Marion County Medical Center

Health Shorts

October 2008

Keeping Your Blood Pressure in Line
    More than 50 million Americans have high blood pressure, and it’s a major risk factor for stroke, heart attack and kidney failure. A chronic disease, hypertension requires constant attention, but you can keep your blood pressure low by:

•    keeping your weight within a normal range;
•    following a low-sodium and low-fat diet;
•    eating five servings of fruits, five servings of vegetables and adequate quantities of whole grain foods and low-fat dairy products each day;
•    limiting your intake of saturated and trans fats;
•    exercising regularly;
•    limiting your alcohol intake (if you drink) to two drinks a day if you’re a male and one drink if you’re a female;
•    using a home blood pressure monitor to track your blood pressure and keep it below 120/80; and
•    taking the medicine that your doctor prescribes.
[SOURCE: American Heart Association, “Let’s talk about high blood pressure and stroke.”]

How Fast To Lower BP after Stroke?
    About 60 to 70 percent of patients develop elevated blood pressure immediately after a stroke, and doctors have always been a bit concerned about what to do about this in order to lessen the effects of the stroke.

For a hemorrhaging stroke, lower blood pressure may help stem the flooding that’s taking place in the brain. On the other hand, some patients may need the increased pressure to make sure all areas of the brain are getting adequate circulation.

    Recent results presented at the American Stroke Association’s International Stroke Conference (2008) indicated that patients given blood pressure lowering drugs immediately after a stroke had a lower three-month mortality rate without serious adverse effects. It was a small study, however, and the researchers stressed that it’s premature to make recommendations.
[SOURCE: CHIPPS: Immediate blood pressure lowering after stroke may reduce mortality,” Medscape Medical News, February 25, 2008]

Morning BP Good Indicator of Risk
    What’s your blood pressure when you first wake up in the morning? It’s normal to have lower blood pressure while you’re sleeping and then show a gradual increase during the early morning hours just before and just after awakening. Some individuals with hypertension don’t follow this pattern, and these persons may have a particularly high risk of stroke.

“Non-dippers,” or those who do not have the normal drop in blood pressure during the night, are likely to develop greater damage to blood vessels in the brain, kidneys and heart. Some studies indicate that they have the highest risk of stroke. “Extreme dippers,” who have an exaggerated dip in BP at night and then an extreme morning surge, are also at increased risk.

    Studies carried out at Jichi Medical School in Tochigi, Japan concluded that for older patients with hypertension, morning blood pressure was the best predictor of stroke. Each 10 mm Hg increase in morning BP was correlated with a 44 percent higher risk of stroke.
[SOURCE: Susan Jeffrey, “Early to rise–morning blood pressure predicts stroke,” Neurology Reviews.com, March, 2003]

When BP Mounts, So Does Risk
    More than 65 percent of Americans suffering their first stroke have blood pressure higher than 160/95. But persons with even moderately high readings are also at risk.
   New guidelines stress that what was previously considered “high normal” blood pressure–readings between 120 and 139 mm Hg systolic and 80 and 90 mm Hg diastolic–should be reason for concern and call for treatment with lifestyle changes and, in some cases, medication.
[SOURCE: American Stroke Association, “Blood pressure and its relationship to stroke,” Stroke Connection Magazine, October, 2003]

Scuba Diving, Flying Don’t Mix
    Air travelers often experience ear popping and pain related to changes in atmospheric pressure–problems similar to those faced by scuba divers. Ear specialists warn that “flying within 12-24 hours of scuba diving is absolutely contraindicated.”
[SOURCE: John Ogle, M.D., MPH, FACEP, “Aerospace medicine,” emedicine from WebMD, August 29, 2006]

Test Your Ears Before Taking Off
    One of the best remedies for the ear discomfort encountered during flying is using the Valsalva maneuver to force air into the back of your nose and equalize air pressure on both sides of the ear drum. Keeping your mouth closed, blow out gently, as if you’re blowing your nose, while pinching your nostrils shut

This same technique can be used before flying to see if you have upper respiratory congestion that could put you at risk of ear problems in the air. If you do the Valsalva maneuver and can’t pop your ears or feel a change in pressure, you might consider changing your flight or using an oral or nasal decongestant to clear your air passages.
[SOURCE: John Ogle, M.D., MPH, FACEP, “Aerospace medicine,” emedicine from WebMD, August 29, 2006; “Ears and airplane travel, ear wax, and ear cleaning, Oregon Health & Sciences University]

Toys Should Be Emotionally Safe Too
Most parents take for granted that the toys they buy their children should be physically safe–free of lead-based paint, toxic chemicals, sharp edges and small parts that could be swallowed by toddlers. But emotional and social safety are also important.

Studies have indicated that children can be negatively influenced by graphic depictions of violence presented in an interactive way in computer or video games. Games are rated, but parents should do their own checking as well since games rated as suitable for “everyone” often contain significant violence.

    Toys that promote negative racial, ethnic, cultural or gender stereotypes can also be emotionally damaging and give children a message about what their parents value.
[SOURCE: Danette Glassy, et al, “Selecting appropriate toys for young children: the pediatrician’s role,” Pediatrics, April, 2003]

Reporting an Unsafe Toy or Product
    Have you discovered a safety hazard in a toy or other product? Report it to the Consumer Product Safety Commission (CPSC): 1-800-638-2722; www.cpsc.gov/incident.html; mailto%20info@cpsc.gov.
    The CPSC has the authority to issue recalls on toys or other products it finds to be hazardous.
[SOURCE: Dr. Steven Parker, “Toy safety,” Healthy Children blog, WebMD, November 29, 2005]

Buy Proper Safety Equipment Too
    If you’re buying your child a bicycle, scooter, inline skates or skateboard, make sure you also give the proper safety equipment. Recommended safety gear include helmets that meet safety standards plus hand, wrist, knee and shin guards.
    Look on the label for certification by Snell or Consumer Product Safety Commission.
[SOURCE: KidsHealth for Parents, “Choosing safe toys,” reviewed by Kate Cronan, M.D., May, 2007]

Facts about Phthalates
    The U.S. Public Interest Research Group, a consumer advocacy organization, recommends that parents check product labels this holiday season for the presence of phthalates. Phthalates are substances added to plastics to make them softer and more flexible. Products containing phthalates, including toys and baby care products, are widely available, although less frequently than in the past because of health concerns.
    Based on research showing adverse effects on laboratory animals and human studies suggesting abnormalities in children born to mothers with high levels of phthalates, the use of the substance in toys has been restricted by the European Union and several states.
    A U.S. law banning the use of six phthalates for products intended for children under 12 was signed into law in August, 2008 and will take effect in 2009.
    The “Phthalate Information Center” (www.phthalates.org), an internet site that claims the health concerns of phthalates are unfounded, is sponsored by major plastics manufacturers rather than independent scientists.
[SOURCE: Phthalate Information Center]

Specialized Grief Therapy Helps
    It’s normal to experience long and difficult periods of grief after the death of a loved one, but 10 to 20 percent of grieving persons have a more severe reaction, known as complicated grief.
    Persons with complicated grief tend to have recurring thoughts, pervasive sadness, guilt and loss of interest in daily activities but without all of the physical symptoms of major depression (loss of appetite, weight loss, frequent and early awakening from sleep).
    A study published in the Journal of the American Medical Association found that more than half of subjects getting therapy tailored specifically for complicated grief reported significant improvement while only 28 percent of subjects getting traditional psychotherapy reported improvement.
[SOURCE: “Finding help for overwhelming grief,” Johns Hopkins Medical Letter, July, 2006]

When Grief Becomes Overwhelming
    The death of a loved one is never easy to accept, but some circumstances increase the likelihood of intense grieving. These include a sudden or unexpected death; the death of a child or young person; a suicide; or a violent death.
Grief is intensified in persons who had a particularly close or dependent relationship with the deceased and in those who have experienced other major losses or bouts of depression.
[SOURCE: Ellen jaffe-Gill, Melinda Smith and Jeanne Segal, “Coping with grief and loss,” helpguide.org, last modified December 14, 2007]

Watch Your Health When Grieving
    Grief related to the loss of a close family member has physical as well as emotional effects. Studies show that about half of widows develop depression in the year after a spouse’s death. They also show reduced activity of immune cells and increased levels of stress hormones that, over time, can result in reduced immunity, increased blood pressure and cholesterol and abnormal heart rhythms.
[SOURCE: “Grief takes no holiday,” Harvard Women’s Health Watch, December, 2002]

Health Shorts

October 2008

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