Does Your Blood Pressure Spike at the Doctor’s Office?

One of the biggest health problems in the United States today is high blood pressure. It is reaching epidemic proportions. Often a silent killer, high blood pressure may show no symptoms until levels are very elevated. I see high blood pressure and its consequences every day in my patients.
In our cardiology practice, approximately one-half to two-thirds of people who come in for evaluation of heart rhythm disorders already have high blood pressure. It is one of the most common causes of atrial fibrillation, heart failure, and stroke.
White Coat Hypertension: When Stress Spikes Blood Pressure
What is white coat hypertension? It is a condition in which your blood pressure is higher in a physician’s office, but is otherwise normal.
What makes your blood pressure go up in a doctor’s office? Most people say they are anxious or worried they may receive bad news. Or it may be the cost of their appointment or of medical care. Anxiety and stress are important causes of blood pressure elevation.
To take your blood pressure, ideally you should be seated and relaxed. And typically, once seated, you should wait three to five minutes before measuring your blood pressure. Then, the best practice is to take three measurements in each arm and average the readings.
Most of you are probably thinking that this never happens when you see a doctor, because most offices are busy and check people in quickly without taking the time to correctly measure your blood pressure. But if you go to a high blood pressure clinic, this process will sound familiar.
Another important aspect to consider is that not all blood pressure machines and devices are the same. Blood pressure devices are only as good as the readings they provide. Most adults need a full-size or adult-size, large blood pressure cuff that goes around the upper arm. Smaller devices that are placed on the wrist or ankle tend to be less accurate.
If you have a blood pressure machine you use at home, bring it in to your doctor’s office and compare readings. Oftentimes, we will find the measurements are similar. However, at times we find that the home machine reading is either too high or low. Most of the time, we find that the blood pressure cuff is too small.
Assuming your blood pressure is measured correctly, and in the office it is still higher than at home, does white coat hypertension matter? The general sense of my patients is no, because the blood pressure values are not the same as those measured at home. I agree with this partially, as errors can occur in a doctor’s office. But what is important to consider is that the doctor’s office blood pressure measurements can give you some insight into how your body deals with situational stress.
We all face many stresses each day, many of which we cannot avoid. These may come from our jobs, commutes, spouse or family relationships, financial issues, health problems, and more. If each time we face stress our blood pressure skyrockets to very high levels, our hearts can be strained and injured. In this regard, white coat hypertension that reflects our response to stress can be a marker of heart disease risk.
White Coat Hypertension, Stress, and Heart Disease Risk
A new white coat hypertension study, published in Hypertension in June 2015, looked at heart disease risk. The study included 3,200 people in Italy. These patients were seen in a doctor’s office for three blood pressure measurements. Then they were sent home with a 24-hour blood pressure monitor that sampled their blood pressure every 20 minutes. When the patients returned, they had three more office blood pressure measurements. With these measurements, the researchers could determine what was happening to the blood pressure in the doctor’s office and throughout the day.
White coat hypertension was diagnosed if the average office blood pressure measurement was higher than 140 mgHg for systolic blood pressure or higher than 90 mmHg for diastolic blood pressure but the 24-hour average blood pressures (at home) were normal.
Then the investigators divided the group with white coat hypertension into two: those who experienced high blood pressure frequently with stress, and those who experienced high blood pressure occasionally with stress.
This is a summary of their findings about heart disease risk over 20 years of follow-up care:
Heart disease mortality was strongly associated with white coat hypertension.
The risk was higher for those whose white coat hypertension was stable (all blood pressure levels were high when at the doctor’s) compared to those whose pressure was unstable (one of two blood pressure levels at the doctor’s were high). Specifically, when compared to people without white coat hypertension, risk of heart-disease related death increased 2.4 times in those with unstable white coat hypertension and 16 times in those with stable white coat hypertension.
Total mortality was 1.9 times higher in people with stable white coat hypertension compared to those without white coat hypertension.

These risks increased as people aged, in men compared with women, and in people with a larger body mass indexes (BMI).

E-mail us on pkdclinic888@hotmail.com or kidneyservice@hotmail.com to get more information.
Or you can just consult our online doctor for timely help. They are online for 24hours every day.
Or you can add Whatsapp:+8618330162295 is also available for you.

It’s free of charge.

High Blood Pressure Drug Lisinopril Lowers Risk Of Heart Block

The average heart beats 100,000 to 120,000 times each day. And since the average person in the United States will live into their mid- to late-seventies, this means your heart will beat over two billion times in your life. To accomplish all of this pumping, your heart develops specialized pacemaker cells and conduction tissues that conveys electrical impulses across your heart.
Despite their critical role, these specialized conductive tissues are delicate. They also age, and in some people they can stop working and cause heart disease. New research shows that a common treatment for high blood pressure (hypertension) may help keep the heart’s electrical system healthy as you get older.
How Your Heart’s Electrical System Works
Are Chronic Kidney Disease And Heart Problems Related
The electrical impulse of your heart begins in the right upper chamber from a group of specialized pacemaker cells called the sinoatrial (SA) node. The electrical impulse is quickly carried across both upper heart chambers: the atria. When heart muscle cells are stimulated by electricity, they contract, or squeeze. The two upper chambers squeeze in unison and pump blood into the two lower heart chambers: the ventricles.
The electrical signal is collected in the middle of the heart in a relay center called the atrioventricular (AV) node. Then, through long specialized electrical tracts called the right and left bundle branches, the electricity is delivered to the bottom portion of the ventricles, which then squeeze from the bottom up and push the blood out to the great arteries of your body.
What Is Electrical Heart Block?
Life Expectancy for Stage 4 Kidney Failure with Congestive Heart Failure
When most people think about heart blockages, they see images of blocked arteries from cholesterol plaques that can cause a heart attack (myocardial infarction). But a completely separate blockage that involves the heart’s electrical system — a heart block — can develop along all levels of the conduction systems and on multiple levels: in the AV or SA node, or in the bundle branches (parts of the heart’s electrical system that deliver impulses to your ventricles).
If you experience a heart block, you may experience some of the following:
Fatigue
Dizziness
Chest discomfort
Shortness of breath
Exercise intolerance
Syncope (temporary loss of consciousness, or fainting)
Unfortunately, once disease develops in the heart’s conduction system, it often progresses with no known medical therapies to improve it. If you develop heart block and have symptoms, or if the upper and lower heart chambers of your heart no longer communicate electrically, you may need a surgically implanted pacemaker. This device, which delivers small electrical impulses to your upper and lower heart chambers, replaces any missed beats from the diseased conduction system or from significant delays or blocks in electrical communication.
Best Heartburn Medicine for Patients with Kidney Disease
You may know someone who has a pacemaker. Between 1993 and 2009, about three million U.S. patients received a pacemaker for symptomatic electrical heart block, according to a survey published in the Journal of the American College of Cardiology in October 2012. During the study time, the use of pacemakers increased by 56 percent — a trend that continues today as our society ages, and people live longer with heart disease.
Risk Factors for Electrical Heart Block
Risk factors for heart block include:
Aging
High blood pressure
Heart valve disease
Heart infection
Heart attack
Heart failure
Having heart surgery
The most common risks are aging and high blood pressure. And while you can’t do much about aging, you can do something about high blood pressure. Depending on how you treat it, you may lower your risk of conduction system disease.
How High Blood Pressure Treatment Can Help
Doctors treat high blood pressure in many different ways, some of which I’ve covered in previous columns, like being careful not to eat too much salt. In addition to lifestyle changes, multiple blood pressure medications called anti-hypertensive agents can be used to treat the disease and prevent progression and complications.
All blood pressure medications lower your blood pressure, but drugs like beta-blockers and calcium channel blockers also lower heart rate. And some, like diuretics, lower fluid levels in the body and can decrease edema (swelling). Still others, such as ACE inhibitors or angiotensin receptor blockers (ARBs), can impact the body’s inflammatory response and decrease fibrosis or cell breakdown.
Research: ACE Inhibitors Lower Risk of Heart Block
With these unique aspects of blood pressure medications in mind, and knowing that high blood pressure can result in early conduction system disease, researchers asked which medications might lower blood pressure and also decrease risk of conduction system disease.
The Antihypertensive and Lipid Lowering Treatment to Prevent Heart Attack Trial (ALLHAT) included 21,004 patients ages 55 and older who had high blood pressure and one other heart disease risk factor, such as high cholesterol, diabetes, coronary artery disease, or a history of smoking. The patients were either treated with an ACE inhibitor lisinopril; a calcium channel blocker, Norvasc (amlodipine besylate); or a diuretic, Thalitone (chlorthalidone) and a statin drug, Pravachol (pravastatin) for their high cholesterol. ALLHAT results were published in JAMA Internal Medicine in June 2016.
Researchers followed the patients for up to eight years to look for heart disease and found that 1,114 people developed heart block. These included 570 patients with a complete right bundle branch block, and 389 with a complete left bundle branch block.
Being older increased the risk of developing conduction system disease by 47 percent in this group of patients with high blood pressure, and was the strongest predictor that they would develop a heart block.
In this study, statins didn’t lower a person’s risk of conduction system disease. But using the ACE inhibitor lisinopril lowered risk of electrical conduction disease by 19 percent compared to the diuretic, and by 14 percent compared to the calcium channel blocker.

This large study of older adults also confirmed that high blood pressure and age present unique challenges to the heart’s electrical system, and that conduction abnormalities commonly develop. But for the first time, we have insight into a potential way to prevent or significantly lower the risk of conduction system disease in people who have high blood pressure by using a commonly prescribed drug.

The Worst Fast Food

First, an Ohio McDonald's employee and Reddit Web-site user named GameMisconduct63 submitted an "ask me anything" post on June 26, in which he responded to any question about working for the fast-food chain. Nine days later on July 5, Reddit user 4ScienceandReason posted a thread asking: "Fast food workers of Reddit, what is the one menu option at your employment that you would recommend people never eat? (Because of cooking safety, cleanliness, unhealthy, etc)."

The Worst Offenders

Chicken

Are Fish and Chicken Acceptable for IgA Nephropathy Patients

Reddit member Dfunkatron says that as a McDonald's employee before 2003 — the year the chain switched to all white meat minced chicken nuggets — he left a bag of frozen nuggets on a counter for "way too long." The result: "They melted. Into a pool of liquid." Another poster named Kalevatar replied that because the chain's current frozen nuggets are coated with a glaze of ice, "they do get kinda melty still if you leave them out, but that's only because the melting ice dissolves the breading and the ground chicken isn't fully-cooked before it goes in the fryer." A further visualization of this process is offered by a user named bamp, who says, "Think of IKEA furniture being left in water... then turning to wood pulp."

Attempts to contact McDonald's for comment regarding its McNuggets were unsuccessful.

Surprisingly, it is grilled chicken and not nuggets that receives the worst beating from employees. In his "ask me anything," GameMisconduct63 says McDonald's grilled chicken "doesn't sell too well," and "can remain there for a decent amount of time.... Where I work, they can push it to two hours waiting." Another user says of the grilled chicken that although it's the most healthy thing on the menu, it "can end up lasting an hour in a heated cabinet."

Unconventional pizza toppings

Is OK to Take Parsley Tea When You Have Parapelvic Cyst on Kidney

One poster named K_Lobstah said that in his pizza-making experience," 'quirky' pizza toppings" that aren't ordered often (he mentions green olives, artichokes,and sun-dried tomatoes) don't get much turnover, and so aren't as fresh. And while he does say these toppings will be "replaced before they're actually rotten," he also notes that that could be "a long time after they're considered unfit for consumption."

Sweetened tea

Iced tea may sound healthier than a soft drink, however, most fast-food sweetened teas contain a whopping amount of sugar that's nearly equivalent to sodas of comparable size.

Ice

Many users told tales of moldy, unsanitary ice-making machines, while others said they'd never seen this problem. Perhaps the grossest description was from someone named rustyshackelford3000, who wrote: "These machines are only cleaned out usually when they break. The bottom of the ice bins are usually covered in very nasty stuff and slime."

Chili

One former Wendy's employee, Cozmo23 revealed the secret to the chain's beefy chili: "The meat comes from hamburger patties that sat on the grill too long to serve to customers. They take them and put them in a bin and then throw them in the fridge. When the chili is made they...boil it, chop it up, and dump [it] in the chili."

But Wendy's senior vice president of communications Denny Lynch tells Everyday Health this is no secret at all. He confirms that Cozmo23's description is pretty much spot on. "We have never hidden from the fact that since we started in 1969 we use hamburgers that are overcooked as chili meat," Lynch says. What's more, Lynch agrees with several Reddit users who responded to Cozmo23 by saying the Wendy's process makes perfect sense. "As several people pointed out, that's a way you don't waste meat," Lynch says. But he's also quick to add that "There are food safety issues and food safety procedures that we do have to follow," including rules for refrigeration and reheating the meat.

What Food Can One Eats to Prevent Protein Urine

Double quarter pounder with cheese

Asked for his opinion of the worst food, healthwise, on the McDonald's menu, GameMisconduct63 says it's the double quarter-pounder with cheese, which has "the highest element content of most things on the menu. Element content meaning sodiums, carbohydrates, fats, etc."

If you want to know more information, you can:

E-mail us on pkdclinic888@hotmail.com; kidneyservice@hotmail.com to get more information.

Or you can just consult our online doctor for timely help. They are online for 24hours every day.

Or you can add Whatsapp:+8618330162295 is also available for you.

It’s free of charge.