Blood Pressure Archive

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.

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.

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Research we're watching

Frail, older people with health problems may live longer if they take the blood pressure medications their doctors prescribe, according to a study published in the August 2020 issue of the journal Hypertension.

Previous research suggests that in general, older people benefit from blood pressure drugs. But trials usually don't include people with multiple medical conditions, because those health problems make longevity findings challenging to interpret.

High blood pressure can damage the brain in several ways. Treating this common problem can protect your mind as well as your heart.

High blood pressure seldom causes any symptoms. But over time, the excessive force and friction of blood pushing against the inner walls of the arteries can damage blood vessels throughout the body. And while the biggest threat may be to your heart, your brain can also suffer.

Even slightly elevated blood pressure in middle age has been linked to a 30% higher risk of dementia two decades later. But taking blood pressure drugs may help people avoid that risk, according to a study in the May 19, 2020, issue of JAMA.

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.

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.

Sesame seeds may be most familiar as a topping on bagels, burger buns, and breadsticks. The tiny, tear-shaped seeds have a nutty, slightly sweet flavor that's enhanced when they're baked or lightly toasted in a skillet. Most are off-white or tan, but you can also find black varieties, which are popular in Asian cuisine.

Sesame seeds contain lignans and phytosterols, plant compounds that may have cholesterol-lowering effects. They're also a decent source of calcium and magnesium, two minerals linked to better blood pressure control.

Ask the doctor

Q. A recent electrocardiogram showed that I have a right bundle branch block. My doctor says it's fairly common and nothing to worry about, but I'm a bit concerned. What is it, exactly? And what specifically can cause this problem?

A. Bundle branch block refers to a small glitch in the heart's electrical conduction system. The term "bundle" refers to a collection of nerve fibers that receive the "contract now" signal from the atrioventricular node and relay it to the ventricles, the heart's lower chambers (see illustration).

The latest recommendations focus on newer medications, lifestyle changes, and procedures.

If you have heart disease, following a healthy diet and getting regular exercise should be a top priority. Both habits can help you reach and stay at a healthy weight and lower your blood pressure and cholesterol level. Chances are you'll also need to take medications to further improve those common heart-related risk factors. But if you also have diabetes, you may need even more aggressive treatment, according to new advice from the American Heart Association.

The recommendations, published May 12, 2020, in the journal Circulation, detail the latest evidence about treatments for people with both heart disease and diabetes. Diabetes, which affects about one in 10 adults, doubles the odds of having a heart attack or stroke (see "Why is diabetes hard on your heart?").

If you haven't made a video call yet, give it a try to fight isolation.

When much of the world began lockdowns to battle coronavirus in March 2020, many people turned to video calls to fight off the loneliness that often accompanies social isolation. Tech companies reported that the use of video calls for socializing surged by as much as 80%, enabling people to "see" family and friends. But it doesn't take a lockdown to warrant the use of this technology.

The epidemic of loneliness and isolation

Loneliness affects more than a third of older Americans. Another third of older adults feel isolated: they may be living alone, lack transportation, or live far from loved ones. Or they may have outlived a spouse or friends.