Controlling Your Blood Pressure Archive

The next time you have your blood pressure checked, ask your health care to check it in both arms, rather than just in one. Why? A big difference between the two readings can give you an early warning about increased risk of cardiovascular disease, a new study suggests. Harvard researchers found that people who have a 10-point difference in blood pressure from one arm to the other are 38% more likely to have a heart attack, stroke, or a related problem than those with arm-to arm differences less than 10 points. Small differences in blood pressure readings between the right and left arm are normal. But large ones suggest the presence of artery-clogging plaque in the vessel that supplies blood to the arm with higher blood pressure. Clogging there means there’s a good chance the arteries in the heart and brain are also clogged, boosting the odds of having a heart attack or stroke.

Many foods—from the everyday to the exotic—are rich in nutrients that may help keep your arteries clear and your heartbeat stable.

Start your day with a bowl of oatmeal and some orange wedges. Enjoy a hearty bowl of bean soup for lunch. Grab a handful of peanuts for a midafternoon snack. For dinner, tuck into some grilled salmon and spinach salad drizzled with extra-virgin olive oil.

This menu features common foods full of nutrients associated with better heart health.

New guidelines raise the threshold for drug treatment of high blood pressure to 150/90 mm Hg in adults ages 60 and older.

Q. I recently started using an alpha blocker to relieve my difficulties starting urination and emptying my bladder. I am concerned about the drug's known tendency to lower blood pressure, since mine is already on the low side. Is this medication safe to take?

A. You can use these medications safely if you are aware of the side effects and report any problems to your doctor so adjustments can be made. Alpha blockers vary in their effects on blood pressure. The medications relax the muscles in the prostate gland to allow easier emptying of the bladder. But the medication also relaxes muscles in blood vessels, which makes blood pressure drop.

Less aggressive treatment prevents side effects but could lessen the proven benefits of treating high blood pressure.

New expert recommendations for treating high blood pressure call for a higher threshold at which men age 60 and older should consider taking medication to lower their blood pressure. The new treatment threshold is 150/90 mm Hg, higher than the previous recommendation of 140/90.

A diet high in fresh fruits and vegetables can help reduce your risk of heart disease, high cholesterol, and high blood pressure. And it may not take a wide variety of fruits and vegetables to do the job. A Harvard study in the December 2013 American Journal of Clinical Nutrition found that the amount of produce people ate was more important than the types of produce. People who ate the most fruits and vegetables each week (five servings or more) had up to a 17% lower risk of developing heart disease than people who ate fewer servings. "It's likely from compounds found in these healthy food choices, which may explain why foods usually come out more beneficial in health studies than studies of pills that test a single compound extracted from foods and put into a pill," says Dr. Eric Rimm, one of the study authors and an associate professor of epidemiology and nutrition at the Harvard School of Public Health. Despite the finding about quantity, Dr. Rimm and his colleagues also noted that specific fruits and vegetables were associated with a lower risk of heart disease, including citrus fruit, dark green leafy vegetables such as kale and spinach, and vegetables loaded with beta carotene, such as carrots and sweet potatoes. So which should you focus on, variety or quantity? "Clearly to get the most benefit, at least a few different types of fruits and vegetables should be in your diet," he says.

There's new hope for people with hard-to-control blood pressure known as resistant hypertension. Often—70% of the time—they also have obstructive sleep apnea (OSA), a condition that interrupts their breathing while they sleep. Now researchers say using a special machine to treat the OSA can help lower blood pressure as well. The findings, published Dec. 11, 2013, in The Journal of the American Medical Association, suggest that using a small bedside air pump and mask that keep the airways open with continuous positive airway pressure (CPAP) can lower average daily blood pressure by a few points. Though small, the improvements are important. Nighttime interruptions in breathing stress the cardiovascular system, increasing the risk of heart attack and stroke. A CPAP machine shouldn't replace medications to control blood pressure, but this study suggests the machine may complement them.

Many people develop high blood pressure during their lifetime. These steps may delay your need to take medicines.

Hypertension, defined as a blood pressure reading of 140/90 mm Hg or above, is the primary risk factor for heart attack and stroke. Additionally, it sets the stage for other serious conditions, such as kidney failure, blood vessel damage, vision loss, and dementia.

Despite a 2012 FDA warning that taking the cholesterol-lowering drugs known as statins may lead to memory loss or confusion, the evidence supporting that claim is very weak. The warning was apparently based on a number of case reports, which are considered less reliable than other studies, such as those that compare users of a drug to nonusers. The latest research, in Annals of Internal Medicine, included data from 27 studies and found no proof linking statin use to dementia or other problems associated with thinking and memory.

The study authors also looked at data collected by the FDA from people who reported side effects while taking statins or either of two other drugs, the blood pressure drug losartan (Cozaar) and the anti-clotting drug clopidogrel (Plavix). Reported rates of cognitive problems were similar for all three medications, yet the FDA has not issued similar warnings on losartan or clopidogrel (nor does it need to).

Q. I've heard that extra potassium can improve my blood pressure. What do you think?

A. It can in most people. Potassium is a mineral that is essential to health. But, like a lot of essential minerals and vitamins, the question is: how much do we need? Answering that begins with two other questions. First, how much potassium is in your daily diet? (You'd work with a dietitian to answer that one.) Most people in the United States do not eat enough potassium-rich foods, according to the National Health and Nutrition Examination Survey.