Blood Pressure Drug Linked with Increased Risk of Bowel Condition

Kate Wighton wrote . . . . . . . . .

A type of blood pressure lowering medication, called a calcium-channel blocker, may be linked with increased risk of bowel condition diverticulosis.

This condition causes small bulges or pouches to appear in the lining of the intestine. Particularly affecting the elderly (as many as 65 per cent of over 85s may be affected), diverticulosis can in some cases can lead to a medical emergency if the pouches become infected or burst.

The new early-stage research finding comes from a team of scientists led by Imperial College London, who investigated the effectiveness and side effects of three common blood pressure medications: ACE-inhibitors, beta-blockers and calcium channel blockers.

High blood pressure affects one in ten adults across the globe, and increases the risk of heart attack and stroke. The most common treatments for high blood pressure are lifestyle changes and medications.

However, despite the three main medications being taken by millions, investigating their potential side effects (as well as studying their effectiveness for treating other diseases), can be difficult and often involves lengthy and expensive clinical trials.

Genetic clues

To overcome this problem, the research team, led by Imperial’s School of Public Health, used genetic analyses to study the effects of the drugs.

By investigating versions of genes that mimic the effects of these drugs, the team were able to study the drugs’ effectiveness – and their potential side effects.

First, the researchers, who published their work in the journal Circulation, identified the proteins targeted by the drugs, and which help lower blood pressure. Next, they analysed genetic data from around 750,000 people and identified the so-called genetic variants that code for these proteins.

The team, who included researchers from LMU Munich, then studied whether these gene variants – which cause increased production of these proteins – were linked to an increased or decreased risk of other diseases.

The good news was that, as expected, these so-called genetic variants (which coded for proteins involved in lowering blood pressure) were linked to lower heart disease and stroke risk.

Increased risk

However after assessing the risk of around 900 different diseases – using data from the UK Biobank study – the team found that the versions of genes related to the effects of a particular type of calcium channel blocker – the non-dihydropyridine class, were linked to an increased the risk of a bowel condition called diverticulosis.

The team compared their findings with further genetic data, and supported the potential link with an increased risk of the bowel condition.

The link now needs further investigation with larger trials, explains Dr Dipender Gill, co-lead author of the research from Imperial’s School of Public Health: “This is the first time that this class of blood pressure drug has been associated with diverticulosis. We’re not sure of the underlying mechanism – although it may relate to effects on the function of intestine muscles, which perform contractions to transport food through the gut.”

Dr Joanna Tzoulaki, senior author from Imperial’s School of Public Health added: “The study of genetic variants that mimic the effect of drugs is evolving as a powerful concept to help prioritise clinical trials and design clinical trials more likely to be successful”.

Dr Gill cautions the findings should not change current prescribing guidelines and that people should not stop taking their medication unless first consulting their doctor.

He added: “These findings should not change clinical practice, but instead should act as a catalyst for further research.”

Source: Imperial College London

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Sleepless Nights Linked to High Blood Pressure

A bad night’s sleep may result in a spike in blood pressure that night and the following day, according to new research led by the University of Arizona.

The study, to be published in the journal Psychosomatic Medicine, offers one possible explanation for why sleep problems have been shown to increase the risk of heart attack, stroke and even death from cardiovascular disease.

The link between poor sleep and cardiovascular health problems is increasingly well-established in scientific literature, but the reason for the relationship is less understood.

Researchers set out to learn more about the connection in a study of 300 men and women, ages 21 to 70, with no history of heart problems. Participants wore portable blood pressure cuffs for two consecutive days. The cuffs randomly took participants’ blood pressure during 45-minute intervals throughout each day and also overnight.

At night, participants wore actigraphy monitors — wristwatch-like devices that measure movement — to help determine their “sleep efficiency,” or the amount of time in bed spent sleeping soundly.

Overall, those who had lower sleep efficiency showed an increase in blood pressure during that restless night. They also had higher systolic blood pressure — the top number in a patient’s blood pressure reading — the next day.

More research is needed to understand why poor sleep raises blood pressure and what it could mean long-term for people with chronic sleep issues. Yet, these latest findings may be an important piece of the puzzle when it comes to understanding the pathway through which sleep impacts overall cardiovascular health.

“Blood pressure is one of the best predictors of cardiovascular health,” said lead study author Caroline Doyle, a graduate student in the UA Department of Psychology. “There is a lot of literature out there that shows sleep has some kind of impact on mortality and on cardiovascular disease, which is the No. 1 killer of people in the country. We wanted to see if we could try to get a piece of that story — how sleep might be impacting disease through blood pressure.”

The study reinforces just how important a good night’s sleep can be. It’s not just the amount of time you spend in bed, but the quality of sleep you’re getting, said study co-author John Ruiz, UA associate professor of psychology.

Improving sleep quality can start with making simple changes and being proactive, Ruiz said.

“Keep the phone in a different room,” he suggested. “If your bedroom window faces the east, pull the shades. For anything that’s going to cause you to waken, think ahead about what you can do to mitigate those effects.”

For those with chronic sleep troubles, Doyle advocates cognitive behavioral therapy for insomnia, or CBTI, which focuses on making behavioral changes to improve sleep health. CBTI is slowly gaining traction in the medical field and is recommended by both the American College of Physicians and the American Academy of Sleep Medicine as the first line of treatment for insomnia.

Doyle and Ruiz say they hope their findings — showing the impact even one fitful night’s rest can have on the body — will help illuminate just how critical sleep is for heart health.

“This study stands on the shoulders of a broad literature looking at sleep and cardiovascular health,” Doyle said. “This is one more study that shows something is going on with sleep and our heart health. Sleep is important, so whatever you can do to improve your sleep, it’s worth prioritizing.”

Source: Science Daily

Energy Drinks May Increase Risk of Heart Function Abnormalities and Blood Pressure Changes

Drinking 32 ounces of an energy drink in a short timespan may increase blood pressure and the risk of electrical disturbances in the heart, which affect heart rhythm, according to a small study published in Journal of the American Heart Association, the Open Access Journal of the American Heart Association/American Stroke Association.

The study enrolled 34 healthy volunteers between the ages of 18 and 40 years. Participants were randomly assigned to drink 32 ounces of one of two commercially available caffeinated energy drinks or a placebo drink on three separate days. The drinks were consumed within a 60-minute period but no faster than one 16-ounce bottle in 30 minutes.

Researchers measured the electrical activity of the volunteers’ hearts by electrocardiogram, which records the way a heart is beating. They also recorded participant’s blood pressure. All measurements were taken at the study’s start and every 30 minutes for 4 hours after drink consumption.

Both energy beverages tested contained 304 to 320 milligrams of caffeine per 32 fluid ounces. Caffeine at doses under 400 milligrams is not expected to induce any electrocardiographic changes. Other common ingredients in the energy drinks in the study included taurine (an amino acid), glucuronolactone (found in plants and connective tissues) and B-vitamins. The placebo drink contained carbonated water, lime juice and cherry flavoring.

In participants who consumed either type of energy drink, researchers found that the QT interval was 6 milliseconds or 7.7 milliseconds higher at 4 hours compared to placebo drinkers. The QT interval is a measurement of the time it takes ventricles in the heart (the lower chambers) to prepare to generate a beat again. If this time interval is either too short or too long, it can cause the heart to beat abnormally. The resulting arrhythmia can be life-threatening.

The results of the study confirm previous findings and suggest that the QT interval changes are generally sustained over the four-hour monitoring period rather than being a short-lasting effect after consuming 32-ounces of an energy drink.

Researchers also found a statistically significant 4 to 5 mm Hg increase in systolic and diastolic blood pressure in participants who consumed the energy drinks.

“We found an association between consuming energy drinks and changes in QT intervals and blood pressure that cannot be attributed to caffeine. We urgently need to investigate the particular ingredient or combination of ingredients in different types of energy drinks that might explain the findings seen in our clinical trial,” said lead author Sachin A. Shah, Pharm.D., professor of pharmacy practice at University of the Pacific, Thomas J. Long School of Pharmacy and Health Sciences in Stockton, California.

The study is the largest controlled study of the effects of energy drinks on the heart and blood pressure in young healthy volunteers. Estimates indicate that about 30% of teenagers between the ages of 12 through 17 years in the United States consume energy drinks on a regular basis, which have been linked to increased emergency room visits and death.

“Energy drinks are readily accessible and commonly consumed by a large number of teens and young adults, including college students. Understanding how these drinks affect the heart is extremely important,” said study co-author Kate O’Dell, Pharm.D., professor of pharmacy and director of experiential programs at the Thomas J. Long School of Pharmacy and Health Sciences.

Among the study’s limitations, it was designed to assess the effects of short-term consumption of an energy drink and does not provide insight into long-term effects nor the effects of routine energy drink consumption. Additionally, energy drink consumption was evaluated alone, and it is not uncommon for energy drinks to be consumed in combination with other substances such as alcohol. Finally, the study included only healthy individuals between the ages of 18 to 40 years and the results may be different in other populations.

“The public should be aware of the impact of energy drinks on their body especially if they have other underlying health conditions,” Shah said. “Healthcare professionals should advise certain patient populations, for example, people with underlying congenital or acquired long QT syndrome or high blood pressure, to limit or monitor their consumption.”

Source: American Heart Association


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Novel 5-minute Workout Improves Blood Pressure, May Boost Your Brain

Lisa Marshall wrote . . . . . . . . .

Could working out five minutes a day, without lifting a single weight or jogging a single step, reduce your heart attack risk, help you think more clearly and boost your sports performance?

Preliminary evidence suggests yes.

Now, with a new grant from the National Institute on Aging, CU Boulder researchers have launched a clinical trial to learn more about the ultra-time-efficient exercise known as Inspiratory Muscle Strength Training (IMST).

“It’s basically strength-training for the muscles you breathe in with,” explains Daniel Craighead, a postdoctoral researcher in the Integrative Physiology department. “It’s something you can do quickly in your home or office, without having to change your clothes, and so far it looks like it is very beneficial to lower blood pressure and possibly boost cognitive and physical performance.”

Developed in the 1980s as a means to wean critically ill people off ventilators, IMST involves breathing in vigorously through a hand-held device—an inspiratory muscle trainer—which provides resistance. Imagine sucking hard through a straw which sucks back.

During early use in patients with lung diseases, patients performed a 30-minute, low-resistance regimen daily to boost their lung capacity.

But in 2016, University of Arizona researchers published results from a trial to see if just 30 inhalations per day with greater resistance might help sufferers of obstructive sleep apnea, who tend to have weak breathing muscles, rest better.

In addition to more restful sleep and developing a stronger diaphragm and other inspiratory muscles, subjects showed an unexpected side effect after six weeks: Their systolic blood pressure plummeted by 12 millimeters of mercury. That’s about twice as much of a decrease as aerobic exercise can yield and more than many medications deliver.

“That’s when we got interested,” said Professor Doug Seals, director of the Integrative Physiology of Aging Laboratory.

Seals notes that systolic blood pressure, which signifies the pressure in your vessels when your heart beats, naturally creeps up as arteries stiffen with age, leading to damage of blood-starved tissues and higher risk of heart attack, cognitive decline and kidney damage.

While 30 minutes per day of aerobic exercise has clearly been shown to lower blood pressure, only about 5 percent of adults meet that minimum, government estimates show. Meanwhile, 65 percent of mid-life adults have high systolic blood pressure.

“Our goal is to develop time-efficient, evidence-based interventions that those busy mid-life adults will actually perform,” said Seals, who was recently awarded a $450,000 NIA grant to fund a small clinical trial of IMST involving about 50 subjects. “The preliminary data are quite exciting.”

With about half of the tests done, the researchers have found significant drops in blood pressure and improvements in large-artery function among those who performed IMST with no changes in those who used a sham breathing device that delivered low-resistance.

So far, the IMST group is also performing better on certain cognitive and memory tests.

It’s something you can do quickly in your home or office, without having to change your clothes, and so far it looks like it is very beneficial to lower blood pressure and possibly boost cognitive and physical performance.” –Daniel Craighead

When asked to exercise to exhaustion, they were also able to stay on the treadmill longer and keep their heart rate and oxygen consumption lower during exercise.

“We suspect that as you improve the function of your respiratory muscles, they don’t need as much blood to work and that blood can be redistributed to your legs so you exercise longer,” said Craighead.

Some cyclists and runners have already begun to use commercially-available inspiratory muscle trainers to gain a competitive edge.

But Seals and Craighead stress that their findings are preliminary, more research is necessary and curious individuals should ask their doctor before considering IMST.

That said, with a high compliance rate (fewer than 10 percent of study participants drop out) and no real side-effects, they’re optimistic.

“High blood pressure is a major risk factor for cardiovascular disease, which is the number one cause of death in America,” said Craighead. “Having another option in the toolbox to help prevent it would be a real victory.”

Source: University of Colorado Boulder

Sleeping Pill Use by Older Adults Linked to Greater Need for Blood Pressure Medications

In a Geriatrics & Gerontology International study of 752 older adults with hypertension followed from 2008–2010 through 2012–2013, using sleeping pills on a regular basis was linked with use of an increasing number of blood pressure medications over time.

The association was observed regardless of sleep duration and quality, body mass index, diet, physical activity, and hypertension control.

Although additional research is needed to understand this link, the findings suggest that sleeping pill use may be an indicator of a future need for greater hypertension treatment and the need to investigate underlying sleep disorders or unhealthy lifestyles that may contribute to hypertension.

“Previous reports on associations of sleep characteristics with blood pressure and hypertension were focused on middle-aged adults; however these associations were absent or inconsistent among older adults,” said senior author Dr. José Banegas, of the Universidad Autónoma de Madrid, in Spain.

Source: Wiley


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