More Support for Aggressive Blood Pressure Treatment for Elderly

By Amy Norton
HealthDay Reporter

SATURDAY, May 14, 2016 (HealthDay News) — People who get their high blood pressure down to normal levels may substantially cut their risk of heart disease — even if they’re elderly or have already had heart problems, new research suggests.

The study results, from a major clinical trial called SPRINT (Systolic Blood Pressure Intervention Trial), add to evidence that aggressively treating high blood pressure in older adults can pay off.

Specifically, experts said, the benefits appear to extend to elderly and less-healthy patients.

That might sound obvious. But for years there has been “major controversy” over whether such intensive treatment is even safe for older people, explained Dr. Dalane Kitzman, a cardiologist at Wake Forest Baptist Medical Center, in Winston-Salem, N.C.

Kitzman is one of the researchers who will present the latest SPRINT findings Saturday at the annual meeting of the American Society of Hypertension (ASH), in New York City.

The trial’s initial results, which came out last year, challenged the current recommendations for treating older adults’ high blood pressure.

U.S. national guidelines suggest that patients younger than 60 get their systolic (top number) blood pressure down to 140 mm/Hg or lower. Older adults are advised to strive for 150 or lower.

The SPRINT trial tested that approach against a more aggressive one, aiming to get patients of all ages down to 120 or below — which is considered “normal.”

The trial, which began in 2009, was stopped early when it became clear that tighter control was better: Patients who went for lower numbers were one-quarter to one-third less likely to die or suffer a heart attack, heart failure or stroke.

The results that are to be reported at the ASH meeting go deeper, according to Dr. Robert Phillips, of Houston Methodist Hospital in Texas.

A big unanswered question has been whether different subgroups of patients fare well, he explained.

Phillips is secretary/treasurer for ASH and chaired the session on the SPRINT findings.

Some of the most important results focus on heart failure — a chronic condition in which the heart muscle cannot pump efficiently enough to meet the body’s needs. That leads to problems like chronic fatigue, breathlessness and fluid buildup.

Kitzman’s team found that patients on tight blood pressure control were 38 percent less likely to be hospitalized for worsening heart failure. And even those at increased risk of heart failure benefited.

That included patients aged 75 and older, blacks, and people with kidney disease or a history of heart problems or stroke.

Phillips called the reduction in heart failure hospitalizations “dramatic.”

Doctors have long known that when older adults get their blood pressure below 150, their heart failure risk goes down, Kitzman said.

“Now we know that lowering it to normal levels reduces the risk even further,” he said.

On average, patients on tighter blood pressure control used three medications, versus two in the group on standard care. That does raise the risk of side effects, such as dizziness and fainting.

Another study to be presented at the meeting focused on those potential downsides.

The researchers, from Wake Forest University and the University of Florida, found that patients on tighter blood pressure control faced a slightly higher risk of dizzy spells and fainting: Just over 3 percent had problems with dizziness, versus 2 percent of other patients. The findings were nearly identical when it came to fainting.

But among people older than 75, those on tighter blood pressure control were actually 21 percent less likely to fall and suffer an injury.

It’s not clear why that was, according to Phillips. But it’s possible that healthier blood vessel function protects many seniors from getting lightheaded and falling, he said.

That’s an important finding, according to Phillips. For years, it was thought that blood pressure had to keep rising with age, so that the brain received enough blood flow, he explained.

“There’s a long history of doctors being afraid to treat high blood pressure in the elderly,” he said.

These latest results confirm that, in general, “lower is better,” Phillips said.

Kitzman made the same point. Going into the SPRINT study, he said, the researchers themselves had “mixed feelings” about whether tight blood pressure control would be a good thing for all.

But, Phillips added, caution is still in order. If you’re suffering dizzy spells on blood pressure medication, you should talk to your doctor about lowering the dose, he suggested.

Kitzman also noted that regardless of how many medications you’re taking, lifestyle matters. He advised getting a balanced diet with limited salt and plenty of fruits and vegetables, being physically active, and maintaining a healthy weight.

Research has shown that older adults can make those kinds of lifestyle changes, too, Kitzman noted. “No matter how old you are,” he said, “addressing high blood pressure is feasible and beneficial.”

The SPRINT trial included over 9,300 patients aged 50 and up, recruited from nearly 100 clinics across the United States. It was funded by the U.S. National Institutes of Health.

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

More information

The American Heart Association has advice on blood pressure control.

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Your Ability to ‘Smell’ the Taste of Foods Can Lessen With Age

FRIDAY, May 13, 2016 (HealthDay News) — Your ability to “smell” the foods you taste weakens as you age, new research suggests.

Along with your nose, you can detect aromas through your mouth when you chew your food, which releases certain types of molecules, researchers explained.

The study included 102 healthy nonsmokers, aged 18 to 72, who ate various foods and were asked to rate how intensely they detected two tastes (sweet and salty) and four odors (strawberry, vanilla, chicken and soy sauce).

The volunteers tended to be better at tasting sweet and salty rather than detecting the odors. Only 3 percent of the participants had difficulty tasting at least traces of sweet or salty, but up to 23 percent had trouble detecting some of the odors.

This suggests that there’s little difference in how people experience the same taste. But, there could be significant variation in how intensely they experience an aroma, according to researchers Tyler Flaherty and Juyun Lim, of Oregon State University.

Increasing age lowered people’s ability to smell more than their ability to taste, according to the study published recently in the journal Chemosensory Perception.

“Generally, large individual differences in odor responsiveness become even greater when aging is considered as a factor,” Flaherty said in a journal news release.

Reasons why the ability to smell declines as people get older may include long-term medication use or age-related physical and mental changes. Factors that could affect the ability to detect smells through the mouth include the use of dentures, according to the researchers.

More information

The U.S. National Institute on Aging has more about smell and taste.

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Many Fertility Apps, Websites Miss the Mark

By Amy Norton
HealthDay Reporter

FRIDAY, May 13, 2016 (HealthDay News) — Websites and apps that promise to calculate a woman’s most fertile days may often be off base, a new study suggests.

When doctors put 53 fertility calculators to the test, they found that only four accurately predicted a hypothetical woman’s “precise fertile window.”

“I’d recommend that consumers be cautious, and not completely rely on these sites and apps,” said lead researcher Dr. Robert Setton. He is an obstetrics and gynecology resident at New York-Presbyterian Hospital/Weill Cornell Medical College, in New York City.

Setton was to present the findings Sunday at the annual meeting of the American College of Obstetricians and Gynecologists, in Washington, D.C. Such research is considered preliminary until published in a peer-reviewed medical journal.

The concept behind online fertility calculators is simple, Setton explained. A woman typically needs to know the date of her last menstrual period, and the average length of her cycles. The calculator then tells her which days she’ll have the best chance of conceiving.

There are many such services out there, according to Setton. “But to the best of our knowledge, no one has studied their accuracy,” he said.

His team assessed 20 websites and 33 apps that were the top results in an online search. The researchers put the same information into each fertility calculator: the same date for the last menstrual period, and an average menstrual cycle length of 28 days.

According to Setton, research shows that a woman’s “fertile window” — or the best time to have sex — includes the day she ovulates and the five days before that. For a woman with a menstrual cycle of 28 days, that would be days 10 through 15.

Yet only one website and three apps came up with that fertile window, Setton said. They included the Babymed.com site and the apps Clue; My Days – Period & Ovulation; and Period Tracker, the study found.

The rest of the calculators, Setton said, “were all over the place.”

Some gave fertile windows that were 10 days long, he noted, and some incorrectly predicted the day of ovulation.

What’s not clear is whether any of these calculators are hindering couples from conceiving.

“If the average woman without fertility issues uses one of these, will it affect her ability to get pregnant?” Setton said. “We don’t know.”

But, he added, the concern is that some couples, especially those having trouble conceiving, will rely on these tools.

Dr. Jennifer Wu, an obstetrician-gynecologist at Lenox Hill Hospital in New York City, agreed.

“Many patients use fertility apps on their smartphones. They do need to be aware that many of these apps are inaccurate,” said Wu, who was not involved in the study.

She noted that this study used an average menstrual cycle length of 28 days. “But it’s actually normal for cycle length to vary from 21 to 35 days,” she said.

Wu suggested that women trying to conceive talk to their doctor about their individual cycle length, and how it varies from month to month.

In some cases, Wu said, women might benefit from an ovulation prediction kit. Those are home-based electronic monitors that gauge hormone levels in the urine or saliva.

Setton made another point: There are some people who use fertility-prediction sites and apps to avoid pregnancy.

“Definitely don’t rely on them for that,” he advised.

More information

The U.S. Centers for Disease Control and Prevention has advice on planning for pregnancy.

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A Barefoot Run Might Be a Brain Booster

FRIDAY, May 13, 2016 (HealthDay News) — Runners who want to boost their brain function should consider taking their running shoes off, new research suggests.

The study found that after running barefoot, participants saw improvements in working memory, or the ability to recall or process information. Running in shoes, however, didn’t result in the same advantage, researchers said.

“The little things often have the greatest impact. This research shows us that we can realize our cognitive potential and enjoy ourselves at the same time,” said study leader Ross Alloway in a University of North Florida (UNF) news release.

“If we take off our shoes and go for a run, we can finish smarter than when we started,” added Alloway, a researcher in the university’s department of psychology.

For the study, the researchers instructed 72 volunteers to run barefoot and with shoes at their own pace for about 16 minutes. The volunteers were between 18 and 44 years old.

In order to simulate running outside, the participants had to step on flat objects with and without shoes.

The researchers noted that while running barefoot, people must pay more attention to their foot placement to avoid stepping on objects that could hurt their feet.

Before and after the runs, the researchers tested the participants’ working memory.

They found a roughly 16 percent increase in working memory performance following the barefoot runs. The same benefit was not seen after the participants ran in shoes, according to the study, published in the journal Perceptual and Motor Skills.

The study authors suggested running barefoot requires greater mental intensity and use of working memory, which may explain this discrepancy.

Runners’ speed and heart rate was also measured, but didn’t have an effect on memory performance.

Co-author Tracy Alloway, an associate professor of psychology at UNF, said, “Working memory is increasingly recognized as a crucial cognitive skill, and these findings are great news for people looking for a fun way to boost their working memory.”

More information

The U.S. National Institute of Neurological Disorders and Stroke provides more information on the human brain and how it works.

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7 Office Plants You Won’t Kill

Photo: Getty Images

Fill your workspace with some greenery—it might make your workday better. Christopher Satch, The Sill’s in-house plant expert, shares the best office plants that can withstand limited sunlight, freezing temps (thanks to that overzealous office AC), and little water.

Neon Pothos (Epipremnum aureum cultivar)

This vivid green plant can really wake up a boring desk space—Satch recommends using it if your office is full of bland white, black, and gray hues. “This will grow into a beautiful vine that cascades over the pot’s edge,” he says. “It can be used for tabletops, but it also looks great in a hanging basket.”

Care tips: Medium-low light; water once a week

Snake Plant (Sansevieria spp.)

“It’s a steadfast plant that is upright and loyal,” he says. “It can go for weeks without water, so it’s a good choice for forgetful office managers—plus it will also tolerate offices that crank up the heat or air conditioning.” And don’t worry if you don’t have a window view; the plant will still be happy in a dark corner.

Care tips: Low light; water once a month

Peace Lily (Spathiphyllum spp.)

Also known as “Mauna Loa,” this plant can add some tropical flair to your workspace with its large and lush leaves, and pretty white blooms. “Serene and stoic, the Peace Lily is great for offices that are heavy on the air conditioning,” Satch says. “Although cranking up the air conditioner isn’t great for any plant, this one can tolerate it, as well as low light.” Warning: You might not want to put this in your home office—it’s poisonous if consumed by dogs or cats.

Care tips: Medium-low light; water once a month

Aglaonema (Aglaonema spp.)

An Aglaonema’s leaves are variegated, which means they have different textures, patterns, and colors (making for an eye-catching desk plant). “This one will let you know if it needs more water by dramatically drooping,” he says.

Care tips: Medium light; water once a week

Rubber Tree Plant (Ficus elastica)

If you’re lucky to have your own office, this floor plant will dress up an empty corner. “Colorful and sometimes variegated, the rubber tree plant is a solid choice for those who would like a splash of color to their offices,” he says. “Younger plants produce larger leaves, but when they age, their leaves become somewhat reduced in size. In tropical South and Southeast Asia, the aerial roots of the plant are trained to create living bridges—but you can use them to create a living office!”
Care tips: Medium-low light; water once a week

Aloe (Aloe vera)

You’ll only want to own one of these if you have an office that gets a lot of sun. “These desert beauties love to sunbathe!” says Satch. If you have a hard time remembering to water your plants, or you’re always traveling on business trips, this is a great choice—it can go for weeks without water.
Care tips: High light; water once a month

Dracaena (Dracaena fragrans)

This tall floor plant is as close as you can get to having a tree in your office. Also known as a corn plant, this one will flower regularly if the conditions are right, and will do well in most offices.

Care tips: Medium light; water once a week

This article originally appeared on RealSimple.com.

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How to Keep Your Skin from Becoming as Dry as a Sandbox This Summer

Photo: Getty Images

Who’s excited for summer? Oh, is that a unanimous yes? That’s what I thought. But, bear with me here, there’s a downside to the coming sunny days. If you’re out and about, your skin has the potential to get a little dry or irritated. Or worse, burnt.

However, this year, we are taking it upon ourselves to be prepared, and therefore, prepare our skin for the warmth and fun in the sun. But we needed advice, and who better to turn to than a woman who has made taking care of her skin her business. The president and founder of Skyn Iceland, Sarah Kugelman, gave us all of her best tips for keeping her skin in tip-top shape during the upcoming warmer months.

RELATED: Learn From These People Who Made Really Expensive Beauty Mistakes

Kugelman’s first tip for us? Exfoliation during the summer is going to be different in the other months of the year. Why? Because it can make your skin photosensitive. And of course, the golden rule, the first commandment: You must always, always, always wear SPF, regardless of whether you are in the city or at the beach.

As for her daily routine, Kugelman starts with a cleanser that cleans the SPF on your face as well as the grime, but still protects it from drying out. All of us here at MIMI would suggest something like the Tata Harper purifying cleanser. In the summer months, Kugelman suggests a hydration booster and serum, “In the summer, I often use a hydration booster in between my serum and moisturizer. A pure form of Sodium Hyaluronate or Hyaluronic Acid is good. This gives skin an extra boost of hydration.”

Once you’ve boosted all of that moisture in your face, then you seal it all in with a good moisturizer. “A lot of people like lotions in the summer because they are lighter in the warm weather, but I tend to still like cream as I find my skin is dry in summer. I go for something fast absorbing and not heavy/greasy with a light scent, like Skyn ICELAND’s Pure Cloud Cream,” says Kugelman.

RELATED: Reapplying Your Sunscreen On-the-Go Just Got So Much Easier

Another secret weapon? Oh, just our favorite beauty staple these days: face mist. Says Kugelman, “I also carry around a face mist, like Skyn ICELAND’s Arctic Face Mist, to continuously add moisture to my skin throughout the day and especially before/after a workout. This is key to keeping skin moist.”

And the most important part of keeping your skin looking fresh in the summer? A good exfoliating face mask. “It’s critical to do a mask once a week. Again, that helps detox skin, remove dead skin, and open the pores. This also won’t make your skin more sensitive to the sun if you do it at night.”

Might we suggest the new Exfoliating Facial by Goop? It’s one of our faves. 

RELATED: Do You Have a Sunburn? Here’s What You Need to Do

To finish things up, Kugelman suggests using oil at night, not during the day (certain oils can create sun sensitivity). So there you have it. Throw in a couple of Skyn Iceland’s Hydro Cool Eye Gels and you are bound to have the best summer of skin you’ve had in a while.

This article originally appeared on InStyle.com/MIMI.

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What Teen Girls Should Eat to Reduce Breast Cancer Risk

Photo: Getty Images

Fruits and vegetables are staples in a healthy diet, and that includes one aimed at preventing cancer. Many studies have documented the lower risk of various cancers among people who eat more fresh produce, and avoid things like red and processed meat.

But the majority of those studies have focused on adults, and it’s becoming clear that many of cancer’s drivers start early in life, with genes and even with childhood exposures to potential carcinogens.

To investigate this further, Maryam Farvid, a research associate at Massachusetts General Hospital and a visiting scientist at the Harvard T. H. Chan School of Public Health, and her colleagues decided to study how diet during adolescence might affect cancer risk. In a study reported in the BMJ, they plumbed the Nurses’ Health Study, a massive survey of nurses who filled out questionnaires on their diet and were followed for various health outcomes, including cancer.

About half of the 90,000 women who participated in the Nurses’ Health Study also answered questions about their typical diet while they were teens. Those who reported eating nearly three servings of fruit a day on average had a 25% lower risk of developing breast cancer than those who ate half a serving of fruit.

RELATED: With Early Breast Cancer Treatment, Less May be More: Studies

Certain fruits seemed to confer the biggest protection against breast cancer—apples, bananas and grapes were associated with the greatest reduction in risk while kale and oranges in adulthood also contributed to reduced breast cancer risk.

Farvid says that apples, bananas and grapes contain fiber, which could help to lower cancer risk; they are also high in flavonoids, which act as antioxidants to combat damage to cells that can trigger abnormal growth. Kale and oranges are high in vitamin C, another antioxidant.

RELATED: Mediterranean Diet With Olive Oil Linked to Lower Breast Cancer Risk

“This study underscores the importance of what a young girl eats for her future health,” says Farvid. “This study also has an important message for schools and the need to provide students with the opportunity to consume more fruits and vegetables as part of the school meal program.”

Farvid wasn’t able to document a strong relationship between vegetables and lower breast cancer risk, but says that may be because the study wasn’t powered enough to detect an effect.

The findings are among the first to look at how diet during adolescence can affect health later, and highlights the importance of establishing healthy habits from a young age, especially since many of the chronic diseases occur over many years and get rooted early in life.

The results also underscore the importance of eating whole fruit, rather than fruit juice. In the study, Farvid and her team could not find any significant relationship between fruit juice and breast cancer risk; that may be because fruit’s anti-cancer effects may have to do with the fiber found in the whole fruit, which is stripped out of juice. In the latest Dietary Guidelines for Americans, however, government nutritionists equated servings of whole fruit with fruit juice. “We recommend whole fruit and not fruit juice,” says Farvid, “because maybe one of the most important ways that fruit decreases risk of breast cancer is through fiber, and even natural fruit juice often has no fiber in it.”

In another study also published in the BMJ, a separate group of researchers found that among 22,000 Danish women, those who added two alcoholic drinks a day on average increased their risk of developing breast cancer by 30% over five years. The added risk of cancer, however, was counterbalanced by a lower risk of heart disease.

Taken together, the results show how critical diet can be in modulating risk of breast cancer. While challenging, changing diet can be a relatively easy way to alter a woman’s breast cancer risk equation, beginning even at a young age.

This article originally appeared on Time.com.

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Sugar-Free Gum Can Be Deadly for Dogs

FRIDAY, May 13, 2016 (HealthDay News) — Here’s an alert for all dog lovers: Sugarless chewing gum isn’t good for your pooch. In fact, it could be deadly.

Xylitol, the substance that gives sugar-free gum its sweetness, is dangerous to dogs, the U.S. Food and Drug Administration warns. The FDA has received multiple reports in recent years of dogs being poisoned by xylitol, which is used in various consumer products, such as sugar-free candy, breath mints, baked goods, chewable vitamins, mouthwash and toothpaste.

“If you’re concerned about your dog eating a food or product with xylitol in it, check the label of ingredients,” Martine Hartogensis, an FDA veterinarian, said in a statement from the agency. “If it does, indeed, say that it contains xylitol, make sure your pet can’t get to it.”

Xylitol isn’t dangerous to people, but dogs process it differently than humans. They absorb it quickly, and it can spike their insulin levels, causing dangerously low blood sugar. This can be life-threatening if it’s not treated, Hartogensis said.

Take your dog to the vet or emergency animal hospital immediately if you suspect xylitol poisoning, she said. A dog may vomit and suffer from similar symptoms to those of an adult with low blood sugar such as lethargy, weakness, lack of coordination, staggering and seizures. Monitoring could be necessary because symptoms may not appear for as long as 24 hours.

To avoid xylitol exposure, keep human toothpaste, sugar-free gum and any other xylitol-containing product away from your dog. Don’t use human toothpaste on dogs, the FDA says.

Also, be aware that nut butters can include xylitol. If you give your dog nut butter as a treat or as a way to get your dog to take pills, check the label first to make sure it doesn’t contain xylitol.

And what about cats? According to the FDA, they aren’t fans of sweets, so xylitol doesn’t seem to be a major threat for them.

More information

For more about xylitol and similar sweeteners, visit the U.S. Food and Drug Administration.

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Out-of-Pocket Costs Rose Moderately Under Obamacare: Report

FRIDAY, May 13, 2016 (HealthDay News) — Many Americans enrolled in Obamacare marketplace plans saw their out-of-pocket costs rise moderately in the past year, a new report shows.

For those who did not receive government subsidies under the Affordable Care Act (ACA), there were slight increases in copayments and deductibles between 2015 and 2016, the Commonwealth Fund study found.

“More than 40 percent of people buying plans in the Affordable Care Act marketplaces don’t qualify for plans with reduced cost-sharing, so it is important that we track people’s cost-sharing obligations and the effect they have on their ability to get the care they need,” said Sara Collins in a news release from the Commonwealth Fund. She is the nonprofit organization’s vice president for health care coverage and access.

The report authors also warned that as expenses related to medical care continue to increase, consumers are likely to gain less protection from rising costs of medical care.

“It is certainly promising that cost-sharing only increased moderately in marketplace plans this year,” said Commonwealth Fund President Dr. David Blumenthal. “However, health care costs will likely continue to rise in the next few years, and many consumers will feel the impact of those increases.”

For the study, researchers led by Jon Gabel at NORC at the University of Chicago analyzed deductibles, copayments, coinsurance and out-of-pocket limits in plans offered in government-run marketplaces across the country.

They compared their results to cost-sharing in private employer-based plans in 2015.

The study showed the ACA reduces cost-sharing for low-income enrollees, but plans for people with annual incomes over about $30,000 do not offer such subsidies.

For those people, cost-sharing was similar to those in employer plans, but employer plans had fewer protections guarding against increasing out-of-pocket costs, the researchers found.

Overall, cost-sharing in the government marketplaces increased for out-of-pocket limits, annual deductibles and brand-name drugs that were not included in a plan’s list of preferred prescriptions.

What didn’t change were copayments for primary care office visits. Those costs remained constant, while copayments for generic drugs fell by more than 3 percent. Meanwhile, the percentage of marketplace plans that require enrollees to meet a deductible before paying for medication and office visits was virtually unchanged.

Overall, deductibles in the marketplace plans increased 10.3 percent in 2016, the researchers noted. They concluded this rise reflects a shift among consumers towards cheaper plans with the potential for higher out-of-pocket expenses.

Copayments for brand-name prescription drugs were also higher, on average, in marketplace plans than in employer-based plans, the study revealed.

Under marketplace plans, copayments for primary care visits cost, on average, $29. The average copayment under employer-based plans was $24.

Looking ahead, as expenses related to medical care continue to increase, consumers are likely to gain more protection from these escalating costs in the ACA marketplaces than in employer-based insurance, according to the study.

“The financial protections the Affordable Care Act provides for those buying plans on the marketplaces will help assure people can continue to afford the health care they need,” said Blumenthal. “But more work is needed to lower growth in medical costs overall.”

More information

The Kaiser Family Foundation provides more information on the cost-sharing subsidies in federal marketplace plans.

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