What Do The Numbers In Your Blood Pressure Mean?

In November 2017, for the first time in 14 years, the American Heart Association changed their blood pressure guidelines. The new guidelines lowered the number for what’s considered high blood pressure, also called hypertension. The result: a May 2018 study in JAMA Cardiology estimates that nearly half of American adults are now considered hypertensive.

Find out more about the new guidelines from the American Heart Association and the American College of Cardiology, plus how to check your numbers and lower your hypertension risk.

How to understand your numbers
Blood pressure is depicted as a fraction or a division equation, with a larger number on top and a small number on the bottom, separated by a slash.

The top number is systolic blood pressure, which measures the pressure inside the arteries when the heart contracts or beats. The bottom number, diastolic blood pressure, measures the pressure in the arteries at rest, between heartbeats. So, a blood pressure reading that’s 120/80 means the systolic blood pressure is 120 and diastolic is 80.

“If your blood pressure is high, your heart muscle is pumping against high resistance,” explains Khalil Afsh, MD, an internist and clinical lipidologist with Orange Park Medical Center in Jacksonville, Florida.

Given enough time pumping against high resistance, says Dr. Afsh, the heart will hypertrophy, or grow bigger. This can lead to impaired blood flow, arrhythmia and cardiac arrest.

Under the new guidelines, the JAMA Cardiology study estimates approximately 105.3 million adults in the US have high blood pressure. Prior to the new guideline release, about 74.1 million Americans were counted as having hypertension. It’s in your best interest to know your numbers because high blood pressure can lead to a host of problems, such as artery damage, stroke, heart attack and even kidney and eye damage.

What changed under the new guidelines
The guidelines for what’s considered normal blood pressure remained the same: a blood pressure reading of less than 120 mm Hg systolic and less than 80 mm Hg diastolic. However, the new guidelines defined hypertension as a reading above 130 mm Hg systolic or 80 mm Hg diastolic. This is a change from the old definition of hypertension—140/90 and higher.

The JAMA Cardiology study estimates that under new guidelines, 45.4 percent of American adults are considered hypertensive, up from 32 percent under the old guidelines. The number of hypertensive adults in the US rose by 31 million, as well, and those for whom blood pressure-lowering treatment is recommended, by 11 million. Despite these increases, less than one-third of people who are recommended medication are successfully being treated.

The new guidelines also eliminated the category of prehypertension, once defined as a blood pressure reading between 120 and 139 systolic or 80 to 89 diastolic. Now, the guidelines list:

• Elevated: Systolic between 120 and 129 and diastolic less than 80
• Stage 1: Systolic between 130 and 139 or diastolic between 80-89
• Stage 2: Systolic at least 140 or diastolic at least 90—previously classified as stage 1

If your reading shows systolic blood pressure above 180 or diastolic above 120, this is considered a hypertensive crisis, and patients should seek prompt medical care.

Research suggests complications can arise before blood pressure reaches 140/90. These changes encourage early intervention to prevent any further increase in blood pressure levels and reduce the likelihood of hypertension-related complications, like stroke, vision loss and heart attack.

Tools of the trade: How to measure your blood pressure
Blood pressure is measured in millimeters of mercury or mm Hg. Why mercury? Take a closer look at the blood pressure cuff the nurse or doctor puts around your arm. The cuff is called a sphygmomanometer and, even today, many contain mercury to measure barometric pressure in the arteries, according to Afsh.

The cuff is inflated to squeeze the artery and prevent blood from flowing, then the air is released. When the blood starts flowing again, the doctor or nurse will look at the pressure reading and determine the systolic blood pressure. “When the pulse goes away, we’re measuring diastolic blood pressure,” says Afsh.

Afsh says he tests blood pressure at least once more after a reading comes back high. “When someone comes to our practice and we find high blood pressure, we ask the patient to relax and then measure again,” he says. “Anxiety can raise blood pressure.”

Talking while your blood pressure is being monitored or having a full bladder can also throw the reading off. Sometimes someone can have high blood pressure in one arm and not the other due to a problem with their veins, adds Afsh. “I usually go with the lower reading because when you have high blood pressure in one arm, there’s probably a blockage.”

You might want to get a device to monitor your blood pressure at home. Many people’s readings are higher in the doctor’s office than they are at home because doctors make them nervous; it’s a phenomenon known as white coat hypertension.

Look for a device that takes measurements from the upper arm and can be used on both arms. It’s a good idea to bring the device to your healthcare provider’s office to make sure it works correctly and you know how to use it properly.

What you can do about high blood pressure
There is no cure for high blood pressure, but a combination of lifestyle modifications and medication can help manage the condition, and reduce your risk of complications. Your doctor is most adept to guide you through the changes you should be making, which might include:

• Quitting smoking
• Limiting salt intake
• Scaling back alcohol consumption
• Eating a well-balanced diet
• Upping daily physical activity
• Maintaining healthy weight
• Sticking to your medication schedule

****The above was taken from ShareCare.

Are You Constipated?

Did you know when it started in 1919, the comic strip Popeye was called Thimble Theatre and there was no muscle-bound, spinach-eating sailor in sight? Quick-witted Castor Oyl and his sister, Olive Oyl, were the main characters who made the comic go week after week.

Funny thing about that—although we doubt creator E.C. Segar realized it—both castor and olive oil are natural remedies for constipation! That’s something more than 35 million U.S. adults suffer from on an (ir)regular basis.

What is constipation? Well, even if you go once a day, if your stools are hard to pass and dry, that’s a sign. And if you have trouble eliminating more than a couple times a week—that signals your bowels are moving slowly.

To get things going, try taking one tablespoon of olive oil on an empty stomach in the morning. The healthy fat helps soften intestine walls, making things slide along more easily, and it keeps stools softer by helping them retain more water. If that doesn’t work, with your doc’s guidance, try castor oil. It’s a stimulant laxative that’s tougher on the gut than olive oil. It works by increasing intestinal contractions and can only be used for a couple of days. Overuse damages intestinal muscles and can cause vitamin deficiencies!

Then, for sustained regularity, up your fiber intake: Eat 2-3 servings of 100 percent whole grains and 5-9 servings of fruits and veggies daily. Like Popeye, you’ll be able to say; “I’m strong to the finich… ‘cause I eat my spinach!”

**Taken from ShareCare.

Headspace to Treat Disease?

You might know Headspace as a meditation app. What if it were also a prescription medication?

The California-based company recently launched Headspace Health, a subsidiary whose executives’ goal is to apply to the U.S. Food and Drug Administration as a prescription meditation app by 2020. The company will soon launch a series of clinical trials to support an application.

The prescription products would include a specific dose and meditation technique for different health conditions, says Megan Jones Bell, the company’s chief science officer, who will lead the new health effort. “This will likely be a unique code that the physician gives a patient” for access to the program, she says.

They wouldn’t copy the company’s current programs, which are designed for wellness. They would be created and tailored specifically for each condition they treat.

The FDA has cleared prescription mobile medical apps for various conditions in the past, such as substance abuse, and treats them as medical devices. Headspace believes the new products will require a prescription because the FDA’s guidelines on software as a medical device say that digital interventions that treat a disease require a prescription and doctor supervision.

The announcement comes as meditation has grown in popularity, fueled in part by a growing number of apps.

According to the most recent statistics from the National Institutes of Health, in 2012 about 8%, or 18 million U.S. adults, reported meditating. Headspace reports having 30 million users, up from 10 million a year ago.

Research into meditation’s impact on health is ongoing. Researchers are unclear on whether people benefit from a meditation app the way they can from group or individual meditation.

“The evidence is the strongest for meditation related to blood pressure, irritable bowel syndrome and certainly in the area of lower-back pain,” says Wendy Weber, acting deputy director of the National Center for Complementary and Integrative Health, part of the NIH. There is also a growing body of evidence showing how meditation can help patients with depression.

Dr. Weber says some may prefer more personal ways to learn meditation. “I do think that working with a teacher, they can customize and work with you if you’re struggling, whereas an app format may not have that sort of structured assistance,” she says.

On the other hand, doctors are always looking for non-pharmacological approaches to pain management. Connecting patients to things like meditation through data-supported apps could be one way of doing that, she says.

Aditi Nerurkar, medical director of the Cheng-Tsui Integrated Health Center at Beth Israel Deaconess Medical Center in Boston, has been suggesting meditation to her patients for years. She says more patients are asking her about meditation apps. She usually teaches her patients how to meditate in person.

Dr. Nerurkar, who has no financial or research relationships with any apps, says she uses them herself sometimes. She usually recommends three to her patients: Headspace, Calm and Insight Timer. All have at least some free content. Headspace charges for some as well.

“Whatever allows you to practice on a consistent basis, that’s what you should do,” she says, “whether that’s an app, by yourself or in a group.”

Headspace is launching its first phase-one trials this summer, but declined for competitive reasons to disclose which health condition it will be studying.

“We’ve identified a dozen conditions that we plan to pursue,” says Dr. Bell, a psychologist working with a team of about seven health professionals.

Separately, Headspace is working with researchers across the world studying its products’ impact on employee health and well-being. About 65 studies are completed or under way looking at outcomes like work productivity, employee stress and absentee rates.

Some include taking blood samples to measure different hormones, and brain scans. The studies using brain scans are being done with novice meditators. “A lot of meditation studies have been done with monks,” Dr. Bell says. “We’re interested in seeing what changes in the average person’s brain.”

Aric Prather, an assistant professor in the department of psychiatry and the Weill Institute for Neurosciences at University of California, San Francisco, is leading a study testing Headspace with UC employees who report increased stress levels. The study, which aims to recruit several thousand patients, will compare those using Headspace for at least 10 minutes a day for eight weeks with a control group.

David Creswell, an associate professor in psychology at Carnegie Mellon University in Pittsburgh, is planning to work with Headspace on a large workplace study examining its impact on the brain and immune system. The study would replicate similar studies he’s done testing the impact of meditation performed during in-person sessions, which showed a positive impact on brain functioning and the immune system.

Dr. Creswell’s research has already tested a 14-day mindfulness meditation app developed at Carnegie Mellon used for 20 minutes a day. The study, published in the journal Psychoneuroendocrinology in January, included 135 stressed adults divided into three different groups. Two weeks of mindfulness training was enough to reduce cortisol levels and blood pressure, two biological signs of stress.

They also found that use of the app improved the participants’ reporting of positive emotions and increased their social interactions.

“What this study suggested to me was that these smartphone approaches can be very powerful,” Dr. Creswell says. “They’re cheap, they’re easy to disseminate and they’re effective in terms of hard-to-reach populations that may not want to come in for weekly classes or programs.”

Other meditation apps are also delving into the realm of health.

Buddhify, a U.K.-based app, created a product for cancer patients with a University of Pittsburgh Medical Center oncologist two years ago.

The free website, Kara, is designed to help cancer patients with the range of difficult emotions they often deal with, says Rohan Gunatillake, founder of Buddhify.

And a Boston-based company called 10% Happier worked with Arizona State University to test its app’s use with cancer patients, comparing its impact on pain relief to in-person meditation, says Samuel Johns, head of product engagement and coaching for the company. Researchers are still analyzing the results.

Write to Sumathi Reddy at sumathi.reddy@wsj.com

***Taken from Flipboard.

Secrets To Live To Be 100

The secrets to a long healthy life may not be as elusive as they seem. In 2014, more than 70,000 Americans lived to be at least 100 years old. So, what might these people be doing that we aren’t?

Dan Buettner, National Geographic Fellow, bestselling author and the creator of the Blue Zones, traveled the globe to identify the places in the world with the highest population of people living beyond 100 years of age. He dubbed these places “Blue Zones.”

Common themes among the Blue Zones, which include Sardinia, an Italian island in the Mediterranean Sea, Nicoya Peninsula, Costa Rica, Ikaria, Greece, a community of Seventh Day Adventists in Loma Linda, California and Okinawa, Japan include these nine principles. These pillars of a long, healthy life are known as the Power 9 principles.

Your Guide to the Power 9

1. Move Naturally: The benefits of regular exercise are seemingly endless. Physical activity boosts weight loss, improves mood and more, but you don’t have to rush to the gym or run a marathon to reap these benefits. Instead, residents of the Blue Zones, allow their environments to help them move in the garden, washing dishes and more.
    
2. Purpose: Let’s face it—going through the motions of your day-to-day life can be exhausting, and even a bit boring. Luckily, something as simple as finding your sense of purpose can add up to seven years to your life. And that’s not all—a sense purpose can improve your heart health and protect your brain from disease.
   
   Looking for simple ways to find your purpose? Decide what you’d love to do most, set specific goals and meditate.
    
3. Down Shift: We all experience stress—even people who live in Blue Zones. Not all stress is bad, but chronic stress can take a toll on your health, leading to conditions like depression, high blood pressure and heart disease. Take a page out of the BZ book and find a way to decompress.
   
   The Sardinians, for example, enjoy happy hour to relax, while Ikarians take a nap. If you’re feeling stressed, take a walk, try meditating or spend time with your family and friends.
    
4. 80 Percent Rule: About two-thirds of American adults are considered overweight or obese. Excess weight is linked to higher rates of diabetes, heart disease and certain cancers, all of which shed years off your life. You don’t have to slash your portions to be “healthy,” but you shouldn’t stuff yourself either.
   
   The rule of thumb? For a longer life, eat until your stomach is about 80 percent full—you should not feel hungry, but you shouldn’t necessarily feel full either.
    
5. Plant Slant: Plant-based diets are a popular in the Blue Zones, but you don’t have to live in these regions to reap the benefits of a veggie-rich diet. On average, people in Blue Zones eat five small servings of meat, primarily pork, per month. Rather than eating meat, they load their plates with plant-based proteins, like beans and lentils. People who eat less meat have lower rates of heart disease, the leading cause of death among both men and women in the United States. 
    
6. Wine at Five: Are you a lover of a nightly cocktail? Well, you’re in luck! Moderate drinking—categorized as one daily drink for women and two for men—has been linked to longevity. Studies suggest moderate drinkers live longer than those who drink more heavily, and even those who don’t drink at all.
    
7. Belong: Faith is an important part of life in Blue Zones, regardless of denomination. Members of faith-based communities—a group of individuals who unify around a specific religious or spiritual belief—who attended services four times each month can expect to add between four and 14 years to their life. 
    
8. Loved Ones First: Those with close-knit families may be destined to live longer. The most successful members of these Blue Zones are married—which can up your life expectancy by three years—live near aging parents and grandparents and invest time in their children.
    
9. Right Tribe: A motivational speaker named Jim Rohn famously professed that you are the average of the five people you spend the most time with. Research suggests he might be right. Take the Okinawans, for example, who create small groups—called moais—that are committed to one another for life and tend to share the same healthy behaviors. Spending time with people who smoke, are unhappy or have unhealthy eating habits will make you more likely to do the same.   

**Taken from ShareCare.

Is It Normal to Be Tired All The Time?

Do you often feel exhausted with more than your run-of-the-mill fatigue? Hypothyroidism, an underactive thyroid, may be to blame. We talked to endocrinologist Parveen K Verma, DO, FACE, of Our Lady of Lourdes Medical Center in Camden, New Jersey, to learn more about hypothyroidism and how it’s treated. 

What is hypothyroidism?
Dr. Verma: “Hypothyroidism … is a problem with the thyroid gland, a gland in the base of your neck that controls metabolism. Someone with hypothyroidism does not make enough thyroid hormone. It can be caused by an infection and may be a transient problem … that gets better without treatment. It may also be the result of an autoimmune disease, more commonly known as Hashimoto's disease, where the thyroid doesn't make enough thyroid hormone.”

What are symptoms of hypothyroidism?
Dr. Verma: “Typical symptoms of hypothyroidism include fatigue, weight gain, decreased energy, depression, dry skin and hair and constipation. ... A lot of people just feel like everything has closed down. For women, they may have fertility issues or abnormal menstrual cycles.”

If I experience extreme fatigue, when should I see my healthcare provider?
Dr. Verma: “If common things that cause fatigue (not getting enough sleep, nutritional issues, multitasking) have been ruled out and you don’t feel better after a few weeks, then you should seek a medical evaluation from a primary care doctor. … An initial workup may include a discussion about sleep habits, nutrition, work schedule, personal stressors and blood work that looks for things like anemia or other metabolic problems, such as hypothyroidism.”

How is hypothyroidism treated?
Dr. Verma: “The typical treatment for hypothyroidism is to use a form of thyroid hormone called levothyroxine. … There are some other formulations that are considered more natural, such as Armour Thyroid. To decide which would be an appropriate choice for you, discuss your options with your primary care doctor or endocrinologist.”

Are there lifestyle modifications I can make to improve my symptoms?
Dr. Verma: “Everyone should engage in regular physical activity, a minimum of 30 minutes a day, five days a week. In terms of diet, our typical recommendation is to follow a well-balanced diet that includes a variety of fruits and vegetables. Overall, maintaining a well-balanced diet and exercise regimen can improve some of the symptoms that result from hypothyroidism, but there is no diet or exercise plan that works better than another to stimulate the thyroid. Also, it's important to look at [your sleep]. Are you sleeping enough? Is your sleep restful sleep? Are you waking up multiple times at night? Some of us feel that we slept for nine hours, but if we have other diseases like sleep apnea, it's not a restful sleep. If you have a lot of stress or you're not eating well, these are all other things that can contribute to fatigue.”

What should I do if I continue to feel excessively tired, despite treatment?
Dr. Verma: “It's important that when symptoms persist or if you don't improve, that you follow up with your doctor. He or she will repeat blood work, most commonly measuring TSH (thyroid stimulating hormone), which is the best marker of thyroid function. Your doctor may do additional testing … to make sure there's not something else contributing.”

What else should I know about hypothyroidism treatment?
Dr. Verma: “When you are treated for hypothyroidism it's very important that you take your thyroid hormone replacement at approximately the same time every day so you get a consistent and stable level. That would be the reason to have a regular schedule of sleeping at approximately the same time, with the appropriate amount of sleep -- seven to nine hours for adults -- and proper nutrition.”

**The above article is take from ShareCare.