Stemming Falls in the Elderly - South Florida Sun-Sentinel.com

By Judith Graham, Tribune Newspapers

As we age, our risk of falling increases. Our feet may catch on a well-worn rug or we may miss a step going downstairs to the kitchen at night. We lose balance, strength and agility; medications may make us drowsy; or we may become dizzy after getting up from a chair as our blood pressure plummets.

No one has done more to highlight the medical significance of this issue than Dr. Mary Tinetti of Yale University. The recipient of a 2009 MacArthur Foundation "genius" grant, Tinetti has spent almost two decades exploring why seniors fall. Most recently, she co-chaired a committee of American and British experts that helped prepare new guidelines for preventing falls.

Tinetti spoke at length about the guidelines, which were published in January in the Journal of the American Geriatrics Society. An edited version of our discussion follows.
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Two Medicines Taken Together Improve Control of Blood Pressure

ScienceDaily (2011-01-12) -- New research shows that starting treatment of blood pressure with two medicines rather than the one produces better and faster results and fewer side effects -- findings that could change clinical practice world-wide.

One BP Target Won't Fit All Dialysis Patients from MedPage Today

by Crystal Phend

One size doesn't fit all for blood pressure management in dialysis patients, researchers found in a large cohort study.

Age and diabetes status impacted the link with mortality -- higher at low blood pressures in some groups but high pressures in others, Philip G. Zager, MD, of the University of New Mexico Health Sciences Center and Dialysis Clinic, both in Albuquerque, N.M., and colleagues reported.

Blood pressure targets should take these factors into account, they recommended online in the Journal of the American Society of Nephrology.
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People Over 80 Often Have Mixed Pathologies In Their Brains That Account For Their Memory Loss, Confusion

Most recent studies show that elderly people over the age of 80 often have mixed pathologies in their brains that account for their memory loss and confusion. Very few senior citizens have "pure Alzheimer disease"; therefore, this terminology should be used with caution. It now appears that vascular problems such as high blood pressure and diabetes can shrink the parts of the brain that control memory and can significantly affect at what age elderly people become demented.

The following tips may be able to postpone cognitive decline late in life:
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Dilation Of Blood Vessels Restores Muscle Synthesis In Elderly

University of Texas Medical Branch at Galveston researchers believe they've found a way to use widely available blood pressure drugs to fight the muscular weakness that normally accompanies aging.

The discovery draws on research linking the loss of muscle mass with age-related changes in the behavior of the hair-thin blood vessels, or capillaries, which supply muscles with the amino acids they need for growth.

"When a young person eats food, insulin secretion causes the blood vessels in the muscle to dilate, so a lot of blood goes into the muscle and a lot of amino acids are available to build muscle proteins," said UTMB professor Elena Volpi, senior author of a paper on the work ("Pharmacological vasodilation improves insulin-stimulated muscle protein anabolism but not glucose utilization in older adults") now available in the "Online Ahead of Print" section of the journal Diabetes. "Older people's blood vessels have far less response to insulin, but we found that if you give them a drug that causes them to dilate, you can increase the nutritive flow to the muscles and completely restore normal growth."

Drugs that induce blood vessels to widen, called vasodilators, are commonly used to control high blood pressure and prevent angina. The UTMB study used sodium nitroprusside, a drug used in hospitals and administered intravenously.
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Patient Monitoring Improves BP Control from MedPage Today

By Kristina Fiore, Staff Writer, MedPage Today

Patients who use telemonitoring to manage their hypertension and titrate their own medication doses see improvements in systolic blood pressure, researchers found.

Such patients saw a significantly greater reduction in mean systolic blood pressure at six months and a year compared with patients who received standard care (P=0.013 and P=0.0004, respectively) Richard J. McManus, FRCGP, of the University of Birmingham in England, and colleagues reported online in The Lancet.

"These findings seem to be the result of an increase in the number of antihypertensive drugs prescribed according to a simple titration plan," they wrote. "Thus, self-management represents an important new addition to the control of hypertension in primary care."

Only about half of patients being treated for hypertension have achieved current recommended levels, which leaves room for other interventions to lower blood pressure, such as patient self-management. Trials of this strategy have shown it to be effective, the researchers noted.

Another strategy is self-titration, in which patients make changes in their medication according to response and based on a pre-agreed formula. This has been tested only on a small scale, the researchers said, but the model has been successful in patients with conditions such as asthma and diabetes.

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Hypertension Linked to Thinking Problems in Middle Age - Forbes.com

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(HealthDay News) -- High blood pressure is linked to loss of mental function in people over 45, a new study finds. Read More