Racial bias prevents many people from attending adequate schools, entering promising careers, and accessing adequate healthcare. This bias also affects where they can find suitable housing, and that housing may contribute to health difficulties brought on by pollution or vermin infestation. The situation, undeniably, is untenable, and anyone who believes in human rights will find each of these impediments anathema.

All the above is clear, but taking the situation two steps further will reveal the hidden extent of the potential damage raining down on anyone who is a victim of this bias. And, most disturbing, this further damage to health happens in the medical realm.

Socioeconomic factors lead to health risks such as asthma, and the need for ongoing, accurate treatment for asthma is mostly with inhalers. The condition is so severe that frequent emergency treatment is sought. Compared with white people with asthma, African American people with asthma are five times more likely to visit the emergency room for symptoms.

One of the inhalers of choice for asthma is albuterol, and here, again, there is a problem with treatment. A study of over 1,400 children revealed a genetic lack of appropriate response to this drug in some patients. And problems in sampling were apparent. We and others have documented the implications and challenges posed by the lack of non-European study populations in biomedical research. Sampling bias is at the heart of one major problem in device engineering.

Once asthma treatment is sought, there still needs to be a resolution to the underlying measurement problem. While in the ER, how is the oxygen level of these patients determined? The usual initial route is to get a quick level using an oximeter slipped on a finger. It’s a rapid and supposedly accurate measure of how much oxygen the patient has in their blood; vital information.

Who questions the oximeter readings? The assumption is that the task is accurate because the device is FDA approved, made by a reputable company, and has been used for years in hospitals. But that conclusion is patently false.

The validity of the readings was made primarily on persons of European descent. How accurate would they be on anyone who did not meet that criterion? The answer would seem obvious.

Studies dating back to 2005 show pulse oximeters tend to overestimate the amount of oxygen a patient with darker skin may actually have in their blood. It’s simple physics: Melanin in skin absorbs some of the light the devices analyze to make their readings. The darker the skin, the more melanin there is, and the less light passes through.

If the readings are wrong, how does that have an impact on treatment? Again, no question that there is a bias in oxygen levels leading to changes in medical care.

The FDA issued an alert on oximeters, but did everyone dispose of their older, inaccurate devices in healthcare and the home? Other factors affect these readings, including poor circulation, skin pigmentation, skin thickness, skin temperature, current tobacco use, and use of fingernail polish.

NASA had developed guidelines and devices for more accurately measuring blood oxygen, but the corporation involved in it changed its marketing direction and the device was dropped.

We know that the disturbing use of oximeters tested in Japan (with a relatively homogenous population) may lead to delays in treatment in persons with darker skin. How is this permissible? It’s not, and the NASA devices should be considered again.

The post The Medical Device That May Lead to Harm in People of Color appeared first on Medika Life.

Today we explore a study suggesting that as blood pressure rises above 90 mm, we risk damaging our heart’s blood vessels (coronary arteries). Today we look at that recent discovery before turning to more practical issues about blood pressure measurement:

• How often should you check your blood pressure?
• What time of day is best?
• Should you immediately repeat the measurement?
• What substances should you avoid for 30 minutes before checking you?

First of all, thank you for joining me today and caring about your health.

Blood pressure basics

I recently bought a blood pressure measuring tool. Do you know what the medical term is for the device? Kudos if you know this remarkably long name: Sphygmomanometer.

When I measure my blood pressure, the machine gives me two numbers, systolic and diastolic blood pressure. The former refers to systole, when my heart pumps blood into the main blood vessels, the aorta.

Diastolic points to diastole, the resting time when blood refills the heart. My heartbeats and the blood pressure rises to the systolic level. In-between beats, it drops to the diastolic level.

I have long thought that I had ideal blood pressure, with a systolic blood pressure of 110 to 118. The American Heart Association agrees with my assessment, offering these observations about blood pressure:

• Normal: Systolic less than 120 and diastolic less than 80
• Elevated: Systolic 120 to 129 and diastolic less than 80
• High blood pressure, stage 1: Systolic 130 to 139 or diastolic 80 to 89
• High blood pressure, stage 2: Systolic 140 or higher or diastolic over 90
• High blood pressure crisis (contact a doctor immediately): Systolic 180 or higher or diastolic over 120

A medical professional must confirm a high blood pressure diagnosis. If you have shallow blood pressure, you should connect with a medical professional.

Blood pressure: A new normal?

Am I right in thinking I am perfect for my blood pressure? Now comes a study that calls our historical definitions of blood pressure into question.

The study title gets right to the point: “Intensive Blood Pressure Control Lowers Cardiovascular Risk.”

Let’s get a bit more granular: When systolic blood pressure rose above 90 mm, the risk of coronary artery damage rose with it. The study suggests that we have made significant improvements in modifying heart disease risk factors (such as tobacco cessation), but we have more work to do. Cardiovascular disease remains the leading cause of death in the USA.

For every 10 mm increase in systolic blood pressure, the risk of calcium deposits and cardiovascular events rose accordingly. Compared with people with systolic pressures of 90 to 99 mm, those with pressures of 120 to 129 mm were 4.58 times more likely to have experienced a cardiovascular event.

We in the USA (and elsewhere) have work to do. As we put on more and more pounds, we increase our risk of two risk factors for heart disease — type 2 diabetes and high blood pressure.

Yes, we have pills for treatment, but they can come with side effects. You probably know what I am going to say: Use lifestyle, including my five pillars of health:

• Move (walking is my go-to)
• Get adequate sleep
• Eat well (and watch your cholesterol and blood sugar levels)
• Mindfulness
• Community engagement

It goes without saying to avoid tobacco and to dodge excess alcohol. Now back to blood pressure. As positive encouragement, I offer this: Individuals in traditional non-industrial societies typically maintain systolic blood pressure in the low 90s throughout life.

Measuring your blood pressure

The Mayo Clinic offers guidance on performing accurate blood pressure monitoring at home:

• Check your blood pressure device’s accuracy. Check it against your healthcare provider’s office model before you start using a monitor. Your provider can also make sure you are using it correctly.
• Measure your blood pressure twice daily. Check in the morning before eating or taking medications, and check again in the evening. Aim for the same times each day.
• Don’t measure blood pressure immediately after you awaken. If you exercise in the morning, check before exercising.
• Avoid caffeine, alcohol, and tobacco use in the 30 minutes before measuring, and go to the toilet first (a full bladder may increase your blood pressure).
• Sit quietly during monitoring and always use the same arm. Get your arm to the level of your heart when measuring. Put the cuff on bare skin, not over clothing.
• Repeat the measurement one to three minutes after the first measurement. Write down the results.

Be kind to your heart, brain, and kidneys. Watch your blood pressure. Most of us, myself included, can do better. Thoughts?

The post Rethinking Blood Pressure appeared first on Medika Life.

• Systolic blood pressure 120 (the first number) – indicates how much pressure your blood is exerting against your artery walls when the heart beats.
• Diastolic blood pressure 80 (the second number) – indicates how much pressure your blood is exerting against your artery walls while the heart is resting between beats.

An easy way to to remember this is that up (or the top number) is when the pressure is up, and the bottom or down number is when the pressure is down. The measurement unit, mm Hg, simply means millimeters of mercury. Mercury was used in the first accurate pressure gauges and is still used in medicine today as the standard unit of measurement for pressure.

Which Number is more important?

Typically, more attention is given to systolic blood pressure (the first number) as a major risk factor for cardiovascular disease for people over 50. In most people, systolic blood pressure rises steadily with age due to the increasing stiffness of large arteries, long-term buildup of plaque and an increased incidence of cardiac and vascular disease.

However, either an elevated systolic or an elevated diastolic blood pressure reading may be used to make a diagnosis of high blood pressure. According to recent studies, the risk of death from ischemic heart disease and stroke doubles with every 20 mm Hg systolic or 10 mm Hg diastolic increase among people from age 40 to 89.

What readings are considered normal?

If your blood pressure falls within the following ranges then it’s considered normal, From 90-120/60-80 mm Hg. These numbers can also be adjusted for age. This chart will help you better understand the numbers

Your Heart Beat (Pulse Rate) and Blood Pressure

While your blood pressure is the force of your blood moving through your blood vessels, your heart rate is the number of times your heart beats per minute.

• They are two separate measurements and indicators of health.
• For people with high blood pressure (HBP or hypertension), there’s no substitute for measuring blood pressure.

A rising heart rate does not cause your blood pressure to increase at the same rate. Even though your heart is beating more times a minute, healthy blood vessels dilate (get larger) to allow more blood to flow through more easily. When you exercise, your heart speeds up so more blood can reach your muscles. It may be possible for your heart rate to double safely, while your blood pressure may respond by only increasing a modest amount.

Can other factors affect my Blood Pressure?

Yes. Each patient needs to be monitored and carefully assessed on an individual basis There are factors that can lead to a temporary elevation of your Blood pressure. You doctor will consider these factors if your blood pressure is unusually high and you can mention these to your Healthcare Provider.

1. White Coat Hypertension

Some people experience white coat hypertension, when blood pressure is elevated in the doctor’s office but not in other settings. These patients need to monitor their blood pressure at home or wear an ambulatory blood pressure monitor that takes your blood pressure every 30 minutes for 24 hours.

While white coat hypertension was formerly considered simple nervousness, recent research suggests otherwise.

A study published in the journal Hypertension found that people with white coat hypertension are at a significantly greater risk for developing sustained high blood pressure than people who have normal blood pressure. One possible explanation is that people with white coat hypertension have a harder time managing stress and anxiety.

2. Stress

Emotional stress and anxiety can temporarily increase blood pressure. Over time, excess stress can take a toll on your cardiovascular system and might lead to permanent blood pressure problems. 

3. Medication

Both over-the-counter and prescription medications can impact your blood pressure. Some medications, like diuretics and blood pressure pills, are designed to lower your blood pressure numbers. Others, like cold and allergy medications, can increase your blood pressure. Be sure to discuss any medication you may be taking with your doctor if you’re assessed with high blood pressure.

4. Activity

Exercise, talking, laughter, and even sex can cause blood pressure fluctuations. These increases are generally small and short lived. If you’ve been running to get your doctors appointment, resting a few minutes before you have your blood pressure taken will negate the effects and allow for a “normal” reading.

5. Food and Drink

What you eat or drink might impact your blood pressure reading. Foods high in tyramine, a substance found in aged foods, can increase blood pressure. This includes foods that are:

• fermented
• pickled
• brined
• cured

Drinks with caffeine can boost blood pressure numbers temporarily, too.

6. Adrenal Issues

Your adrenal system is responsible for hormone production. Adrenal fatigue occurs when your hormone production is low. Your blood pressure may fall as a result. An overactive adrenal system can cause sudden spikes in blood pressure and hypertension.

7. Pheochromocytoma

This rare tumor develops in the adrenal glands and impacts hormone production. It can cause sudden bursts of irregular blood pressure readings with normal spans in between.

Additional Risk Factors

These factors may put you at greater risk for experiencing fluctuating blood pressure:

• high levels of stress
• anxiety
• taking blood pressure pills that aren’t effective or don’t last until your next dose
• tobacco use
• excessive alcohol consumption
• night-shift work

Certain conditions can also increase your risk for developing an abnormal blood pressure. These include:

• diabetes
• pregnancy
• dehydration
• cardiovascular disease
• obstructive sleep apnea
• kidney disease
• thyroid problems
• nervous system problems

Further Resources

1. The American Heart Association
2. Center for Disease Control: Heart Health

The post Understanding Your Blood Pressure appeared first on Medika Life.