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Fluctuating BP ‘Warning Sign for Stroke’


People with occasionally high blood pressure are more at risk of stroke than those with consistently high readings, research suggests.
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Current guidelines focus on measuring average blood pressure levels to spot and prevent the chance of a stroke.

But research suggests doctors should no longer ignore variation in test results and give drugs that produce the most steady blood pressure levels.

The Stroke Association called for national guidelines to be overhauled.

In the first of the series of studies published in The Lancet, UK and Swedish researchers looked at the variability in blood pressure readings at doctors’ checks.

They found those with fluctuating readings at different GP visits had the greatest risk of future stroke regardless of what their average blood pressure reading was.

A review of previous trials also found that the differences in effectiveness of several blood pressure drugs could be explained by how well they kept blood pressure on an even keel.

Some drugs, in particular beta blockers, were shown in a separate study in The Lancet Neurology, to increase variation in a patient’s blood pressure.

‘Major implications’

Professor Peter Rothwell of the Department of Clinical Neurology at the University of Oxford, who led the research, said the findings have major implications for how GPs spot and treat people at high risk of stroke.

“At the moment, the guidelines for GPs say not to believe a one-off unusual reading, to bring the patient back and measure again, and as long as it’s not consistently high, there is no need to treat.

“What we’re saying is don’t discount that one-off high blood pressure reading.”

He added that GPs would also need to make sure they prescribe the most effective drug combinations – ideally one that lowers blood pressure but also stabilises it.

It is not know exactly why occasional spikes would increase a person’s risk of stroke but it is thought it puts undue stress on the system.

If you get rapid fluctuations that can cause turbulent flow of blood which can cause damage and stiffening in the arteries,” said Professor Rothwell.

He said anyone with high blood pressure who tests themselves at home might want to mention to their GP if they spot variations in their results.

The National Institute for Health and Clinical Excellence‘s guidelines on high blood pressure is in the process of being rewritten and these latest studies will be taken into account.

Joe Korner, director of communications at The Stroke Association said people who have occasional high blood pressure readings – known as episodic hypertension – are often not treated.

“With this new research it is now important that the clinical guidelines about treating high blood pressure are reviewed.

“In the meantime we urge GPs to read this research to help them prescribe the best treatment for people at risk of stroke.”

Experts stressed that those already prescribed medication for high blood pressure should not worry or stop taking their pills.

Professor Peter Weissberg, medical director at the British Heart Foundation said: “Current practice is not wrong, but this might add a new measure to help doctors make decisions on who to treat for hypertension and which drug to use.”

Source : BBC News:12th.March.2010

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Is Your Full Figure an Increased Risk for Diabetes?

A new study suggest that women who have smaller breasts in their late teens and early 20s may enjoy a lower risk of developing type 2 diabetes later in life. However, many doctors have cautioned that the results may have more to do with obesity than they do with breast size alone.

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Researchers surveyed more than 92,000 women with an average age of 38, asking each of the participants to recall her bra size at the age of 20.

Women who recalled having a D cup or larger had about three times the risk of developing type 2 diabetes. Women who reported wearing B cup and C cup bras also experienced a higher risk than women who wore an A cup, even after figuring in age, body mass index (BMI), waist circumference, eating habits, family history of diabetes, physical activity level and pregnancies.

The study lead investigator believes that the correlation has something to do with how breasts develop during puberty. Puberty is a period marked by raised insulin resistance. Just as breast development is both accelerated and more pronounced in obese girls, their levels of insulin resistance may be as well.

However, if that is the case, many experts question why they should abandon the tried-and-true methods of evaluating type 2 diabetes risk by calculating their BMIs and evaluating lifestyles.

Sources:
ABC News January 28, 2008
Canadian Medical Association Journal January 29, 2008; 178(3): 313–315 (Free Full Text Article)

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Anger Slows Down Healing Process

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The adage that laughter is the best medicine has been backed by an unusual investigation which says that people who seethe with anger take longer to recover from injury.

Previous studies have linked ill tempered behaviour, whether brow-beating or road rage, with higher incidence of coronary heart disease, hypertension and stroke, especially among men.

But the new study, published on Wednesday in the British journal Brain, Behaviour, Immunity, is the first controlled experiment that directly measures the impact of ire on the healing process.

Researchers at the University of Ohio inflicted minor burns on the forearms of 98 volunteers who were then monitored over eight days to see how quickly the skin repaired itself.

The subjects had each taken a battery of psychological tests beforehand to assess how easily and often they felt and expressed wrath, and were then ranked on an “anger scale”.

Persons who took certain pharmaceutical drugs, smoked cigarettes or drank excessive quantities of caffeine-laden coffee were excluded, along with individuals who were extremely over- or under-weight.

The results were startlingly clear: individuals who had trouble controlling expressions of anger were four times likelier to need more than four days for their wounds to heal, compared with counterparts who could master their anger.

But the researchers were also surprised to find that anger has its nuances, too.

Subjects described as showing “anger out” (regular outbursts of aggression or hostility) or “anger in” (repressed rage) healed almost as quickly as individuals who ranked low on all anger scales.

Only those who tried but failed to hold in their feelings of upset and distemper took longer to heal.

This same group also showed a higher secretion of the stress hormone cortisol, which could at least partly explain the difference in healing time, the study noted.

Earlier research has shown a clear link between cortisol and anger. Hostile men who yelled at spouses during marital spats secreted more of the endocrine modulator within minutes, as did teachers experiencing high levels of stress in the classroom.

High levels of cortisol appears to decrease the production at the point of injury of two cytokines crucial to the repair process, suggests the study.

Cytokines are proteins released by immune-system cells. They act as signallers to generate a wider immune response. “The ability to regulate the expression of one’s anger has a clinically relevant impact on wound healing,” concludes lead author Jean-Philippe Gouin, a psychologist at the University of Ohio. “Those who has low anger control secreted more cortisol following exposition to this stressor. This individual difference in the response to the blistering was related to longer healing,” Gouin added.

Anger-control therapy could help patients recovering from surgery or injury heal more quickly, the paper says.

Click to see also:->

Laughter, the best medicine

Laugh loudly and get rid of many illness

Sources: The Times Of India

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Dark chocolate ‘not so healthy’

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For those of you tucking into dark chocolate this Christmas using the excuse it is good for you, think again.

Studies have suggested dark chocolate is good for the heart

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A top medical journal said any health claims about plain chocolate may be misleading.

Plain chocolate is naturally rich in flavanols, plant chemicals that are believed to protect the heart.

But an editorial in the Lancet points out that many manufacturers remove flavanols because of their bitter taste.

Instead, many products may just be abundant in fat and sugar – both of which are harmful to the heart and arteries, the journal reported.

Previous studies have suggested that plain chocolate can help protect the heart, lower blood pressure and aid tiredness.

But the Lancet said: “Dark chocolate can be deceptive.

When chocolate manufacturers make confectionery, the natural cocoa solids can be darkened and the flavanols, which are bitter, removed, so even a dark-looking chocolate can have no flavanol.

“Consumers are also kept in the dark about the flavanol content of chocolate because manufacturers rarely label their products with this information.”

And the journal also pointed out that even with flavanols present, chocolate-lovers should be mindful of the other contents.

“The devil in the dark chocolate is the fat, sugar and calories it also contains.

“To gain any health benefit, those who eat a moderate amount of flavanol-rich dark chocolate will have to balance the calories by reducing their intake of other foods – a tricky job for even the most ardent calorie counter.

“So, with the holiday season upon us, it might be worth getting familiar with the calories in a bar of dark chocolate versus a mince pie and having a calculator at hand.”

Click to see:-
Chocolate ‘lowers’ blood pressure
03 Jul ’07 |BBC NEWS , Health

Chocolate ‘cuts blood clot risk’
15 Nov ’06 |BBC NEWS , Health

Chocolate trial on heart patients
10 Apr ’06 |BBC NEWS , Health

Chocolate ‘has health benefits’
22 Mar ’05 |BBC NEWS , Health

Chocolate may cut heart disease
20 Dec 05 | BBC NEWS, Health

Dark chocolate may be healthier
27 Aug 03 |BBC NEWS, Health

Chocolate ‘is good for you’
06 Aug 99 |BBC NEWS, Health

Sources: BBC NEWS ,25th. Dec’07

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Improve Lifestyle to Avoid High BP

High blood pressure toll to boom within 20 years.

Unhealthy lifestyle might bring a boom in high blood pressure, with the sufferers exceeding a billion within 20 years, a new study has found. One in four adults suffer from high blood pressure which increases the risk of heart disease, stroke and death.

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Lifestyle factors, such as physical inactivity, a salt-rich diet with high fatty foods, and alcohol and tobacco use could see the problem spreading from developed to developing economies, like India and China.

According to The Lancet medical journal, the number of BP patients may rise to 1.56 billion by 2025, up from 972 million in 2000. Another editorial has claimed that the rise in BP is due to poor observance of medication by patients.

“Many patients still believe that hypertension is a disease that can be cured, and stop or reduce medication when blood pressure levels fall. Physicians need to convey the message that hypertension is the first, and easily measurable, irreversible sign that many organs in the body are under attack,” the editorial was quoted, as saying.

“Perhaps this message will make people think more carefully about the consequences of an unhealthy lifestyle and give preventative measures a real chance,” it said.

Currently, a person in the Western world has a greater than 90 per cent lifetime risk of developing high blood pressure or hypertension.

Dr Isabel Lee, of The Stroke Association insisted that many strokes can be prevented by the control of high BP. “Every five minutes someone in the UK has a stroke — that’s 150,000 every year. Yet, over 40 per cent of these strokes could be prevented by the control of high blood pressure. Whilst it is important to get your blood pressure measured regularly, it is equally important that people who are prescribed blood pressure medication continue to take it even once their blood pressure is back under control,” Lee said.

“GPs need to ensure that patients are made fully aware of the importance of continuing with their blood pressure medication. People can also take additional steps to help improve their lifestyles and reduce their risk of high blood pressure by stopping smoking, having a healthy diet and exercising regularly,” she said.

Source: The Times Of India

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