Many Women Struggle With Uncontrolled Blood Pressure

(HealthDay News) -- Nearly one in three Americans suffers from high blood pressure -- more than 73 million adults.

But half of them -- women -- face unique challenges in controlling their blood pressure.

For instance, women with high blood pressure are more likely to be obese and have high cholesterol levels. They're also less likely than men to meet target goals for their blood pressure. And they're also less likely than men to receive medications such as aspirin, blood pressure-lowering drugs or cholesterol-lowering drugs, compared to men, recent research found.

These findings add greater urgency to the American Heart Association's ongoing "Go Red for Women" campaign, which seeks to change the perception that high blood pressure and heart disease are "male" health threats.

Most people don't know that heart disease is the No. 1 killer of American women -- as well as men. An estimated 480,000 women die of cardiovascular disease every year, more than the total number of cardiovascular disease-related deaths in men, or the next four causes of death combined, according to the heart association.

Unchecked high blood pressure -- also known as hypertension -- can produce terrible systemic damage and disease. It can lead to a heart attack, stroke, heart failure, kidney damage, blindness and a host of other medical problems.

Despite this, a large segment of women aren't adequately addressing their hypertension.

"Only about 60 percent of women with high blood pressure are having it controlled," said Dr. Nieca Goldberg, medical director of New York University Medical Center's Women's Heart Program, and a spokeswoman for the "Go Red for Women" campaign. "When you bring your blood pressure down, you cut your stroke risk in half and risk of heart attack by 25 percent."

Part of the problem is that women tend to suffer from an increased systolic rate, said Dr. Daniel Jones, president of the American Heart Association.

Blood pressure is the force of the blood against artery walls when the heart beats and then rests. Measurement renders two numbers. Systolic pressure, the top number, is recorded when your heart beats and forces blood out to the body. Diastolic pressure is the bottom number, and is the minimum pressure that occurs when the heart relaxes between beats. The ideal blood pressure is below 120/80 mmHg, according to the heart association.

But, Jones added, "The systolic rate is more resistant to treatment through medication."

Goldberg believes that some women might be stopping their blood pressure medication without talking with their doctor, after suffering from side effects that can include insomnia, lethargy and depression.

"If the medication is a problem, we have many different medications that help," said Goldberg, author of Dr. Nieca Goldberg's Complete Guide to Women's Health.

Further complicating treatment is the perception of high blood pressure as a "man's disease," which might affect the intensity of care they receive, Goldberg said.

"Sometimes, the woman's needs aren't being met at the doctor's office," she said. "They need to ask the simple question, 'What is my blood pressure?' And if it seems a little elevated, they need to talk to a doctor about what to do to fix it."

Women also shouldn't ignore the lifestyle changes they can pursue that will lower their blood pressure, or help prevent it from rising in the first place, Jones said.

"They're not as easy to do as some things, but they are very powerful," he said.

Diet can have a big impact on high blood pressure. A recent study found that women 45 years old and older who ate low-fat diary foods were at lower risk of developing high blood pressure.

"Those [low-fat diary products] are great, because they have calcium, which is good for our bones, so there's more than one benefit," Goldberg said.

Reducing fat and salt intake is also helpful.

"When you're going to the market and buying prepared foods, purchase those that are grilled, not fried," Goldberg said. "You also should realize many condiments are very high in salt."

Quitting smoking and reducing the amount of alcohol you drink is also important for reducing your overall risk for heart attack and stroke.

On the horizon, researchers are developing a vaccine that could prove successful in moderating blood pressure. It works by inhibiting angiotensin II, a molecule that constricts blood vessels and raises blood pressure.

"The potential attractiveness of a vaccine is it might be a more convenient way to manage high blood pressure in some people," Jones said.

Researchers at the 2007 American Heart Association annual meeting discussed some early encouraging results, although Jones cautioned that the vaccine is still years away from use in patients. "People should not be anticipating this is something that would be clinically available anytime in the near future," he said. "It's not anywhere close to being tested by the FDA for use."

Until then, following a healthy lifestyle and sticking with a good medication are a woman's -- and man's -- best bet for beating back high blood pressure.

"We know that a diet that is low in sodium and high in fruits, vegetables and low-fat dairy products is very useful in both preventing and treating high blood pressure," Jones said. "I always like to remind people of the importance of simple things in lifestyle that can make a difference."

More information
To learn more about the Go Red for Women campaign, visit the American Heart Association.

Hypertension Takes Huge Toll in Developing Countries

(HealthDay News) -- Roughly 80 percent of high blood pressure-related deaths in the world occur in developing nations, a new study by New Zealand researchers shows.

Once regarded as a problem only in high-income countries, high blood pressure is now a global problem that affects both rich and poor nations, the researchers said.

The researchers calculated that 7.6 million premature deaths (about 13.5 percent of the worldwide total) and 92 million disability-adjusted life years (DALYS) -- 6 percent of the worldwide total -- among people over age 30 were caused by high blood pressure in 2001.

About 54 percent of strokes and 47 percent of heart disease cases were attributed to high blood pressure. About half of those cases occurred in people with hypertension (greater than 140 mm Hg systolic), while the remainder occurred in people with lesser degrees of high blood pressure.

In high-income countries, the proportion of premature deaths due to high blood pressure was 17.6 percent, compared to 12.9 percent in middle- and low-income nations. The proportion of DALYS due to high blood pressure in high-income nations was 9.3 percent, compared to 5.6 percent in middle- and low-income nations.

However, 80 percent of worldwide high blood pressure-related deaths occurred in middle- and low-income nations in eastern Europe and Asia, including China and India. More than one-third of all deaths in lower-income nations in Europe and central Asia were related to high blood pressure.

In high-income countries there were 1.39 million high blood pressure-related deaths; 418,000 stroke deaths; 668,000 heart disease deaths; 109,000 deaths due to hypertensive disease; and 197,000 deaths due to other cardiovascular diseases.

In low- and middle-income countries, there were 6.22 million high blood pressure-related deaths: 2.5 million stroke deaths; 2.68 million heart disease deaths; 598,000 hypertensive disease deaths; and 445,000 deaths due to other cardiovascular diseases.

"Most of the disease burden caused by high blood pressure is borne by low-income and middle-income countries, by people in middle age, and by people with lesser degrees of high blood pressure. Prevention and treatment strategies restricted to rich countries or individuals with hypertension will miss much blood pressure-related disease," wrote the University of Auckland researchers.

The study is published in this week's issue of The Lancet.

"Middle-income countries and low-income regions have a five times greater burden of disease than high-income regions, with access to less than 10 percent of the global treatment resource... This travesty cannot continue to be ignored by those most able to bring about change," Stephen MacMahon, of the George Institute for International Health at the University of Sydney in Australia, and his international colleagues, wrote in an accompanying editorial.

More information
The American Heart Association has more about high blood pressure.

Health Tip: Donating Blood

(HealthDay News) - Donating blood is a safe and easy procedure that can help save lives.

Here is information on what to expect when you donate blood, courtesy of the American Red Cross:

• You'll have a mini-physical exam, where your blood pressure, pulse and temperature will be checked. You also will be asked questions about your lifestyle and health.


• The injection site on your arm will be sterilized, then a sterile needle will be inserted. Some minor stinging or discomfort is common when the needle enters the skin.


• It takes about 10 minutes to collect a pint of blood.


• You may need to lie still for a few minutes after the donation, and have a snack or a drink.
  If you donate to the Red Cross, you'll be given a form with follow-up instructions and a phone number to call in case you realize that your blood may not be safe to give to another person.


• A small number of donors may experience dizziness, fatigue or bruising at the injection site.

Calcium Scans Help Predict Coronary Risk

(HealthDay News) -- Scanning the heart arteries for calcium deposits can help predict future cardiac problems, a new study shows, but experts aren't sure that adding such scans to routine checkups would be worth the cost.

"It has been shown to be predictive" of potential heart trouble, said Dr. Diane Bild, deputy director of the division of prevention and population sciences at the U.S. National Heart, Lung, and Blood Institute, which funded the study. "Whether it is actually beneficial to the people who are screened has not been shown."

A calcium scan using computed tomography (CT) costs $300 to $600. These scans look for calcification -- hardening of the arteries caused by high blood fats and calcium deposits that can eventually cause blood vessel blockage. The scan is a potential competitor for much less expensive tests for coronary risk, such as blood cholesterol and blood pressure readings.

The new study involved more than 6,700 American men and women across a number of racial and ethnic groups -- white, black, Chinese, Hispanic -- who were followed for an average of 3.8 years. It found that the risk of a coronary event was nearly 10 times higher for those with the highest calcium deposit scores than for those with the lowest.

"This study was launched in 1999, a time when there was a lot of interest in whether this new test could predict coronary artery disease," Bild said. "A lot of studies have been done in predominantly white populations. This was one of our efforts to include minority groups."

The study does show that calcium scanning "modestly improves predictions over traditional risk factors," she said. "Several pieces of information are needed in order to understand whether this is clinically useful."

The findings are published in the March 27 issue of the New England Journal of Medicine.

The cost of such scans could be reduced, according to a statement from study lead author Dr. Robert Detrano, professor of radiological sciences at the University of California, Irvine, who is traveling in China. Scans have been done for just $30 in China, Detrano noted.

"It is mostly an issue of cost," said Dr. William S. Weintraub, chief of cardiology at the Christiana Health Care System, the largest health-care system in Delaware, who wrote an accompanying editorial in the journal. "It does add to our discrimination, but it costs a couple of hundred dollars and we're not sure how you use it."

Reducing the cost would make the test more usable, and "more epidemiological studies showing its value in risk prediction would be of great value," Weintraub said.

"But I'd be uncomfortable now with the idea of recommending this for everybody, or even defining a middle ground where we are unsure how we treat people so they get this first," he said.

A calcium scan also carries some risk, since it exposes a person to radiation, Bild noted. "It would be worth it if the benefit outweighed that risk," she said. "We don't clearly have both sides of that equation established."

More information
For more on coronary calcium scans, visit the U.S. Heart, Lung, and Blood Institute.

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A good marriage could be the key to better blood pressure

Story Highlights:

• Most happily married people had better blood pressure, study showed


• Doctor: Marital quality more important than just being married


• Spouses with low marital satisfaction had higher blood pressure than singles


• Study involved mostly white people; not known if race is a factor

NEW YORK (AP) -- A happy marriage is good for your blood pressure, but a stressed one can be worse than being single, a preliminary study suggests.

That second finding is a surprise because prior studies have shown that married people tend to be healthier than singles, said researcher Julianne Holt-Lunstad.

It would take further study to sort out what the results mean for long-term health, said Holt-Lunstad, an assistant psychology professor at Brigham Young University.

Her study was reported online Thursday by the Annals of Behavioral Medicine.

The study involved 204 married people and 99 single adults. Most were white, and it's not clear whether the same results would apply to other ethnic groups, Holt-Lunstad said.

Study volunteers wore devices that recorded their blood pressure at random times over 24 hours. Married participants also filled out questionnaires about their marriage.

Analysis found that the more marital satisfaction and adjustment spouses reported, the lower their average blood pressure was over the 24 hours and during the daytime.

But spouses who scored low in marital satisfaction had higher average blood pressure than single people did.

During the daytime, their average was about five points higher, entering a range that's considered a warning sign. (That result is for the top number in a blood pressure reading).

"I think this (study) is worth some attention," said Karen Matthews, a professor of psychiatry, psychology and epidemiology at the University of Pittsburgh. She studies heart disease and high blood pressure but didn't participate in the new work.

Few studies of the risk for high blood pressure have looked at marital quality rather than just marital status, she said.
It makes sense that marital quality is more important than just being married when it comes to affecting blood pressure, said Dr. Brian Baker, an associate professor of psychiatry at the University of Toronto.

Even in Middle Age, Starting to Drink May Lower Heart Risks

(HealthDay News) -- If you start drinking moderate amounts of alcohol in middle age, particularly wine, you can lower your risk of heart attack by up to 68 percent, compared to nondrinkers, a new study finds.

While previous research had suggested that moderate alcohol consumption was good for the heart, it hadn't been clear whether starting drinking later in life confers a benefit.

"Among middle-aged people who began to drink alcohol in the middle age, we found considerable cardiovascular benefit," said lead researcher Dr. Dana E. King, a professor at the Medical University of South Carolina's Department of Family Medicine.

Current American Heart Association guidelines suggest that moderate drinking may be good for you, King noted. "But if you don't currently drink, you shouldn't start, because of the possible negative consequences of alcohol," he said, summarizing the guidelines.

But this new study will challenge that policy, King said. "The study shows, in a natural experiment, what did happen when people started to drink in middle age," he said. "Indeed, there was a considerable cardiovascular health benefit without paying the penalty in mortality or in higher blood pressure. In fact, it improved the cholesterol profile."

The findings are published in the March issue of The American Journal of Medicine.
For the new research, King and his colleagues collected data on 7,697 people taking part in the Atherosclerosis Risk in Communities study. All were between 45 and 64 years old and non-drinkers at the start of the trial.

During the study, 6 percent of the participants began moderate drinking, which was defined as one drink a day or less for women and two drinks a day or less for men.

After four years, those men and women who became moderate drinkers reduced their risk of developing cardiovascular disease or having a heart attack by 38 percent, compared to the non-drinkers.

However, the type of alcohol did matter, King said. "Wine-only drinkers had 68 percent fewer cardiovascular events, whereas the drinkers of beer, liquor and mixed drinks had only a 21 percent benefit, and that was not [statistically] significant," he said.

"A sip of wine with dinner is part of a healthy lifestyle, even if you haven't been doing it previously," he added.

King cautioned that starting to drink isn't a wise choice for everyone. "There's a small percentage of people who, when they start to drink, will drink too much," he said. "People should discuss this with their physician if they have liver disease or a family history of alcoholism or other medical problems."

But Dr. Gregg C. Fonarow, a professor of cardiology at the University of California, Los Angeles, is one heart expert who doesn't think that studies have conclusively proven that alcohol reduces your cardiovascular risk.

People should stick to controlling known risk factors for heart disease -- such as cholesterol and blood pressure levels -- before taking up drinking, he advised.

"A number of observational studies have suggested moderate alcohol consumption is associated with lower risk of cardiovascular" problems, Fonarow said. "However, it has not been established whether it is the alcohol consumption itself or other factors that distinguish those with moderate alcohol consumption from non-drinkers which account for the lower cardiovascular risk."

The new study offered evidence that moderate alcohol consumption was linked to lower heart risks, but there was no difference in overall mortality between drinkers and non-drinkers, he noted.

"The findings suggest that for non-drinkers, adopting mild alcohol consumption may have cardiovascular benefits," Fonarow said. "However, until the potential cardiovascular benefits of moderate alcohol consumption are tested in a prospective randomized trial, there will continue to be debate as to whether this is advisable or not.

"Individuals wishing to lower their cardiovascular risk should stick to what is proven and recommended by the American Heart Association, including maintaining a healthy blood pressure, weight, and cholesterol levels, exercising, and avoid smoking," he advised.

More information
For more on the benefits of alcohol, visit the American Heart Association.

New Hope for Depressed Teens

(HealthDay News) -- If a depressed teen doesn't respond to treatment with commonly prescribed antidepressants the first time around, new research suggests there's still hope.

Switching medications and adding behavioral talk therapy turned out to be the most effective alternative, although just switching medications also helped many individuals.

"On average, these kids were ill for two years and no matter which treatment they got, at least 40 percent responded within 12 weeks," said study author Dr. David Brent, a professor of psychiatry at the University of Pittsburgh School of Medicine. "I really think the take-home message to families is if you don't respond to the first treatment, don't give up."

The study appears in the Feb. 27 issue of the Journal of the American Medical Association.

The issue of whether depressed or troubled children should even take antidepressants has been at the center of an intense public debate in recent years.

Some research has turned up evidence that kids on antidepressants have a higher rate of suicide ideation, meaning suicidal thoughts and behavior.

Heeding this data, the U.S. Food and Drug Administration in 2004 asked manufacturers of antidepressants to add a black-box warning to their labels warning about the increased suicide risk.

Recent research, however, has found that the benefits of antidepressants outweigh the risks for children and teens under the age of 19.

About 60 percent of adolescents with depression respond to treatment with antidepressants known as selective serotonin reuptake inhibitors (SSRIs).

Guidelines recommend prescribing SSRI medications, psychotherapy or both as a first-line treatment for this younger population. (The only SSRI approved by the FDA for use in pediatric patients is Prozac, but others are prescribed on an off-label basis).

Unfortunately, 40 percent do not respond to the first therapy they try, and there's little guidance on what to do next.

"There's just not that much research in kids, period," said Dr. Jane Ripperger-Suhler, an assistant professor of psychiatry and behavioral science at Texas A&M Health Science Center College of Medicine and a psychiatrist with Scott & White Mental Health Center in Temple.

For this latest study, the researchers chose 334 patients aged 12 to 18 years, all of whom had major depressive disorder and had not responded to two months of SSRI treatment. They were randomly selected to receive one of four treatment possibilities for 12 weeks: a second, different SSRI; a different SSRI plus cognitive behavioral therapy; Effexor (a serotonin-norepinephrine reuptake inhibitor, or SNRI); or Effexor plus cognitive behavioral therapy.

While the drugs were taken for 12 weeks; therapy lasted nine sessions.

There was a 54.8 percent response rate among those teens who switched to talk therapy plus either medication, compared to 40.5 percent for a medication switch alone.

There was no difference in response rates between Effexor and a second SSRI. However, there was a greater increase in blood pressure and pulse and more frequent skin problems with Effexor than the other drugs.

Ripperger-Suhler said that every time she puts a teen on an antidepressant, she refers them for therapy anyway. The results of this trial might prompt primary-care doctors, who are more apt to write a prescription and do nothing else, to also recommend therapy, she said.

One caveat, however, is that there are few really good cognitive behavioral therapists out there, nor is there any way to distinguish clearly among them, Ripperger-Suhler stated. "To do cognitive behavioral therapy effectively you really need someone who is well-trained and there aren't very many," she said.

But other types of talk therapy might also be effective, she added.

More information
Visit the U.S. National Institute of Mental Health for more on adolescent depression.

Hypertension Linked to Risk of Mild Cognitive Impairment

(HealthDay News) -- High blood pressure may be associated with increased risk for mild cognitive impairment, says a study by researchers at the Columbia University Medical Center in New York City.

Mild cognitive impairment, which causes learning and thinking difficulties, has "attracted increasing interest during the past years, particularly as a means of identifying the early stages of Alzheimer's disease as a target for treatment and prevention," the study authors wrote.

They followed 918 Medicare recipients aged 65 and older (average age 76.3) who were assessed every 18 months for an average of 4.7 years. None of the participants had mild cognitive impairment at the start of the study, but 334 of them developed the condition during the study period.

Of those, 160 developed amnestic mild cognitive impairment (which involves low scores on memory portions of neuropsychological tests), and 174 developed non-amnestic mild cognitive impairment. Hypertension was associated with an increased risk of all types of mild cognitive impairment, especially non-amnestic mild cognitive impairment, the researchers said.

The findings are published in the December issue of the Archives of Neurology.

"The mechanism by which blood pressure affects the risk of cognitive impairment or dementia remains unclear. Hypertension may cause cognitive impairment through cerebrovascular disease. Hypertension is a risk factor for subcortical white matter lesions found commonly in Alzheimer's disease. Hypertension may also contribute to a blood-brain barrier dysfunction, which has been suggested to be involved in the cause of Alzheimer's disease.

Other possible explanations for the association are shared risk factors," including the formation of cell-damaging compounds known as free radicals, the study authors wrote.

"Our findings support the hypothesis that hypertension increases the risk of incident mild cognitive impairment, especially non-amnestic mild cognitive impairment," the researchers concluded. "Preventing and treating hypertension may have an important impact in lowering the risk of cognitive impairment."

More information
The Alzheimer's Association has more about mild cognitive impairment.

Health Tip: Risk Factors for Type 2 Diabetes

(HealthDay News) - Type 2 diabetes is a disease in which the body doesn't properly process the hormone insulin, which regulates blood sugar. This form of diabetes is controlled with medication, proper diet and exercise, and maintaining a healthy body weight, and normal blood pressure and cholesterol levels.

The National Diabetes Information Clearinghouse lists common risk factors for type 2 diabetes:

• Being overweight.
• Being over age 45.
• Having a family history of type 2 diabetes.
• Giving birth to a large baby (more than 9 pounds).
• Having high blood pressure or high cholesterol.
• Having a history of heart disease.
• Maintaining a sedentary lifestyle and getting little or no exercise.

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Weight Loss Can Control Hypertension

(HealthDay News) -- An Italian study has identified overweight as a direct cause of high blood pressure. And it also showed that up to half of overweight people can bring down blood pressure to healthy levels by weight reduction.

But the weight loss has to be achieved before the borderline to outright obesity is crossed, said Dr. Roberto Fogari, professor of medicine at the University of Pavia. He was to present the study findings Friday at the annual meeting of the American Heart Association's Council for High Blood Pressure Research, in Tucson, Ariz.

It's important that the study linked overweight to high blood pressure, which usually is described as "essential," a medical term meaning that the cause is unknown, Fogari said.

"The study suggests that, in many cases, hypertension [high blood pressure] is not essential," he said. "It is secondary to overweight. So, in the first stages of overweight, if we can induce people to reduce overweight, they can also avoid being treated for hypertension."

The study included 210 men and women whose body mass index [a ratio of weight to height] was between 25 and 29.9, indicating overweight but just short of the 30 mark of obesity. Their systolic blood pressure was between 140 and 159, and their diastolic pressure was between 90 and 99, indicating moderately high blood pressure.

An individualized low-calorie diet was designed for each study participant. Some also were prescribed orlistat, a drug that prevents fat from being metabolized.

After six months, 53 percent of the men and 49 percent of the women in the study achieved normal body weight, and a 5 percent reduction in blood pressure.

"The other 50 percent of those in the study already had abnormal changes in the vascular tree [blood vessel system], so that hypertension was no longer reversible by losing weight," Fogari said.

The implication for practicing physicians who see moderately overweight people with high blood pressure is that their first goal should be weight reduction, he said.

"Only after six months of trying to reduce the patient's weight can a decision be made about drug treatment," Fogari said.

Dr. Daniel W. Jones, dean of the University of Mississippi School of Medicine, and a spokesman for the American Heart Association, said the study finding "is not new news, but it is important news."

There have been a number of previous studies showing that weight loss can reduce blood pressure, Jones said. "But this is an increasingly important problem in societies around the world," he said. "Once you gain weight, you find it difficult to lose weight, which is why we focus so much on preventing obesity these days."

As for drug treatment of high blood pressure, about half of California adults diagnosed with hypertension do not take medication for it, another report presented at the same meeting found.

The study of 11,467 persons given a diagnosis of hypertension found that 49.4 percent were not taking drugs to reduce their blood pressure, said the report by researchers at the California Department of Public Health's Heart Disease and Stroke Prevention Program.

There were some bright spots in the picture. Compliance was more than five times higher for those who had seen a doctor in the past year than for those who had not. And the compliance rate was twice as high for persons with health insurance than the uninsured.

More information
For more on high blood pressure and what to do about it, turn to the American Heart Association.

Blood Pressure Drop During Bypass Might Impair Thinking

(HealthDay News) -- Patients who experience a blood pressure drop during bypass surgery may be at increased risk for a short-term dip in their cognitive abilities.

Researchers at the Johns Hopkins University School of Medicine in Baltimore studied 15 patients, aged 57 to 81, who were given cognitive tests before and then three to five days after they had coronary artery bypass graft (CABG) surgery.

All the patients had a decrease in mean arterial pressure (MAP) during surgery compared with their MAP before surgery. MAP provides doctors with an estimate of the blood pressure in various organs in the body.

The study found that patients whose MAP decreased by 27 millimeters of mercury or more had an average decrease of 1.4 points (out of a maximum of 30 points) on a standard cognitive test. Patients with a MAP decrease of less than 27 millimeters of mercury increased their scores by an average of one point.

Patients with a high MAP before their surgery were more likely to score lower on the cognitive test after their surgery.

The researchers also used MRI to examine the brains of 13 of the patients. They found that patients whose MAP decreased by more than 27 millimeters of mercury were 2.7 times more likely to show evidence of acute stroke.

The study was published online this week in the Archives of Neurology and is expected to be published in the August print issue.

The preliminary data from this small study suggests "that a substantial decrease in MAP from a patient's baseline may be a risk factor for short-term cognitive dysfunction," the study authors wrote. "This may be in part because of an increased risk for radiographic stroke."

Further studies are needed, the researchers said.

More information
The Alzheimer's Association has more about mild cognitive impairment.

Health Tip: Causes of Fainting

(HealthDay News) -- Fainting occurs due to a sudden drop in blood flow to the brain, resulting in brief loss of consciousness. Fainting can be accompanied by dizziness or nausea.

Here are some common triggers, courtesy of the U.S. National Library of Medicine:

• Straining during urination or a bowel movement.
• Excessive coughing.
• Standing for too long in the same position, or quickly standing up from a lying position.
• Severe pain, stress, fear or emotional distress.
• Excessive bleeding or dehydration.
• Medications used to treat conditions like high blood pressure, anxiety, allergies and nasal congestion.
• Use of drugs or alcohol.
• Low blood sugar.

No Clear Evidence Meditation Can Boost Health: Study

(HealthDay News) -- There's no definitive evidence that meditation eases health problems, according to an exhaustive review of the accumulated data by Canadian researchers.

"There is an enormous amount of interest in using meditation as a form of therapy to cope with a variety of modern-day health problems, especially hypertension, stress and chronic pain, but the majority of evidence that seems to support this notion is anecdotal, or it comes from poor quality studies," concluded researchers Maria Ospina and Kenneth Bond of the University of Alberta/Capital Health Evidence-based Practice Centre, in Edmonton.

They analyzed 813 studies focused on the impact of meditation on various conditions, including high blood pressure, cardiovascular disease and substance abuse.

Released Monday, the report looked at studies on five types of meditation practices: mantra meditation; mindfulness meditation; yoga, Tai Chi and Qi Gong.

Some of the studies suggested that certain types of meditation could help reduce blood pressure and stress and that yoga and other practices increased verbal creativity and reduced heart rate, blood pressure and cholesterol in healthy people.

However, the report authors said it isn't possible to draw any firm conclusions about the effects of meditation on health, because the existing studies are characterized by poor methodologies and other problems.

"Future research on meditation practices must be more rigorous in the design and execution of studies and in the analysis and reporting of results," Ospina said in a prepared statement.

Bond added that the new report doesn't prove that meditation has no therapeutic value, but it can inform medical practitioners that the "evidence is inconclusive regarding its effectiveness."

For the general public, the report "highlights that choosing to practice a particular meditation technique continues to rely solely on individual experiences and personal preferences, until more conclusive scientific evidence is produced," Ospina said.

The study was funded by the U.S. National Center for Complementary and Alternative Medicine in Bethesda, Md., part of the National Institutes of Health.

More information
The U.S. National Center for Complementary and Alternative Medicine has more about meditation for health purposes.

Don't Get Burned by Heat Stroke

(HealthDay News) -- Staying cool on hot summer days isn't just comfortable, it could save your life, according to the Pennsylvania Medical Society.

Heat stroke -- injury to internal organs caused by an excessively high body temperature -- is a serious and potentially deadly illness that can usually be prevented. Even so, it still happens all too frequently, experts say.

Many people recall the August 2001 death of Minnesota Viking's football player Korey Stringer.

He died after developing multi-organ system failure on a hot day. Athletes are particularly vulnerable to heat stroke -- especially football players, who wear body-covering uniforms and practice in the hottest temperatures -- but it can affect anyone.

Heat stroke can occur when you are in an extremely hot environment for a long period of time. It also happens when people overexert themselves on very hot days.

According to the Pennsylvania Medical Society, you should be alert to heat stroke on days when the relative humidity is at least 70 percent and temperatures are 95 degrees Fahrenheit and higher.

Other heat-related afflictions that may be a sign of looming heat stroke include heat cramps and heat exhaustion, which is characterized by pale, moist skin; headache; dizziness; nausea;

increased heart rate; low blood pressure; elevated temperature and profuse sweating.

The symptoms of heat stroke are more severe than those of heat exhaustion and may include:
Initial profuse sweating.
Hot, dry red skin.
High fever.
Vomiting.
Confusion.
Seizures during cooling.
Unconsciousness.
Sometimes lack of sweating, though athletes may perspire.
High body temperature (often 105 degrees or higher).
Anyone experiencing these symptoms should immediately seek emergency medical help.

Steps you can take to keep cool despite hot temperatures include:
Avoid overexertion.
Drink a quart of fluids an hour.
Wear loose, light-colored clothing made of light fabrics.
Wear a hat and sunblock.
Stay in the shade or indoors when possible.
Open windows and use fans and/or air conditioning; if you don't have air conditioning, go to a public place that does (a mall, library or movie theater).
Avoid dehydrating beverages such as caffeine and alcohol.

More information
The U.S. Centers for Disease Control and Prevention has more about extreme heat.

New Cholesterol Check Gauges Kids' Heart Risk

(HealthDay News) -- Whether America's fast-food-and-video-game culture, or some other confluence of factors is to blame, there's no denying that adolescents' health is at risk.

Little wonder, then, that one group of researchers has begun to take a serious look at the long-term health consequences of kids' inactivity. And they are using cholesterol levels as a window into these youngsters' futures.

Obesity, inactivity and cholesterol are closely linked, and data from the latest U.S. National Health and Nutrition Examination Survey (NHANES) finds that 17 percent of U.S. teens are overweight. Just one in four high school students packs enough physical activity into their day, and 12 percent get little or no daily exercise, reports the U.S. Centers for Disease Control and Prevention.

So, measuring kids' cholesterol in a really detailed way may make sense.
"There is growing scientific evidence indicating that cholesterol levels in childhood and adolescence have an effect on the development of plaque in the arteries, which is a clear indication of cardiovascular disease risk," explained study leader Ian Janssen, an assistant professor in the School of Kinesiology and Health Studies at Queens University in Ontario, Canada.

"There is also strong evidence indicating that children and youth with high cholesterol will continue to have high cholesterol in adulthood," he added. "Thus, it is important to start treatment and prevention efforts early."

Using data from the NHANES on more than 6,000 kids aged 12 to 20, Janssen and his colleagues developed age- and gender-specific reference points for total cholesterol, LDL ("bad") cholesterol, HDL ("good) cholesterol and triglyceride fat levels. The new tables, published last year in the journal Circulation, take into account fluctuations in cholesterol and fat that occur as a child matures.

The new reference data are meant to improve upon current guidelines, published by the U.S. National Cholesterol Education Program, which do not account for age-related fluctuations.
Still, Janssen admits that the guidelines have not yet been routinely adapted into clinical care settings in the United States. "These sorts of changes to clinical practice typically take years to manifest," he said.

Dr. Marc S. Jacobson, director of the Center for AtherosclerosisAtherosclerosis Prevention at Schneider Children's Hospital in New Hyde Park, N.Y., said it's unclear how the new tables will be received in the United States.

"It complicates lives of people like me who treat adolescents with lipid problems because instead of just having one number, you have to have four graphs and plot them out by age," he said.
"Instead of having one cut point," he continued, "you have a graph that you have to plot out a percentile. With each lipid profile, you have to decide which percentile this is for that individual's age. And when it goes up and when it goes down, did it go down because of treatment? Or did it go down because of advancing puberty?"

The challenge, then, is to make sense of that information, he explained. "It argues that you almost have to take it into account because you could say if the LDL changes, is it the treatment or is it a change in puberty?"

Currently, the federal government recommends cholesterol screening for children and teens with at least one parent with high cholesterol or a family history of early heart disease.
"Typically high-risk adolescents should be screened, and probably every year or two," Janssen said. "A high-risk adolescent would be one who's had a parent or grandparent with premature cardiovascular disease or high cholesterol, or a teen with other risk factors, such as obesity and high blood pressure."

Other risk factors, such as high blood pressure, obesity, diabetes or smoking, also would trigger cholesterol testing in doctors' offices, "and that covers a lot of kids now," Jacobson noted.
The issue is destined to garner greater attention when a U.S. National Heart, Lung, and Blood Institute (NHLBI) panel updates guidelines on cholesterol screening in children and teens. The new guidance is scheduled for release in April 2008, said Dr. Rae-Ellen Kavey, senior medical officer with the Pediatric Cardiovascular Risk Reduction Program in NHLBI's Office of Prevention, Education, and Control.

"Stay tuned," Kavey said, "because there really is going to be new information."

More information
Find out more about cholesterol at the U.S. National Heart, Lung, and Blood Institute.

Certain ACE Inhibitors Cut Elderly Dementia Risk

(HealthDay News) -- Certain types of ACE inhibitor hypertension drugs may help cut the risk of dementia in older adults, say researchers at the Wake Forest University School of Medicine.
They analyzed data from the long-term Cardiovascular Health Study of almost 5,900 people over age 65 in the United States.

The researchers found that "centrally acting" ACE (angiotensin-converting enzyme) inhibitors may help reduce inflammation that might contribute to dementia.

Centrally acting ACE inhibitors are able to cross the blood-brain barrier and reach the brain.
"For older adults who are going to take an ACE inhibitor for blood pressure control, it makes sense for their doctors to prescribe one that goes into the brain," lead researcher Dr. Kaycee Sink, an assistant professor of internal medicine/gerontology, said in a prepared statement.

She and her colleagues found that for each year that people took centrally acting ACE inhibitors, they had a 50 percent lower rate of mental decline than people taking other kinds of hypertension drugs.

Mental decline was measured using the Modified Mini-Mental State Exam, which evaluates memory, language, abstract reasoning and other cognitive functions.

"These results suggest that there is more to treating blood pressure than achieving a goal of 140/80," Sink said. "Which drug you choose for blood pressure can have broader implications. We know that ACE inhibitors protect against heart failure and kidney failure, and now there is evidence that some of them may also protect against dementia."

The study was expected to be presented this weekend at the annual meeting of the American Geriatrics Society, in Seattle.

More information
The American Medical Association has more about dementia.

Drug Cuts 'Off' Time for Parkinson's Patients

(HealthDay News) -- Taking 24-hour prolonged release ropinirole significantly reduced daily "off" time that Parkinson's disease patients experience due to the return of symptoms such as tremors, slowness, stiffness and difficulty walking as drugs wear off, a U.S. study says.

The study, published in the April 3 issue of the journal Neurology, included 393 Parkinson's patients who weren't fully responding to the widely-used Parkinson's drug levodopa. Half the patients took 24-hour prolonged release ropinirole and levodopa for six months, while the other half took a placebo and levodopa. None of the patients' other Parkinson medications were changed during the study.

The average daily "off" time in the ropinirole group was reduced 2.1 hours, compared to 0.3 hours in the placebo group. The study also found that more than half the patients in the ropinirole group were "much improved" or "very much improved," compared to 14 percent of patients in the placebo group. In addition, patients taking ropinirole were able to reduce their dosage of levodopa.

The study was supported by GlaxoSmithKline and Skye Pharma, makers of prolonged release ropinirole.

Involuntary movements, nausea, dizziness, drowsiness, hallucinations, and sudden drops in blood pressure were common side effects among patients taking prolonged release ropinirole.
"Ropinirole 24-hour prolonged release, when taken with levodopa, is effective in reducing daily 'off' time for Parkinson patients who aren't getting the best results from levodopa. We also found the drug helped improve quality of life and motor function," study author Dr. Rajesh Pahwa, of the University of Kansas Medical Center, said in a prepared statement.

More information
We Move has more about Parkinson's disease.

The Cardiovascular Cure

The Cardiovascular Cure

Written by John P. Cooke, M.D., Ph.D. and Judith Zimmer
Category: Medical - Diet Therapy
Publisher: BroadwayFormat: Trade Paperback, 336 pagesPub Date: August 2003
Price: $15.95
ISBN: 978-0-7679-0882-5 (0-7679-0882-1)

ABOUT THIS BOOK
The Cardiovascular Cure offers a groundbreaking approach to preventing heart attack and stroke by enhancing your body’s own natural defenses. Dr. John Cooke, head of Stanford Medical School’s vascular unit, has devised a powerful new method for fighting cardiovascular disease without bypass surgery or angioplasty.

Drawing on his own investigations, as well as Nobel Prize-winning research from a team of American scientists, Dr. Cooke provides heart patients with a diet, supplement, and exercise program that will help them feel better in as little as two weeks.

His program also works to prevent heart disease in those at risk.

In 1998, the Nobel Prize in Physiology or Medicine was awarded for the discovery of EDRF (endothelium-derived relaxing factor), a chemical produced in the lining of the blood vessels, which keeps them free of plaque. Dr. Cooke and other investigators have found that specific nutrients can enhance EDRF production and improve blood flow in people with high cholesterol, high blood pressure, diabetes, or other risk factors for heart disease.

This potentially life-saving book shows how anyone can achieve healthier blood vessels (the key to preventing heart disease). A two-week menu plan contains recipes that emphasize EDRF-enhancing foods, and there is detailed information on supplemental nutrients and vitamins that are useful in strengthening the cardiovascular system. Recipes from breakfast (Banana Date-Nut Bread; Blueberry Oat Pancakes; Pineapple Ginger or Tropical Smoothies; Pumpkin Muffins) to dinner (Moroccan Red Snapper; Chicken Wrap with Refried Beans; Soy-Glazed Salmon; Turkey Meatloaf) feature healthy fats found in fish, nuts, and olive oil.

There is also welcome news that red wine and chocolate can be good for you (there are recipes for Double Chocolate Cake and Chocolate Raspberry Surprise). The exercise program consists of the same therapeutic plans Dr. Cooke has prescribed for even his most severely ill patients, many of whom begin to walk and even exercise more vigorously without pain after two weeks. In addition, there are aerobic workouts designed for more active patients.

Dr. Cooke also provides state-of-the-art information (pro and con) on conventional drugs–from aspirin to beta blockers–and medical tests and procedures to further combat cardiovascular disease. With an introduction by Sir John Vane, a Nobel Prize-winning cardiovascular scientist, this book will provide anyone concerned about his or her cardiovascular health with new hope for a pain-free, disease-free life.

From the Hardcover edition.PRAISE“In The Cardiovascular Cure, Dr. Cooke has translated the research of our field into life-saving information that we can all use. If you really care about your cardiovascular health, you must read this book!”--Louis J. Ignarro, Ph.D., 1998 Nobel Laureate in Physiology or Medicine for the discovery of Nitric Oxide“This authoritative book appropriately points out why everyone should worry about the health of their endothelium and, better still, do something to protect it if it shows signs of damage.

Early identification and treatment of reduced nitric oxide release should be the preventive agenda for the new millenium.”--Jay N. Cohn, M.D., Professor of Medicine, University of Minnesota Medical School“This book should be read by all patients with heart disease as well as anyone at increased risk for a heart attack or stroke.

The comprehensive risk reduction program recommended by Dr. Cooke uses the most advanced research to help everyone improve the health of their blood vessels.” --William L. Haskell, Ph.D., Stanford Center for Research in Disease Prevention“The Cardiovascular Cure is a lucidly written description of EDRF and endothelial dysfunction.

Treatment with exercise and a diet rich in arginine, vitamins, and anti-oxidants is important to the many patients prone to develop heart attacks or stroke.”--Dr. Ferid Murad, M.D., Ph.D., Director of the Institute of Molecular Medicine at the University of Texas, 1998 Nobel Laureate in Physiology or Medicine“Helping yourself prevent a heart attack means knowing more than your ‘cholesterol count.’

In this clearly written book, Dr. Cooke introduces you to the important role played by the endothelium (the lining of your blood vessels) in this process, and what you can do to keep this vital organ as healthy as possible.”--Gerald Reaven, Professor of Medicine, Stanford University School of MedicineFrom the Hardcover edition.

ABOUT THIS AUTHORJOHN P. COOKE, M.D., Ph.D., is Associate Professor of Medicine and Director of the Section of Vascular Medicine at Stanford University’s Medical School. He trained at the Mayo Clinic, earning a Ph.D. in physiology there, and he was on the faculty of Harvard Medical School before he was recruited to Stanford to spearhead the program in Vascular Biology and Medicine.

He is a sought-after consultant and has served on numerous national and international committees dealing with cardiovascular diseases, including those of the American Heart Association and the National Heart, Lung and Blood Institute. JUDITH ZIMMER has been a medical journalist for more than fifteen years.

She has contributed to such publications as the New York Times, and Self and Fitness magazines, and she currently writes for academic medical centers in New York City.
From the Hardcover edition.

Calculator Helps Users Gauge Heart Attack Risk

(HealthDay News) -- A new online heart disease risk calculator that can help you understand and gauge your heart attack risk is available from the Mayo Clinic.

The risk calculator on MayoClinic.com asks several questions about your lifestyle and health and then determines your 10-year risk of a heart attack. The risk score is based on a number of factors, such as age, gender, tobacco use, cholesterol levels, and blood pressure.

You can find the risk calculator by heading to MayoClinic.com and looking under "Heart Disease Risk Factors," in the Web site's Heart Disease Center.

About one in 10 people with a risk level of 12 percent will have a heart attack or die of heart disease within the next 10 years, experts say.

Here are five heart disease prevention tips:

• Don't smoke or use tobacco products.
• Get exercise. Regular, moderately vigorous physical activity can reduce the risk of fatal heart disease by 25 percent. Combining physical activity with other positive lifestyle habits, such as maintaining a health weight, can provide even more heart health benefits.
• Eat a heart-healthy diet that includes plenty of fruits, vegetables, whole grains, and low-fat dairy products. Legumes, low-fat sources of protein and certain types of fish may also help reduce heart disease risk.
• Limit intake of saturated fats and trans fat.
• Watch your weight.
• Excess pounds can lead to conditions -- high blood pressure, high cholesterol and diabetes -- that increase the risk of heart disease.
• Get regular blood pressure and cholesterol screenings.
• High blood pressure and high cholesterol can damage your cardiovascular system, including your heart.

More information
There's more on reducing heart disease risk factors at the American Heart Association.

The Mind as Medicine

(HealthDay News) -- What if your mind's eye could take you to a place so peaceful that the experience eased your pain or sped your recovery from surgery? It's not such a far-fetched concept.

"Guided imagery," a type of mind-body therapy that uses visualized images to communicate to the housekeeping systems of the body, is making its way into traditional medical settings.

"People are just now taking a very serious look at it," said David E. Bresler, co-founder of the Academy for Guided Imagery, in Malibu, Calif., and author of the book Free Yourself From Pain. "There are a handful of hospitals around the country and around the world that are starting to implement these programs," he said.

In one study, researchers at Harvard Medical School found that more than 30 percent of U.S. adults have used some form of mind-body medicine, a category that includes imagery, according to the National Center for Complementary and Alternative Medicine.

Bresler, a traditionally trained Ph.D. neuroscientist, first became intrigued with alternative methods of pain relief in the early 1970s, as founder and director of the University of California, Los Angeles, Pain Control Unit. Patients often used vivid images to describe their pain. It felt like an ice pick to one person, fire ants to another. One particular patient, a psychiatrist with a painful rectal carcinoma, suffered low back pain that he said "felt like a dog chewing on my spine."

Bresler knew that when patients used their imagination to go to a peaceful place, it helped them to relax, so he guided the agitated psychiatrist through a relaxation exercise. When the man's pain flared up, Bresler instructed him to speak to the dog. Would it let go of his spine? Then, an astonishing thing happened -- when the dog let go to talk, the man's pain subsided.

Today, guided imagery has numerous applications. Sports psychologists use it to enhance athletes' physical performance. Cancer centers often use it to relieve patients' pain and nausea.
In a 2004 study in the journal Pain, researchers at Cincinnati Children's Hospital Medical Center found that children who used guided-imagery tapes before and after routine surgery had significantly less pain and anxiety than a control group. More recently, researchers examined how children used these tapes, which suggested that they "go" to a park, at least in their mind. Many, though, put their own spin on the proposed image, allowing them to escape to places like a swimming pool, a lake or an amusement park.

Bresler said imagery is the language of the autonomic nervous system, the part of the nervous system that regulates many involuntary body functions, such as heart rate, blood pressure and digestion. "So, when you're working with images, it's really a set of instructions to the system," he said.

Victoria Menzies, an imagery researcher and professor at Florida International University's School of Nursing, in Miami, said the first step for a patient in any guided-imagery session is to develop a rapport with the guide who is asking you to close your eyes and relax. Once the patient is in a relaxed state, the guide will either offer an image or ask the person to come up with their own, someplace where he or she would feel calm and safe or joyful -- the mountains, the seacoast, a favorite room in their home, whatever.

Engaging the senses is the next step, she explained. The guide might ask where you are and what you see, hear, smell, feel and even taste.

Menzies led a 10-week guided imagery intervention for a small group of patients with fibromyalgia, a condition involving chronic pain and fatigue. In the study, published in January 2006 in the Journal of Alternative and Complementary Medicine, one group of patients received usual care and used a set of guided-imagery audiotapes. The other group received only usual care. Compared with the controls, the patients who participated in guided imagery were better able to perform activities of daily living and had a greater sense of being able to manage their pain and other symptoms, the study showed.

What's more, Menzies found, "The pain did not change, but the ability to cope with the pain was improved."

Bresler considers it shocking that medical colleagues would reach their hands into someone's body and remove organs before allowing a patient to go through an imaging exercise.
"It only takes a few moments to do these things and to really check on the wisdom from inside, because there is tremendous wisdom that's being generated if only we'd listen to it," he said.

More information
To learn more, visit the University of California, San Diego.