Heart Beat December 2011 Issue

Heart Beat: December 2011

Just having slightly high blood pressure may significantly raise your risk of having a stroke, according to research published Sept. 28 in the journal Neurology. A review of 12 studies involving more than 500,000 people found that adults who had pre-hypertension—defined as have a systolic blood pressure between 120 and 139 mmHg or diastolic pressure between 80 and 89 mmHg—had a 55 percent increased risk of having a stroke compared to adults whose blood pressure fell within the normal range. The American Heart Association notes that blood pressure is the most powerful determinant of stroke risk. Individuals younger than 65 were at greater stroke risk due to pre-hypertension than older adults, many of whom have other risk factors that influenced their stroke risk. The study raises the question of whether pre-hypertensive individuals should be treated more aggressively. Researchers say the next step is to study whether treating pre-hypertensive patients results in a significantly lower stroke risk.

The time at which you take your antihypertensive medications affects your blood pressure patterns, but new research also suggests that when you take them can also impact your long-term health. A study published online Oct. 24 in the Journal of the American Society of Nephrology found that patients who took at least one blood pressure-lowering medication at bedtime had better control of their blood pressure and were about one-third as likely to experience a cardiac event such as a heart attack, stroke or heart failure, compared to those patients who took their medications when they wake up. Researchers also determined that sleep-time blood pressure is a more accurate measure of heart health than wake-time blood pressure. The study also revealed that cardiovascular event rates could be reduced by more than 50 percent by simply taking at least one blood pressure medication before bed instead of in the morning. However, many patients are instructed to take their antihypertensive medications first thing in the morning or at certains times of day. So before you change the timing of your medication regimen, talk with your doctor and ask if taking at least one of your pills at night may be a healthier option.

Heart disease after a spinal cord injury (SCI) has long been known as the leading cause of morbidity and mortality among patients with those types of injuries. A widely held belief was that heart trouble followed spinal injuries because these patients were often limited in the amount of physical activity they could engage in after their injuries. But research presented in October at the Canadian Cardiovascular Congress showed that one of the main factors contributing to heart disease in SCI patients is damage to the autonomic nervous system, which controls bodily functions that are involuntary, such as the heart, bladder and blood vessels. Researchers suggest that because it is difficult to predict which pathways in the autonomic nervous system are affected by an SCI, during the recovery period SCI patients should be routinely screened for autonomic nervous system damage. Typically, the focus on SCI patients is on motor and sensory response, but this study suggests that’s not enough.

Positive lifestyle factors such as eating a healthy diet, moderate alcohol consumption, regular exercise, not smoking and maintaining a weight, can significantly lower a person’s risk of developing type 2 diabetes, according to a study published Sept 6 in Annals of Internal Medicine. The study followed more than 207,000 people, age 50 to 71 years, during an 11-year period. No one in the study showed evidence of diabetes, cancer or heart disease at the beginning of the study. During the study period follow-up, 9.6 percent (11,031) of the men and 7.5 percent (6,969) of the women developed new-onset diabetes. Those participants with the greatest number of positive lifestyle factors had an 80 percent lower chance of developing diabetes compared to those with the fewest. Each factor alone also contributed to a decreased risk.