Controlling Your Blood Pressure Archive

New findings challenge the widespread belief that aggressive blood pressure treatment may trigger a condition linked to fainting and falls.

When doctors treat older people with high blood pressure, they often worry about a condition that causes blood pressure to plummet when a person stands up from a seated or lying position. Known as orthostatic hypotension (hypotension means low blood pressure), it affects as many as one in five people ages 65 and older.

Because orthostatic hypotension can make you feel dizzy or lightheaded after standing, it may lead to fainting and falls — with possibly serious repercussions. This concern leads some doctors to ease up on prescribed blood pressure medications. But a new study suggests that practice actually might do more harm than good.

Research we're watching

Walking even at a "casual" pace — covering a mile in 30 minutes — five days a week may lower the odds of high blood pressure in postmenopausal women, a new study finds.

Researchers relied on data from more than 83,000 women ages 50 to 79 who did not have high blood pressure. When they joined the study, they filled out questionnaires about their walking speed and duration. This was followed by yearly questionnaires that included checking for a diagnosis of high blood pressure.

If you've been diagnosed with heart disease, the FITT approach can reduce your risk for heart attack and stroke.

About half of all Americans have at least one of the key risk factors for heart disease, such as high cholesterol, high blood pressure, and excess weight.

You can address those risks with a heart-healthy diet and medications to lower blood pressure and cholesterol levels. But perhaps the biggest boost you can give your heart is regular aerobic exercise.

Labels on the bottles promise better health, but these supplements may wind up hurting you.

Keeping your heart healthy requires a combination of strategies, such as eating a healthy diet, exercising regularly, and managing stress. Adding a dietary supplement may seem like another means of protection.

But be careful. Unlike prescription medications, supplements are often sold without evidence that they work or they're safe. There's no way to know what's really inside pills or potions, since the FDA doesn't evaluate whether the manufacture of supplements is high quality, such as whether the pills are free from impurities. The following supplements may pose heart risks.

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.

Make some simple swaps to lighten up traditional fare. But feel free to enjoy small servings of favorite treats, too.

'Tis the season to be jolly — and to indulge in favorite holiday foods and beverages. The weeks between Thanksgiving and New Year's Eve are often full of opportunities to feast on foods high in fat and sugar. The average American packs on an extra pound of weight every year, and at least half of that is gained over the holiday season, according to several studies.

To help curtail that trend, which will help your heart as well as your waistline, try some of the alternative or lighter versions of foods and drinks traditionally served during the December holidays, described below. But there's no need to deprive yourself of special favorites that you have just once a year. "You can weave them in with healthier options," says Liz Moore, a dietitian at Harvard-affiliated Beth Israel Deaconess Medical Center.

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.

News briefs

Bisphenol A (BPA), used to make some plastics and epoxy resins, has made headlines for years because of its association with an increased risk for obesity, diabetes, high blood pressure, and cardiovascular disease in humans. Now high levels of BPA exposure have been linked to an increased risk for premature death from any cause, according to a study published online Aug. 17, 2020, by JAMA Network Open. Scientists analyzed the survival rates of about 3,900 people who provided health information and urine samples and were then followed for 10 years. People with the highest levels of BPA in their urine had a 51% higher risk of dying during that period, primarily from heart disease, compared with people who had the lowest levels of BPA. The findings don't prove that BPA caused premature death, but they add to concerns about BPA's potential toxicity. BPA and related chemicals are found in many products, such as water bottles, cups, dental sealants, paper receipts, and the linings of food and beverage cans and pipes, so it's hard to avoid them. Simple precautions include relying less on canned foods and more on fresh foods; avoiding plastics with a 3 or 7 recycling label; microwaving food in glass or ceramic containers, not plastic; and looking for BPA-free products.

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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.