Blood Pressure and the Brain – risk for Alzheimer’s?

Provided by Psychology Today

The next time a nurse inflates a blood pressure cuff around your bicep, pay attention. Those numbers are not just important for your heart, but for your brain as well.

It's becoming increasingly clear that high blood pressure, or hypertension, is at the root of much cognitive decline that has previously been attributed to aging. The more that scientists scrutinize brain function, and especially memory, the more they conclude that we have the ability to keep our memory and spirit strong well into old age. But it depends on how well we nourish our brain throughout life.

Hypertension is defined as blood pressure of 140/90 or above. The first number is the measurement of the blood's force against artery walls when the heart is beating. The second number is the pressure between beats. A person is hypertensive if either number is too high.

Most people think salt is the culprit in high blood pressure. In the vast majority of hypertensives, salt isn't the root of the problem. Only about one third of people with high blood pressure are what doctors call "salt sensitive."

"The rest of the folks can eat all the salt they want without seeing much change in their blood pressure," says Shari Waldstein, Ph.D., associate professor of psychology at the University of Maryland at Baltimore County, who studies the cognitive consequences of hypertension. People whose diets are not to blame can pinpoint the problem through a trial of medications that target differing pathways in the body. Blood pressure is affected by many of the body's systems, including kidney function, hormones such as insulin and the sympathetic and parasympathetic nervous systems.

Regardless of cause, high blood pressure is extremely dangerous, especially for people who don't know they have it, typically people who rarely see a doctor. Hypertension has few symptoms; some sufferers complain of headaches, nosebleeds or shortness of breath but for the most part the body suffers in silence.

High blood pressure does its damage by weakening the blood vessels, over time leading the inner lining to slough off. Vessels can be weakened to the point that they tear, causing sudden death or disability via a stroke or aneurysm. Hypertension can also lead to heart attacks.

But long before it creates a health emergency, hypertension takes a subtle toll on mental faculties. It can reduce attention, learning, memory and decision-making skills in ways that can be clearly seen in studies.

"Generally, whatever problems impact cardiovascular health also affect cognitive functioning," says Merrill Elias, Ph.D., a professor of epidemiology at Boston University who has studied hypertension for 35 years.

Indeed, some researchers now believe that a substantial amount of age-related mental decline has little to do with age and much to do with blood pressure. Waldstein says there's a large body of research linking hypertension directly to brain function, but scientists don't yet know how it causes damage at the cellular level.

Elias says high blood pressure exerts a constant stress on the brain and cardiovascular system that appears to be cumulative. "It's more of a problem for people who don't go to the doctor," he says. "Just think of it as your brain taking a hit every day."

The damage to the brain can come in a variety of forms. In the elderly, more than half of whom suffer from hypertension, the damage can be detected on MRIs in the form of "white matter lesions." These are pinpoint lesions in the brain's message-carrying axons that affect cognitive function, especially weakening memory and reasoning and significantly impacting quality of life.

High blood pressure can also cause small strokes that may go unnoticed, but which diminish the brain's capacity to function. Other people who have chronic hypertension actually have small spots on their brain where the tissue is dead, says Elias.

But that doesn't mean that high blood pressure is a disease of old age. For one thing, many people who are in their 20s and 30s suffer from it as well. It's especially important for younger people to control their blood pressure so that the damage doesn't start early and snowball over time.

But neither is high blood pressure inevitable with age. Blood pressure can be kept in check by keeping cholesterol low, not smoking and limiting salt. But perhaps the most important factor is keeping obesity at bay, a struggle most Americans are not winning.

"Weight is a biggie," says Elias. "The more you weigh, the more pressure there is."

Too much belly fat can be downright risky

By Michael Jensen, M.D., an endocrinology specialist at Mayo Clinic, Rochester, Minn.,

If you are carrying a few extra pounds — whether in the form of belly fat, love handles, a beer gut or potbelly — you're not alone. In recent years, the number of people who are overweight has increased dramatically worldwide. Two-thirds of American men are overweight or obese. But this is one case where following the crowd is not the best idea, because extra weight — especially belly fat — can be downright risky. And while women often put on extra pounds in the hips, thighs and legs, men are much more likely to gain belly fat.

How can you tell if you have too much belly fat?

Not surprisingly, how big around you are at the waist is a good indicator of whether you have too much belly fat. Although measurements that compare your hip and waist circumference (waist-to-hip ratio) or compare your height and weight (body mass index) are more precise and can be useful for research, your waist size alone can give you a pretty good idea of how much belly fat you have.

For most men, the risk factors for heart disease and other diseases increase with a waist size over 40 inches (102 centimeters).

To accurately measure your waist:

• Place a tape measure around your bare abdomen just above your hipbone.
• The tape measure should be snug — but not so tight it pushes into your skin.
• Check to make sure the tape measure is level all the way around.
• Relax, and measure your waist after you breathe out — no sucking in your belly!

Can you reduce belly fat with sit-ups?

Sit-ups will make your abdominal muscles stronger, sure. And, you may look thinner by building your abdominal muscles because you can hold in your belly fat better. But strengthening your stomach muscles alone will not specifically reduce belly fat.

There are no particular "spot" exercises that are best at reducing belly fat. But most people do lose belly fat before losing fat in other parts of their body when they get more exercise of any kind.

Is belly fat inherited?

While some men are more likely to put on extra pounds because of their genes, for the vast majority of men, the problem has a lot more to do with lifestyle than inherited traits. Simply put, when you take in more calories than you burn — the excess calories are stored as fat.

We've had a huge change in our environment. Men — and women — used to have much more active lifestyles. But our lifestyles today allow us to live and work with virtually no opportunity for physical activity. About 60 percent of American adults get no vigorous exercise in their leisure time at all. We are also eating larger amounts of high-calorie foods than we used to, such as "fast food" that is high in fat and carbohydrates. People are responding to this change in the way you'd expect — by gaining weight. Men need to be more active — to get out and keep moving.

Can you really get a beer belly from drinking?

We do know that there is a link between drinking excess alcohol and gaining belly fat — the "beer belly." However, it isn't just beer that can increase belly fat. Drinking too much of any kind of alcohol can have that effect. We know that alcohol is high in calories and increases appetite, but still aren't exactly sure why drinking too much causes increased belly fat in particular.

If you drink, the key is to drink in moderation. While increased belly fat is most noticeable in people who drink to excess, keeping it to less than two drinks a day will reduce the amount of calories you consume and help you avoid putting on belly fat. It is also better for your overall health.

Turning dreams of a baby into reality

Many couples experience fertility problems. Sometimes, having a child does not always happen as easily as expected. Unfortunately for many people, conceiving can be difficult.

Samitivej Sriracha Hospital in collaboration with Superior Assisted Reproduction Technology (A.R.T) from Sydney, Australia offers excellence in clinical expertise and state-of-the-art technology for fertility treatments to couples who are having fertility problems.

Since the first IVF baby over 29 years ago, assisted reproductive technology has been greatly enhanced, leading to better outcomes for couples desiring children. Present technology includes IVF or in vitro fertilization, a method of assisted reproduction where fertilization of a woman’s eggs is done outside of her body. The sperm provided by the male partner is afterwards mixed with eggs that have been aspirated from the woman’s ovaries. After a few days, one or more fertilized eggs are then transferred to the woman’s uterus (womb), with the hope that pregnancy will occur. This procedure has helped hundreds of couples to conceive and have healthy babies.

In addition to this, embryo testing for diagnosis of any genetic disorders before putting it back into the womb is also possible. This technique is called PGD or Pre-implantation Genetic Diagnosis. This involves the genetic testing of embryos created through IVF for harmful, heritable genetic conditions known to be present in the family of the couple seeking treatment. It allows couples previously at risk of producing a child with a genetic disorder to select the best quality embryo without a genetic disease for transfer.

Through the use of superior facilities and techniques Samitivej Sriracha Hospital offers fertility treatments that are customized to fit the individual patient and maximize her chances of pregnancy. These are treatments that help infertile couples not only conceive, but also help those who carry a mutation for single gene disorders such as beta thalassemia to have a healthy baby. Couples, who have an existing child with a variety of disorders, can select an embryo which is a HLA (Human leukocyte antigen) match to the child with the disorder. After the birth of the new baby, cord blood can be donated for stem-cell extraction to aid in the treatment of the baby’s elder sister or brother.

At Samitivej Hospital in Sriracha, one hour South of Bangkok, patients are treated with compassion and understanding as we work with couples to fulfill their dreams of building a family. These treatments will benefit not only couples with infertility problems but also couples requiring gender selection for medical reasons. These would also greatly benefit patients who have experienced repeated miscarriages or couples carrying a genetic disorder. Samitivej has now enabled couples to choose from a wide range of state-of-the art fertility techniques that would help patients turn their dreams of a baby into reality.