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Posts Tagged ‘blood pressure’

 

Strike a Pose to Lower Your Blood Pressure

Monday, November 23rd, 2015
Image courtesy of arztsamui at FreeDigitalPhotos.net

Image courtesy of arztsamui at FreeDigitalPhotos.net

By Kathrine Distel, PharmD Student Cedarville University School of Pharmacy

Hypertension or, as it is more commonly known, high blood pressure, is a chronic disorder that is becoming increasingly prevalent. It can be caused by a number of different factors, including a sedentary lifestyle, poor sleep habits, food choice and smoking. The most common treatment for high blood pressure is medication geared toward lowering blood pressure along with a suggestion to make some lifestyle changes. Unfortunately, those changes—namely diet and exercise—are unappealing at best to most people. Few people want to drastically alter their eating habits and rearrange their schedule so they can go to the gym every other day. Fortunately, there are plenty of other options that are emerging as effective ways to lower blood pressure without endlessly circling a track. One such option, yoga, has been in practice for many years.

Many people balk at the idea of doing yoga because it brings to mind impressive flexibility, leggings, and a room full of yoga mats. However, that doesn’t have to be the case. Thanks to the internet, you can pick a yoga instructor who moves at your pace in the privacy of your living room, avoiding all of the unappealing aspects of the exercise. A study1 conducted in India, a country that has been practicing yoga for centuries, found that regular yoga combined with blood pressure medications can produce significant decreases in blood pressure.

Study participants were divided into two groups. The first group, the control, continued to take their blood pressure medications as they had been with no changes besides instructions to avoid smoking, alcohol and any medications that may interfere with the study. The second group, besides the same set of instructions, began practicing yoga with trained yoga therapists three times a week. The sessions were about 45 minutes long and included preparatory practices, static postures, pranayama—exercises that focus on breathing control—and relaxation techniques. Participants were also encouraged to practice what they had learned throughout the rest of the week. 1

The study lasted for 12 weeks and, while the control group had no significant changes from its original measurements, the group practicing yoga showed some interesting results. When compared with both their own original measurements and the end results of the control group, the group practicing yoga had a significant decrease of both components of blood pressure (p < 0.05)—systolic and diastolic pressures— as well as mean arterial pressure (MAP) (p < 0.001). MAP is influenced by several different components, including blood pressure, heart rate, how much blood the heart is pumping every minute, and how much resistance the blood vessels are offering to the heart. When these values are low, the heart doesn’t have to work as hard and risks such as heart attack and stroke are decreased.1

There were two main limitations to this study. The sample size—70 people split evenly between the two groups—was a small one. Additionally, the study only lasted 12 weeks which did not allow it to assess the long-term effects of yoga on high blood pressure. However, other studies2-7 have also found yoga to have positive effects on blood pressure. One systematic review6 of 32 articles found that yoga could lower blood pressure in both healthy and hypertensive patients. Another study5, a year-long study in Hong Kong consisting of 182 participants, found that regular yoga practice could lead to decreased blood pressure, resting heart rate and waist circumference.

When the exercises for these studies were designed, the instructors kept in mind the group they would be teaching. The exercises were geared toward beginners and seniors. One case study, 7 which used resources such as a DVD and a YouTube video, evaluated the effectiveness of a modified chair yoga. This program increased safety for participants with decreased mobility or balance while still effectively lowering blood pressure. Participants also reported decreased anxiety and joint pain.

Results of systematic reviews3,6,8 have been mixed on the effects of yoga. Many, but not all of the trials found positive effects on blood pressure, some of those results were statistically significant while others were not. With so many varying results, there is still more research that needs to be done to determine a true measure of the effect of yoga on blood pressure.It is important to note that, because research into the effects of yoga on blood pressure is still relatively new, this practice has not yet been shown be effective in replacing blood pressure medications. Rather, it works well in conjunction with those medications.

So if your doctor has recommended a lifestyle change to aid in controlling your blood pressure, yoga may be a great place for you to begin. There are many free resources available, ranging from DVDs at the library to videos on YouTube, and it doesn’t require any equipment besides an open floor and perhaps a chair.

What do you think? Will you try yoga to assist in controlling your blood pressure?

 

References:

1. Pushpanathan P, Trakroo M, RP S, Madhavan C. Heart rate variability by poincaré plot analysis in patients of essential hypertension and 12-week yoga therapy. National Journal of Physiology, Pharmacy & Pharmacology. 2015;5(3):174-180.

2. Centre for Reviews aD. Yoga and hypertension: A systematic review (provisional abstract). Altern Ther Health Med. 2014:32-59.

3. Cramer H, Haller H, Lauche R, Steckhan N, Michalsen A, Dobos G. A systematic review and meta-analysis of yoga for hypertension. Am J Hypertens. 2014;27(9):1146-1151.

4. Hagins M, Rundle A, Consedine NS, Khalsa SBS. A randomized controlled trial comparing the effects of yoga with an active control on ambulatory blood pressure in individuals with prehypertension and stage 1 hypertension. J Clin Hypertens (Greenwich). 2014;16(1):54-62.

5. Siu PM, Yu AP, Benzie IF, Woo J. Effects of 1-year yoga on cardiovascular risk factors in middle-aged and older adults with metabolic syndrome: A randomized trial. Diabetology & Metabolic Syndrome. 2015;7(1):1-12.

6. Yang K. A review of yoga programs for four leading risk factors of chronic diseases. Evidence-based Complementary & Alternative Medicine (eCAM). 2007;4(4):487-491.

7. Awdish R, Small B, Cajigas H. Development of a modified yoga program for pulmonary hypertension: A case series. Altern Ther Health Med. 2015;21(2):48-52.

8. Centre for Reviews aD. Yoga for hypertension: A systematic review of randomized clinical trials (provisional abstract). Complement Ther Med. 2014:511-522.

Goodnight, Sleep Tight, Make Sure Your Blood Pressure is Right

Friday, October 30th, 2015

By: AJ OliverMoon_by_Adam_Cebula

Take a quick moment to think about your typical nightly routine. It most likely includes actions such as washing your face, showering, brushing your teeth or setting aside your outfit for the next day. If you are someone who has been diagnosed with high blood pressure (hypertension), adding the task of taking your medication may prove more beneficial to your health. In 2011, a new study reported by Harvard Health Publications claimed that taking your daily blood pressure medications at night will help lower the reading in those diagnosed with high blood pressure.1 Although that sounds like a no brainer, it is important to note that those not diagnosed with hypertension experience blood pressure readings that alternate based on the time of day. Getting out of bed is the hardest part of the day but once you do get out of bed, blood pressure rises. Before you start getting scared that your blood pressure will reach sky high before you start eating lunch, do not worry because your blood pressure will remain steady. Guess when your blood pressure will be at its lowest? Yep, you guessed it – it is lowest at night, usually between midnight and three or four o’ clock in the afternoon.1 This phenomenon is called “dipping”. However, people with high blood pressure experience “non-dipping,” meaning their blood pressure does not decrease at night – making the finding above important.2

Unfortunately, the same hormone that contributes to hypertension also increases the release of sugars from the liver and lowers insulin sensitivity.2 The combination causes an increase of risk for Type 2 diabetes in those who have hypertension. This was investigated in a study published in the Journal of Human Hypertension.3  In the study of 2,012 people with high blood pressure, half of the participants were instructed to take their blood pressure medications at night while the other half were instructed to take these medications in the morning.4 They monitored the participants for six years over which time 171 of the participants developed Type 2 diabetes.2 The researchers found that the half who took the blood pressure medications at night before going to bed had lowered their blood pressure more than those who took it in the morning.4 Additionally, these same participants also had a 57 percent lower risk for diabetes. Therefore, study authors concluded that taking a blood pressure medication before going to bed could benefit those who have hypertension by lowering blood pressure readings at night and decrease the risk of developing diabetes.1 However, with these studies there is a point that is important to note. Authors found that some older participants taking their blood pressure medications at night had critically low readings in the morning when trying to rise out of bed causing an increased risk of falls.1

Considering the evidence, taking blood pressure medication at night appears to be effective for improvement in blood pressure and risk of diabetes. However, it is necessary to take the proper precautions before starting blood pressure medications at night. Contact your doctor and pharmacist to see if you are suitable for taking blood pressure medications at night. Also, make sure that you use the same methods as you would use if you were to take these medications during the day. For instance, be sure to make a list of all the blood pressure medications taken.5 Also, try to get a good understanding of the side effects of your medications, not all blood pressure medications should be taken at night. For example, blood pressure medications like hydrochlorothiazide and Lasix are within a class of medications called diuretics.6 One of the side effects of diuretics is an increase in the volume of urine, which may result in multiple trips to the bathroom throughout the night.  For the medications you do take at night, make it a routine to take it at the same time every day.5 Do not alternate between taking the medications at night and during the day. Finally, keep your doctor informed and get your blood pressure checked regularly. If your primary care physician says you are good to go for taking your blood pressure medications at night then get to it! This may be a hard change and a lot to keep in mind. What are some ways to remind yourself to take these medications at the same time every night as well as reminding yourself to check your blood pressure? Do you think that taking blood pressure medication at night would be helpful for you?

References:

  1. LeWine H. Taking blood pressure pills at bedtime may prevent more heart attacks, strokes. Harvard Health Publications. October 25, 2011. http://www.health.harvard.edu/blog/taking-blood-pressure-pills-at-bedtime-may-prevent-more-heart-attacks-strokes-201110253668. Accessed October 29, 2015.
  2. Thompson D. Timing your blood pressure med right might prevent diabetes. News & View. September 24, 2015. http://news.health.com/2015/09/24/taking-blood-pressure-drugs-at-night-may-help-prevent-type-2-diabetes/. Accessed October 29, 2015.
  3. Hermida RC, Ayala DE, Mojón A, Smolensky MH, Portaluppi F, Fernández,J.R. Sleep-time ambulatory blood pressure as a novel therapeutic target for cardiovascular risk reduction. J Hum Hypertens. 2014;28(10):567-574. Accessed October 29, 2015.
  4. Bakalar N. Hypertension drugs may be more effective if taken at night. Well. October 2, 2015. http://well.blogs.nytimes.com/2015/10/02/hypertension-medicines-are-best-taken-at-night/?ref=health&_r=1. Accessed October 29, 2015.
  5. Web M. D. Taking high blood pressure drugs properly. http://www.webmd.com/hypertension-high-blood-pressure/how-take-blood-pressure-medicine-properly-why-you-should. Accessed October 29, 2015.
  6. Drugs.com. Diuretics. http://www.drugs.com/drug-class/diuretics.html.