Category Archives: Health and Wellness

Understand Blood Pressure

Understanding Blood Pressure

Getting your blood pressure checked is nothing new. But do you understand it all?

What Exactly Is Blood Pressure?

Blood pressure’s the force of your blood pushing against the walls of your arteries. High blood pressure, or hypertension, is a common disease when that pressure of the blood flowing through the blood vessels is too high.

If your blood pressure gets too high, it can cause serious damage which can lead to blockage which can cause heart attacks, strokes, and heart failure.

There are 2 main types of high blood pressure:

  • Primary high blood pressure is the most common type and it tends to develop as you age.
  • Secondary high blood pressure is caused by another medical condition or use of certain medicines and it usually goes away when this issue is treated.

Risk Factors for High Blood Pressure

  • Age – Men usually develop it around age 45 and women after age 65.
  • Race – High blood pressure and serious complications are more common for African Americans.
  • Family history – It tends to run in families.
  • Certain chronic conditions – Kidney disease, diabetes, and sleep apnea can raise your blood pressure.
  • Stress
  • Pregnancy
  • Being overweight
  • Not being physically active
  • Tobacco use
  • Too much salt
  • Too much alcohol
  • Too little potassium
  • Too little vitamin D

If you have some of these other risk factors, your doctor may set your blood pressure target lower.

What Are the Numbers?

  • Systolic is the pressure in your arteries when your heart contracts, the top number.
  • Diastolic is when your heart rests, the bottom number.

 What Are They Doing?

When a nurse takes your blood pressure, you might wonder what they’re doing. These are the steps they’re following:

  • They wrap the blood pressure cuff around your arm.
  • They place a stethoscope under the cuff at the crease of your elbow (where the major blood vessel of the upper arm is.)
  • They inflate the cuff until it stops the flow of blood.
  • They slowly loosens the cuff’s valve to let the blood start to flow again and listen for sounds in the blood vessel.
  • Then, the first tapping noise they hear, they’ll note as the systolic number, the maximum pressure when the heart contracts.
  • The taps fade, and they note the pressure at the last tap as your diastolic number, the minimum pressure while your heart’s at rest.
  • Along with your numbers, they note which arm they took your blood pressure on and how you were positioned, like sitting with your feet flat.

 Where Should My Numbers Be?

Systolic Measure

Diastolic Measure

What to Do

Normal

Below 120

Below 80

Maintain a healthy lifestyle to avoid raising your levels.

High-normal

120 to 139

80 to 89

Make lifestyle changes.

High

140 to 159

90 to 99

Make lifestyle changes. Possibly start a low-level diuretic.

Extremely High

160 or higher

100 or
higher

Often 1 or 2 meds are required right away, plus lifestyle changes.

Source: Consumer Reports, “onHealth”, Volume 23 Number 2

It’s also normal for your blood pressure to change when you sleep, wake up, are active, and are excited or nervous.

If you’re worried about your blood pressure, keep an eye on your levels and take them with you to your next appointment. A broad look at your numbers can help your doctor put you on the right track for heart health.

Wintertime Worries and Falling

Falling and SAD in the Winter

The air is getting crisper and unfortunately, the sun shines less and less. Before we know it, snowflakes and ice will begin to fall. These wintery mixes can compromise both our balance and mental health. Both falling and SAD (Seasonal Affective Disorder) can come with the winter weather.

Falling

Each year, more than 300,000 injuries result from falls. Give yourself plenty of time and don’t rush around. Be especially careful getting into and out of your car by holding onto the door or framework for support.

If you must carry things, try to distribute the weight evenly and carry them below waist level, to help keep your center of gravity low. Go down icy stairs sideways.

Take short, flat-footed steps with your feet slightly farther apart than normal with your hands out of your pockets. Keep your eyes on the ground in front of you.

Wear boots or shoes with good traction. Rubber soles are better than plastic or leather. If you wear heels, wear wedges of no more than 2 inches. Once you’re inside, wipe and dry your shoes off to prevent creating slippery conditions inside too.

If you do lose your footing, try to fall so your thighs, hips, then shoulders hit the ground in that order, to keep your arms from taking all your body weight and possibly breaking. Tuck and bend your back and head toward your chest to keep from smacking your head.

SAD

A person suffering from SAD usually experiences depression and unexplained fatigue throughout the winter, while his or her symptoms disappear with the return of spring.

The reasons for developing SAD are still largely unknown, although experts believe it’s somehow triggered by decreased exposure to sunlight.

The symptoms are very similar to depression, but someone with SAD will experience these changes in mood and behavior in a regular, seasonal pattern.

A person with SAD or depression may have a few or all of the symptoms, like loss of energy, changes in mood, trouble concentrating, appetite changes, and weight gain.

Once you’re diagnosed, your doctor may prescribe antidepressants for just the months you need them. Another option is light therapy. Light therapy uses a special light panel or box that mimics the light from the sun.

Your Home's Thermostat

Long View: No One Wins in Thermostat Wars

When I was little, I loved visiting my grandparents in the winter. There was always lots of snow, and my siblings, cousins and I would play outside for hours. Our folks would slap a stocking cap on our heads with a pair of woolen mittens and any available coat. Then off we would go. The cold didn’t even bother me then. We usually came in when our cheeks and fingers were numb, but not before.

Things have changed, to say the least. I now own every thermal article of clothing known to mankind. If it’s cold enough, I have been known to wear gloves to get the mail, and the letter box is on my front porch. Winter weather is no longer the joyful playground of my youth.

My grandmother lived with my aunt and cousin until she was in her 90s. I remember the “thermostat wars” every winter. Grandma was never warm enough and would flip the thermostat up to 85. My aunt would be “roasting to death,” as she would say, and turn the thermostat down to 65 degrees. They went back and forth until spring.

So what happens to transform cold-tolerant kids into shivering adults? Dr. Stephen Belgrave is a medical director at Health Alliance Medicare and a family practice physician. He puts it this way.

“Peripheral vascular disease affects many of our older patients,” he said. “This can slow circulation, and this often affects temperature sensations. It’s important to protect older people from extremes in temperature because of these types of sensory deficits.”

Ah, there you have it. It seems I now qualify as an “older patient.” But the question is how can caregivers help their mature friends and family members?

Here are a few suggestions:

• Be more tolerant when someone complains about being uncomfortable. Even if you think the temperature is cozy, that may not be true for older people.

• Make sure your loved ones have protection from the cold when they go outside. Check and see if they have a cold weather emergency kit in their car. If they don’t have one, it makes a great gift.

• Offer rides (in your preheated car) to the store, appointments and errands during colder months. Removing snow and warming up a car can be a serious hurdle to older adults and people with peripheral vascular disease.

• Finally, find a comfortable, temperate middle ground. Do not engage in “thermostat” wars. I can say from personal experience no one ever wins.

*This piece first ran in 2009.

Remembering with Alzheimer’s

Vantage Point: Sometimes Behavior is not a Problem, it is a Message

My grandmother died of Alzheimer’s over 15 years ago. I still remember my family’s denial. We couldn’t agree on her course of care, and it cut like a knife when she no longer recognized us.

Alzheimer’s is the third-leading cause of death in Washington. Yet current resources are treating less than five percent of those suffering. Recently, I attended an excellent presentation by Bob LeRoy of the Inland Northwest Chapter of the Alzheimer’s Association. Bob provided some staggering data which showed in comparison to diseases like diabetes, cancer, and HIV, Alzheimer’s receives the least funding for research. Yet it has grown the most drastically.

Nationally, more than five million people live with Alzheimer’s. With 10,000 people turning 65 every day, that number will grow quickly. Alzheimer’s has become the most expensive disease to treat in America and yet still lacks resources for support. Most caregivers of those diagnosed are unpaid family members.

Sadly, since my grandma’s time there have not been major strides in awareness, education or advocacy. But there are those trailblazing a path of hope. The Inland Northwest Alzheimer’s Association has a vision of a world without Alzheimer’s, where through research they can provide and enhance care to support all affected and reduce the risk of dementia through promoting brain health. Current resources include:

• Online workshops – Know the Ten Warning Signs
• Alzheimer’s Navigator – Help creating custom plans
• Community Resource Finder
• ALZ Connect – Networking with others who care for people with dementia
• Care Team Calendar – For coordination of responsibilities among family and friends
• Safety Center – Information and resources for safety in and out of the home

Find these resources at ALZ.org, or you may call 800-272-3900 for a 24/7 helpline.

Want to get involved? ALZ.org can help you find information on a 2014 Walk to End Alzheimer’s event in your area. In Douglas County, it’s a good idea to register your loved one on the Vulnerable Persons Register to help emergency responders assist and better meet their special needs. Find more.

Health Alliance Medicare encourages its members to take advantage of their comprehensive wellness benefits and in doing so hopes any signs of dementia can be identified early.  Until there is a cure taking action can help ease the pain of Alzheimer’s, both those for those who cope with the disease and those who care for them.

Baby Feet

Before the Burp Cloths, Learn These Baby Basics

If you or someone you love has had a baby, you know the joys that come with being pregnant. Soon-to-be moms and dads might also be nervous about what their health plan covers.

Heather Miller knows. Her team in our call center gets lots of questions from soon-to-be parents.

And she just gave birth to her son Kolton.

If she didn’t know the ins and outs from working at a health plan, Heather says she would have questions, too.

“My first questions would be, ‘Are my visits covered? What about my sonograms?’” she said.

Here’s what Heather says members need to know.

Before the baby is born, we cover:

  • Doctor’s office visits
  • Lab work
  • Sonograms

After the baby is born, we cover:

  • Being in the hospital (48 hours, or 96 hours after a C-section)
  • Most lab work
  • Follow-up visits

New parents typically have 31 days to add their newborn to their plan. Once they have, the baby is covered beginning on the date of birth.

Heather says to review your policy or log in at YourHealthAlliance.org for more details. If you still have questions, call the number on the back of your ID card.

“You’ll feel a little less nervous when you know what your plan covers before you start setting up those pre-baby visits,” she said.

Cholesterol Defined

Understanding Cholesterol

Cholesterol is a waxy substance made in your liver. Your body needs it to build your cells’ walls, digest fat, and make some hormones. Every day your liver makes enough for what your body needs, so you don’t need to add extra to your diet.

From hamburgers to cheese, cholesterol hides in some of our favorite foods. The average American man eats 337 milligrams of it each day, which is 37 milligrams more than the American Heart Association says is healthy.

Although 37 milligrams doesn’t seem like much, in a week, that adds up to 259 extra milligrams. A diet high in fat and cholesterol is the main reason for heart disease, which is the #1 cause of death in the United States.

Bad cholesterol can happen at any age to anyone, regardless of shape, size, or gender.

Guidelines

Total Cholesterol Level

Category

Less than 200 mg/dL

Good

200-239 mg/dL

Borderline High

240 mg/dL or higher

High

LDL (Bad) Cholesterol Level

Category

Less than 100 mg/dL

Best

100-129 mg/dL

Good

130-159 mg/dL

Borderline High

160 mg/dL or higher

High

HDL (Good) Cholesterol Level

Category

60 mg/dL or higher

Best

Less than 40 mg/dL

Too Low

Via The American Heart Association

Talk to your doctor to find out your numbers. The sooner you know them, the sooner you can plan for better health.

Know Your Heart Meds

Your Meds and Your Heart

Know Your Heart Meds

You don’t need to be an expert on your drugs, that’s what your doctor’s for, but you should ask questions and know the basics about your heart meds.

Whether it’s a pill for high cholesterol or your blood pressure medicine, make sure you know the answers to these questions:

  • What’s the name of my medicine?
  • What does it do?
  • What are its side effects?
  • What can I do to reduce those side effects?
  • How does this drug work with other drugs, dietary supplements, foods, or drinks?
  • How much is a one dose?
  • When’s the best time to take this medicine, like when you wake up, with breakfast, or before bed?
  • How long will I take this medicine?
  • What should I do if I miss a pill?

Helpful Terms for Understanding Your Blood Pressure Heart Meds

Blood vessels move blood through your body. These are the types of blood vessels:

  • Arteries – These carry blood away from your heart
  • Capillaries – These connect your arteries to your veins and help move water and chemicals between your blood and tissues.
  • Veins – These carry blood from your capillaries back to your heart

Did you know? If you laid all the blood vessels of an average adult in a line, it would stretch over 100,000 miles.

Kinds of Blood Pressure Heart Meds

Blood pressure meds fall into 11 different classes, but they all have the same goals, to lower and control your blood pressure.

Classes

How It Works

Possible Side Effects

Diuretics Help your body flush extra salt and water through your urine.
  • More trips to the
    bathroom
  • Low potassium
Beta-Blockers Reduce your heart rate and how much blood it pumps to lower your blood pressure.
  • Drowsiness
  • Low heart rate
  • Decreased sexual
    ability
ACE Inhibitors (Angiotensin-Converting Enzyme) Narrow your arteries and make you produce less angiotensin, so that your blood vessels can open up to lower your blood pressure.
  • Dry cough
  • High potassium levels
Angiotensin II Receptor Blockers Block your blood vessels from angiotension, so that your blood vessels can open up to lower your blood pressure.
  • High potassium levels
Calcium
Channel Blocker
Prevents calcium from entering the muscle cells of your heart and arteries, which makes your heart’s job easier, and helps your blood vessels open up to lower your blood pressure.
  • Low heart rate
  • Uneven or rapid heartbeat
  • Constipation
  • Ankle swelling
Alpha-Blockers Reduce nerve impulses to your blood vessels to let blood pass more easily.
  • Headache
  • Pounding heartbeat
  • Nausea
  • Weakness
  • Weight gain
  • Small decreases in bad cholesterol
Central
Agonists
Decrease your blood vessels’ ability to narrow, which also helps to lower blood pressure.
  • Anemia
  • Constipation
  • Dizziness
  • Lightheadedness
  • Drowsiness
  • Dry mouth
  • Decreased sexual
    ability
  • Fever

Via the American Heart Association.

Kinds of Cholesterol Heart Meds

Depending on the type, cholesterol meds help:

  • Lower your bad cholesterol.
  • Lower your triglycerides, a fat in your blood that raises your risk of heart disease.
  • Increase your good cholesterol, which guards against heart disease.

Types of Cholesterol Meds

How It works

Possible Side Effects

Statins
Altoprev (lovastatin)
Crestor (rosuvastatin)
Lescol (fluvastatin)
Lipitor (atorvastatin)
Mevacor (lovastatin)
Pravachol (pravastatin)
Zocor (simvastatin)
Lower bad cholesterol and triglycerides and cause small increases in good cholesterol.
  • Constipation
  • Upset stomach
  • Diarrhea
  • Stomach pain
  • Cramps
  • Muscle soreness
  • Muscle pain
  • Weakness
  • Interaction with grapefruit juice
Bile Acid Binding Resins
Colestid (colestipol)
Questran (cholestyramine/ sucrose)
Welchol (colesevelam)
Lower bad cholesterol.
  • Constipation
  • Bloating
  • Upset stomach
  • Gas
  • May increase triglycerides
Cholesterol Absorption Inhibitor
Zetia (ezetimibe) Lowers bad cholesterol, and causes small decrease in triglycerides and small increase in good cholesterol.
  • Stomach pain
  • Exhaustion
  • Muscle soreness
Combination Cholesterol Absorption Inhibitor and Statin
Vytorin (ezetimibe-simvastatin) Lowers bad cholesterol and triglycerides and increases good cholesterol.
  • Stomach pain
  • Exhaustion
  • Gas
  • Constipation
  • Cramps
  • Muscle soreness
  • Muscle pain
  • Weakness
  • Interaction with grapefruit juice
Fibrates
Lofibra (fenofibrate)
Lopid (gemfibrozil)
TriCor (fenofibrate)
Lower triglycerides and increases good choleterol.
  • Upset stomach
  • Stomach pain
  • Gallstones
Niacin
Niaspan (prescription niacin) Lowers bad cholesterol and triglycerides and increases good cholesterol.
  • Flushed face and neck
  • Upset stomach
  • Throwing up
  • Diarrhea
  • Joint pain
  • High blood sugar
  • Peptic ulcers
Combination Statin and Niacin
Advicor (niacin-lovastatin) Lowers bad cholesterol and triglycerides and increases good cholesterol.
  • Flushed face and neck
  • Dizziness
  • Irregular heartbeats
  • Shortness of breath
  • Sweating
  • Chills
  • Interaction with grapefruit juice
Omega-3 Fatty Acids
Lovaza (prescription omega-3 fatty acid supplement)
Vascepa (Icosapent ethyl)
Lowers triglycerides.
  • Burping
  • Fishy taste
  • Increased infection risk

Via The Mayo Clinic

When Should I Take My Heart Meds?

Your body’s inner clock can affect how well some medications work. Since, you can’t read your body’s clock though, researchers have studied how well heart meds work when they’re taken at different times of the day.

According to a clinical trial from Medscape, blood pressure meds are most effective when taken at night. The random trial tested the effect of taking blood pressure meds at bedtime versus in the morning.

It found that treatment at bedtime was the most cost-effective and simplest strategy to reach the right blood pressure when sleeping and of getting a normal 24-hour blood pressure pattern.”

It also estimated that each 5-mm-Hg decrease in overnight blood pressure reduced the risk of heart events by 14%.

Of course, you should always talk to your doctor before you make a change to your meds or their schedule. You can also learn more about the importance of taking your heart meds regularly and on-time in our Health section.