and doesn't prove that drinking alcohol protects the brain. In fact, the subject is debated: some studies have suggested that moderate alcohol drinking is associated with better cardiovascular health compared with heavy alcohol intake, but other studies have found that drinking any amount of alcohol increases the risk for high blood pressure and stroke. The takeaway: if you're going to raise a glass, do so only in moderation.

Image: © Ridofranz/Getty Images

Ask the doctor

Q. My husband is reluctant to get tested for sleep apnea. But I'm pretty sure that he has it, and I'm concerned because I've heard that it can contribute to heart disease. How are these two conditions connected?

A. As you likely know already, people with sleep apnea may snore loudly and may also periodically gasp for breath throughout the night. These explosive snorts often wake up bed partners or roommates — although not necessarily the person with apnea.

From badminton to pickleball to tennis, hitting objects across a net can be a fun, effective way to get in shape.

Looking for an exercise that gets your heart pumping and strengthens muscles in your legs, arms, and core? Tennis and other racquet sports can serve up all those benefits and more. In fact, several long-running studies have linked racquet sports to a lower risk of cardiovascular disease and a longer life.

"Playing tennis is an amazing workout. And no matter how good you are, you can have fun doing it," says Joe DiVincenzo, a physical therapist at Harvard-affiliated Spaulding Rehabilitation Hospital and former competitive tennis player. In general, racquet sports engage muscles throughout your upper and lower body, which challenges your heart. During a match, you do frequent, short bursts of high-intensity activity interspersed with less vigorous movements — a perfect example of interval training. Also known as HIIT (high-intensity interval training), this workout strategy seems to be a good way to boost cardiovascular fitness.

In the journals

Lowering high blood pressure with medication is good for the brain as well as the heart, suggests a study published online May 19, 2020, by JAMA.

Scientists reviewed 14 trials involving more than 96,000 people who had their high blood pressure monitored without medication vs. those who took one or more blood pressure drugs, such as beta blockers, ACE inhibitors, and angiotensin-receptor blockers. Almost 58% were men, and the average age was 69. The people were tested for dementia or cognitive impairment (trouble learning a new task, concentrating, or making decisions) before taking medication. They were tested again an average of four years later.