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Showing posts with label Blood. Show all posts
Showing posts with label Blood. Show all posts

Sunday, August 11, 2013

Self-Monitoring Blood Pressure Appears to Improve Results, Study Finds

Patients engaged in their health care do better, expert saysPatients engaged in their health care do better,

By Steven Reinberg

HealthDay Reporter

TUESDAY, Aug. 6 (HealthDay News) -- Tracking your own blood pressure at home can help you control hypertension, a new research review finds.

And if you have a clinician's help in monitoring your blood pressure, you'll likely do even better, at least in the short term, according to the study, which was published Aug. 6 in the journal Annals of Internal Medicine.

"For adults with hypertension who are willing and able to monitor their blood pressure at home in conjunction with their health care center, self-monitored blood pressure can be a useful tool to lower blood pressure, and possibly lower the risk of cardiovascular events, at least for the short term," said lead researcher Dr. Ethan Balk, from the Institute for Clinical Research and Health Policy Studies at Tufts Medical Center in Boston.

Whether the benefits extend beyond one year needs further research, said Balk, whose team looked at more than 50 studies on the effectiveness of home blood pressure monitoring.

Self-monitoring includes keeping a record of the readings so a physician can determine if your blood pressure medicine is working effectively or needs tweaking. Left uncontrolled, high blood pressure can lead to stroke, eye and kidney damage, heart disease and disability.

Exactly how home monitoring keeps blood pressure levels low isn't clear, Balk said. "Likely reasons are improved monitoring and tailored treatment of blood pressure by both the clinician or nursing staff and the patient, and increased incentives to control one's diet and increase physical activity," he said. "But these explanations are purely conjectural."

Also, it isn't clear to what degree additional support enhances the benefits or which methods of additional support are best, Balk said.

"An important caveat is that the evidence refers to self-monitored blood pressure used in conjunction with clinicians and/or nurses who are using and monitoring the information," he said.

The results don't apply to people who decide on their own to measure their blood pressure at home without consulting medical professionals, he said.

The findings support current health care guidelines, said Dr. Gregg Fonarow, a professor of cardiology at the University of California, Los Angeles, and a spokesman for the American Heart Association.

"National and international guidelines, including those from the American Heart Association, recommend that patients with hypertension measure and monitor their blood pressure in the home setting, and a number of studies have shown this can result in better blood pressure control," he said.

"These findings ... highlight the importance of actively engaging patients in the measuring, monitoring, goal achievement and goal maintenance of their blood pressure," he said.

Blood-pressure-monitoring devices available in drugstores and other shops range in price from $30 to more than $100.

When choosing a device, the American Heart Association recommends an automatic, cuff-style, upper-arm monitor. Wrist and finger monitors are not recommended because they yield less reliable readings. Monitors for the elderly or pregnant women should be validated specifically for those purposes.

For the current report, Balk's team reviewed 52 published studies in which patients monitored their blood pressure with and without assistance. Such help ranged from educational materials to contact with a nurse or pharmacist or counseling over the telephone.

They found some evidence that monitoring blood pressure at home improved control at six months, but not at 12 months.

When patients got help, either through educational material or direct contact with medical professionals, home monitoring improved blood pressure control at both six and 12 months.

From this data, Balk's group concluded that home blood pressure monitoring is effective in the short term.


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Wednesday, August 7, 2013

High Blood Sugar Levels Tied to Small Increases in Dementia Risk

Elevated blood glucose may harm the brain, even in people without diabetes, researchers sayElevated blood glucose may harm the brain, even

By Brenda Goodman

HealthDay Reporter

WEDNESDAY, Aug. 7 (HealthDay News) -- Elevated blood sugar levels, even among people who don't have diabetes, are associated with an increased risk for dementia, a new study shows.

The effect was very subtle, however, suggesting that higher blood sugar levels may be more of a nudge toward memory loss than a shove.

"If I had diabetes and I read this study, my reaction would be relief," said Dr. Richard O'Brien, chair of neurology at Johns Hopkins Bayview Medical Center in Baltimore, who was not involved in the research. "The effect was small."

The risk increases tied to rising blood sugar (or blood glucose) levels ranged from 10 percent to 40 percent. O'Brien pointed out that other risks appear to have much greater impacts. Having a parent with dementia, for example, roughly doubles or triples a person's risk for developing the disease.

O'Brien recently conducted a different study that looked at a similar, but slightly different question: whether or not blood glucose levels were linked to brain changes of Alzheimer's disease. That study, published online July 29 in JAMA Neurology, concluded there was no connection.

But O'Brien's study had fewer participants than the current investigation, which means it may not have been large enough to detect the slight differences between people who did and did not have signs of Alzheimer's. And because his study was solely focused on Alzheimer's disease, it couldn't rule out the possibility that higher blood sugar levels might be contributing to other kinds of dementia, particularly when it's caused by damage to the small blood vessels of the brain.

"The studies are completely compatible with each other," he said.

The U.S. obesity epidemic has led to soaring rates of type 2 diabetes, which is characterized by higher than normal blood sugar. As the baby boom generation ages, Alzheimer's disease is also on the rise, and experts are trying to determine whether a connection exists between the two.

For the new study, published Aug. 8 in the New England Journal of Medicine, researchers followed more than 2,000 adults enrolled in the Group Health Cooperative, a nonprofit managed care collective in Washington State.

All study participants were aged 65 and older and free of dementia at the start of the study. Everyone had had at least five blood sugar checks in the two years prior to study enrollment.

At the start of the study, 232 people had diabetes, while 1,835 did not.

Through detailed health records kept on each participant, the researchers were able to estimate each person's average glucose levels.

Over the next seven years, on average, one-quarter of the participants developed dementia, including 450 who did not have diabetes and 74 with diabetes. About 20 percent of them had probable Alzheimer's disease, the most common form of dementia, while roughly 3 percent had dementia from vascular disease and slightly more than 3 percent were deemed to have dementia from other causes.


View the original article here