Tuesday, July 31, 2012

Kloset Jongkok Lebih Baik buat Kesehatan

http://properti.kompas.com/read/2009/12/16/11273993/Kloset.Jongkok.Lebih.Baik.buat.Kesehatan




KOMPAS.com — Gangguan fungsi kemih sebenarnya bisa dikurangi dengan berbagai cara. Salah satunya dengan mengurangi konsumsi minuman yang mengandung kafein, alkohol, serta obat-obatan. 

"Kafein memiliki zat yang dapat memacu detak jantung serta meningkatkan produksi urine," kata Mulyadi Tedjapranata, dokter Klinik Medizone di Apartemen Taman Kemayoran, Jakarta Pusat.

Menurut Mulyadi, upaya pencegahan gangguan kemih sejatinya bisa dilakukan sedini mungkin. Beberapa cara yang bisa dilakukan adalah membiasakan untuk tidak menahan keinginan untuk buang air kecil. Bagi anak-anak, melakukan latihan buang air kecil atau toileting assistance bahkan sudah harus dilakukan sejak anak-anak berusia di bawah lima tahun atau balita.

Cara lain yang efektif adalah menghindari penggunaan kloset duduk. Penggunaan kloset duduk dalam jangka panjang akan memperbesar risiko terjadi infeksi saluran kencing yang bisa menyebabkan terjadinya gangguan berkemih. Pasalnya, permukaan toilet umumnya menjadi perantara penyebaran kuman. Penggunaan toilet jongkok justru lebih baik.

Pasalnya, ini akan membuat pengguna tidak bersentuhan langsung dengan permukaan toilet sehingga lebih higienis. "Apalagi, jika kerap memakai fasilitas toilet umum, toilet jongkok lebih baik," ujar dia.

Tak hanya itu, penggunaan kloset duduk juga membuat otot saluran kencing bekerja lebih keras saat mengejang atau mengeluarkan urine. Dalam tahap ringan, infeksi saluran kemih biasanya ditandai dengan anyang-anyangan atau keluarnya air seni yang tak tuntas, sakit perut bagian bawah, serta rasa sakit saat akhir buang air kecil. 

Kondisi ini tentu mengganggu aktivitas kita. Bahkan, kalau dibiarkan berlarut, ini bisa menimbulkan infeksi pada saluran kencing, gangguan psikososial seperti depresi dan gangguan tidur.

Jangan Remehkan Kloset Jongkok!

http://properti.kompas.com/read/2011/09/15/18505530/Jangan.Remehkan.Kloset.Jongkok.
Penulis : Natalia Ririh | Kamis, 15 September 2011






KOMPAS.com - Kecuali di rumah, kloset jongkok rasanya sudah semakin ditinggalkan. Tengoklah di hotel, mal, restoran, dan perkantoran, yang hampir semuanya menggunakan kloset duduk.
Budaya buang air dalam posisi duduk ini berawal pada  pertengahan abad 19 di Eropa, yang umumnya dilakukan oleh para raja dan ratu. Dalam perjalanan waktu, akhirnya banyak orang ingin merasa sederajat dengan para bangsawan dengan melakukan kegiatan sama.
Era industri di Inggris disebut-sebut memicu produksi kloset duduk hingga kini semakin mendunia. Ada yang mengatakan, memakai kloset duduk terkesan modern, praktis, dan lebih higienis.
Tapi, tunggu dulu. Sebelum membuat kesimpulan demikian, perlu dicermati bahwa kloset jongkok memiliki beberapa kelebihan yang mungkin belum Anda ketahui. Karena menurut Dr Saeed Rad dari Iran, posisi jongkok saat buang hajat lebih baik dibandingkan posisi duduk.
Dalam kajiannya kali ini Dr Saeed tidak sendirian, karena sudah banyak ahli dari berbagai negara yang mengkaji perbandingan ini sejak 1980-an lalu. Hasil temuan para ahli ini serupa, yakni pertama, posisi jongkok membuat pembuangan lebih lancar dan tuntas. Pasalnya, otot-otot sekitar usus besar lebih nyaman bekerja karena otot paha saat jongkok ikut membantu peregangan. Hal ini dapat mencegah terjadinya hernia.
Kedua, saat posisi duduk dan mengejan, ada beberapa syaraf rentan terkena tekanan misalnya syaraf kandung kemih, prostat, dan rahim. Sementara posisi jongkok melindungi syaraf-syaraf tersebut dari kerusakan.
Ketiga, ketika seseorang dalam posisi jongkok, katup antara usus besar dan usus kecil menutup. Sehingga, mencegah usus kecil terkontaminasi bakteri dari usus besar.
Keempat, khususnya bagi ibu hamil, posisi berjongkok menghindari rahim tertekan ketika membuang air. Jika dilakukan setiap hari, maka akan membantu persalinan secara normal. Posisi jongkok juga merupakan posisi alami manusia saat melahirkan.

Hypertension: Controlling the “silent killer”

http://blog.targethealth.com/?p=1880


Are you at risk for hypertension?
Harvard Medical School – Essential hypertension has no known cause. As a result, identifying clear risk factors is difficult. Researchers have discovered a few patterns, however. Some factors you have no control over — for example, you can’t alter your genes. But others, like smoking and heavy drinking, are habits you can change.
Risk factors you can’t change
Even though you can’t control these risks, that doesn’t mean you can forget about them. Awareness of your risk factors can help you put your overall cardiovascular risk profile into perspective and may provide you with extra incentive to adopt healthier habits.
Race
Hypertension often develops earlier and with more ferocity in African Americans than in other races. African Americans are nearly twice as likely to suffer a fatal stroke, 1½ times more likely to die from heart disease, and four times more likely to suffer kidney failure than are whites. For black men, the picture is particularly disturbing — they face a death rate from disorders related to high blood pressure that’s more than three times that of the death rate in white men.
The high incidence of hypertension among African Americans may have a genetic explanation. Some researchers suspect that people who lived in equatorial Africa developed a genetic predisposition to being salt sensitive, which means their bodies retain more sodium. This condition increases blood volume, which, in turn, raises blood pressure. Salt sensitivity can be beneficial in a hot, dry climate because it allows the body to conserve water. Generations later, however, the American descendants of these individuals remain disproportionately salt sensitive (see Figure 2).
On a positive note, the 1997 Dietary Approaches to Stop Hypertension (DASH) study showed that a low-fat diet rich in fruits, vegetables, and fiber was particularly beneficial to African Americans, especially when it was combined with additional limits on salt consumption (see “How the DASH diet helps”).
Salt sensitivity and race
Family history
Hypertension, like many disorders, runs in families. In addition, a family history of heart attack, stroke, diabetes, kidney disease, or high cholesterol increases your risk of developing high blood pressure.
This doesn’t necessarily mean, however, that genetics always plays a role. Some of the similarities observed in families may be the result of environmental influences. Children’s eating patterns, coping skills, and propensity toward healthy and unhealthy habits are shaped by their parents’ behavior and the social climate in which they’re raised.
Research indicates that about 25% of cases of essential hypertension in families and up to 65% of cases of essential hypertension in twins may have a genetic basis. In addition, at least 10 genes have been found to influence blood pressure. So far, however, only a few studies have identified a link between particular genes and hypertension. For instance, a rare form of hypertension called Liddle’s syndrome, which develops in childhood and often leads to an early death from cardiovascular disease, results from a defective gene that causes the kidneys to retain too much sodium and water.
Age
Although aging doesn’t invariably lead to hypertension, high blood pressure becomes more common in later years. Diastolic pressure increases an average of 10 mm Hg up to age 55 in men and age 60 in women, and then begins to decline. Between ages 30 and 65, systolic pressure increases an average of 20 mm Hg, and it continues to climb after 70. This age-associated increase largely explains isolated systolic hypertension.
Sex
Up to about age 55, women have a lower incidence of hypertension and other cardiovascular diseases than men do. But women’s blood pressures, especially the systolic readings, rise more sharply with age. Indeed, after age 55, women are at greater risk for high blood pressure. This pattern may be partly explained by hormonal differences between the sexes. Estrogen tends to protect women against cardiovascular diseases, including hypertension, but as the production of estrogen drops with menopause, women lose its beneficial effects, and their blood pressures climb.
Controllable risk factors
Your health habits are key factors in determining your cardiovascular risk. In fact, you may be able to bring your blood pressure readings into a safe range simply by making changes in your lifestyle, such as quitting smoking and losing weight.
Smoking
Doctors have long known that smoking promotes heart disease, but for a long time smoking didn’t appear to have a direct connection to hypertension. Observations have revealed a crucial link that earlier studies missed because blood pressure is generally measured in doctors’ offices and clinics, where smoking is prohibited.
When researchers tested blood pressure while people smoked, they discovered that within five minutes of lighting up, the subjects’ systolic pressures rose dramatically — more than 20 mm Hg, on average — before gradually declining to their original levels over the next 30 minutes. This means the typical smoker’s blood pressure soars many times throughout the day. Like people with labile hypertension (in which blood pressure may jump frequently in response to daily stresses), smokers may suffer “part-time” hypertension. For example, smokers with a prehypertensive reading of less than 140/90 mm Hg may actually have stage 1 hypertension every time they puff a cigarette.
This increase occurs because nicotine, whether smoked or chewed, constricts small blood vessels, forcing the heart to work harder to circulate blood. As a result, the heart speeds up and blood pressure rises. Nicotine also interferes with some antihypertensive drugs, most notably beta blockers. The chemicals in tobacco smoke raise heart disease risk in other ways, too. They can reduce the body’s oxygen supply, lower levels of HDL (“good”) cholesterol, and make blood platelets more likely to stick together and form clots that can trigger a heart attack.
Excess salt
Doctors first noticed a link between hypertension and sodium chloride — the most common form of dietary salt — in the early 1900s, when they found restricting salt in patients with kidney failure and severe hypertension brought their blood pressures down and improved kidney function. When a massive effort began in the 1960s to educate the public about reducing the risk of heart disease, one recommendation was that all Americans decrease salt consumption to prevent hypertension.
Federal guidelines advise people to limit sodium intake to 2,300 milligrams (mg) per day — about the amount in 1 teaspoon of table salt. Yet Americans typically consume 1–3 teaspoons or as much as 7,200 mg a day (see Figure 3). This fact, coupled with the high prevalence of hypertension in the United States, led researchers to assume that salt overload was the culprit.
American salt consumption
As it turns out, this may or may not be true. Nearly 50% of people who have hypertension are salt sensitive, meaning eating too much sodium clearly elevates their blood pressure and puts them at risk for complications. In addition, people with diabetes, the obese, and older people seem more sensitive to the effects of salt than the general population. However, the question of whether high salt consumption also puts generally healthy people at risk for hypertension is the source of considerable debate (see “Consume less salt”). Regardless of whether high salt intake increases blood pressure, it does interfere with the blood pressure–lowering effects of antihypertensive medications.
Obesity
Excess weight and hypertension often go hand in hand because carrying even a few extra pounds forces your heart to work harder. People who are overweight or obese are also more likely to develop diabetes, heart disease, arthritis, gallstones, sleep apnea, gout, and some cancers.
High blood pressure is about six times more common in people who are obese than in those who are lean. Twenty-two pounds more weight boosts systolic blood pressure by 3 mm Hg and diastolic blood pressure by 2.3 mm Hg. These increases cause a 12% greater risk of heart disease and a 24% greater risk of stroke, according to a 2006 statement from the American Heart Association.
What’s a healthy weight for you? Let the body mass index (BMI) guide you. A BMI of 25 to 29 indicates that an individual is overweight, while a BMI of 30 or above designates obesity.
The body mass index (BMI) is an index of weight by height. The definitions of normal, overweight, and obese were established after researchers examined the BMIs of millions of people and correlated them with rates of illness and death. These studies found that the normal BMI range is associated with the lowest rate of illness and death.
Another thing to keep in mind is that it’s not weight alone that matters, but also where you carry your extra weight. People with excess fat in the abdominal area (see Figure 4) are not only at greater risk for hypertension, but also for high cholesterol and diabetes. So if your BMI is 25 or more, and especially if you have accumulated abdominal fat, the unfortunate reality is that you need to lose weight.
WHR
The waist to hip ratio (WHR) is one way to estimate how much weight a person is carrying around the abdomen versus around the hips. Men and women with a higher WHR (resembling an apple shape) have a higher risk for heart attack and stroke than men and women with a lower WHR (resembling a pear shape).
To determine your WHR:
With your abdomen relaxed, measure your waist at its narrowest (usually at the navel).
Measure your hips at the widest point (usually at the bony prominence).
Divide the waist measurement by the hip measurement to find your ratio (Waist measurement/hip measurement = WHR).
A healthy WHR for women is 0.8 or less (and a waist measurement of 35 inches or less), and a healthy WHR for men is 1.0 or less (and a waist measurement of 40 inches or less).
Sedentary lifestyle
Compared with the physically active, sedentary people are significantly more likely to develop hypertension and suffer heart attacks. Like any muscle, your heart gets stronger with exercise. A stronger heart pumps more blood more efficiently, with less force, through your body. Other cardiovascular benefits of exercise include losing excess weight, increasing levels of “good” HDL cholesterol, and making stroke-causing clots less likely.
Heavy drinking
Excessive drinking — having three or more drinks per day — is a factor in about 7% of hypertension cases. It can also interfere with antihypertensive medications, increase your risk of stroke, and lead to heart failure.
While moderate alcohol consumption (no more than one drink per day for women and two drinks a day for men) significantly lowers your risk of cardiovascular disease and has little effect on your blood pressure, heavier drinking has the opposite effect. How alcohol raises blood pressure is unknown, but it appears that once you go past two drinks per day, the more you drink, the higher your blood pressure. This effect becomes more pronounced as you age and occurs regardless of what type of alcohol you drink.
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Blood pressure basics
You can’t see your blood pressure or feel it, so you may wonder why this simple reading is so important. The answer is that measuring your blood pressure gives your doctor a peek into the workings of your circulatory system. A high number means that your heart is working overtime to pump blood through your body. This extra work can result in a weaker heart muscle and potential organ damage down the road. Your arteries also suffer when your blood pressure is high. The relentless pounding of the blood against the arterial walls causes them to become hard and narrow, potentially setting you up for stroke, kidney failure, and cardiovascular disease.
Having your blood pressure measured is a familiar ritual at most visits to the doctor’s office. The examiner inflates a cuff around your upper arm, listens through a stethoscope, watches a gauge while deflating the cuff, and then scribbles some numbers on your chart. You may be relieved if you learn your blood pressure is normal or alarmed if the examiner says “180 over 100.” But what do these numbers actually mean?
Understanding the numbers
Blood pressure is recorded as millimeters of mercury (mm Hg) because the traditional measuring device, called a sphygmomanometer, uses a glass column that’s filled with mercury (whose chemical symbol is Hg) and is marked in millimeters. A rubber tube connects the column to an arm cuff. As the cuff is inflated or deflated, mercury rises and falls within the column (see Figure 1). Although mercury gauges are still considered the gold standard for measuring blood pressure, newer mercury-free devices are available. Many modern instruments use a spring gauge with a round dial or a digital monitor, but even these are calibrated to give readings in millimeters of mercury.
Measuring blood pressure
A health care professional measures a patient’s blood pressure using a stethoscope and a cuff that is inflated until the pressure it exerts is greater than the patient’s systolic pressure (the pressure when the heart contracts). The cuff compresses the arm until the brachial artery is squeezed shut. At first, the artery walls will be closed, and the clinician will not hear anything through the stethoscope. As air is released from the cuff, he or she will hear a thump. This is the moment when the clinician records the systolic blood pressure — the first and higher of the two numbers in a person’s blood pressure. As the cuff pressure continues to drop below the level of systolic pressure, the artery will begin to open and close, and the clinician will hear a thumping noise. When the rhythmic sound disappears, he or she records the diastolic pressure — the second, lower figure. As the cuff pressure declines below the diastolic pressure in the artery (the pressure between heartbeats), the vessel remains open, and no further sounds are heard.
The top number, or systolic pressure, reflects the amount of pressure during the heart’s pumping phase, or systole. As the heart contracts with each beat, pressure in the arteries temporarily increases as blood is forced through them. The bottom number, or diastolic pressure, represents the pressure during the resting phase between heartbeats, or diastole. Hypertension is defined as having a systolic reading of at least 140 mm Hg or a diastolic reading of at least 90 mm Hg (see Table 1).
How high is high blood pressure?
The Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC), a group of physicians and researchers from across the United States, developed these guidelines for classifying blood pressure in 2003. The figures are based on extensive reviews of the scientific literature and are updated periodically to keep pace with new research.
To classify your blood pressure, a health professional averages two or more readings taken after you have been seated quietly for at least five minutes. For example, a patient with a measurement of 135/85 mm Hg on one occasion and 145/95 mm Hg on another has an average blood pressure of 140/90 mm Hg and is said to have stage 1 hypertension.
When systolic and diastolic pressures fall into different categories, the JNC advises physicians to rate overall blood pressure by the higher category. For example, 150/85 mm Hg is classified as stage 1 hypertension, not prehypertension. This is also an example of systolic hypertension — defined as a systolic pressure of 140 mm Hg or higher and a diastolic pressure below 90 mm Hg.
The JNC notes that people in the normal category — those with blood pressure below 120/80 mm Hg — have the lowest risk of developing cardiovascular disease. Patients in the “prehypertension” category have a greatly increased risk of developing hypertension and should make changes in their lifestyle to reduce the risk. Patients with stage 1 hypertension generally require medication, although aggressive changes in lifestyle sometimes eliminate the need for medication.
What does blood pressure measure?
Blood pressure reflects both how hard your heart is working and what condition your arteries are in. The formula is as simple as ABC — or actually, C × A = B. That is, cardiac output times arterial resistance equals blood pressure.
Cardiac output is the amount of blood your heart pumps per minute. With each beat, your heart propels about 5 ounces of blood into the arteries. That adds up to about 4 to 5 quarts over the course of a minute of normal activity. During strenuous activity, your heart must pump considerably more blood to meet your body’s increased demand for oxygen.
Arterial resistance is the pressure the walls of the arteries exert on the flowing blood. As blood pushes into the arteries with each heartbeat, it forces the artery walls to expand, much like an elastic waistband stretches to accommodate your body. When the blood flow ebbs, the vessel returns to its original shape. The less flexible the vessels are, the greater the arterial resistance. Narrowed, tightened, or inflexible vessels result in a higher pressure at any level of flow. As cardiac output or arterial resistance increases, so does blood pressure.
Natural blood pressure controls
Your blood pressure is never constant, nor should it be. Your body continually adjusts cardiac output and arterial resistance to deliver oxygen and nutrients to the tissues and organs that most need them — your muscles during a jog or your digestive system at mealtime, for example. Your blood pressure also varies according to the time of day. It’s highest in the morning and lowest at night during sleep.
Your body can make dramatic adjustments in blood pressure within seconds. A sprint for the elevator, the sound of breaking glass, or a confrontation with someone may send blood pressure soaring from an idling 110/70 mm Hg to a racing 180/110 mm Hg or higher.
These changes occur without conscious thought and are directed by complex interactions among your central nervous system, hormones, and substances produced in your blood vessels. The layer of cells lining the inner wall of blood vessels (known as the endothelium) produces an enormous number of vasodilators and vasoconstrictors — chemicals that cause the vessels to widen or narrow. The endothelium helps maintain the tone of your blood vessels by releasing these substances as your body’s needs change. As long as your blood pressure is in the normal range, healthy vessels tend to be dilated.
When blood pressure gets too high (such as during times of stress) or too low (when you’re dehydrated, for example), pressure-sensing nerve cells located throughout your circulatory system relay this information to your autonomic nervous system. The autonomic nervous system manages the involuntary activities of smooth muscles, including those in the intestines, sweat glands, airways, heart, and blood vessels. It responds by setting off a chain of events designed to restore blood pressure to normal levels.
A complex chain reaction
The autonomic nervous system is divided into two parts: the sympathetic nervous system and the parasympathetic nervous system. The sympathetic nervous system prepares the body for action by quickening heart rate and breathing, while the parasympathetic nervous system has the opposite effect. The sympathetic nervous system rules during times of stress or fear. The parasympathetic governs during sleep.
When your blood pressure drops suddenly, the sympathetic nervous system compensates by releasing two neurotransmitters, or chemical messengers, from nerve endings: norepinephrine and epinephrine (also called adrenaline). These substances stimulate your heart muscle and cause your blood vessels to tighten. This reaction speeds your heart, increases cardiac output, and raises your blood pressure. To lower the pressure, the parasympathetic nervous system releases acetylcholine, a neurotransmitter that slows the heart.
The autonomic nervous system can also trigger specific organs to release chemicals that regulate blood pressure. For example, when blood pressure drops, the sympathetic nervous system signals your kidneys to release an enzyme called renin into the circulatory system. Renin, in turn, triggers the production of angiotensin, a protein that helps increase pressure by constricting the walls of small arteries. Angiotensin also stimulates your adrenal glands to secrete the hormone aldosterone, which causes the kidneys to conserve sodium and water, thereby raising blood volume and blood pressure. Together, this sequence of events is called the renin-angiotensin-aldosterone cascade.
Given the many mechanisms the body uses to regulate blood pressure, there are a number of ways something could go wrong. Some researchers suggest, for instance, a lack of vasodilators — particularly nitric oxide, which is also known as endothelium-derived relaxing factor — or an overproduction of certain vasoconstrictors, such as endothelin, can cause some cases of hypertension, although this hasn’t been proved.

Step up to better blood pressure

Harvard Health Publications

http://www.health.harvard.edu/newsletters/Harvard_Mens_Health_Watch/2012/July/step-up-to-better-blood-pressure?utm_source=HEALTHbeat&utm_medium=email&utm_campaign=HB072812
JUL 2012



To stay in the healthy zone, lock in the basics and talk to your doctor about escalating your medications.

Are you being treated for high blood pressure but your numbers are still higher than you want them to be? Your situation is fairly common, and there is much you can do. First, lock in on the basic moves, like regular exercise, that will help bring blood pressure into line. Then you and your doctor can take additional steps, such as home blood pressure monitoring or reducing salt intake further.

When self-help measures fail, doctors are sometimes forced to add more medication, says Dr. William Kormos, editor in chief of Harvard Men's Health Watch and a primary care physician at Massachusetts General Hospital. "There are many men who are always resistant to you adding on another pill, but if people aren't doing the other things, then our only choice is to use the medications."

Hypertension danger zones
Hypertension danger zones


Hypertension has far-reaching effects all over the body. High blood pressure not only harms your arteries, making them stiffer and narrower, but can also damage your heart, brain, eyes, and kidneys. These are known as the "target organs" of hypertension.

Out of control

Whatever your blood pressure, the risk for harm persists continuously until your pressure dips below 120 systolic (the upper number) and 80 diastolic (the lower number). Above this threshold, the risks increase. For anyone diagnosed with high blood pressure (hypertension), the first goal is to bring blood pressure under control. To your doctor, that means getting the numbers below 140/90 millimeters of mercury (mm Hg).

In a report in Circulation, researchers took a look at information about people with hypertension obtained from the National Health and Nutrition Examination Survey (NHANES). The people surveyed included more than 13,000 adults with high blood pressure. Based on 2007–2008 NHANES survey data, some 68 million Americans have hypertension, and only about half of them have their blood pressure under control.

Among the 33 million out of control is a special class of people with hypertension known to doctors as "treated but uncontrolled." These are people who have sought medical treatment to get blood pressure below 140/90—or perhaps even lower if they have diabetes or kidney disease—but for whom treatment is not working well enough.


Lock in the basics

Fortunately, we know what to do about hypertension. True lifetime control requires a healthy lifestyle and optimizing medications. All of the components of a healthy lifestyle act to control blood pressure. Indeed, not following these basics is what leads to hypertension.
  • Maintain a healthy weight.
  • Eat a healthy diet rich in fruits, vegetables, and whole grains Get regular physical exercise.
  • Drink alcohol in moderation (one to two drinks per day for men).
  • Don't smoke.

What more can you do?

Have you done your best with the basics and want to escalate your hypertension care? Here are some things you and your doctor can work on together.

Adopt the DASH diet: The medically proven Dietary Approaches to Stop Hypertension (DASH) plan, especially the low-sodium version, can lower your blood pressure by 10 points or more. (You can get more details about the DASH diet at health.harvard.edu/122.) The DASH diet emphasizes fruits and vegetables and reduces saturated fat, sugar, and salt.

Reduce salt: The basic DASH diet calls for limiting sodium to 2,300 milligrams (mg) daily. Studies show that for middle-aged or older people, African Americans, and those with hypertension, limiting sodium to 1,500 mg works even better for lowering blood pressure.

Monitor your own blood pressure: There are a couple of important things home monitoring of blood pressure can do. For one, it can provide a more accurate, long-term portrait of your pressure. Also, some people experience "white coat hypertension," in which blood pressure spikes higher than normal when measured at the doctor's office. Home monitoring can prevent the white coat effect.


Make your meds work for you

In established hypertension, medication plays a vital role in achieving your blood pressure goals. Taking medications as recommended is fundamental to maintaining good control. An inadequate level of medication therapy—either because you are not being prescribed enough medication, or are not taking those you are prescribed as directed—is often at the root of uncontrolled hypertension.

The NHANES survey provides some insight. In the 2005–2008 survey data, about one-third of all people with uncontrolled hypertension were already taking medication. However, seven out of 10 people in this group (treated but uncontrolled) were taking only one or two medications. These folks were older and were at significantly higher risk of cardiovascular problems than people whose hypertension was adequately controlled with the same number of medications.

Naturally, many men would prefer not to take additional medications with the added expense and potential for side effects that comes with them. But over time, inadequate blood pressure control can have devastating consequences (see box below). By combining medications that work to lower blood pressure via different physiological "control circuits" in the body, your doctor can help you reach your target pressure. "You have to add medications for some people just to get their blood pressure better controlled," Dr. Kormos says. "You try to pick medications in different classes that complement each other and won't just be redundant."

On the other hand, nutrition, exercise, and other lifestyle measures can reduce the need for such medications and potentially enable you to stop taking some of them eventually. Is it time to schedule a reality check with your doctor about your blood pressure?



How hypertension harms the body
Hypertension is called the silent killer because you don't feel its effects directly. But over the years, the quiet effects of persistent high blood pressure grow louder and more noticeable. Eventually, hypertension damages not just the blood vessels themselves, but also the heart, brain, kidneys, and eyes. These are the "target organs" of hypertension, meaning the organs most likely to be affected by the disease.
  • Stroke: Arteries weakened by hypertension may rupture in the brain (hemorrhagic stroke). Or, clotting can block blood flow (ischemic stroke).
  • Blocked arteries: Increased blood pressure damages the artery walls, causing inflammation that encourages plaque buildup and narrowing. The higher pressure also contributes to stiffening or "hardening" of the arteries.
  • Heart attack: High blood pressure causes changes in the physical makeup of your arteries. The middle layer of the arteries thickens. The lining is less healthy and tends to form more clots. If a clot forms in the coronary arteries, it triggers a heart attack.
  • Heart failure: Because of narrowing of the arteries, the heart has to work harder. The left ventricle, the heart's main pumping chamber, becomes thicker and more muscular in order to contract with greater force. This thickened wall is stiffer and leads to impaired filling of the heart. Over time, these abnormal walls weaken, causing the heart to enlarge and lose strength.
  • Kidney damage: High blood pressure causes blood vessels supplying the kidneys to get narrow, weak, and less elastic, which compromises the blood supply to the kidney tissue. Also, high blood pressure damages the tiny filtering units of the kidney.
  • Vision loss: The arteries in the eye can become narrower and bleed, damaging the light-sensing retina (hypertensive retinopathy). High blood pressure can also cause swelling in the optic nerve.
  • Vascular dementia: Compromised blood supply to the brain can cause brain damage that accumulates over time, eventually impairing mental functioning.
  • Erectile dysfunction: By damaging arteries that direct blood to the penis, hypertension can contribute to erectile dysfunction (ED), or the inability to achieve or sustain an erection sufficient for sexual intercourse.
  • General organ damage: Narrowing of the arteries and increased clotting deprives the organs of adequate blood supply and its oxygen and nutrients. Tissues accumulate damage over time.

Friday, July 27, 2012

Two apples a day keeps the cardiologist away

http://www.todayonline.com/Focus/Health/EDC120727-0000097/Two-apples-a-day-keeps-the-cardiologist-away



LONDON - Just two apples a day could help protect women against heart disease by cutting their cholesterol levels, according to new research.

Scientists found apples significantly lowered blood fat levels in postmenopausal women, the group most at risk of heart attacks and strokes.

Snacking on the fruit every day for six months slashed cholesterol by almost a quarter, reported the Daily Telegraph.

The biggest reduction was seen in low-density lipoprotein, the so-called "bad" cholesterol that furs up arteries and raises the risk of a life-threatening clot forming near the heart or brain.

The findings, by a team of researchers at Florida State University in the United States, support previous evidence that apples could be good for the heart.

But the latest study suggests they could benefit one of the highest-risk groups.

Around 45 per cent of British women will suffer from heart disease or a stroke and it is the biggest single cause of death among post-menopausal women.

Up to the menopause, women appear to have a natural immunity to heart disease and the rate of illness is only a third of that seen in men.

But from the age of around 50 onwards, the incidence increases sharply.

Researchers wanted to see if eating the equivalent of two apples every day could have a significant effect on heart disease risk.

They recruited 160 women who had been through the menopause and got half to eat 75 grammes a day of dried apple - the equivalent of two medium-sized fresh apples.

As a comparison, the other half were told to eat the same quantity of prunes to see if they had a similar effect. Each volunteer underwent blood tests every three months for one year.

The results, published in the Journal of the Academy of Nutrition and Dietetics, showed that after three months total cholesterol levels in the apple-eating group had dropped by nine per cent and LDL cholesterol by 16 per cent.

After six months, levels were even lower, with total cholesterol down 13 per cent and LDL levels dropping by 24 per cent. There was no further decline in the remaining six months of the experiment.

Prunes lowered cholesterol levels slightly but not to the same extent as the dried apple.

In a report on their findings the researchers said: 'Consumption of about two medium-sized apples can significantly lower cholesterol levels as early as three months.'

British consumers munch their way through nearly 500,000 tons of apples a year.

In 2009, a Polish study revealed two apples a day also halved the risk of bowel cancer in adults.

And research by scientists at St George's Hospital Medical School in London shows lung function is boosted in middle-aged men if they eat at least one apple every day. AGENCIES

Office workers burn as many calories as hunter gatherers

http://www.todayonline.com/World/EDC120727-0000098/Office-workers-burn-as-many-calories-as-hunter-gatherers



LONDON - Office workers burn as many calories as their hunter gatherer forebears meaning the obesity epidemic cannot be blamed on our lack of exercise, a study suggests

Researchers found that western men and women used strikingly similar amounts of energy each day compared with peers from a traditional community from the open savannah of Tanzania.

Despite trekking great distances each day to forage and hunt for game, results showed that the members of the Hadza tribe burned no more calories each day than a group of Americans and Europeans, reported the Daily Telegraph.

Experts have long assumed that our hunter-gatherer ancestors would have used up more energy than we do today, indicating that a lack of exercise could be behind the current obesity epidemic.

But the study in the PLoS ONE journal - the first to directly measure how much energy hunter-gatherers use - suggests that the rate at which humans use up calories remains relatively constant regardless of lifestyle.

Professor Herman Pontzer, of Hunter College in New York, who led the study with colleagues from Stanford and Arizona universities, said: "The vast majority of what we spend our calories on is things you will never see like keeping our organs and immune system going. Physical activity is just the tip of the iceberg.

"If you spend a bit more (energy) on something like physical activity, you spend a bit less on something else but you do not notice it. This study shows that you can have a very different lifestyle, but (energy use) all adds up tot he same level no matter what."

It follows that the modern obesity problem is more likely down to our higher consumption of food than our ancestors, rather than our lower rates of physical activity, he added.

"People argue about why it is that Westerners are getting so fat, and at the end of the day it has to be the fact that we are taking in more energy from food than we are burning - but is the big problem that we are taking in too many calories, or that we are not burning enough?

"But even if we had a lifestyle like our ancestors did ... (we) would not burn more calories than we do today. That has not changed a lot, but over the last 50 years we are eating a lot more than we need to be, so that gets to the heart of this issue."

Despite its apparent limited impact on obesity, Prof Pontzer emphasised that exercise has a wide variety of physical benefits and is essential for keeping the body healthy.

The fact that the Hadza spend more of their daily energy output on physical exercise could be behind the good health of older tribe members, who are much more resistant to chronic illnesses such as heart disease than Westerners, he said.
"We are not saying that physical activity is not important for health - clearly it is - but it does not appear to be the main cause of obesity." AGENCIES

High-carb diet tied to breast cancer risk for some

http://uk.reuters.com/article/2012/07/27/us-carbohydrates-idUKBRE86Q02020120727
Fri Jul 27, 2012 2:49am BST



(Reuters) - Older women who eat a lot of starchy and sweet carbohydrates may be at increased risk of a less common but deadlier form of breast cancer, according to a European study.
The findings from a study of nearly 335,000 European women, published in the American Journal of Clinical Nutrition, do not prove that sweets, French fries and white bread contribute to breast cancer - but they do hint at a potential factor in a little understood form of breast cancer.
Specifically, the study found a link between high "glycemic load" and breast cancers that lack receptors for the female sex hormone estrogen, so-called "ER-negative" breast cancers.
A high glycemic load essentially means a diet heavy in foods that cause a rapid spike in blood sugar, such as processed foods made from white flour, potatoes and sweets.
The study, conducted by Isabelle Romieu of the International Agency for Research on Cancer in Lyon, France, looked at nearly 335,000 women who took part in a long-running European study on nutrition factors and cancer risk.
Of these, 11,576 developed breast cancer over a dozen years. Overall, there was no link between breast cancer risk and glycemic load, as estimated from diet questionnaires the women completed at the study's start.
But the picture changed when the researchers focused on postmenopausal women with ER-negative cancer. Among women in the top 20 percent for glycemic load, there were 158 cases of breast cancer, versus 11 cases in the bottom 20 percent - a 36 percent higher risk.
ER-negative tumors account for about one-quarter of breast cancers. They typically have a poorer prognosis than ER-positive cancers because they tend to grow faster and are not sensitive to hormone-based therapies.
Christina Clarke, a research scientist at the Cancer Prevention Institute of California in Fremont, and a consulting assistant professor at Stanford University, said the results are interesting because so little is known about what cases ER-negative breast cancers. Most breast tumors have their growth fueled by estrogen.
"This study gives us a really important clue for future research," said Clarke, who was not involved in the study.
Diets with a high glycemic load are associated with a bigger secretion of insulin, a hormone that regulates blood sugar. High insulin levels, in turn, have been linked to certain cancers, possibly because insulin helps tumors grow.
The current findings hint at a role for "insulin pathways" in ER-negative breast cancer, Clarke said, adding that more research definitely needs to be done.
She noted that while there is no single factor in any woman's risk of breast cancer, the findings offer more incentive to eat a balanced diet that limits refined carbohydrates in favor of healthier fare - like lean protein, vegetables, "good" fats and high-fiber grains.
"Really, you want to avoid these (high glycemic load) diets anyway," she added. SOURCE:bit.ly/MZY2qw
(Reporting by Amy Norton; Editing by Elaine Lies and Bob Tourtellotte)

Sunday, July 22, 2012

Knees and Your Weight

http://inhealth.about.com/knocking-out-knee-arthritis/knees-and-your-weight?did=t5cc_rss4
Content provided by the Faculty of the Harvard Medical School



Obese people with arthritic knees have about 3 1/2 fewer years of able, pain-free life than slim people with healthy knees. That estimate comes from a new study. It focused on U.S. adults ages 50 to 84. Researchers used census data and other sources. They made estimates of how long people live with obesity and knee osteoarthritis. They also calculated how much of that time is hampered by pain and disability. For example, people may have trouble walking. The study found that obese people with arthritic knees lose an average of 3 1/2 healthy years. For obese people without knee problems, the loss is 2 1/2 healthy years. People with knee arthritis and normal weight lose nearly 2 years of good health, the study found. The journal Annals of Internal Medicine published the study. HealthDay News wrote about it February 14.

What Is the Doctor's Reaction?

Similar to most doctors, I encourage overweight and obese patients to lose weight by pointing out the health risks. Here are some of the ones linked with obesity:
  • Diabetes
  • High blood pressure
  • Heart disease
  • Certain cancers, such as breast cancer in women and the more aggressive types of prostate cancer in men
These are conditions that shorten life span. But today many people are concerned with quality of life as they age, even more than how long they live.
Some medical conditions severely reduce quality of life. Osteoarthritis, especially in the knees, is high on this list. Yet I usually don't mention the link between weight and knee osteoarthritis until an overweight person complains about knee pain.
A new study reminds us how much the combination of obesity and osteoarthritis of the knee can reduce quality of life. The journal Annals of Internal Medicine published the study February 15.
Osteoarthritis breaks down cartilage. This is the tissue that covers and protects the ends of bones. Osteoarthritis can appear in many joints. The risk is higher for the knee because it bears weight. This means it is subject to daily wear and tear as well as sudden injury.
Why do some people get osteoarthritis while others don't? Excess weight is a major reason. Demanding physical activity earlier in life plays a role. So do your genes. If your parents or grandparents had arthritis, you are more likely to develop it yourself.
Gender, race and ethnicity also make a difference. Women are more likely to develop knee osteoarthritis than men. Obese black women have a higher risk than white and Asian women with similar body weights.

What Changes Can I Make Now?

Knee osteoarthritis can happen to anyone. Today 1 out of 3 people over age 62 has some amount of osteoarthritis in one or both knees. Obesity has been rising quickly. So the percentage of people with osteoarthritis of the knee will surely increase.
People will lose an average of 3 ½ years of being pain-free if they become obese and also develop knee osteoarthritis. Obesity is defined as a body mass index (BMI) of 30 or greater. If you have a family history of knee osteoarthritis, you probably will have a reduced quality of life for even longer. Prior knee injury or prolonged physical demands on your knees also increase the number of quality years lost.
You can't totally prevent knee osteoarthritis if you are destined to have it. But you can delay how soon your symptoms begin. You also have a good chance of preventing it from becoming severe and disabling.
Obviously, you should lose weight if needed. Exercise is equally important, even if you have trouble losing weight. Regular exercise can strengthen the muscles around the knees. The stronger and bigger muscles can absorb much of the day to day trauma your knees endure.
Choose the right kind of exercise. You probably should avoid running and fast walking on the sidewalk or pavement. If you love jogging or fast walking, do it on a track or treadmill. Wear well-cushioned shoes to help reduce the impact on your knees. Consider cycling or swimming, which may be better choices.
Also do leg resistance training 2 to 3 times per week. Using weight machines, such as Cybex or Nautilus, strengthens the muscles around the knees. Range-of-motion exercises help maintain joint function. They also help prevent stiffness.

What Can I Expect Looking to the Future?

Osteoarthritis has no cure. So we must focus on preventing knee pain and disability. Knee replacement is a last resort. But the number of knee replacements will continue to rise until more people maintain a healthy weight and do the right kinds of exercise.
Growing new cartilage probably will happen. It can be done now in the laboratory. But implanting new cartilage and getting it to grow inside the knee remains a challenge.
Last Annual Review Date: Feb 16, 2011Copyright: Harvard Health Publications

Tone Your Arms with No Weights & No Pushups

http://caloriecount.about.com/tone-your-arms-no-weights-no-b579924?utm_source=newsletter&utm_medium=email&utm_campaign=newsletter_20120722&utm_term=title1




It’s not always possible to have access to a gym or a wide range of exercise equipment. However, it is important to keep your workouts well rounded by including upper body exercises, cardio exercises, lower body exercise, and even core exercise. Push-ups are usually the first upper body exercise that comes to mind when people think of upper body moves that require no equipment.  Although there are many forms of pushups that can be done at any fitness level, there are also a variety of other no-equipment upper body moves that can be done to tone your arms and upper body.  

Below is one of my favorite workouts designed to shape your arms.  It’s very challenging and is as simple as clapping your hands. All it requires is a timer or clock to track your time and a towel, rag, or old t-shirt.

After you warm up and stretch your arms complete the following moves: (Replace the exercise equipment seen on the linked pictures with your towel) There is a link to a video of this workout below. 
  1. One Minute Forward Shoulder Rotations
  2. 20 Reps of Front Raises with Chest Press
  3. One Minute Backward Shoulder Rotations
  4. 20 Reps Right Side Tricep Pull Back
  5. One Minute Extended Arm FULL Claps
  6. 20 Reps Left Side Tricep Pull Back
  7. One Minute Extended Arm FULL Claps
  8. 20 Reps Front Back Shoulder Press (be careful here if you have trouble with your shoulders)
  9. 20 Reps Single Right Arm Towel Bicep Curls
  10. 20 Reps Single Left Arm Towel Bicep Curls

Take a short break. Hydrate with water and repeat all ten steps above once more. You can repeat again in 2-3 more days.