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Category: blood pressure

Published on Leave a comment on Can Exercise Be As Effective As Blood Pressure Medications In Lowering Blood Pressure?

Once again, a study found health benefits from exercise. This time a large review of studies found that the blood pressure lowering effect of exercise for persons with high blood pressure (hypertension) appears to be similar to that of commonly used blood-pressure (antihypertensive) medications. The study was designed to compare the effect of exercise and medications on systolic blood pressure (greater than 140 mmHg). Unfortunately no study directly compared the two, but the researchers were able to draw conclusions from 391 studies that had used randomly controlled trials (people assigned randomly to different conditions).

The American and UK researchers found that all programs of exercise and all blood pressure medications lowered blood pressure. They did find greater reductions in blood pressure in taking blood pressure lowering medications vs just exercise ("structured exercise regimens"), but pointed out that when studies just focused on people with high blood pressure (instead of everyone), then the results looked more impressive. Meaning the higher the blood pressure, the more effective the exercise.

Other findings: They did not observe a dose-response relationship between exercise intensity and blood pressure reduction. They found that even low-intensity exercise may be effective in reducing blood pressure. The researchers stressed the need for studies that directly compare  exercise programs to blood pressure medications, but point out that pharmaceutical companies are the ones doing the vast majority of studies and they don't have any incentive to do such a study (it could mean the loss of profits from medicines!). Many of the studies compared blood pressure medicines + exercise vs just blood pressure medicines. Thus the researchers said the topic of exercise and blood pressure is currently under studied.

Bottom line: get out and move, move, move for your health! All activity and movement is better than none. Yes, it's easier to just take daily pills, but all medications have side-effects and cost money. Exercise is free and the health benefits are many. Some health benefits of exercise from other studies: lowers blood pressure, lower risk of heart (cardiovascular) disease, lower the waist circumference (get rid of belly rolls!), and lowers triglyceride levels (in the blood).

From Science Daily: Exercise may be as effective as prescribed drugs to lower high blood pressure

Exercise may be as effective as prescribed drugs to lower high (140 mm Hg) blood pressure, suggests a pooled analysis of the available data, in what is thought to be the first study of its kind, and published online in the British Journal of Sports Medicine.   ...continue reading "Can Exercise Be As Effective As Blood Pressure Medications In Lowering Blood Pressure?"

Published on Leave a comment on Blood Pressure Doesn’t Always Increase With Age

In the US and other developed countries it is generally accepted that blood pressure increases with age -  that a blood pressure rise starts in childhood and that it's a normal part of aging. However, a new study found that this is not true - a South American rainforest tribe (the Yanomami) who do not eat a western diet (at all!) and have an active lifestyle, have the exact same blood pressure throughout life. This was true for all the individuals studied - from age 1 to 60. A nearby village of the Yekwana tribe have some western influences on lifestyle and diet, had the same low blood pressure in childhood, but showed increases with age.

The researchers feel that a Western diet and lifestyle play a role in the blood pressure increasing over the life span. They are now looking at the gut microbes of the two tribes to see what role they have in these blood pressure differences. Bottom line: get off your butt  and get active, and eat a high fiber, whole food diet (to feed the beneficial microbes) -  and avoid highly processed foods if you can. Easier said than done. From Science Daily:

Study of two tribes sheds light on role of Western-influenced diet in blood pressure

...continue reading "Blood Pressure Doesn’t Always Increase With Age"

Published on Leave a comment on Even Low Level Lead Exposure Is Linked to Later Health Problems

New research published in The Lancet estimates that lead exposure results in about 400,000 deaths every year in the USA - which includes about 250,000 deaths from cardiovascular disease. The study looked at "historical exposure" to lead, which means they looked at a person's lead exposure years ago (which could have been from many sources, such as breathing lead contaminated dust, drinking water from leaded pipes, from lead paint, leaded gas, or eating from cans that have been soldered with lead). What was noteworthy in this study following over 14,000 adults was that there were increased death rates even from low lead blood levels (concentrations of lead in blood lower than 5 μg/dL).

Lead exposure has been declining since the 1970s after lead was eliminated (banned) from paint and gasoline, but this study looked at adults born in the years when lead exposure was higher during childhood and adulthood. Baseline data (blood lead levels) was collected between 1988 and 1994 and then individuals were followed for the next 2 decades. The researchers found that there was a dose response curve - the higher the blood lead level, the higher the death rate from any cause (all-cause mortality), from cardiovascular disease, and from ischaemic heart disease in the next two decades.

Lead is a naturally occurring heavy metal, but it's also a poisonous substance for humans, and accumulates in teeth and bones. Lead can pass through the blood-brain barrier in children and fetuses and kill brain cells (and cause neurological damage). Lead can enter blood vessels and harm the endothelial cells that line the blood vessels. This process hardens arteries and causes plaque to form in blood vessels, increasing blood pressure, and the risk of heart disease and stroke. Lead can damage the kidneys, which play an important role in regulating blood pressure, and so increase a person’s risk of heart disease and stroke.

The Centers for Disease Control and Prevention (CDC) have stated that there are no safe blood levels of lead for children (zero is best), and the researchers of this study believe the same is true for adults. From Science Daily:

Historical lead exposure may be linked to 256,000 premature deaths from cardiovascular disease in adults in United States each year

New estimates suggest that 256,000 premature deaths from cardiovascular disease -- including 185,000 deaths from ischemic heart disease -- in the USA may be linked to historical lead exposure in middle-aged and older adults (people currently aged 44 years or over), according to an observational study following 14,300 people for almost 20 years, published in The Lancet Public Health journal.  ...continue reading "Even Low Level Lead Exposure Is Linked to Later Health Problems"

Published on Leave a comment on DASH Diet Linked To Lower Rate of Depression

A number of recent studies and articles have discussed the effectiveness of diet in treating or preventing depression with the main conclusion that yes, it helps. Now an observational study (that will be presented in April) found that elderly people following the DASH diet most closely were 11% less likely to become depressed over time than those that did not.

Researchers studying 964 elderly participants over six and a half years found that those who followed the DASH diet, which emphasizes whole grains, fruits, and vegetables, had lower rates of depression, while those who ate a traditional Western diet were more prone to depression. The DASH (Dietary Approaches to Stop Hypertension) diet also emphasizes low sodium (salt) to lower blood pressure, as well as foods rich in nutrients (such as potassium, calcium, and magnesium) that are thought to lower blood pressure.

The study's lead author L. J. Cherian (at Rush Medical Center in Chicago) said that "we need to view food as medicine”. Yes. Eating more fruits and vegetables, whole grains, legumes, seeds, nuts have many health benefits (such as cardiovascular benefits, improving the gut microbes) -  a win-win. From Science Daily:

Diet shown to reduce stroke risk may also reduce risk of depression

People who eat vegetables, fruit and whole grains may have lower rates of depression over time, according to a preliminary study that will be presented at the American Academy of Neurology's 70th Annual Meeting in Los Angeles, April 21 to 27, 2018. The study found that people whose diets adhered more closely to the Dietary Approaches to Stop Hypertension (DASH) diet were less likely to develop depression than people who did not closely follow the diet. In addition to fruit and vegetables, the DASH diet recommends fat-free or low-fat dairy products and limits foods that are high in saturated fats and sugar. Studies have shown health benefits such as lowering high blood pressure and bad cholesterol (LDL), along with lowering body weight.  ...continue reading "DASH Diet Linked To Lower Rate of Depression"

Published on Leave a comment on Eating Yogurt Associated With Lower Risk of Heart Attack and Stroke

Another study finding health benefits from eating yogurt - that men and women with hypertension who eat at least 2 servings or more per week of yogurt were at a lower risk of having a heart attack (myocardial infarction) and stroke. Women also had a lower risk of a revascularization procedure (such as a coronary artery bypass). The strongest association between yogurt consumption and lower risk of cardiovascular disease was among those with higher DASH (Dietary Approaches to Stop Hypertension) diet scores.The DASH diet is considered a healthy diet, one rich in fruits, vegetables, nuts, whole grains, beans (legumes), etc.

The major thing to keep in mind is that high blood pressure is a major cardiovascular disease risk factor. So anything that helps lower risk of heart attack or stroke is good. Note that in this large study they did not randomly assign people to different groups - so the higher yogurt intake people also tended to have a healthier lifestyle. But other studies have had similar findings to this one. For example, eating dairy products regularly is linked to lower rates of cardiovascular disease and high blood pressure, while eating yogurt regularly is linked to lower rates of hypertension and type 2 diabetes.

Also note that the types of yogurt (whole-fat, low-fat, non-fat) eaten were not looked at, as well as the types of probiotics added to yogurts. Some research suggests that beneficial effects are from whole fat dairy products rather than low-fat dairy products - which is different than DASH diet recommendations. From Science Daily:

Eating yogurt may reduce cardiovascular disease risk

A new study in the American Journal of Hypertension, published by Oxford University Press, suggests that higher yogurt intake is associated with lower cardiovascular disease risk among hypertensive men and women. .... High blood pressure affects about one billion people worldwide but may also be a major cause of cardiovascular health problems. Higher dairy consumption has been associated with beneficial effects on cardiovascular disease-related comorbidities such as hypertension, type 2 diabetes, and insulin resistance.

For the current analyses, participants included over 55,000 women (ages 30-55) with high blood pressure from the Nurses' Health Study and 18,000 men (ages 40-75) who participated in the Health Professionals Follow-Up Study.

Higher intakes of yogurt were associated with a 30 percent reduction in risk of myocardial infarction among the Nurses' Health Study women and a 19 percent reduction in the Health Professionals Follow-Up Study men. There were 3,300 and 2,148 total cardiovascular disease cases (myocardial infarction, stroke, and revascularization) in the Nurses' Health Study and the Health Professionals Follow-Up Study, respectively. Higher yogurt intake in women was associated with a 16 percent lower risk of undergoing revascularization.

In both groups, participants consuming more than two servings a week of yogurt had an approximately 20 percent lower risks of major coronary heart disease or stroke during the follow-up period. When revascularization was added to the total cardiovascular disease outcome variable, the risk estimates were reduced for both men and women, but remained significant. Higher yogurt intake in combination with an overall heart-healthy diet was associated with greater reductions in cardiovascular disease risk among hypertensive men and women.  [Original study.]

Published on Leave a comment on Blood Pressure Declines For More Than A Decade Before Death

This is interesting, that blood pressure naturally starts lowering in the 14 to 18 years prior to death in people 60 years or older - whether they are healthy, have hypertension, have heart disease, take hypertension medicines or not.

The researchers analyzed 20 years of medical data for patients in the United Kingdom, and while everyone's blood pressure dropped for more than a decade before death, the decreases were "steepest in patients with hypertension, dementia, heart failure, and late-life weight loss".

From Science Daily: Blood pressure declines 14 to 18 years before death

Blood pressure in the elderly gradually begins to decrease about 14 or so years before death, according to a new study published today in the Journal of the American Medical Association Internal Medicine. Researchers from UConn Health and the University of Exeter Medical School in the U.K. looked at the electronic medical records of 46,634 British citizens who had died at age 60 or older. The large sample size included people who were healthy as well as those who had conditions such as heart disease or dementia.

They found blood pressure declines were steepest in patients with dementia, heart failure, late-in-life weight loss, and those who had high blood pressure to begin with. But long-term declines also occurred without the presence of any of these diagnoses.

Doctors have long known that in the average person, blood pressure rises from childhood to middle age. .... Some studies have indicated that blood pressure might drop in older patients and treatment for hypertension has been hypothesized as explaining late-life lower blood pressures. But this study found blood pressure declines were also present in those without hypertension diagnoses or anti-hypertension medication prescriptions. Further, the evidence was clear that the declines were not due simply to the early deaths of people with high blood pressure. [Original study.]

Published on Leave a comment on Frequent Sauna Bathing May Be Good For Blood Pressure

Is frequent sauna bathing beneficial? That's what one study suggests. When the study started all 1621 men (aged 42 to 60) had normal blood pressure and none had been diagnosed with hypertension, and the follow-up was about 22 years later. The study took place in Finland, where sauna bathing is an important part of the culture - for all men, from all walks of life. The study found that frequent sauna bathing lowered the risk of developing hypertension - 46% when comparing men who sauna bathed once a week vs those who sauna bathed 4 to 7 times a week.

How could sauna bathing have these effects? There are several possibilities, but one is that sauna bathing produces "acute vasodilation" of the blood vessels, which leads to a significant drop in blood pressure. The temperature in the sauna is usually from 80 °C to 100 °C (176 to 212 degrees Fahrenheit), and the average sauna session (in this study) lasted an average of 14.4 minutes. From Science Daily:

Frequent sauna bathing keeps blood pressure in check

Frequent sauna bathing reduces the risk of elevated blood pressure, according to an extensive follow-up population-based study carried out at the University of Eastern Finland. The risk of developing elevated blood pressure was nearly 50% lower among men who had a sauna 4-7 times a week compared to men who had a sauna only once a week. The same researchers have previously shown that frequent sauna bathing reduces the risk of sudden cardiac death, and cardiovascular and all-cause mortality. Elevated blood pressure is documented to be one of the most important risk factors of cardiovascular diseases.

The Kuopio Ischaemic Heart Disease Risk Factor Study (KIHD) involved 1,621 middle-aged men living in the eastern part of Finland. Study participants without elevated blood pressure of over 140/90 mmHg or with diagnosed hypertension at the study baseline were included in this long-term follow-up study. Based on their sauna bathing habits, men were divided into three sauna frequency groups: those taking a sauna once a week, 2-3 times a week, or 4-7 times a week. During an average follow-up of 22 years, 15.5% of the men developed clinically defined hypertension. The risk of hypertension was 24% decreased among men with a sauna frequency of 2-3 times a week, and 46% lowered among men who had a sauna 4-7 times a week.

Sauna bathing may decrease systemic blood pressure through different biological mechanisms. During sauna bathing, the body temperature may rise up to 2 °C degrees, causing vessels vasodilation. Regular sauna bathing improves endothelial function, i.e. the function of the inside layer of blood vessels, which has beneficial effects on systemic blood pressure. Sweating, in turn, removes fluid from the body, which is a contributing factor to decreased blood pressure levels. Additionally, sauna bathing may also lower systemic blood pressure due to overall relaxation of the body and mind.

[NOTE: Above photo is of interior of a modern Finnish sauna. Credit: Wikipedia]

Published on Leave a comment on Is ‘Fat But Fit’ A Myth?

Is "fat but fit" a myth or true? The results of this study suggest that it is a myth. That there is a higher risk of coronary heart disease, and even if everything looks OK initially, it is associated with an eventual metabolic changes (and problems). Just wait a while - as can be seen in the results of this study that followed people from 8 European countries over many years (about 12.2 years). The study found that being normal weight and fit is best, and that "metabolically healthy" obese people were more likely to go on to develop metabolic abnormalities (and become metabolically unhealthy obese people) over the years. Metabolically unhealthy signs included high blood pressure, low HDL-cholesterol, and hyperglycemia (high blood sugar).

Bottom line: aim for normal weight for a lower risk of heart disease (and of course, be physically active and eat a healthy diet - fewer processed foods, and more fruits, vegetables, whole grains, seeds, nuts, and legumes). From Science Daily:

'Fat but fit' are at increased risk of heart disease

Carrying extra weight could raise your risk of heart attack by more than a quarter, even if you are otherwise healthy.Researchers have found that being overweight or obese increases a person's risk of coronary heart disease (CHD) by up to 28 per cent compared to those with a healthy body weight, even if they have healthy blood pressure, blood sugar and cholesterol levels.The findings add to a growing body of evidence that suggests being 'fat but fit' is a myth, and that people should aim to maintain a body weight within a healthy range.  ...continue reading "Is ‘Fat But Fit’ A Myth?"

Published on Leave a comment on Could Changing Your Diet Prevent Gout?

Gout is something that is not discussed that much, but it has been increasing in recent years and now afflicts about  3.9% of adults in the US. Gout is a form of inflammatory arthritis, characterized by recurrent attacks of pain, tenderness, and swelling of a joint, frequently the joint of the big toe. It is caused by elevated levels of uric acid in the blood (known as hyperuricaemia).

Gout occurs more commonly in men ages 40 and older, who eat a lot of meat and seafood, drink a lot of alcohol (especially beer) or sweetened drinks, have high blood pressure, metabolic syndrome, or are overweight.  Gout used to be known as "the disease of kings" or "rich man's disease". [On the other hand, past research has shown that consumption of coffee, cherries, vitamin C foods, and dairy products, losing weight and physical fitness seems to decrease the risk.]

Recent research showed that the DASH diet reduces blood pressure and reduces uric acid in the blood, which is why a research team (study in The BMJ) now looked at  whether it lowers the risk of gout. The Dietary Approaches to Stop Hypertension or DASH diet is high in fruit, vegetables, whole grains, legumes, nuts, and low-fat dairy, and low in red and processed meats, salt, and sugary drinks. On the other hand, the typical Western diet has higher intakes of red and processed meats, sweetened beverages, sweets, desserts, French fries, and refined grains. The researchers analysed data on a total of 44,444 male health professionals, who had no history of gout at the start of the study. During the 26 years of the observational study, they documented 1731 cases of gout.

The researchers found that eating a more DASH type diet - a diet rich in fruits, vegetables, legumes, nuts, whole grains, and low in salt, sugary drinks, and red and processed meats, is associated with a lower risk of gout. On the other hand, a more 'Western' diet is associated with a higher risk of gout. They found that the effects are dose dependent - the more DASH-type diet, the lower the risk of gout. Bottom line: Once again, eating lots of fruits, vegetables, nuts, legumes, and whole grains is linked to health benefits. From Science Daily:

Diet rich in fruit, vegetables and whole grains may lower risk of gout

A diet rich in fruit and vegetables, nuts and whole grains and low in salt, sugary drinks, and red and processed meats, is associated with a lower risk of gout, whereas a typical 'Western' diet is associated with a higher risk of gout, finds a study published by The BMJ.

Gout is a joint disease which causes extreme pain and swelling. It is most common in men aged 40 and older and is caused by excess uric acid in the blood (known as hyperuricaemia) which leads to uric acid crystals collecting around the joints. The Dietary Approaches to Stop Hypertension (DASH) diet reduces blood pressure and is recommended to prevent heart disease. It has also been found to lower uric acid levels in the blood. Therefore, the DASH diet may lower the risk of gout.

To investigate this further, a team of US and Canada based researchers examined the relationship between the DASH and Western dietary patterns and the risk of gout. They analysed data on over 44,000 men aged 40 to 75 years with no history of gout who completed detailed food questionnaires in 1986 that was updated every four years through to 2012.

Each participant was assigned a DASH score (reflecting high intake of fruits, vegetables, nuts and legumes, such as peas, beans and lentils, low-fat dairy products and whole grains, and low intake of salt, sweetened beverages, and red and processed meats) and a Western pattern score (reflecting higher intake of red and processed meats, French fries, refined grains, sweets and desserts). During 26 years of follow-up, a higher DASH score was associated with a lower risk for gout, while a higher Western pattern was associated with an increased risk for gout.

 Gout. Credit: NHS in the UK

Published on Leave a comment on Blood Pressure Study Contradicts Sodium Limits in Dietary Guidelines

Another large recent study found that lowering sodium intakes (less than 2500 milligrams per day) wasn't linked to lower blood pressure. Over the course of 16 years, the researchers found that the study participants who consumed less than 2500 milligrams of sodium a day had higher blood pressure than participants who consumed higher amounts of sodium. However, the current 2015-2020 Dietary Guidelines for Americans recommends limiting sodium intake to 2,300 grams a day for healthy people. The researchers felt that based on recent studies with similar findings that the sodium guidelines should be changed.

This 16 year study found that people in the study who had normal intakes of sodium, but also higher intakes of potassium, calcium and magnesium exhibited lower blood pressure over the course of the study. And those people with higher combined intakes of sodium (3717 milligrams per day on average) and potassium (3211 milligrams per day on average on average) had the lowest blood pressure.

Some good potassium foods:  avocado, winter squash, sweet potato, potato, white beans, banana, spinach, salmon, dried apricots, tomato sauce, beans, and milk. Some good magnesium foods: dark leafy greens, nuts, seeds, fish, beans, whole grains, avocados, yogurt, bananas, dried fruit, dark chocolate. Some good calcium foods: milk, cheese, yogurt, kale, sardines, broccoli, white beans, and rhubarb. From Science Daily:

Low-sodium diet might not lower blood pressure: Findings from large, 16-year study contradict sodium limits in Dietary Guidelines for Americans

A new study that followed more than 2,600 men and women for 16 years found that consuming less sodium wasn't associated with lower blood pressure. The new findings call into question the sodium limits recommended by the current Dietary Guidelines for Americans. Lynn L. Moore, DSc, associate professor of medicine at Boston University School of Medicine, will present the new research at the American Society for Nutrition Scientific Sessions and annual meeting during the Experimental Biology 2017 meeting, to be held April 22-26 in Chicago.

"We saw no evidence that a diet lower in sodium had any long-term beneficial effects on blood pressure," said Moore. "Our findings add to growing evidence that current recommendations for sodium intake may be misguided." The 2015-2020 Dietary Guidelines for Americans recommends limiting sodium intake to 2,300 grams a day for healthy people. For the study, the researchers followed 2,632 men and women ages 30 to 64 years old who were part of the Framingham Offspring Study. The participants had normal blood pressure at the study's start. However, over the next 16 years, the researchers found that the study participants who consumed less than 2500 milligrams of sodium a day had higher blood pressure than participants who consumed higher amounts of sodium.

Other large studies published in the past few years have found what researchers call a J-shaped relationship between sodium and cardiovascular risk -- that means people with low-sodium diets (as recommended by the Dietary Guidelines for Americans) and people with a very high sodium intake (above the usual intake of the average American) had higher risks of heart disease. Those with the lowest risk had sodium intakes in the middle, which is the range consumed by most Americans.

The researchers also found that people in the study who had higher intakes of potassium, calcium and magnesium exhibited lower blood pressure over the long term. In Framingham, people with higher combined intakes of sodium (3717 milligrams per day on average) and potassium (3211 milligrams per day on average on average) had the lowest blood pressure.....Moore says that there is likely a subset of people sensitive to salt who would benefit from lowering sodium intake, but more research is needed to develop easier methods to screen for salt sensitivity and to determine appropriate guidelines for intakes of sodium and potassium in this salt-sensitive group of people.