Controlling Your Blood Pressure Archive

News briefs

If your doctor or pharmacist offers a service to monitor blood pressure measurements you send from home (called telemonitoring), consider taking advantage of it. Past research has shown that telemonitoring — often paid for by Medicare — may help you reduce your blood pressure. And a study published online Aug. 31, 2020, by Hypertension suggests telemonitoring is also associated with a long-term reduction in heart attacks, strokes, and medical costs. The recent study is a follow-up to a randomized controlled trial from 2013 that divided 450 people into two groups: those who received routine primary care, and those who received a year of telemonitoring services with a pharmacist who helped manage their treatment. People in the telemonitoring group had lower blood pressure for up to two years afterward, compared with people who received routine care. In the recently published follow-up, which followed the same participants for five years, researchers found there were about half as many heart attacks, strokes, and hospitalizations in the telemonitoring group as there were in the group that received routine care. Because there were fewer cardiovascular problems, people in the telemonitoring group also saved an estimated $1,900 each in medical costs.

On call

Q. My blood pressure stays low. Sometimes it drops so low, it causes dizziness and weakness. What causes this?

A. Of the possible causes of low blood pressure, two are at the top of my list. First, I would review your medications. Drugs prescribed to treat high blood pressure and heart disease are the ones that most often cause this side effect. Reducing the dose with your doctor's approval may be all you need.

Research we're watching

Need another reason to quit smoking? A study published in the September 2020 issue of the Journal of Neurology, Neurosurgery and Psychiatry found that women ages 30 to 60 who smoked had four times the risk of having a brain aneurysm (a weakened artery in the brain that bulges and could burst) compared with nonsmokers.

Researchers looked at nearly 550 women who had a brain scan performed, most often because of persistent headaches. The scans showed that 113 of them had one or more brain aneurysms. These individuals were then matched with 113 people who did not have brain aneurysms. In comparing the two groups, the researchers found not only that smoking drove up the risk of finding a brain aneurysm, but also that women who both smoked and had high blood pressure had seven times the risk compared to nonsmokers with normal blood pressure. If future research shows that smokers also have a significantly higher risk of brain aneurysm rupture, women smokers ages 30 to 60 might be candidates for aneurysm screening.

Research we're watching

A specialized fall prevention program managed by nurses wasn't able to significantly reduce the rate of serious falls among high-risk adults over age 70, according to a study published July 9, 2020, in The New England Journal of Medicine. The STRIDE program (the name stands for Strategies to Reduce Injuries and Develop Confidence in Elders) was tested by the Patient-Centered Outcomes Research Institute and National Institutes of Health as a means of reducing falls among high-risk seniors.

Falls are a leading cause of injury in people 65 and older, with some three million adults heading to the emergency room each year with a serious injury caused by a fall. Program staff worked with individuals at least 20 months to identify and modify such risk factors as problems with walking or balance, hazards in the home that made a fall more likely, a history of low blood pressure when standing, and low vitamin D levels.

Get an approved blood pressure device and follow these steps.

Monitoring your blood pressure at home has always made good sense. Blood pressure is one of the main indicators of cardiovascular health, and taking measurements is an important way to manage chronic conditions between doctor visits.

Now, with a pandemic under way and fewer people visiting their doctors, the case for monitoring blood pressure at home has never been stronger. Home monitoring yields valuable information for you and your physician, who'll be counting on you to provide accurate blood pressure measurements when you talk on the phone or in a video chat.

People who take frequent saunas or hot baths may lower their risk of heart problems. But be cautious if you have low blood pressure.

Soaking in a bathtub or basking in a sauna can be a pleasant way to relax. Done on a regular basis, both habits may also help prevent heart attacks and strokes, according to several studies.

"The high temperatures in a warm tub or sauna cause your blood vessels to dilate, which lowers blood pressure," says Dr. Adolph Hutter, professor of medicine at Harvard Medical School. The volume of blood your heart pumps will also rise, especially in a hot tub. That's a result of the pressure of the water on the body, which increases the heart's workload, he explains.

Research we're watching

Frail, older people with health problems may live longer if they take the blood pressure medications their doctors prescribe, according to a study published in the August 2020 issue of the journal Hypertension.

Previous research suggests that in general, older people benefit from blood pressure drugs. But trials usually don't include people with multiple medical conditions, because those health problems make longevity findings challenging to interpret.

News briefs

Here's a finding worth toasting if you're partial to a tipple: a study published online June 29, 2020, by JAMA Network Open linked low-to-moderate alcohol drinking in middle age with better cognitive (thinking) skills in older age. Researchers analyzed the health data of about 20,000 adults (average age 61) who took part in cognitive screenings every few years during a nine-year period and reported how much alcohol they drank each week. Men who had fewer than 15 drinks per week, and women who had fewer than eight drinks per week, were considered moderate drinkers. And they're the ones who appeared to have better word recall and vocabulary over time, and slower rates of cognitive decline, compared with people who never drank. The study is observational and doesn't prove that drinking alcohol protects the brain. In fact, the subject is debated: some studies have suggested that moderate alcohol drinking is associated with better cardiovascular health compared with heavy alcohol intake, but other studies have found that drinking any amount of alcohol increases the risk for high blood pressure and stroke. The takeaway: if you're going to raise a glass, do so only in moderation.

Image: © Ridofranz/Getty Images

Ask the doctor

Q. My husband is reluctant to get tested for sleep apnea. But I'm pretty sure that he has it, and I'm concerned because I've heard that it can contribute to heart disease. How are these two conditions connected?

A. As you likely know already, people with sleep apnea may snore loudly and may also periodically gasp for breath throughout the night. These explosive snorts often wake up bed partners or roommates — although not necessarily the person with apnea.