JustCare

Tag: Blood pressure

  • New research finds link between drinking alcohol and cancer

    New research finds link between drinking alcohol and cancer

    Americans continue to drink a lot of alcohol. To quantify it in economic terms, we spend about $250 billion a year on our liquor. But, it’s probably time we cut down our alcohol consumption. The latest research supports the mounting evidence that drinking alcohol is linked to cancer, reports Robert Shmerling, MD for Harvard Health.

    NB: Moderate drinking comes with risks, but less than half of Americans know this. More research is needed on alcohol’s clear risks. No research shows that drinking alcohol has a causal effect on our health. It simply shows an association between those who drink and higher mortality and morbidity risks.

    Here are some of the many reasons we should consider stopping drinking altogether. Alcohol is linked to:

    • Cancer: In particular, liver, breast, colon, mouth, throat and esophagus cancer
    • Liver disease: Cirrhosis of the liver as well as liver failure
    • High blood pressure: Heart failure and dementia
    • Injury: Falls and drunk driving
    • Depression and anxiety
    • Alcohol poisoning: Physical harm and even death
    • Harm to social networks

    The Surgeon General’s most recent advisory from earlier this year recommended that all alcoholic drinks should bear the warning that alcohol can cause cancer. There is no amount of alcohol you can drink safely. But, Congress would need to pass legislation for this to happen. Today, alcohol labels warn of general risks to your health.

    The benefits of drinking alcohol? The jury’s still out on whether drinking a little is any more harmful than abstaining completely from drinking. Of note, some studies show that drinking a little–one to three drinks each week–reduced cancer and death rates over not drinking at all. And, a recent study found similar death rates between nondrinkers and light drinkers. Drinking alcohol can put people at ease and make them more likely to be engaged socially.

    Bottom line: It’s no longer clear that alcohol offers any health benefits. Whatever the benefits of alcohol–and they vary based on people’s lifestyle and genes–the harms are of serious concern. So consider skipping the alcohol, try a nonalcoholic drink.

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  • Do wall squats, improve your heart health and build strength

    Do wall squats, improve your heart health and build strength

    If you’d like to improve your health health as well as your strength, do wall squats, reports Knvul Sheikh for the New York Times. This isometric exercise can reduce your blood pressure better than aerobic exercise or other types of workouts. And, no, it does not involve using a barbell or any other weight!

    A study in the British Journal of Sports Medicine found that if you could squat with your back against a wall–as if you were seated on a chair, sort of–four times for two minutes each time, with two-minute breaks between each squat, you could improve your health. All it takes is 14 minutes and endurance!

    In short, eight minutes of isometric exercise three times a week should reduce your blood pressure in a meaningful way. If you can take a brisk walk for 30 minutes five times a week, that’s great too. But, if you do the wall squats, you can address high blood pressure without the aerobic exercise.

    All exercise is good. And, many exercises could reduce blood pressure. If walking 15o minutes a week isn’t getting your blood pressure down, it could be worth adding on the wall squats to your repertoire. You might avoid having to take a prescription.

    The researchers did not review studies on the value of doing planks. But, they did look at 270 trials of nearly 16,000 people to see the effects of different isometric exercises on blood pressure..

    Isometric exercises work to lower blood pressure because the positions reduce blood flow to muscles that are contracted. When the exercise ends, your muscle tissue receives greater blood flow. Then your blood vessels relax and allow for easier blood flow.

    Here’s how to do a wall squat. Stand with your feet hip width apart a couple of feet in front of a wall. With your back facing the wall, lean against it. Then lower your upper body down. If not the first time, over time your goal should be to get your back down as if you were seated.

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  • Prevent dementia: Take care of your eyes

    Prevent dementia: Take care of your eyes

    If you’re like me, you’re wondering what it’s going to take to stave off dementia as you grow older. While it might not be possible, there are things you can do. But, Paula Span reports for the New York Times on research finding that people who take care of their health, including their eyes, are more likely to forestall or prevent dementia.

    More people are being diagnosed with dementia. At the moment, there’s no drug to keep dementia at bay. Your genes play a big role in whether you will be diagnosed with dementia, and there’s little you can do about that. Some risk factors, however, are within your control, including high blood pressure, hearing loss and smoking.

    Simple behavior changes–which are not so easy to undertake in practice–such as stopping smoking, wearing a hearing aid and taking medications to bring blood pressure down, are all important. In addition, it’s important to keep a healthy weight, stay physically active, not drink too much alcohol and be socially engaged.

    Staving off dementia is also about keeping your neural system stimulated through sensory organs. People with healthy vision are less likely to suffer from dementia. So, get your eyes checked, wear glasses and get cataract surgery, if necessary. Without good hearing and vision, your neurons die. And, your brain function deteriorates.

    A paper in JAMA Neurology finds that these types of behavior changes could have prevented more than 60 percent of dementia cases today.

    Medicare does not cover most vision care, but there are ways to get free or low-cost treatment for your eyes. By doing so, almost everyone can avoid blindness or serious vision impairment. Medicare also does not cover hearing aids or most treatment for hearing loss. But, there are ways to get treatment for hearing loss as well.

    Medicare does cover treatment for glaucoma and macular degeneration as well as cataract surgery. People tend to think that Medicare Advantage plans will cover hearing aids. In fact, typically, coverage is extremely limited, just a few hundred dollars off a total cost that is usually several thousand dollars. So, out-of-pocket costs remain very high and a barrier to getting hearing aids.

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  • How to prepare for your doctor’s visit

    How to prepare for your doctor’s visit

    Whether you’re in good health or poor health, in a separate post I explained why it’s important to have a good primary care doctor. And, I’ve provided four questions to help you know whether your primary care doctor is meeting your needs. Here, I want to help you prepare for your doctor’s visit, so that you make the most of it.

    1. Confirm that your doctor accepts your insurance. If you have traditional Medicare, ask if the doctor accepts assignment, which means that the doctor accepts Medicare’s rate as payment in full. If you have a private insurer such as Aetna or Cigna, to save money, make sure the doctor is in-network. Always find out how much more you may have to pay out-of-pocket.
    2. Ask a family member or person you trust to join you. No matter what your age, it’s always good to have a health care buddy, a second pair of ears to listen to the doctor’s advice and, ideally, to take notes. You may also want your buddy to ask questions. The doctor’s visit can be stressful. You can decide to have your buddy be present for some or all of the visit – you are in charge!
    3. Make sure you bring a list of your medications with you, both prescription drugs and over the counter. And, ask your doctor whether you should be taking all these drugs.  It may be that you don’t need to be on a drug or that one drug you’re taking interacts poorly with another one. As you collect the bottles, think of any concerns, side effects or questions you have about your treatments.
    4. Make a list of all the questions you have for your doctor and other information you want to share, including any symptoms and concerns you have about your health. [Editor’s note: If you go alone to the visit, be sure to bring a pen and paper to take notes and repeat the doctor’s advice in order to confirm that you understand it.]
    5. If it’s your first appointment, you want to be sure to let your doctor know about any chronic conditions and any other health problems you have, as well as diseases that run in your family. If possible bring past medical records, test results, and your immunization records. You can ask the last doctor you saw to provide this information to your doctor, or you can sign a release form to have your new doctor’s office request your prior records.  If you are already an established patient of the doctor, be ready to provide your doctor with any major family health updates—for example, if your brother has been recently diagnosed with high blood pressure, or a parent was diagnosed with cancer.
    6. Check with the office if you are expected to come on an empty stomach to your appointment. There are only a few tests that need to be done in the “fasting state” (meaning, no food or drinks other than water for 12 hours). If you are expected to be fasting, tell the office if you are taking medications that require food, or if you think this will be difficult for you for any reason. Remember that most routine tests are not affected by drinking water, but being dehydrated could lead to slightly abnormal results.
    7. If your doctor is suggesting a test or treatment, to avoid overtreatment, be sure to understand why you need it. What are your options? How will it help? Are there side effects?
    8. Be sure that when you leave the office you understand your diagnosis and what you need to do, as well as when and how to contact the doctor and when to make another appointment. If you need a new prescription, make sure you know when to take it and what to do if you experience any side effects.

    [Editor’s note: This post was originally published on June 29, 2016.]

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  • Ten tips for checking your blood pressure at home

    Ten tips for checking your blood pressure at home

    Doctors are increasingly recommending that patients check their blood pressure at home to diagnose high blood pressure (hypertension) and make treatment decisions. Seeing the pattern of your blood pressure at home allows a doctor to make a more informed decision about treatment than a single test at the doctor’s office.

    To ensure appropriate treatment, it’s important that you take appropriate steps when you monitor your blood pressure. Mistakes in your technique at home could misdirect the doctor to prescribe you too much, too little, or the wrong type of medication.

    If you’ve been advised to monitor your blood pressure at home, follow these ten tips to ensure your data is accurate:

    At your doctor’s visit:

    1. Learn your numbers. Ask your doctor what your target blood pressure is. Targets can differ by as much as 20 points, depending on age and medical condition. Ask your doctor how often to check, and what results require an urgent call to the office, or a visit to the emergency room.
    2. Bring your machine to the doctor at least once. The office can check your machine against office measurements. Make sure that your cuff size is correct: a cuff that’s too small will overestimate your pressure and a cuff too large will underestimate it.
    3. Relax. It’s common for your blood pressure at the office to be higher than your results at home. This is called “white coat hypertension,” and is probably a result of the mild anxiety you may feel at the doctor’s office. That’s why doctors often recommend patients check their blood pressure at home. Doctors sometimes recommend further testing with another method, if available, for patients with white coat hypertension; this method is called ambulatory blood pressure monitoring.

    At home:

    1. Plan in advance. No smoking, caffeine or exertion 30 minutes before. Empty your bladder. Rest for 5-10 minutes before you start.
    2. Know the correct body position.
      • Sit upright with your back supported and your feet on the floor. Don’t cross your legs or rest them on an ottoman.
      • Rest your arm at the level of your heart (for example, on pillows, books, or on a table). If your arm is too low—for example, lying in your lap–your results could overestimate your pressure.
    3. Consistently measure either the right or left arm.
    4. Stay still and quiet while the machine runs.
    5. Repeat the cycle once.
    6. If you get a high number, don’t panic. Expect some normal variations between days. Remember things like emotion, stress, exertion, or pain temporarily raise blood pressure, and this is not necessarily the same as poorly controlled blood pressure. Your blood pressure will typically be a little higher in the morning than the evening. Use your doctor’s guidelines to know what your action plan should be for high numbers.
    7. Check your blood pressure regularly, if your doctor has recommended home monitoring.  Checking it only when you are feeling bad can be misleading. But, do not become overly obsessed with checking if your blood pressure is alright. Two to three times a week is usually sufficient, unless your doctor recommends otherwise. Light headedness may indicate your blood pressure is too low, so do check in that instance. Low blood pressure is a frequent problem for older patients leading to falls or other problems, so it is important to note when this happens. Record your numbers in a log with the date and time, and bring the log to your next doctor’s appointment.

    This post was originally published on May 15, 2015

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  • After a heart attack, multiple drugs can affect quality of life

    After a heart attack, multiple drugs can affect quality of life

    Elderly nursing home patients prescribed a multitude of medications following a heart attack may live longer compared to those given just one prescription drug, but it can come at a cost: It may negatively impact their quality of life.

    Researchers examined claims data from nearly 4,800 nursing home residents, most of whom were white women with an average age of 84. The study looked at deaths, hospitalizations and decreased ability to manage daily activities after the residents were prescribed one of four kinds of medications after leaving the hospital following a heart attack. Those medications were beta blockers, blood thinners, blood pressure drugs and statins.

    Results, published in Circulation: Cardiovascular Quality and Outcomes, showed that residents prescribed three or four medications after hospital discharge were less likely to die within 90 days compared with those prescribed just one medication. The death risk between those taking one or two prescription drugs did not differ.

    Additional analysis found that, with the exception of blood thinners, greater prescription drug use was associated with a 30% increase in functional decline.

    “Since using more medications may interfere with older adults’ ability to do their daily activities, more medications should not be taken by older adults who wish to maintain their independence and daily functioning rather than live longer,” lead author Andrew R. Zullo, PharmD, PhD, an assistant professor at the Brown University School of Public Health, said in a statement. “Using more medications after a heart attack does not simply improve all health outcomes.”

    This article originally appeared in Medshadow.org

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  • Keeping mentally and physically healthy and engaged may prevent dementia

    Keeping mentally and physically healthy and engaged may prevent dementia

    A 2017 study by a worldwide team of dementia experts, published in Lancet, lays out the latest research findings on dementia, and the news is better than you might expect. There are a range of proven ways, particularly through mental and physical stimulation, to prevent or delay dementia.

    Dementia literally translates from the Latin to mean “out of mind.” It is a brain disorder that affects memory and the ability of people to process information. In 2015, 47 million people around the world, mostly people over 65, were living with dementia at a cost of $818 billion. By 2050, there are expected to be almost 150 million people living with dementia. Today, one in three older people die with dementia.

    Though there is no cure for dementia, people’s daily activities may delay or prevent its onset. And, for people diagnosed with dementia, there are ways to slow down the course of the disease and improve quality of life. The data suggest that people who are better educated, as well as more mentally and physically active and socially engaged, are less likely to be diagnosed with dementia.

    Not surprisingly, social isolation, not having friends or family to talk to and spend time with, and poor education, increases the risk of dementia. In addition, people with hearing loss who are not managing that condition are prone to getting dementia.

    Here are a few ways that have been found to delay or prevent dementia:

    • Treatment for hypertension or high blood pressure is important since high blood pressure has been found to cause dementia.
    • It is possible that more than one in three cases of dementia can be delayed or prevented through exercise, having a social network, and engaging your mind.
    • Smoking less.
    • Managing hearing loss,
    • Keeping your blood sugar level under control if you have diabetes.
    • Maintaining a healthy weight; and,
    • Treating depression.

    Getting a diagnosis of dementia in its early stages can allow for treatment interventions that maximize memory and cognition, and reduce stress and depression. There are many people living with dementia who are able to drive and function independently. You can learn more about the living with dementia movement, here.

    Here are ways to help people living with dementia remain independent. And, here are best practices for communicating with a person with dementia.

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  • Talk to your doctor before taking a cold medicine

    Talk to your doctor before taking a cold medicine

    With cold and flu season in full swing, people with high blood pressure that is not controlled well or who have heart disease need to be careful with over-the-counter cold medicines, as they may cause a spike in blood pressure.

    Many cold medicines contain decongestants and nonsteroidal anti-inflammatory drugs (NSAIDs), both of which can raise blood pressure. Examples of decongestants are pseudoephedrine and phenylephrine. Some NSAIDs are Advil (ibuprofen) and Aleve (naproxen).

    “People with uncontrolled high blood pressure or heart disease should avoid taking oral decongestants,” Sondra DePalma, a physician assistant at UPMC Pinnacle in Pennsylvania, told American Heart Association News. “And for the general population or someone with low cardiovascular risk, they should use them with the guidance of a healthcare provider.”

    Guidelines released last year by the American Heart Association and the American College of Cardiology dealing with high blood pressure management say that decongestants should be used for as short a time as possible, and to try alternatives such as nasal saline or antihistamines.

    Regarding NSAIDs, guidelines say to use Tylenol (acetaminophen) or topical NSAIDs as other options.

    Healthcare professionals also say if your cold symptoms are mild or moderate, rest and drink plenty of fluids. Avoiding dehydration can help reduce body aches and may reduce the need for decongestants.

    This article was originally published in Medshadow.org

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  • If you’re often tired during the day, you could have sleep apnea

    If you’re often tired during the day, you could have sleep apnea

    Many people suffer from sleep apnea, particularly older adults.  Sleep apnea is a pausing of breath or shallow breathing while you sleep.  But, because it occurs during sleep, it often goes undiagnosed and untreated. Indeed, it is estimated that up to 80 percent of people with sleep apnea have not been diagnosed for it.

    Most people with sleep apnea have obstructive sleep apnea. During sleep the airway collapses or is blocked. When air squeezes through the blockage it can cause you to snore loudly. People who are overweight are more likely to have it. A small number of people have central sleep apnea. With this condition, the part of your brain that controls your breathing will not send the proper signals and you will not breathe for short periods.

    The National Institutes of Health explains that sleep apnea has one of two causes: a person’s physical structure or medical conditions.  A wide variety of medical conditions  could cause sleep apnea, including obesity, large tonsils, endocrine disorders, neuromuscular disorders, heart or kidney failure, certain genetic syndromes, and premature birth.

    Sleep apnea symptoms include snoring, stopping breathing, or gasping during your sleep. If sleep apnea is severe, you might experience 30 or more long interruptions in breathing an hour. Or, interruptions can be few and only last for a few seconds. But, these interruptions in your breathing can pull you out of your deep sleep into a light sleep. You then end up with a bad night’s sleep and may feel tired during the day. You might also wake up with a headache.

    Healthy changes in your lifestyle could decrease your risk of developing sleep apnea. Smoking, drinking alcohol and unhealthy eating patterns that lead to obesity all could increase your risk of sleep apnea.

    Sleep apnea, when untreated, is associated with heart disease and heart deaths, as well as high blood pressure or hypertension. It can increase your risk of asthma, atrial fibrillation and pancreatic, renal and skin cancers. Sleep apnea is more prevalent among people with diabetes, coronary artery disease and congestive heart failure.

    Your doctor cannot diagnose sleep apnea through a blood test. It is typically diagnosed through a polysomnogram. Once diagnosed, you can usually treat sleep apnea through changes to diet and lifestyle, devices that help you breathe, mouthpieces and surgery.

    The NIH has a short video to help you better understand what happens to people with sleep apnea.  And, here are seven tips from the National Institutes of Health for getting a good night’s sleep.

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  • Drug that treats high blood pressure increases risk of skin cancer

    Drug that treats high blood pressure increases risk of skin cancer

    A common medicine used to treat high blood pressure, hydrochlorothiazide, may drastically increase one’s risk for developing skin cancer, according to a new study out of Denmark.

    Researchers in Denmark looked at about 80,000 Danish cases of skin cancer and determined that those people who were taking hydrochlorothiazide (HCTZ) had a risk of developing skin cancer — more specifically, squamous cell carcinoma — that was up to seven times greater than those not taking the drug. The risk was highest in those who had taken HCTZ for more than 10 years. Other hypertension medicines were looked at as part of the study, but none of them increased the risk of skin cancer.

    “We knew that hydrochlorothiazide made the skin more vulnerable to damage from the sun’s UV rays, but what is new and also surprising is that long-term use of this blood pressure medicine leads to such a significant increase in the risk of skin cancer,” study leader Anton Pottegård, PhD, of the University of Southern Denmark, said in a statement.

    This post was first published in Medshadow.org.

    From Just Care: About 10 million people in the US take a hypertension medication containing HCTZ. HCTZ also has been found to be strongly associated with an increased risk of lip cancer. Brand name drugs with HCTZ include Microzide, Oretic and Esidrix.

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