How to Prevent High Blood Pressure

Around half of American adults have high blood pressure (hypertension). Many of those people don't know they have it because there are usually no warning signs. This can be dangerous, because high blood pressure can lead to life-threatening conditions like heart attack or stroke. The good news is that you can often prevent or treat high blood pressure. Early diagnosis and heart-healthy lifestyle changes can keep high blood pressure from seriously damaging your health.

Each time your heart beats, it pumps blood into your arteries (the blood vessels that carry blood from your heart to the tissues and organs in your body). Blood pressure is the force of your blood pushing against the walls of your arteries. Blood pressure is measured as two numbers:

• Systolic pressure (the first and higher number) measures pressure inside your arteries when your heart beats
• Diastolic pressure (the second and lower number) measures the pressure inside your arteries when your heart rests between beats

As an example, a blood pressure reading of 120/80 means a systolic of 120 and a diastolic of 80.

High blood pressure usually has no symptoms. So the only way to find out if you have it is to get regular blood pressure checks from your health care provider. Your provider will use a gauge, a stethoscope or electronic sensor, and a blood pressure cuff. They will take two or more readings at separate appointments before making a diagnosis:

For children and teens, the provider compares the blood pressure reading to what is normal for other kids who are the same age, height, and sex.

Anyone can develop high blood pressure, but there are certain factors that can increase your risk:

• Age. Blood pressure tends to rise with age.
• Race/Ethnicity. High blood pressure is more common in Black adults. They also tend to have higher average blood pressure numbers and get high blood pressure earlier in life.
• Sex. Men are more likely than women to develop high blood pressure throughout middle age. But in older adults, women are more likely than men to develop high blood pressure.
• Lifestyle. Certain lifestyle habits can raise your risk for high blood pressure, such as eating too much sodium (salt) or not enough potassium, lack of exercise, drinking too much alcohol, and smoking.
• Family history and genetics. High blood pressure often runs in families. Many genes are linked to small increases in high blood pressure risk.
• Social and economic factors:
  • Research shows that factors such as income, education level, where you live, and the type of job you have may raise your risk of high blood pressure. For example, working early or late shifts can raise your risk.
  • Experiencing discrimination and poverty has been linked to high blood pressure. Also, some research has shown that trauma in childhood may raise the risk of high blood pressure.
• Certain medicines. Some medicines can raise your blood pressure, including:
  • Certain antidepressants
  • Decongestants (medicines to relieve a stuffy nose)
  • Hormonal birth control pills
  • Non-steroidal anti-inflammatory drugs (NSAIDs), which are a type of pain reliever
• Having certain other medical conditions, such as:
  • Some tumors
  • Chronic kidney disease
  • Diabetes
  • Metabolic syndrome
  • Overweight and obesity
  • Sleep apnea
  • Thyroid problems

You can help prevent high blood pressure by having a healthy lifestyle. This means:

• Eating a healthy diet. To help manage your blood pressure, you should limit the amount of sodium (salt) that you eat and increase the amount of potassium in your diet. It is also important to eat foods that are lower in fat, as well as plenty of fruits, vegetables, and whole grains. The DASH eating plan is an example of an eating plan that can help you to lower your blood pressure.
• Getting regular physical activity. Regular physical activity can help you maintain a healthy weight and lower your blood pressure.
• Being at a healthy weight. Being overweight or having obesity increases your risk for high blood pressure. Maintaining a healthy weight can help you control high blood pressure and reduce your risk for other health problems.
• Limiting alcohol. Drinking too much alcohol can raise your blood pressure. It also adds extra calories, which may cause weight gain.
• Not smoking. Cigarette smoking raises your blood pressure and puts you at higher risk for heart attack and stroke. If you do not smoke, don't start. If you do smoke, talk to yourprovider for help in finding the best way for you to quit.
• Managing stress. Learning how to relax and manage stress can improve your emotional and physical health and lower high blood pressure. Stress management techniques include exercising, listening to music, focusing on something calm or peaceful, and meditating.
• Getting enough high-quality sleep.

If you already have high blood pressure, it is important to prevent it from getting worse or causing complications. You need to get regular medical care and follow your treatment plan. Your plan will include healthy lifestyle habit recommendations and possibly medicines.

NIH: National Heart, Lung, and Blood Institute

Huntington's Disease

Huntington's disease (HD) is an inherited disease that causes certain nerve cells in the brain to waste away. People are born with the defective gene, but symptoms usually don't appear until middle age. Early symptoms of HD may include uncontrolled movements, clumsiness, and balance problems. Later, HD can take away the ability to walk, talk, and swallow. Some people stop recognizing family members. Others are aware of their environment and are able to express emotions.

If one of your parents has Huntington's disease, you have a 50% chance of getting it. A blood test can tell you if have the HD gene and will develop the disease. Genetic counseling can help you weigh the risks and benefits of taking the test.

There is no cure. Medicines can help manage some of the symptoms, but cannot slow down or stop the disease.

NIH: National Institute of Neurological Disorders and Stroke

Leukodystrophies

What are leukodystrophies?

Leukodystrophies are a group of rare genetic disorders that affect the central nervous system (CNS). The CNS is made up of your brain and spinal cord. Leukodystrophies damage the white matter of your CNS. The white matter includes:

• Nerve fibers, also called axons, which connect your nerve cells
• Myelin, a layer of proteins and fatty materials that covers and protects the nerve fibers. It also helps speed up signals between the nerve cells.

When the white matter is damaged, it can slow down or block the signals between nerve cells. This can cause many different symptoms, including trouble with movement, vision, hearing, and thinking.

There are over 50 types of leukodystrophies. Some types are present at birth, while others may not cause symptoms until a child becomes a toddler. A few types mainly affect adults. Most types get worse over time.

Leukodystrophies are caused by genetic changes. These changes are usually inherited, meaning that they are passed from parent to child.

The symptoms of leukodystrophies depend on the type; they can include a gradual loss of:

• Muscle tone
• Balance and mobility
• Walking
• Speech
• Ability to eat
• Vision
• Hearing
• Behavior

There can also be other symptoms, such as:

• Learning disabilities
• Bladder issues
• Breathing problems
• Developmental disabilities
• Muscle control disorders
• Seizures

Leukodystrophies can be hard to diagnose because there are so many different types which can have different symptoms. Your health care provider may use many tools to make a diagnosis:

• Physical and neurological exams
• A medical history, including asking about family history
• Imaging tests, such as an MRI or CT scan
• Genetic testing to look for genetic changes that could cause leukodystrophies
• Lab tests

There is no cure for leukodystrophies. Treatment focuses on relieving symptoms and providing support. It may include:

• Medicines to manage muscle tone, seizures, and spasticity (muscle stiffness)
• Physical, occupational, and speech therapies to improve mobility, function, and cognitive problems
• Nutritional therapy for eating and swallowing problems
• Educational and recreational programs

Stem cell or bone marrow transplantation can be helpful for a few types of leukodystrophy.

One type of leukodystrophy, CTX, is treatable if it is diagnosed early. It is treated with chenodeoxycholic acid (CDCA) replacement therapy.

NIH: National Institute of Neurological Disorders and Stroke

Lewy Body Dementia

What is Lewy body dementia (LBD)?

Lewy body dementia (LBD) is one of the most common types of dementia in older adults. Dementia is a loss of mental functions that is severe enough to affect your daily life and activities. These functions include:

• Memory
• Language skills
• Visual perception (your ability to make sense of what you see)
• Problem solving
• Trouble with everyday tasks
• The ability to focus and pay attention

There are two types of LBD: dementia with Lewy bodies and Parkinson's disease dementia.

Both types cause the same changes in the brain. And, over time, they can cause similar symptoms. The main difference is in when the cognitive (thinking) and movement symptoms start.

Dementia with Lewy bodies causes problems with thinking ability that seem similar to Alzheimer's disease. Later, it also causes other symptoms, such as movement symptoms, visual hallucinations, and certain sleep disorders. It also causes more trouble with mental activities than with memory.

Parkinson's disease dementia starts as a movement disorder. It first causes the symptoms of Parkinson's disease: slowed movement, muscle stiffness, tremor, and a shuffling walk. Later on, it causes dementia.

LBD happens when Lewy bodies build up in parts of the brain that control memory, thinking, and movement. Lewy bodies are abnormal deposits of a protein called alpha-synuclein. Researchers don't know exactly why these deposits form. But they do know that other diseases, such as Parkinson's disease, also involve a build-up of that protein.

The biggest risk factor for LBD is age; most people who get it are over age 50. People who have a family history of LBD are also at higher risk.

LBD is a progressive disease. This means that the symptoms start slowly and get worse over time. The most common symptoms include changes in cognition, movement, sleep, and behavior:

• Dementia, which is a loss of mental functions that is severe enough to affect your daily life and activities
• Changes in concentration, attention, alertness, and wakefulness. These changes usually happen from day to day. But sometimes they can also happen throughout the same day.
• Visual hallucinations, which means seeing things that are not there
• Problems with movement and posture, including slowness of movement, difficulty walking, and muscle stiffness. These are called parkinsonian motor symptoms.
• REM sleep behavior disorder, a condition in which a person seems to act out dreams. It may include vivid dreaming, talking in one's sleep, violent movements, or falling out of bed. This may be the earliest symptom of LBD in some people. It can appear several years before any other LBD symptoms.
• Changes in behavior and mood, such as depression, anxiety, and apathy (a lack of interest in normal daily activities or events)

In the early stages of LBD, symptoms can be mild, and people can function fairly normally. As the disease gets worse, people with LBD need more help due to problems with thinking and movement. In the later stages of the disease, they often cannot care for themselves.

There isn't one test that can diagnose LBD. It is important to see an experienced doctor to get a diagnosis. This would usually be a specialist such as a neurologist. The doctor will:

• Do a medical history, including taking a detailed account of the symptoms. The doctor will talk to both the patient and caregivers.
• Do physical and neurological exams
• Do tests to rule out other conditions that could cause similar symptoms. These could include blood tests and brain imaging tests.
• Do neuropsychological tests to evaluate memory and other cognitive functions

LBD can be hard to diagnose, because Parkinson's disease and Alzheimer's disease cause similar symptoms. Scientists think that Lewy body disease might be related to these diseases, or that they sometimes happen together.

It's also important to know which type of LBD a person has, so the doctor can treat that type's particular symptoms. It also helps the doctor understand how the disease will affect the person over time. The doctor makes a diagnosis based on when certain symptoms start:

• If cognitive symptoms start within a year of movement problems, the diagnosis is dementia with Lewy bodies
• If cognitive problems start more than a year after the movement problems, the diagnosis is Parkinson's disease dementia

There is no cure for LBD, but treatments can help with the symptoms:

• Medicines may help with some of the cognitive, movement, and psychiatric symptoms
• Physical therapy can help with movement problems
• Occupational therapy may help find ways to more easily do everyday activities
• Speech therapy may help with swallowing difficulties and trouble speaking loudly and clearly
• Mental health counseling can help people with LBD and their families learn how to manage difficult emotions and behaviors. It can also help them plan for the future.
• Music or art therapy may reduce anxiety and improve well-being

Support groups can also be helpful for people with LBD and their caregivers. Support groups can give emotional and social support. They are also a place where people can share tips about how to deal with day-to-day challenges.

NIH: National Institute of Neurological Disorders and Stroke

Memory

Every day, you have different experiences and you learn new things. Your brain cannot store all of that information, so it has to decide what is worth remembering. Memory is the process of storing and then remembering this information. There are different types of memory. Short-term memory stores information for a few seconds or minutes. Long-term memory stores it for a longer period of time.

Memory doesn't always work perfectly. As you grow older, it may take longer to remember things.

It's normal to forget things once in a while. We've all forgotten a name, where we put our keys, or if we locked the front door. If you are an older adult who forgets things more often than others your age, you may have mild cognitive impairment. Forgetting how to use your phone or find your way home may be signs of a more serious problem, such as:

• Alzheimer's disease
• Other types of dementia
• Stroke
• Depression
• Head injuries
• Blood clots or tumors in the brain
• Kidney, liver, or thyroid problems
• Reactions to certain medicines

If you're worried about your forgetfulness, see your health care provider.

NIH: National Institute on Aging