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World Hypertension Day


Did you recently hear on the news that your previously “normal” blood pressure is now considered “high” and recommended new medical interventions? If so, you may want to hold off until you discuss this with your physician further, says a new report in JAMA Internal Medicine.

According to the University of Sydney and Bond University, getting more aggressive with your treatment could have unintended consequences. By lowering the threshold for drug treatment of adults considered at risk of extreme high blood pressure from 140/80 mmHg to 130/80, patients are at greater risk for medication side effects and feelings of anxiety and depression due to worry about the diagnosis. There’s also the concern that if there’s a switch in health insurance you could suddenly find yourself with a pre-existing condition.

There are other good reasons to not get more aggressive about treatment—the report says that as many as 80 percent of people who get medication receive no increased benefit against cardiovascular disease. How to know if you’re in the other 20 percent? Check with your doctor. Your health history is necessary to determine whether going on medication will be beneficial.

In the meantime, everyone can take proactive steps to improve their blood pressure. Here are a few ideas:

Drop the weight. There’s a reason doctors mention this frequently—you can reduce your blood pressure by about 1 millimeter of mercury (mmHG) with each kilogram (2.2 pounds) you lose.

• Watch your waistline. Carrying extra pounds around your waist can increase the risk of high blood pressure. For men, that means a waist of 40 inches or more; for women, 35 inches and over.

Check your snoring. For some people, snoring and waking up suddenly during the night can be signs of sleep apnea. Disrupted breathing from sleep apnea can raise your blood pressure, so it’s a good idea to get this checked out. Fortunately, losing weight can markedly improve sleep apnea.

Get moving. You know the drill; 30 minutes of exercise a day can improve your blood pressure. You can even break it up—new studies say that three, 10-minute bouts of exercise are also valuable. And strength training counts and is good for your bone health as well.

Shop the produce section. Increasing your consumption of fruit and vegetables, especially those rich in potassium, can help your blood pressure. And don’t forget the Dietary Approaches to Stop Hypertension (DASH) diet if you’d like more help.

Cut the salt. Even a small reduction in your sodium intake can make a big difference in your blood pressure, especially if you’re salt sensitive. For more on this, take a look at my earlier column on reducing sodium.

Happy Half-Hour? While one drink a day for women and two for men can help your blood pressure, more than that can raise it and make your medications less effective.

Quit smoking. Your blood pressure increases for every minute you smoke. So get some help and quit.

Dr. Nieca’s tip: A doctor who knows you and your health history will be the best judge as to whether you need to go on medication for your blood pressure. In the meantime, the tips above are a great way to keep your readings in the safety zone.

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Why Breakfast Still Matters

Diet fads come and go, but the latest one could actually be dangerous to your health—intermittent fasting, usually expressed by skipping breakfast. I recently spoke on The Doctors to discuss this trend and how it affects your cardiovascular health.

There are many reasons that I favor a healthy breakfast, including:

  • Studies show an association between skipping breakfast and obesity, thought to be linked to impulsive snacking during the day to slake hunger pains.
  • Eating breakfast is the first step to planning a healthier lifestyle and making better choices.
  • Eating more food earlier in the day when you’re most active is an excellent way to control weight. The old adage: eat breakfast like a king, lunch like a prince and dinner like a pauper, still has merit.
  • Studies show that regularly eating a healthy breakfast helps schoolchildren do better on tests.

But can skipping breakfast actually be dangerous? As my colleague, nutritionist Robert Ferguson, pointed out on The Doctors, if you are one of the 1.5 million Americans who develop undiagnosed type 2 diabetes per year, fasts can cause low blood sugar, which in turn can lead to lightheadedness and even fainting. Since most people don’t think of skipping a meal as being in the same vein as starting a new diet, too few people will check with their doctor first. ALWAYS check with your doctor before fasting.

The key to making breakfast part of a healthy lifestyle is making wise food choices. For example, eating eggs for breakfast is fine for people with healthy cholesterol, but be careful about what you eat with them. Adding fried potatoes, fatty meats such as sausage or bacon, and toast with butter greatly increases the saturated fat and calories. Instead, how about trying the Middle Eastern dish of shakshuka—eggs poached in a sauce made from tomatoes, onions and peppers? Or take a page from the Pacific Northwest toast craze and top a slice of grilled sourdough with a poached egg, arugula and a dash of hot sauce. As long as you have something from each food group with your meal you can’t go wrong.

No time in the morning? Try one of these super easy, make-ahead breakfasts that you can take with you:

  • Steel-cut oatmeal. You can make this in a slow-cooker, but for ultimate ease, add half-cup of oats to 2 cups of rapidly boiling water. Let boil for one minute and then put on the lid and take it off the heat. Allow it to sit overnight. In the morning pack up a few jars with the oats, milk of your choice, some fruit and perhaps a teaspoon of chopped nuts. Reheat in your office microwave.
  • Refrigerator oats. This recipe is reminiscent of European museli. Add a half-cup of rolled oats to a pint jar along with a half-cup of low-sugar yogurt or kefir, and a half-cup of the milk of your choice. Kick it up with a half-cup of berries or diced fruit and a teaspoon of toasted nuts or seeds. Stir well and refrigerate overnight.
  • Omelet muffins. Did you know you can make mini omelets in muffin tins? Beat eight eggs with 2 tablespoons of ice cold water. In the tins add some chopped veggies (bell peppers and asparagus are particularly good), a little baby spinach, maybe a teaspoon of low-fat cheese or chopped, cooked lean meat such as turkey. Pour the egg mixture evenly between the cups. Bake for 20 minutes at 350 degrees. When cool, pop two into a baggie and you’re good to go.

Try making a nutritious breakfast part of your healthy lifestyle. It can make the start of heart-healthy habits for 2018.

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Keeping those New Year’s Resolutions Going

Stop me if you heard this one: You hit the gym with great motivation after New Year’s, determined to work off all the Christmas cookies, ham, latkes, pot roast, eggnog and cocktails. You signed up for yoga, cut out sugar, bought a lot of kale and started drinking eight glasses of water a day.

Now, two weeks in your willpower is waning. The kale is lying limp in your vegetable drawer. You’re craving hot cocoa and pasta. And it’s so cold outside and so dark when the alarm goes off at 6 a.m. all you want to do is stay curled up in bed watching Netflix and eating comfort food.

“It’s only January,” you tell yourself. “I have plenty of time to get into beach shape before summer.”

Instead of putting your fitness resolutions on hold, there are ways to get back into shape that will not only help you look better, but feel better and help you ditch the winter blues.

  • Easy does it. Ignore anyone who says you have to be able to run a mile right from the start. Starting slowly and building over time will increase your confidence and your endurance.
  • Every step counts. Not a gym rat but not happy about walking in the cold? Many malls welcome walkers in the morning—or do a few laps while window shopping during your lunch hour.
  • Eat good to feel good. Eating a healthier diet doesn’t mean deprivation. You can enjoy the foods you’re craving in the cold by using healthier ingredients and being aware of portion size. And this is a good time to make sure you’re getting the nutrients you need to fight the winter blues and keep your immune system humming.
  • Netflix is your friend. That Netflix series you want to binge on can become your workout buddy. Bring your tablet to the gym and make it a rule that you can only watch while you’re on the treadmill or elliptical.