TIME Heart Disease

Serious Salt Confusion: New Research On How Much Salt You Should Eat

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New studies question our salt intake Getty Images

Three new studies add to the debate—and confusion—about how much salt we should be eating

Three new papers published in the New England Journal of Medicine look at the cardiovascular risks of salt consumption, with some research saying too much salt is bad for the heart and other research saying there’s a sweet spot between too little and too much that is best. This has led to a range of headlines from “Pour On The Salt?” to “Death By Salt?“—adding to the confusion about whether we need to be cutting our consumption or forgetting about it.

So what to make of it all?

Our bodies need salt, but if we consume it in excess, we increase our risk for hypertension, which can ultimately lead to heart disease. The American Heart Association (AHA) recommends consuming less than 1,500 mg of sodium per day. Here’s what that looks like:

1/4 teaspoon salt = 575 mg sodium
1/2 teaspoon salt = 1,150 mg sodium
3/4 teaspoon salt = 1,725 mg sodium
1 teaspoon salt = 2,300 mg sodium

One of the studies had a particularly interesting finding, showing that people who consumed more than 6,000 mg a day and people who consumed less than 3,000 a day had a greater risk of cardiovascular events and mortality. People consuming a moderate amount in the 3,000-6,000 mg range had the lowest number of heart-related events. (The AHA limit—1,500 mg of sodium—is half the lower-limit of what the moderate group consumed.)

The latest studies likely won’t eliminate the debate, though. In an editorial in the same issue of the journal, Dr. Suzanne Oparil of University of Alabama at Birmingham writes: “Taken together, these three articles highlight the need to collect high-quality evidence on both the risks and benefits of low-sodium diets.”

Still, the AHA stands by its guidelines. “The bulk of the available evidence to date shows reduced sodium intake is associated with reduced blood pressure, which itself is associated with a reduction in cardiovascular event,” AHA president Dr. Elliott Antman said in the statement. “Along with improving overall diet, controlling weight, and increasing physical activity, lowering sodium intake is key to lowering blood pressure in the general population and improving blood pressure control in those with hypertension.”

Some scientists have argued that public-health messaging encouraging people to significantly cut their sodium and salt consumption is overblown or missing the point—that we should focus less on the salt in the shaker and instead encourage people to eat more whole and non-processed food, since most processed food is full of sodium and since most whole foods contain negligible amounts of naturally occurring sodium.

The debate is ongoing, but lightening up your sodium intake—particularly from processed and restaurant food—can’t hurt.

 

 

TIME Heart Disease

Mississippi Men Learn About Heart Disease — At the Barber

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John Sigler—Getty Images

Barbershops may be the new doctor's office, at least in Mississippi where African American men are learning about high blood pressure...while they get their hair cut

Barber shops and hair salons are great community hubs where residents gather for both grooming and gossip. So public health experts in the Mississippi Delta have decided to exploit these social meccas to connect with groups that don’t often see health care providers, including African American men.

Heart disease and stroke, for example, disproportionately affect this population of men, partly due to genetics, and partly due to lifestyle behaviors. But in places like the Mississippi Delta region, these men also do not get regular heart disease screenings. They do, however, go to barbershops for trims and to catch up on community news. So the Centers for Disease Control and Prevention (CDC) is funding a barbershop initiative called Brothers (Barbers Reaching Out to Help Educate Routine Screenings) located throughout the Mississippi Delta, where heart disease and stroke are the second and fourth leading causes of death in black men.

The Mississippi Department of Health spent a year recruiting and training barber shop workers on how to read a blood pressure screening, and discuss risk factors. During appointments, barbers talk to their clients about heart health, take their blood pressure, and refer them to a physician if they need further counseling. Recruitment was, and continues to be a challenge since some of the barbers were on board with the benefits of educating their clients, but worried about whether the program would hurt their business.

So far, thought, the barbers are being pretty persuasive. The project, which involves 14 barbershops that have so far served 686 men, just released its first set of data. Only 35% of the customers said that they had a doctor and 57% did not have health insurance. Among the men who received blood pressure readings, 48.5% had prehypertension, and 36.4% had high blood pressure. The findings, published in the journal Preventing Chronic Disease, shows that the program provides care to men who need it, as well as gives public health care workers a better idea of how prevalent heart disease is in the region, and how many patients are in need of medical care. The next step for the researchers is to create a community health worker network that could introduce these men to the health care system and help them navigate more regular screenings and better treatment of their condition.

Shifting health care from the clinic to the community isn’t a new idea; in some areas, health screenings and education are conducted in churches. But the faithful are a select group, and the study’s lead author says it’s important to bring services to hard-to-reach populations, such as young black men, to where they are. “We realized in our standard community health screenings–which were happening in churches–that we were not reaching adult black men,” says lead study author Vincent Mendy, an epidemiologist at the Mississippi State Department of Health. “We think the best way to reach them is through barbershops.” The program is part of a partnership between the CDC and the Mississippi State Department of Health, and is funded through September 2015.

Mendy is hopeful that the program will reach more men and bring them into treatment, since a similar 2011 initiative in Texas, funded by the National Institutes of Health, found that barbers helped to lower blood pressure in a population of African American men by 20%. Based on this growing body of research, the CDC is considering relying on community health workers to help improve the health of minority groups that have a disproportionate risk of disease and death in the U.S. — but are often outside of the health care system. Barbershops aren’t clinics, but they do seem to be a good place to get health messages across.

TIME Diet/Nutrition

Yogurt Could Lower Your Blood Pressure: New Study

The latest study links certain probiotics with better blood pressure control

Bacteria aren’t the first allies we turn to for staying healthy – there are enough strains that can cause serious illness, after all – but there’s growing evidence that certain strains of the bugs can actually be good for your health, and may even relieve symptoms of inflammatory conditions, allergies and possibly even obesity.

In the latest report on these microbial allies, researchers add one more possible benefit of probiotics – the live concoctions of bacteria contained in foods like yogurt. In an analysis of nine studies that looked at probiotic use and blood pressure, the report in the journal Hypertension found that people using probiotics tend to have lower blood pressure compared to those who didn’t eat them. The effects seemed to be stronger among those with higher blood pressure to begin with, and among those consuming multiple probiotic strains and in higher doses.

What do bacteria have to do with blood pressure? The researchers say that the micro-organisms could be helping to address hypertension in a variety of ways, from lowering cholesterol levels, which can contribute to less fatty buildup in the vessels and therefore reduce the chances of developing hypertension, to controlling blood sugar and keeping the enzymes and proteins that control blood flow and fluid volumes in check.

The results aren’t exactly a prescription for treating hypertension — at least not yet. But they raise the interesting possibility of incorporating a probiotic regimen into blood pressure management. The study authors admit, however, that more questions still need to be answered, such as which micro-organisms might be associated with the strongest effect on blood pressure, as well as which combinations of bacterial strains work best. The formulation of the probiotic may also be important, they say – in the studies they reviewed, participants consumed probiotics primarily from yogurt, but also from cheese, sour milk and supplements (liquid or capsules). Hitting the right threshold of microbes also seems to be important, and figuring out that volume is also essential before any advice about using probiotics to lower blood pressure is given.

TIME Heart Disease

6 Ways to Lower Your Blood Pressure Naturally

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Exercise and eating well can help keep your blood pressure down PASIEKA—Getty Images/Brand X

Before opting for drugs, here are some safe ways to lower your blood pressure

This week, two groups of researchers presented a major discovery in the New England Journal of Medicine: They identified mutations in a single gene that can help prevent heart attacks by keeping triglycerides—a type of fat in the blood—low. This discovery will likely help pave the way for the development of new drugs that mimic the effect of that mutation.

In the mean time, if you want to keep your own blood pressure in check, talk to your doctor, and try these natural approaches:

Lose weight
It’s established that blood pressure can rise with weight, so maintaining a healthy weight range is one of the best ways to protect yourself. Losing weight has also been shown to lower blood pressure and lessen the strain on the heart. According to the Mayo Clinic:

  • Men are at risk if their waist measurement is greater than 40 inches (102 centimeters, or cm).
  • Women are at risk if their waist measurement is greater than 35 inches (89 cm).

Eat healthy
Consuming a diet that’s rich in fruits and vegetables is a good idea to keep blood pressure in check. Studies looking at the Mediterranean diet—which is high in plant-based foods, grains, and healthy fats like nuts and olive oil—show it may have heart protective benefits. Why? It’s thought that compounds in these foods can lower inflammation, which allows for stronger and clearer blood vessels. And experts agree that whatever you do, avoid processed foods as much as possible.

Exercise
Breaking a sweat can keep you protected from hypertension. Getting at least 30 to 60 minutes of exercise many days a week can lower blood pressure, according to the Mayo Clinic. Even exercise like walking can be good for your heart.

Cut back on caffeine
Even if you do not have high blood pressure, caffeine has been shown to spike heart rate and blood pressure. It’s unclear why, but it’s possible that the adrenaline gets blood pressure to rise, or caffeine interferes with how wide our arteries are. Some people are more sensitive to the effects of caffeine than others, so know your limit. Most public health agencies say that four cups of coffee per day should be your limit.

Chill out
Too much stress is known to get your blood boiling, at least temporarily. It’s not confirmed that stress causes high blood pressure, but the American Heart Association notes that the hormones involved with the body’s “flight or fight” response can make the heart beat faster and constrict blood vessels–that can cause blood pressure to rise for a short period. Taking care of your stress and mental health is important for your overall wellbeing, so don’t ignore signs you are feeling overwhelmed.

Avoid smoking and cut back on drinking
Nicotine raises blood pressure even after you’ve put the cigarette out, so people who smoke throughout the day are keeping their blood pressure elevated. Drinking too much alcohol can also temporarily raise blood pressure, and consuming a lot of alcohol similarly keeps these levels up. Not to mention, heavy drinking can lead to weight gain, which is another risk factor for blood pressure. Cutting back can lower your risk.

TIME

How Low Should We Go? (When It Comes To Blood Pressure)

A new study suggests getting blood pressure as low as possible may not be critical for people with hypertension

About one in three Americans has high blood pressure, and typically it’s thought that getting that blood pressure number down as low as possible is the goal. However, a new study published in the journal JAMA Internal Medicine didn’t find that to be true.

The researchers looked at data from 4,480 participants in a 21-year long study that followed them to see if they developed any sort of heart illness. The researchers specifically looked at the participants’ systolic blood pressure (SBP)—the top number in a standard blood pressure reading.

In the study, elevated SBP was classified as 140 or greater, standard was 120-139, and low was less than 120. The researchers found that among people with high blood pressure, lowering their blood pressure to below 120 provided no additional benefit for reducing heart attack, heart failure and stroke risk. Getting blood pressure levels below 140 helped, but lower than 120 didn’t.

“As a clinician there is a notion suggesting that lower blood pressure is better but our current research to date is controversial and not conclusive,” says lead study author Dr. Carlos J. Rodriguez, an associate professor of public health sciences at Wake Forest Baptist Medical Center. “We found that hypertensives with a blood pressure between 120-138mmhg have the greatest benefit and those with a blood pressure less than 120mmhg did not have additional benefit.”

The study goes against conventional blood pressure wisdom. The American Heart Associations’ numbers are a little different, and show that the objective is to get below 120.

Here are the blood pressure categories defined by American Heart Association:

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Source: American Heart Association

“Our study does emphasize that the greatest clinical benefit comes from getting patients below 140mmhg. This was not a treatment study so I do not think it changes treatment but it does bring into question the notion of whether lower blood pressure is better,” says Rodriguez.

There’s a lot of research on the benefits of lowering blood pressure, and there would need to be many more studies, including clinical trials to confirm whether these new findings are true. For now, it’s just preliminary.

TIME Aging

7 Medical Tests Every Man Needs

Medical patient and doctor
Lee Edwards—Getty Images/Caiaimage

Admit it, guys: You don’t even like going to the doctor when there’s something wrong, let alone for preventative check-ups. But being proactive about your health—by getting recommended screenings for serious conditions and diseases—could mean you’ll spend less time at the doctor’s office down the road.

Depending on age, family history, and lifestyle factors, people need different tests at different times in their lives. Here’s a good overview for all men to keep in mind.

Diabetes

You may never need a screening for diabetes if you maintain a healthy weight and have no other risk factors for the disease (such as high cholesterol or high blood pressure). But for most men over 45—especially overweight men—a fasting plasma glucose test, or an A1C test, is a good idea, says Kevin Polsley, MD, assistant professor of internal medicine at Loyola University Health System in Chicago.

The U.S. Department of Health and Human Services also recommends diabetes screenings for overweight adults younger than 45 who have a family history of the disease, or who are of African American, Asian American, Latino, Native American, or Pacific Islander descent.

Fasting plasma glucose and A1C are both blood tests that should be done in your doctor’s office. The A1C test does not require fasting beforehand, but if your doctor wants to test you using fasting plasma glucose, you will be asked not to eat or drink anything but water for eight hours beforehand.

Health.com: Could You Have Type 2? 10 Diabetes Symptoms

Sexually Transmitted Infections

Even if you’ve been in a monogamous relationship for years, it’s not a bad idea to get tested if you haven’t already done so. Many common sexually transmitted infections can go undiagnosed for years. For example, people can go as long as 10 years without showing symptoms of HIV. The U.S. Preventive Services Task Force recommends that everyone ages 15 to 65 be screened for HIV at least once. This is especially important, Dr. Polsley says, if you have had unprotected sex, used injected drugs, or had a blood transfusion between 1978 and 1985.

In addition, the Centers for Disease Control and Prevention recommends a one-time hepatitis C screening for all adults born between 1945 and 1965, regardless of risk factors. “Believe it or not, there’s a lot of hepatitis C cases out there in which people either don’t have symptoms yet or don’t know what’s causing their symptoms,” says Dr. Polsley. “Screening for STIs is something I offer as routine at just about every physical, regardless of a patient’s age or health history.”

Health.com: Best and Worst Foods for Sex

Body Mass Index

You don’t need to make an appointment to figure out your body mass index, a measure of body fat based on your height and weight. Regardless of whether you calculate this stat yourself or your physician does the math for you, it’s important to be aware of this number, says Dr. Polsley.

A BMI between 18.5 and 24.9 is considered normal weight. Although this calculation isn’t perfect—and can sometimes label healthy people as overweight or vice versa—most doctors agree that it’s still an important component of assessing overall health. “It can be a very good opportunity to discuss diet and exercise, and to show our patients how important these things are,” Dr. Polsley says.

Health.com: 11 Reasons Why You’re Not Losing Belly Fat

Cholesterol

The American Heart Association recommends men have their cholesterol levels tested every four to six years once they turn 20. “Men have an overall higher risk for cardiovascular disease than women, and high cholesterol is often a big part of that,” Dr. Polsley says. But your doctor may want to screen you earlier (and more often) if you have heart disease risk factors such as diabetes, tobacco use, or high blood pressure.

Cholesterol is measured by a blood test, and your doctor may ask you not to eat for 9 to 12 hours beforehand. Generally, a cholesterol test will measure your levels of total cholesterol, HDL (good) cholesterol, LDL (bad) cholesterol, and triglycerides. Depending on your results, your doctor may make dietary recommendations or prescribe a cholesterol-lowering medication like a statin.

Blood pressure

Like high cholesterol, high blood pressure is often a symptomless condition—but luckily, the test for hypertension is quick and painless, involving a rubber cuff that squeezes the arm and measures the flow of blood through a large artery in the bicep. “You should have your blood pressure checked pretty much every time you see your doctor,” says Dr. Polsley, starting at age 18.

Don’t get to the doc often? Have it checked at least every two years, or yearly if your numbers were previously considered borderline (a top “systolic” number above 120 or bottom “diastolic” number higher than 80).

You can check your blood pressure at health fairs, in pharmacies, or at home with a monitoring device. If your systolic pressure cracks 130 or your diastolic goes over 85, your doctor may recommend lifestyle modifications—like exercising more and eating less salt—or they might prescribe medication.

Health.com: 31 Fat-Burning Recipes

Colonoscopy

Most men should be screened for colon cancer beginning at age 50, but those with a family history of the disease may benefit from earlier testing. Men and women alike tend to dread this test—in which a small camera is inserted into the anus and explores the large intestine for polyps or other signs of cancer—but Dr. Polsley says it’s not as bad as it sounds.

“The preparation for the test is actually the worst part,” he says: You’ll need to empty your bowls completely before the exam, which may involve not eating solid foods for one to three days, drinking lots of clear liquids, or taking laxatives. “The actual colonoscopy shouldn’t be too uncomfortable, because you’re sedated through the whole thing.”

But here’s the bright side: If your doctor doesn’t find anything suspicious, you won’t need another colonoscopy for up to 10 years.

Prostate exam

Screening for prostate cancer is more controversial than for other cancers, says Dr. Polsley, and some studies have shown that these tests can be expensive and unnecessary, and may do more harm than good. But he suggests that all men over 50 at least talk with their doctors about the pros and cons of these tests—usually either a digital rectal exam (in which the doctor inserts a gloved finger, or digit, into the rectum to feel for lumps and abnormalities) and a PSA test, which measures a protein called prostate-specific antigen in the blood.

Prostate cancer screenings can and do save lives, but they may also result in false-positive or false-negative results. And because many cases of prostate cancer progress very slowly, some men (especially older men) don’t benefit from aggressive treatment. Whether you decide to get screened for prostate cancer should be a decision you make with your doctor, says Dr. Polsley. In the meantime, it’s important to know the symptoms of an enlarged prostate—like having to urinate frequently or having trouble urinating—which could also signal cancer.

This article originally appeared on Health.com.

TIME Nutrition

Sugar Goes Straight to Your Blood Pressure

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JamieB—Getty Images/RooM RF

A new study shows sugar can send blood pressure soaring in two ways

Eating too much sugar can lead to obesity, and weight gain can contribute to high blood pressure—that’s been known for years now.

But the latest research shows that the sweet stuff can affect blood pressure in an entirely different way, independent of its effect on weight. Scientists from University of Otago in New Zealand reviewed several randomized controlled trials that looked at sugar’s effect on blood pressure, and concluded that not only does sugar help pack on the pounds, but it independently impacts blood pressure and lipids.

The study is one of the first to connect this one-two punch from sugar among people eating average diets—the participants were not provided measured amounts of sugar by the researchers but rather reported on how much sugar they consumed as part of their daily diet. It’s easy to underestimate how much sugar we eat, since it can hide in processed foods and add up.

“Although the effects of sugars on blood pressure and lipids are relatively modest, our findings support public health recommendations to reduce added sugar in our diets as one of the measures which might be expected to reduce the global burden of cardiovascular diseases,” said lead study author Dr. Lisa Te Morenga in a statement. The findings are published in the American Journal of Clinical Nutrition.

TIME Blood Pressure

Oregano Can Satisfy Your “Salt Tooth”

Oregano helps cut down on sodium
Oregano helps cut down on sodium The Image Bank via Getty Images

Adding the herb to food samples coaxed salt lovers toward lower-sodium offerings, research shows

Compared to those with healthy blood pressure (BP) levels, hypertension sufferers are more likely to hanker for salty snacks, suggests a small study from Brazil. But adding oregano to food options led the salt lovers to select lower-sodium offerings, the study shows.

When offered bread samples containing either high, moderate, or low concentrations of salt, people with hypertension showed a preference for the samples with the highest salt content, the study shows. (On the other hand, people with BP levels in the “normal” range tended to prefer the low-salt or moderately salted samples.) But when the study team added oregano to the bread samples in a follow-up experiment, both study groups showed a reduced preference for salt.

Despite years of research linking high sodium consumption with hypertension, there’s not much evidence that people with high BP crave salt more than others. And despite this new study, the links between your “salt tooth” and your blood pressure are still open for debate, says Dr. Dominic Sica of the American Society of Hypertension. “This study was very small, and its findings are preliminary,” Sica says. “A lot more research is needed before I’d use these findings to inform my advice to patients.”

Sica adds that reducing salt is not necessarily advisable for everyone—even those with elevated blood pressure. “Salt restriction is not one size fits all,” he says. “And advice on salt intake needs to be patient-specific.” He recommends talking to your doctor about the proper amount of salt for your diet.

That said, for people who’ve been told to cut back on salt, adding oregano (or other spices) to your food may provide a painless way to trim sodium from your diet, the study authors write. (Research backs them up: Learning how to substitute herbs and spices for salt can help you trim nearly 1,000 mg of sodium a day from your diet, suggests research from the University of California, San Diego.)

TIME movies

Intense Movies May Be Dangerous for People With Weak Hearts

Robin Tunney In 'Vertical Limit'
A scene from the 2000 movie 'Vertical Limit' Columbia Pictures/Getty Images

Dramatic scenes that leave moviegoers’ chests pounding could be dangerous for viewers with already weak hearts, a small study shows, drawing a link between emotionally stressful cinematography and potentially dangerous cardiac changes in audience members

It’s no surprise to anyone who’s felt their heart jump into their throat while watching a scary movie that these scenes can be stressful. But can that stress be measured by scientists — and is it dangerous?

In a small study published yesterday in the American Heart Association journal Circulation: Arrhythmia and Electrophysiology, researchers tracked how emotional stress — in this case, watching a harrowing five-minute clip of the rock-climbing movie Vertical Limit — affects the heart. They measured the blood pressure, heart rhythm and breathing speed of 19 heart patients while they watched the scene and found that the clip affected the stability of their heart beat while also increasing blood pressure and how quickly the patients were breathing.

“If someone already has a weakened heart, or if they experience a much more extreme stress,” said study author Dr. Ben Hanson of University College London, “the effect could be much more destabilizing and dangerous.”

(Researchers recreated those breathing patterns without subjecting the patients to the clip and found no such change in heart rate, suggesting that the emotional stress — and not just the increased respiration — was to blame.)

In a statement about the study, Dr. Ben Hanson, one of its authors, said that the results did vary but the observation of cardiac changes was consistent. So, though there’s no reason for healthy movie fans to worry, those with preexisting heart problems might want to take it under consideration.

Watch the clip at your own risk here:

 

TIME

Single Gene Responsible for Group of Heart Disease Risk Factors

It’s rare, but a genetic mutation may explain the collection of heart-harming factors, including obesity, known as metabolic syndrome

Researchers have been pretty successful at identifying individual genes that can contribute to obesity, diabetes, high blood pressure or high cholesterol levels. Having any—or a combination of these risk factors—can significantly increase the risk of heart disease and stroke.

But by studying three families whose members had higher than average rates of heart disease, diabetes and obesity, researchers zeroed in on a single gene, DYRK1B, that when mutated, can contribute to nearly all of these risk factors, which together are known as metabolic syndrome.

“Historically, there has been debate about the existence of metabolic syndrome. The question is, are the [risk factors] together coincidentally or are they here because the patient has a unifying [problem that explains them all],” says Dr. Ali Keramati, a resident in internal medicine at the Yale University School of Medicine. “This study shows that it’s possible for one patient to have all the risk factors that are all explained by one mutation.”

Normally, that gene is responsible for taking stem cells and turning them into fat or muscle, and for directing the liver to produce glucose to balance out insulin levels. In the aberrant form found among members of the three families, it became overactive, pushing the body to produce more fat cells, and driving the liver to pump out more glucose, raising blood sugar levels. The result is likely metabolic syndrome; family members with the mutated gene were more likely to be obese, have diabetes and early heart disease compared to those who did not.

For those who might think that their genes are to blame for their obesity, hypertension or diabetes, Keramati stresses that the mutation is rare, and likely only explains metabolic syndrome in a very small percentage of people. But for people who are affected, the good news is that a drug may help to control the hyperactivity of the gene. “It may be possible to develop a drug that knocks down the function of this gene,” he says.

And for the vast majority who don’t have the DYRK1B mutation, the finding may still lead to other drug treatments by improving doctors’ understanding of how various risk factors form the perfect storm of conditions for heart. In the meantime, the strongest ways to avoid metabolic syndrome are the most familiar – keeping weight, blood pressure, blood sugar and cholesterol levels under control with a healthy diet and plenty of exercise.

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