KRON 4 | Heart Attack Predictor: A Third Blood Pressure You Need to Know

Ever wonder what your blood pressure numbers mean? Here’s an explanation using a water faucet and pipe to demonstrate. And now there’s a THIRD pressure that’s important to your overall health and is worth monitoring as well.

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What’s Your Pulse Pressure?

Pulse pressure is the numeric difference between systolic and diastolic blood pressure.

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Predictor of Heart Attacks and Cardiovascular Disease

A resting pulse pressure in sitting position in healthy adults is about 30-40 mm Hg. For adults over age 60, especially men, a pulse pressure higher than 60 can be a useful predictor of heart attacks or other cardiovascular disease.

  • A greater pulse pressure indicates that your vessels are stiffer and more damaged.
  • If the aorta becomes rigid, such as from atherosclerosis, a.k.a., “hardening of the arteries”, your pulse pressure would be very high.
  • Per a meta-analysis of several studies of 8,000 elderly subjects, the combined results found that a 10-point increase in pulse pressure increased the risk of major cardiovascular complications and mortality by nearly 20%.

NOTE: A low pulse pressure (i.e., 25 mm Hg or less) may mean aortic valve stenosis or congestive heart failure where a low volume of blood is ejected per beat.

Causes of Arterial Stiffness 

The most important cause of an elevated pulse pressure is arterial stiffening, in particular, stiffness of the aorta (the largest artery in the body). Arteries stiffen with age, just like tissues in your skin, lungs, heart, tendons, and joints, due to:

  • Degeneration of elastin fibers
  • Stiffer collagen
  • Fatty deposits damaging the arterial walls and resulting in them being less elastic (atherosclerosis)

Results of Arterial Stiffness 

  • Your heart enlarges. When arteries stiffen and lose their elasticity, your heart must contract more forcefully with each heart beat in order for your blood to circulate adequately. The extra work that your heart must perform can lead to physical changes in the musculature of your heart (e.g., size and shape), specifically the lower chambers (the ventricles). It’s just like how your biceps get bigger that occurs when you exercise them harder.
  • You’re prone to irregular heart beats (cardiac arrhythmias). If the remodeling also affects the upper chambers (the atria), it can disrupt the electrical pathways that generate the signals telling your heart when to contract.
  • You’re at a higher risk of a heart attack and stroke. The cause of most cardiovascular events and cerebrovascular accidents is the growth and eventual rupture of arterial plaques.

Which Is the Better Pulse Pressure?

160/120 mm Hg OR 110/70 mm Hg? (The pulse pressure in each pair = 40 mm Hg.)

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Answer: 110/70
Higher systolic and diastolic pairs imply higher risk of heart attacks and heart disease

Can Atherosclerosis (Coronary Artery Disease) Be Reversed?   

Continue reading “KRON 4 | Heart Attack Predictor: A Third Blood Pressure You Need to Know”

KRON 4 | Payoffs from Losing Just Five Pounds

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If you resolved to lose weight at the beginning of the year, but haven’t reached your goal, here’s some good news. You really don’t have to lose that much weight to reap huge health benefits.

How Losing Just Five Pounds Boosts Your Health

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Lower Blood Pressure

  • The American Heart Association says if you are overweight, losing as little as five pounds may help lower blood pressure.
  • Lowering blood pressure reduces risk of stroke, heart disease, heart failure, and kidney failure.
  • The National Heart, Lung and Blood Institute says for every 20 pounds you lose, you can drop systolic pressure 5-20 points. That is, drop a pound, drop a point.

Improve Urinary Incontinence (UI)

Simbolo toilette, bagno uomo e donnaLosing weight reduces risk factors for many medical conditions, especially heart disease, stroke, and type 2 diabetes. Now, there’s a new benefit that can be added to the long list of health benefits: reduced urinary incontinence (involuntary urination). About 25 million Americans have urinary incontinence and about 25% are men. About half of U.S. women over age 65 leak.

Causes and Cures for UI

  • Gravity, aging tissue, and hormonal changes all contribute to urinary incontinence.
  • Increased pressure on the bladder during pregnancy and as well a weakened or stretched pelvic floor from childbirth can cause incontinence.
  • Losing five pounds can reduce the stress on the pelvic floor and reduce incontinence significantly.
  • A UCSF study of over 338 women (average age of 53), those who lost an average of just three pounds reported 28% fewer urinary incontinence episodes. Those that lost 17 pounds had 47% fewer episodes. These outcomes improved quality of life measures. The study strongly suggests weight loss decreases incontinence episodes, and a reduction of intra-abdominal pressure (due to central obesity, i.e., belly fat) on the bladder and pelvic floor is possibly why.

Weight loss is an effective, nonsurgical, and noninvasive treatment and should be considered a first line therapy for incontinence. Incontinence drugs have side effects (e.g., dry mouth, dry skin, dry eyes, constipation, upset stomach), and it has been reported that 50% of women discontinue drug treatment within one year because of the side effects.

Improve and Prevent Arthritis Symptoms

  • Osteoarthritis is the leading cause of disability in the U.S.
  • When you carry extra pounds it puts huge pressure on your joints and puts you at risk of osteoarthritis (degenerative “wear and tear arthritis”).
  • In knee osteoarthritis, the cartilage in the knee joint gradually wears away. As the cartilage wears away, the protective space between the bones decreases. The deterioration of the “shock absorber” can result in bone rubbing on bone, pain, stiffness, loss of movement in the affected joint, and painful bone spurs.
  • Wake Forest University conducted an 18-month diet and exercise study on sedentary, overweight, older adults with symptomatic knee osteoarthritis. They concluded that for each pound of weight lost, each knee bears four pounds less pressure per step.

Amount of Knee Pressure When Walking

Senior woman power walking on a Gulf Coast beach.

  • If you lose five pounds, you reduce 20 pounds of pressure bearing down on each knee which can lessen pain.
  • When walking one mile (assuming 2,000 strides per mile), a five-pound loss in weight would be a reduction of more than 40,000 pounds of accumulated pressure on each knee.
  • Walking on an incline, walking up/down stairs, squatting, and jogging significantly reduce pressure on each knee even more.

Apple c heart symbol_40x54Fit Tip: Aim for losing a little weight versus a lot. It’s less daunting and the scientific evidence is clear. You’ll receive the health payoffs long before you drop large amounts of weight.

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KRON 4 | Salt Affects More Than Blood Pressure

VIDEO: You may think you’re one of the lucky ones who can eat unlimited bags of chips and other troves of salt; and yet, it doesn’t affect your blood pressure. But according to research published in the American College of Cardiology, excess sodium can adversely affect other target organs even if you don’t have hypertension.

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Blood Vessels

Studies show elevated sodium levels can cause the inner lining of blood vessels (called the endothelium) to “malfunction”. The following occurs as a result:

  1. Vessels stiffen. Arteries that become less elastic and lose their contractility (ability to fully contract and relax) make it harder for the heart to pump blood throughout the body. Eventually, the heart wears out (heart failure).
  2. Vessels become sticky. Think of the lining of your blood vessels as being slick like Teflon. An unhealthy endothelium is sticky like Velcro and causes plaque to attach. Plaque builds up in the brain too — leading to Alzheimer’s.
  3. The body breeds dangerous inflammation. Inflammation may cause plaque inside blood vessels to crack, rupture, and dislodge from arterial walls. The body responds like with any other injury by causing blood to clot. Clots clog up vessel freeways and block blood flow to the heart (heart attack) or brain (stroke). Inflammation is also the key reason behind why heart attacks are more likely to occur after getting the flu.

NOTE: Eating too much sugar can have the same effect on the endothelium as an excessive intake of sodium.

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Heart

Research found that elevated sodium levels may increase the wall thickness of the heart’s main pumping chamber (left ventricle). This thickening can lead to cardiac issues, such as:

  • Arrhythmia (abnormal heart rhythm)
  • Heart attack
  • Sudden cardiac arrest (sudden loss of heart function)
  • Heart failure (inability of the heart to pump enough blood throughout the body)

High blood pressure is a major risk factor for this muscle tissue enlargement, but it was also found in healthy people with NORMAL blood pressure who consumed high amounts of sodium.

Kidneys   

Healthy kidneys remove extra fluid and waste from the blood. Studies found that a high Continue reading “KRON 4 | Salt Affects More Than Blood Pressure”

When a Lower Blood Pressure is NOT Better

Blood Pressure Monitor_If you’ve been managing your blood pressure, you’re probably well aware of its high’s and low’s. You delight in a low blood pressure, but when your diastolic pressure (represented by the bottom number in your blood pressure reading) is low, you may be at risk for the following:

  • New-onset heart failure
  • Brain atrophy
  • Increased mortality if you have chronic kidney disease

Diastolic blood pressure measures the pressure within your arteries as it flows through them. It’s the pressure between heartbeats, that is, when your heart is at rest. Your systolic blood pressure (represented by the top number in your blood pressure reading) measures the amount of pressure that your blood exerts on vessels when your heart contracts or ‘beats’.

Isolated Diastolic Hypotension

“Isolated diastolic hypotension” (IDH) is a condition that occurs when your diastolic blood pressure is low (less than 60 mm Hg), but your systolic blood pressure is 100 mm Hg and above.

If you’ve been congratulated for having a good systolic blood pressure (less than 120 mm Hg — or even less than 130 mm Hg), don’t be so quick to start your celebratory dance. What’s your diastolic blood pressure? Many clinicians don’t consider a low diastolic blood pressure reading as problematic.  Continue reading “When a Lower Blood Pressure is NOT Better”

10 Factors That Affect Blood Pressure Readings

In “The #1 Biggest Mistake That Affects Blood Pressure Readings“, wrong blood pressure cuff size topped the list as one of the most frequent errors made when measuring blood pressure. Be conscious of the following factors the next time you get a blood pressure reading. They can affect it by 5 to 50 points, and artificially high or low readings could affect your medical treatment.

1. Arm Position

Correct blood pressure arm position

Your palm should be facing up and your arm should be supported and horizontal at the level of the midpoint of your sternum (chest bone) which is at the approximate level of the right atrium of your heart. It may be necessary to place a pillow under your arm or adjust the chair or table to achieve the correct position.

  • If your upper arm is BELOW the level of the right atrium, your blood pressure readings will be too high (blood is flowing down into the arm).
  • If the upper arm is ABOVE heart level, the readings will be too low (blood is flowing down from the arm).

Researchers studied a group of outpatients to determine the effects of arm position on blood pressure measurements. Blood pressures were taken and compared in the following arm positions:

  1. Sitting with arms hanging down and elbows resting on the armrests of a chair (i.e., the elbow is at a right angle)
  2. Sitting with arms supported at the level of the mid-sternum
Blood pressure should be read with arm supported at the level of the mid-sternum

The results showed that blood pressure readings were significantly higher when sitting with arms on the armrest of the chair. Readings can be over 10 mm Hg higher in both systolic (upper number) and diastolic (lower number) pressures.

Blood pressure readings are elevated significantly when the arm is hanging down.

In another study of 100 random emergency room patients, blood pressures were compared in two positions: 1) Arm lax and hanging down parallel to the body and 2) Arm in the “correct” position. Among the seated patients, 22% of them were diagnosed with hypertension, but twice as many patients were diagnosed with high blood pressure with the arm hanging down. Be sure to note the position of your arm whenever a clinician takes your blood pressure.   Continue reading “10 Factors That Affect Blood Pressure Readings”