New Under the Sun:
Volume 3, Issue 11
Wow! It is already November. This year has just flown by. Since we are entering both the holiday season with its many opportunities to overeat, and the flu season with its potential for illness, this might be a good time to take stock of your current health situation and seek ways to make sure it is functioning optimally and will continue to do so.
Optimal Blood Pressure is Lowered: It seems not so long ago that when the physician told you your blood pressure (BP) was 120/80 this meant your health was fine, at least where blood pressure was concerned. However, after a recent spate of research, it has been shown that a BP of 120/80 is actually at the lower end of prehypertension; and those with prehypertension are at greater risk of health problems than those whose BP is below 120/80. Hypertension begins at 140/90.
A national survey of 3488 individuals over the age of 20 found that 31% were prehypertensive while another 29% were hypertensive. Men were more likely to be prehypertensive than were women. And for those under age 40, African Americans were more likely to be prehypertensive than were European Americans or Mexican Americans. After age 40, the percentage of prehypertensive African Americans dropped because their rates of hypertension significantly increased relative to the other populations.
Other groups prone to prehypertension and hypertension are those who are overweight and those who are in the lower socioeconomic stratum. While it seems probable that those with prehypertension may be unaware of it, it is of great concern that, in a national study, 31% of participants did not realize they had hypertension. Of those who did know they had hypertension, only 66% reported that they had been told by their health care provider how to manage and modify their BP; and only 31% succeeded in this effort.
Those with prehypertension are significantly more likely to have heart disease and strokes than are normotensive individuals because they are also significantly more likely to have other risk factors such as overweight/obesity, high cholesterol levels, and type 2 diabetes. If your blood pressure is hovering around the 120/80 level, it could be time to make some lifestyle changes that will lower your BP. Kurt J. Greenlund, Janet B. Croft, George A. Mensah. Prevalence of Heart Disease and Stroke Risk Factors in Persons With Prehypertension in the United States, 1999-2000 Arch Intern Med. 2004;164:2113-2118. Youfa Wang, Qiong Joanna Wang. The Prevalence of Prehypertension and Hypertension Among US Adults According to the New Joint National Committee Guidelines. Arch Intern Med. 2004;164:2126-2134.
Comment: As more research into blood pressure has shown that what was considered normal is actually the first stages of abnormal, so, too, has more research on vitamin D shown that blood levels that were considered normal are much too low. It is interesting to note that one of the effects of maintaining optimal blood levels of vitamin D (40 ng/ml of 25 OHD) is that blood pressure is reduced. It is also interesting to note that African Americans have among the highest rates of hypertension and the lowest blood levels of vitamin D. Strong hint: make sure you either get adequate and appropriate UVB radiation exposure for your skin color and latitude of residence, or make sure that you take at least a 1000 IU supplement of vitamin D3 each day (up to 4000 IU if you have dark skin color and/or live at high latitudes). This will not only help lower your blood pressure, but will optimize your health in numerous other ways that have been detailed in previous issues of AnthroHealth News.
Hypertension and Cognition: Continuing with the hypertension theme, another research study found that individuals with elevated blood pressure, even if they were young adults, experienced the same pattern of cognitive decline as did older adults with hypertension. The study began in 1976-77 and included 529 adults divided into two groupings: those aged 18 – 46 and those aged 47 – 83. Blood pressure was measured at baseline. Beginning at baseline and over a 20 year period, the participants were given several cognitive tests using the Wechsler Adult Intelligence Scale. No matter their age at the beginning of the study, if the individual entered the study with elevated blood pressure, he or she experienced cognitive decline on the Visualization/Fluid Abilities examination. This test measures the ease with which an individual responds to and uses novel concepts. However, hypertension did not appear to be associated with the other cognitive tests which included Speed Performance, Crystalized/Verbal Abilities, and Memory.
Given the results of their research, and given that cognitive decline becomes permanent, the authors feel that every effort should be made to control and lower an individual’s blood pressure, no matter that person’s age. The studies on prehypertension found that those with prehypertension frequently convert to hypertension. Therefore, it seems that optimizing blood pressure is not only good for our physical health, but our cognitive health as well. Penelope K. Elias, Merrill F. Elias, Michael A. Robbins, and Marc M. Budge. Blood Pressure-Related Cognitive Decline: Does Age Make a Difference? Hypertension 2004 44: 631-636.
Keep Moving Through the Pain: Back pain is a common problem. Bipedality (walking on two legs), while opening up a world of possibilities to humans, also increased the ease with which we can injure our backs through stress, over-extension, and other improper movements. Unfortunately, there is no easy cure for back pain.
Researchers in England examined the treatment protocols and outcomes for those treated for mild-to-moderate back pain by the physiotherapists working for the National Health System. Patients with at least six weeks of back pain were randomized to either multiple (average of 5) treatment sessions with a physiotherapist at one of seven centers, or to a one-hour counseling session with a physiotherapist who advised remaining active. The treatments sessions included a variety of techniques such as joint movement, massage, and exercises to increase muscle strength. After 12 months, 200 of the 286 patients who began the study were available for follow-up and were examined for improvements in movement and reduction in pain. They were also asked their opinion about the effectiveness of the treatment. Although the patients who went through the multiple treatment sessions felt that the sessions had been very beneficial, the researchers found no objective evidence that these patients were any better off than those who received the brief counseling session in which they were told to remain active. The authors conclude that for less severe back pain, special treatment sessions may not be worth the time and effort, and that the best course of action is probably the same sort of exercise program that is recommended for cardiovascular health and for increasing muscle strength. Although not mentioned by the authors, it is possible that the multiple sessions were no more beneficial than the single advice session because those receiving the physiotherapists’ treatments may not have bothered to exercise on their own between sessions. In this case, instead of the advice to “move it or lose it”, it might be “move it, or freeze into position.” Helen Frost, Sarah E Lamb, Helen A Doll, Patricia Taffe Carver, Sarah Stewart-Brown. Randomised controlled trial of physiotherapy compared with advice for low back pain. BMJ 2004;329:708.
AnthroHealth Tip of the Month: Click here http://www.epa.gov/SunWise/uvindex.html to see the distribution of UVB radiation by latitude in the United States. If you live, for instance, in Seattle and you also have dark skin color, you will have extreme difficulty in optimizing blood levels of vitamin D without taking vitamin D3 supplements. Actually, anyone living at the higher latitudes, no matter their skin color, will be unable to obtain vitamin D via skin exposure during the majority of the year. In fact, those individuals with dark skin color who live in the lower UV zones will still have problems optimizing their blood levels of vitamin D without supplementation unless they spend a significant portion of the hours of 10 am to 3 pm outdoors each day, and do not use sunscreen. So, this month’s tip is to use this map to help you determine what your vitamin D supplementation needs might be.
© 2001-2009 Kathleen E. Fuller, PhD. All rights reserved.