Healthy Lifestyle Helps Manage HypertensionStudy Finds Wide Range of Measures Effective< April 22, 2003 >Focusing on a healthy diet and regular exercise can help keep blood pressure under control, but staying committed to this lifestyle is a must, according to a study reported in the Journal of the American Medical Association. New research shows that people who cut down on salt and alcohol, while losing weight and getting regular exercise, take important steps in controlling their blood pressure. And, following a low-fat diet that is high in fruits and vegetables works even better. The scientists conclude that people can pick and choose from a buffet of healthy lifestyle habits to lower their blood pressure. "You can combine all these things together, and that's pretty encouraging," says Victor J. Stevens, a psychologist at the Kaiser Permanente Center for Health Research in Portland, Ore., and a co-author of the study. Blood Pressure Problems Affect MillionsNearly 50 million Americans, or about a quarter of the adult population, have high blood pressure - a reading of at least 140 mmHg (millimeters of mercury) for the systolic (the higher number) and 90 mmHg for the diastolic (the lower number). High blood pressure raises the risk of heart attacks and stroke, and can seriously damage other organs, such as the kidneys. An ideal blood pressure reading is 120/80. "Reducing your blood pressure by even a few millimeters makes a difference," Stevens says. "The more pressure there is, the faster your circulatory system wears out." The study looked at 810 men and women with higher than optimal blood pressure, with 38 percent of the participants classified as having clinical hypertension. Their average age was 50. A third of the group received a single counseling session, typically with a registered dietitian, about the importance of diet in controlling their blood pressure. They were then left on their own to alter their behaviors. The rest of the participants were assigned to two groups, both of which received much more intensive advice - as many as 18 sessions over a six-month period - about the link between lifestyle and hypertension. They were told to lose weight if they needed to, to get at least three hours each week of moderate exercise, and to cut down on their salt and alcohol intake. Participants in one of these two groups also were advised to adopt the DASH (Dietary Approaches to Stop Hypertension) diet, a low-fat meal plan that emphasizes fruits and vegetables and cuts back on red meat. It has been shown to help lower blood pressure. Greatest Benefits from Intensive ApproachIndividuals in all three groups saw their blood pressure drop, but those who received intensive counseling reaped far more benefits. These participants' blood pressure came down more on average, and fewer developed high blood pressure. They were also more likely to lose a significant amount of weight, and less likely to require drugs to control their hypertension. The improvement was best for those who had the intensive counseling as well as the DASH diet, with blood pressure falling twice as much, on average, compared with the first group. Yet the addition of the DASH diet to aggressive lifestyle counseling only slightly reduced blood pressure compared with lifestyle changes alone. Losing weight had the greatest impact on reducing blood pressure and keeping it in a healthy range. The relatively weak impact of the DASH diet in the latest study points up the challenge of implementing behavioral programs outside the confines of a clinical trial, says Dr. Thomas Pickering, a physician at Mount Sinai Medical Center in New York. "When you are giving people food that is already prepared [prepackaged just as in previous studies with DASH], you can be pretty sure they're getting what you want them to have," says Pickering, author of an editorial accompanying the journal article. But when they do it themselves they often dilute the benefits of the diet, he said. Expert Says Move Toward a Healthy LifestyleDr. Laura Svetkey, director of the Duke Hypertension Center at Duke University and a study co-author, says it is not clear why adding DASH to the counseling regime did not have a bigger effect. Sveltkey says it may be that when it comes to blood pressure, "maybe there's a maximum bang for the buck that you can get" by altering behavior. Another factor, she says, is that people in the study may not have eaten precisely the DASH diet prescribed in earlier trials with the meal program. But Svetkey says there are plenty of good reasons to make the DASH diet part of a routine to control or prevent hypertension. Although the intensive counseling is just that, Svetkey says "there's nothing magic" about the regimen. All it requires is motivation, support, and the willingness to set small goals. "We simply asked people to eat a healthy diet, eat reasonable portions, increase their physical activity to a moderate level, and reduce their salt intake to recommended levels," she says. Always consult your physician for more information. Benefits From Regular Exercise or Physical Activity:
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For more information on cardiovascular disease and nervous system disorders, please visit health information modules on this Web site. Proteins in Spinal Fluid Mark Alzheimer's Disease, Study ShowsTwo proteins that appear in the spinal fluid appear to be useful in diagnosing Alzheimer's disease, say researchers in the Journal of the American Medical Association. Alzheimer's, a degenerative brain disease which is thought to be caused by a buildup of toxic beta-amyloid in the brain, affects about 4 million Americans. Today, with one in 10 persons over age 65 (and nearly half of persons over age 85) affected, Alzheimer's disease is recognized as the most common cause of dementia (a disorder in which mental functions deteriorate and breakdown). Alzheimer's is commonly diagnosed through symptoms and by ruling out other diseases. New research suggests that physicians may be able to diagnose people in the early stages of Alzheimer's, or even predict the onset of the disease, by looking for abnormal levels of two substances, called beta-amyloid and tau. Physicians who treat patients with Alzheimer's agree that early diagnosis of the disease is key because the few treatments now available can slow the progression of symptoms by six months or so. And, new drugs are being developed to inhibit toxic beta-amyloid. A test that detects Alzheimer's before it surfaces could maximize the effectiveness of these therapies, if and when they arrive, says Dr. Trey Sunderland, an Alzheimer's expert at the National Institute of Mental Health (NIMH), a part of the National Institutes of Health (NIH), and lead author of the study. "We think that's very important," Sunderland says. "Once you identify people at risk, then you can target them with the new medications aimed at slowing down the development" of the disease. In the latest work, Sunderland and his colleagues compared tau and beta-amyloid levels in spinal fluid samples from 131 men and women with suspected Alzheimer's disease - 31 had a confirmatory diagnosis upon autopsy (the only way to confirm the disease is present) - and 72 without the condition. Tau is released by dying brain cells, so higher concentrations of the molecule in cerebrospinal fluid reflect increased damage to neurons. The reason beta-amyloid levels fall in the spinal fluid of Alzheimer's patients, experts say, is because more of the protein stays in the brain to cause harm. Sunderland and his colleagues also reviewed 51 previous studies of the link between tau and beta-amyloid in spinal fluid and Alzheimer's. Taken together, these studies included more than 3,100 people with the brain disorder, and the overall results echoed his group's own findings. Always consult your physician for more information. What Is Alzheimer's Disease?Alzheimer's disease is a progressive, neurodegenerative disease that occurs in the brain and often results in the following:
With Alzheimer's disease, motor function is often preserved. When Alzheimer's was first identified by German physician, Alois Alzheimer, in 1906, it was considered a rare disorder. Always consult your physician for more information. Online Resources(Our Organization is not responsible for the content of Internet sites.) Centers for Disease Control and Prevention (CDC) National Cancer Institute (NCI) 5 A Day For Better Health National Heart, Lung, and Blood Institute (NHLBI), part of NIH National Institute of Neurological Disorders and Stroke (NINDS), part of NIH |
