ESH/ESC publish hypertension guidelines: Lifestyle changes reduce BP!

The European Society of Cardiology and the European Society of Hypertension released Guidelines for Physicians to treat Hypertension (high BP). The joint guidelines are designed to reduce the morbidity and mortality associated with hypertension.

Worldwide, 1.5 billion people currently have high blood pressure, according to the World Health Organization.

Dr Robert Fagard, the chair of the ESH/ESC writing committee, reiterated that treatment decisions for patients should be dictated by their overall level of risk and a holistic approach to treatment should be advised by physicians.

 

Lifestyle changes for treatment!.

 

The new guidelines make a host of lifestyle recommendations for lowering blood pressure.

1. Salt intake:  The Guidelines recommend salt intake of approximately 5 to 6 g per day, in contrast with a typical intake of 9 to 12 g per day. A reduction to 5 g per day can decrease systolic blood pressure about 1 to 2 mm Hg in normotensive individuals and 4 to 5 mm Hg in hypertensive patients.

2. Lower BMI:  While the optimal body-mass index (BMI) is not known, the guidelines recommend getting BMIs down to 25 kg/m2 and reducing waist circumferences to <102 cm in men and <88 cm in women. Losing about 5 kg can reduce systolic blood pressure by as much as 4 mm Hg.

3. Exercise: Aerobic endurance training in hypertensive patients can reduce systolic blood pressure by 7 mm Hg.

 

Fagard said that physicians can typically give low/moderate-risk individuals a few months with lifestyle changes to determine whether they’re having an impact on blood pressure. They should be more aggressive with higher-risk patients, however, noting that drug therapy is started typically within a few weeks if diet and exercise are ineffective.

 

via ESH/ESC publish hypertension guidelines | theheart.org.

Check for sleep apnea in individuals with diabetes and hypertension.

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!

 

via AASM says check for sleep apnea in diabetes, hypertension | theheart.org.

Beet juice reduces BP in hypertensives!

 

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!

 

via Dietary nitrates in beet juice cut BP in hypertensives | theheart.org.

Fall in cardiac risk in diabetes with multiple risk-factor control

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!

Take care!

via Kaiser: Fall in CV risk in diabetes with multiple risk-factor control | theheart.org.