Tag Archive for: blood pressure

How Isometrics Help Lower Your BP

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If you have a home blood pressure monitor, try a little experiment on yourself. Set up your monitor and cuff and sit quietly in a chair. After five minutes or so, take a deep breath, exhale, and hit the Start button on the monitor while breathing normally as your BP is taken. Record the results. Make sure the cuff deflates completely and continue sitting for another five minutes.

Then repeat the deep breath, exhale, and hit the Start button. This time, I want you to contract the muscle in the opposite arm as much as you can and hold the contraction until the BP is done, breathing normally the entire time. Do you notice a difference in the BP without and with contracting your opposite arm? Unless you lift heavy weights on a regular basis, you probably did.

When you contract the opposite arm, you’re restricting blood flow to that arm, thereby increasing the resistance. When you relax, there should be an increase in blood flow to that tissue. When you do isometric exercises regularly, that’s what happens in every muscle group involved.

How Isometrics Can Lower BP

Let’s return to the study. The researchers did a secondary analysis to see if they could find the exercise that lowered BP the most. The wall sit or wall chair worked best to lower systolic blood pressure, while running lowered diastolic blood pressure the most.

What’s the wall sit? It’s depicted in the photo above. The idea is to stand a foot or so from the wall, lean back until your back contacts the wall, and slide down to a sitting position for five to ten seconds, then slide back up. Repeat ten times several times per day; the key is to never hold your breath while you do it. The quadriceps and the gastrocnemius are a substantial amount of muscle. Restricting blood flow with isometrics will increase the resistance on the heart and blood vessels. The benefit is that you will get a training effect on both that lowers BP.

What’s actually going on with the nervous, cardiovascular, and muscular system isn’t quite clear, but knowing why won’t help you do them. If you don’t have orthopedic issues (and you don’t hold your breath while performing the isometrics), no matter what muscle groups you use, you may help lower your BP. I think the wall sit works the best due to total muscle mass involved, but every muscle group will help.

The Bottom Line

Will isometrics make you super fit? No. Super strong? No. There are also limitations as to the angles where strength will increase due to specificity of training. But there seems to be an emphasis on improving health with short episodes of exercise. Isometrics fit that niche quite well and as the study demonstrated, quite effectively as related to BP. We’re not done yet because two other studies have focused on activities that involve movement. We’ll talk about those next week. In the meantime, have a great Labor Day holiday.

What are you prepared to do today?

        Dr. Chet

Reference: British J Sp Med Online July 2023. doi: 10.1136/bjsports-2022-106503

Isometric Exercise Lowers Blood Pressure

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This summer has seen several studies about exercise, so we’ll just continue with the flow from last week. The first study caught me by surprise: isometric exercise lowers blood pressure. When you do isometric exercises, you increase tension in a muscle without moving the joint, such as holding your leg still while you clench your thigh muscles; if you’ve got a wall, a chair, and a floor, you’ve got all you need. We don’t think of isometric, also called static exercise, as being effective in changing the dynamic flow of blood in the cardiovascular system. Let’s take a look at the study.

Researchers conducted a literature search of all published studies that examined the impact of any type of exercise on systolic blood pressure (SBP) and diastolic blood pressure (DBP.) They conducted a pairwise and network meta-analysis to see which exercise helped BP the most. The most important finding was that every form of exercise significantly reduced SBP and DBP when performed for two weeks and longer: aerobic exercise, dynamic resistance (weight) training, combined training, high-intensity interval training (HIIT), and isometric exercise.

When they compared the efficacy of the different forms, isometric exercise lowered SBP the most, followed, in order, by combined training, weight training, aerobic training, and HIIT.

To me, isometrics are somewhat easy to perform because it removes obstacles such as orthopedic issues or equipment. But why would it reduce blood pressure more than other modes of exercise? We’ll check that out on Saturday.

What are you prepared to do today?

        Dr. Chet

Reference: British J Sp Med Online July 2023. doi: 10.1136/bjsports-2022-106503

How Coffee Relates to CVD

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Researchers in Germany used a unique approach in the Hamburg City Health Study: they selected the first 10,000 volunteers. Volunteers who didn’t drink coffee were eliminated from the study, so they ended up with 9,009 subjects.

The researchers collected dietary data along with a variety of other demographic and physiological variables, integrating lifestyle-related behavior, comorbidities, biomarkers, electrocardiographic and echocardiographic data, and finally major cardiovascular diseases (CVDs). They divided up the subjects by coffee intake: low = less than three cups a day, medium = three or four cups per day, and high = more than four cups of coffee per day.

Results

This epidemiological cross-sectional study resulted in the following:

  • High coffee consumption correlated with slightly higher LDL cholesterol
  • Moderate and high coffee consumption correlated with lower systolic blood pressure and lower diastolic blood pressure
  • Different levels of coffee intake didn’t impact heart rhythms or function
  • Most important, coffee intake did not impact the presence of CVD nor prior cardiac events such as heart attacks and heart failure

Were the results of coffee and LDL cholesterol concerning? No—the difference was just five mg/dl, well within measurement error.

Is Coffee Safe to Drink?

Coffee was always safe to drink; the question was how our bodies responded to consuming it. Neither of these studies was perfect, but they show that even high coffee consumers, including myself, may not be at any significant risk for promoting or advancing CVD or cardiovascular events.

I think for most people coffee and caffeine are closely linked. What most of us don’t realize is that coffee is a complex liquid consisting of more than 1,000 bioactive substances, including phytochemicals that have proven beneficial for many organ systems; it’s not only a nervous system stimulant because of the caffeine content.

The Bottom Line

When it comes to coffee, I think it’s person-specific. Taste aside, some people may process caffeine differently, which may impact how much coffee someone could enjoy. These studies add to a body of work which shows that coffee is safe for the heart and other organs; other benefits or issues require further study. For me, time for another mug of Sumatra Roast.

What are you prepared to do today?

        Dr. Chet

Reference: https://www.nature.com/articles/s41598-023-31857-5

Research Update: Coffee and Heart Rhythms

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In one of the first jobs I ever had, the foreman would pour a half-cup of coffee and fill it up with water; he’d had a heart attack and his doctor told him to limit his coffee intake. Fifty years ago, physicians recommended that people avoid coffee if they had high blood pressure or had a cardiac event such as a heart attack. The thought was to lower the stimulating effect of caffeine to keep heart rate and blood pressure lower. In the interim, some studies showed that coffee contributes to cardiovascular disease and more recently, that it may not. So if you love coffee the way I love coffee, you may be encouraged by a couple of recent studies.

The first study examined the effect of coffee on heart rhythms in 100 subjects with a mean age of 39 who served as their own controls. All subjects had a variety of blood tests as well as genetic tests to determine if they were fast or slow processors of caffeine. They also wore a new-age heart rhythm monitor for the 14 days of the study. I’ve worn that monitor, and it gives accurate EKGs to monitor heart rate and heart rhythm abnormalities such as premature atrial contractions and atrial fibrillation.

The subjects were notified the evening before whether they were going to be on a two-day coffee drinking cycle or two-day caffeine avoidance; the idea was to track immediate impacts. The good news: there were no differences in abnormal rhythms on coffee days versus non-caffeine days and no impact of caffeine processing. One interesting observation: on the days subjects drank coffee, they walked more steps. We’ll look at the impact of coffee on cardiovascular disease events on Saturday.

What are you prepared to do today?

        Dr. Chet

Reference: N Engl J Med 2023;388:1092-100.

Taking Biotin? Tell Your Doctor

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Biotin is a B vitamin often used for skin health among other benefits; it’s involved in many metabolic processes in the body. Due to its chemical nature, it’s used as a coenzyme in several tests. One of those tests is for troponin, a protein released from the heart into the bloodstream during a heart attack. There are no large trials that have tested the effects of biotin on troponin testing, but a physician or lab tech needs to know if you’re taking extra biotin.

The amounts in multi-vitamins appear to cause no issues, but adding the biotin in products to improve hair, skin, and nails could be enough to impact the test. Did it in our subject’s case? Maybe. We don’t know for sure.

As we approach this long holiday weekend, take a minute to add up all the biotin you’re taking in supplements. If it’s more than one gram, and if you end up in the ER because of a suspected heart attack or stroke, tell the lab tech. It doesn’t impact your having a heart attack; it impacts the test as to whether you may have damage to your heart as a result of a heart attack. You don’t want that test to be inaccurate because it’s important to arriving at the correct diagnosis.

Enjoy the July Fourth holiday, check out the audios on sale for men and women, and I’ll be back next week.

What are you prepared to do today?

        Dr. Chet

Still in Doubt? Check It Out Again

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In the last Memo, I said we weren’t done with the person who had waited three days. We spoke again after a couple of days, and she still had the same pain profile: back and chest, not as intense. She’d had a heart catheterization that came back clear: no blockages in any of her coronary arteries. Still the discomfort bothered her.

I’ve talked to many people over the years who were going through the same thing. I always recommend they go to the ER immediately. She had done that, albeit a couple of days later, and the diagnosis was indeterminate. She did have extremely high blood pressure which had come down with treatment in the hospital, but like most people, she disliked some of the side effects and didn’t want to take the meds. As we talked, she mentioned that she also had dizziness going up a flight of stairs and her vision was blurry. That was it—that’s a symptom of a stroke, so I recommended she go back to the ER if someone was there to drive her.

They ran more tests including and MRI of her head. No blockages or evidence of a stroke; her blood pressure was still way too high, but that could be managed at home. Still there was a diagnosis of a heart attack based on enzyme levels even though the ECG didn’t show it. She is working on lifestyle changes to get off blood pressure medications if possible.

But the enzyme level triggered something in my memory, and I’ll tell you about that on Thursday. Make sure you read it before the holiday weekend begins. Remember, the audios Dr. Chet’s Health Tips for Women with Dr. Pam and Health Tips for Men are still on sale through the Fourth of July.

What are you prepared to do today?

        Dr. Chet

Knowing Your Health Patterns

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The reason it’s important to track health variables is to find any patterns in the results. Remember the study on hs-CRP and cancer? Paula immediately looked up her CRP levels and found two things. First, it had gone down consistently over several years. Second, she hadn’t had it tested every year, but she will from now on.

Remember my blood pressure? I tracked it from that point (five weeks post-surgery) through today. From 177/107, it has come down appreciably though not in a consistent way; it’s consistently around 130/80 before exercise and 110/70 after exercise. That’s two patterns.

There are some other patterns that may be more relevant. For example, perhaps you’ve had heartburn after eating. Tracking what you eat may show a pattern that the higher the fat content, the worse the heartburn seems to be; the same may be true with constipation.

In short, you may find that one thing leads to another, but only under certain conditions. It’s knowing which conditions that’s most important to finding an answer to your health issue.

Patterns for Disease States

Many conditions have patterns of events that can be predictive of disease. For example, as bone density declines, your risk of a bone fracture increases. As blood pressure goes up, so does the risk of stroke. For type 2 diabetes, as blood sugar and HbA1c rise, so does the risk of prediabetes, type 2 diabetes, and all the accompanying complications.

Those types of patterns can be predictive of disease. Or they may not. As we’ve learned in the Memos, risk factors set the odds but they’re not cause and effect. But there’s another reason.

Your Pattern

The reason tracking to establish patterns of response is important to you is that it may just be your unique pattern—because while we’re all the same in many ways, we all have our unique variations. You may not know what’s unique about you because you haven’t tested it or tracked it to find your pattern. But whether it’s your blood pressure, your blood sugar, your response to foods, or some other variable, it simply may be your individual pattern and may be indicative of nothing.

That doesn’t mean you don’t get the issue checked out by a healthcare professional, but it may mean you don’t have a disease or condition as a general response would indicate. And since you know your pattern, you can track the results of any medication or other intervention your doctor prescribes.

The Bottom Line

Tracking variables to detect patterns is useful to us all. While it won’t help everyone who tries it, the goal is to know yourself better. You won’t have to do it forever, but if you’re concerned about a specific condition, this is a way to help yourself.

And it won’t necessarily be bad news; Paula was relieved to find her hs-CRP had been going down, and you may find an encouraging pattern as well. Even if the results are not what you’d hoped, better to know than not know, right? Because now you can take action.

If you have no idea where to begin, become an Insider or Member at DrChet.com. You’ll have exclusive access to me by email or phone, and I can guide you in checking out whatever factors could be related to the health issue you’re concerned about.

What are you prepared to do today?

        Dr. Chet

Track Your Health Issue

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Over the past few months, I’ve written about my blood pressure increasing from being sedentary for five weeks after my knee replacement. I’ve also written about hs-CRP in the study on inflammation and cancer. In addition, I’ve gotten questions about the impact of foods on the digestive system and the variation in blood sugar readings throughout the day.

While the questions vary, my answer is always the same: track it for a while. Whether it’s on a fitness watch, on a spread sheet, an app, or a notebook, record it somewhere. Doesn’t matter how you do it—just record the numbers along with other pertinent information, such as:

  • Date and time of day.
  • What you ate, if it’s important to the issue such as gastroesophageal reflux, or if you’re restricting calories for weight loss or longevity.
  • When you took your meds and supplements.
  • How well and how long you slept.
  • If it’s your blood pressure, record your anxiety or stress level as well as reading in relation to exercise.

The combination of factors is endless, and not every factor will be as obvious. If you continue to track it, you’ll have an edge determining what is and isn’t related to what you’re tracking.

Could this be a lot of work? Yes. Will you find an answer? Maybe, maybe not. What it can do is allow you to discover something that’s useful and I’ll talk about that on Saturday.

What are you prepared to do today?

        Dr. Chet

Want Fewer Medications? Change Your Lifestyle

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The study that we examined on Tuesday showed that a regular exercise program can help reduce the number of medications related to cardiovascular disease and type 2 diabetes. We’re not talking about youngsters; 51 subjects completed the study with an initial mean age of 54. There were some outcomes that were likely unexpected; for example, waist circumference did not change between the experimental group and control group over the five years. There was a significant decrease in body fat in the exercise group that explained the difference in body weight. Still, the control group lost about two pounds in five years while the exercise group lost about six pounds. That actually turns out to be a good thing, as I’ll explain a little later.

The Exercise Program

The high-intensity interval training was just as advertised: intense. It included a 10-minute warm up, followed by four 4-minute intervals at 90% of maximum heart rate (HRMax) interspersed with 3 minutes of active recovery. They finished with a 5-minute cooldown. They used percentage of HRMax as assessed in the exercise test, because that’s an intense level. The focus is on the 4 minutes but those 4 are brutal. You do get to rest, but then you have to do it over again, and that’s a significant challenge to the cardiovascular system. As people got fitter, the intensity would be changed to sustain the 90% level.

What surprised me was that there was no organized exercise activity in the other eight months of the year; they just kept track of activity levels using the activity monitors. There were no differences between the control group and the exercise group in the eight months with no organized activity. That’s interesting.

Most Variables Didn’t Change

This probably surprised the researchers, but it was a desirable outcome. There were no significant differences in body fat, waist circumference, BMI, or overall percentage of body fat. While the subjects probably would have liked to have lost more weight, the fact that they didn’t shows that the changes that occurred in the risk factors for cardiovascular disease, such as high blood pressure and low HDL cholesterol as well as a lower insulin levels, showed that the difference was the actual exercise program itself. The differences in distribution of nutrients in the diet and in the total caloric intake were insignificant. As I mentioned earlier, the number of steps per day and other activities were still even. That means, again, the changes could be attributed to the exercise program alone.

The Bottom Line

What is abundantly clear is that if you really want to reduce medications, you have to pay the price by changing your lifestyle. In this study they focused on one variable: exercise. If you add a change in dietary intake, and or a change in the distribution nutrients, you may get even more benefits. But for me, it answers the question that I started with. You want to reduce medications? Change your lifestyle.

Is it worth it? That’s your call. But that’s what Aging with a Vengeance is all about.

What are you prepared to do today?

        Dr. Chet

Reference: MSSE. 2021. 53(7):1319-1325.

Can You Reduce Your Medications?

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One of the questions that I get asked frequently goes something like this: “Dr. Chet, how can I reduce the medications I’m taking?” Along with that question is, “I don’t want to have to take medications for blood pressure or cholesterol or diabetes. What can I do?” As we proceed with a focus on Aging with a Vengeance, a recently published study illustrated at least a partial answer to these questions.

Researchers in Spain recruited 64 subjects for an exercise program. The exercise program was a high-intensity interval training (HIIT) program, three days a week, that ran for four months under staff supervision. The rest of the year these subjects were given activity monitors that automatically uploaded data on activity, sleep, etc. The researchers also took a variety of blood samples for testing metabolic variables, tested the subjects’ fitness levels, assessed anthropomorphic measures such as body weight and waist circumference, and recorded medications related to blood pressure, cholesterol, triglycerides, and blood sugars. The subjects were retested after two years and again after five years.

Over the period of five years, an amazing 51 subjects completed the exercise sessions and all the testing required. That, in and of itself, is remarkable—I’ve done this type of study, and holding on to the subjects is one of the main challenges.

The primary question was answered: those who exercised as the study required took fewer medications for blood pressure, cholesterol, and blood sugar control. As you might expect, that isn’t the entire story, so we’ll wrap this up on Saturday.

What are you prepared to do today?

        Dr. Chet

Reference: MSSE. 2021. 53(7):1319-1325.