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Showing posts with label Improve. Show all posts
Showing posts with label Improve. 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.


View the original article here

Saturday, August 10, 2013

Could Hot Cocoa Improve Brainpower in Seniors?

Small early study hints it might help, but author says it's too soon to recommend nightly cupSmall early study hints it might help, but author

By Randy Dotinga

HealthDay Reporter

WEDNESDAY, Aug. 7 (HealthDay News) -- A preliminary new study links two cups of hot cocoa per day to improved memory skills in seniors who had low levels of blood flow in their brains.

So, should you start stocking up on Swiss Miss? Not necessarily.

The research is too limited to prove that cocoa directly boosted the brainpower of those with lower blood flow in the brain, and the findings don't say anything about long-term effects. In addition, drinking two cups of a sweet drink each day could cause or worsen obesity, which is linked to declines in brain function.

"Before we recommend cocoa, it's important to go back and figure out what's in it that's doing this and make sure it's sustainable," said study author Dr. Farzaneh Sorond, an assistant professor of neurology at Harvard Medical School. "I'd prefer people wait until we figure out how to get the benefit without the calories, sugar and fat that comes in cocoa."

Still, the research is allowing scientists to get a better handle on a somewhat mysterious topic -- the flow of blood in the brain. The brain cells known as neurons need fuel to do their job, and blood provides it.

"The brain is a greedy organ, with just 2 percent of body mass and 20 percent of energy requirements," explained Andrew Scholey, director of the Center for Human Psychopharmacology at Swinburne University in Australia. "It requires a constant supply of blood to deliver the metabolic fuels of glucose and oxygen. Blood flow to the brain reduces with aging, and this correlates with cognitive [mental] decline."

Previous research has linked cocoa, which is found in chocolate, to health benefits. In the new study, researchers wanted to find out if it would affect blood flow in the brain, and brainpower itself.

The researchers recruited 60 people with an average age of 73 and assigned them to 30 days of either drinking cocoa rich in flavanol -- which is linked to improved blood flow -- or drinking cocoa low in flavanol. The special cocoa was provided by Mars Inc., but the company didn't have any other role in the study.

Eighteen people had impaired blood flow in the brain when the study began. Almost all of the 60 participants had high blood pressure and half had a form of diabetes. Almost all -- 85 percent -- were white.

Brain blood flow improved by an average of 8 percent by the end of the study in those participants whose levels were low at the beginning. There was no effect among the others who had normal blood flow.

Those with lower blood flow also performed better on memory tests, improving the time they needed to complete tasks (dropping from an average of 167 seconds to 116 seconds), but it's not clear what this would mean in day-to-day life. Again, those with regular blood flow levels didn't improve.


View the original article here