21 February, 2014

Blood pressure medications not beneficial after stroke

Lowering blood pressure during the first 48 hours after a stroke does not reduce the likelihood of death or major disability, claims research.

Blood pressure often is elevated following a stroke. ‘In most cases, treatment is unnecessary because the blood pressure declines naturally over time and lowering blood pressure may be contra-indicated,’ warned stroke specialist Jose Biller at Loyola University Medical Centre. It is important not to overtreat and cause low blood pressure, because the most important objective is to maintain adequate blood flow to the brain, Biller advised.

Lowering blood pressure has been shown to reduce the risk of stroke. The study investigated whether there also would be a benefit to lowering blood pressure immediately after a stroke. The study included more than 4,000 stroke patients in 26 hospitals across China who were randomly assigned to receive blood pressure medications or to discontinue blood pressure medications.  At 14 days or hospital discharge, there were no statistically significant differences between the groups in mortality or disability, said the study published in the Journal of the American Medical Association. 

It involved patients who had suffered ischemic strokes, which account for about 85 percent of all strokes. Such strokes are caused by blood clots that block blood flow to a part of the brain.  

The more you sit after 60, the likelier you’re to be disabled

No matter how much moderate exercise you get, a new study suggest that if you’re 60 and older, every additional hour a day you spend sitting is linked to doubling the risk of being disabled. The Northwestern Medicine study is the first to show sedentary behavior is its own risk factor for disability, separate from lack of moderate vigorous physical activity. In fact, sedentary behavior is almost as strong a risk factor for disability as lack of moderate exercise.

If there are two 65-year-old women, one sedentary for 12 hours a day and another sedentary for 13 hours a day, the second one is 50 percent more likely to be disabled, the study found. ‘This is the first time we’ve shown sedentary behavior was related to increased disability regardless of the amount of moderate exercise,’ Dorothy Dunlop, professor of medicine at Northwestern University Feinberg School of Medicine and lead author of the study, said.  

‘Being sedentary is not just a synonym for inadequate physical activity,’ she said. The finding — that being sedentary was almost as strong a risk factor for disability as lack of moderate vigorous activity — surprised Dunlop. ‘It means older adults need to reduce the amount of time they spend sitting, whether in front of the TV or at the computer, regardless of their participation in moderate or vigorous activity,’ she said. The study is set to be published in the Journal of Physical Activity and Health.  

If you can’t do anything about it, then let it go. Don’t be a prisoner to things you can’t change

Tony Gaskins