Sunday, Oct. 10 news tips


From the American Heart Association’s 58th Annual High Blood Pressure Conference

***Embargo times listed with each abstract***

1:45 p.m., Sunday, Oct. 10

Abstract P89 – Education reduces blood pressure in African-American communities. Education programs were associated with lower blood pressure readings in African-American communities where the prevalence of high blood pressure is high. Before implementing a high blood pressure education program, researchers visited 20 churches and civic organizations in the "Triangle" region of North Carolina -- Durham, Raleigh, Chapel Hill and surrounding communities to record baseline blood pressure measurements. They noticed that some places they visted already had general health education programs, and that there seemed to be a trend of lower blood pressures among participants at those sites. They reported blood pressure data for 117 people screened at 13 of the sites. In eight communities that had established health education programs, systolic blood pressures (the top number in a blood pressure reading) averaged 130.5 mmHg compared to an average of 140.8 mmHg in five communities with no education programs. Diastolic pressure (the bottom number) averaged 77.4 mmHg in the communities with education programs versus 86.2 mmHg in the areas without. In both instances the differences were statistically significant. Researchers also noted that African Americans at the study sites had a prevalence of hypertension greater than the national rate (36.6 percent). Of the 117 people screened, 47.8 percent had high blood pressure (at or above 140 mmHg systolic and/or 90 mmHg diastolic).

1:45 p.m., Sunday, Oct. 10

Abstract P92 – Sleeping position can influence blood pressure. For the first time, researchers evaluated whether changing sleeping positions alters blood pressure. The risk of cardiovascular disease increases in people who experience high blood pressure or extreme dips in blood pressure during the night and in people whose blood pressure falls when they stand up suddenly (orthostatic hypotension). Using an automatic cuff, researchers monitored blood pressure in 271 men (average age 50) without cardiovascular disease and who were not taking medicine to control high blood pressure. They first took measurements while the men were lying on their backs (supine), then after they had rolled onto their stomachs (prone).

Average systolic blood pressure fell significantly from 130 millimeters of mercury (mmHg) to 125 mmHg in response to lying on their stomachs. Twenty-five of the men (9.2 percent) experienced a more dramatic drop (more than a 15 mmHg) in systolic blood pressure. The researchers call for further investigation of whether marked blood pressure changes in response to sleep position might be a possible cause of cardiovascular events during sleep.

1:45 p.m., Sunday, Oct. 10

Abstract P93 – Coronary artery disease far more common in people with impaired kidney function. Kidney disease can be a cause and a consequence of heart disease, elevating the risk of heart disease even before it causes symptoms, according to a 2003 scientific statement by the American Heart Association. However, the extent to which impaired kidney function contributes to the prevalence of coronary artery disease in the U.S. population has not been quantified. Researchers analyzed the relationship between kidney function, other heart disease risk factors, and the prevalence of coronary artery disease (CAD) among 15,639 adults participating in the Third National Health and Nutrition Examination Survey (NHANES III).

The glomerular filtration rate (GFR), which measures the kidney's ability to filter and remove waste products, was used to categorize participants into four levels of kidney function. Compared with people with normal GFR (90+), the prevalence of CAD rose as GFR was reduced. The age-adjusted prevalence of CAD was 6.9 percent in those with GFR over 90; 8.0 percent with GFR between 60-89; 14.8 percent with a GFR of 30-59, and 16.3 percent with a GFR lower than 30 (a degree of kidney impairment that usually causes symptoms). Compared with adults having normal GFR, the odds of CAD increased with the level of kidney impairment: 2.93 times as likely with a GFR between 60-89, 10.88 times as likely with GFR between 30-50, and 13.52 times as likely with GFR lower than 30. Researchers then adjusted the odds to consider the occurrence of known Framingham coronary risk factors – age, cigarette smoking and diabetes – and inflammatory factors such as C-reactive protein and homocysteine. The researchers concluded that much of the increased prevalence of CAD in people with impaired kidney function can be explained by an excess prevalence of traditional Framingham risk factors and, to a lesser extent, with inflammatory factors.

1:45 p.m., Sunday, Oct. 10

Abstract P104 – Blood pressure control can be achieved, even in rural area devastated by political upheaval. In rural Georgia, a republic of the former Soviet Union, the healthcare system has been severely compromised by political upheaval. But, a team of medical professionals demonstrated that they could achieve lifesaving improvements in blood pressure control by providing access to inexpensive medications and training nurses and physicians to monitor and manage high blood pressure.

The team trained eight physicians and 10 nurses to accurately measure blood pressure, educate patients about their condition, and use an inexpensive diuretic (hydrochlorothiazide) and beta-blocker (atenolol) to treat high blood pressure.

Over three years, 562 people with uncontrolled hypertension were identified, with an average blood pressure of 170/96 millimeters of mercury (mmHg). In an area where drugs are available without prescription, half took some form of anti-hypertensive medication, but fewer than 2 percent were taking a diuretic or beta-blocker. After 18 months of the program, 99 percent of the patients were taking hydrochlorothiazide and 81 percent took atenolol; purchased in bulk, the medications cost $7.50/year for each patient. On the program, a blood pressure control rate of 52 percent was achieved, with an average reduction in blood pressure of 31 mmHg systolic pressure (the top number in a blood pressure reading) and 14 mmHg diastolic (bottom number). The researchers estimate that this level of blood pressure improvement could reduce stroke and heart attacks by at least 40 percent.

They conclude that hypertension can be easily, quickly and inexpensively controlled, even in the most basic of rural family care settings.

Source: Eurekalert & others

Last reviewed: By John M. Grohol, Psy.D. on 21 Feb 2009
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-- Jerome Lawrence