Blood pressure control – take the low road

Take the low road

Parts I and II of this series explain why this is important and how to recognize hypertension. This post is about how to get it all under control.

Your target and how to bullseye it

We need ‘normal’ [young person] levels of <120/<80 to minimise cardiovascular risk. For example, a level of 110/70 would be wonderful.

Two Key Questions:

1. How do we get to that level when our BP is up?
2. Is this degree of reduction safely achievable?

There are lifestyle and medical approaches.

The best approach is a combined one. Don’t say ”I will try the lifestyle approach first and see about medication if that fails”, because any time spent with high BP is damaging, and the acute events like heart attack and stroke that may occur with untreated BP are life threatening. SO do not delay getting your BP down. Fortunately, as modern BP medication is non-harmful there is no reason to be shy of taking treatment. 

The optimum approach is start on medication, get control, do the lifestyle change, too, and maybe later, reduce the meds a bit. Moreover, if you are overweight, a drinker, eat a lot of salt, and have insulin resistance you will only get optimum control by making lifestyle changes to alter those factors alongside your medication. Around 50% of you will need only one drug to get your BP down but equally 50% will need two.

Salt reduction is always helpful but has a low impact; magnesium supplementation at around 300mg daily has a significant effect.

The Short Answer

Reduce alcohol; lose 5-10 Kg depending on how over-heavy you are; try for 10,000 steps a day and a more active life overall; take either candesartan 8mg [potentially increasing to 16mg] or indapamide Slow Release 1.5 mg as your first line agent and add the other drug if you need a combination to get the needed result. It is possible that taking a magnesium supplement as I recommend for all over 60’s may have a beneficial effect.

To get the whole inside story read more

Musculoskeletal Problems

Summary

Musculoskeletal deterioration is a major cause of loss of function as we age. From 50 onwards loss of muscle, bone mass and collagen lead to reduced strength, susceptibility to fracture, and problems with joints. When somebody is 70 and these problems have been going on for 20 years, they frequently are frail. Frailty is a specific term for a tragic inability to perform daily acts of living and consequently reduced independence. When we say ‘so and so is looking old …’ what we mean is they are looking frail.

Fidgets

Be a fidgeter!

Start today. These extra movements can help you increase your activity, boost your metabolism, keep your weight down and maintain joint function.

In a café or on a train you can see the fidgets: they are playing invisible pianos, tapping out rhythms, bouncing their knees. This is all beneficial. – often they don’t know they are doing it. I just want you to make it systematic, conscious and targeted.

Ageing Internally

Are you older on the inside than you look on the outside?

From the foods you eat and how you exercise to your friendships and lifestyle goals — it all influences how fast or slowly your body ages.

Eat well

If you look at your eating habits, even just small changes can make a difference in the way your body ages. Bad habits need to go! 

Focus on eating mindfully and making healthier choices, the chances are you'll have more energy and you'll lose weight. Studies have shown that what we eat may be one of the most important lifestyle modifications each of us can make to significantly increase our HealthSpan and add quality years of enjoyable life as we age. It’s all about having a balance. Aim to fill up your plate with ‘the good stuff’. Good means a rainbow plate of many colours, to get the full spectrum you need.

Dementia Prevention

You are aware of the curse of dementia [mainly as Alzheimer’s Disease – AD] either as a risk of ageing or more powerfully because of personal experience of a sufferer.

There IS an inherited ie genetic component related principally to the APOE e4 gene. But lots of people who have the gene don’t get AD. The important information is not whether you have the gene [so don’t rush to get a test] but whether the gene is switched on - this is called gene expression.

Supernutrition #3: The dangers of central fat

How do I lose my dangerous central fat?

This is important for your HealthSpan- This is not ‘fat-shaming’ just the truth that accumulating central fat increases your risk of fatal and life-diminishing diseases, shortens your life, and reduces the quality of your life. But you probably know that, deep down.

Clearly, keeping slim is difficult for many: so what do we know that is useful if you need some help, what are the myths?

Exercise - The New You

Yes you have ‘January Good Intentions’ to do more exercise! But how do you put this into the overall context of keeping your biological age well below your actual years?

Well the simple answer is ‘just get moving’ but it needs to be well thought out to get the maximum benefit for the time and effort involved. Here are 5 things to think about.

1. Prioritise consistency and being energetic

The trouble with exercise is that it has to be a regular thing to be beneficial. So first, be consistent -  move in some way, every day of the week. Moving can be anything you like eg walking, swimming, cycling, roller skating, dancing, playing tennis, doing a yoga sequence or a quick body weight workout just to name a few options.

Blow me down with a feather- where did all that muscle go?

You know the story: “Mum’s got a bit frail… Dad has difficulty getting up the stairs, now … my folks don’t seem to be able to do much for themselves these days, it’s very sad to see”

This is frailty – a combination of loss of muscle [sarcopaenia] and loss of strength [dynopaenia] that causes adverse outcomes, eg difficulties in all activities of daily living, likelihood of osteoporosis and falls, also meaning higher risk of hospitalisation, a longer hospital length of stay and risk of re-admission if there is an illness. The final consequences are loss of independence and death sooner than might be expected. The good news is you can prevent it or recover from it.

Body Composition, not Body Weight

You may think being on top of age means being weight obsessed. But in reality, it is the quality of what your body consists of that is important in terms of limiting ageing.

The key is having a sense of how much muscle [positive] you have and how much central fat [potentially damaging] you have gained.

So the number on the scale is less important  as long as you are travelling in the right direction.

How old do you feel, Box-fresh or Antique Roadshow?

My message is simple

You can slow the negative aspects of ageing and have a good quality of life right up until you die – if you do what has to be done! So where are you on the slippery slope, now?

Take this test/quiz...

Are you borderline malnourished?

Strange but true. As you age not only must you avoid being in the overweight camp, but you also need to escape undernourishment which has even worse consequences. The reason malnourishment happens is either physiological, social, or medical issues. Your food is absorbed a lot less well, we all get reduced appetite, may be solitary and less ’bothered’ about food so eating too little, or have increased needs because of long term illness. Nowadays, rising food costs add another cause. Medically, inflammation is the key driver ie the ‘inflammaging’ addressed in other InfoSheets,

How to MAXIMISE your healthspan and have a Diamond Life

Your Diamond Life

Not in the sense being rich materially, but rich in good 'quality of life' years. So your HealthSpan is the good years, your LifeSpan the total including those bad end-of-life years you have seen others have.

Want help you to limit the effects of ageing and maximise your HealthSpan?

What is Ageing?

What is Ageing? This is a key question: if we want to slow ageing we need to know what we are aiming to influence.

Ageing is a combination of several processes: first loss of power in muscles and joints, leading to frailty. Frailty means being vulnerable to injury or accident because of muscular weakness, loss of physical coordination, which leads to falls etc. The difficulty with the process is that one should become frail, it becomes progressive - because you’re frail you are unable to exercise and retain your strength and therefore your capacity to do things diminishes making you even more vulnerable in a downward spiral. You will have seen this progression in people you have known.