Sam Bauman: How to take your own blood pressure

I get all kinds of health literature from such as OnHealth, Consumer Reports or the Mayo Clinic, excerpts from which I will share.

High blood pressure is the leading cause of heart attacks and strokes. Many of us use home blood pressure monitors (I’ve got one that gathers dust, unfortunately).

What we’re looking for is the ideal reading, a systolic pressure of 120 millimeters or less (the top number) and a diastolic (the bottom number) reading of 80 or less of mmHg. Until recently, most experts agreed medication was needed when the systolic (when the heart contracts) hit 140 or the diastolic (the level between heartbeats) reached 90. The aim was even lower for those with diabetes or chronic kidney disease: 130/80.

But a bunch of experts advocated changing the numbers for seniors 60 or older who don’t need drugs until their levels hit 150/90, and not needed for diabetes or chronic kidney disease until they are at 140/90.

A British study found that drug treatment isn’t needed until systolic hits 160.

OnHealth experts felt that 140/90 is good for seniors over 60 and 140/90 for most with diabetes or kidney illness. They felt getting to 140/90 can call for high doses of drugs that increase risks of side effects, such as persistent coughs, erectile problems and frequent urination. The drugs also can lead to dizziness and falls.

Blood pressure medicines often are not expensive (around $30 a month) but once people start taking them they continue for life.

So, what to do?

Even if pressure is moderately elevated you might not need to take medicines right away. Here are two things to do first:

Make sure your readings are accurate, how you’re sitting or whether the monitor cuff is placed right. Sometimes a “white coat hypertension” spike happens in the doctor’s office, though it’s normal at home. Get several readings. And get a home monitor so you can check yourself.

Second, change your lifestyle. Lose weight, exercise more, cut back on sodium, drink less alcohol. Such changes can eliminate your need for drugs. If your systolic level is moderately elevated (150 to 160 for seniors 60 or older; 150 to 160 for others) think about drugs six months after life changes. If 60 or older and you have diabetes or kidney problems no need to change your medications.

What to aim for: 140/90 if under 60, for diabetes and kidney problems, 150/90 and below that if over 60.

Some tips for getting an accurate reading at home:

Go to the bathroom first, a full bladder can boost readings by 10 to 15 points.

Try to take readings at the same time daily, avoid exercise, tobacco and caffeine at least an hour before.

Rest five minutes before reading. Feet flat on the floor, legs uncrossed and cuff at heart level.

Cuff on bare skin, putting it over clothing can boost systolic by 40.

Remain quiet during test. Talking can raise systolic by 10-15 points.

Home monitors run around $60. I’m dusting mine off.

Shrimp — a study and answers

Once upon a time shrimp were something special on the American dinner table. But not anymore.

We eat three times more shrimp than we did 35 years ago. And about 94 percent of our shrimp comes from Indonesia, India and Thailand, according to Consumer Reports. There the shrimp are raised in artificial ponds where they are fed commercial pellets sometimes containing antibiotics. The ponds are easy to become contaminated hurting the shrimp and causing environmental problems.

Questions start at the grocery store. Labels can be confusing, meaningless or deceptive. There is little in the way of unfrozen shrimp; it’s almost all flash frozen and thawed at the market except for some American caught types.

Shrimp raised overseas are required by the FDA to be free of unapproved substances. “But enforcement is practically nonexistent,” says Jean Halloran, director of food inspects for Consumer’s Union, which publishes Consumer Reports, from which much of this article is based.

Even if he shrimp ponds are clean, the processing along the way where shrimp are deheaded, shelled and deveined. Processors may not be clean and the FDA requires processors to identify potential health hazards “but some of the bacteria we found such as staphylococcus auras can come from handling,” said Michael Crupain, MD.

More on shrimp next week.

Sam Bauman writes about senior issues for the Nevada Appeal.