An article published online in The Lancet today and featured in the Huffington Post shows evidence that a process called denervation of nerves near the kidneys can radically lower blood pressure for people with very high, uncontrolled blood pressure. In a procedure like the ones used to detect coronary blockages, insert stents, and stop atrial fibrillation, researchers inserted a catheter into the artery near the groin and used radio waves to deaden some of the nerves in the kidney region. The stimulation of these nerves plays a key role in the development of high blood pressure.
The researchers randomly assigned 106 patients to an intervention group or a control group. All patients had systolic blood pressure of 160 mm Hg or higher or, if they had diabetes, 150 mm Hg. They were all taking multiple medication for their high blood pressure but not achieving any success in lower it. After six months, 84% of those in the intervention group had reduced their systolic blood pressure by at least 10 mm Hg compared with only 35% of the patients in the control group.
The researchers therefore conclude that denervation works to lower medication-resistant high blood pressure.
A good temper and easygoing nature might pay off with better heart health. A new study published online by Hypertension finds that thickening of the carotid artery is more pronounced in people who scored higher for antagonism on a personality assessment. The study looked at 5000 people in four villages on the island of Sardinia. Carotid artery intima media thickness is one measure of the progression of atherosclerosis. The carotid artery carries blood to the head.According to heartwire:
Those who scored in the bottom 10% of agreeableness and were therefore the most antagonistic had about a 40% increased risk for elevated IMT; the effect on artery walls was thus similar to having metabolic syndrome, say the researchers.
Men generally tend to have thicker artery walls than women, but those women who scored in the highest category for antagonism had carotid walls just as thick as those of men. The article abstract notes that:
Antagonistic individuals, especially those who are manipulative and aggressive, have greater increases in arterial thickening, independent of traditional cardiovascular risk factors.
Heartwire reports an interesting study that shows the relationship between body mass index (BMI), cardiorespiratory fitness, and blood pressure. Using records of more than 35,000 patients, researchers found that BMI was more closely associated with blood pressure than fitness. Only for those people with the lowest and highest BMI measurements did fitness make a difference. Otherwise, weight, as measured by BMI, was closely associated with blood pressure. People with normal weight had average systolic blood pressure (the top number of the BP reading) that was 12 mm Hg lower than people who were in the obese BMI range - 115 mm Hg versus 127 mm Hg. This compares with only an 6 mm Hg difference between the most fit versus the least fit individuals - 119 mm Hg to 125 mm Hg.
One limitation of this study is that 69% of the sample is white men.
An article in the Journal of the American Society of Nephrology links pop consumption - specifically throught fructose - with elevated blood pressure. The researchers from the University of Colorado used data from the National Health and Nutrition Examination Survey (NHANES) to look at 4500 adults with no history of hypertension. They adjusted for a range of factors and found that consumption of at least 74 grams per day of fructose - equal to about 2 1/2 bottles/cans of pop - significantly increases the likelihood of high blood pressure.
Another article in WebMD notes that the research is under fire from the Corn Refiners Association, whose members I assume make a lot of fructose, as well as the American Beverage Association. The Corn Refiners argue that the researchers miscalculated the amount of fructose in a pop because it doesn't take account of other sugars used in soft drinks. However, as reported here last Spring, a clinical study by another group of researchers compared glucose consumption with fructose consumption. This group found that fructose promoted an increase of bad fat - visceral adipose tissue - higher lipids, and decreased insulin senstivity when compared to glucose.
The president of the American Society of Hypertension also commented in the WebMD piece - saying that all sugar is bad and that fructose shouldn't be singled out but not really criticizing the science of the research.
AP reports that Luiz Inacia da Silva, known as Lula, has quit smoking after 50 years. He was scared into it by a widely-publicized bout of hypertension that forced him to cancel an appearance at the World Economic Forum in Davos. The story also notes that Barak Obama is still smoking.
"the dramatic underpricing of sugar-sweetened beverages, their widespread availability, and the ceaseless marketing of these products constitute a stumbling block to good health and are a clear and present danger to the future of our children.”
But New York's not the only place pushing for a tax on sweetened beverages. A member of the California State Assembly has introduced a bill to tax soda pop and other sugar-sweetened beverages. The money raised by this tax would be devoted to childhood obesity prevention. The California Centre for Public Health Advocacy estimates that the tax – one cent on every teaspoon of added sugar or other caloric sweetener – would raise $1.5 billion per year.
In Washington State, the Governor is also pushing for a tax on pop, bottled water, and candy.
A study just published in one of the leading medical research journals, the Archives of Internal Medicine, provides evidence that such a tax could be effective: Researchers looked at the diet and health of 5115 young adults aged 18 to 30 years over a 21 year period, from 1985 to 2006. They also looked at food prices over that time. A 10% increase in the cost of pop and pizza resulted in a 7% decline in caloric intake from pop and a 12% decrease in calories from pizza.
A new study shows more evidence of a link between vascular disease and cognitive impairment. As reported earlier, there is increasing evidence of a connection between high blood pressure and dementia. This new study found that patients with familial hypercholesterolemia (I know it's a mouthful), that is high cholesterol that has a genetic basis, had a greater incidence of mild cognitive impairment than people without that condition. The study only had 117 participants, with 47 having familial hypercholesterolemia. More solid evidence would require a much larger sample. The press release is here.
It turns out New York is on the cutting edge of more than just salt reduction. The New York City Public Health Dept. posted this video on youtube that has had almost 600,000 views. Be careful, though, it's pretty gross.
New York has also introduced the green cart program to promote fruit and vegetable consumption in the city's low income neighbourhoods. Starting last year, New York licenced 1,000 vendors to operate old-style fruit and veggie carts in specific areas. The idea is to increase access to healthy food that study after study has shown is least available in the poorest neighbourhods. Many of these same neighbourhoods are also sites of the fastest rising obesity rates in the city. Although many of the vendors are very busy (one was open 24 hours a day, 7 days a week), the New York Times points out that not everyone is happy about the new program:
“It may be good for health, but it’s bad for business,” said George Katehis, manager of the Splendid Deli Restaurant at 387 East Fordham Road. “A guy might buy a piece of fruit there instead of coming in here for a soda.”