Sunday, May 29, 2016

Blood pressure-Hypertension



A Harvard Medical school report on hypertension with credit due to the editors for Harvard Health Publications. Najam Hasan 

Hypertension:


An alarming one in three American adults has high blood pressure. Known medically as hypertension, many people don't even know they have it because high blood pressure has no symptoms or warning signs. But when elevated blood pressure is accompanied by abnormal cholesterol and blood sugar levels, the damage to your arteries, kidneys, and heart accelerates exponentially. Fortunately, high blood pressure is easy to detect and treat. Sometimes people can keep blood pressure in a healthy range simply by making lifestyle changes, such as losing weight, increasing activity, and eating more healthfully. This report details those changes, including a Special Section that features numerous ways to cut excess salt from your diet — a policy strongly recommended by new federal guidelines. This report also includes tips on how to use a home blood pressure monitor, as well as advice on choosing a drug treatment strategy based your age and any other existing medical issues you may have.

Blood pressure and your brain
When you think of the effects of high blood pressure, you probably think of heart attack and stroke. And for good reasons—many patients with high blood pressure develop coronary artery disease or heart failure, and many die as a result. But all parts of the body depend on the circulation, and many organs suffer from the impact of untreated high blood pressure. One of the organs at greatest risk is the brain.
High pressure, short memory
A variety of illnesses and medications can contribute to memory loss—and as research continues to come in, it's increasingly clear that high blood pressure takes a toll on the aging brain.
Mild cognitive impairment can be a problem, but it's usually quite manageable. But severe memory loss is a disaster; it causes severe disturbances of memory, reasoning, and judgment.
The details vary from study to study, but the weight of evidence now suggests that high blood pressure increases the risk of mild cognitive impairment, a type of dementia called vascular dementia, and even Alzheimer's disease. Both high systolic (the top number of a blood pressure reading) pressure and high diastolic (the bottom number) pressure take a toll. In general, the higher the pressure and the longer it persists without treatment, the greater the risk.
Most investigations focus on older adults. For example, a study of 2,505 men between the ages of 71 and 93 found that men with systolic pressures of 140 mm Hg or higher were 77% more likely to develop dementia than men with systolic pressures below 120 mm Hg. And a study that evaluated blood pressure and cognitive function in people between 18 and 46 and between 47 and 83 found that in both age groups high systolic and diastolic pressures were linked to cognitive decline over time.
Treat blood pressure, prevent dementia?
The damage and disability done, by dementia,  cannot be reversed. That makes prevention doubly important. Can treating high blood pressure help prevent dementia?
Yes. Here's some of the evidence:
  • European scientists reported that long-term therapy for high blood pressure reduced the risk of dementia by 55%.
  • One American study linked therapy to a 38% lower risk.
  • Another reported that each year of therapy was associated with a 6% decline in the risk of dementia.
  • A study of American men and women linked therapy to a 36% reduction in the risk of Alzheimer's disease. In that study, a type of medication called diuretics appeared to be the most beneficial medication.
  • A team of investigators from Harvard and Boston University reported that six months of high blood pressure treatment actually improved blood flow to the brain.
The risk factors that increase your chances of having a stroke
Why stroke symptoms can differ from person to person
The reason “mini-strokes” can be just as serious as ischemic strokes
The app you should have on your phone or tablet that shows how to detect a stroke
The type of therapist you may not know about who can help you regain speech after a stroke
And so much more!
Never too late
It's good to know that blood pressure control can reduce the risk of cognitive dysfunction. But what about people who already have mild memory loss? Can treating high blood pressure help stave off further damage?
Perhaps. Italian scientists studied 80 patients with mild cognitive dysfunction. Over a two-year period, people who were given medications to treat high blood pressure were 80% less likely to progress to full-blown Alzheimer's than untreated patients. It's only one study, and a small one at that, but hopefully additional research will back up that finding.
An alarming one in three American adults has high blood pressure. Known medically as hypertension, many people don't even know they have it because high blood pressure has no symptoms or warning signs. But when elevated blood pressure is accompanied by abnormal cholesterol and blood sugar levels, the damage to your arteries, kidneys, and heart accelerates exponentially. Fortunately, high blood pressure is easy to detect and treat. Sometimes…
Stroke is a feared medical problem because it can be debilitating or even deadly. Your best defense is to make sure you know how to prevent a stroke and how to recognize one so you can get treatment right away.
In Stroke, Harvard Medical School experts distil the latest research and recommendations into understandable advice that can help you prevent or cope with a stroke.
Harvard Medical School’s Stroke report reveals:
Prepared by the editors of Harvard Health Publications in consultation with Randie M. Black-Schaffer, M.D., M.A., Medical Director, Stroke Program Spaulding Rehabilitation Hospital, Associate Chief for Clinical Affairs Department of Physical Medicine and Rehabilitation, Harvard Medical School with Natalia Rost, M.D., Stroke Neurologist, Massachusetts General Hospital, Instructor in Neurology, Harvard Medical School.