How many individuals have their blood-pressure and cholesterol levels under control?
Less than one third!
Less than one in three patients in the US have their blood-pressure and cholesterol levels under control, according to a new analysis of the National Health and Nutrition Examination Surveys (NHANES). Researchers say there exist significant opportunities for improving hypertension and cholesterol control.
People with high blood pressure have about double the risk of coronary heart disease, but treating hypertension only reduces heart attack risk by only 25%. It is important to treat and control both high blood pressure and cholesterol.
In the study, published online July 1, 2013 in Circulation, the researchers assessed concurrent hypertension and hypercholesterolemia control in NHANES 1988 to 1994, 1999 to 2004, and 2005 to 2010.
Across the three surveys, 60.7% to 64.3% of the individuals with hypertension also had high cholesterol levels.
The control of LDL-cholesterol levels increased over time, up from 9.2% in 1988-1994 to 45.4% in 2005-2010.
In 2005-2010, approximately 54% of all hypertensive patients had good blood-pressure control, defined as <140/90 mm Hg. In total, 21.5% of all hypertensive patients were treated and uncontrolled.
For patients with high blood pressure and elevated cholesterol levels, the concomitant control of both risk factors increased approximately sixfold from 1988-1994 to 2005-2010. The control of blood pressure and LDL-cholesterol levels increased from 5.0% in 1988-1994 to 30.7% in 2005-2010.
“What we find is that while there has been a lot of progress in controlling both blood pressure and cholesterol, still about 70% of patients who have high blood pressure and high cholesterol don’t have both risk factors controlled,” said Egan, the lead author of the study.
Are you addicted to tea or coffee?
A large French retrospective analysis provides good news for caffeine lovers: investigators showed that drinking tea or coffee was associated with a small statistically significant reduction in systolic and diastolic blood pressure.
Drinking tea and coffee was also associated with a significant reduction in pulse pressure and heart rate, although the heart-rate reductions were greater with tea.
The results of this data were presented at the recently held European Society of Hypertension ESH 2013 Scientific Sessions, at Paris, France.
Presenting the data on 176 437 subjects aged 16 to 95 years of age who had a checkup at their center between 2001 and 2011, the authors explained that the analysis was based on a questionnaire asking participants how much coffee or tea they drank per day. Individuals were classified into three groups: those who drank no coffee/tea, those who drank one to four cups, and those who drank more than four cups.
Overall, coffee is consumed more frequently than tea. Men were more likely to drink coffee, while women were more commonly tea drinkers.
Both coffee and tea consumption was associated with a significant reduction in systolic and diastolic blood pressure.
So go ahead. Grab your cuppa!
All patients with type 2 diabetes or hypertension should be evaluated for sleep apnea by a board-certified sleep medicine physician, the American Academy of Sleep Medicine (AASM) advised this week in a position statement.
“Type 2 diabetics and people with hypertension are much more likely to have obstructive sleep apnea [OSA] than other people, and as a result, should immediately discuss their risk for sleep apnea with a sleep specialist,” AASM president Dr M Safwan Badr said in statement.
Obstructive sleep apnea (OSA) is a sleep disorder seen in overweight and obese individuals where patients have obstruction of their upper airways during sleep leading to disruption of sleep. This disturbed sleep at night causes excessive daytime somnolence and fatigue. This disorder also causes hypertension, increase in blood sugars and increased incidence of a heart beat disorder called atrial fibrillation.
New research has consistently proved that sleep apnea may drive uncontrolled BP. Prompt recognition and treatment of sleep apnea improves BP control and also reduces average 24-hour blood sugar by 11 mg/dl. This also improves diabetes control and reduces the number of drugs required for BP control.
Prompt recognition of sleep apnea and its treatment will improve control of BP and diabetes!
A small study has demonstrated that the blood-pressure lowering effects of Beet-root juice by increasing the intake of dietary nitrates.
Dr Amrita Ahluwalia (Barts and the London School of Medicine and Dentistry, UK) and colleagues have previously shown that beet juice, after coming into contact with human saliva, increases levels of plasma nitrate and nitrite and leads to significant blood-pressure decreases in healthy volunteers.
In their latest study, published online April 15, 2013 in Hypertension, Ahluwalia and colleagues from the Queen Mary University of London, UK turned again to beetroot, which, along with green leafy vegetables, has high concentrations of inorganic nitrate.
The authors tested the beet-juice effects in 15 hypertensive, drug-naive patients, randomized to either 250 mL of inorganic nitrate-rich beetroot juice or an equal volume of water. The “dose” of juice elevates nitrite levels approximately 1.5 fold.
In patients who drank the juice, systolic blood pressure dropped by a mean of 11.2 mm Hg between three and six hours after consumption (vs 0.7 mm Hg in subjects who drank water). By 24 hours, clinic systolic BP remained significantly lower in the beet-juice group and roughly 7.2 mm Hg lower than baseline. Peak drop in diastolic BP also occurred within the first six hours, dropping by a mean of 9.6 mm Hg. Pulse-wave velocity also decreased in the beet-juice group, but not in the controls.
Grab your glass of beet juice today!
Individuals detected to have mildly elevated blood pressure may be able to maintain normal blood pressure for the next 15 years without any medications!
That’s what the HARVEST trial says. The data was presented at the 2013 International Conference on Prehypertension and Cardiometabolic Syndrome.
Young adults (1012 in number with a mean age of 33 years) were diagnosed with mildly elevated blood pressure (grade 1 hypertension). They were followed up for the next 15 years.
It was observed that in 198 patients, the blood pressure fell to within normal range within the first few months and they managed to remain normotensive (normal blood pressure) over next 15 years.
The patients whose blood pressure fell and remained normal had a slightly lower body-mass index (BMI), lower coffee consumption, lower triglycerides, and higher physical-activity levels than the ones in whom the blood pressure remained higher!
Again a trial highlighting the importance of body weight and exercise to avoid diseases like diabetes and blood pressure.
Fifteen years later, hypertension free!
That’s great! Isn’t it? So start walking and eat healthy!
New study throws light on reducing Cardiovascular risk in patients with Diabetes!
It is a general feeling among diabetic patients and their physicians that controlling their sugar levels and their glycosylated hemoglobin (HbA1C) levels in the normal range would suffice to reduce the cardiovascular risk.
However, a recent study including 26,636 diabetic patients with longitudinal blood pressure, LDL-cholesterol, and HbA1c measurements followed for a mean of 5.6 years proves that it would not suffice!
These patients were analysed and followed up over a period of 5.6 years and their first cardiovascular hospitalization rates were studied. The analysis got published online January 24, 2013 in the Journal of General Internal Medicine.
It was found that diabetic patients who kept their blood pressure, LDL cholesterol and glycosylated hemoglobin levels all under control showed a 2.5 fold drop in the risk of cardiovascular-disease hospitalization over 6 years, compared with those who controlled none of the 3 risk factors.
Most of the observed benefit came from control of blood pressure and LDL-cholesterol as per guidelines.
Patients who had none of the three markers under control had the highest hospitalization rates of 18.2 per 1000 person-years.
And, patients with all three parameters controlled had the lowest rates, at 6.1 per 1000 person-years.
So, Diabetics Beware! Pay equal attention to your blood pressure and LDL-Cholesterol levels to reduce your cardiac risk!