Controlling Your Blood Pressure Archive

How healthy are you, and how does your life expectancy stack up against the average? To answer these questions, your doctor will ask about your smoking, drinking, diet, and exercise. He'll measure your cholesterol, blood pressure, blood sugar, and weight or waist size. And he may ask if you're happy or stressed and if you sleep well.

These facts and numbers do count; men who rate well in midlife stay healthier and live longer than gents who score poorly. Still, scientists are always looking for additional measurements that predict survival. And research from Denmark proposes an unlikely candidate: semen quality.

Ideal CV health

Lloyd-Jones DM, Hong Y, Labarthe D, Mozaffarian D, Appel LJ, Van Horn L, Greenlund K, Daniels S, Nichol G, Tomaselli GF, Arnett DK, Fonarow GC, Ho PM, Lauer MS, Masoudi FA, Robertson RM, Roger V, Schwamm LH, Sorlie P, Yancy CW, Rosamond WD. Defining and setting national goals for cardiovascular health promotion and disease reduction: the American Heart Association's strategic Impact Goal through 2020 and beyond. Circulation 2010; 121:586-613.

Bambs C, Kip KE, Dinga A, Mulukutla SR, Aiyer AN, Reis SE. Low prevalence of "ideal cardiovascular health" in a community-based population: the heart strategies concentrating on risk evaluation (Heart SCORE) study. Circulation 2011; 123:850-7.

Some people experience drops in blood pressure when they stand up. Falls are a risk. But there are often simple ways to counter the problem.

When we stand up, blood tends to pool in the lower half of our bodies, filling veins in the liver, intestines, and other abdominal organs, as well as those in the legs. The downward flow means there's a danger of not enough blood reaching the brain, which can lead to a loss of consciousness. But adjustments occur that keep that from happening. Sensors in the aorta in the torso and in the carotid arteries in the neck trigger a response that revs up the "fight-or-flight" part of the nervous system and dials down the "rest-and-digest" part. The heart beats a little faster and stronger. Blood vessels constrict, squeezing blood into a tighter space. Blood flow and blood pressure stay more or less normal.

Surviving a heart attack — A success story

Morbidity and Mortality Chart Book, National Heart, Lung, and Blood Institute, 2009.

Measuring blood pressure: Let a machine do it

Myers MG, Godwin M, Dawes M, et al. Conventional versus automated measurement of blood pressure in primary care patients with systolic hypertension: randomised parallel design controlled trial. BMJ 2011; 342:d286.

Automating this task could yield more accurate blood pressure readings.

Doctors are notoriously bad at measuring their patients' blood pressure. Nurses are better but many still don't use the correct method. And clinicians who do follow the proper procedure often get a reading that is higher than the person's usual blood pressure. This is called white-coat hypertension — blood pressure that is high when a doctor or other clinician measures it but normal the rest of the time.

Do you know your blood pressure? Do Americans get most of their sodium from table salt? Is sea salt a low-sodium alternative to table salt? If you answered yes, no, and no, give yourself a gold star. Your fellow Americans, though, didn't do quite as well on these questions, all part of an American Heart Association poll.

Among the 1,000 people who completed the poll in March 2011:

Researchers are exploring the many ways in which music may influence health, from stress relief to athletic performance.

Stepping up prevention efforts could brighten up predictions.

Baby boomers have been blamed for a litany of social woes, from the breakdown of the American family to global warming. The American Heart Association (AHA) adds another: sparking a huge increase in cardiovascular disease and health care costs over the coming decades. But this one boomers could walk away from — literally.

The baby boom began in 1946 and ended in 1964. By 2030, anyone born during that period will be ages 65 and older, the key years for cardiovascular disease to blossom. (We use the term "cardiovascular disease" to cover a range of heart and artery conditions, including heart attack, stroke, heart failure, and peripheral artery disease, among others.)

If you've ever sought information about how to cope with a medical condition, chances are that other patients were one of your best sources. Listening to the stories of people "in the same boat" can bolster us in many ways; for example, it can help us stick with sometimes burdensome treatments. Personal storytelling has long had a place in medicine — in support groups and doctor-patient relationships, for example. But how it affects the behavior of patients is hard to test. Now, in a trial, researchers have found that the blood pressure of patients with uncontrolled hypertension improved after they viewed DVDs of other people in their community talking about their own experiences with hypertension. Results were published in Annals of Internal Medicine (Jan. 18, 2011).

The study. Researchers at the University of Massachusetts Medical Center in Worcester, Mass., working with colleagues in Birmingham, Ala., randomly assigned 299 inner-city African Americans with hypertension (more than two-thirds of them women) to either usual care or a "storytelling" intervention in which they watched interviews with other inner-city African Americans who talked about living with high blood pressure. Some of them had their hypertension under control and others did not. All of the study subjects were given three DVDs. The intervention group received the storytelling DVDs, while the usual care group received DVDs covering health topics but nothing specifically about hypertension. Both groups watched the first set of DVDs in the clinic and were mailed the next two sets at home three months later and six months later. Blood pressure was measured at the start of the study, three months later, and then six to nine months later. Researchers also asked participants how much time they spent viewing the DVDs.

Q. Sometimes I take a walk while wearing my blood pressure cuff. For the first few minutes, as I walk at a modest pace, my systolic blood pressure rises from 115 to 130 or so, while my heart rate hardly changes from its usual 60-something beats per minute. But when I start walking faster, my systolic pressure stays steady or sometimes goes down a bit, while my heart rate increases to 110. Is this a normal pattern? Can you explain what is going on?

A. When the average healthy person is sitting or walking at a normal pace, the heart, lungs, and blood vessels easily supply the body with all the oxygenated blood it needs. Start walking faster, or running, and the extra oxygen demanded by the leg muscles causes predictable changes in the circulatory system: the heart pumps faster and harder as it works to supply more blood to the active muscle; changes in the muscle tone of blood vessels redirect blood away from the digestive system and toward working muscle. These changes in heart rate, pumping intensity, and vascular tone usually cause a modest increase in systolic blood pressure. This is the pressure recorded as the heart contracts during systole (SIS-tuh-lee). It is represented by the upper number of a blood pressure reading.