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Got a Spare 15 Minutes? A Little Exercise May Boost Life Span

TUESDAY, June 14, 2016 (HealthDay News) — Just 15 minutes of exercise a day may lower older adults’ risk of early death by one-fifth, a new study suggests.

The research included more than 123,000 people, aged 60 and older. The study’s mean follow-up time was 10 years. Compared to those who were inactive, those with low levels of activity were 22 percent less likely to die during the study period, the investigators found.

In addition, for people with medium and high levels of physical activity, the risk of dying during the study was reduced by 28 percent and 35 percent, respectively, compared to people who weren’t active at all.

The findings were scheduled to be presented Tuesday at the European Society of Cardiology meeting in Sophia Antipolis, France.

The study wasn’t designed to prove a cause-and-effect relationship, but the results “show that the more physical activity older adults do, the greater the health benefit. The biggest jump in benefit was achieved at the low level of exercise, with the medium and high levels bringing smaller increments of benefit,” said Dr. David Hupin, of the University Hospital of Saint-Etienne, France.

The low level of exercise is equivalent to a 15-minute brisk walk each day, according to Hupin.

“Age is not an excuse to do no exercise,” he said in a society news release. “It is well established that regular physical activity has a better overall effect on health than any medical treatment. But less than half of older adults achieve the recommended minimum of 150 minutes moderate intensity or 75 minutes vigorous intensity exercise each week.”

Hupin said people shouldn’t make drastic changes to the amount of activity in their lives. Instead, they should progressively increase the amount of activity they’re doing, he suggested.

“Fifteen minutes a day could be a reasonable target for older adults. Small increases in physical activity may enable some older adults to incorporate more moderate activity and get closer to the recommended 150 minutes per week,” he concluded.

Research presented at meetings should be viewed as preliminary until published in a peer-reviewed journal.

More information

The U.S. National Institute on Aging has more about exercise and physical activity.





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Shouting? The ‘Silent Treatment’? How Spouses Argue Linked to Physical Ills

By Maureen Salamon
HealthDay Reporter

TUESDAY, June 14, 2016 (HealthDay News) — How spouses disagree may predict which ones are more likely to develop certain ailments down the road, new research suggests.

Analyzing 156 older couples over 20 years, scientists found that patterns of angry outbursts raised the risk of heart problems, while emotional withdrawal or “stonewalling” could lead to musculoskeletal issues such as back pain or stiff neck.

“We’ve known for a long time that stress and negative emotions are bad for your health,” said study author Claudia Haase. She’s an assistant professor of human development and social policy at Northwestern University in Evanston, Ill.

“But in our new study we wanted to dig deeper, and found that very specific behaviors led to specific health problems over time,” she added.

Cardiovascular disease is the leading cause of death and a major cause of disability worldwide, according to the World Health Organization. Meanwhile, musculoskeletal symptoms such as back pain are among the most frequently reported health problems in industrialized nations, according to study documents.

Study participants were drawn from ongoing research of long-term heterosexual marriages, with about half of spouses aged 40 to 50 and the rest aged 60 to 70 at the start of the study. According to the 2009 U.S. Census, 96 percent of Americans over the age of 65 had been married at least once in their life.

Every five years, the couples were videotaped in a laboratory setting as they discussed areas of both enjoyment and disagreement. Expert behavioral coders rated the interactions based on facial expressions, body language and tone of voice. Spouses also completed questionnaires asking details about specific health problems.

To track displays of anger, the researchers combed videotaped conversations for behaviors such as pressed lips, knitted brows, raised or lowered voices and tight jaws.

To identify “stonewalling” behavior — defined as shutting down emotionally during conflict — researchers looked for so-called “away” behavior, such as facial stiffness, rigid neck muscles, and little or no eye contact.

The data was then correlated to health symptoms that were measured every five years over a 20-year span. The study didn’t prove cause-and-effect between behavior and health problems, only an association. And, the links were strongest for husbands, though some of the key associations were found in wives as well.

The anger-cardiovascular relationship was most robust, with 81 percent of spouses rated in the “high anger” group experiencing at least one cardiovascular symptom within 20 years, Haase said. Cardiovascular symptoms include chest pain and high blood pressure.

Conversely, she said, about 53 percent of those in the “low anger” group had experienced such symptoms within the 20-year period.

About 45 percent of husbands rated as “high stonewallers” experienced back pain, muscle tension or stiff neck over the 20-year study. Only 23 percent of husbands who were “low stonewallers” had such symptoms in that time, Haase said.

“Our findings suggest that hot-headed people might want to consider if they would benefit from interventions such as anger management,” Haase said. “If they’re stonewalling, they may want to consider resisting the impulse to bottle up their emotions.”

Vanessa Downing is a psychologist and behavioral health coordinator at the Christiana Care Center for Heart & Vascular Health in Wilmington, Del. She wasn’t surprised by the study findings.

“When we look at health psychology as a whole and the movement to integrate psychologists into health care settings, it’s because of the mounting research supporting these relationships between our emotions and personality traits and what happens with our health outcomes over time,” Downing said.

But emotions such as disappointment or betrayal are normal in any long-term relationship, she noted, and it’s only their chronic nature that can lead them to become destructive to one’s health.

“Probably the most important message here is the importance of us starting to recognize our patterns,” Downing said.

“A lot of times people get the message that they need to do something about their anger, for instance, because it’s a problem for other people. But this study suggests that anger is really a problem for you, and that can be motivating for people because behavior change takes commitment,” she explained.

The study was published online recently in the journal Emotion.

More information

The University of Minnesota offers more about how thoughts and emotions impact health.





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Shouting? The ‘Silent Treatment’? How Spouses Argue Linked to Physical Ills

By Maureen Salamon
HealthDay Reporter

TUESDAY, June 14, 2016 (HealthDay News) — How spouses disagree may predict which ones are more likely to develop certain ailments down the road, new research suggests.

Analyzing 156 older couples over 20 years, scientists found that patterns of angry outbursts raised the risk of heart problems, while emotional withdrawal or “stonewalling” could lead to musculoskeletal issues such as back pain or stiff neck.

“We’ve known for a long time that stress and negative emotions are bad for your health,” said study author Claudia Haase. She’s an assistant professor of human development and social policy at Northwestern University in Evanston, Ill.

“But in our new study we wanted to dig deeper, and found that very specific behaviors led to specific health problems over time,” she added.

Cardiovascular disease is the leading cause of death and a major cause of disability worldwide, according to the World Health Organization. Meanwhile, musculoskeletal symptoms such as back pain are among the most frequently reported health problems in industrialized nations, according to study documents.

Study participants were drawn from ongoing research of long-term heterosexual marriages, with about half of spouses aged 40 to 50 and the rest aged 60 to 70 at the start of the study. According to the 2009 U.S. Census, 96 percent of Americans over the age of 65 had been married at least once in their life.

Every five years, the couples were videotaped in a laboratory setting as they discussed areas of both enjoyment and disagreement. Expert behavioral coders rated the interactions based on facial expressions, body language and tone of voice. Spouses also completed questionnaires asking details about specific health problems.

To track displays of anger, the researchers combed videotaped conversations for behaviors such as pressed lips, knitted brows, raised or lowered voices and tight jaws.

To identify “stonewalling” behavior — defined as shutting down emotionally during conflict — researchers looked for so-called “away” behavior, such as facial stiffness, rigid neck muscles, and little or no eye contact.

The data was then correlated to health symptoms that were measured every five years over a 20-year span. The study didn’t prove cause-and-effect between behavior and health problems, only an association. And, the links were strongest for husbands, though some of the key associations were found in wives as well.

The anger-cardiovascular relationship was most robust, with 81 percent of spouses rated in the “high anger” group experiencing at least one cardiovascular symptom within 20 years, Haase said. Cardiovascular symptoms include chest pain and high blood pressure.

Conversely, she said, about 53 percent of those in the “low anger” group had experienced such symptoms within the 20-year period.

About 45 percent of husbands rated as “high stonewallers” experienced back pain, muscle tension or stiff neck over the 20-year study. Only 23 percent of husbands who were “low stonewallers” had such symptoms in that time, Haase said.

“Our findings suggest that hot-headed people might want to consider if they would benefit from interventions such as anger management,” Haase said. “If they’re stonewalling, they may want to consider resisting the impulse to bottle up their emotions.”

Vanessa Downing is a psychologist and behavioral health coordinator at the Christiana Care Center for Heart & Vascular Health in Wilmington, Del. She wasn’t surprised by the study findings.

“When we look at health psychology as a whole and the movement to integrate psychologists into health care settings, it’s because of the mounting research supporting these relationships between our emotions and personality traits and what happens with our health outcomes over time,” Downing said.

But emotions such as disappointment or betrayal are normal in any long-term relationship, she noted, and it’s only their chronic nature that can lead them to become destructive to one’s health.

“Probably the most important message here is the importance of us starting to recognize our patterns,” Downing said.

“A lot of times people get the message that they need to do something about their anger, for instance, because it’s a problem for other people. But this study suggests that anger is really a problem for you, and that can be motivating for people because behavior change takes commitment,” she explained.

The study was published online recently in the journal Emotion.

More information

The University of Minnesota offers more about how thoughts and emotions impact health.





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Clashes at Nursing Homes Not Uncommon

By Amy Norton
HealthDay Reporter

MONDAY, June 13, 2016 (HealthDay News) — Many elderly adults in nursing homes face aggressive or disturbing behavior from their fellow residents, a new study suggests.

The study found that one in five nursing home residents had been involved in an incident with a fellow resident within the past month.

Most often that meant a verbal altercation, with a resident yelling or cursing at another. But some seniors were involved in physical scuffles, and some experienced inappropriate sexual behavior, the study found.

Dr. Lisa Gibbs, a geriatrics specialist who was not involved in the study, called the findings “enlightening” and “something we need to be talking about.”

“In nursing homes, we put a lot of focus on residents’ medical conditions,” said Gibbs, who is chief of geriatrics and gerontology at the University of California, Irvine.

“We’ve worked on areas like reducing medical errors, and preventing falls and pressure sores [on the skin],” Gibbs said. “And all of that is important. But we can also reduce the prevalence of this kind of mistreatment.”

The study included 10 randomly selected New York state nursing homes. The researchers collected information on resident-to-resident “mistreatment” through interviews with residents and staff, chart reviews and direct observation.

Of more than 2,000 residents, about 20 percent had been involved in at least one incident within the past month, the findings showed. Men and women were equally affected.

Just over 9 percent of residents had gotten into a verbal clash, while about 5 percent had been in a physical incident, including hitting and pushing. About 4 percent had an “invasion of privacy” issue, and 0.6 percent experienced a sexual incident, such as inappropriate touching, the investigators found.

However, no one is blaming residents themselves.

Often, nursing home residents are in some stage of dementia. Even when that’s not the case, they may be suffering from anxiety or depression, Gibbs pointed out.

The study did find that incidents were more common in nursing homes’ dementia units. On the other hand, one-quarter of residents with no dementia symptoms were involved in at least one incident.

“Nursing homes need to pay attention to this, and implement humane and respectful ways of dealing with it,” said Dr. Laura Mosqueda, another geriatrics specialist who reviewed the study.

One way is to identify residents who seem to be having issues with each other, and limit their interactions, according to Mosqueda, who directs the National Center on Elder Abuse at the University of Southern California, in Los Angeles.

Evaluating residents’ mental health — including symptoms of anxiety and depression — is also key, Mosqueda said.

Gibbs agreed, and pointed to other issues, too. “Maybe they’re in pain, or dealing with loss of function — and loss of the life that they knew,” she said.

Part of the solution to the problem, according to Gibbs, is to “understand each resident as a whole person.”

And, Mosqueda noted, it’s not clear how staff training fits into the picture. “Are staff trained to intervene appropriately? Are they even recognizing it? If this is behavior you see all the time, you might think it’s normal,” she suggested.

But one study finding does give some context: Incidents were more common in units with relatively fewer certified nursing assistants — the staff who are responsible for residents’ daily care.

“That may be a sign of systemic neglect in the nursing home,” Mosqueda said.

She and Gibbs offered similar advice to families with a loved one in a nursing home: Visit regularly and observe what’s going on, including in common areas. And note whether staff members are observant, as well.

If you think there is an issue, Mosqueda said, you can talk to the nursing home administration, or contact the local long-term care ombudsman. Ombudsmen are certified advocates who can help resolve issues between residents (or their families) and long-term care facilities.

“If you contact the ombudsman,” Mosqueda said, “an independent eye will come in [to the nursing home] and check things out.”

Gibbs said it’s also important for nursing homes to offer residents daily activities that keep them engaged and give them an outlet.

“We need to make sure they have rewarding interactions with other people,” she said.

Researchers led by Dr. Mark Lachs, of Weill Cornell Medical College in New York City, reported the findings online June 13 in the Annals of Internal Medicine.

More information

The U.S. National Institute on Aging has advice on choosing a nursing home.





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Fewer Injured Workers Getting Opioid Prescriptions in Some States

MONDAY, June 13, 2016 (HealthDay News) — As the United States continues to grapple with the painkiller addiction epidemic, a new study reports that fewer injured workers are getting prescriptions for opioids in most of the 25 states included in the research.

The study included information from 337,000 workers’ compensation claims in the study states. The researchers also reviewed nearly 1.9 million prescriptions linked to those claims. The information came two 24-month time periods, ending in March 2012 and in March 2014.

The amount of opioid painkillers, such as OxyContin and Percocet, received by injured workers dropped during both time periods in the majority of the states in the study. Significant reductions — between 20 percent and 31 percent — were seen in Maryland, Massachusetts, Michigan, Oklahoma, North Carolina and Texas, the study found.

Opioid use was most common among workers who were off work for more than seven days. Sixty-five percent to 80 percent of these injured workers who were given pain medications received opioids in most states included in the current research.

Injured workers in Louisiana, New York and Pennsylvania were given the highest average amounts of opioids in the 25 states in the study.

Simultaneous use of opioids and sedating medications called benzodiazepines occurred among 1 percent to 9 percent of injured workers. Simultaneous use of opioids and muscle relaxants occurred among 30 percent to 45 percent of injured workers.

This information may be used by state officials who wonder if opioid use in their state is higher or lower than other states, said study author Vennela Thumula. She’s a policy analyst at Workers Compensation Research Institute in Cambridge, Mass.

The study’s findings might also help doctors who wonder whether their prescribing habits are similar to those of their peers. The study information could also be useful for insurance companies and people working with injured workers, Thumula said in an institute news release.

More information

The U.S. National Institute on Drug Abuse has more about opioids.





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Obama’s 3-Pronged Effort to Speed Organ Transplants

MONDAY, June 13, 2016 (HealthDay News) — The Obama administration on Monday announced wide-ranging public and private measures to speed the wait for lifesaving organ transplants in the United States.

The goals include making it easier for Americans to become organ donors and increasing the number of organ transplants. Also, almost $200 million in new investments will “facilitate breakthrough research and development,” the White House said in a media release.

“New breakthroughs in bioengineering, transplantation, and organ preservation can further increase the number of organ transplants and improve outcomes,” the President’s office said.

The administration has enlisted the cooperation of dozens of corporations, universities, hospitals, foundations and patient advocacy organizations in this ongoing project.

Last year, more than 30,000 transplants took place in the United States, a record number. Yet more than 120,000 people remain on the organ waiting list, according to the President’s report.

“Every 10 minutes, someone is added to the waiting list for a lifesaving organ transplant in the United States. And every day, 22 people die while waiting,” the White House noted.

Many viable transplant organs go unused because of time constraints.

“If even half of all unused donated hearts and lungs could reach transplant patients in time, experts estimate that the waiting list for hearts and lungs could end in two to three years,” according to the Office of the Press Secretary.

In one initiative announced Monday, more than 30 transplant centers have said they’ll share data and best practices for kidney transplants for hard-to-match patients. This could help almost 1,000 more people a year obtain transplants, the White House said. The vast majority of transplant patients need kidneys.

UnitedHealthcare, the nation’s largest health insurer, also announced on Sunday that it will cover travel costs of up to $5,000 for kidney donors, according to the Washington Post. By eliminating potential obstacles, this is intended to encourage more organ donations.

The U.S. Department of Defense (DOD) plans to announce a public-private investment of more than $160 million in a new Advanced Tissue Biofabrication Manufacturing Innovation Institute. It’s goal: to try and manufacture cells and tissues for repair and replacement, perhaps even organ replacement.

The DOD is also announcing $7 million in awards to small businesses that are working to advance organ and tissue preservation, the White House said.

Also, to improve overall health and survival after lung transplantation, the Cystic Fibrosis Foundation is committing $15 million for new projects.

Another multimillion-dollar project will explore ways to maximize the quantity and quality of organs that each donor can give.

“Researchers have the potential to repair or replace tissues and organs, reduce waitlists for organ transplants, and potentially reduce health care cost for treatments — but we must continue to invest in breakthrough research and development,” the White House said.

The administration said that over the next six months it will outline “common-sense steps to reduce the organ transplant waiting list and improve outcomes for patients,” the announcement noted.

Currently, 95 percent of Americans say they support organ donation, but just 50 percent are registered organ donors. Experts hope to narrow that gap.

Online partners may be key: The White House said that several organizations, including Facebook, ORGANIZE, Tinder and Twitter, are all pursuing new tools and campaigns that should help boost donor registrations.

Monday’s developments build on earlier actions by the Obama administration to improve the organ transplant process and support living donors. Over three years, seven government agencies have spent nearly $3 billion to advance bioengineering and knowledge of organ and tissue regeneration and preservation, the White House announcement said.

More information

The U.S. Department of Health & Human Services has more about becoming an organ donor.





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Could Eating More Whole Grains Help You Live Longer?

By Kathleen Doheny
HealthDay Reporter

MONDAY, June 13, 2016 (HealthDay News) — Health experts have long urged people to swap their processed white grains for the whole-grain variety, and new research suggests that advice might help you live longer.

Researchers found that people who ate three or more servings of whole grains a day had a 20 percent reduced risk of premature death during the study period, compared to those who ate fewer or no servings of whole grains.

“The higher the whole grain intake, the lower the death rate, especially deaths from cardiovascular disease,” said study author Dr. Qi Sun. He is an assistant professor of nutrition at the Harvard T.H. Chan School of Public Health in Boston.

Whole grains are so named because they contain the entire grain kernel, including bran (outer husk), germ (nutrient-rich core) and endosperm (middle layer). Whole-grain foods include whole-wheat flour, oatmeal, brown rice and whole cornmeal.

When grains are refined, they have been milled and that process removes the bran and the germ, as well as fiber, iron and many of the B vitamins. White breads, white rice and white flour are all refined grains, according to the U.S. Department of Agriculture (USDA).

Sun and his colleagues reviewed the findings of 12 published studies as well as data from the National Health and Nutrition Examination Surveys (NHANES). The studies included nearly 800,000 men and women. The study populations were from the United States, the United Kingdom and Scandinavian countries. The studies covered 1971 to 2010. Over the study periods, there were almost 98,000 deaths recorded.

The study couldn’t show a direct cause-and-effect relationship. But the review suggests that the risk of dying prematurely from heart disease and stroke dropped approximately 25 percent when people had three servings of whole grains (48 grams total) daily, compared to those who ate fewer or no servings of whole grains. The risk of death from cancer appeared to decrease about 15 percent, the study authors said.

Sun said many possibilities can help explain why whole-grain consumption seemed to affect death risk. Whole grains are high in fiber, so they can help regulate blood sugar and improve blood cholesterol levels, which can lower the risk of heart disease and diabetes. Fiber also makes you feel full longer, so you may eat fewer calories, maintain a healthy weight, and lower heart disease risk, he added.

Based on the study findings, Sun said that low-carbohydrate diets that neglect the health benefits of whole grains “should be adopted with caution,” due to a possible higher risk of heart disease.

To get 48 grams of whole grains, Sun said, people could eat three slices of whole-grain bread, for instance.

One registered dietitian agreed with the findings.

“The outcomes of this study provide support to the dietary guidelines recommendation to include three servings of whole grains in our daily diet,” said Connie Diekman, director of university nutrition at Washington University in St. Louis. “Contrary to many popular diets, this study supports the health benefits of whole grains as opposed to a popular perception that grains are the cause of obesity.”

So how can you be sure the foods you’re eating actually are whole-grain? Foods that list “whole” before the first ingredient on the ingredient list are whole-grain foods, the USDA says.

Some foods are also naturally whole grains, such as oatmeal, quinoa, brown rice, rolled oats, bulgur, wild rice and popcorn. The USDA says you can’t judge whether a food is whole-grain from its color. And, the agency notes that certain claims, such as 100 percent wheat, on packaging don’t necessarily mean a product is made with whole grains. Check the ingredient list to be sure.

The study was published June 13 in Circulation.

More information

To learn more about whole grains, see ChooseMyPlate.gov.





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Could Eating More Whole Grains Help You Live Longer?

By Kathleen Doheny
HealthDay Reporter

MONDAY, June 13, 2016 (HealthDay News) — Health experts have long urged people to swap their processed white grains for the whole-grain variety, and new research suggests that advice might help you live longer.

Researchers found that people who ate three or more servings of whole grains a day had a 20 percent reduced risk of premature death during the study period, compared to those who ate fewer or no servings of whole grains.

“The higher the whole grain intake, the lower the death rate, especially deaths from cardiovascular disease,” said study author Dr. Qi Sun. He is an assistant professor of nutrition at the Harvard T.H. Chan School of Public Health in Boston.

Whole grains are so named because they contain the entire grain kernel, including bran (outer husk), germ (nutrient-rich core) and endosperm (middle layer). Whole-grain foods include whole-wheat flour, oatmeal, brown rice and whole cornmeal.

When grains are refined, they have been milled and that process removes the bran and the germ, as well as fiber, iron and many of the B vitamins. White breads, white rice and white flour are all refined grains, according to the U.S. Department of Agriculture (USDA).

Sun and his colleagues reviewed the findings of 12 published studies as well as data from the National Health and Nutrition Examination Surveys (NHANES). The studies included nearly 800,000 men and women. The study populations were from the United States, the United Kingdom and Scandinavian countries. The studies covered 1971 to 2010. Over the study periods, there were almost 98,000 deaths recorded.

The study couldn’t show a direct cause-and-effect relationship. But the review suggests that the risk of dying prematurely from heart disease and stroke dropped approximately 25 percent when people had three servings of whole grains (48 grams total) daily, compared to those who ate fewer or no servings of whole grains. The risk of death from cancer appeared to decrease about 15 percent, the study authors said.

Sun said many possibilities can help explain why whole-grain consumption seemed to affect death risk. Whole grains are high in fiber, so they can help regulate blood sugar and improve blood cholesterol levels, which can lower the risk of heart disease and diabetes. Fiber also makes you feel full longer, so you may eat fewer calories, maintain a healthy weight, and lower heart disease risk, he added.

Based on the study findings, Sun said that low-carbohydrate diets that neglect the health benefits of whole grains “should be adopted with caution,” due to a possible higher risk of heart disease.

To get 48 grams of whole grains, Sun said, people could eat three slices of whole-grain bread, for instance.

One registered dietitian agreed with the findings.

“The outcomes of this study provide support to the dietary guidelines recommendation to include three servings of whole grains in our daily diet,” said Connie Diekman, director of university nutrition at Washington University in St. Louis. “Contrary to many popular diets, this study supports the health benefits of whole grains as opposed to a popular perception that grains are the cause of obesity.”

So how can you be sure the foods you’re eating actually are whole-grain? Foods that list “whole” before the first ingredient on the ingredient list are whole-grain foods, the USDA says.

Some foods are also naturally whole grains, such as oatmeal, quinoa, brown rice, rolled oats, bulgur, wild rice and popcorn. The USDA says you can’t judge whether a food is whole-grain from its color. And, the agency notes that certain claims, such as 100 percent wheat, on packaging don’t necessarily mean a product is made with whole grains. Check the ingredient list to be sure.

The study was published June 13 in Circulation.

More information

To learn more about whole grains, see ChooseMyPlate.gov.





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What You Should Know About the Anxiety That Kept Zayn Malik Offstage

Photo: Getty Images

Photo: Getty Images

Zayn Malik, member of the now-disbanded One Direction, cancelled his UK performance at the London Capital Summertime Ball on Saturday evening. The reason? His anxiety.

The British singer/songwriter took to Instagram and Twitter to explain why he couldn’t perform at the much-anticipated show. “My anxiety that has haunted me throughout the last few months around live performances has gotten the better of me … with the magnitude of the event, I have suffered the worst anxiety of my career,” he wrote in a statement to his fans.

RELATED: 19 Natural Remedies for Anxiety

Malik’s honest Tweet is a moving testament to just how crippling anxiety can be for those who suffer from it—and unfortunately millions do. According to the National Institutes of Mental Health, anxiety disorders affect about 18% of adults in the United States.

“Specifically performance anxiety is not unusual,” says Gail Saltz, MD, Health’s contributing psychology editor. “If left untreated, one may become physiologically incapacitated, and the anxiety can grow in severity. Shortness of breath, sweat, and nausea are all symptoms of panic that preclude being on stage and performing.”

Malik’s supermodel girlfriend, Gigi Hadid, supported the artist’s decision, tweeting at him: “You made the best of the situation and have given your fans an opportunity to understand you better as a performer.”

What’s more, Malik is helping others with anxiety disorders understand that they are not alone.




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Spikes in Blood Pressure Don’t Always Need ER Care

MONDAY, June 13, 2016 (HealthDay News) — If your blood pressure reading at a routine doctor’s office visit is alarmingly high, in most cases that doesn’t mean a trip to the emergency room, a new study suggests.

In the Cleveland Clinic study of office visits by almost 60,000 patients with “hypertensive urgency” (very high blood pressure), less than 1 percent needed a referral to a hospital ER.

The rest were treated and then sent home with no added risk in terms of patient outcomes, the researchers said.

“Hypertensive urgency is common in the outpatient setting,” noted the team led by the clinic’s Dr. Krishna Patel. However, the researchers believe that “most patients probably can be safely treated in the outpatient setting, because cardiovascular complications are rare in the short term.”

Dr. Suzanne Steinbaum, who directs Women’s Heart Health at Lenox Hill Hospital in New York City, called the finding “reassuring.”

“For those patients with hypertension, an episode of elevated blood pressure can be alarming,” she said.

However, the Cleveland study suggests that “hypertensive urgency — defined as a blood pressure of at least 180/110 [millimeters of mercury, or mm Hg] — without symptoms or evidence of end organ damage can be managed safely as an outpatient,” Steinbaum said.

The findings are published online June 13 in JAMA Internal Medicine.

As the researchers explained, high blood pressure can result in organ damage over time. So, doctors may be concerned about the threat of organ damage in people with severely elevated blood pressure — even for a brief period.

But it’s been unclear whether the best course of action is to send such patients to the ER.

The new study found it was only necessary in a small minority (0.7 percent) of patients. And overall, patients referred to the ER and those sent home had similar rates of major heart problems within the next week, month and year, the research team said.

Patients who were sent home had lower odds of needing admission to a hospital over the next week, compared to those who’d been sent to the ER, the study found.

And while patients who were sent home were more likely to have uncontrolled blood pressure one month later, this difference faded away by the six-month mark, Patel’s team said.

Treating people outside of the ER could be cost-effective, too.

Sending people to the hospital “was associated with increased use of health care resources but not better outcomes,” the Cleveland Clinic researchers reported.

All of this doesn’t mean that most patients’ hypertension disappeared, however: Most still had uncontrolled high blood pressure months later, the study found.

That was a concern for Steinbaum.

“The real issue becomes addressing the reality that two-thirds of [study] patients who were either hospitalized or outpatient had uncontrolled blood pressures at six months,” she said.

Dr. Howard Selinger is chair of family medicine at the Frank H. Netter M.D. School of Medicine at Quinnipiac University, in North Haven, Conn. He believes doctors must still treat hypertensive patients on a case-by-case basis.

Frailty is a key factor, Selinger said.

“If this patient is a frail elderly who perhaps sustained an earlier stroke, that changes the potential for an adverse outcome,” he explained.

Other factors — including the speed at which treatment is available in an outpatient setting, or transport or communication issues — should also factor into the decisions physicians make, Selinger said.

And, of course, a spike in blood pressure becomes more urgent when other symptoms of heart trouble are present, he added.

“Not to be confused as a hypertensive urgency is a hypertensive crisis — in which symptoms are already present, such as severe headache, visual changes, chest pains,” Selinger stressed. In those cases, ER care may be warranted, he said.

More information

The American Academy of Family Physicians has more about high blood pressure.





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