September 19, 2019
Ask a Doctor: Hypertension Control and Dementia

Ask a Doctor: Hypertension Control and Dementia


EVERY OTHER THURSDAY – WE’RE TAKING A LOOK AT A HEALTH ISSUE OR CONCERN AFFECTING MA WELCOME BACK. EVERY OTHER THURSDAY WE’RE TAKING A LOOK AT A HEALTH ISSUE OR CONCERN AFFECTING MANY PEOPLE, BREAKING DOWN THE INFORMATION FOR YOU AND TELL YOU WHAT YOU NEED TO KNOW TO KEEP YOU HEALTHY. DR. KALANI BRADY WITH THE JOHN A. BURNS SCHOOL OF MEDICINE JOINS US NOW WITH THE TOPIC HYPERTENSION AND DEMENTIA. GOOD MORNING. GOOD MORNING, KELLY. BEFORE WE TALK ABOUT THE TWO TOGETHER, CAN YOU BREAK IT DOWN FOR US FIRST. WHAT IS HYPERTENSION CONTROL? HYPERTENSION IS HIGH BLOOD PRESSURE AND IT IS VERY COMMON IN THE AMERICAN POPULATION AND IN THE HAWAI’I POPULATION. SO THERE ARE GUIDELINES FOR CONTROL OF THIS. AS WE KNOW, CONTROL OF HIGH PRESSURE LOWERS THE RATE OF HEART ATTACKS, STROKES, KIDNEY FAILURE, BLINDNESS AND A WHOLE BUNCH OF OTHER THINGS. WHAT WE NOW KNOW IS THAT TIGHTER CONTROL OF HIGH BLOOD PRESSURE LOWERS THE RISK OF PROGRESSION OF DEMENTIA AND MINIMAL COGNITIVE DISORDER WHICH MEANS THE PRE DEMENTIA CELL PHONE MEANT DEMENTIA. FOR THOSE WHO DON’T KNOW, WHAT EXACTLY IS DEMENTIA? BASICALLY THE LOSS OF COGNITIVE FUNCTION OF THE BRAIN, OF THE ABILITY TO THINK. IT ALSO INVOLVES LOSS OF MEMORY AND YOU MAY HAVE TROUBLE REMEMBERING A LOT OF THINGS THAT ARE RECENT. LONG-TERM MEMORY IS USUALLY PRESERVED BUT SHORT-TERM MEMORY AND RECALL ARE AFFECTED WITH DEMENTIA, AND THEN AS DEMENTIA PROGRESSES, YOU LOSE THE FUNCTION OF TAKING CARE OF YOURSELF, BRUSHING TEETH, WASHING YOUR HAIR AND WASHING YOUR BODY, THINGS THAT BASICALLY WE TAKE FOR GRANTED IN TERMS OF SELF-CARE. OKAY. AND IT’S INTERESTING. NOW WE KNOW THAT HYPERTENSION CONTROL COULD ACTUALLY HELP OUT WITH I GUESS PREVENTING DEMENTIA. RIGHT. AT LEAST PROLONGING THE CHANCE YOU MIGHT GET IT. HOW DOES THAT WORK? HOW DOES IT IMPACT IT? WELL, WE HAVE RECENTLY TIGHTENED THE GUIDELINE FOR HIGH PRESSURE CONTROL, THE AMERICAN COLLEGE OF CARDIOLOGY, THE AMERICAN HEART ASSOCIATION HAVE COME OUT WITH NEW GUIDELINES FOR A GOAL OF SYSTOLIC OR THE TOP NUMBER BEING 120 AND DIASTOLIC BEING 80. THIS IS TIGHTER THAN IT WAS BEFORE AT 140 OVER 90. HOWEVER, IT HAS RESULTED AT THAT TIGHTER CONTROL IN THE GREEN LINE HERE IN A DECREASE OF A LOT OF DISEASES INCLUDING PROGRESSION OF DEMENTIA. AND DO WE ACTUALLY KNOW THE NUMBERS OF THE RATE THAT IT DOES HELP OUT? YES, MILD COULD GO COGNITIVE IMPAIRMENT GOES FROM 7.6% TO 6.1%. NOW THAT MAY NOT SEEM TO BE A BIG CHANGE, BUT IN A WHOLE POPULATION THAT’S A LOT OF PEOPLE. DEFINITELY. YOU MENTIONED THE TIGHTER CONTROL. HOW DOES THAT IMPACT THE GENERAL PUBLIC? IT DECREASES OUR RISK OF THESE SERIOUS DISEASES. NOW WHAT’S THE FIRST TREATMENT FOR HIGH BLOOD PRESSURE, KELLY? NOT EATING SO MUCH SALT? OH, KELLY, YOU GET AN A. YAY! I LEARN SO MUCH FROM DR. BRADY. THE LANGUAGE I KNOW THAT, I EAT SO MUCH SHOYU BUT THAT’S OKAY BECAUSE I NATURAL HAVE LOW BLOOD PRESSURE. I HOPE IT STWIKS ME. I HOPE IT DOES TOO. AND WHAT ELSE? AEROBIC ACTIVITY. ANY EXERCISE IS GOOD. 150 MINUTES A WEEK IS RECOMMENDED. THAT’S 30 MINUTES FIVE TIMES A WEEK. IT CAN BE WALKING. IT CAN BE FAIR MASTER. IT CAN BE JOGGING OR SWIMMING. IT CAN BE ANAEROBIC SPORT LIKE SOCCER OR TENNIS, A WHOLE BUNCH OF ACTIVITIES, EVEN HEAVY HOUSEWORK IS ACCEPTABLE. SO NATURAL TREATMENT FOR HIGH BLOOD PRESSURE IS THE FIRST TREATMENT. BUT IN ORDER TO GET THAT NUMBER SYSTOLIC DOWN TO 120 OR LESS THAN FREQUENTLY A LITTLE EXTRA MEDICINE IS NECESSARY. USUALLY THE SAME MEDICINES WERE TAKING BUT SOMETIMES AT A LITTLE HIGHER DOSE. OKAY. GOOD TO KNOW. SO THAT’S SOMETHING THAT’S EASY FOR PEOPLE TO DO ON THEIR OWN. I MEAN WHEN YOU HAVE LOWER BLOOD PRESSURE IT WILL HELP YOU OUT IN THE LONG RUN WITH, AS YOU WERE SAYING, A LOT OF DIFFERENT DISEASES BUTTONS DEMENTIA. YOUR BRAIN IS HOW YOU’RE GOING TO BE ABLE TO FUNCTION AND HOPEFULLY BE ABLE TO TAKE CARE OF YOURSELF. SO IF THAT GOES DOWNHILL. WE’RE IN TROUBLE. DEMENTIA, THERE ARE NO MEDICINES THAT REVERSE DEMENTIA. REALLY. THERE ARE SOME MEDICINES THAT SLOW PROGRESSION OF DEMENTIA, BUT IN TERMS OF REVERSING DEMENTIA, THERE ARE NO MEDICINES. THIS IS A SCARY DISEASE. IT’S INCREASING EPIDEMIC PROPORTIONS IN THE UNITED STATES AND IN HAWAI’I, AND YOU WANT TO GET RID OF IT AS A RISK. THIS IS AN EASIER WAY TO DO IT THAN SOME OTHER RISKS. AGAIN, THERE’S NO CURE SO PREVENTION IS EVERYTHING. EVERYTHING. RESTRICT THE SALT IF YOU NEED TO AND EXERCISE, MOVE AROUND AS MUCH AS YOU CAN. THANK SO MUCH, DR. BRADY. VERY INTERESTING. I DID NOT KNOW THOSE TWO WERE CONNECTED AT ALL BUT THEY ARE CONNECTED IN A BIG WAY. IN A BIG WAY. AND YOU’RE GOING TO BE BACK IN NEXT WEEK. ASK THE DOCTOR NEXT WEEK AND “TAKE 2” IN TWO WEEKS. PERFECT.

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