Blood Pressure Archive

Contrary to conventional wisdom, some blood pressure drugs are linked to a lower risk of depression.

Like all medications, blood pressure drugs sometimes cause unwanted side effects. While many are mild and short-lived, some are more worrisome, including mood changes such as depression. But contrary to what doctors have long assumed, blood pressure drugs may not raise the risk of depression. In fact, some appear to be linked to a lower risk, according to a recent study (see "Depression rates in people taking different blood pressure drugs").

"The traditional view has been that blood pressure drugs that cross the blood-brain barrier are more likely to cause depression," says Dr. Randall -Zusman, a cardiologist at Harvard-affiliated Massachusetts General Hospital. Depression has also been associated with drugs known as beta blockers. But beta blockers (which work in part by slowing the heart rate) can also make you feel tired and listless, which may dampen your mood, Dr. Zusman explains.

The benefits of tub baths are more than skin deep. Bathing regularly can help ease pain and potentially benefit your heart.

You know that sinking into a warm bath at the end of a long day can help you relax and unwind, but did you know it might also be good for your health? Research shows that using baths as a form of medical therapy, sometimes referred to as balneotherapy (see "Balneotherapy, or bath therapy"), can bring health benefits — among them, easing certain types of chronic pain, helping your skin, and potentially even improving heart health.

Certain drugs or treatments may affect the skin, causing side effects like excessive dryness or blue spots.

Having problems with your skin? You may want to look in your medicine cabinet. Numerous prescription drugs and even over-the-counter treatments may bring unexpected skin changes, says Dr. Suzanne Olbricht, an associate professor of dermatology at Harvard Medical School. Medications to look out for include the following.

Blood-thinning medications

Spontaneous bruising that occurs even without bumping into something becomes more common as you get older. Doctors call it senile or actinic purpura and it happens often in people who take medication to prevent blood clots, such as warfarin (Coumadin) or even a baby aspirin. "As you age, the dermis, the thick middle layer of the skin, begins to thin and doesn't support the blood vessels inside as well as it used to," says Dr. Olbricht. This can make the blood vessels more likely to break. Even the tiniest injury can release blood under the skin, leading to the discoloration and dark purple bruises that characterize this condition.

News briefs

If your doctor or pharmacist offers a service to monitor blood pressure measurements you send from home (called telemonitoring), consider taking advantage of it. Past research has shown that telemonitoring — often paid for by Medicare — may help you reduce your blood pressure. And a study published online Aug. 31, 2020, by Hypertension suggests telemonitoring is also associated with a long-term reduction in heart attacks, strokes, and medical costs. The recent study is a follow-up to a randomized controlled trial from 2013 that divided 450 people into two groups: those who received routine primary care, and those who received a year of telemonitoring services with a pharmacist who helped manage their treatment. People in the telemonitoring group had lower blood pressure for up to two years afterward, compared with people who received routine care. In the recently published follow-up, which followed the same participants for five years, researchers found there were about half as many heart attacks, strokes, and hospitalizations in the telemonitoring group as there were in the group that received routine care. Because there were fewer cardiovascular problems, people in the telemonitoring group also saved an estimated $1,900 each in medical costs.

On call

Q. My blood pressure stays low. Sometimes it drops so low, it causes dizziness and weakness. What causes this?

A. Of the possible causes of low blood pressure, two are at the top of my list. First, I would review your medications. Drugs prescribed to treat high blood pressure and heart disease are the ones that most often cause this side effect. Reducing the dose with your doctor's approval may be all you need.

Research we're watching

Need another reason to quit smoking? A study published in the September 2020 issue of the Journal of Neurology, Neurosurgery and Psychiatry found that women ages 30 to 60 who smoked had four times the risk of having a brain aneurysm (a weakened artery in the brain that bulges and could burst) compared with nonsmokers.

Researchers looked at nearly 550 women who had a brain scan performed, most often because of persistent headaches. The scans showed that 113 of them had one or more brain aneurysms. These individuals were then matched with 113 people who did not have brain aneurysms. In comparing the two groups, the researchers found not only that smoking drove up the risk of finding a brain aneurysm, but also that women who both smoked and had high blood pressure had seven times the risk compared to nonsmokers with normal blood pressure. If future research shows that smokers also have a significantly higher risk of brain aneurysm rupture, women smokers ages 30 to 60 might be candidates for aneurysm screening.

Research we're watching

A specialized fall prevention program managed by nurses wasn't able to significantly reduce the rate of serious falls among high-risk adults over age 70, according to a study published July 9, 2020, in The New England Journal of Medicine. The STRIDE program (the name stands for Strategies to Reduce Injuries and Develop Confidence in Elders) was tested by the Patient-Centered Outcomes Research Institute and National Institutes of Health as a means of reducing falls among high-risk seniors.

Falls are a leading cause of injury in people 65 and older, with some three million adults heading to the emergency room each year with a serious injury caused by a fall. Program staff worked with individuals at least 20 months to identify and modify such risk factors as problems with walking or balance, hazards in the home that made a fall more likely, a history of low blood pressure when standing, and low vitamin D levels.

Get an approved blood pressure device and follow these steps.

Monitoring your blood pressure at home has always made good sense. Blood pressure is one of the main indicators of cardiovascular health, and taking measurements is an important way to manage chronic conditions between doctor visits.

Now, with a pandemic under way and fewer people visiting their doctors, the case for monitoring blood pressure at home has never been stronger. Home monitoring yields valuable information for you and your physician, who'll be counting on you to provide accurate blood pressure measurements when you talk on the phone or in a video chat.

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.