Blood pressure drugs are good for you even you don't need them?

A new analysis suggests that blood pressure drugs may benefit heart disease patients even if they don’t have high blood pressure.

The paper, published in the March 2 issue of The Journal of the American Medical Association, is an analysis of 25 published studies, and the authors cautioned that randomized controlled trials must be done to confirm the results. (They reported no financial ties to drug makers.)

Patients in the studies were followed for two years on average, and many had blood pressure levels that were normal or slightly above. Compared with similar patients who took dummy pills, those who took so-called antihypertensive medication cut their risk of stroke by 23 percent; heart attack by 20 percent; congestive heart failure by 29 percent; and death by 13 percent.
The study’s lead author, Angela M. Thompson, said that while current guidelines call for treatment when blood pressure is 140/90 or higher, “we know from other studies that there’s a graded relationship between cardiovascular disease risk and blood pressure” — starting when the first number, the systolic reading, is as low as 115.
But Ms. Thompson, a doctoral student in epidemiology at Tulane University School of Public Health and Tropical Medicine, noted that these cutoff points had changed over time. “So the question is: Is this still the best cutoff point? Or if you lower it a little bit, are people going to obtain more benefit?”

Risks: Higher Fructose Intake Is Linked to Visceral Fat

The health effects of fructose consumption, largely from high-fructose corn syrup, have been the subject of considerable controversy among scientists and consumers alike. Now a study in the February issue of The Journal of Nutrition reports that fructose consumption may increase cardiovascular risk factors because it increases visceral fat, the kind that accumulates around internal organs.

Researchers examined 559 14- to 18-year-olds in Georgia, recording body mass index, exercise habits and fat mass. They also asked what the students had consumed in the past 24 hours and measured their body fat.

After controlling for other factors, the researchers found that higher fructose consumption was associated with increased systolic blood pressure, C-reactive protein (a sign of systemic inflammation) and visceral fat, and reduced HDL (good) cholesterol — all known risks for cardiovascular disease and Type 2 diabetes.

But when they controlled for visceral fat, the effect of fructose alone was weakened. It was apparently not fructose itself, but its tendency to increase visceral fat that led to a rise in risk factors.

“To just say ‘fructose is bad’ is incorrect,” said Norman K. Pollock, the lead author and an assistant professor of pediatrics at Georgia Health Sciences University. “But when calorie intake from fructose is greater than 16 percent of total intake, we’re seeing these risk factors appear.”

Feeling racist? Blood pressure pill Propranolol can open harts and minds

A commonly prescribed drug used to treat high blood pressure may have the unintended benefit of muting racist thoughts in those who take it.

A new Oxford University research study found that Propranolol, which works to combat high blood pressure, anxiety, migraines, and a number of heart ailments, affects the same part of the central nervous system that regulates subconscious attitudes on race.

"Implicit racial bias can occur even in people with a sincere belief in equality," said Sylvia Terbeck, lead author of the study, which was published in the journal Psychopharmacology. "Given the key role that such implicit attitudes appear to play in discrimination against other ethnic groups, and the widespread use of Propranolol for medical purposes, our findings are also of considerable ethical interest."

Of course, the study is sure to raise concerns both over its validity and whether we should rely on prescription medication to regulate behavior, even for positive outcomes.
As Cardiff University School of Psychology's Dr. Chris Chambers told the Telegraph: "We don't know whether the drug influenced racial attitudes only or whether it altered implicit brain systems more generally. And we can't rule out the possibility that the effects were due to the drug incidentally reducing heart rate."
Another point of concern is the very limited range of subjects used in the test: All 36 participants were white males.
Nonetheless, the study yielded some discussion-worthy results. According to the Telegraph, test subjects who took 40mg of Propranolol scored "significantly lower" on the Harvard University Implicit Association Test, which measures "subtle and spontaneous biased behavior."

Science has had a long and complicated history with race and cultural issues. For example, a 2009 study trained Caucasian test subjects to better recognize the facial features of African-American men with similar characteristics. Early results from that research indicated that the individuals better equipped to differentiate between other individuals of different ethnicity displayed a greater level of racial tolerance. Conversely, the infamous "Little Albert Experiment," which tested conditioned emotional responses in a toddler found that certain negative emotional responses could be learned, and even programmed, over time. And there's the once-popular philosophy of Eugenics, which sought to improve the human race through natural selection. After gaining popularity with the Nazis during World War II, the term has been relegated to more of a political insult than a serious theoretical practice these days.

Device 'could revolutionise blood pressure monitoring'

A device which can be worn like a watch could revolutionise the way blood pressure is monitored in the next few years, scientists say.

Researchers at the University of Leicester and in Singapore have developed a device to measure pressure in the largest artery in the body.
Evidence shows it gives a much more accurate reading than the arm cuff.
The technology is funded by the Department of Health and backed by Health Secretary Andrew Lansley.
It works by a sensor in the watch recording the pulse wave of the artery, which is then fed into a computer together with a traditional blood pressure reading from a cuff.
Scientists are then able to read the pressure close to the heart, from the aorta.
Professor Bryan Williams, from the University of Leicester's department of cardiovascular sciences at Glenfield Hospital, said: "The aorta is millimetres away from the heart and close to the brain and we have always known that pressure here is a bit lower than in the arm.

"Unless we measure the pressure in the aorta we are not getting an appreciation of the risks or benefits of treatment."

He said the device would "change the way blood pressure has been monitored for more than a century" and he expected the technology to be used in specialist centres soon, before being "used much more widely" within five years.
"The beauty of all of this is that it is difficult to argue against the proposition that the pressure near to your heart and brain is likely to be more relevant to your risk of stroke and heart disease than the pressure in your arm," he said.
But it was important to ensure the new device was as small as possible to encourage clinicians and patients to use it, he added.
The research work was funded by the Department of Health's National Institute for Health Research (NIHR).
The NIHR invested £3.4m, with a further £2.2m of funding coming from the Department of Health, to establish a Biomedical Research Unit at Glenfield Hospital in Leicester.
The university collaborated with the Singapore-based medical device company HealthSTATS International.
Dr Choon Meng Ting, chairman of HealthSTATS, said: "This study has resulted in a very significant translational impact worldwide as it will empower doctors and their patients to monitor their central aortic systolic pressure easily, even in their homes and modify the course of treatment for blood pressure-related ailments."
Mr Lansley said the device was "a great example of how research breakthroughs and innovation can make a real difference to patients' lives".
Judy O'Sullivan, senior cardiac nurse at the British Heart Foundation, said previous research had shown that measuring pressure close to the heart was a better indicator of the effectiveness of treatment for high blood pressure than the standard method.
"However, further research is needed before we can be certain of its superiority in the doctor's surgery," she said.

iPhone Blood Pressure Monitor is out

Withings' Blood Pressure Monitor is a BP cuff that connects directly to your iPhone, iPad, or iPod Touch, to measure and track blood pressure stats via a free app.

French company Withings has made a name for itself with its Wi-Fi body scale. Now it's announced the U.S. availability of its Blood Pressure Monitor, which it touts as the only "BP cuff in the world to connect directly into any iOS device."
While the extra hardware will run you a somewhat steep $129.99, needless to say, there's a free app in the mix that shows BP measurements and keeps track of user stats.
Withings is calling the Blood Pressure Monitor truly plug-and-play. Wrap the cuff around your arm, then plug the cable into your iPhone, iPod Touch, or iPad, and the Withings app automatically launches.
You can access your stats from your iOS device or your personal Withings Web page. The company says results are saved denoting dates and time of day for each reading, to help when comparing morning, afternoon and evening readings. You can share results with your doctor via an integrated email link or sync with personal health record sites like Google Health and Microsoft HealthVault that your doctor can access.
If you happen to have a Withings Body Scale, your weight and blood pressure are tracked on the same graph of the application. No word yet on whether you'll be able to tweet your daily blood pressure as you can tweet your weight with the body scale app, but we certainly hope it's an option.
Here are the tech specs for the Withings Blood Pressure Monitor:

• Measurement: Oscillometric method
• Measurement range: 0 to 285mmHg
• Pulse: from 40 to 180 beats per minute
• Cuff fits arm circumferences from 9 to 17 inches
• Pump: automatic inflation with air pump, controlled pressure release
• FDA: device has received FDA clearance
• Works in direct conjunction with an iPhone/iPad/iPod touch (sorry, no Android yet)
• Price: $129.99

Study: Short Delay in Treating Blood Pressure Safe for Diabetics

Waiting up to a year to treat high blood pressure in a person with diabetes is probably not harmful, but waiting many years to get blood pressure under control could result in serious complications, new research indicates.
In the study, published online Jan. 9 in the Journal of General Internal Medicine, researchers from the University of Chicago suggested that the one-year delay could give patients time to make certain lifestyle changes that could help correct the problem, such as limiting their salt intake, exercising or losing weight.

The study also suggests that delays in lowering blood pressure among patients with diabetes are not uncommon. Some patients may not have access to health care, while others may not follow through on their treatment, they explained.

Still, other experts were cautious, noting that prompt control of blood pressure with medications can prevent serious cardiovascular trouble.
In the study, a team led by Dr. Neda Laiteerapong used a simulated model with a theoretical population of adults in their 50s newly diagnosed with type 2 diabetes.
The researchers found that a lifetime of uncontrolled blood pressure increased complications significantly, or by 1,855 events per 10,000 patients. It also reduced their life expectancy by almost one year.
In contrast, a one-year delay in controlling blood pressure resulted in only a minor increase in the number of complications and reduced life expectancy by only two days.
However, waiting very long before treatment wasn’t advised. The study authors found that 10 years or more of delays in the treatment of high blood pressure could lead to serious health problems, including greater risk for stroke and heart attack.
“Among middle-aged adults with diabetes, the harms of a one-year delay in managing blood pressure may be small. Health care providers may wish to focus on diabetes management alone in the first year after diagnosis, to help patients establish effective self-management and lifestyle modification,” Laiteerapong and colleagues wrote in a journal news release.
Experts said the findings add to the debate on when to initiate therapy, but questioned the authors’ conclusions.
The study “contributes to the ongoing discussion about blood pressure targets and the importance of blood pressure control in people who have diabetes,” said Dr. Ronald Tamler, clinical director of the Mount Sinai Diabetes Center in New York City.
“However, we should not forget that this latest study is merely a computer simulation. Studies have shown that uncontrolled blood pressure in real patients with diabetes is still a source of concern and may lead to complications, such as heart disease, stroke and kidney disease,” added Tamler, who is also assistant professor of medicine at the center.
One cardiologist added that quick action in getting blood pressure under control can be life-saving, and he questioned whether waiting for lifestyle changes to occur was advisable.
Dr. Henry Black, clinical professor of cardiology at NYU Langone Medical Center in New York City, said that many studies have shown “that prompt control of blood pressure reduces events, although neither of these studies were specifically aimed at patients with diabetes, although many of the study volunteers had diabetes mellitus.”
According to Black, most trials have found changes in lifestyle to be less effective than drug therapy in reining in high blood pressure. That means that, “dithering with ‘lifestyle changes’ . . . will delay getting effective treatment to these high-risk individuals,” he said. “The time wasted focusing on control of diabetes with lifestyle changes is a bad bargain, if blood pressure is pushed to the back burner.”