Study: High Blood Pressure Progresses Faster In Blacks
(BlackDoctor.org) — It’s well known that blacks are at greater risk for developing high blood pressure than whites are, but new research now suggests they also progress more rapidly from a pre-hypertension state to full-blown high blood pressure.
The findings, published online and in the October print issue of Hypertension, suggest that intervening earlier with medication, as well as lifestyle changes, may help prevent high blood pressure and some of its consequences among people who are at the greatest risk.
Pre-hypertension is defined as a systolic (pumping) pressure between 120 and 139, and a diastolic (resting) reading between 80 and 89. High blood pressure (or hypertension) is a blood pressure reading of 140/90 or higher. A blood pressure reading of less than 120/80 is considered ideal.
Researchers analyzed electronic medical records of 18,865 adults aged 18 to 85 from 197 health clinics in the southeastern United States between 2003 and 2009. Thirty percent of the study participants were black.
According to the findings, blacks had a 35 percent greater risk of progressing from pre-hypertension to hypertension and tended to develop the condition up to one year earlier than their white counterparts. Exactly why this occurs is not fully understood.
“This means the well-known end-points of hypertension — such as kidney failure, stroke, heart failure — could occur faster in blacks than in whites,” said study author Anbesaw Selassie, an epidemiologist at the Medical University of South Carolina in Charleston.
Race was not the only risk factor seen in the new study. Other individuals who were at increased risk for rapid progression to hypertension included those with systolic blood pressure ranging from 130 to 139, as well as those participants aged 75 and older. Other risk factors include being overweight or obese and having type 2 diabetes.
In high-risk individuals, “it is time to seriously consider the use of safe and cheap blood pressure-lowering medicines to arrest the progression of pre-hypertension,” Selassie said.
Previous research has demonstrated that such early therapeutic preventive measures are “effective, practical, and cost-effective if one considers the cost of caring for hypertension and its complications,” Selassie added.
“This is very important information,” said Dr. Stephen Green, the chief of cardiology at North Shore University Hospital in Manhasset, N.Y. “Blacks with pre-hypertension develop high blood pressure quicker than whites,” he said.
Lifestyle changes, like losing weight if you are overweight or obese, consuming less salt and eating a healthy diet can help lower this risk. The most widely recommended diet to lower blood pressure is the DASH diet (Dietary Approaches to Stop Hypertension), which focuses on fruits and vegetables, low-fat or non-fat dairy products and whole grains, he added.
Still, Green noted, “we should be more aggressive with medication in people who are at high risk.”
Outsmart Your Brain To Stop Smoking
If you’ve ever tried to quit smoking, you know how tough it can be. And you’re not alone – 70% of smokers want to stop, according to the Centers for Disease Control and Prevention (CDC).
“Quitting smoking is the single most important thing anyone can do to improve their health and decrease their risk of dying,” says Lloyd I. Sederer, M.D., medical director of the New York State Office of Mental Health.
But as former smokers know, fighting the urge to smoke can require almost superhuman mental strength.
According to the U.S. Public Health Service, while medications and nicotine-replacement therapies can help reduce urges and ease temporary withdrawal symptoms, they can’t stop a smoker from lighting up again weeks, months or even years after quitting.
But it doesn’t have to be that hard — there are also psychological tricks that reduce cigarette cravings and overcome the desire to light up.
“Smokers need to realize that the wiring in their brains has changed,” says Saria Carter Saccocio, M.D., chief medical officer of Danville Regional Medical Center in Virginia. “Medication is one part of it, but the mental piece plays into it as well. When we have a craving, our brain’s trying to get us to do something we don’t want to do. Cigarettes trick smokers’ brains into thinking those cigarettes are essential.”
Here are 10 expert tips tips experts that are effective enough to help you outsmart your own brain and stop lighting up…for good.
1. Adjust your attitude.
You won’t be able to push through cigarette cravings until you’ve decided that quitting is something you really want.
“If you’re quitting because your spouse asked you to or someone’s nagging you, it’s not going to last,” says Voelker. “Step 1 is getting your head in the right place.”
That includes changing your point of view to that of a non-smoker, rather than an ex-smoker who’s feeling deprived.
“Once you quit, if in the bottom of your heart you can pity those who still smoke – in the same way you might pity the alcoholic passed out on the bar or the diabetic eating a hot fudge sundae – it gives you the best chance of walking away from smoking for good,” Voelker says.
2. Identify your triggers.
Cigarette cravings tend to be triggered by “cues” or things you associate with smoking.
That could be anything from a person, song or smell to a place (like your car) or a time (such as after a meal), Lieberman says.
To identify what triggers your urge to smoke, you need to be conscious of when you light up, Saccocio adds.
“Many smokers smoke without even realizing it,” she says. They don’t [notice] they light up every time they turn right on Main Street on the way to work.
“When you have a craving, notice where you are and what you’re doing and thinking about,” she adds. Even better, write it down.
One way to avoid your triggers is to shake up your routine by doing things in a different order or adding an activity.
“We coach people to change all their patterns,” says Barry Hummel, Jr., M.D., co-founder of the Quitdoc Research and Education Foundation, a group of physicians dedicated to reducing the U.S. death rate from tobacco use.
For example, make a new habit of brushing your teeth right after you eat. This not only helps you fill the time needed for the craving to pass, it also changes the taste in your mouth.
It takes 25-30 times of successfully doing something differently to break a habit, says Voelker. So you’ll need to remember to brush after meals repeatedly before it becomes second nature.
Try to avoid your most powerful cigarette associations, Sederer suggests. Drinking alcohol, for example, is one of the most common triggers for smokers. So are situations where others smoke.
“Maybe you have to stop going to clubs on Friday nights for a few months,” he advises.
3. Delay yourself.
Cigarette cravings will pass, experts say.
“You think the only way to make the craving go away is to give in to it, but that’s not true,” Lieberman says.
If you manage to delay gratification for as little as 3-5 minutes, the urge will subside, he says.
“The technique is called ‘craving surfing,’ ” Lieberman explains. “It involves recognizing that cravings [come in] waves. Every minute you wait, the intensity goes down.”
4. Get moving.
Exercise is one of the best ways to distract yourself from smoking, Voelker says. It has other benefits too: Quitting smoking often leads to negative mood states and weight gain, and exercise is a powerful weapon against both, he adds.
That’s why the American Lung Association recommends daily workouts for all participants in its tobacco-cessation programs
“Exercise definitely reduces cigarette cravings,” Voelker says. “It also relieves stress, releases endorphins [natural mood-enhancing chemicals] and can help keep you from gaining weight.”
Withdrawal symptoms and cigarette cravings in ex-smokers decreased during exercise and for up to 50 minutes afterward, according to a 2007 review of 12 studies by researchers from the University of Exeter in England. In a 2006 Austrian study, 80% of smokers who combined exercise with nicotine replacement therapy successfully quit. The success rate was only 52% for those who used nicotine replacement alone.
5. Don’t worry about short-term weight gain.
Putting on weight is one of women’s major concerns when they’re quitting smoking, according to Hummel.
Weight gain usually occurs for two reasons, Hummel says. First, nicotine increases metabolism, which slows when you quit. Second, foods taste and smell better after you quit because nicotine dulls those senses.
“It’s a wicked combination,” Hummel says. “Average weight gain is 5-8 pounds. If women aren’t prepared, it can be very discouraging, and many go back to smoking because of it.”
The good news is that the situation is temporary. “Within six months to a year, your metabolism corrects itself, and the novelty of the improved taste and smell wears off,” Hummel says.
Still, “women have to give themselves permission to gain a little weight until they’re smoke-free,” Lieberman says. “They’ll lose the weight afterward.”
6. Get support.
“You know you’re going to have cigarette cravings,” Sederer says. “The question is, what are you going to do when they strike?”
Reach out for support, he advises – whether online, from a hotline, or by calling friends or family.
If you’re taking medication to help you quit, getting support doubles your chance of success, according to Hummel.
Every state has a “quit line,” some of which offer free coaching. You can call the national number, 1-800- QUIT-NOW, for the line in your own state.
“Someone who has training in tobacco cessation [will] give you tools to use every time you have a craving,” Saccocio says.
It’s also important to have a supportive social network, she says.
“You know [your friends and family] care about you and want you to succeed,” Saccocio says. “Having that kind of accountability can keep you in check.”
Also, make a list of phone numbers, including hotlines and supportive friends, that you can call when you’re alone and your mind begins to obsess about buying a pack of cigarettes, Sederer advises.
7. Avoid situations that make you vulnerable.
Certain conditions can make you more likely to give in to your urge to smoke. Doctors refer to them as HALT: Hungry, Angry, Lonely or Tired.
“For smokers, cigarettes are a solution to every stress and problem,” says Lieberman. “HALT are states that tend to weaken us and our ability to cope with stress.”
Of course, it’s impossible to avoid these conditions at all times. But if you recognize them, you can stop self-destructive behavior, Lieberman says.
Instead, deal with the problem at hand – eat if you’re hungry, rest if tired, get support when lonely, and find someone to vent to when angry.
Dehydration can trigger cigarette cravings just as it sets off food cravings, Hummel says. Your body wants something, and when you’re a smoker, that translates into a cigarette.
That’s why drinking plenty of water is crucial when you’re quitting smoking, he says.
Fluids also help flush toxins from your body.
“You’ve been collecting a lot of chemicals in your body during the years you’ve been smoking, and [drinking water helps you] excrete them in your urine,” Hummel says.
9. Never have “just one.”
Smokers often tell themselves a single puff will let them safely subdue cigarette cravings. But it actually makes them worse.
“They think they can handle it,” Voelker says. “But the truth is [smokers are] just one puff away from [smoking] a pack a day.”
Remember the basic rule of quitting: No matter what, don’t pick up a cigarette.
10. Don’t give up.
Statistically, you’ll need to quit 6-8 times before you’re successful, according to Voelker.
“It’s like riding a bike,” he says. “There’s no shame in falling down, as long as you get back up and try again.”
Slips are part of the process – each attempt actually increases your chances of success the next time, adds Hummel. So pay attention to what worked and didn’t, and don’t use a mistake as an excuse to start smoking again.
“You might try five times and tell yourself, ‘Forget it. I can’t do this,’” Lieberman says. “But you have to remember it takes a number of attempts. Eventually, you’ll be successful.”