What’s the Skinny On Salt?

By Beth Piraino, MD

If you were following the health news this week, you may have heard advice contrary to what we have always been told –too little salt is also no good and there’s no reason to toss your salt shaker. That might work for those who do not have heart disease, high blood pressure or kidney disease. For people with high blood pressure who are at risk for kidney disease or people who already have kidney or heart disease, large population studies such as this one do NOT point to safe advice.

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Migraines and Hypertension—Is there a Link?

Many people suffer from headaches, with migraines making up a particularly severe form that can greatly affect quality of life.  Anecdotally, we’ve all heard about people who suffered migraines and later found out they had severe high blood pressure that damaged the kidneys. But what does the science show? Are migraines linked to high blood pressure? This possible connection has been a subject of interest for many years and the results are actually conflicting. What complicates this issue further is that some blood pressure medications can cause headaches, while others are used in its prevention.

 

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Blood Pressure Matters even for Young “Invincibles”

By Alex Chang, MD, MS

A recent article published in the Journal of the American Medical Association found that rising blood pressure over time in 18-30 year old adults was associated with increased risk for atherosclerosis. In this study, blood pressure was measured at eight different exams with a cardiac CT scan done at the end of the 25-year time period to evaluate for calcification of the coronary vessels. Almost all young adults had normal blood pressure at the beginning of the study, but some steadily increased over time while others had stable blood pressure.

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Hype or Hope–New Remedies to Treat High Blood Pressure?

High blood pressure can commonly be managed and kept under control through a combination of healthy lifestyle and medication. By losing excess weight, cutting down salt, limiting alcohol intake, and exercising regularly, it may be possible to lower your blood pressure. Medications may also be needed and many effective medicines are available to treat high blood pressure. Doctors often recommend a combination of medications to combat hypertension. But sometimes, despite everyone’s best efforts, high blood pressure can be resistant to treatment. Resistant hypertension, as it is known, continues to be a challenge to physicians.

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New Blood Pressure Recommendations and Kidney Patients

Last month, a new set of blood pressure guidelines were released by the 8th Joint National Committee on the Management of High Blood Pressure In adults, or JNC-8. These guidelines offer doctors information on when to treat high blood pressure in the elderly, those with diabetes as well as kidney patients. These guidelines replace the JNC 7 guideline from 2003.  What do people with kidney disease need to know? The major change in the new guideline is that the target blood pressure for patients with kidney disease and hypertension is now less than 140/90 mm Hg based on the available evidence, whereas the JNC 7 recommended a treatment goal of 130/80 mm Hg.  A review of randomized controlled trials in chronic kidney disease revealed only three studies that achieved the 130/80 target and the analysis did not find consistent benefit for the lower target.

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Physical Activity and High Blood Pressure Risk—Does it Matter Where You Exercise?

Can you skip your workout and just take care of your daily exercise at work, if you have a job that involves physical activity? Not if you want to reduce your blood pressure, according to a new study. The study found that recreational exercise for four hours each week was linked to a 19 percent lower risk of developing high blood pressure. But the health benefit did not extend to those who had similar levels of physical activity during the course of their work. They had the same high blood pressure risk as those in less physically taxing jobs.

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Defying My Genetics

By Beth Piraino, MD

A few years ago, I diagnosed myself with hypertension.  I ‘inherited’ a blood pressure from my mother, who was hypertensive and religious about monitoring her own blood pressure twice a day, so one day I decided to check my blood pressure.  To my horror it was 180/110 mm Hg.  I rechecked it and got the same reading.  I should not have been surprised as both my parents had hypertension that came with increasing age, and I had also gained considerable weight over the preceding several years.  As a nephrologist, I am very aware that hypertension is one of the leading causes of kidney disease.

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