Filet mignon and sautéed asparagus
“In this large prospective study, higher plant protein intake was associated with lower total and CVD-related mortality. Although animal protein intake was not associated with mortality outcomes, replacement of red meat protein or processed meat protein with plant protein was associated with lower total, cancer-related, and CVD-related mortality.”
Source: Association of Animal and Plant Protein Intake With All-Cause and Cause-Specific Mortality | Cardiology | JAMA Internal Medicine | JAMA Network
Steve Parker, M.D.
Click the pic to purchase at Amazon.com
Not good enough
Aiming for systolic blood pressure of 120 or less (instead of 140) may reduce the risk of age-related brain impairment. A recent study suggests the mechanism is better brain blood flow.
The 2017 guidelines from the American College of Cardiology recommend a BP treatment goal of under 130/80.
Ischemia means poor or no blood flow.
Small vessel ischemic disease (SVID in the brain) is something I see so often on CT scans of 70-year-olds that I usually ignore it. Mind you, I’m a hospitalist and usually looking for acute major strokes, brain tumors, and bleeding on CT scans. SVID is a chronic disease and it’s often difficult to say how long a specific lesion has been present and whether it’s causing symptoms. Ischemia in the brain is linked to impaired cognitive functioning and dementia. On the other hand, some brain ischemic lesions don’t seem to cause any detectable impairment.
From JAMA Network:
Question: Is intensive blood pressure treatment associated with less progression of small vessel ischemic disease, as reflected by cerebral white matter lesion volume?
Findings: In this substudy of a randomized clinical trial of 449 hypertensive patients with longitudinal brain magnetic resonance imaging, intensive blood pressure management to a target of less than 120 mm Hg, vs less than 140 mm Hg, was associated with a smaller increase in white matter lesion volume (0.92 cm3 vs 1.45 cm3).
Meaning: More intensive blood pressure management was associated with less progression of cerebral small vessel ischemic disease, although the difference was small.
Source: Association of Intensive vs Standard Blood Pressure Control With Cerebral White Matter Lesions | Dementia and Cognitive Impairment | JAMA | JAMA Network
Steve Parker, M.D.
PS: The Mediterranean diet also reduces dementia and cognitive impairment.
Click the pic to purchase at Amazon.com
“This is much easier than exercising and losing 30 pounds!”
Fiona Godlee, editor-in-chief of the British Medical Journal, has a heretical short article at BMJ. I recommend you read the whole thing. It starts thusly:
More than half of adults aged over 45 will be labelled as hypertensive if new US guidelines are adopted, concludes a study in The BMJ this week (doi:10.1136/bmj.k2357). This equates to 70 million people in the US and 267 million people in China being eligible for antihypertensive drugs, a marked increase on already high rates of drug treatment for high blood pressure. Furthermore, the study calculates that 7.5 million people in the US and 55 million in China would be advised to start drug treatment, while 14 million in the US and 30 million in China would be advised to receive more intensive treatment. The evidence from trials indicates some benefit from drugs in terms of reduced risk of stroke and heart disease, but is mass medication really what we want?
Hypertension is just one of the many heads of the lifestyle disease hydra. Another is type 2 diabetes. Once thought to be irreversible and progressive, it is now known to be potentially reversible through weight loss. This is the cautious conclusion of the review by Nita Forouhi and colleagues (doi:10.1136/bmj.k2234), part of our series on the science and politics of nutrition (bmj.com/food-for-thought). Whether by calorie or carbohydrate restriction, weight loss has been shown to improve glycaemic control, blood pressure, and lipid profile and is the key to treatment and prevention of type 2 diabetes, they say.
She goes on to talk about fatty liver disease (NASH) and offers an alternative, of sorts, to pills. Good luck with that.
We’re supposed to eat more fruit, right?
Someone needs to figure out how to put healthy lifestyle in a pill.
Source: Pills are not the answer to unhealthy lifestyles | The BMJ
Two diet books in one
High blood pressure is linked to heart attacks
I’ve never heard of regular physician offices measuring blood pressure like this meta-analysis describes. It may be the standard of care in the future if the automated device is affordable.
Should automated office blood pressure (recording several blood pressure readings using a fully automated oscillometric sphygmomanometer with the patient resting alone in a quiet place) measurement replace readings recorded by nurses and physicians in routine clinical practice?
This systematic review and meta-analysis of 31 articles comprising 9279 participants compared automated office blood pressure with awake ambulatory blood pressure, a standard for predicting cardiovascular risk. Mean automated office blood pressure readings were similar to the awake ambulatory blood pressure readings and did not exhibit the “white coat effect” associated with routine office blood pressure measurement.
Automated office blood pressure measurement should replace the recording of blood pressure by nurses and physicians in routine clinical practice.”
Source: Comparing Automated Office Blood Pressure Readings With Other Methods of Blood Pressure Measurement for Identifying Patients With Possible Hypertension: A Systematic Review and Meta-analysis | JAMA Internal Medicine | JAMA Network
Lot’s of good ideas in this video. Additionally, I’ve see a couple studies supporting hibiscus tea as a natural remedy.
Dr Berry says only one in a million persons has blood pressure that is sensitive to dietary salt. That is, high salt intake increases blood pressure. On the other had, I’d say one in four of the hypertensive population is salt-sensitive.
“Systolic of 140 isn’t good enough anymore.”
Keep your eyes on this development, folks. Potential game-changer. And a boon to Big Pharma. From NBCnews.com…
Lowering blood pressure to recommended levels can prevent dementia and the memory and thinking problems that often show up first [mild cognitive impairment], researchers reported Wednesday.
People whose top blood pressure reading was taken down to 120 were 19 percent less likely to develop mild cognitive impairment, the loss of memory and brain processing power that usually precedes Alzheimer’s, the study found. And they were 15 percent less likely to eventually develop cognitive decline and dementia.
It may take a few more years before the study conclusively shows whether the risk of Alzheimer’s was actually reduced because of the lower blood pressure,the researchers said.
It’s the first intervention that has been clearly demonstrated to lower rates of mental decline.
The findings come from a large trial of blood pressure called the Systolic Blood Pressure Intervention Trial, or SPRINT.
It has already found that lowering systolic blood pressure — the top number in a blood pressure reading — to 120 or less can prevent stroke, heart attacks, kidney disease and other problems.
Source: Tight blood pressure control can cut memory loss, study finds
Guess what else helps prevent memory loss and dementia? The Mediterranean Diet.
Two diet books in one
What kind of blood pressures are we talking about here? 147 mmHg systolic versus 134.
“Autopsies on nearly 1,300 older people, including about 640 clergy members, found more signs of damage and one of the hallmarks of Alzheimer’s disease in the brains of those with higher blood pressure than among those with pressure closer to normal, researchers reported Wednesday.”
Source: Late-life high blood pressure may harm the brain, study says – ABC News