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to your Address Book or Safe List. Learn how here. | February 20, 2011 | |  |  | What Your Doctor May Not Tell You About High Blood Pressure | | | Drug-Free Treatment Reverses Even Bone-on-Bone Arthritis... | | | Bagged Lettuce Can Look Fine But Still Harbor Dangerous Bacteria | | | Natural Diabetes Cure | | | Even Not-So-High Heels Can Cause Anatomical Damage | | | |  |  | |  | |
 | | What Your Doctor May Not Tell You About High Blood Pressure My friend Naomi was diagnosed with high blood pressure and went on medication prescribed by her doctor. Within a few months, she was back at the doctor’s office, her blood pressure heading up instead of down. It turned out that she was not taking her medication properly -- and that the drug she had been given was not the most appropriate one for her. Naomi is hardly alone. Nearly one-third of US adults have hypertension (blood pressure higher than 140/90), a symptomless disease that, if not appropriately managed, can result in a heart attack or stroke. I spoke to Mark C. Houston, MD, director of the Hypertension Institute at Saint Thomas Medical Group in Nashville and author of What Your Doctor May Not Tell You About Hypertension. He told me that failure to take medication properly is one primary reason why high blood pressure is often so hard to get under control. Another problem is that finding the right medication or combination of medications can be tricky, and often doctors have resorted to a "try this, try that" approach. Good news: Recent research has helped clarify which types of drugs are likely to work best for certain patients. So if you have recently been diagnosed with hypertension or if your medication is not working, it’s time to talk to your doctor about... Your levels of the blood pressure-modulating enzyme renin. A recent study showed that people with different blood levels of renin responded differently to various hypertension drugs -- and that taking the wrong kind of medication actually made blood pressure go up. Patients with high-renin hypertension responded best to... - Angiotensin-converting enzyme (ACE) inhibitors, which reduce blood pressure by blocking an enzyme that produces angiotensin II (a hormone that causes blood vessels to narrow)... dilating arteries... and reducing inflammation and oxidative stress. They also decrease clotting, further protecting against heart attack and stroke.
- Angiotensin receptor blockers (ARBs), which work by blocking receptors for angiotensin I (the precursor to angiotensin II). They also dilate blood vessels and ease inflammation and oxidative stress.
- Direct renin inhibitors, which reduce angiotensin I and relax blood vessels.
- Beta-blockers, which reduce blood pressure by reducing nerve signals to the heart and blood vessels and slowing the heart rate.
People with low-renin hypertension responded best to... - Calcium channel blockers, which combat high blood pressure by preventing calcium from moving into arteries and heart muscle cells and allowing arteries to dilate.
- Diuretics, which cause kidneys to remove excess sodium and water from the body and dilate blood vessel walls.
How your blood pressure is being measured. The blood pressure cuff in your doctor’s office may not be reliable if you are prone to "white-coat hypertension" (blood pressure that rises from the anxiety of being in the doctor’s office) or "masked hypertension" (lower blood pressure numbers in the doctor’s office but consistently higher numbers at other times). Ask your doctor if you might benefit from using a high-quality home blood pressure monitor (sold over the counter in pharmacies and online for $50 to $150) to keep track of your readings every day. Also discuss the option of using a 24-hour ambulatory blood pressure monitor. A cuff worn on your arm and a small device clipped to your belt record your pressure every 15 to 30 minutes for 24 hours... then your doctor analyzes that data. How consistently you take your medicine. The different types of hypertension drugs can cause a variety of side effects, such as fatigue, memory problems and sexual dysfunction. If you experience these or other problems, do not suffer in silence -- and certainly do not keep silent if you sometimes skip doses to avoid side effects. Tell your doctor and discuss alternative drugs. But if you are conscientious about taking your meds, be sure your doctor knows that, too. Otherwise he or she may wrongly assume that any lack of effectiveness is due to your noncompliance rather than to a need for a different medication. When to take your medication. Since blood pressure medications are effective for only 24 hours, it is important to take them at the same time every day. Don’t drive yourself crazy if you are an hour early or an hour late, but do not be off by several hours. Very important: Most heart attacks and strokes happen between 3 am and 10 am, which is when blood pressure typically is highest. That’s why the new recommendation generally is to take your medicine at night, Dr. Houston said -- to block that early morning blood pressure spike. Source: Mark C. Houston, MD, is an associate clinical professor of medicine at Vanderbilt University School of Medicine and director of the Hypertension Institute at Saint Thomas Medical Group, both in Nashville. He is the author of four books, including What Your Doctor May Not Tell You About Hypertension and the upcoming What Your Doctor May Not Tell You About Heart Disease (both from Grand Central). www.HypertensionInstitute.com
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 | | Bagged Lettuce Can Look Fine But Still Harbor Dangerous Bacteria Many consumers assume that ready-to-eat bagged lettuce will start to look nasty by the time any foodborne bacteria build up to unsafe levels. But a recent study published in Journal of Food Science shows that this is not the case. Scientists bought packaged romaine and iceberg lettuce at stores, then opened the bags and sprayed the lettuce with Escherichia coli (E. coli), a common strain of bacteria that can cause severe diarrhea, abdominal cramps and even organ damage. The bags were then resealed and stored at either 41°F (the FDA-recommended safe storage temperature) or 53°F (what experts call a "mild temperature abuse situation") until their labeled "best if used by" date. Results: At the lower temperature, E. coli survived but its growth was limited... at the higher temperature, E. coli proliferated to potentially harmful levels within three days -- even though the lettuce still looked fine. Self-defense: Set your refrigerator to no higher than 41°F. This is easy if the control mechanism displays the exact temperature setting. But: The control knobs on some refrigerators just show various warmer or cooler options in the manufacturer’s preset range of about 33°F to 47°F -- so you can’t tell exactly how cold the fridge is. Solution: If your refrigerator has no temperature display or you suspect that it isn’t accurate, buy a refrigerator thermometer (about $2 and up at kitchenware stores and online). Source: Yaguang Luo, PhD, is a research food technologist at the USDA Agricultural Research Service in Beltsville, Maryland, and leader of a laboratory study on E. coli growth in packaged lettuce.
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 | | Natural Diabetes Cure Scientists at the University of Pittsburgh have established that 83% of obese patients who try a new natural treatment, code-named "LGB," that dramatically corrects the way your body metabolizes food, see dramatic improvement in their diabetes. In fact, many see total reversal of the disease. Dr. Philip Schauer, who led the study, also comments, "Most patients in the study with type 2 diabetes... achieved excellent biochemical [blood sugar] control and were able to reap the clinical benefits of withdrawing from most, if not all, antidiabetes medications, including insulin." LGB works in as little as 90 minutes, even on morbidly obese patients... | |
Learn more...  | |  | | |
| | | Even Not-So-High Heels Can Cause Anatomical Damage When we wear high heels, we look taller and leaner and our derrieres stick out oh-so-becomingly. But: Even heels of a relatively moderate height can permanently damage muscles, tendons and joints, according to two recent studies. Details... In the first study, European researchers used ultrasound and MRI to analyze the leg anatomy of women who had worn shoes with a minimum heel height of five centimeters (just under two inches) at least five days per week for two or more years. Compared with women who did not regularly wear heels, the high-heelers had calf muscle fibers that were 13% shorter, on average... Achilles tendons (which attach calf muscles to heel bones) that were thicker and stiffer... and reduced range of motion in the ankles. This explains why long-term heel-wearers often feel pain when they wear flat shoes or sneakers. The second study, from Iowa State University, assessed the forces acting on the knee joint and the heel strike-induced shock wave that moves up the body when a woman walks in flats... in two-inch heels... or in 3.5-inch high heels. Results: The higher the heel, the greater the compression on the inside of the knee -- a factor that could contribute to joint degeneration and knee osteoarthritis. Researchers also found that high heels altered posture by changing the position of the joints at the ankle, knee and hip, which could lead to low-back strain. Our expert’s views: High heels are OK to wear occasionally, we heard from podiatric surgeon Johanna Youner, DPM, of New York Downtown Hospital, who was not affiliated with the studies. Her advice: Reserve high heels just for special events, or at least avoid wearing them on consecutive days or for more than two hours on any given day, so calf muscles have a chance to elongate. Take off your high heels periodically during the day and stretch your calf muscles... stretch again at the end of the day. Limit the distance you walk in heels -- for instance, do not wear them to walk down city streets or trek through the mall. Source: Johanna Youner, DPM, is a podiatric surgeon in private practice and an attending physician at New York Downtown Hospital, both in New York City. www.HealthyFeetNY.net
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 |  |  Tamara Eberlein, the editor of HealthyWoman from Bottom Line, has been a health journalist for nearly three decades. An award-winning author of four books, she is committed to helping other women in midlife and beyond live healthy, fulfilling lives. She is also the "chief health adviser" to her husband of 25 years, college-age twins and teenaged son. |  | | Bottom Line Publications | 281 Tresser Boulevard, 8th Floor | Stamford, CT 06901
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