Blood pressure cuffs

Two news items about high blood pressure that should interest anyone with a blood pressure problem, which is most of us.

First, one study concluded that contrary to earlier reports, insomnia does not lead to higher blood pressure, which is great news for the reported 30 % of people who have a sleeping problem.

And second, a warning from the US FDA about the use of blood pressure machines in kiosks.

According to the FDA, since kiosk BP machines tend to use only a single size of blood pressure cuff, they may both underestimate (if the cuff is too large such as may be the case for smaller people) or over-estimate (if the cuff is too small which is the case for the increasingly larger number of significantly overweight people out there) a person’s true BP.

So, says the FDA, best to get your BP measured in a doctor’s office where the doc should be able to measure your BP with a cuff that’s right for you.

But that’s only true, I’d like to note, when the doc is willing to change her BP cuff and that isn’t always the case in a busy doctor’s office, so if you’re a large person and you think you need a larger BP cuff, don’t be afraid to politely and diplomatically ask your doctor if the cuff size on her BP machine is the right one for you.

But don’t tell her I told you to ask.

Intellectual stimulation and your brain

We’ve long known that getting a lot – as much as you can – education early in life stands your brain good stead later in life when you hit that point that a dementia and cognitive decline become a real issue.

And it’s not, it seems, that lots of education prevents cognitive decline but rather that getting lots of education builds a larger brain “reserve” so that a person who is beginning to experience cognitive impairment can “cover” for it better and longer, sort of like having more money in the bank to help deal with financial setbacks.

In other words, lots of education doesn’t prevent dementia, merely postpones it (although some studies indicate that when it hits in such cases, it tends to hit harder than in those in whom it’s been a slower, steadier decline).

The good news, though, from this morning’s study in JAMA Neurology is that even if you missed out on getting much of an education early in life, you can make up for that lack in midlife by continuing to get “intellectual stimulation”.

In this smallish study of roughly 2000 people followed for about a decade, the researchers concluded that “intellectual stimulation” in midlife helps delay the onset of dementia, and that bonus accrues particularly to people who got less education when they were younger.

In other words, it’s never too late to help your brain.

The big question is, of course, what exactly makes up “intellectual stimulation” besides the same-old, same-old standbys such as doing crosswords, reading, etc.

In other words, does arguing about the permutations of who will play whom in the Soccer World Cup elimination rounds count as intellectual stimulation?

I’d argue that it does but the clear answer is that we don’t really know.

Healthy Foods

Great little study – 318 people – that concluded that using labels like “anti-oxidant” and “gluten-free” on a product led those people to assume that the product was healthier than a similar product that didn’t carry those labels.

Now I’ve known that I’m a celiac for over 40 years now, and for the first 35 or so of those years, I could count, the number of GF products out there that actually tasted like food and not like sawdust, I am over-the-moon happy with the explosion of tasty GF products now available to us so I don’t wanna do anything to knock that market, but hey! There’s absolutely no scientific basis to believe that GF products are “healthier” for anyone besides celiacs (and maybe gluten-intolerant” people, too) than non-GF products.

GF is just a label to warn off those allergic or sensitive to the ingredients in that product.

Even more egregious, there’s absolutely no scientific evidence to believe that adding anti-oxidants to a health-neutral or unhealthy product (like soda pop, for example) is going to suddenly make that product more healthy.

Bottom line: read the ingredients on something you want to eat, don’t pay any attention to the labels.

And remember this, too: the more ingredients they add to something (and the more labels they plaster on that something), the more likely it is that the maker of that product is trying to get you to forget that that products isn’t something you should be eating lots of in the first place.

How low should your blood pressure be

Yet another lesson that medicine is not a game of limbo: so going as low as you can does not necessarily help you win the game.

So the background here is that for the last few years, many experts have argued that when it comes to matters like your cholesterol level and your blood pressure, you should try to keep those levels as low as you can get them without producing any untoward symptoms (such as dizziness, for example, from a too-low BP).

The twin troubles with that approach are that 1) we really have no proof that below a certain level, there is much to gain from going any lower, and 2) to get your cholesterol and blood pressure down really low, you often have to resort to taking 2, 3, even more meds and that of course has its own often debilitating untoward effects.

So if you’re on 2,3 or more meds to get your systolic BP (the upper number) below 120, which is what a lot of doctors have urged in a bid to lower the risk of stroke, you might want to note that a study out today in JAMA found that yes, lowering systolic BP below 140 does lower the risk of stroke, but lowering that systolic BP even more, that is , below 120 does not produce any better stroke risk than simply keeping the systolic BP between 120-139.

Lycopene

Despite some of the headlines accompanying a terrific small study, we're really not quite ready for ketchup in a pill.

But one day . . .

In this study of 36 people, half of whom were normal and half of whom had heart disease and were taking statins, adding a capsule of 7 mg of lycopene to their daily regime had a huge beneficial effect on the arteries of the heart disease patients, although it had no effect on the arteries of the normal folk.

What the lycopene produced was a " relaxing" effect on the muscle cells in the arterial walls so that the arteries became significantly wider.

The expectation is (although this study was not set up to find this) that the more open the arteries become, the less likely those people are to suffer a heart attack or stroke due to a blocked artery (that's for a much larger, much longer study to determine).

In the meantime, though, there doesn't seem to be much reason not to add some lycopene to your diet even if you don't have heart disease, and the great news there is that you don’t have to take supplements because lycopene is found in great abundance in tomatoes, and given that lycopene is best extracted from tomatoes when they've been cooked, a great, healthy, safe way to get more lycopene is to eat more tomato sauce.

And even pizza.

Not sure about ketchup, though, because ketchup seems to me to be more sugar than anything else.