AMPK deficiency in smooth muscles causes persistent pulmonary hypertension of the new-born and premature death

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How To Recognize Normal Versus High Blood Pressure

DEAR DR. ROACH: I have been confused about what normal blood pressure is for me (or anyone). I know there is some debate on what normal is today, but let us say that normal is 120/80 mm Hg. Does this mean that 110/90 mm Hg, 130/70 mm Hg, or 150/50 mm Hg is also normal? Is there any significance of the ratio between systolic and diastolic blood pressure? — L.P.

ANSWER: Because so many people have high blood pressure, and the consequences of untreated or poorly treated high blood pressure include a risk for heart attacks and strokes, it's critically important to understand this thoroughly.

For a young, healthy person, the lower the blood pressure, the lower the risk of blood vessel damage that leads to these dreaded complications of heart attack and stroke. I routinely see people with blood pressures of 90/60 mm Hg who are just fine (although they are a bit more likely to faint).

But for middle-aged and older people, we define blood pressure as normal when the systolic (first or top number) pressure is less than 120 mm Hg and the diastolic (the second or bottom number) is less than 80 mm Hg. Elevated blood pressure is when the systolic pressure is between 120-129 mm Hg and the diastolic pressure is less than 80 mm Hg. It's considered hypertension when the systolic number is 130 mm Hg or greater, or the diastolic number is 80 mm Hg or greater.

So, all of the readings you proposed are hypertension — not just elevated blood pressure.

Of course, the higher the reading (in general), the higher the risk of damage to the blood vessels and, after some years, the higher the risk of heart attacks or strokes. It's not the ratio of the systolic and diastolic numbers that is of interest; it's the difference between them (also called the pulse pressure). So, with the numbers you gave, the pulse pressures are 20, 60 and 100 mm Hg. Independent of blood pressure levels, a higher pulse pressure confers additional risk to the person, mostly because very stiff blood vessels cause a high pulse pressure. Different types of blood pressure medicines affect pulse pressure differently.

What's a good platelet count?

DEAR DR. ROACH: Is a platelet count of 135,000 low or in the normal range for a 76-year-old male in good health, with no signs of abnormal bruising or bleeding? — P.R.

ANSWER: The normal range for a platelet count is 150,000-450,000 per microliter, so 135,000 is just below the lower limit of normal. However, it's quite rare to have abnormal bleeding with a platelet count like this, even under stress like a surgical procedure.

About 2.5% of the healthy population will have a platelet count below 150,000, so a level of 135,000 may not represent any disease at all. Typically, the risk of spontaneous major bleeding becomes high when platelet levels drop below 30,000.

The most common cause of low platelets in older adults is an immune-mediated condition called "immune thrombocytopenia," but there are many possible causes, including medications, bone marrow diseases, and liver disease. For a 76-year-old, if repeat blood counts show that the platelet count is stable in the 100,000 range, most experts would not do further testing in absence of any symptoms.

Dr. Roach regrets that he is unable to answer individual questions, but will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth@med.Cornell.Edu.

You Just Found Out You Have High Blood Pressure—Here Are 4 Things Doctors Recommend Doing First

If you've been diagnosed with high blood pressure, these diet and lifestyle changes may bring down your numbers.

Reviewed by Dietitian Karen Ansel, M.S., RDNReviewed by Dietitian Karen Ansel, M.S., RDN

Nearly half of all adults in the U.S. Are living with high blood pressure, according to the Centers for Disease Control and Prevention (CDC). If you're one of them, you might have heard that medication is the first line of defense. But medication isn't the only way to bring down your numbers.

When it comes to managing high blood pressure, doctors are also firm believers in lifestyle changes, like eating a healthy diet and exercising. "It may take a few weeks for you to see the benefit, but there's no doubt that lifestyle works," says Eduardo Sanchez, M.D., M.P.H., FAAFP, Chief Medical Officer for Prevention for the American Heart Association. "These habits can complement the medicine you're on, or even eliminate your need for them."

In fact, lifestyle changes are so powerful that research reveals they may significantly lower systolic blood pressure and drop the risk of cardiovascular disease by 30%.

So we spoke with doctors to learn their top four tips to lower high blood pressure—plus some other worthy moves to consider. Here's what they told us.

What Is High Blood Pressure?

High blood pressure (also called hypertension) develops when the blood flowing through your arteries pushes through at a higher-than-normal pressure—placing stress on your arterial walls. Over time, your arteries can become damaged, and that's what ups your risk for heart attack and stroke.

Blood pressure is measured in millimeters of mercury, or mmHg, for short. A healthy blood pressure is less than 120/80 mmHg. Your blood pressure is too high when you have a reading of 130/80 or higher. Anything in between is considered to be elevated, which may be a potential warning sign that your numbers are creeping up.

You Just Found Out You Have High Blood Pressure—Here Are 4 Things Doctors Recommend Doing First 1. Consider your eating habits

There's good evidence that a Mediterranean-style diet or DASH diet—both of which emphasize fruits, vegetables, healthy fats, whole grains and lean protein—can lower blood pressure by 8 to 12 mmHg, says Sanchez. In fact, research shows that the Mediterranean diet may reduce the odds of high blood pressure by 36%.

How do these diets work? "It seems to be a package," says Lawrence Appel, M.D., M.P.H., Director of the Welch Center for Prevention, Epidemiology and Clinical Research at Johns Hopkins University. "It's a combination of the foods you eat—an overall eating pattern—as opposed to single foods or individual nutrients in your diet."

2. Watch your sodium

Sodium is one nutrient that—on its own—can hike up blood pressure. "It may do this by causing your body to retain fluid, which expands the amount of fluid in your blood and can increase blood pressure," says Appel.

Research reveals that eating a very low-sodium diet with just 500 milligrams of sodium per day for one week may lower systolic blood pressure by 8 mmHg compared to consuming a high-sodium diet. However, our experts say that any amount you can cut could help. Studies on the DASH diet, which limits sodium to 1,500 to 2,300 mg daily, have also shown significant reductions in blood pressure.

Taking the salt shaker off the table can help, but it isn't the most important thing to do, says Sanchez. "Highly processed foods and foods you get from restaurants is where a lot of that sodium comes from," he says. "So think about cutting back there."

3. Get regular physical activity

Exercise can increase blood flow and strengthen your heart—both things that can reduce blood pressure. Research has found that multiple types of activity—including regular cardio exercise, high-intensity interval training, isometric exercise, and resistance training—may all benefit blood pressure.

Interestingly, isometric exercises—like planks and wall sits, where you hold the exercise versus moving through it—had an edge over some of the other types of exercise. Why? One theory: Squeezing your muscles to hold the exercise constricts the surrounding blood vessels and temporarily inhibits the flow of oxygen. Then, when you get out of the move, the release of pressure gives you a boost in blood flow.

"But really, the point here is to do whatever type of activity you enjoy. It's all good," says Sanchez. "Fitting in the recommended 150 minutes of moderate exercise a week can lower your systolic blood pressure by 4 to 9 mmHg."

4. Aim for a healthier weight

Even a little weight loss can be beneficial. "You don't have to get to a completely healthy weight," says Sanchez. "Just dropping some of that weight will result in a drop in systolic blood pressure anywhere from 5 to 20 mmHg."

Research finds that losing around 5 pounds was associated with a 6-point drop in systolic blood pressure. So small wins can pay off in big ways.

Other Tips for Managing High Blood Pressure

Here's a quick hit list of some other ways to reduce your blood pressure:

Limit or avoid alcohol. Lots of sneaky habits can increase your blood pressure. Like a nightly glass or two of wine. If you drink at all, women should have no more than one per day; men should have no more than two.

Quit smoking. Stopping smoking does more than help your blood pressure. "Quitting can save your life in so many other ways," says Sanchez. According to the CDC, it can add 10 years to your life.

Sleep well. Inadequate rest has been shown to up your odds of high blood pressure, says Sanchez. Exactly how isn't clear, but he recommends aiming for seven to nine hours of good-quality sleep each night.

Manage stress. Chronic stress in and of itself can raise your numbers. Additionally, stress can cause you to reach for less healthy foods, skip the gym, drink more and make other choices that may drive your numbers up, says Sanchez. Try doing something every day that relaxes you, whether that's a long walk with your dog, chatting with a friend, meditating or any type of self-care that makes you feel good.

The Bottom Line

Just because you have high blood pressure doesn't mean you can't get those numbers down. Yes, some people will require medication. However, eating a healthy diet, keeping sodium in check, losing some weight and getting regular exercise are the four most effective lifestyle changes doctors recommend to help lower your blood pressure. The bonus is that these habits will help your health in so many other ways, from reducing your odds of other chronic conditions to giving you more energy to live your life.

Read the original article on Eating Well.

More Pregnant Women Being Diagnosed With High Blood Pressure, Studies Show

Studies find more pregnant women are being diagnosed with hypertension

Studies find more pregnant women are being diagnosed with hypertension 00:57

BOSTON - Maternal mortality is on the rise in the U.S and a leading cause is pregnancy-induced hypertension.

Pregnancy-induced hypertension is essentially developing high blood pressure during pregnancy and according to KFF Health News, more pregnant people are being diagnosed with dangerously high blood pressure. That can cause serious complications for the mom, including organ damage, vision loss, heart attack, seizures, strokes, and in some cases death. It also threatens the life of the unborn baby.

Being overweight and having babies later in life are both risk factors but it can happen to anyone. If you're pregnant, make sure you go to all of your prenatal appointments where they will check your blood pressure and your urine and if you develop severe headaches, belly pain, blurred vision, or excessive swelling of the hands, ankles, or face, call your doctor right away.

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