Friday, 20 December 2013
New Elder Blood Pressure Guidelines (and Chicken)
On Wednesday, The Journal of the American Medical Association (JAMA) upended 30 years of medical advice by publishing new hypertension (high blood pressure) guidelines from a committee of 17 academcis that apply to people age 60 and older.
For 30 years, conventional medical wisdom has been that most people (and particularly elders) should strive for a blood pressure reading of less than 140/90, that anything higher, according to the new report
”leads to myocardial infarction, stroke, renal failure, and death if not detected early and treated appropriately.”
And so tens of millions of Americans take one or more drugs to control blood pressure above that magic number, 140/90 which describes a majority of Americans older t han 55. Here's a chart about that from the Wall Street Journal from data compiled by the Centers for Disease Control (CDC):
The new number below which drug treatment is no longer recommended is 150/90. That is, the diastolic (bottom) number remains the same; the systolic (top) number is increased by 10.
As you can imagine, there is some controversy about this announcement. It comes mainly because so much progress has been made in controlling hypertension with drugs for the past several decades.
”The old blood pressure targets made a huge difference in patients’ health, said Dr. Marvin Moser, a hypertension expert [quoted in The New York Times], who was the chairman of the first blood pressure guidelines committee in 1977 and a member of the six committees after that, but not of the most recent one.
“'The thing about hypertension is that it is a dull disease, but the results of treatment are spectacular,' he said. The incidence of strokes has fallen by 70 percent since 1972, and heart failure rates have fallen more than 50 percent.
“'It used to be that every third or fourth hospital bed had someone with hypertension in it,' Dr. Moser said. 'Today it is very rare to find someone with malignant hypertension' — that is, dangerously high and uncontrolled blood pressure.”
So if your systolic blood pressure reading falls between 140 and 150 and you take medication for it, maybe you can stop. Or maybe not. It would be foolish to not consult your physician first.
You can read the full report online at JAMA.
While we're discussing health issues, this new study from Consumer Reports is seriously important. The testers bought
”...316 chicken breasts from major national grocery chains, big-box stores, and regional markets in 26 states, and tested them for six bacteria...We tested 252 samples from conventionally produced chickens and 64 from brands that use no antibiotics in raising chickens, including 24 organic samples.
“97% of the breasts we tested harbored bacteria that could make you sick.
While losing 30-plus pounds this year, I gave up all meat – beef, pork, lamb – not because I object all that much to eating them in moderation. The problem for me or anyone determined to lose weight is the high number of calories packed into small amounts of meat.
I would rather use those calories for a larger volume of food – vegetables, fruit, whole grains and fish – that fill my stomach more.
But I did eat chicken, in small amounts as in a salad, on occasion. But never again. Let's repeat that Consumer Reports' finding:
97 PERCENT OF THEIR CHICKEN SAMPLES WERE CONTAMINATEDHere are some other frightening details from the report:
• We found no significant difference in the average number of types of bacteria between conventional samples and those labeled “no antibiotics” or “organic.”
• More than half of the chicken breasts were tainted with fecal contaminants (enterococcus and E. coli)
• About half of our samples (49.7 percent) tested positive for at least one multidrug-resistant bacterium, and 11.5 percent carried two or more types of multidrug-resistant bacteria.
• Even if you keep your kitchen very clean, you could still be exposed to illness-causing bacteria if you don’t cook the chicken to an internal temperature of 165° F. It’s vital that you check using a meat thermometer.
• According to James R. Johnson, M.D., a professor of medicine in the division of infectious diseases and international medicine at the University of Minnesota, you don’t have to ingest a lot of bacteria to become sick. It’s possible that simply touching the plastic wrapping on the outside of chicken packages might expose you to harmful bacteria, Johnson says.
• Our tests did not find brands or types of chicken breasts that had less bacteria than the rest.
Personally, I will never eat chicken again. Not at home and certainly not in a restaurant where I have no control of its handling and cooking.
You don't need to be a Consumer Reports subscriber to read the entire report here.
At The Elder Storytelling Place today, Janet Thompson: A Horsehair Bridle