You may not be able to eradicate all of your individual stroke risk factors, but you likely can mitigate some of them enough to significantly reduce your chance of suffering a stroke. Along with any medications you may be prescribed to lower your blood pressure, cholesterol, and blood sugar, a healthy diet and plenty of exercise are cornerstones of stroke prevention. Eat plenty of fruits, vegetables, and whole grains, and substitute fish and poultry for red meat. Cut back on your salt intake, since too much salt raises blood pressure. Get at least 30 minutes of physical activity each day (you can break this up into smaller segments). If you’ve already had a stroke, eating more healthfully can help prevent another, and exercise can help you regain your cardiovascular fitness and cognitive function, as well as combat the depression that often follows stroke. Stroke rehabilitation programs focus closely on diet and exercise, so ask your doctor to refer you to one of these programs if he or she has not already done so.

Another crucial element of stroke protection is knowing the symptoms that can red-flag a stroke. The American Stroke Association recommends learning the “BE FAST” rubric:

• B for Balance. Do you have a sudden loss of balance or coordination? To check, walk in a straight line or touch your finger to your nose.

• E for Eyes. Are you noticing sudden vision changes, such as double vision, or loss of vision in one eye?

• F for Face drooping. Is there drooping or numbness on one side of your face? Is your smile uneven?

• A for Arm weakness. Look for weakness in one arm (raise both arms and see if one arm drifts downward).

• S for Speech difficulty. Is your speech slurred or otherwise hard to understand?

• T for Time to call 911. If you have any of the above symptoms, call 911.

Keep in mind that women may experience additional stroke symptoms, including confusion and disorientation, nausea and vomiting, and fatigue.

As our article emphasizes, time is brain. Recognizing possible stroke symptoms and seeking medical help immediately can make a huge difference to post-stroke function, since treatment with a clot-busting drug is most effective within 4.5 hours of symptom onset if your stroke is caused by a blood clot.

The post Address Your Stroke Risk appeared first on University Health News.

Among those who don’t have their high blood pressure (hyperten­sion) under control, many simply don’t know they have hypertension or, if they do, aren’t getting treat­ment or taking any steps on their own to bring their blood pressure into a healthy range.

Then there are individuals who have a condition known as treat­ment-resistant hypertension. Research suggests that about 20 per­cent of people with high blood pres­sure have treatment-resistant hyper­tension, which means their blood pressure is higher than normal even though they are taking at least three different antihypertensive medica­tions (taken at the maximum recom­mended doses), one of which is a diuretic. Other commonly pre­scribed blood pressure-lowering drugs that may be used include angiotensin-converting enzyme (ACE) inhibitors, angiotensin II receptor blockers (ARBs), and cal­cium channel blockers. Another class of medications, known as aldos­terone antagonists—typically spironolactone (Adactone) or eplerenone (Inspire)—are also often among medications used to treat resistant hypertension.

In March 2024, the Food and Drug Administration (FDA) approved aprocitentan (Tryvio), the first endothelial-receptor agonist specifically meant for people with treatment-resistant hypertension. “It’s a completely new class of drug, so it offers us an opportunity that we haven’t had until very recently,” says Randy Zusman, MD, director of the Division of Hypertension at Massa­chusetts General Hospital.

He adds that the options for physi­cians and their patients with treat­ment-resistant hypertension continue to grow. In 2023, the FDA approved a procedure called renal denervation for treatment-resistant hypertension. The procedure involves the use of radiofrequency (heat) energy or ultra­sound to destroy certain nerves in the kidneys that affect the function of the renal arteries, which deliver blood to the kidneys. The reduced nerve activ­ity can help lower blood pressure.

Dr. Zusman adds that an experi­mental antihypertensive drug that is injected once or twice a year is show­ing promise, though much more research is needed to determine who would be best served by the drug and how to deal with safety concerns, such as a sudden drop in blood pressure.

Medication Management

While it’s certainly helpful to have additional options to help people get their high blood pressure under con­trol, Dr. Zusman notes that managing treatment-resistant hypertension is much more than finding the right mix of meds. He says that a big prob­lem is non-compliance—individuals who don’t take their medications as recommended or stop taking their medications because they finally got a good blood pressure reading or they don’t like the side effects. Of course, stopping the medications that helped lower your blood pressure—without first consulting your health­care provider—means your blood pressure is likely to rise again.

For others who have been diag­nosed with treatment-resistant hypertension, the problem may be that they aren’t yet taking the right combination of medications at the right doses and at the right times during the day.

He also explains that many indi­viduals, especially older adults, may have other health conditions that make it more difficult to get their blood pressure under control. For example, they may take other medi­cations that drive up blood pressure. Over-the-counter drugs, such as cer­tain cold medications and nons­teroidal anti-inflammatory drugs, such as ibuprofen (Advil) and naproxen (Aleve), may interfere with antihypertensive medications.

You may find that taking an alter­native painkiller or cold medicine, for example, will provide symptom relief without interfering with your antihypertensive regimen. It’s impor­tant to talk with your health-care provider about all the medications you take—over-the-counter and pre­scription drugs—as well as any sup­plements. Don’t assume that dietary or herbal supplements labeled “natu­ral” are necessarily harmless or even especially helpful.

Diet, Exercise, and Much More Even the most effective medication management can only go so far. Dr. Zusman explains that obesity, a high­salt diet, a sedentary lifestyle, smoking, and other unhealthy behaviors can conspire to keep your blood pressure elevated along with your risk for stroke, cardiovascular disease, and other health problems.

“Controlling treatment-resistant hypertension involves lifestyle mod­ifications and medications,” Dr. Zusman says, acknowledging that breaking long-held eating habits can be difficult for some people. Like­wise, getting up and moving more can be a challenge for individuals who have settled into a fairly seden­tary lifestyle.

Research suggests that even small changes can make a big difference. The AHA recommends 150 minutes a week of moderate-intensity aero­bic activity, such as brisk walking, swimming, cycling, or tennis. That works out to about 30 to 40 minutes a day, most days of the week. You can even break those daily workouts into shorter bursts of exercise if that helps.

The AHA also suggests that losing just 10 pounds can lead to notice­able improvements in your blood pressure. Some studies have found that some people may see a drop of 1 millimeter of mercury (mm Hg) in their systolic blood pressure (the top number in a blood pressure reading) for every two pounds of lost weight.

What You Can Do

Dr. Zusman recommends getting reliable blood pressure checks peri­odically to know whether your treat­ment is working and to spot con­cerning changes in your blood pres­sure as early as possible. “This is especially important for people with a family history of hypertension or cardiovascular disease,” he says.

Talk with your doctor about using a home blood pressure monitor. The

more proactive you can be and con­sistently follow your doctor’s advice about medications and lifestyle changes, the more likely you may be to move from treatment-resistant hypertension to well-managed hypertension.

The post What Does It Take to Effectively Manage Treatment-Resistant Hypertension? appeared first on University Health News.

A person whose blood pressure is usually normal has an appointment at a clinic or medical center. There is a bit of anxiety about the visit. Anxiety elevates blood pressure, and having it checked is a routine procedure.

Blood pressure is taken by a physician or other provider who often wears a white coat that symbolizes medical professionalism. The reading is higher than it normally would be when not in a clinical setting. The presumed result: white coat syndrome.

Until recently, white coat syndrome had been considered a temporary spike—no harm, no foul. But not anymore.

Real—Dangerous for Some

White coat syndrome/hypertension was first described more than 40 years ago. Since then, multiple studies have confirmed that it’s a real thing. The original scenario is the same—anxiety can elevate blood pressure in a clinical setting. But current research suggests that white coat syndrome may also be a symptom of something more concerning.

In February 2022, a review of studies in the journal Hypertension became the first to provide evidence that white coat syndrome in patients (with no previous organ damage) had an increased risk of mortality, new hypertension, and new organ damage. This study and others have resulted in a decidedly different approach to white coat syndrome diagnosis and treatment. (https://www.ahajournals.org/doi/full/10.1161/HYPERTENSIONAHA.121.18792)

Blood Pressure—How High is Too High?

To be clear, white coat hypertension for most people is still a one-time event that needs attention only in combination with other cardiovascular conditions. According to Cleveland Clinic and other medical centers, the syndrome affects 15-30 percent of people who already have high blood pressure. Patients who don’t normally have high blood pressure can also have the syndrome. (https://my.clevelandclinic.org/health/diseases/23989-white-coat-syndrome)

The definition of high blood pressure has been a moving target and remains a number that your physician determines is right for you. The American Heart Association defines “normal” as less than 120 for the upper (systolic) number; less than 80 for the bottom (diastolic) number. “Elevated” is 120-129 over 79 or less. For numbers defining three advanced stages of hypertension, go to https://www.heart.org/en/health-topics/high-blood-pressure.

The definition of normal can change, depending on a person’s age and health conditions. The AHA’s guideline for those 65 and older is lower than 130/80.  Normal for patients over the age of 80 may be higher.

Diagnosis— Multiple Readings

Diagnosis of white coat syndrome requires at least three separate blood pressure readings at a clinic, as well as elevated numbers when checked at home. Home blood pressure kits and regular checks are a good idea, regardless of the white coat issue.

When you take your blood pressure (BP) at home, follow these CDC guidelines: 1) nothing to eat or drink 30 minutes before taking BP; 2) empty bladder; 3) feet flat on the floor, legs uncrossed; 4) arm resting on a surface, chest high; 5) cuff snugly against bare skin, not over clothing; 6) no talking; 7) same time every day; 8) at least two readings, 1-2 minutes apart. (https://universityhealthnews.com/daily/heart-health/how-to-get-an-accurate-blood-pressure-reading/)

Treatment—Lifestyle Changes, Medications

If blood pressure is found to be slightly elevated—your doctor makes that call—you may be asked to consider lifestyle changes. You’ve heard them; all easier said than done. Here’s a review:

• Lose weight.
• Sit less, exercise more.
• Eat more fruits and vegetables, less red meat and processed foods.
• Limit daily salt intake to 2300 mg.
• Don’t smoke.
• Work on managing stress. (https://universityhealthnews.com/daily/stress-anxiety/how-to-deal-with-stress/)

If your blood pressure is more than slightly elevated, your doctor may prescribe medications to lower it. Examples are diuretics, alpha- and beta-blockers, ACE inhibitors, and calcium blockers. The Hypertension study mentioned earlier also found that patients with white coat syndrome who take medications to control blood pressure don’t have elevated risks of cardiovascular disease.

Antihypertensive drugs carry risks, mostly mild, for some patients. Ask your doctor about medications that might lower your blood pressure too much. Hypotension, as it’s called, could cause dizziness, lightheadedness, passing out, weakness, nausea, and other symptoms.

How low is too low? The National Library of Medicine says that while there is no universally-accepted standard, blood pressure readings under 90/60 indicate hypotension.

White Coat Syndrome—Answers and Actions

It’s real—well documented. It can be dangerous for some, leading to a variety of conditions that require medical intervention. High blood pressure, whether conventional or white coat, is treatable. It starts with lifestyle changes, and for more serious cases, advances to effective and safe antihypertensive medications.

Don’t dismiss white coat hypertension if it shows up at your next doctor’s appointment. Have it checked or regularly check it yourself.

Other Helpful Links from University Health News

https://universityhealthnews.com/daily/heart-health/uhn-blog-whats-the-right-blood-pressure-for-you-it-depends/

https://universityhealthnews.com/daily/heart-health/is-the-blood-pressure-reading-from-your-doctors-visit-accurate/

The post White Coat Syndrome – Real? Dangerous? Treatable? appeared first on University Health News.

Healthy lifestyle choices can help you control conditions and reduce your risk for stroke. For example, high cholesterol and high blood pressure increase your chances of having a stroke. Eating foods low in saturated fats, trans fat, and cholesterol and high in fiber can help prevent high cholesterol, and limiting sodium in your diet can lower your blood pressure.

“The chief risk factors for stroke include high blood pressure, high cholesterol, and diabetes,” says Dana Leifer, MD, a neurologist at Weill Cornell Medicine. “People who control these factors through diet, exercise, and medication can significantly reduce the risk of stroke.” Cigarette smoking and the use of other forms of tobacco or nicotine are also major risk factors. “Smoking cessation is the single most important way of preventing strokes in anyone who smokes,” explains Dr. Leifer.

Stroke Risk Reduction

Maintaining a healthy weight and getting regular exercise also can reduce your stroke risk. Physical activity can help you stay at a healthy weight and lower your cholesterol and blood pressure levels. For adults to maintain health, the Surgeon General recommends 2 hours and 30 minutes of moderate-intensity physical activity, such as a brisk walk, each week, but any amount of exercise is a step in the right direction.

Limiting alcohol consumption and taking the medications prescribed by your doctors are also instrumental in reducing the risk of stroke. Because alcohol can raise blood pressure, the CDC recommends that women have no more than one drink per day. If you have heart disease, high cholesterol, high blood pressure, or diabetes and you have been prescribed a regimen of daily medications, be sure to follow your doctor’s orders. Set an alarm on your smartphone to help you remember to take medicine at the same time every day. It’s a simple way to lower your risk of stroke.

If you take estrogen supplements, talk to your doctor about your risk of stroke. “Estrogen supplements increase the risk of clotting and therefore of stroke and should be used with caution, especially in women who use tobacco or nicotine or have other risk factors or a prior history of stroke,” warns Dr. Leifer. “In addition,” he says, “an irregular heart rhythm such as atrial fibrillation is also a risk factor for stroke. Therefore strong bloodthinning drugs should be considered in patients who have atrial fibrillation.”

Stroke Warning Signs

Dr. Leifer describes the warning signs of stroke as sudden onset of any of the following:

• Facial droop

• Limb weakness on one side

• Difficulty speaking

• Loss of vision in one eye or one side

• Double vision

• Numbness or tingling on one side

• Dizziness • Unsteady gait

• Decreased coordination

• Severe headache

“Sudden onset of these problems is a reason to go to an emergency room immediately. Even if these symptoms last only a short time, they should be evaluated urgently because they may be transient ischemic attacks (TIAs),” he explains. A TIA is the same as a stroke, but the symptoms last a short time. People get stroke symptoms when experiencing a TIA because a clot is blocking the blood supply in the brain. When the clot moves away, the stroke symptoms stop. Having a TIA is a warning that a stroke may be imminent. “The same things that cause TIAs can also cause strokes. TIAs are a risk factor for stroke, and the greatest risk of stroke is probably within 24 to 48 hours after a TIA,” explains Dr. Leifer.

Importance of Quick Treatment

Stroke patients who are taken to the hospital in an ambulance may get diagnosed and treated more quickly because emergency treatment starts on the way to the hospital. The quicker someone gets treated, the better the chance for recovery, which is why recognizing the signs and symptoms of stroke is vital.

While stroke poses a significant risk of death and disability, making healthy lifestyle choices reduces the risk considerably, and recognizing the signs of stroke—and acting quickly if they occur—can increase the likelihood of survival.

The post Reduce Your Risk of Stroke by Making Healthy Lifestyle Choices appeared first on University Health News.

Under Pressure.

The first number, the systolic blood pressure, is the pressure on the artery walls when the heart contracts and pushes blood out into the arteries. The second number, the diastolic pressure, is a measure of the pressure on the artery walls when the heart is at rest between beats.

The artery walls need to stretch when the heart pushes blood into them. Blood pressure gets higher if the artery walls lose elasticity and cannot stretch adequately, or if the volume of blood increases (due to water retention because of too much dietary sodium, for example). Over time, the increased pressure on the blood vessel walls can create an environment that allows atherosclerotic plaque to build up. This plaque makes the walls stiffer and narrower, which results in even higher blood pressure.

The Silent Threat.

High blood pressure—also known as hypertension—generally has no symptoms, but it is extremely damaging to your health. Atherosclerotic plaque is the leading cause of chest pain (angina), heart attack, and stroke. In the presence of less flexible and narrower blood vessels, the heart needs to work harder, which contributes to heart failure. High blood pressure also effects the brain. Hypertension increases stroke risk and, as brain cells receive less and less oxygen and nutrients through plaque-narrowed vessels, risk for cognitive decline increases.

Lifestyle changes and medications are a powerful combination for lowering blood pressure. In some cases, lifestyle changes allow people to cut the dose of medication that is needed to control their blood pressure. Everyone can benefit from blood-pressure-friendly lifestyle choices. “The advice we give to control high blood pressure also prevents it,” says Hannah Wolf, MS, RD, an ambulatory dietitian at Tufts Medical Center.

The Food Fix.

Dietary intake has a definite impact on blood pressure. The most important blood-pressure related nutrients are sodium and potassium. High sodium intake increases blood pressure, and adequate dietary intake of foods that supply potassium can help lower blood pressure or keep it in a normal range.

“There is a lot of evidence behind the DASH and Mediterranean-style dietary patterns for controlling blood pressure,” says Wolf. These research-backed patterns are both higher in vegetables, fruits, whole grains, seafood, legumes, and nuts than the typical American diet. These naturally low-sodium foods are excellent sources potassium (and other nutrients that support general health). You can learn more about these dietary patterns, or customize a pattern that best suits your preferences and lifestyle by following a few simple rules:

➧ Limit Sodium: “We need some sodium in our diets,” says Wolf, “but excess can definitely have a negative impact on our health.” Unfortunately, most Americans consume more than the recommended 2,300 milligrams (mg) a day. Research shows even modest reductions in salt intake can result in reduced blood pressure over time.

Added salt (sodium chloride) is the primary source of sodium in our diets. “Only around 11 percent of the sodium in our diets comes from table salt,” says Wolf. “The bulk comes from processed foods and restaurant meals. Cutting out highly processed foods naturally lowers added sodium.”

➧ Eat Plants: “Eating plenty of naturally low-sodium fruits, vegetables, legumes, and unsalted nuts and seeds ensures you get minerals that help support healthy blood pressure, including potassium,” says Wolf. “These minimally processed plant foods also provide fiber, which is another dietary component research shows may help lower blood pressure.”

Other Lifestyle Choices.

In addition to making heart-healthy dietary choices, losing weight, moving more, limiting alcohol, avoiding tobacco, getting adequate sleep, and limiting or managing stress all help prevent and treat high blood pressure.

Find out what your blood pressure is. If it is high, work with your healthcare professional to bring it down. In addition to lifestyle changes, medication may be necessary. Making the lifestyle changes discussed here can lower your blood pressure, so your medication dose may need to be reduced. Monitor your blood pressure regularly at home so you can see how you’re doing. Be sure to share any significant lifestyle or blood pressure changes with your healthcare provider.

Set a goal that moves you toward better blood-pressure control. Your heart (and your brain) will thank you.

The post High Blood Pressure: The Silent Killer appeared first on University Health News.

“A stroke may produce life-changing consequences. It may impair your ability to function so severely that you become incapable of caring for yourself, which is why stroke is a leading cause of nursing home admissions,” says Dana Leifer, MD, a neurologist at Weill Cornell Medicine. “That’s why it is very important to take preventive action by addressing any stroke risk factors you have. Control of high blood pressure, high cholesterol, and diabetes can significantly reduce the risk of stroke. Proper treatment of atrial fibrillation is also very important And if you smoke, it is essential to stop smoking.”

Risk Factors

Common risk factors for stroke include:

• Eating an unhealthy diet
• Getting little or no exercise
• Having atrial fibrillation or any type of cardiovascular disease, including coronary artery or heart disease and peripheral artery disease
• Having high blood pressure
• Having high total and/or LDL cholesterol
• Having diabetes
• Being overweight Smoking tobacco.

Preventive Strategies

Making healthy lifestyle choices, addressing conditions that affect your cardiovascular health, maintaining a healthy weight, and not smoking will significantly lower your risk of stroke.

➊ Choose a healthy eating pattern.

A Mediterranean-style diet, which contains plenty of whole, plant-based foods such as legumes (beans, peas, and lentils), vegetables, fruits, whole grains, and nuts, has been shown to lower stroke risk. Another key feature of a Mediterranean-style diet is that olive oil is the primary fat used for cooking. The typical “Western” diet, which is high in red and processed meats, sweets, fried and fast foods, and highly processed foods, is linked with a higher stroke risk. For more details, see What You Can Do.

➋ Get and stay physically active.

Women who are sedentary (get no exercise) have a 25 to 30 percent higher risk of stroke than physically active women. Aim for at least 150 minutes of moderate-intensity or 75 minutes of vigorous-intensity aerobic activity each week. If you can’t get that much in, do whatever you can; even five or 10 minutes will provide some benefit.

Do activities that you enjoy; you’re much more likely to stick with an exercise regimen if you’re doing something you like. Any activity that gets your heart rate up and keeps it up will be beneficial. Aerobic activities include brisk walking, bicycling, jogging, dancing, swimming, rowing, and using an elliptical machine.

➌ Get treatment for atrial fibrillation (A-fib) and any other cardiovascular conditions.

Having A-fib, an irregular heart rhythm, can increase the risk of stroke by more than 400 percent. If you have A-fib, follow your cardiologist’s instructions. The same recommendation applies if you have any type of heart or vascular disease and/or you’ve previously had a heart attack or a transient ischemic attack (a mini-stroke). Even if you are taking medication, exercise, healthy eating, and quitting smoking if you smoke will be part of your treatment program.

➍ Control blood pressure, cholesterol, and blood glucose.

Following a heart-healthy eating pattern and getting regular physical activity will help you lower your blood pressure, your total and LDL cholesterol, and your blood glucose level. Many people will also require medication to get their numbers to healthy levels.

If you are prescribed medication, take it exactly as recommended. If you have problematic side effects, report them to your doctor and discuss other possible options, but don’t just stop your medication. Also make sure to attend regular follow-up visits with your doctor so he or she can monitor your progress.

If you cannot afford your medication, tell your doctor or pharmacist; samples or coupons may be available. Some medications are provided free or at low cost by the pharmaceutical companies.

➎ Shed some pounds if you are overweight or obese.

If you’ve repeatedly tried and failed to lose weight on your own, ask your doctor for a referral to a registered dietitian nutritionist who specializes in weight loss. Medicare and some insurance companies now cover obesity treatment, which may include nutrition education, tools and strategies for changing the way you eat, and/or weight-loss medications.

➏ If you smoke, quit.

Even if you’ve been smoking for decades, quitting cigarettes now will still provide significant health benefits. Ask your doctor for a referral to a smoking cessation program, and go to https://smokefree.gov to access free programs that can help you quit. Taking these steps may be challenging, but it’s nothing compared to the difficulties a stroke will cause. When you’re ordering broiled fish instead of a T-bone, taking your medication, or putting on your walking shoes, remind yourself that you are reducing your chances of having long-term disabilities, and you may even be saving your own life.

Know the Symptoms of Stroke

Signs that indicate a possible stroke include sudden onset of weakness, tingling, or numbness on one side of the body; blurred or double vision or loss of vision in one or both eyes; slurred or garbled speech, or trouble understanding someone else’s speech; loss of balance or difficulty walking; drooping or numbness on one side of your face; or sudden severe headache or dizziness.

“If you have any of these symptoms, get to an emergency room as quickly as possible,” urges Dr. Leifer. Don’t drive yourself, and call 911 immediately; the faster you get treatment, the better your chances are of avoiding permanent loss of function.

The post Take These 6 Steps to Reduce Your Stroke Risk appeared first on University Health News.

If you want to protect the health of your heart and blood vessels and lower your risk of heart attack and stroke, where’s the best place to start?

Begin with the Four Bs

“‘Life’s Essential 8’ can be divided into health behaviors and health factors. Behaviors can be challenging to change, so I like to start with the modifiable risk factors that sometimes can be easier to control,” says Lakshmi Nambiar, MD, FACC, a board-certified cardiologist at Weill Cornell Medicine’s Wellness and Prevention Center. “I tell my patients to know your 4 Bs—blood pressure, blood glucose, blood lipids, and BMI—and work on getting them into the goal range through both lifestyle modifications and medications. When patients can better manage their hypertension, diabetes, high cholesterol, and/or obesity, they reduce their risk of developing cardiovascular disease (CVD) and deaths caused by CVD.”

Get Enough Sleep

Health experts at the AHA added sleep to their checklist of essential items due to growing evidence that inadequate sleep can have detrimental effects on cardiovascular health.

“Sleep and cardiovascular health are closely linked. Your heart is a muscle: When you sleep, your heart rate slows down and your blood pressure dips, which essentially gives your heart a chance to rejuvenate itself,” explains Dr. Nambiar.

“Poor sleep can raise your blood pressure, increase inflammation, and affect blood sugar, contributing to weight gain, diabetes, and coronary artery disease.”

She notes that getting sleep of adequate quality and duration can be especially challenging for women, since many women work multiple jobs or night shifts and are often the primary caretakers for their families as well.

When to See a Specialist

If you have persistent sleep problems like insomnia, consult a sleep specialist.

“Sleep-related breathing disorders, such as obstructive sleep apnea (OSA), can contribute to various cardiovascular diseases if left untreated. See a doctor who specializes in sleep medicine if you note any of the following symptoms while you sleep: snoring, gasping, or breathing pauses,” says Dr. Nambiar. “People with OSA often report excessive daytime sleepiness and/or difficulty concentrating. Untreated OSA can lead to worsening hypertension, heart failure, and atrial fibrillation, a type of abnormal heart rhythm.”

Diet and Exercise

“Healthy eating and physical activity can lower your blood pressure and cholesterol, reducing your risk of developing cardiovascular disease. A hearthealthy diet consists of plant foods, fruits, vegetables, lean proteins, and healthy fats,” says Dr. Nambiar. She recommends adopting the following dietary strategies:

• Use healthy fats like olive oil instead of saturated fats like butter.
• Eat lean protein like chicken or fish instead of fatty meats like ground beef, sausage, bacon, or hot dogs.
• Eat more foods high in soluble fiber, including legumes (beans, peas, and lentils), whole grains, and vegetables.

“In terms of exercise, you want to aim for 150–300 minutes of physical activity every week. Try walking for 30–45 minutes a day at least five days a week,” advises Dr. Nambiar. “When I discuss exercise with my patients, they often tell me they do not know where to start. If you are sedentary, start with just a few minutes of walking every day.”

Your Mental and Emotional Health

The AHA advisory also notes that psychological health is a factor that plays a role in your cardiovascular health.

“We are increasingly finding that there is a mind-heart-body connection. One example of this is stress-induced cardiomyopathy, or ‘broken heart syndrome,’ in which an acute, extreme emotional stress can severely weaken your heart function. This type of cardiovascular event is more commonly seen in women,” explains Dr. Nambiar.

She adds, “Anxiety, depression, and chronic stress increase your risk of cardiovascular disease. Directly, they can increase inflammation, affecting your blood pressure, blood glucose, and blood lipids. Indirectly, they can affect your health-promoting behaviors and your resilience in dealing with health issues. It is critical to optimize your mental health when managing cardiovascular health.”

Finally, remember that all the items on the “Life’s Essential 8” checklist can be beneficial even if you already have been diagnosed with CVD, such as coronary artery disease or other heart disease.

“’Life’s Essential 8 is also about preventing the progression of already existing disease. The best example of this is smoking. If you are able to change one health behavior, I would say stop smoking. Quitting smoking will significantly reduce your risk of developing further cardiovascular events, even if you’ve had a heart attack in the past,” explains Dr. Nambiar.

The post Improve Your Cardiovascular Health with Eight Essential Steps appeared first on University Health News.

Hard on Your Heart

In hot weather, your core temperature rises. Your body responds to this rise by attempting to transfer heat to the environment. Two methods it uses are vasodilation (dilation of the blood vessels) and sweating.

• Vasodilation enables more blood to flow through the skin so that heat can be lost. But to increase blood flow to the skin, blood has to be redirected from elsewhere in the body. This may lower your blood pressure—and low blood pressure places extra demand on the heart. Mount Sinai cardiologist Bruce Darrow, MD, PhD, adds that heart medications may make the problem worse. “For example, beta-blockers and calcium channel blockers, which are used to treat high blood pressure and abnormal heart rhythms, can slow the heart rate,” he says. “This means that your heart rate may not increase appropriately to compensate for the change in blood pressure.”

• Sweating helps cool the body as it evaporates—but it also removes water and vital minerals, such as sodium and potassium, from the body. Dehydration is a risk, and this forces the heart to work harder and raises the risk of blood clots. “Fluid loss may be exacerbated if you take diuretics to treat high blood pressure or heart failure, since these drugs increase urine output,” Dr. Darrow notes. “ACE inhibitors—also used to treat high blood pressure— can increase sweating in some people, thereby raising the risk of dehydration.” Other drugs you may take alongside heart medications also may alter the way the body responds to heat—for example, anticholinergic drugs, pain medications such as opioids, and some antidepressants.

Dr. Darrow recommends these strategies to keep your heart safe in the heat.

1. Stay Indoors When the Sun is Strongest If you like exercising outdoors, schedule it for the early morning. “Aim to stay inside between 10 a.m. and about 4 p.m., when the sun is strongest,” says Dr. Darrow. “It’s also a good idea to engage in activities that keep you cooler— for example, swimming or a water aerobics class, instead of jogging or tennis—or join a gym so that you can exercise indoors in an air-conditioned environment.”

2. Dress Light Lightweight, light-colored clothing in breathable fabrics like cotton reflects the sun’s rays and allows heat to escape from your skin.

3. Stay Hydrated Water is best—avoid caffeinated or alcoholic beverages, since these contribute to dehydration. “If you have heart failure, drinking large amounts of water may contribute to swelling or sodium imbalance,” Dr. Darrow says. “Clarify with your doctor how much you can safely drink.” Keep in mind that older age, as well as medical conditions like stroke, Parkinson’s disease, and Alzheimer’s disease can dull your sense of thirst—people with these conditions need to be particularly careful about rehydrating throughout the day.

4. Keep Your Home Cool If you don’t have air conditioning, purchase some freestanding fans. Applying cool, damp cloths to your skin and standing or sitting next to a fan is a great way to cool down.

5. Take Your Medications Even though some of the drugs that are used to manage cardiovascular disease can contribute to dehydration, you shouldn’t stop taking them—their benefits far outweigh their risks. “If you are at all concerned that a medication you take may be causing heat intolerance, discuss your worries with your health-care provider,” advises Dr. Darrow.

6. Know the Signs of Heat Exhaustion They include headaches; chills; dizziness; fainting; a rapid heart rate; muscle cramps; and nausea. If you experience these symptoms, take steps to cool down.

7. Treat Heatstroke as a Medical Emergency Signs of heatstroke include warm skin with no sweating; a rapid, strong heart rate; confusion; fever (103 degrees Fahrenheit or higher); headaches; nausea; vomiting; and loss of consciousness. “Seek immediate medical help if you or a loved one experience these symptoms,” says Dr. Darrow.

The post Protect Your Heart in the Heat appeared first on University Health News.

Managing Pain

Researchers writing in the January issue of the Journal of the American Geriatrics Society (JAGS) investigated cannabis use among 568 people ages 65 and older. About 15 percent said they had used cannabis within the past three years. Of these individuals, half reported using the drug on a daily or weekly basis. Most used it to manage pain from age-related conditions such as arthritis, but others reported using it to help ease poor sleep, anxiety, and depression. Only 41 percent of cannabis users reported telling their health-care provider about their cannabis use. That is worrying, says Yasmin Hurd, PhD, director of the Addiction Institute at Mount Sinai. “All drugs have side effects, hence the reason for controlled clinical trials to determine not only efficacy, but potential harms,” Dr. Hurd explains. “Unfortunately, not much research has been dedicated to studying cannabis use in older adults, so it is still unclear what the potential harmful side effects are in that population.”

Risk Perception Low

A more recent study (JAGS, May 26) suggests that many older adults who use cannabis for medical reasons may not be aware of the drug’s risks. The study included 18,794 adults ages 65 and older. Between 2015 and 2019, the perceived risk associated with regular cannabis use decreased from 52.6 percent to 42.7 percent. Decreases in perceived risk were detected in particular among heavy drinkers and tobacco users. But perceptions of risk also decreased in people with cardiovascular disease, kidney disease, and chronic obstructive pulmonary disease. People with these conditions often take several medications to manage their symptoms. If they also use cannabis, they may increase their risk of harmful drug interactions.

CBD vs. THC

In the first study we reference, most participants reported using products containing only cannabidiol (CBD). CBD is the active ingredient in medical marijuana. It doesn’t have the mind-altering effects of another chemical in cannabis (tetrohydrocannabinol, or THC)—however, research suggests that it interacts with several medications. “CBD is metabolized by similar liver enzymes as common medications used by older adults, including drugs for sleep, pain, and anxiety,” Dr. Hurd confirms. “As such, CBD products have the potential to alter the effectiveness of these medications and impact your health in negative ways.”

Sensible Precautions

Dr. Hurd recommends you inform your health-care providers if you are using medical marijuana. Obtain a prescription from a doctor, and purchase the drug from a state dispensary. Cannabis products are not regulated by the U.S. Food & Drug Administration, and products purchased outside of state dispensaries may be stronger than you realize. Dr. Hurd adds that since so little is known about the effective dosage range of medical marijuana, it’s best to start with a low dose and increase as necessary to achieve symptom relief.

If recreational cannabis is legal in your state, keep in mind that it contains THC. Older adults are more vulnerable than younger people when it comes to THC’s intoxicating effects. It also may lower your blood pressure and affect your balance, raising your risk of falls—plus, it is associated with heart rhythm abnormalities.

The post Get Informed About the Risks of Cannabis Use appeared first on University Health News.

In an attempt to identify the optimal intake of fruits and vegetables associated with maintaining long-term health, researchers collected information on the typical dietary intake of over 100,000 healthy men and women in the U.S. over a 30 year period. That data was analyzed along with data from 24 other studies.

In general, the more fruits and veggies participants reported eating, the less likely they were to die during the study period, particularly from cancer, cardiovascular disease, and respiratory disease. Intake of five servings per day of fruits and vegetables (two servings of fruits and three servings of vegetables) was associated with the lowest mortality. Eating more than five servings was not associated with additional benefits. The only exceptions were starchy vegetables like peas and corn, fruit juices, and potatoes. Higher consumption of these was not associated with lower risk of death.

People who eat more fruits and vegetables often eat less of other, less healthful, foods, such as refined grain products and sweets. They may also make other healthy lifestyle choices. Aim for five servings of fruits and vegetables a day as one component of your healthy lifestyle.

DASH Diet Plus Sodium Reduction Best for Protecting the Heart

The heart can show signs of damage before a heart attack or other heart problem occurs. Scientists can measure things like inflammation, cardiac injury, and cardiac strain by looking at biomarkers in the blood.Researchers looked at data from the original DASH-Sodium trial and compared the effects of the Dietary Approaches to Stop Hypertension (DASH) diet, sodium reduction, and a combination of the two on these markers.

The DASH-Sodium trial was a controlled feeding study. The 412 participants, who all had high blood pressure, were randomly assigned to either a DASH diet or a control diet. Researchers changed the amount of sodium in the assigned diet every four weeks and measured blood levels of biomarkers for inflammation, cardiac injury, and cardiac strain. Calories were adjusted to keep body weight constant, since weight loss is known to lower blood pressure.

Consuming a DASH diet and lowering sodium intake were both helpful independently, but a combination of the two had the most favorable impact on cardiac injury and strain compared with the high sodium control diet.

Whether you have high blood pressure or not, the DASH diet is a healthy dietary pattern. If you want to lower your blood pressure, following this dietary pattern while reducing sodium intake below 2,300 milligrams a day is one proven approach to protecting your heart—even before you have symptoms of heart trouble.

Supplements and Alternative Therapies Not Shown to Help Weight Loss

An estimated 34 percent of Americans who want to lose weight have tried a weight loss supplement. A new study reviewed 315 randomized controlled trials testing the effectiveness of 14 dietary supplements, alternative weight loss therapies, or a combination of the two. The authors found most of the studies had small sample sizes, short follow-up periods, and flawed study designs, and they led to inconsistent results and conclusions.

Of the 52 studies determined to be of good quality, the researchers found just 16 in which participants in the treatment group lost more weight than those in the placebo group, and no single weight loss treatment worked consistently.

The supplements and treatments evaluated included chitosan, calcium plus vitamin D, chocolate/cocoa, chromium, ephedra/caffeine, garcinia and/or hydroxycitrate, green tea, guar gum, conjugated linoleic acid, Phaseolus, phenylpropylamine, pyruvate, acupuncture, and mind-body interventions.

In the U.S., dietary supplements require little or no testing to show efficacy or safety before being marketed to the public. In an accompanying commentary, the authors strongly recommended regulatory authorities “protect consumers by ensuring accurate and safe marketing claims and preventing promotion of unproven and potentially unsafe products and claims.”

Make sure any supplements you buy are third-party verified. Look for seals from companies like NSF International, United States Pharmacopeia, Informed-Choice and ConsumerLab, or go to their websites for lists of products that have been tested and approved.

The post Newsbites: Fruits and vegetables; diet for heart health; supplements and weight loss appeared first on University Health News.