Once ALS starts, it almost always progresses, eventually taking away the ability to walk, dress, write, speak, swallow, and breathe, and shortening the life span. The onset of ALS often involves muscle weakness or stiffness as early symptoms. Progression of weakness, wasting, and paralysis of the muscles of the limbs and trunk, as well as those that control vital functions such as speech, swallowing, and breathing, generally follows.

How fast and in what order this occurs is very different from person to person. While the average survival time is three years, about 20 percent of people with ALS live five years, 10 percent will survive 10 years and 5 percent will live 20 years or longer.

End stages of ALS often include trouble swallowing and speaking. Weak and paralyzed vocal cords make speaking difficult and eventually impossible. Trouble swallowing occurs gradually in some patients, but can occur suddenly in others.

Stages of ALS

ALS is a relentlessly progressive disorder. The rate of progression between individuals is variable and the history generally reflects gradual and progressive worsening over time until death occurs.

Early stages:

Muscles

• Muscles may be weak and soft, or they may be stiff, tight, and spastic. Muscle cramping and twitching (fasciculation) occurs, as does loss of muscle bulk (atrophy).
• Symptoms may be limited to a single body region or mild symptoms may affect more than one region.

Physical effects

• The person may experience fatigue, poor balance, slurred words, a weak grip, tripping when walking, or other minor symptoms.
• Sometimes this stage occurs before a diagnosis is made.

Middle stages:

Muscles

• Symptoms become more widespread.
• Some muscles are paralyzed, while others are weakened or unaffected. Fasciculations may continue.

Physical effects

• Unused muscles may cause contractures, in which the joints become rigid, painful, and sometimes deformed.
• If a fall occurs, the person may not be able to stand back up alone.
• Driving is relinquished.
• Weakness in swallowing muscles may cause choking and greater difficulty eating and managing saliva.
• Weakness in breathing muscles can cause respiratory insufficiency, especially when lying down.
• Some people experience bouts of uncontrolled and inappropriate laughing or crying (pseudobulbar affect). Despite how it seems, the person usually doesn’t feel particularly sad or happy.

Late stages:

Muscles

• Most voluntary muscles are paralyzed.
• The muscles that help move air in and out of the lungs are severely compromised.

Physical effects

• Mobility is extremely limited, and help is needed in caring for most personal needs.
• Poor respiration may cause fatigue, fuzzy thinking, headaches, and susceptibility to pneumonia. (Respiratory insufficiency is a leading cause of death in ALS.)
• Speech, or eating and drinking by mouth, may not be possible
• Assistance needed if not needed in the previous stage yet; in the home care you would need:
  
  • Power wheelchair, hospital bed, mechanical lift, and switches that enable any moving body part to operate computers, environmental control units, and communication devices.
  • Assisted ventilation, either noninvasive or invasive (tracheostomy).
  • Feeding tube.
  • Possibly urinary catheters aren’t required but can make toileting easier.
  • The type of home assistance you need:

  1.) Caregivers should:

  • Find and train caregiving help.
  • Oversee 24-hour care operations.
  • Find ways to help the person with ALS stay socially and mentally active.
  • Get into a routine that supports themselves as well as the person with ALS.
  • Know that although this stage is all-consuming, surprisingly many caregivers report great stability and satisfaction in their daily lives at this later stage of the disease.

       2.) Visiting RN (Nurse) who basically follows up on the care and decline or no change in pt    with letting the attending M.D. in charge be kept informed on pt’s status who makes any change with orders on the pt’s care.  It’s a whole team effect to make sure the pt gets the best care!

• Progression is not always a straight line in an individual, either. It is not uncommon to have periods lasting weeks to months where there is very little or no loss of function. There are even very rare examples in which there is significant improvement and recovery of lost function. These ALS “arrests” and “reversals” are, unfortunately, usually transient. Less than 1 percent of people with ALS will have significant improvement in function lasting 12 months or longer

End stage

• The vast majority of deaths in ALS are the result of respiratory failure, a process that progresses slowly over months. Medications can relieve discomfort, anxiety, and fear caused by respiratory insufficiency.
• Far less-common causes of death in ALS include malnutrition as a result of swallowing problems, pulmonary embolism (a blockage in one of the arteries of the lungs), abnormalities in the heart’s electrical pacing system called cardiac arrhythmias, and pneumonia as the result of aspiration (when food or fluid gets into the lungs).
• Hospice care (in a facility or in the home) focuses on providing comfort and maintaining quality of life by supporting the physical, emotional, and spiritual needs of the individual with ALS and their family members. Families should contact hospice early on to see what in-home services are available even before the most advanced stage.
• At MDA clinics, physicians work closely with palliative care teams to coordinate treatment with in-home hospice care providers, assisted living facilities, or inpatient hospice settings. Such cooperation helps ensure the person with ALS has the most peaceful and painless experience possible.

“The more you learn about ALS, the better prepared you’ll be. Remember, in addition to doing your own research, speaking regularly with your healthcare provider(s) will help you make the most informed decisions moving forward. Amyotrophic lateral sclerosis (ALS), also known as Lou Gehrig’s Disease, is a disease that affects parts of the nervous system that control voluntary muscle movements (the muscles that people move at will, like those of the arms and legs). ALS is referred to as a progressive disease, meaning the symptoms continue to get worse over time. People with ALS gradually lose strength in their muscles and become weaker, which can limit movement and the ability to live an independent life.

As ALS progresses, it will eventually affect muscles that control breathing, as well as chewing and swallowing food.”

ALS Pathways (https://www.alspathways.com/als-overview)

Amyotrophic lateral sclerosis concept illustration

ALS amyotrophic lateral sclerosis is a rare neurological disease affecting nerve cells that control voluntary muscle movement.  Amyotrophic Lateral Sclerosis or ALS, more commonly known as Lou Gehrig’s disease, is a terminal and progressive motor neuron disease. ALS specifically targets and kills the motor neurons responsible for controlling the vast majority of skeletal muscles in the human body, which eventually leads to respiratory failure and death.

Individuals with ALS experience a degeneration of their motor neurons, which causes the muscles to stop receiving the signals needed to function. After a certain time, the brain completely loses its ability to control voluntary movements, hence, people with ALS are unable to walk, move, or even breathe properly.

ALS belongs to, and is perhaps the most common example of, a group of neurological disorders known as Motor Neuron Diseases.  These diseases affect the body by causing the death of millions of neurons found in the motor cortex of the brain as well as the spinal cord. These nerve cells are directly responsible for the regulation and control of skeletal muscle function.

How ALS is diagnosed:

Considering the damage ALS can do, it became essential to spread the message regarding the disease so that people could treat it at an early stage. Though there is no cure for ALS but early detection can help in improving the quality of life of those with the disease. 

The signs and symptoms of this diagnosis:

1-Fatigue

A positive diagnosis of ALS is based primarily on a patient’s symptomatology.  Unfortunately there is no test that can currently provide a more conclusive assessment.

There are many diseases whose symptoms resemble those observed in patients with ALS. Therefore, diseases such as cervical osteoarthritis, cervical hernias that compress the spinal cord, heavy metal poisoning, and some infectious diseases such as Lyme disease or syphilis, can delay a correct diagnosis of ALS immediately.

As such, when ALS is suspected, it is common practice to rule out other diseases through a variety of tests including but not limited to lumbar punctures, MRIs, and electromyographic studies. In some cases, it might be necessary to perform a biopsy of muscle tissue in order to assuage any remaining doubts.

Often, the earliest symptoms of ALS are ignored or outright dismissed. Therefore, better understand this disease’s signs and symptoms.

2-Loss of strength

Pt’s with ALS eventually lose the ability to control all voluntary movement. During the progression of the disease, which typically lasts for several years, patients will experience a cumulative loss of muscle strength.

In most cases, the first muscles affected by the disease are those of the arms and legs which results in patients experiencing awkwardness when walking or moving about, an increased propensity for stumbling or tripping, and difficulty performing everyday tasks especially fine motor tasks like texting on the phone, typing, and even tying shoe or sneaker laces.

3-Muscle Atrophy

This is when the muscle actually deteriorates and muscle is lost.  Leading to muscle dystrophy,in the specific case of ALS, it occurs due to a dramatic reduction in the connection between nerves and muscle fibers caused by the death of motor neurons.  It often culminates to paresthesia to partial or total paralysis.

4-Fasciculations

Fasciculations are slight and involuntary muscular contractions that occur underneath the skin, but that do not produce any observable limb movement. Fasciculations are visible to the naked eye and are sometimes described as looking like small worms are moving within the muscle. These contractions occur because of spontaneous nerve discharges that fire within clumps of skeletal muscle fibers.  They can occur due to damage present in the lower motor neurons. They could be considered an early warning sign of the possible onset of ALS.

5-Cramps

Muscle cramps are highly common in patients who have ALS, and their incidence increases as the disease progresses. These sustained involuntary contractions of the muscles are typically accompanied by palpable contractures, can last anywhere from 30 to 45 seconds, and tend to be extremely painful.  Spasticity could develop and may not allow certain movements as a consequence of cramps;  in which antagonistic muscle groups participate.

Other Symptoms include:

• Tripping and falling
• Hand weakness or clumsiness
• Slurred speech or trouble swallowing
• twitching in your arms, shoulders and tongue
• Inappropriate crying, laughing or yawning
• Cognitive and behavioral changes

“There are two main types of high blood pressure.

1.) Primary hypertension, also called essential hypertension:
For most adults, there’s no identifiable cause of high blood pressure. This type of high blood pressure is called primary hypertension or essential hypertension. It tends to develop gradually over many years. Plaque buildup in the arteries, called atherosclerosis, increases the risk of high blood pressure.

2.) Secondary hypertension
This type of high blood pressure is caused by an underlying condition. It tends to appear suddenly and cause higher blood pressure than does primary hypertension. Conditions and medicines that can lead to secondary hypertension include:

-Adrenal gland tumors
-Blood vessel problems present at birth, also called congenital heart defects
-Cough and cold medicines, some pain relievers, birth control pills, and other prescription drugs
-Illegal drugs, such as cocaine and amphetamines
-Kidney disease
-Obstructive sleep apnea
-Thyroid problems

Sometimes just getting a health checkup causes blood pressure to increase. This is called white coat hypertension.”

MAYO CLINIC (https://www.mayoclinic.org/diseases-conditions/high-blood-pressure/symptoms-causes/syc-20373410)

The times and the era we live in are those of uncertainty. The state of flux caused by economic upheavals and pandemic-related restrictions have added to our health woes, with the crazy chaosis going on with our government to not protesting but RIOTING being allowed on college campuses like now aiding to having hypertension in your life that you didn’t have before. People have been facing stress on all fronts. Job losses, health issues starting, family issues or even losses, etc.  Our government is not thinking of family (the US citizens but illegals?  Really!)   Stress can cause short-term spikes in blood pressure. It is your body doing FIGHT OR FLIGHT and your rotten diet living on fast food places or going 3 times a week as finally starting to impact you at a later age or now with the stress induced on it. 

Being under stress can cause your blood pressure to spike briefly. But researchers aren’t sure whether stress can cause blood pressure to rise long-term.

Experts do know that exercising 3 to 5 times a week for 30 minutes can lower stress. For people with high blood pressure, doing activities that help manage stress and improve health can help lower blood pressure.

We do know furthermore the following facts in how reactions to stress can affect the blood pressure:

The body releases a surge of hormones when under stress. These hormones cause the heart to beat faster and the blood vessels to narrow. These actions increase blood pressure for a time.

There’s no proof that stress by itself causes long-term high blood pressure. But reacting to stress in unhealthy ways can raise blood pressure and increase the risk of heart attack and stroke.

Behaviors linked to higher blood pressure.  What we do know already is how diet can impact B/P due to bad diet behaviors in your choice in what to eat commonly which is the following:

• Drinking too much alcohol or caffeine.
• Eating unhealthy foods=Processed, restaurants/fast foods, bakery items, food delivery, pizzeria, deli meats.
• Eating too much.  Too much salt in your diet or caffeine or unhealthy foods.
• Not moving enough.

Heart disease also might be linked to certain health conditions related to stress, such as:

• Anxiety.
• Depression.
• Being cut off from friends and family.

Diabetes alot of times goes with heart disease, renal disease and others.  The best thing too do eat healthy, stay in your body mass index (therapeutic weight), some exercise everyday 30 mins or more & routine M.D. check ups.

There’s no proof that these conditions are directly linked to high blood pressure but it can impact it. Remember again when we are under stress we go through flight and flight (meaning we either deal with it or we don’t at all). But the hormones the body makes when under emotional stress might damage arteries. The artery damage might lead to heart disease. And symptoms of depression and anxiety might cause some people to forget to take medicines to control high blood pressure or other heart conditions.

Stress can cause a steep rise in blood pressure. But when stress goes away, blood pressure returns to what it was before the stress. However, short spikes in blood pressure can cause heart attacks or strokes and may also damage blood vessels, the heart and the kidneys over time. The damage is like the damage from long-term high blood pressure.

SO THE BIG QUESTION IS CAN ANYTHING BE DONE IN CONTROLLING STRESS? THE ANSWER IS YES!!!

Here are some ways to manage stress:

One way is simply adjust your schedule. If you have too much to do, look at your calendar and to-do lists. Ask others to do some things. Schedule less time for activities that aren’t important to you. Say no to things you don’t want to do.

Harvard Health Publishing/Harvard Medical School states the following in helping to reduce stress:

1. Get enough sleep. Inadequate or poor-quality sleep can negatively affect your mood, mental alertness, energy level, and physical health.
2. Learn relaxation techniques. Meditation, progressive muscle relaxation, guided imagery, deep breathing exercises, and yoga are powerful relaxation techniques and stress-busters.
3. Strengthen your social network. Connect with others by taking a class, joining an organization, or participating in a support group.
4. Hone your time-management skills. The more efficiently you can juggle work and family demands, the lower your stress level.
5. Try to resolve stressful situations if you can. Don’t let stressful situations fester. Hold family problem-solving sessions and use negotiation skills at home and at work.
6. Nurture yourself. Treat yourself to a massage. Truly savor an experience: for example, eat slowly and really focus on the taste and sensations of each bite. Take a walk or a nap, or listen to your favorite music.
7. Ask for help. Don’t be afraid to ask for help from your spouse, friends, and neighbors. If stress and anxiety persist, talk to your doctor.

Along with these ways to reduce stress, add in a healthy lifestyle — maintaining a healthy weight, not smoking, regular exercise, and a diet that includes fruits, vegetables, whole grains, lean protein, and healthful fats — and high blood pressure could be a thing of the past.

American Heart Association states the following in how to go about stress to lower it that decreases your B/P:

“1. You can’t control all the outside events in your life.

However, you can change how you handle them emotionally and psychologically. Try to learn to accept things you can’t change. You don’t have to solve all of life’s problems.

2. Think about problems under your control and make a plan to solve them.

You could talk to your boss about difficulties at work, talk with your neighbor if his dog bothers you or get help when you have too much to do.

3. Know your stress triggers.

Think ahead about what may upset you. Some things you can avoid. For example, spend less time with people who bother you or avoid driving in rush-hour traffic.

4. Reduce stress by taking care of your mood

Relaxing is important!  Even if you are busy, take 15 to 20 minutes a day to sit quietly, breathe deeply and think of a peaceful picture.

5. Spend time developing supportive and nurturing relationships.

We all need supportive and encouraging relationships. Invest yourself in developing relationships that build character and foster growth.

6. Give yourself the gift of a healthy lifestyle.

Engage in physical activity regularly. Do what you enjoy; walk, swim, ride a bike or jog to get your muscles going. Letting go of the tension in your body will help you feel better.

Limit alcohol, don’t overeat and don’t smoke.

Relaxing for short periods during your workday, at night and on weekends may help lower your blood pressure. Another great stress-buster is to get regular physical activity.

7. Reduce stress by practicing gratitude and joy

Change how you respond to difficult situations, focusing on the positive, not the negative. Expressing gratitude to others can also boost your level of feeling good about life and reduce stressful thoughts.

8. Know what brings you pleasure and find ways to enjoy the experience.

Perhaps you enjoy volunteer opportunities or cooking your favorite foods. By taking time not only to participate in these activities but to intentionally enjoy them, you can build a satisfying life rather than hurry through your “relaxing activities” at a stressful pace.

Reducing B/P by reducing bad foods in our diet the would cause vessel vasoconstriction or blockages in our vessels causing HTN, with reducing stress in out lives, practicing activities healthy in our lives like getting a 1/2 to 1 full hour of exercise a day, meditating a few times a week, loosing weight to therapeutic level will all help reduce your B/P or HTN.  It is all up to you in what moves you do to change your live to better your health and live a productive, happy and relaxing at frequency in your life!  Don’t be ill that stops you from doing things you enjoy and be healthy!

Revised 5/07/24

“Statistics on Hypertension by CDC:

• Having hypertension puts you at risk for heart disease and stroke, which are leading causes of death in the United States.²
• In 2021, hypertension was a primary or contributing cause of 691,095 deaths in the United States.²
• Nearly half of adults have hypertension (48.1%, 119.9 million), defined as a systolic blood pressure greater than 130 mmHg or a diastolic blood pressure greater than 80 mmHg or are taking medication for hypertension.³
• About 1 in 4 adults with hypertension have their hypertension under control (22.5%, 27.0 million).³
• About half of adults (45%) with uncontrolled hypertension have a blood pressure of 140/90 mmHg or higher. This includes 37 million U.S. adults. ³
• About 34 million adults who are recommended to take medication may need it to be prescribed and to start taking it. Almost two out of three of this group (19 million) have a blood pressure of 140/90 mmHg or higher.^3″

Centers for Disease Control and Prevention (https://www.cdc.gov/bloodpressure/facts.htm)

The signs and symptoms of high B/P=Hypertension could be:

Usually, high blood pressure causes no signs or symptoms. That’s why healthcare providers call it a “silent killer.” You could have high blood pressure for years and not know it. In fact, the World Health Organization estimates that 46% of adults with hypertension don’t know they have it.

When your blood pressure is 180/120 mmHg or higher, you may experience symptoms like headaches, heart palpitations or nosebleeds. Blood pressure this high is a hypertensive crisis that requires immediate medical care.

Remember this, for many High blood pressure is known as the “silent killer” and its given that nickname for a reason.  For those patients with high B/P they don’t feel ANY SIGNS OR SYMPTOMS OF HIGH B/P to go to the doctor!  So they let their B/P get so high, never going to the MD or regularly checking their B/P on their own and puff they die awake or in their sleep due to the high B/P that caused the death!

You may not feel that anything is wrong, but high blood pressure could be quietly causing damage that can threaten your health. The best prevention is knowing your numbers and making changes that matter in order to prevent and manage high blood pressure.

Why not just buy a blood pressure monitor from the pharmacy which will help you keep an eye on your B/P or even keeping your B/P therapeutic and have no HTN!

A BIG factor in helping to reduce or decrease high blood pressure for those with hypertension is DIET alone will impact greatly.  Less SODIUM=Salt in the diet will have an impact in lowering your B/P!

Your provider will diagnose you with one of two types of high blood pressure:

• Primary hypertension. Causes of this more common type of high blood pressure (about 90% of all adult cases in the U.S.) include aging and lifestyle factors like not getting enough exercise.
• Secondary hypertension. Causes of this type of high blood pressure include different medical conditions or a medication you’re taking.

Most people with high b/p are asked to eat less sodium. Sodium attracts water and makes the body hold fluid. To pump the added fluid the heart works harder. Also sodium in the body causes the arteries to vasoconstrict increasing pressure in the vessels causing the pressure to rise.

Most people with high b/p are asked to eat less sodium at 2000mg or less a day and this is to prevent water retention and vasoconstriction in which both actions increase the blood pressure. Follow your doctor’s advice about your sodium intake.

Many prepared foods and spices are high in sodium. But, the most common source of sodium is table salt. Table salt is 40% sodium and 60% chloride. One teaspoon of table salt contains 2000mg of sodium.  Get rid of your table salt period will help you in trying to lower your B/P or keeping your B/P therapeutic (in the norm).

HINTS IN HOW TO LOWER YOUR SODIUM IN YOUR DIET:

What is Sodium (NA+)?  One it’s an important substance in our body. It helps your body balance the level of fluid inside and outside of the cells; this prevents the cells from becoming dehydrated. To keep up this balance, the body needs about 2000mg of sodium a day or less. Yet most of us eat 3000 to 6000mg of sodium each day.  On average Americans eat 3400mg of sodium a day and now it is recommended to eat 1500 mg a day.  A major start is no salt shaker on the table and don’t add salt to your foods unless you know the amount in them already with not going over 1500 mg of salt a day or what your cardiologist recommends who is the expert!

Other tips could  be:

-Season foods with fresh or dried herbs, vegetables, fruits or no-salt seasonings.

-Do not cook with salt or add salt to foods after they are on the table.

-Make your own breads, rolls, sauces, salad dressings, vegetable dishes and desserts when you can.

-Stay away from fast foods. They are almost all high in salt.

-Eat fresh, not frozen or canned, and do eat unsalted vegetables. These have less sodium than most processed foods. Read the labels and if they don’t have a label DON’T EAT IT. Read the labels and eat the portioned size it says to for 1 portion with keeping a diary of what you ate with adding the sodium and when it reached 2000mg no more food that day with salt in it unless the doctor prescribes less.

Know this frozen meals are often high in sodium. In fact, it’s estimated that around 70% of the sodium people consume in the United States comes from prepackaged, processed, and restaurant foods = high in sodium.

-Buy water packed tuna and salmon. Break it up into a bowl of cold water, and let stand for 3 minutes. Rinse, drain and squeeze out water.

-Don’t buy convenience foods such as prepared or skillet dinners, deli foods, cold cuts, hot dogs-one of the worst foods to eat to begin, frozen entrees or canned soups. These have lots of salt. Be picky on what you eat.

-Again, read all labels for salt, sodium or sodium products (such as sodium benzoate, MSG). Ingredients are listed in the order of amount used. A low sodium label means 140mg of less per serving. Try to buy products labeled low sodium/serving. Do not eat products that have more sodium than this per serving.

-AHA states, “If you drink, limit your alcohol consumption to no more than two drinks per day for men and no more than one drink per day for women. A drink is one 12 oz. beer, 4 oz. of wine, 1.5 oz. of 80-proof spirits or 1 oz. of 100-proof spirits.

I’ve read that red wine is heart healthy — can I drink as much as I’d like?
Unfortunately, red wine as a miracle drink for heart heath is a myth. The linkage reported in many of these studies may be due to other lifestyle factors rather than alcohol. Like any other dietary or lifestyle choice, it’s a matter of moderation and disciplining yourself in almost anything especially junk food, processed foods, foods high in fat or fried should once in awhile in aiding yourself in controlling your blood pressure.  Don’t only do moderation when the B/P goes high instead make the moderate eating of bad foods a regular part of your life and high odds it will only aid in helping your B/P to stay normal or to get in a therapeutic range.  The other way is only a high potential to aid in getting hypertension or increasing your b/p.

If you need help–
If cutting back on alcohol is hard for you to do on your own, ask your healthcare provider about getting help.

The AHA says your lifestyle plays an important role in treating your high blood pressure. If you successfully control your blood pressure with a healthy lifestyle, you might avoid, delay or reduce the need for medication.

Foods to keep out of your diet or ever have on a regular basis and have maybe have once every 3 months or less

-Canned Vegetables, sauerkraut. Self rising flour and corn meal. Prepared mixes (waffle, pancake, muffin, cornbread, etc…)

-Dairy Products high in fat- like buttermilk (store-bought), canned milks unless diluted and used as regular milk).  I personally switched to skim milk and drink it every day and with other things taken in my life in moderation with trying to watch my weight still keeps my b/p under 120/80.   Egg substitute limit to ½ cup/day. Eggnog (store bought) and salted butter or margarine do not buy everyday but have eggnog around holiday time is what I do and that’s it.  I limit my butter intake where it is on bread and never add it to cooking or have extra on the table for like mashed potatoes.  Trust me processed foods have plenty in them and bakery goods without question.

-Soups: Boullon (all kinds), canned broth, dry soup mixes, canned soups are severely high in sodium especially the noodles you add water to.  Just have one of them and your already over 1000mg of salt.  Surprise, Dietary Guidelines for Americans recommends adults limit sodium intake to less than 2,300 mg per day—that’s equal to about 1 teaspoon of table salt! Salt is in the majority of foods so look on the back of the food and read the amount of fat,carbohydrates and salt is in a serving with seeing what the food’s size of a serving is.  It may make you fall in the chair.

-Meats and meat substitutes not to buy=Canned meats, canned fish, cured meats, all types of sausages, sandwich meats, peanut butter, salted nuts.  High in sodium again.

-Prepared mixes (pie, pudding, cake) or store bought pies, cakes, muffins.

-Cooking ingredients to use low sodium type or limit to 2 tbsp/day=ketchsup, chili sauce, barbecue   sauce, mustard, salad dressing.  Read the label!

-Drinks to stay away from Athletic Drinks (such as energy drinks-caffeine/Gatorade), canned tomato or vegetable juice (unless unsalted).  Caffeine is a commonly used neurostimulant that also produces cerebral vasoconstriction by antagonizing adenosine receptors. Chronic caffeine use results in an adaptation of the vascular adenosine receptor system presumably to compensate for the vasoconstrictive effects of caffeine=vasoconstriction of all blood vessels=this increases your b/p.

NIH=The National Library of Meidicine found this with caffeine (https://www.ncbi.nlm.nih.gov/books/NBK202224/):

The West Florida Vein Center states this about caffeine:

“Caffeine is a drug found in coffee, soda and tea, doesn’t just wake you up. It sets your whole body into a different motion, stimulating the nervous system and constricting blood vessels. Caffeine is safe when ingested in moderation, but excessive consumption can lead to vascular complications like high blood pressure, poor circulation and narrow blood vessels.  I have 2 cups a day on average.  Being a night RN I have one in the morning to have one at night.  When off of work just one or two in the am.

Upon consumption, caffeine gives you your morning jolt of energy. It achieves this by attaching to your adenosine receptors, which ordinarily dilate your brain’s blood vessels. Instead, your blood vessels constrict, also known as vasoconstriction. When vasoconstriction of the brain occurs, the pituitary gland sounds an alarm and reacts as if in an emergency state. It then releases adrenaline, which leads to increased heart rate.“

Know adrenaline is released in fight or flight and adrenaline causes peripheral vasoconstriction which further increases the B/P due to pressure build up in the vessels away from the core or center of the body.  That is what peripheral means.

The West Florida Vein Center further states:

“With vasoconstriction comes faster heart rate but slower blood flow. A study by “Human Brain Mapping” found heavy caffeine users experienced “reduced cerebral blood flow by an average of 27 percent.” What this means? Excessive caffeine intake leads to unnecessary stress on your venous system. Because your brain receives an inadequate amount of blood, your whole venous system operates under stress to compensate for the blood flow changes.

When stressed, veins are at greater risk of disease. Venous conditions like varicose veins and deep vein thrombosis can occur with vasoconstriction. Narrow blood vessels can prevent sufficient blood flow, causing clotting and inflammation.  To avoid stressing your venous system, limit coffee intake to 24 ounces per day.” OR we say less if you can!  Even better is decaffeinated coffee and no venous constriction will occur or if you need the caffeine have one glass or 12 ounces of caffeinated and the rest of the day decaffeinated coffee.

So yes, long term caffeine heavy users do get overall VASOCONSTRICTION that increases your blood pressure in the body, including in the brain.  While there’s no broad percentage of caffeine dependence in the US population, smaller studies have been conducted. According to a study conducted by the University of Florida, 28% fulfilled the criteria for caffeine dependence compared to 50% for alcohol and 80% for nicotine.  From this study 2 factors cause vasoconstriction Nicotine and Caffeine.  Remember one of the symptoms of high B/P is a headache! So change your diet if you need to in your life, based on this information and hope it is useful!

Remember Moderation to stopping completely out of your diet things that increase your blood pressure is the key to helping you reach normal blood pressure with other factors like obesity, and disease from Diabetes to Athero- sclerosis (which is partly or completely blocking an artery vessel) including arteriosclerosis which is brittle arteries and Renal Failure (acute or chronic).

(Updated 5/12/24)

Understand the numbers in your B/P!

“Hypertension Stage 1 is when blood pressure consistently ranges from 130 to 139 systolic or 80 to 89 mm Hg diastolic. At this stage of high blood pressure, health care professionals are likely to prescribe lifestyle changes and may consider adding blood pressure medication.

Hypertension Stage 2 is when blood pressure consistently is 140/90 mm Hg or higher. At this stage of high blood pressure, health care professionals are likely to prescribe a combination of blood pressure medications and lifestyle changes.

Hypertension Stage 3-This stage of high blood pressure requires medical attention. If your blood pressure readings suddenly exceed 180/120 mm Hg, wait five minutes and then test your blood pressure again. If your readings are still unusually high, contact your health care professional immediately. You could be experiencing a hypertensive crisis!

Experiencing new symptoms with your B/P this high than call 911!

American Heart Association (https://www.heart.org/en/health-topics/high-blood-pressure-understanding-blood -pressure-readings)

Know the numbers of concern and know yours to keep your health well and avoiding problems from High B/P. We will review S/S with more tomorrow continuing the topic hypertension (HTN).

  Systolic BP is heart at work, Diastolic BP is heart at rest!

High Blood Pressure – what is it?

High Blood Pressure or Hypertension affects 80 million Americans and nearly half of the people in the UK between the ages of 65 and 74, and a large percentage of those between the ages of 35 and 65. One of the problems associated with high blood pressure is that you will probably not even know you have it until you happen to have your blood pressure taken during a routine physical examination.  In our B/P you have 2 numbers one on the top that is called your systolic b/p that will always be higher that the bottom number b/p.  What do they mean? The top number systolic B/P will be the number representing your heart pressure at work whereas the bottom number called diastolic B/P will always be lower that the top number representing the B/P at rest.  Normal B/P for some is 90/50 for those who are a work out nut, in good shape, and at their normal weight level or body mass index (BMI).  For others normal B/P can go has high as 120/80 or less.  High B/P is over 120/80.  In earlier years 122/80 was considered the norm now its not.  Where do you really see problems for a high B/P?  Well looking at a B/P chart this should give you some direction:

Remember in the nursing and medical field a systolic B/P of 180 these professional get concerned for stroke or a vessel somewhere about to burst (Ex. like a abdominal aneurysm which many don’t feel since its in their abdomen making room for the pouch vessel to grow making the vessel wall weaker to pop and than for many when realized its too late, take the actor John Ritter!)  With a stroke it can be caused by a hemorrhagic stroke-this meaning a vessel ruptures (most commonly high B/P) or ischemic stroke a build up of a blockage or blockages of a vessel in the brain).

Upon diagnosis, you may wonder why you never saw it coming. Most people don’t. Only those with severe high blood pressure experience any warning signs at all.

These signs can include headaches, impaired vision, and black-outs.

What is blood pressure ?

It is the measurement of the force that blood applies to the walls of the arteries as it flows through them carrying oxygen and nutrients to the body’s vital organs and systems. Naturally, our blood is under pressure as it rushes through our arteries. Even those with blood pressure in the normal range will experience an increase in their blood pressure during rigorous physical activity or during times of stress. It only becomes a problem when the blood continues to run high. This condition of blood pressure is known as hypertension or high blood pressure and in 95% of the cases, the cause of it is never known. However, we do know the factors that set a person up to develop hypertension.

Factors influencing High Blood Pressure:

They are as follows:

NON-MODAFIABLE RISK FACTORS ARE 4:

1. HEREDITY-HIGH B/P RUNNING IN THE FAMILY

2. AGE-THE OLDER, THE HIGHER PROBABILITY YOU WILL END UP WITH B/P DEPENDING ON YOUR HEALTH AND HOW GOOD YOU TAKE CARE OF YOURSELF.

3. GENDER or SEX-MALES VS FEMALES.  THE GENDER THAT BEATS THE OTHER EASILY IS MEN!

4. RACE-HIGHIER IN AFRO-AMERICAN AS OPPOSED TO WHITE.

MODAFIABLE RISK FACTORS=FACTORS YOU CAN CONTROL IN YOUR LIFESPAN:

1-Obesity=Those with a body mass index of 30 or greater.

2-Drinking more than 2 to 4 alcoholic drinks a day.

3-Smoking

4-High cholesterol

5-Diabetes

6-Ongoing Stress/Anxiety

7-Continuous use of excessive salt consumption

Possible causes of High Blood Pressure

Sometimes the cause of a person’s high blood pressure is determined, but this happens in only 5% of the cases. When a cause is found, the person is diagnosed with secondary high blood pressure [hypertension]. In most of these cases, the cause can be linked to an underlying illness such as kidney disease, adrenal gland disease, or narrowing of the aorta. Contraceptive pills, steroids, and some medications can also cause secondary high blood pressure [hypertension], though instances of this are not all that common since in most cases these can be stopped or with medications changed if a med is still needed to resolve high blood pressure.

Reviewing High Blood Pressure and the important numbers

We hear the numbers, but do we really know what they mean? Since your blood pressure numbers can help you to understand your overall health status, it is important that you keep track of it. By knowing where your numbers are right now, you can head off such serious high blood pressure complications as angina, heart attacks, stroke, kidney damage, and many others that might surprise you – like eye problems and gangrene.

Hear is a review of understanding what blood pressure means and tells our medical professionals from RN’s who see the pt the most and see the vital signs with doctors being told who generally provide your blood pressure to you in terms of two numbers – a top one and a bottom one. For example, if your blood pressure is 120/80, they may say that you have a blood pressure of 120 over 80. Here is a definition again for these numbers:

The top number– this is your systolic blood pressure. It measures the force of blood in the arteries as your heart beats. The top number means the pressure is reading your heart at work.  That is why this number is always highier.

The bottom number – this is your diastolic blood pressure. It is the pressure of your blood when the heart is relaxed in between the times when it is pumping. Means the pressure is reading your heart at rest.  That is why the number is always lowest.

Your blood pressure requires monitoring when you have a systolic blood pressure of 140 or over and/or a diastolic blood pressure of 90 or over. Those with diabetes must maintain a lower blood pressure that those who don’t have the condition. Diabetics should maintain a blood pressure of less than 130/80.  It would be ideal at 120/80 and there are some that do.

Monitors for measuring High Blood Pressure

It is wise to monitor your blood pressure at home in addition to having it taken at your doctor’s office. This will allow you to provide your doctor with readings that have been taken over time, providing a more in depth look at your personal health condition. This will help him or her to prescribe the right hypertensive medication and treatment for your specific condition.

Tips to help reduce your B/P:

The best you could do over 50 or if already diagnosed with high blood pressure than monitor it at home with automatic B/P machines or get a manual one with a stethoscope for taking your B/P measurement with your pulse for some that you take from the upper arm at home each day when you first get up. Especially have a B/P monitor is recommended in taking your B/P meds to eval how good the med is working but if on lopressor or metoprolol (commonly used antihypertensives) or any selective beta blocker which can lower your B/P and pulse. Since with metoprolol or lopressor if the b/p is 90/60 or the pulse is lower than 60 you should call the M.D. first since readings that low could bottom out your B/P and pulse with making them too low putting the pt at problems with dizziness, feeling weak to bottoming out so bad you just sleeps or better falls.  So call your doctor immediately before taking the med.  Always take the B/P from the upper arm above the elbow unless your M.D tells you otherwise.  You’ll also want to make sure that the blood pressure monitor you are considering has been proven in clinical trials. Trusted name brands include those made by Omron, LifeSource, Mark of Fitness, Micro Life, and A and D Instruments. There are other brands available – the important thing is to do your research.

Always check with you cardiologist preferred or your general practitioner before making any changes in your lifestyle in anyway for safety.

Updated 5/07/24

“Key facts