COMMUNITY HYPERTENSION PROGRAMS IN THE AGE OF MOBILE TECHNOLOGY AND SOCIAL MEDIA

ALEXANDER G. LOGAN

Community programs for the prevention of cardiovascular disease have generally succeeded in lowering blood pressure (BP) and improving cardiovascular health in the general population. They have also met the challenge of raising awareness, increasing knowledge, and promoting changes in health behavior. Moreover, they have likely contributed to the improved rates of BP control among hypertensive patients in North America over the past 2 decades. Successful population-based interventions combined the power of mass media and other communication tools with screening and counselling activities. These targeted BP programs were firmly rooted in sound scientific evidence that interventions to lower BP improve health outcomes. The study by Salazar et al. adds another dimension to population-based programs by highlighting the importance of sustained public health activity to maintain good BP control. These investigators demonstrated that individuals whose BP rose during the community intervention were at higher risk of developing a cardiovascular event.

The new challenge for hypertension programs is maintaining community interest while reiterating the same health messages. A recent measles outbreak among unvaccinated adults in Canada has shown that in the absence of constant reminders, memories about serious preventable illnesses fade. To communicate effectively, community hypertension programs will need to borrow heavily from the world of technology about packaging messages to meet the changing ways that the general population consumes information.  Public health interventions will need to take into account the new communication tools and fashion messages that fit the constraints of these instruments. It has amply been demonstrated that multiple approaches are required and communication strategies differ markedly among the target population to be reached. Interventions must also tap into risk factors that are products of the changing lifestyle of the community. It is apparent that lifestyle messages need to adapt to the reality of more prolonged periods of sitting at work, decreased time for meal preparation, financial constraints requiring dual-earner partnerships, and more fragmented and disrupted sleep. New public health approaches need to be rigorously evaluated to ensure that they are both cost-effective and applicable to large segments of the population. In the past, several well-thought-out, community-wide strategies for cardiovascular disease prevention, when properly evaluated, proved to have modest or no effect, leading the investigators to conclude that there was a need for new designs and new interventions.

We are now living in an age where telecommunication systems allow individuals easy access to reliable health information anytime, anywhere. Networks using 3G and 4G technology enable high-speed data transfer and support a wide variety of information technology platforms. This new technology provides patients with direct access to personal health records, web portals, and healthcare providers. Presently, it is unclear what system works best and whether there are differences between countries. There are trials demonstrating the benefits of telecommunication in both developed and developing countries.

Wireless connectivity is growing rapidly, and mobile devices are replacing landlines, desktop computers, and workstations as the preferred method of communication. The sale of smartphones with built-in messaging systems now outstrips that of cell phones. The recent flood of mobile healthcare devices and software applications has greatly expanded self-care capabilities across the spectrum of healthcare activities. Apart from ubiquitous educational materials, there is a cornucopia of self-help wellness and fitness programs for individuals interested in maintaining or improving their health. There is also a wide range of mobile services and solutions to prevent, diagnose, and treat diseases. Mobile health applications running on wireless devices facilitate disease monitoring.They enable remote monitoring of vital parameters to ensure health maintenance and provide early signals of potentially dangerous trends away from good health. Sleek wearable medical technology, now highly fashionable, allows individuals to monitor a wide array of vital signs and symptoms effortlessly and unobtrusively. Many such devices have built-in Bluetooth capabilities to transmit the data to a secure online database using a protected Internet connection, which in turn provides immediate feedback to users.

In the past decade, there has been a shift away from the traditional medical model of healthcare delivery to a more personalized system in which individuals are encouraged to participate in health maintenance activities and, for those with health problems, to work collaboratively with their healthcare providers. In the new paradigm, community resources, and policies are integrated more closely into the health system to ensure that programs have a broad reach yet provide needed support for targeted activities. The effectiveness of this combined approach was recently demonstrated in a randomized controlled trial of a multipronged, community-based health promotion and prevention program for cardiovascular disease. The intervention, which targeted older adults, engaged public health units, community physicians, and local health organizations, significantly improved cardiovascular risk factor management, and reduced morbidity at the population level. An essential element of the study’s intervention was self-management support.

There are many domains of health under personal control. Individuals can easily learn self-care skills, become more knowledgeable about health matters, modify poor lifestyle choices, use monitoring tools that track vital health parameters, and identify ways of preventing or mitigating the effects of the disease. Interactive technologies and online resources such as social networks, video chat, and instant messaging platforms facilitate these self-help behaviours and are successfully filling gaps in the current health systems. Through social media, individuals can find or create networks with peers to share common experiences, increase problem-solving skills and gain confidence in making life-improving changes. Such interactions build a strong sense of belonging and encourage participation in communal efforts to combat health problems in targeted groups. These developments are encouraged by the US Institute of Medicine and strongly endorsed by academic leaders in the United States.

If information technology is an important key to the future of community-based programs for chronic conditions such as hypertension, it faces many challenges. Foremost, it needs to appeal to all stakeholders, including organizations representing professionals, academic and research institutions, industry, and representatives from the general public. Age is a potential barrier in building successful interventions that use health information technology. The targeted population for hypertension is mostly aged >50 years and, in general, newly acquiring the skills to use the Internet and mobile devices. Nonetheless, the number of users in this age bracket is growing rapidly. A 2010 survey by the American Association of Retired Persons found that most were comfortable using a mobile phone and 7% even had a smartphone. Furthermore, older adults are interested in acquiring the skill to use a mobile health system to track vital signs such as BP and weight. For educators, it is important to recognize that many features of mobile devices are not intuitive for users aged >50 years and developing that intuition takes time. To increase acceptability of mobile health systems for older adults who are more likely to have a hearing, vision, cognition, and mobility problems, developers need to avoid design features such as small buttons and dim screens that impede usability. Apart from age and design issues, other impediments to the use of mobile health technology include affordability and availability that may reduce access. Such barriers are not insurmountable and are amenable to thoughtful solutions such as the use of publically available devices.

In summary, there is a growing body of evidence that community programs reduce BP and improve cardiovascular health in the general population.  Assessments of cardiovascular risk factors by the World Health Organization MONICA project from the mid-1980s to mid-1990s and by the National Health and Nutrition Examination Survey from 1971 to 2010 provide additional support for population-based interventions. Both surveys showed a leftward shift in the frequency distribution of BP. Importantly, the decrease in BP occurred equally at all levels of readings, indicating that the change was not specifically related to better clinical management of hypertension and the increasing application of antihypertensive medications. This evidence, along with the new findings of Salazar et al., justifies supporting community efforts to improve the management of cardiovascular risk factors. For continued success, however, community programs will need to take into account the changing way healthcare is being delivered and incorporate the advances in mobile communication technology and social media in program planning.

REFERENCES:  COMMUNITY HYPERTENSION PROGRAMS IN THE AGE OF MOBILE TECHNOLOGY AND SOCIAL MEDIA

TYPE 2 DIABETES AND SLEEP

Reviewed by Nayana Ambardekar, MD.

People who have diabetes often have poor sleep habits, including difficulty falling asleep or staying asleep. Some people with diabetes get too much sleep, while others have problems getting enough sleep. According to the National Sleep Foundation, 63% of American adults do not get enough sleep needed for good health, safety, and optimum performance.

There are several causes of sleep problems for people with type 2 diabetes, including obstructive sleep apnea, pain or discomfort, restless legs syndrome, the need to go to the bathroom, and other problems associated with type 2 diabetes.

Sleep Problems and Type 2 Diabetes

Sleep Apnea

Sleep apnea involves pauses in breathing during sleep. The periods of stopped breathing are called apneas, which are caused by an obstruction of the upper airway. Apneas may be interrupted by a brief arousal that does not awaken you completely — you often do not even realize that your sleep was disturbed. Yet if your sleep was measured in a sleep laboratory, technicians would record changes in the brain waves that are characteristic of awakening.

Sleep apnea results in low oxygen levels in the blood because the blockages prevent air from getting to the lungs. The low oxygen levels also affect brain and heart function. Up to two-thirds of the people who have sleep apnea are overweight.

Sleep apnea alters our sleep cycle and stages of sleep. Some studies have linked altered sleep stages with a decrease in growth hormone, which plays a key role in body composition such as body fat, muscle, and abdominal fat. Researchers have found a possible link between sleep apnea and the development of diabetes and insulin resistance (the inability of the body to use insulin).

Peripheral Neuropathy

Peripheral neuropathy, or damage to the nerves in the feet and legs, is another cause of sleep disruption. This nerve damage can cause a loss of feeling in the feet or symptoms such as tingling, numbness, burning, and pain.

Restless Legs Syndrome

Restless legs syndrome is a specific sleep disorder that causes an intense, often irresistible urge to move your legs. This sleep disorder is often accompanied by other sensations in the legs such as tingling, pulling, or pain, making it difficult to fall asleep or stay asleep.

Hypoglycemia and Hyperglycaemia

Both hypoglycemia (low blood sugar) and hyperglycemia (high blood sugar) can affect sleep in those with diabetes. Hypoglycemia may occur when you have not eaten for many hours, such as overnight, or if you take too much insulin or other medications. Hyperglycaemia occurs when the sugar level rises above normal. This may happen after eating too many calories, missing medication, or having an illness. Emotional stress can also cause your blood sugar to rise.

Obesity

Obesity, or too much body fat, is often associated with snoring, sleep apnea, and sleep disturbance. Obesity increases the risk of sleep apnea, type 2 diabetesheart diseasehypertensionarthritis, and stroke.

How Are Sleep Problems Diagnosed?

Your doctor will ask you about your sleep patterns, including whether you have trouble falling or staying asleep, are sleepy during the day, have difficulty breathing while asleep (including snoring), have pain in your legs, or move or kick your legs while sleeping.

Your doctor may refer you to a sleep specialist who may do a special sleep study called a polysomnogram to measure activity during sleep. The results of the sleep study can help your doctor make an accurate diagnosis and prescribe an effective and safe treatment.

How Are Sleep Problems Treated in Type 2 Diabetes?

There are several treatments for sleep problems in people with diabetes, depending on the condition:

Sleep Apnea

If you are diagnosed with sleep apnea, your doctor may suggest that you lose weight to help you breathe more easily.

Another potential treatment is continuous positive airway pressure (CPAP). With CPAP, patients wear a mask over their nose and/or mouth. An air blower forces air through the nose and/or mouth. The air pressure is adjusted so that it is just enough to prevent the upper airway tissues from collapsing during sleep. The pressure is constant and continuous. CPAP prevents airway closure while in use, but apnea episodes return when CPAP is stopped or is used improperly.

Peripheral Neuropathy

To treat the pain of peripheral neuropathy, your doctor may prescribe simple pain relievers such as aspirin or ibuprofenantidepressants such as amitriptyline, or anticonvulsants such as gabapentin (Gralise, Neurontin), tiagabine (Gabitril) or topiramate (Topamax). Other treatments include carbamazepine (Carbatrol, Tegretol), pregabalin (Lyrica), lidocaine  injections, or creams such as capsaicin.

Restless Legs Syndrome

Various medications are used to treat restless legs syndrome, including dopamine agents, sleeping aids, anticonvulsants, and pain relievers. Your doctor may also prescribe iron if you have low iron levels.

There are also several medications that treat insomnia, including:

Over the counter drugs such as antihistamines including diphenhydramine (such as Benadryl). These drugs should be used short-term and in conjunction with changes in sleep habits.

Medications used to treat sleep problems such as eszopiclone (Lunesta), suvorexant (Belsomra), zaleplon (Sonata), and zolpidem (Ambien).

Benzodiazepines are an older type of prescription medicine that causes sedation, muscle relaxation, and can lower anxiety levels. Benzodiazepines that were commonly used for the treatment of insomnia include alprazolam (Xanax), diazepam (Valium), estazolam (ProSom), flurazepam, lorazepam (Ativan), temazepam (Restoril), and triazolam (Halcion)

Antidepressants such as nefazodone and very low doses of doxepin

How Can I Improve my Sleep?

In addition to medications, recommendations to improve sleep are:

Learn relaxation and breathing techniques.

Listen to a relaxation or nature sounds CD.

Get regular exercise, no later than a few hours before bedtime.

Don’t use caffeine, alcohol, or nicotine in the evening.

Get out of bed and do something in another room when you can’t sleep. Go back to bed when you’re feeling drowsy.

Use the bed only for sleeping and sexual activity. Don’t lie in bed to watch TV or read. This way, your bed becomes a cue for sleeping, not for lying awake.

Are There Other Links Between Sleep and Type 2 Diabetes?

People who have poor sleep habits are at greater risk of becoming overweight or obese and developing type 2 diabetes, according to several studies. Chronic sleep deprivation may lead to insulin resistance, which can result in high blood sugar and diabetes.

Some studies show that chronic sleep deprivation can affect hormones that control appetite. For example, recent findings link inadequate sleep with lower levels of the hormone leptin, which helps control the metabolism of carbohydrates. Low levels of leptin have been shown to increase the body’s craving for carbohydrates regardless of the number of calories consumed.

WebMD Medical Reference 

TYPE 2 DIABETES AND SLEEP

6 LIFESTYLES TO CONTROL YOUR DIABETES

6 LIFESTYLES TO CONTROL YOUR DIABETES

Working closely with your doctor, you can manage your diabetes by focusing on six key changes in your daily life.

  1. Eat healthily. This is crucial when you have diabetes because what you eat affects your blood sugar. No foods are strictly off-limits. Focus on eating only as much as your body needs. Get plenty of vegetables, fruits, and whole grains. Choose nonfat dairy and lean meats. Limit foods that are high in sugar and fat. Remember that carbohydrates turn into sugar, so watch your carb intake. Try to keep it about the same from meal to meal. This is even more important if you take insulin or drugs to control your blood sugars.
  2. Exercise.If you’re not active now, it’s time to start. You don’t have to join a gym and do cross-training. Just walk, ride a bike, or play active video games. Your goal should be 30 minutes of activity that makes you sweat and breathe a little harder most days of the week. An active lifestyle helps you control your diabetes by bringing down your blood sugar. It also lowers your chances of getting heart disease. Plus, it can help you lose extra pounds and ease stress.
  3. Get checkups. See your doctor at least twice a year. Diabetes raises your odds of heart disease. So learn your numbers: cholesterolblood pressure, and A1c (average blood sugar over 3 months). Get a full eye exam every year. Visit a foot doctor to check for problems like foot ulcers and nerve damage.
  4. Manage stress. When you’re stressed, your blood sugar levels go up. And when you’re anxious, you may not manage your diabetes well. You may forget to exercise, eat right, or take your medicines. Find ways to relieve stress — through deep breathing, yoga, or hobbies that relax you.
  5. Stop smoking. Diabetes makes you more likely to have health problems like heart diseaseeye disease, strokekidney diseaseblood vessel disease, nerve damage, and foot problems. If you smoke, your chance of getting these problems is even higher. Smoking also can make it harder to exercise. Talk with your doctor about ways to quit.
  6. Watch your alcohol. It may be easier to control your blood sugar if you don’t get too much beer, wine, and liquor. So if you choose to drink, don’t overdo it. The American Diabetes Association says that women who drink alcohol should have no more than one drink a day and men should have no more than two. Alcohol can make your blood sugar go too high or too low. Check your blood sugar before you drink, and take steps to avoid low blood sugars. If you use insulin or take drugs for your diabetes, eat when you’re drinking. Some drinks — like wine coolers — may be higher in carbs, so take this into account when you count carbs.

WebMD Medical Reference Reviewed by Neha Pathak, MD

 

BLOOD PRESSURE CHART WITH LATEST BLOOD PRESSURE GUIDELINES

The blood pressure guidelines found in the blood pressure chart further down the page are the 2017 updated blood pressure guidelines as proposed by the American Heart Association and other health organizations.[1] The blood pressure quiz can be completed before or after reading the article and viewing the blood pressure chart.

What is blood pressure?

Blood pressure is the force of blood against the artery walls. It rises during heartbeats and falls in between heartbeats. There are always two pressures expressed in blood pressure ranges, the systolic blood pressure and the diastolic blood pressure.

Blood pressure ranges are usually written using the systolic blood pressure number before or above the diastolic blood pressure number, for example ,120/80 mmHg. The systolic blood pressure, the 120 as illustrated in the blood pressure chart, is the pressure reading as the heart pumps blood out from the ventricle into the veins. The diastolic blood pressure, the 80 as illustrated in the blood pressure chart, is the resting pressure, which is between beats when the pressure decreases before the next heart pumping action.

High blood pressure is termed hypertension; low blood pressure is hypotension. If there is no obvious cause for hypertension, which is often the case, it is called primary hypertension. Secondary hypertension, the term given to only 5 to 10% of cases, can be caused by a number of factors, amongst them ka idney or heart disease and hardening of the arteries.

What is considered high blood pressure?

Hypertension is according to the latest blood pressure guidelines now defined as a systolic reading of 130 mm Hg or higher or a diastolic reading of 80 mm Hg or higher. This a change from the old blood pressure guidelines for hypertension, which was a systolic reading of 140 mm Hg or higher, and a diastolic reading of 80 mm Hg or higher.

Summary of the latest blood pressure guidelines:

Normal Blood pressure: Under 120/80 mm Hg;

Elevated Blood Pressure: A systolic blood pressure of 120-129 mm Hg and a diastolic blood pressure under 80 mm Hg;

High Blood Pressure Stage 1: A systolic blood pressure 130-139 mm Hg or a diastolic blood pressure 80-89 mm Hg;

High Blood Pressure Stage 2: A systolic blood pressure of a minimum of 140 mm Hg or a diastolic blood pressure of a minimum of 90 mm Hg;

Hypertensive Crisis: A systolic blood pressure of more than 180 mm Hg or/and a diastolic blood pressure of more than 120 mm Hg.

Researchers have found that blood pressure changes at 4 phases throughout life: a quick increase throughout adolescent growth; a milder increase early on in adult years; an acceleration in the 40s; and by the age of 50, the normal average blood pressure ranges have increased to 129/85. During a period in late adult years, blood pressure will increase slowly and then reduces.[2]

The primary causes of blood pressure increasing over a lifetime can be modified and could be focused on to help prevent heart disease: even though high blood pressure often has no obvious symptoms, this condition could lead to life threatening stroke and heart attacks, so a reduction in blood pressure is crucial for health.

According to one study, a decrease as well as an increase in your blood pressure throughout middle age could significantly affect your lifetime cardiovascular disease risk.[3]

Individuals that maintained or lowered blood pressure to normal blood pressure levels by 55 years old had the lowest lifetime cardiovascular disease risk of between 22% and 41%. In comparison, people who already had high blood pressure by 55 years old had a greater lifetime risk of between 42% and 69%.

Both avoiding high blood pressure throughout middle age or delaying the start of the development of high blood pressure seem to have a significant affect on a person’s remaining lifetime cardiovascular disease risk.

The study also found:

Nearly 70% of all men that get hypertension during middle age will have a cardiovascular disease incident by 85 years old.

Women that get hypertension by earlier middle age have a higher lifetime cardiovascular disease risk of 49.4% than those that have kept normal blood pressure until the age of 55.

Women generally had higher increases in blood pressure throughout middle age.

At an average of 55 years old, 40.8% of women and 25.7% of men had blood pressure levels that were normal; 47.5% of women and 49.4% of men had prehypertension (the 2017 blood pressure guidelines have eliminated the prehypertension category and is now labeled as stage 1 hypertension).

The overall lifetime cardiovascular disease risk for people aged 55 years or more was 39.9% for women and 52.5% for men, after factoring in all blood pressure levels.

The lifetime cardiovascular disease risk was higher among Blacks in comparison to Whites of the same sex, and went up with increasing blood pressure at middle age.

Risks of high blood pressure

  1. Brain damage

The brain is dependent upon a nourishing blood supply to function correctly and survive. But hypertension can result in various complications, which includes:

Dementia is a brain disease which results in difficulties with thinking, speaking, reasoning, memory, vision and movement. Vascular dementia can happen from the narrowing and blocking of the arteries supplying the brain’s blood. It can also be a consequence of strokes as a result of a disruption of blood flow to the brain. Either way, hypertension could be the reason.

A stroke is when the deprivation of oxygen and nutrients to the brain takes place, which causes brain cell death. Uncontrolled hypertension can result in stroke by the blood vessels in the brain being damaged and weakened, which causes the blood vessels to narrow, rupture or leak. Hypertension can also contribute to blood clots forming in the arteries, causing blocked blood flow in the brain and possibly leading to a stroke.

  1. Eye damage

Blood is supplied to the eyes by small and delicate blood vessels. They can also be damaged by hypertension just like other blood vessels:

Hypertension can damage blood vessels providing blood to the retina, resulting in a condition known as retinopathy. This condition can cause bleeding in the eye, which can lead to blurred vision and total vision loss.

In a condition known as choroidopathy, fluid accumulates below the retina due to a leaky blood vessel. Choroidopathy can lead to distorted vision and in some instances scarring that will impair vision.

In a condition known as optic neuropathy, the optic nerve is damaged by blocked blood flow. It can result in nerve cell death in the eyes, which can lead to bleeding within the eye or loss of vision.

  1. Kidney damage

Excess fluid and waste is filtered from the blood by the kidneys, which is a process that is dependent on healthy blood vessels. The blood vessels in the kidneys as well as the blood vessels leading to the kidneys can be damaged when blood pressure is high, resulting in various forms of kidney disease.

When an aneurysm takes place in an artery that leads to the kidney, it’s known as a kidney artery aneurysm. After a while, high blood pressure levels in a weakened artery can result in a section to enlarge and form an aneurysm, a bulge in the blood vessel wall. Aneurysms can rupture and bring about internal bleeding.

Hypertension is one of the most common reasons for kidney failure because the large arteries which lead to the kidneys as well as the tiny blood vessels within the kidneys can be damaged. Kidneys cannot effectively filter waste from the blood if either of them are damaged, and because of this, dangerous fluid and waste levels can accumulate.

  1. Heart damage

Uncontrolled hypertension can damage the heart in various ways.

Coronary artery disease has an effect on the arteries supplying blood to the heart muscle. Blood does not flow freely through the arteries when they are narrowed as a result of coronary artery disease. A heart attack or irregular heart rhythms can be experienced when blood does not flow freely to the heart.

After a while, the strain on the heart caused by hypertension causes the heart muscle to weaken and work less efficiently. Eventually, the overwhelmed heart simply starts to wear out and results in heart failure.

An enlarged left heart can develop when hypertension forces the heart to work harder than needed to be able to pump blood to the body. This results in the left ventricle thickening or stiffening, which can increase heart attack risk.

  1. Bone damage

The amount of calcium in the urine can increase from high blood pressure levels. An excessive elimination of calcium can result in loss of bone density and osteoporosis.[4]

  1. Sexual dysfunction

Erectile dysfunction is much more likely to happen in men as they get older if they have hypertension. After a while, hypertension damages the blood vessel lining and will cause the arteries to harden and narrow, which restricts blood flow to the penis. The decrease in blood flow can make achieving and sustaining erections difficult for some men.

Women can also experience sexual dysfunction as a result of hypertension.

Check your blood pressure at home

The new blood pressure guidelines advise that blood pressure be measured regularly and it’s encouraged to make use of a home blood pressure monitor. Here is some advice on how to choose the best blood pressure monitor. The best blood pressure monitor is a blood pressure cuff that fits around the upper arm. Finger and wrist monitors aren’t as accurate. Choose an automated blood pressure cuff with a self-inflating cuff and a large, bright digital readout.

HOW TO LOWER YOUR BLOOD PRESSURE

  1. Smoke free

Every cigarette smoked raises blood pressure for a significant time after the cigarette is finished. Quitting smoking will help blood pressure go back to normal.

  1. Less alcohol

Alcohol in moderation can potentially reduce blood pressure by approximately 4 mm Hg. Moderate alcohol consumption is generally 2 drinks per day for men and 1 drink per day for women.

Consuming alcohol in excess can however increase blood pressure.

  1. Less salt (sodium)

If you have hypertension, the smallest decrease of the sodium in the diet can reduce blood pressure by approximately 5 to 6 mm Hg. Sodium should generally be limited to 2,300 mg a day or less, although a lower sodium intake of 1,500 mg a day or less is better. Eating fewer processed foods will help reduce sodium intake as most sodium is added during processing, with just a little amount of sodium occurring naturally in foods.

  1. Healthy weight

Blood pressure typically increases as body weight increases. Being overweight can also result in sleep apnea, which increases blood pressure even more.

One of the best lifestyle changes for managing blood pressure is losing weight. The smallest amount of weight lost if overweight can help reduce blood pressure. Blood pressure can generally be reduced by approximately 1 mm Hg with every kilogram of weight lost.

  1. Exercise more

If you already have high blood pressure, then exercising regularly for 150 minutes per week, or about half an hour most days of the week, can reduce blood pressure by approximately 5 to 8 mm Hg. Consistency is important, because blood pressure can go up again if you stop exercising. If blood pressure is elevated, exercise can help prevent hypertension.

Some kinds of aerobic exercise that can help to reduce blood pressure include walking, cycling, swimming or jogging. High-intensity interval training can be very effective for blood pressure reduction. Strength training can also help in reducing blood pressure. Consult your physician about creating an exercise program.

  1. Healthy diet

If you have hypertension, blood pressure can be reduced by as much as 11 mm Hg with a diet that’s abundant in vegetables, fruits, whole grains, and low-fat dairy products and low in saturated fats. Potassium in vegetables and fruit can help reduce the effects of sodium on blood pressure.

 

 

SHOULD I COUNT CALORIES OR CARBS TO LOSE WEIGHT?

What Matters Most When Weight Loss Is Your Goal

By Malia Frey |

What is the best way to lose weight? Dieters often get confused about whether they should count calories or carbs to slim down. Much of confusion is the result of the calories vs. sugar debate. Does calorie count matter more or should you reduce sugary carbs for weight loss? And what about fat? To get the answer, it’s important to sort through the nutrition facts.

Counting Calories or Carbs to Lose Weight

To lose weight, you must create a calorie deficit. That means you need to burn more calories than you consume. In very simple terms, it means that most of us need to eat less and move more. We can burn more calories through exercise or increased daily activity (for example, by boosting your step count) You can also create a deficit if you consume fewer calories each day.  So calories do count.

But your intake of fat, sugar, and carbohydrates can affect the total number of calories you consume each day. That means you should pay attention to those numbers as well.

How Each Affects Your Diet

Here is a brief explanation of how consuming calories in the form of fat, sugar, and carbohydrates can affect your total caloric intake:

Fat.  A single gram of fat provides nine calories of energy. A single gram of carbohydrate or protein only provides four calories. If you eat foods high in fat, your total caloric intake can increase quickly because the calorie cost is so high. But eating a reasonable amount of healthy fat can be smart for your diet.

Fat helps you to feel full and satiated. If you eat a small amount of fatty food, you may feel satisfied sooner and eat less overall. For that reason, foods that contain healthy fats like certain types of fishnuts or avocado can be a smart addition to your weight loss diet.

Sugar.  Sugar itself isn’t necessarily bad for you. But many of us consume way too much sugar without even knowing it. Sugar is added to many of the processed foods we eat.  Foods like ketchup, salsa or canned soups may contain added sugar even though they aren’t sweet.  And many of the drinks we consume are loaded with sugar. Increased sugar consumption has been linked to serious health consequences such as an increased risk for type 2 diabetes, metabolic syndrome, and obesity.

Aside from the health consequences of consuming too much added sugar, there are diet drawbacks as well. Many experts feel that the more sugar we eat; the more sugar we crave.  So if you can reduce your sugar intake, you may be able to reduce your total caloric intake and lose weight.

Carbohydrates.  At four calories per gram, carbohydrates are a good source of energy for your body.  But overeating refined carbohydrates like white rice and white bread is very easy to do and that habit can drive your calorie count through the roof.  In addition, when you eat low nutrient carbs, those items displace healthier foods—including a protein that can help you feel full and eat less.  If you choose to count carbohydrates to lose weight, make sure that the carbs you keep in your diet are full of important vitamins and minerals like fruits, vegetables, and whole grains.

The Bottom Line

To create a calorie deficit and lose weight, most people find it easiest to count calories. The calorie count is easy to find for most foods and easy to tally with a weight loss app or tracker. Also, your calorie count is what matters in the end if you want to lose weight.

However, as you count calories, it is helpful to look at your balance of carbohydrates, protein, and fat. If you keep your carb intake within recommended guidelines (50-65% of your total calorie intake) that leaves enough room to eat a healthy amount of protein and fat. By consuming a healthy, balanced diet, you are more likely to provide your body with the fuel it needs to stay active.

SHOULD I COUNT CALORIES OR CARBS TO LOSE WEIGHT?

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