New Study Offers Hope for Alzheimer Prevention

A glimmer of hope shines in the devastating world of Alzheimer's Disease (AD), as this week a study published in the Archives of Neurology journal reveals that a class of blood pressure medications (Angiotensin Receptor Blockers, known as ARBs) may reduce the risk of developing Alzheimer's.
Although the mechanism of Alzheimer's is not fully understood, we do know that abnormal deposits of amyloid (a protein) occur early in brain as an early stage in the disease process. This new study, the Impact of Angiotensin Receptor Blockers on Alzheimer Disease Neuropathology in a Large Brain Autopsy Series, looked post-humously at the brains of 890 people who had suffered from AD and high blood pressure, and found that those patients who took ARBs (for their blood pressure) had significantly LESS of these amyloid deposits built up.

The hope is that if we can find ways to prevent the build up of these amyloid deposits, then this will halt the progression of Alzheimer's both pathologically and clinically. Prior studies have shown    some clinical evidence that patients on ARB's for their blood pressure have a lower risk of developing AD, but this is the first study to show us the actual physical changes in the brain- very exciting news!

So, if you have a strong family history of Alzheimer's disease and/or are experiencing progressive memory loss, should you ask your doctor to prescribe you an ARB today? Well... yes and no. I would NOT prescribe an ARB for a patient in this situation who had normal blood pressure. However, if she had newly diagnosed high blood pressure, I would certainly consider starting her on an ARB (rather than a diuretic or beta-blocker, our other first-line medications), and I would be open to a discussion about changing her to an ARB if she had hypertension and was already being treated with another class of medications. Of course, when choosing a medication, there is a range of different issues- from side effects and drug interactions to cost (and health insurance preferences), but potential "side"benefits such as this are absolutely part of the decision process.

BOTTOM LINE: Alzheimer's research is critical to help us find a cure for this debilitating disease, and this new study offers encouragement that ARB's may play a role in slowing the development of AD.

What's YOUR Blood Pressure?

Today the Center for Disease Control and Protection (CDC) released their report "Vital Signs: Awareness and Treatment of Uncontrolled Hypertension Among Adults- United States, 2003-2010), and what did they find?

• 30.4% of American Adults have high blood pressure - over 66.9 MILLION of us!!!
• 14.1 million people HAVE high blood pressure, but do not KNOW it
• 
  Of those that have high blood pressure, over HALF are NOT CONTROLLED.
• 5.7 million people KNOW they have HBP but don't take medicine
• Of the 35.8 million people who have UNCONTROLLED high blood pressure, the VAST MAJORITY (89.4%) have a usual source of health care & (85.2%) have health insurance

The media is all abuzz with this information, and with good reason. Hypertension (high blood pressure) is a disease that is easily diagnosed- just a blood pressure cuff is needed. We have a plethora of medications that treat hypertension, the mainstay of which are older, effective drugs that should not be expensive. High blood pressure, however, is a silent disease- potentially no symptoms until that big heart attack, stroke, kidney or heart failure. It is challenging to convince patients to take a medication when they have no obvious symptoms that will improve by taking the medications. 

With one in three Americans being obese, it should come as no surprise that roughly that same number of Americans have high blood pressure. As a nation, we have got to start reversing these trends, and MEDICATIONS ARE NOT THE ANSWER. Yes, we need them to control pressures (and some hypertension exists in skinny, fit bodies, independent of weight), but the real focus should be on improving our exercise and food choices. The good news is that with even very modest weight loss (of as little as 5-10 pounds), much of high blood pressure resolves! So, back to M.O.R.E. on nutrition!

BOTTOM LINE: High blood pressure is a SILENT disease that will cause serious damage if not discovered and treated, so CHECK YOUR BLOOD PRESSURE today!

Shampoo, Condition, and Blood Pressure??

Okay, you've got to love this! A new study,Effectiveness of a Barber-Based Intervention for Improving Hypertension Control in Black Men, recently published in the Archives of Internal Medicine, showed that barbers were effective in performing blood pressure screenings and referring clients with elevated pressures to medical care.

I think this is a wonderful example of thinking outside the box to reach patients. Virtually everyone gets their hair cut, and has one-on-one time with that barber or stylist. What a great use of an extra minute to add on a quick blood pressure check! I'd bet my lowest blood pressure readings come right after a wonderful shampoo at the salon. People are less likely to be stressed, which would help avoid "white coat" high blood pressure that we often see as patients become anxious in our office.

Bottom Line: Let's take this study one step further, and on your next trip to the grocery store, be your own advocate and take an extra minute to check your blood pressure as you pass by the pharmacy section (many offer their customers a wonderful, high quality cuff that you simply slip your arm into and press start.)