Why it is vital to get the blood pressure reading from BOTH of your arms

Have you had your blood pressure checked in one arm and the reading seemed ‘normal’? Typically it is checked by your GP or another healthcare professional, or you can even do it yourself with a home testing kit. A reading between 90/60 and 139/89 is judged to be normal.

Not many people usually request to have their other arm checked for a blood pressure reading or check it themselves, however it might be worth doing this in the future as it could just save your life.
A new American study into apparently healthy individuals discovered that in instances when there was a significant difference between the blood pressure readings in each arm, there was 38% increased risk for a heart attack, stroke or other cardiovascular problems.

Researchers from Harvard Medical School in the US decided to look at the blood pressure reading of both arms from almost 3,400 men and women over the age of 40 and deemed in good health.

Generally, a small difference between the two readings is considered normal and not sufficient to cause alarm. In this study, systolic pressure – the pressure of the blood when your heart pushes blood out and the higher of the two figures within a blood pressure reading – was found to vary by an average of roughly five points.

For 10% of the people monitored in the study, a difference of at least ten points was found between the two arms. In the subsequent 13 years, those particular men and women were 38% at a higher risk of a potentially deadly heart attack, stroke or other cardiovascular health problems.

For two readings with a large difference, it is believed that the arm showing the higher reading probably has an artery that is congested with fat.

NHS guidelines advise GPs to extract the blood pressure readings of both arm. However, many are guilty of simply getting the reading from whichever arm of the patient happens to be nearest to them.

Thembi Nkala, a senior cardiac nurse with the British Heart Foundation, importance of having your blood pressure checked in both arms, saying: “Even if someone has no other cardiovascular risk factors, uneven high blood pressure could be a sign of an increased future risk of cardiovascular problems. UK guidelines already call for blood pressure to be measured in both arms when diagnosing high blood pressure. If you’re worried about your blood pressure or cardiovascular risk, speak to your GP or practice nurse.”

In respect to a blood pressure reading, you should not instantly panic if you have one blood pressure reading that seems high, you have not actually have high blood pressure (hypertension). Many of us are nervous or may feel stressed when visiting our GP and this can cause fluctuations in blood pressure, increasing it.

In that scenario, patients can be provided with a blood pressure kit to use throughout the day to check if there is a consistent high blood pressure reading or not. Your GP could also request you to undergo blood and urine tests to see if you have conditions that increase blood pressure, such as kidney disease.

Stroke rates among younger people should act as ‘a wake-up call’

An increasing number of young to middle aged people are suffering from strokes around the world because of their unhealthy lifestyle, according to findings from a new study.

Spiralling rates of obesity and diabetes, together with lack of exercise, has caused a rise to the number of strokes effecting people aged between 20 and 64. In fact, the number has increased by a quarter in merely 20 years, calling health experts to label the worrying situation a ‘stroke epidemic’.

Strokes afflicting this age group now comprise of 31% of the global total, whereas in 1990 it was only 25%. Stroke rates among children and young people aged 20 and under have also been studied and even among this age group researchers discovered that there are over than 83,000 cases each year; 0.5% of the total number.

The findings, published in the latest issue of The Lancet, stem from a systematic analysis of data extracted from 50 countries on the causes of illness and major diseases.

Although the analysis demonstrated a decrease in deaths from stroke in the UK, Brits are still more likely to die after suffering a stroke compared to those living in France, Germany and even the U.S.
Those living in less well-off countries are also much more at risk of succumbing from a stroke, with 42% more deaths across poorer countries during 1990 to 2010 in comparison to well-off nations. Over those two decades, stroke rates dropped by 12% in the richer countries.

Numerous lifestyle risk factors are thought to be the result of increasing stroke rates in the low to middle-income countries. For example, smoking, high blood pressure (hypertension), lack of exercise and an unhealthy diet have all been pin-pointed as risk factors.

Stroke Association chief executive Jon Barrick said that the findings of the research were a “wake-up call to governments across the globe”.

Mr Barrick said: “The report reveals a shocking disparity between rich and poor, where death rates from stroke are up to 10 times higher in lower income countries,” Mr Barrick said. Closer to home, within the UK, the number of people dying from stroke is around three times higher in the most economically deprived areas, compared to the least deprived. To help close this health inequality gap, we need more investment in stroke prevention and research.”

He added: “Rising obesity and diabetes rates, coupled with sedentary and unhealthy lifestyles, could wipe out the improvements we’ve seen in reducing stroke mortality in the UK, putting even more pressure on our limited NHS resources. This is a stark warning. We urgently need to address this global stroke crisis by prioritising stroke prevention and investment into stroke research.”

Lead scientist Professor Valery Feigin, director of the National Institute for Stroke and Applied Neurosciences at AUT University in New Zealand, commented: “The worldwide stroke burden is growing very fast and there is now an urgent need for culturally acceptable and affordable stroke prevention, management and rehabilitation strategies to be developed and implemented worldwide.”
Every year there are an estimated 152,000 strokes that occur in the UK, costing the NHS around £3.7 billion.

Broadcaster Andrew Marr suffered a stroke in January 2013 at the age of 53, and recently returned to work. In September he spoke about his experiences, saying: “I thought I’d bounce back in a couple of months. I was lying in bed completely delusional about how ill I was, and [my wife] Jackie was very good, she didn’t tell me. She kept saying, ‘Yes, dear, you’ll get to go to St Petersburg in March, I’m sure it’s going to be fine,’ knowing perfectly well that it wouldn’t. So it took quite a long time for it to sink in just how long it would be. I’ve got another two years before I’ve made a recovery.”

The political journalist has drew strength and positives from what he has gone through, and said: “You definitely see the world differently, actually, that is true. You move more slowly. You suck up experiences more intensely and you live the day more.”

He added: “And you’re much more aware of all the people all around us who have got really, really difficult disabilities who are looking after their parents, perhaps, and who frankly most of the time, like most people, I simply didn’t see. I wasn’t thinking about them. That has changed. I do see them now, I do think about it.”

Can new weight loss drugs rival Xenical

Recently, the American Food and Drug Administration (FDA), approved two new weight loss medications (Belviq and Qysmia), and America breathed a sigh of relief. While weight loss drugs have always been a topic of controversy, over the years it has become clear that their addition to the dieting efforts of many individuals, who struggle with obesity, is extremely beneficial. And with more than one third of Americans (35.7%) falling under the obese category, it is no surprise that medical alternatives to diet and exercise, are needed to counteract the issue.

New obesity treatments are needed to bridge the gap between diet and exercise and the more radical option of bariatric surgery. This is a view backed up by Dr Sue DeCotiis, New York City based Medical Internist and Weight Loss Management Specialist, who said, “While there are potential side effects with every medication, long term studies show that overweight patients do much better losing and keeping off weight, when they are prescribed a weight loss drug.”

“Weight loss medications work in conjunction with healthy eating and exercise, and offer individuals a chance at a real lifestyle change. Those who suffer from obesity often have a host of other health problems that come with the condition. These drugs can alleviate those symptoms, and the result is that many of these patients will live longer and avoid the consequences of medical problems, such as hypertension, stroke, and heart attack.”

Listed below is a description of current weight loss drugs and how they work. Previously the only option was Xenical, but now for the first time in 13 years, Doctors will have a choice of which weight loss drugs to prescribe to overweight or obese patients.

Belviq (Locaserin)

Approved by the FDA in late June of this year, this medication works by activating a receptor in the brain that helps a person to eat less and still feel full. By regulating the appetite, it lowers the likelihood of individuals overeating. It works best in patients who suffer from weight related conditions, such as high blood pressure, type 2 diabetes, or high cholesterol. At least 47.5% of patients lost at least 5% of their body weight from the medication, as opposed to 20.3% who took a placebo during a trial study period.

Qsymia (Phentermine & Topirmate)

This combination of the drugs Phentermine (an appetite suppressant and stimulant) and Topirmate (an anticonvulsant with weight loss side effects) is the most recent of the crop of weight loss medications, that have been approved by the FDA. Drugs in this category are primarily considered appetite suppressants. With the medication producing dramatic weight loss in patients, this is one of the clearest signs of hope for those suffering from obesity related diseases. About half of the patients lost 10% of their body weight and four-fifths lost 5%.

Contrave (Bupropion & Naltrexone)

This drug that is still to be approved by the FDA, works by combining two active ingredients that have been used for over twenty years. With Bupropion initiating the weight loss, Naltrexone sustains it by preventing the body’s natural tendency to counteract efforts, to lose weight. The result of this combination is to reduce appetite and increase the body’s metabolism, giving those who are suffering from obesity related illnesses the ability to sustain continued weight loss, by addressing the portion of the brain that controls food cravings.

Xenical (Orlistat)

Xenical, which is the most established and proven of the weight loss drugs, is a lipase inhibitor. Xenical does not enter the patient’s blood stream, but works in the digestive system in the small intestine as a fat absorber. It blocks out a third of the fat in food eaten in a patient’s diet, leading to steady weight loss. Research involving 11,131 woman and 4,418 men, who had been over weight for an average of 14 years, showed that 87% lost at least 5% of total body weight, half lost at least 10%, around 20% lost more than 15% body weight and some patients lost more than 25%.

Only time will tell which of these weight loss drugs is the most successful. Unfortunately here in the UK Belviq is not expected to be released until 2013 and there has been no UK release date as yet for Qsymia and Contrave. However all is not lost as here in the UK we still have Xenical available, which has a proven track record for assisting weight loss. Here at Medical Specialists Pharmacy we can dispense Xenical after an online consultation with one of our doctors and as soon as these other weight loss drugs become available, we will be offering them. Check our news section for further updates.

A healthy lifestyle could reduce high blood pressure as effectively as drugs

Whilst we all know that exercising regularly, keeping our weight down, drinking in moderation and eating plenty of vegetables can affect our blood pressure, new research suggests that it can reduce the risk of developing high blood pressure, by two thirds.

The impact of these measures on high blood pressure was much higher than expected, and in some cases could even be just as effective a way to treat sufferers as prescribing drugs. Just walking to work and restricting alcohol to two drinks a day can reduce the risk markedly, according to the study of more than 20,000 people.

Every day there are 350 preventable strokes or heart attacks in the UK caused by high blood pressure. In developed countries the lifetime risk of developing high blood pressure is now 90 per cent, and six million Britons take drugs to control it.

People with hypertension (the medical term for high blood pressure) are already routinely advised to make the lifestyle changes highlighted in the study, but the effect far surpassed expectations. The Finnish study followed 9,637 men and 11,430 women aged 25 to 74, who did not have hypertension.

Their adherence to healthy lifestyle factors was recorded, which included alcohol consumption of less than 50g per week (roughly six units), exercise at least three times per week, daily consumption of vegetables, and normal weight. During a follow-up period covering an average of 16 years, 709 of the men and 890 of the women developed hypertension.

Proffesor Pekka Jousilahti, ofFinland’s National Institute for Health and Welfare said: “The risk of hypertension was only one third among those having all four healthy lifestyle factors, compared with those having none. Even having one to three healthy lifestyle factors reduced the risk of hypertension remarkably.

For example, having two healthy lifestyle factors reduced the risk of hypertension by nearly 50 per cent in men, and by more than 30 per cent in women. Alcohol consumption, physical activity, daily consumption of vegetables and keeping normal weight are the four lifestyle factors that seem to have a remarkable effect on the development of hypertension.

Professor Jousilahti went on to add “people should drink a maximum of one to two drinks of alcohol a day and that even a relatively low amount of exercise was enough to make a difference.”  This was backed up by Professor Gareth Beevers, a trustee of the Blood Pressure Association UK charity, who said: “This study shows a big effect from simple changes in lifestyle. It’s surprising and more than you would expect.”

Professor Jousilahti concluded by saying: “that although participants were healthy at the start of the study, it was likely the findings would also help those who already have high blood pressure. Patients could reduce their blood pressure by modifying the four lifestyle factors alone, or by making these modifications while taking blood pressure-lowering medication.”

Forgive and forget, for your hearts sake

We’ve all been offended by someone at one time or another and whether we choose to forgive someone or not can have a big effect on our relationship with that person however new research led by Dr Britta Larsen at the University of California, San Diego has found that whether we choose to forgive or not can have a big impact on our health especially in relation to our heart.

The research found that those who let go of their anger were less likely to suffer dangerous spikes in blood pressure. Short term rises in blood pressure are not known to be harmful however over a longer period high blood pressure can increase the likelihood of a heart attack or stroke.

The researchers at the University of California asked just over 200 people who were wired up to monitors which took their blood pressure to focus on a time a friend or loved one had upset or offended them. Half of the group were told to concentrate on how much the incident had upset or angered them whilst the other half were told to think about the incident in a more forgiving way.

It was found that the angry group saw the greatest increase in blood pressure compared to the group who were trying to see it in a more forgiving way. Interestingly after a five minute timeout period the differing effects could still be seen between the two groups.

The research published in the Journal of Biobehavioural Medicines suggested that forgiveness could lower our reactivity to stressful events and thus prevent dangerous spikes in blood pressure. It also went on to suggest that doing so could offer longer term protection in relation to heart attacks and strokes.

This could prove very helpful as around 30% of adults in the UK have hypertension (high blood pressure) and are unaware of it due to lack of obvious symptoms.