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New blood pressure range means half of Americans have hypertension

by UNTV News   |   Posted on Tuesday, November 14th, 2017

FILE PHOTO: A photo illustration shows a stethoscope and blood-pressure machine of a French general practitioner displayed in a doctor’s office in Bordeaux January 7, 2015. REUTERS/Regis Duvignau

 

(Reuters) – Tighter blood pressure guidelines from U.S. heart organizations mean millions more people need to make lifestyle changes, or start taking medication, in order to avoid cardiovascular problems.

Americans with blood pressure of 130/80 or higher should be treated, down from the previous trigger of 140/90, according to new guidelines announced on Monday by the American Heart Association and the American College of Cardiology.

At the new cutoff, around 46 percent, or more than 103 million, of American adults are considered to have high blood pressure, compared with an estimated 72 million under the previous guidelines in place since 2003.

High blood pressure accounts for the second-largest number of preventable heart disease and stroke deaths in the United States, second only to smoking.

The guidelines do not change the definition of normal blood pressure as 120/80 or lower.

Potentially deadly high blood pressure can be brought under control with a wide array of medications, many sold as relatively inexpensive generics. The drug classes include angiotensin receptor blockers, such as Novartis AG’s Diovan, calcium channel blockers, like Pfizer Incs’s Norvasc, ACE inhibitors, including Pfizer’s Altace, and diuretics, such as Merck & Co Inc’s Hyzaar.

But the drugs have side effects and the new guidelines emphasize lifestyle changes including weight loss, diet and exercise as the first tool for combating hypertension.

“I think this will encourage both patients to adhere to recommendations but also clinicians to be more vigorous in their attempts to prescribe lifestyle changes,” said Dr. Pamela Morris, chair of the ACC’s committee on prevention of cardiovascular disease.

Lifestyle modifications are the cornerstone for treatment, but the guidelines also stress that patients assessed to be at high risk of cardiovascular problems will be started on medication.

A large, government-sponsored study of hypertension patients aged 50 and older showed in 2015 that death from heart-related causes fell 43 percent and heart failure rates dropped 38 percent when their systolic blood pressure was lowered below 120 versus those taken to a target of under 140.

But patients in the 120 systolic blood pressure group had a higher rate of kidney injury or failure, as well as fainting.

Concerns about those side effects, as well as the fact that the close monitoring seen in a clinical trial is hard to replicate, led the AHA, ACC and other groups to select the 130 systolic blood pressure target.

The new guidelines also emphasize the importance of accurate blood pressure measurements, using an average of different readings at different times.

Adults with blood pressure of 130/80 “already have double the risk of heart attack compared to someone in the normal range,” said Dr. Paul Whelton, professor at Tulane University School of Public Health and Tropical Medicine and School of Medicine in New Orleans and lead author of the new guidelines. “It doesn’t mean you need medication, but it’s a yellow light that you need to be lowering your blood pressure, mainly with non-drug approaches.”

Reporting by Deena Beasley; Editing by James Dalgleish

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Pregnant women need routine blood pressure checks

by UNTV News   |   Posted on Wednesday, April 26th, 2017

A child touches her pregnant mother’s stomach at the last stages of her pregnancy in Bordeaux April 28, 2010. REUTERS/REGIS DUVIGNAU

(Reuters Health) – Pregnant women should get their blood pressure checked at each prenatal visit to screen for preeclampsia, a potentially fatal complication that can damage the kidneys, liver, eyes and brain, new U.S. guidelines say.

While many doctors already monitor blood pressure throughout pregnancy, the U.S. Preventive Services Task Force (USPSTF) updated its guidelines for the first time since 1996 to stress that screening at every visit can help doctors catch and treat preeclampsia before it escalates from a mild problem to a life-threatening one.

“Preeclampsia is one of the most serious health problems affecting pregnant women,” task force member Dr. Maureen Phipps, a women’s health researcher at Brown University in Providence, Rhode Island, said by email.

“Because this condition is common and critical, the Task Force offers two separate recommendations to help women lower the risk associated with preeclampsia – screening for preeclampsia is recommended for all pregnant women, and women at high risk of developing the condition can take low-dose aspirin to help prevent it,” Phipps added by email.

The screening recommendations, published on Tuesday in JAMA, apply to women without a history of preeclampsia or high blood pressure. Separate guidelines advise low-dose aspirin after the first 12 weeks of pregnancy for women with a history of elevated blood pressure. (bit.ly/2oIwP5B)

Preeclampsia can progress quickly, and typically develops after 20 weeks of pregnancy. Blood pressure screening earlier in pregnancy can show normal results for women who go on to develop preeclampsia.

In addition to elevated blood pressure, women with preeclampsia may also have excess amounts of protein in their urine, as well as swelling in the feet, legs and hands.

Women may suffer from stroke, seizures, organ failure and in rare cases, death. For babies, complications include slower growth inside the uterus, low birth weight and death.

Risks for preeclampsia include a history of obesity, diabetes, kidney disease, lupus or rheumatoid arthritis, as well as a mother or sister who has experienced the condition.

Because the risks of preeclampsia increase with age, women may be able to lower their chances of developing this complication by having babies sooner, said Dr. Dana Gossett, an obstetrics and gynecology researcher at the University of California, San Francisco, and co-author of an accompanying editorial in JAMA.

“Beyond that, it is also important to ensure that all health problems are well managed prior to pregnancy,” Gossett said by email. “High blood pressure should be under good control, other diseases like kidney disease or lupus should be well controlled, and women should try to be close to their ideal body weight prior to conception.”

Checking blood pressure at every prenatal visit can help prevent complications for mothers and babies alike, said Dr. Martha Gulati, chief of cardiology at the University of Arizona College of Medicine in Phoenix and author of a separate editorial in JAMA Cardiology.

“This is something that should be provided to every woman as part of preventive care,” Gulati said by email. “We will save lives and prevent complications and death in pregnant women with this simple, cost-effective” test that doesn’t take much time.

SOURCE: bit.ly/2oGYMKe and bit.ly/2peNbnM JAMA, online April 25, 2017; and bit.ly/2q1qDH4 JAMA Cardiology, online April 25, 2017.

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Bail hearing ni Sen. Estrada, kinansela ng Sandiganbayan

by UNTV News   |   Posted on Tuesday, September 23rd, 2014

June 30, 2014 File Photo: Si Senator Jinggoy Estrada (gitna) habang kausap ng kanyang mga abugado sa Sandiganbayan. (UNTV News)

MANILA, Philippines – Magsisimula pa lang ang bail hearing ni Sen. Jinggoy Estrada sa Sandiganbayan Fifth Division kaninang umaga ay kaagad pinuna ng abogado ng senador ang tila mabagal na usad ng pagdinig.

Pinuna rin nito ang mahabang oras na ginugugol sa pagtestigo ni Benhur Luy sa isang summary proceeding tulad ng bail hearing.

Sinabi naman ng prosekusyon na ang ginagawang pagkuwestiyon ng abogado ni Estrada na si Atty. Samuel Acut ang dahilan kaya humahaba ang pagdinig.

Bago pa man maresolba ang isyu ay umapela na ang prosekusyon na kung maaari ay ikansela muna ang pagdinig dahil hindi maganda ang pakiramdam ni Benhur Luy.

Pumasok ang nurse ng Sandiganbayan at kinunan agad si Luy ng blood pressure.

Pumalo sa 150/110 ang BP ng whistleblower, mataas kumpara sa normal.

“Masakit daw iyong batok niya, medyo red din iyong eyes, medyo nasusuka, signs and symptoms nga na may high blood pressure,” pahayag ni Ryan Buenviaje, Sandiganbayan Nurse.

Bunsod nito, kinansela ng Sandiganbayan ang natakda sanang bail hearing ng senador upang makapagpahinga si Benhur Luy.

Ayon kay Prosecutor Atty. Jose Justiniano, maaring na-stress si Luy sa kanyang sitwasyon.

“Alam naman po natin na iyang hypertension ay maaaring umatake kahit anong oras eh. Maiintindihan naman natin kasi iyang ganyang pag-testify eh stressful din naman talaga iyan,” anang abogado.

Kaugnay nito, dismayado naman ang kampo ni Sen. Estrada dahil halos kahating araw silang naghintay para sa bail hearing ng senador.

Ayon kay Atty. Alexis Abastillas-Suarez, “Of course there’s no other thing for us to think than this is part of, this is one of the delaying tactics ng prosecution.”

Giit pa nito, dapat tiyakin ng prosekusyon na nakahanda ang kanilang testigo bago ito iharap sa korte. (Joyce Balancio / Ruth Navales, UNTV News)

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