Salt-potassium ratio may trump blood pressure for heart disease

Folks who think low blood pressure means they can consume salt without worry may be in for a surprise. Research suggests that the ratio of sodium to potassium in the diet is more predictive of health risks than high blood pressure is.

Even healthy individuals with normal blood pressure should avoid a "sodium-saturated diet," according to an eMaxHealth article by Dr. Robin Wulffson.
He's no lone voice, either.

Centers for Disease Control and Prevention researchers published a recent study in the Archives of Internal Medicine that found an increased risk based on that ratio, as well. The scientists controlled for "all the major cardiovascular risk factors" and still found an association with deaths from heart disease when the sodium-potassium ratio was bad. Sodium raises blood pressure and reduces the elasticity of arteries. Potassium activates nitric oxide, which relaxes arteries and lowers the risk of high blood pressure. Sodium, by the way, blocks uptake of nitric oxide.

The Institute of Medicine last year looked at data from 12,000 American adults and reported that a high-sodium diet increases the risk of heart disease, as has been widely reported. But of greater portent, it said, is the balance between the two chlorine salts: sodium raises risk, while potassium lowers it.
That study concluded that "no one is immune to the adverse health effects of excessive sodium intake."

Research shows that when the sodium-to-potassium ratio is high, people are nearly 50 percent more likely to die from any cause within the 14.8-year follow-up period and twice as likely to die from ischemic heart disease, compared to those who consumed less sodium than potassium.

Three-fourths of salt in the American diet is eaten in processed foods or at restaurants. Wulffson pointed out that it also comes from water that has run through a water-softener. That can be charged with potassium chloride instead of with sodium chloride, although it costs more.

The human body only needs 220 milligrams of sodium a day; the average diet contains more than 3,400 milligrams a day. Current dietary guidelines cap it at a maximum of 2,300 milligrams for all but those at high risk, who should have no more than 1,500 milligrams a day. That category includes anyone over 50, African-Americans and those with high blood pressure, diabetes or chronic kidney disease.

An article in the New York Times notes that because the Food and Drug Administration categorizes salt as "generally recognized as safe," food producers can put as much into products as they wish. Writes the Times' Jane E. Brody, "To make matters worse, not only does the amount of sodium rise precipitously when foods like tomatoes and potatoes are processed, but the natural potassium in these foods declines significantly, worsening the sodium-potassium ratio."


Wulffson noted that 28 national food companies, retailers and supermarket chains have agreed to the national Salt Reduction Initiative, which targets a 25 percent reduction in sodium in food products by 2014.

The American Heart Association has launched a campaign to make it easy to send comments to the FDA and Department of Agriculture, Food Safety and Inspection Service (FSIS), which have been soliciting suggestions and reaction to reducing sodium consumption. One click and the association links you to their site.

It's going to take a harder push from the government to really make a change, according to the IOM report. "What is needed," it says, "is a coordinated effort to reduce sodium in foods across the board by manufacturers and restaurants — that is, create a level playing field for the food industry."

And an expert at the University of Cincinnati College of Medicine, Dr. Jane E. Henney, who chaired the committee that produced the IOM report, told Brody that salt should lose its "GRAS" status with the FDA, so that it is no longer considered "safe" as it is currently being used.

By Lois M. Collins, Deseret News

What causes very low blood pressure?

Thanks for an interesting question. First, I should define a normal blood pressure.
Blood pressure is measured in millimeters of mercury. The first or upper number is known as the systolic blood pressure. It is the pressure that occurs in the arteries when the heart muscle contracts and pumps blood.

A normal systolic is 120 or less. Blood pressure of 120 to 140 is considered pre-hypertensive. A systolic over 140 is considered hypertensive.

The diastolic is the second or lower number. It is the pressure in the arteries when the heart relaxes and fills with blood. A diastolic of less than 90 is considered normal.

If you are using an automatic blood pressure cuff, it may be reading the diastolic lower than it actually is. This is often a problem if the blood pressure cuff is too big or too small for your arm.

Low blood pressure is only a concern when a patient has symptoms such as being lightheaded, a change in vision, losing consciousness, shortness of breath, or poor exercise tolerance. Patients most commonly complain of these symptoms when standing up from a sitting position or sitting up after lying down for awhile. This is called orthostatic hypotension and usually lasts only a short time. Patients with these symptoms need to seek medical attention.

Hypotension (low blood pressure) is most commonly caused by medications. Blood pressure medications, antidepressants and other drugs can impair the nerves of blood vessels in the legs. Normally these nerves make blood vessels in the leg contract when one is rising. When the blood vessels do not contract when changing position, blood is pooled in the legs. This deprives some blood volume from the heart, and the symptoms occur due to decreased blood perfusion of the brain.

Some patients have symptomatic low blood pressure due to a low amount of fluid in their body. This is called hypovolemia. It can be due to dehydration, caused by sweating from exercise, decreased oral intake, or use of a diuretic. Diuretics are commonly used to treat high blood pressure, but one of the most common diuretics that people encounter is caffeine.

Uncommon reasons for a low blood pressure include problems of the heart. One way that most people's bodies deal with a small amount of dehydration is to increase the heart rate, but some patients have a heart problem that does not allow them to increase their heart rate. This is often treated with a pacemaker.

Congestive heart failure is often associated with high blood pressure but can also be associated with symptomatic low blood pressure. New onset congestive heart failure is an emergency.

Very rarely, the cause of the symptomatic low blood pressure cannot be determined. There are some drug therapies that are used in these cases. Increased salt intake is often a simple solution.

Low blood pressure without any symptoms merits a medical evaluation, but rarely needs to be treated.

Conditions Expert 
Dr. Otis Brawley Chief Medical Officer,
American Cancer Society 

12 Possible Heart Symptoms Never to Ignore

Don't miss these 12 possible warning signs that something is amiss with your heart.

Heart disease is the No. 1 killer of U.S. men and women, accounting for 40% of all U.S. deaths. That's more than all forms of cancer combined.

Why is heart disease so deadly? One reason is that many people are slow to seek help when symptoms arise. Yes, someone gripped by sudden chest pain probably knows to call 911. But heart symptoms aren't always intense or obvious, and they vary from person to person and according to gender.

Because it can be hard to make sense of heart symptoms, doctors warn against ignoring possible warning signs, toughing them out, waiting to see if they go away, or being quick to blame them on heartburn, muscle soreness, or other less serious, noncardiac causes. That's especially true for men and people over 65, as well as for people with other cardiac risk factors, such as high cholesterol or blood pressure, obesity, smoking, diabetes, or a family history of heart disease.

"The more risk factors you have, the higher the likelihood that a symptom means something is going on with your heart," says David Frid, MD, a cardiologist at the Cleveland Clinic. "People often don't want to admit that they're old enough or sick enough to have heart trouble. Putting off treatment for other medical problems might not be so bad, but a serious heart problem can mean sudden death. It's better to go in and get it evaluated than to be dead."

12 Possible Heart Symptoms Never to Ignore

Here are a dozen symptoms that may signal heart trouble.
1. Anxiety. Heart attack can cause intense anxiety or a fear of death. Heart attack survivors often talk about having experienced a sense of "impending doom."
 
2. Chest discomfort. Pain in the chest is the classic symptom of heart attack, and "the No. 1 symptom that we typically look for," says Jean C. McSweeney, PhD, RN, associate dean for research at the University of Arkansas for Medical Sciences College of Nursing in Little Rock and a pioneer in research on heart symptoms in women. But not all heart attacks cause chest pain, and chest pain can stem from ailments that have nothing to do with the heart.

Heart-related chest pain is often centered under the breastbone, perhaps a little to the left of center. The pain has been likened to "an elephant sitting on the chest," but it can also be an uncomfortable sensation of pressure, squeezing, or fullness. "It's not unusual for women to describe the pain as a minor ache," McSweeney says. "Some women say the pain wasn't bad enough even to take a Tylenol."

Women, more so than men, can also experience a burning sensation in their chest, rather than a pressure or pain.  "Sometimes people make the mistake that the pain comes from a stomach problem," says Nieca Goldberg, MD, clinical associate professor of medicine at the NYU Langone Medical Center in New York City and another expert on women's heart symptoms.

3. Cough. Persistent coughing or wheezing can be a symptom of heart failure -- a result of fluid accumulation in the lungs. In some cases, people with heart failure cough up bloody phlegm.
 
4. Dizziness. Heart attacks can cause lightheadedness and loss of consciousness.  So can potentially dangerous heart rhythm abnormalities known as arrhythmias.
 
5. Fatigue. Especially among women, unusual fatigue can occur during a heart attack as well as in the days and weeks leading up to one. And feeling tired all the time may be a symptom of heart failure.

Of course, you can also feel tired or fatigued for other reasons. How can you tell heart-related fatigue from other types of fatigue?

"If you don't feel well and all the wind is knocked out of your sails, don't try to figure it out on the Internet or from a book," says Goldberg.  "Wasting time is dangerous."
 
6. Nausea or lack of appetite. It's not uncommon for people to feel sick to their stomach or throw up during a heart attack. And abdominal swelling associated with heart failure can interfere with appetite.
 
7. Pain in other parts of the body. In many heart attacks, pain begins in the chest and spreads to the shoulders, arms, elbows, back, neck, jaw, or abdomen. But sometimes there is no chest pain -- just pain in these other body areas.  The pain might come and go.

Men having a heart attack often feel pain in the left arm. In women, the pain is more likely to be felt in both arms, or between the shoulder blades.
 
8. Rapid or irregular pulse. Doctors say that there's nothing worrisome about an occasional skipped heartbeat. But a rapid or irregular pulse -- especially when accompanied by weakness, dizziness, or shortness of breath -- can be evidence of a heart attack, heart failure, or an arrhythmia. Left untreated, some arrhythmias can lead to stroke, heart failure, or sudden death.
 
9. Shortness of breath. People who feel winded at rest or with minimal exertion might have a pulmonary condition like asthma or chronic obstructive pulmonary disease (COPD). But breathlessness could also indicate a heart attack or heart failure.

"Sometimes people having a heart attack don't have chest pressure or pain but feel extremely short of breath," Goldberg says. "It's like they've just run a marathon when they haven't even moved." During a heart attack, shortness of breath often accompanies chest discomfort, but it can also occur before or without chest discomfort.
 
10. Sweating. Breaking out in a cold sweat is a common symptom of heart attack. "You might just be sitting in a chair when all of a sudden you are really sweating like you had just worked out," Frid says.
 
11. Swelling. Heart failure can cause fluid to accumulate in the body. This can cause swelling (often in the feet, ankles, legs, or abdomen) as well as sudden weight gain and sometimes a loss of appetite.
 
12. Weakness. In the days leading up to a heart attack, as well as during one, some people experience severe, unexplained weakness. "One woman told me it felt like she couldn't hold a piece of paper between her fingers," McSweeney says.

By David Freeman
WebMD Feature
©2005-2011 WebMD, LLC. All rights reserved.

High blood pressure is no longer just a problem for adults

By Jeff Schnaufer
CTW Features

Nearly one in five young adults have high blood pressure, a surprising jump that has prompted researchers to call it a “sleeping epidemic” according to a new study by the University of North Carolina, Chapel Hill.

UNC researchers analyzed data on more than 14,000 men and women between 24 and 32 years old in 2008 from the National Longitudinal Study of Adolescent Health, known as Add Health, funded by the National Institutes of Health. They found 19 percent had elevated blood pressure, also referred to as hypertension. Only about half of the participants with elevated blood pressure had ever been told by a health-care provider that they had the condition.

“We have been referring to it as a sleeping epidemic of high blood pressure,” says Dr. Kathleen Mullan Harris at the University of North Carolina, who co-authored the UNC study and is also Add Health's principal investigator. “We think that's because most people, including the young, think that they are healthy. They don't go to the doctor and have regular checkups; they are in a busy time of their lives - building careers and families.”

One problem, Harris says, is that “when you have high blood pressure, you are not aware of it physically. You don't feel any different. That's alarming.”

Hypertension is a strong risk factor for stroke and coronary heart disease, the leading cause of death of U.S. adults.

The UNC study was published online in the May 23 journal Epidemiology. By contrast, another reputable study – the National Health and Nutrition Examination Survey - reported only a 4 percent rate of hypertension for a similar age group around the same time period (2007-2008). Both studies defined hypertension as blood pressure reading of 140/90 mmHg (millimeters of mercury) or more.

“We've been running around thinking four out of a hundred young people have hypertension and they are basically saying one out of five young adults have elevated blood pressure. That's an enormous difference, “ says Dr. Richard Stein, professor of medicine and cardiology at NYU School of Medicine and national spokesperson for American Heart Association.

Further research will be done to explore the reasons for the elevated blood pressure levels among young adults, Harris says.

“We think it's due to modern lifestyle,” Harris says. “First, there's a more sedentary behavior: watching TV, sitting in front of a computer. Then there are changes in diet. Especially in young people, we see a greater intake in fast food, including higher sodium that leads to higher blood pressure, as well as an increase in sugar drinks, which leads to higher obesity. We think it's these things that lead to this higher level of high blood pressure.”

“In my mind, there is a greater concern about how young adults should have their blood pressure checked once or twice a year when they see they doctor,” Stein says.

“If you can't afford to go to a doctor, you can get your blood pressure checked at a drug store or at a gym,” Harris says. “We're trying to get the message out that young people need to check on their health.”

Personal Comment: An additional tool in the fight against hypertension (high blood pressure) is your personal home blood pressure unit.

Good Food To Prevent High Blood Pressure

By Laura Kurella

Sturgis Journal

Why do we take our health — and other good things — for granted, until, God help us, they’re gone?

I do not know, but I do know that having recently arrived at the mid-century point in my life, hobbling on a painfully cracked bone in my foot has me seeing every day, especially those without pain or illness, as a real blessing from God.

We are all on this same journey and, like it or not, going to experience the same struggles to cling to health. However, as any good coach will tell you, the best offense is a good defense, especially when it comes to things we can help ourselves with — like blood pressure.

The pressure in our arteries is much like the pressure in a garden hose. When it’s normal, everything’s great. But too much pressure and it can weaken or burst the walls while too little will make everything sluggish.
Fortunately, there are things we can do. According to www.bloodpressure-drs-practical-guide.com, the best place to start is with exercise.

Exercise is vital. It raises the metabolism, which burns more calories and taps fat stores. It also causes the release of endorphins, which give the body an opiate-like sensation, producing a feeling of well-being in both body and mind.

Resulting weight loss can eliminate the blood pressure problems all by itself.

If you want even faster results, try adding the DASH diet.

DASH, which stands for “Dietary Approaches to Stop Hypertension,” is recommended by The Joint National Committee on Prevention, Evaluation and Treatment of High Blood Pressure. It emphasizes fruit, vegetables, nuts and low-fat dairy products, along with a reduction in saturated and total fat and refined carbohydrates (sugar).

Salt can also play a giant role in blood pressure, and simply reducing use can make it drop dramatically, too. Try replacing salt with spicy seasonings like peppers or cumin so you don’t miss it.

Limiting your alcohol to two drinks or fewer per day and consuming herbs like Stevia, garlic, green tea and oolong tea can also help reduce those numbers as can steering your diet toward fruits, vegetables, low-fat milk products, whole grains, fish, poultry and good old nuts.

If you are like me and have the opposite problem- low blood pressure, then simply reverse everything I just wrote and check out:  www.bloodpressure-drs-practical-guide.com.

Here now are some recipes ready to help you lower your blood pressure, too.

Fresh chicken salad
4 small red-skinned  potatoes, cooked
1 1/2 cups orange juice
1 teaspoon ground ginger
1/2 teaspoon ground cumin
1 clove garlic, minced
2 whole boneless, skinless,  chicken breasts
4 baby carrots cut into   matchsticks
2 tablespoons raspberry or   apple cider vinegar
1/4 teaspoon salt
1 teaspoon parsley or cilantro (1 tablespoon fresh)
2 cups favorite lettuces
Orange slices for garnish   (optional)

In a skillet, bring orange juice, ginger, cumin, and
garlic to boil. Add the chicken, cover and cook for
3 minutes, turn chicken, cover, and cook for 5 minutes more or until juices run, clear. Remove chicken to a cutting board to cool. Add carrots to skillet cover and simmer for 3 minutes.
Remove carrots to a plate to cool. Remove skillet from heat and add vinegar salt and parsley. Cut chicken
into bite size chunks. Cut
potatoes into bite-sized chunks or slices. Divide
and arrange lettuce on four individual plates. Evenly
divide and arrange potatoes, chicken and carrots on top of lettuce. Evenly divide and pour dressing over each salad. Garnish with orange slices if desired. Serve warm or cold.

Approximate servings per recipe: 4
Approximate nutrition per recipe: Calories 265; Fat 2g; Carbohydrates 33g; Fiber 4g; Sugar Protein 30g.

Fish chips
1-pound skinless halibut  fillets or other white fish fillets
Egg substitute equivalent  to 1 egg
2 tablespoons skim milk
1/4 cup grated Parmesan   cheese
1/4 cup Panko or ground Rice Krispies
1 teaspoon paprika
Sauce:
1/2 cup fat-free,  cholesterol-free mayonnaise
2 tablespoons  finely chopped dill pickle
1 teaspoon finely shredded lemon peel
1 teaspoon lemon juice

Preheat oven to 450 degrees. Rinse fish and pat dry. Cut fish into 24 bite-size pieces.  Set aside. In a medium bowl, combine egg substitute and skim milk. In a large plastic bag with a tight-fitting seal, combine Parmesan cheese, panko and paprika. Add fish chunks to egg mixture,
stirring until well coated. Using a slotted spoon,
remove fish from egg mixture and place in bag with panko mixture. Seal bag and toss until fish is well coated. Arrange fish in a single layer on a baking sheet or in a shallow baking pan. Bake about 5- 9 minutes or until fish flakes easily with a fork. Meanwhile, in a small bowl, stir together sauce
ingredients.  Serve together.

Servings per recipe: 4.
Approximate nutritional per serving: Calories 191; Fat 3g; Carbohydrates 14g; Sugar 2g; Protein 26g.

Pleasing pineapple chicken
4 boneless chicken breasts
1/4 cup unbleached flour
1 tablespoon olive oil
1 fresh pineapple, sliced, juice reserved
1/2 cup water
3/4 cup cider vinegar
Pepper to taste
1 green pepper, cut into 1/4 inch rings

Preheat oven to 350 degrees. Sprinkle chicken with flour. In a skillet, heat oil and brown chicken on each side for 3 minutes. Place chicken in shallow roasting pan.  Sprinkle with pepper. In a bowl, combine reserved pineapple juice, water and vinegar. Pour over chicken and bake, uncovered for 40 minutes. Add pineapple slices and green pepper rings and place under broiler for 5 minutes just before serving.

Approximate servings per recipe: 4.
Approximate nutrition per serving:  Calories 280; Fat 8g; Carbohydrates 12g; Fiber 1g; Sugar 9g; Protein 35g.

Copyright 2011 Sturgis Journal. Some rights reserved

Low Blood Pressure, Should You Be Concerned!

Blood pressure is the result of the flow of blood times the resistance in the blood vessels as the heart pumps out blood. Each time your heart beats, it pumps blood into the arteries. When the heart is actively pumping blood, the pressure is at its highest and referred to as systolic pressure. Between beats, when your heart is at rest the pressure falls this is diastolic pressure. These two numbers determine your blood pressure and are usually written one above/or before the other for example 120/80 or spoken as 120 over 80 (Normal). A reading of 90/60 or lower is considered as low (Hypotension), while 140/90 is considered as high (Hypertension). A blood pressure chart when used in tandem with your blood pressure monitor can be an invaluable tool towards alleviating your concerns or fears. 

Low blood pressure may not have gained the notoriety as that of high blood pressure but if left untreated its consequences can be just as damaging. There are a variety of ailments related to low blood pressure which if not diagnosed and treated in their early stages can lead to serious complications. Most prominent are: postural (orthostatic) hypotension and neutrally mediated (neurogenic orthostatic) hypotension.

Postural Hypotension manifests itself as a dizzy or light headed feeling when moving from a lying or sitting position to standing position. It is thought to be caused by the inability of the autonomic nervous system (the part of the nervous system that controls involuntary vital actions, such as the heartbeat) to respond appropriately to sudden changes. It is believed that this can happen for a variety of reasons including: lack of food, extended exposure to heat, or being overly tired. People who are taking medication for high blood pressure are also prone to this illness. Treatment is dependent on the severity of the symptoms and may include increased fluid and salt intake and avoiding prolong periods without food or drink. Medication which encourages sodium retention and absorption may also be prescribed.

Neutrally Mediated Hypotension - when the regulation of blood pressure by the body is affected, particularly when standing. It is believed to be a lack of communication between the brain and the nerve censors which control heart rate and blood pressure. Not always is the condition serious, in some cases it may just be temporary while in others it can result in a person being unable to stand for long periods, dizziness, blurred vision and near fainting.

The kidneys can balance low blood pressure naturally by retaining salt and water, thereby making medical intervention unnecessary. However, it is advisable that you speak to your doctor if your monitor registers consistent low blood pressure readings or you are experiencing any of the symptoms mentioned. For some people a reading below 120/80 is normal and no cause for alarm. This low or borderline reading is normal and may even be considered a sign of good cardiovascular health, since this can also be an indication of little stress on the heart, lungs and blood vessels. A fall in pressure may also be due to some event (example standing too quickly) or because of a medical condition. However, low blood pressure cannot always be ignored. If you experience frequent bouts of dizziness, fainting, blurred vision, nausea, rapid weak pulse, muscle weakness, fatigue, headache, cold clammy skin and lack of concentration you should consult your doctor for an evaluation, diagnosis and treatment, if necessary. In extreme cases the body can be deprived of an adequate supply of oxygen which can result in impaired heart and brain functions and respiratory problems leading to loss of consciousness or shock.

© 2010 Goldeneramart.com - All Rights Reserved.