Hypertension

It's time to put our fear of salt in the proper perspective.The USDA recommendation that all Americans cut back on salt is again under fire. This time I hope the blow will be fatal.If you're surprised to hear this from a nutritionist, you probably don't know that many experts question the benefit of low-salt diets for healthy people. In fact, the subject has been debated for years, long before the recent report that people who eat the most salt live longer than people who eat the least.Yet "hold the salt" has remained the prevailing message, in spite of the fact that an estimated two-thirds of the population is not prone to hypertension caused by salt sensitivity.

They didn't have jobs or health insurance. Maybe worse, these East Baltimore men felt as if they didn't have anyone to talk to. What most of them didn't realize was that their blood pressure was as out of control as their lives.But a study released yesterday at the American Heart Association's annual meeting in Dallas has proved that simple steps, and some compassion, can turn around the lives of men whom society has written off."Actually, it's the fact that somebody cares about them," said Mary Roary, the project's director at the Johns Hopkins' Center for Nursing Research.

Investigating conditions from lupus to hypertension, scientists have begun to confront one of the most perplexing questions in disease: How does race shape a person's health?Piece by piece, they are trying to unravel the web of influences that frame our collective destinies, forecasting which ethnic group must struggle with asthma, which gets socked with diabetes, which finds its relatives dying too soon.Researchers have already measured some of these consequences. They have learned that 34 percent more black women die of breast cancer than white women, that Native American toddlers die at almost twice the rate of white children, that Chinese-Americans are more likely than any other ethnic group to develop liver cancer and die from it.Now, more than ever, as people immigrate and travel around the planet, scientists want to explain what's behind these numbers.

Patients taking certain calcium channel blockers for hypertension had a higher risk of "cardiovascular events," including stroke and angina, but those on the long-acting calcium channel blockers appeared to suffer no major side effects, according to a new study.Calcium channel blockers, also called calcium antagonists, are the most widely prescribed medicine for high blood pressure.But some studies have linked the drug's short-acting versions -- those that must be taken several times a day -- to increased risk of strokes and heart attacks.

In its 72 years of fighting the nation's leading killer disease, the American Heart Association has never had anyone but a doctor at the helm. This will change next year when Martha Hill, a nurse from the Johns Hopkins Medical Institutions, becomes president of the national organization.Hill, a nurse practitioner who also holds a doctorate in behavioral science, was voted president-elect at a meeting last week in Atlanta. She will assume the one-year post in June 1997.Her election makes her the first nonphysician to hold the position since the Heart Association was formed in 1924 by six New York cardiologists.

Q: Whenever my 45-year-old husband has gone to the doctor over the past eight months, he has ben told that his blood pressure is high; but his blood pressure is normal when measured with the device in our local supermarket. Do you agree with his doctor who now has recommended that he take a medication to lower his blood pressure?A: Blood pressure readings are considered too high when they exceed 140 systolic and/or 90 diastolic, and certainly no medication should be considered unless pressures exceed these values on a regular basis.

Nine years ago high blood pressure killed Barbara McKinney's parents. Four years ago, it took her sister.Now the 41-year-old Lexington Terrace resident is suffering from hypertension, or high blood pressure, a disease that afflicts many in her West Baltimore community. Like others, she finds it DTC difficult to control her illness, which untreated can lead to heart disease and strokes."We'd like to be on a nutritious diet but that's not feasible on a fixed income," said Ms. McKinney, whose high blood pressure was diagnosed four years ago. Despite her doctor's orders to reduce salt and fat intake, she continues her regimen of eggs and bacon, fried chicken and seasoned salt.

Women are encouraged to get mammograms and Pap smears every other year or so, but doctors should also encourage their patients to get their blood pressure checked -- especially older women.High blood pressure, although prevalent throughout the population, is much more common in women than in men once they reach the age of 60.To find out why this is so and what women can do to keep their blood pressure at a healthy level, I turned to Dr. Paul Whelton at the Johns Hopkins School of Hygiene and Public Health.

The first physical explanation of why blacks are prone to high blood pressure, cardiovascular disease and strokes has been announced by researchers who say the findings may open the door to the development of new treatments.University of Georgia scientists found that arteries from black patients with severe heart disease were unable to return quickly to normal size after they had constricted in response to stress or medications. This relaxation is impaired, they found, because cells lining the arteries do not produce chemicals that stimulate enlargement.

Losing weight and cutting salt consumption could keep thousands of Americans from developing high blood pressure or its potentially fatal complications, scientists said yesterday. But reducing stress appeared to have no effect on blood pressure.Scientists finishing the nation's largest study into non-drug methods of blood pressure control said people don't have to make drastic changes in what they eat to realize profound benefits.In a study involving 2,182 men and women at the Johns Hopkins School of Hygiene and Public Health and 10 other medical centers, volunteers significantly reduced their blood pressure simply by losing an average of 8 1/2 pounds and exercising, or by shaving 2 1/2 grams of salt off their average daily intake of 9 1/2 grams.

Question: : I was diagnosed recently with borderline hypertension. My internist has prescribed the diuretics HCTZ and spironolactone. My reactions to those have been headache, nausea and intestinal upset. We also have tried Coreg, Norvasc, Accupril and lisinopril. My reaction to those medications has been severe migrainelike headaches. Are there any alternative therapies for treating hypertension? Answer: : There are many ways to treat high blood pressure, but you will need to work with your doctor to make sure the tactics you adopt work for you. As one reader of this column has noted, "losing a little weight (even just 10 pounds)

President Barack Obama and congressional Democrats have promised to pass sweeping health reform legislation by year's end. But before they overhaul the entire U.S. health care system - and pledge trillions in spending - they ought to consider policies that transcend traditional political divides and have already proven successful. Here's one such policy: improve patient "adherence" to doctor-ordered courses of prescription drugs. In recent years, pharmaceuticals have been integral to improving Americans' health.

Va'Sean Duvall is a skinny 17-year-old who stays busy with an after-school job, choir rehearsals and school drama productions. On the surface, he doesn't fit the mold of someone - older, obese and inactive - who would be at risk for high blood pressure. Yet he's among as many as 4 million children in the United States estimated to have hypertension, a figure that has grown fivefold in the past generation, according to Johns Hopkins researchers. It's a condition that doctors often fail to diagnose and one that leaves children - particularly African-Americans - at risk for serious heart problems, says a recent Hopkins study.

Is there anything in the way of vitamins or herbs that a person can take instead of a prescription drug for high blood pressure? I've heard about garlic, but I don't like it much. Is there anything else? The newest candidate for natural blood pressure control is beet juice. A study in the journal Hypertension (online Feb. 4, 2008) showed that 2 cups (500 milliliters) of beet juice lowered blood pressure by about 10 points. That is better than many prescription drugs. The effect lasts up to 24 hours.

Doctors fail to diagnose high blood pressure in more than three-quarters of children with the problem, putting them at risk for heart disease and other organ damage later in life, a new study suggests. Calculating elevated blood pressure in children is more complicated than in adults, and many doctors might not bother evaluating kids' pressure because they assume hypertension is an adult problem, the study found. "Hypertension is a disease that doesn't cause symptoms, particularly in children," said Dr. Richard Lange, chief of clinical cardiology at the Johns Hopkins University School of Medicine, who did not participate in the study.

You can identify Alicia Wilkinson's station by the red and white carnations. The lone female barber at the House of Masters barbershop at 6001 Liberty Road, she has delicate flowers there that stand out among the bare stations of her male counterparts and seem slightly at odds in an environment where customers periodically stop at the shop's bench to lift a few weights before sitting to get their hair cut. Yet, Wilkinson seems totally at ease. She is confident in her mission -- to improve her clients' appearance both outside and within.

Ponder this after recalling how you enjoyed - if you were off work to enjoy - a few extra hours of leisure this Labor Day: Workers may be a nation's lifeblood, but when too many work too much, the nation's blood pressure will rise. Combing through a survey of Californians, researchers at the University of California, Irvine have established a long-suspected link between work and health in America - that people who put in long hours on the job are more likely to suffer from hypertension than those who work less.

Put a bunch of 4-year-olds in a room and place two childhood favorites in front of them: salted pretzels and M&Ms. Then tell them to help themselves - and get out of the way. What they choose may have a lot to do with how much they weighed when they were born. It also may shed some light on the risk factors for hypertension later in life. Curious about the links between low birth weight and future risks for heart disease, and between salt and hypertension, researchers began a study to see whether some children are born liking salt more than other children.

I was surprised to hear that taking acetaminophen daily might lead to elevated blood pressure. Even though I eat a low-fat, vegetarian diet, I am stuck with the family curse - high blood pressure. I take extra-strength pain relievers containing acetaminophen several times a week. Researchers reported in the journal Hypertension (September 2005) that women who regularly rely on more than 500 milligrams of acetaminophen daily almost doubled their risk of developing high blood pressure. Although aspirin was not implicated, other nonsteroidal anti-inflammatory drugs such as ibuprofen were associated with higher blood pressure in this study.

If you haven't learned the term yet, make a note of it: prehypertension. The description of elevated but not yet dangerously high blood pressure entered the medical lexicon last year. Three new studies published recently in The Archives of Internal Medicine indicate that prehypertension is widespread and worrisome. "I'm not sure how much people have taken note of it," said Dr. Kurt Greenlund, an epidemiologist at the national Centers for Disease Control and Prevention in Atlanta. "People think, `Well, my blood pressure is a little high, but it's not hypertension,' so they wait until it's too late."