Dragon in the New Year

firworksThe New Year is creeping up on us…again. It happens every year and I’m surprised by it every year. This year I decided that instead of looking forward to the New Year to start my new projects as usual, I would end the old year with one of those projects.

By that I mean I’m dictating this blog with the Dragon Dictation Program that Bear got for me last Christmas. It scared me. I think I may be a little technophobic, but I’m finally getting comfortable with it. I tentatively tried it on my phone almost immediately. That worked, so I even more tentatively tried on my iPad almost 6 months later. Now I’m ready for the big time: the computer. And there you have it; I am now blogging with Dragon.dragon-logo

I was trying to figure out what would be a good end-of-the-year topic and kept getting the same vision of a heart. Unusual, I thought, since this is not a feel good blog. In fact, it’s sometimes downright scary. Then I remembered that the heart pumps blood and there needs to be some pressure for that. Of course! The last blog of 2013 would be about blood pressure, a topic that’s been bandied around quite a bit in the medical field lately.

blood pressure 300dpi jpgThe year was new when Jane Brody of the New York Times wrote, “48% of more than 76 million adults with hypertension have it under control up from 29% in 2000.” That sounds terrific, especially since normal blood pressure was considered lower than 120/80 at the time. You can read more about this now outdated information in her still informative article Keeping Blood Pressure in Check at http://well.blogs.ny times.com/2013/01/28/keeping-blood-pressure-in-check.

Why is this outdated information? Good question. Less than two weeks ago the 8th Joint National Committee announced via the Journal of the American medical Association (JAMA), that the guidelines for hypertension (high blood pressure) have changed. Keep in mind that hypertension can lead to cardiovascular problems and kidney failure.

The new acceptable levels are 150 (systolic) over 90 (diastolic) for people over 60. The big news for people with diabetes or kidney disease – like us – who were considered to have hypertension at 130/80 is that it has shifted to 140/90. This means that those of us who depression-cause-heart-attack-1have been taking hypertension medication because we have chronic kidney disease and were trying to stay below 130/80 can now go up to 140/90 without the medication and as high as 150/90 if we’re over 60. Personally, I don’t want to take the chance.

Apparently many doctors agree with me. Dr. Mariell L. Jessop, president of the American Heart Association, says she’s worried about public reaction. As the medical director of the Pennsylvania Heart and Vascular Center, Doctor Jessop said, “I just get anxious when people hear that they don’t need as much medicine and they can allow their blood pressure to drift up.”  You can read more about this at http://www.washingtonpost.com/national/health-science/new-blood-pressure-guidelines-raise-concern-among-heart-health-groups/2013/12/26/eaa6c73e-6e3d-11e3-b405-7e360f7e9fd2_story.html.

But the American Society of Hematology (which means blood) and the international Society of Hematology have their own guidelines.  According to these two groups, the acceptance of 150/90 for older patients should start at age 80, not 60. There also seems to be a difference in the drugs that they recommend. These differences led the ASH/ISH authors to proclaim “Because of the major differences in resources among points of care it is not possible to create a uniform set of guidelines. For this reason we written a broad statement… and we expect that experts who are familiar with local circumstances will feel free to use their own judgment.”  This does not add to my comfort at the thought of allowing my blood pressure to rise. Those of you who are willing to get a little more technical in your reading you can find this article at www. Medscape.com/view article/818080.

So here we have the first new sets of guidelines for acceptable blood pressure numbers since 1997 and they don’t exactly agree with each other. Let’s make matters worse for the layman. It also turns out that your blood pressure can vary as much as 20 degrees during the same day depending upon circumstances, food intake and the timing of that intake, and physical exertion. This actually makes a lot of sense to me.

Take heart (there’s that image again), as confusing as this might be I discovered something that could really be helpful at http://www.eurekalert.org/pub_releases/2013-03/aha-FO P030 413.php. The American Heart Association has a program called Heart360 in which patients send their daily blood pressure numbers to the health providers directly from their home blood pressure machines.  54% of the Heart360 home monitoring group reached their blood pressure goals after only six weeks as opposed to 35% of the group that was treated in the usual way: diagnosed, education about managing high blood pressure, and the importance of diet and exercise. While the first group received the same information, it seems to be the added monitoring that helped more people succeed.

Talking about the heart, many thanks to step-daughter Kelly and her fiancé Sean for hosting our annual Christmas Eve dinner.  More than half the food was CKD friendly, a specific effort on the part of the cooks (Sean, Kelly, and Lara) for which I am extremely grateful. I’m talking steamed green beans in pureed cauliflower, roasted peppers and what tasted like low sodium turnkey.

IMAG0269 (1)Lara’s love came up with the idea of a Secret Santa since we’re up to seven attending this event each year and it was getting pretty pricey for each of us to gift everyone else.  Since my giftee ended up not being able to attend, I was able to give each household a high heeled ceramic shoe which was a wine holder.  Fast thinking on my part, wasn’t it.  And I gave each of the two cats and four dogs in the family presents.  No one said anything about the animals!

I’ve been corresponding with Amazon’s European sites to correct a book image problem and it’s been a hoot!  The funniest was my attempt to communicate with the French site in French.  They ended up working with the wrong book.  My fault entirely.  I switched to English pretty fast.Book Cover

Oh my, this is the last time in 2013 that I get to write:

Until next week,

Keep living your life!

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