Common Hospital Blood Pressure Mistake (Don’t Let This Happen To You Or A Loved One)

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There’s a major issue in healthcare, Dr. Suneel Dhand tells us, pertaining to the overtreatment of hypertension in hospitals. Here’s how to watch out for it and know when to question it:

Under pressure

When patients, particularly from older generations, are admitted to the hospital, their blood pressure often fluctuates due to illness, dehydration, and other factors. Despite this, they are often continued on their usual blood pressure medications, which can lead to dangerously low blood pressure.

Why does this happen? The problem arises from rigid protocols that dictate stopping blood pressure medication only if systolic pressure is below a certain threshold, often 100. However, Dr. Dhand argues that 100 is already low*, and administering medication when blood pressure is close to this can cause it to drop dangerously lower

*10almonds note: low for an adult, anyway, and especially for an older adult. To be clear: it’s not a bad thing! That is the average systolic blood pressure of a healthy teenager and it’s usually the opposite of a problem if we have that when older (indeed, this very healthy writer’s blood pressure averages 100/70, and suffice it to say, it’s been a long time since I was a teenager). But it does mean that we definitely don’t want to take medications to artificially lower it from there.

Low blood pressure from overtreatment can lead to severe consequences, requiring emergency interventions to stabilize the patient.

Dr. Dhand’s advice for patients and families is:

  • Ensure medication accuracy: make sure the medical team knows the correct blood pressure medications and dosages for you or your loved one.
  • Monitor vital signs: actively check blood pressure readings, especially if they are in the low 100s or even 110s, and discuss any medication concerns with the medical team.
  • Watch for symptoms of low blood pressure: be alert for symptoms like dizziness or weakness, which could indicate dangerously low blood pressure.

For more on all of this, enjoy:

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Want to learn more?

You might also like to read:

The Insider’s Guide To Making Hospital As Comfortable As Possible

Take care!

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  • Staying Strong: Tips To Prevent Muscle Loss With Age

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    Dr. Andrea Furlan, specialist in physical medicine and rehabilitation with 30 years of experience, has advice:

    Fighting sarcopenia

    Sarcopenia is so common as to be considered “natural”, but “natural” does not mean “obligatory” and it certainly doesn’t mean “healthy”. As for how to fight it?

    You may be thinking “let us guess, is it eat protein and do resistance exercises? And yes it is, but that’s only part of it…

    Firstly, she recommends remembering why you are doing this, or because understanding is key to compliance (i.e. your perfect diet and exercise program will mean nothing if you don’t actually do it, and you won’t do it enough to make it a habit, let alone keep it up, if the reasons aren’t clear in your mind).

    Sarcopenia comes with an increased risk of falls, reduced physical capacity in general, resultant disability, social isolation, and depression. Of course, this is not a one-to-one equation; you will not necessarily become depressed the moment your muscle mass is below a certain percentage, but statistically speaking, the road to ruin is laid out clearly.

    Secondly, she recommends being on the lookout for it. If you check your body composition regularly with a gadget, that’s great and laudable; if you don’t, then a) consider getting one (here’s an example product on Amazon), and b) watch out for decreased muscle strength, fatigue, reduced stamina, noticeable body shape changes with muscle loss and (likely) fat gain.

    Thirdly, she recommends more than just regular resistance training and good protein intake. Yes, she recommends those things too, but also getting enough water (can’t rebuild the body without it), avoiding a sedentary lifestyle (sitting leads to atrophy of many supporting and stabilizing muscles, you know, the kind of muscles that don’t look flashy but stop you falling down), and getting good sleep—vital for all kinds of body maintenance, and muscle maintenance is no exception (there’s a reason bodybuilders sleep 9–12 hours daily when in a gaining phase; you don’t need to do that, but don’t skimp on your 7–9 hours, yes, really, even you, yes, at any age).

    Lastly, she recommends continuing to learn about the topic, as otherwise it’s easy to go off-track.

    For more information on all of the above and more, enjoy:

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  • The Evidence-Based Skincare That Beats Product-Specific Hype

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    A million videos on YouTube will try to sell you a 17-step skincare routine, or a 1-ingredient magical fix that’s messy and inconvenient enough you’ll do it once and then discard it. This one takes a simple, scientific approach instead.

    The Basics That Count

    Ali Abdaal, known for his productivity hacks channel, enlisted the help of his friend, dermatologist Dr. Usama Syed, who recommends the following 3–4 things:

    1. Moisturize twice per day. Skin acts as a barrier, locking in moisture and protecting against irritants. Moisturizers replenish fats and proteins, maintaining this barrier and preventing dry, inflamed, and itchy skin. He uses CeraVe, but if you have one you know works well with your skin, stick with that, because skin comes in many varieties and yours might not be like his.
    2. Use sunscreen every day. Your phone’s weather app should comment on your local UV index. If it’s “moderate” or above, then sunscreen is a must—even if you aren’t someone who burns easily at all, the critical thing here is avoiding UV radiation causing DNA mutations in skin cells, leading to wrinkles, dark spots, and potentially skin cancer. Use a broad-spectrum sunscreen, ideally SPF 50.
    3. Use a retinoid. Retinoids are vitamin A-based and offer anti-aging benefits by promoting collagen growth, reducing pigmentation, and accelerating skin cell regeneration. Retinols are weaker, over-the-counter options, while stronger retinoids may require a prescription. Start gently with low dosage, whatever you choose, as initially they can cause dryness or sensitivity, before making everything better. He recommends adapalene as a starter retinoid (such as Differen gel, to give an example brand name).
    4. Optional: use a cleanser. Cleansers remove oils and dirt that water alone can’t. He recommends using a hydrating cleanser, to avoid stripping natural healthy oils as well as unwanted ones. That said, a cleanser is probably only beneficial if your skin tends towards the oily end of the dry-to-oily spectrum.

    For more on all of these, plus an example routine, enjoy:

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    Who Screens The Sunscreens?

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  • Taurine: An Anti-Aging Powerhouse? Exploring Its Unexpected Benefits

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    Dr. Mark Rosenberg explains:

    Not a stimulant, but…

    • Its presence in energy drinks often causes people to assume it’s a stimulant, but it’s not. In fact, it’s a GABA-agonist, thus having a calming effect.
    • The real reason it’s in energy drinks is because it helps increase mitochondrial ATP production (ATP = adenosine triphosphate = how cells store energy that’s ready to use; mitochondria take glucose and make ATP)
    • Taurine is also anti-inflammatory, antioxidant, and anticancer.
    • In the category of aging, human studies are slow to give results for obvious reasons, but mouse studies show that supplementing taurine in middle-aged mice increased their lifespan by 10–12%, as well as improving various physiological markers of aging.
    • Taking a closer look at aging—literally; looking at cellular aging—taurine reduces cellular senescence and protects telomeres, thus decreasing DNA mutations.

    For more on the science of these, plus Dr. Rosenberg’s personal experience, enjoy:

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  • Pumpkin Seeds vs Watermelon Seeds – Which is Healthier?

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    Our Verdict

    When comparing pumpkin seeds to watermelon seeds, we picked the watermelon.

    Why?

    Starting with the macros: pumpkin seeds have a lot more carbs, while watermelon seeds have a lot more protein, despite pumpkin seeds being famous for such. They’re about equal on fiber. In terms of fats, watermelon seeds are higher in fats, and yes, these are healthy fats, mostly polyunsaturated.

    When it comes to vitamins, pumpkin seeds are marginally higher in vitamins A and C, while watermelon seeds are a lot higher in vitamins B1, B2, B3, B5, B6, and B9. An easy win for watermelon seeds here.

    In the category of minerals, despite being famous for zinc, pumpkin seeds are higher only in potassium, while watermelon seeds are higher in iron, magnesium, manganese, and phosphorus; the two seeds are equal on calcium, copper, and zinc. Another win for watermelon seeds.

    In short, enjoy both, but watermelon has more to offer. Of course, if buying just the seeds and not the whole fruit, it’s generally easier to find pumpkin seeds than watermelon seeds, so do bear in mind that pumpkin seeds’ second place isn’t that bad here—it’s just a case of a very nutritious food looking bad by standing next to an even better one.

    Want to learn more?

    You might like to read:

    Seed Saving Secrets – by Alice Mirren

    Take care!

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  • A person in Texas caught bird flu after mixing with dairy cattle. Should we be worried?

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    The United States’ Centers for Disease Control and Prevention (CDC) has issued a health alert after the first case of H5N1 avian influenza, or bird flu, seemingly spread from a cow to a human.

    A farm worker in Texas contracted the virus amid an outbreak in dairy cattle. This is the second human case in the US; a poultry worker tested positive in Colorado in 2022.

    The virus strain identified in the Texan farm worker is not readily transmissible between humans and therefore not a pandemic threat. But it’s a significant development nonetheless.

    Some background on bird flu

    There are two types of avian influenza: highly pathogenic or low pathogenic, based on the level of disease the strain causes in birds. H5N1 is a highly pathogenic avian influenza.

    H5N1 first emerged in 1997 in Hong Kong and then China in 2003, spreading through wild bird migration and poultry trading. It has caused periodic epidemics in poultry farms, with occasional human cases.

    Influenza A viruses such as H5N1 are further divided into variants, called clades. The unique variant causing the current epidemic is H5N1 clade 2.3.4.4b, which emerged in late 2020 and is now widespread globally, especially in the Americas.

    In the past, outbreaks could be controlled by culling of infected birds, and H5N1 would die down for a while. But this has become increasingly difficult due to escalating outbreaks since 2021.

    Wild animals are now in the mix

    Waterfowl (ducks, swans and geese) are the main global spreaders of avian flu, as they migrate across the world via specific routes that bypass Australia. The main hub for waterfowl to migrate around the world is Quinghai lake in China.

    But there’s been an increasing number of infected non-waterfowl birds, such as true thrushes and raptors, which use different flyways. Worryingly, the infection has spread to Antarctica too, which means Australia is now at risk from different bird species which fly here.

    H5N1 has escalated in an unprecedented fashion since 2021, and an increasing number of mammals including sea lions, goats, red foxes, coyotes, even domestic dogs and cats have become infected around the world.

    Wild animals like red foxes which live in peri-urban areas are a possible new route of spread to farms, domestic pets and humans.

    Dairy cows and goats have now become infected with H5N1 in at least 17 farms across seven US states.

    What are the symptoms?

    Globally, there have been 14 cases of H5N1 clade 2.3.4.4b virus in humans, and 889 H5N1 human cases overall since 2003.

    Previous human cases have presented with a severe respiratory illness, but H5N1 2.3.4.4b is causing illness affecting other organs too, like the brain, eyes and liver.

    For example, more recent cases have developed neurological complications including seizures, organ failure and stroke. It’s been estimated that around half of people infected with H5N1 will die.

    The case in the Texan farm worker appears to be mild. This person presented with conjunctivitis, which is unusual.

    Food safety

    Contact with sick poultry is a key risk factor for human infection. Likewise, the farm worker in Texas was likely in close contact with the infected cattle.

    The CDC advises pasteurised milk and well cooked eggs are safe. However, handling of infected meat or eggs in the process of cooking, or drinking unpasteurised milk, may pose a risk.

    Although there’s no H5N1 in Australian poultry or cattle, hygienic food practices are always a good idea, as raw milk or poorly cooked meat, eggs or poultry can be contaminated with microbes such as salmonella and E Coli.

    If it’s not a pandemic, why are we worried?

    Scientists have feared avian influenza may cause a pandemic since about 2005. Avian flu viruses don’t easily spread in humans. But if an avian virus mutates to spread in humans, it can cause a pandemic.

    One concern is if birds were to infect an animal like a pig, this acts as a genetic mixing vessel. In areas where humans and livestock exist in close proximity, for example farms, markets or even in homes with backyard poultry, the probability of bird and human flu strains mixing and mutating to cause a new pandemic strain is higher.

    A visual depicting potential pathways to a novel pandemic influenza virus.
    There are a number of potential pathways to a pandemic caused by influenza. Author provided

    The cows infected in Texas were tested because farmers noticed they were producing less milk. If beef cattle are similarly affected, it may not be as easily identified, and the economic loss to farmers may be a disincentive to test or report infections.

    How can we prevent a pandemic?

    For now there is no spread of H5N1 between humans, so there’s no immediate risk of a pandemic.

    However, we now have unprecedented and persistent infection with H5N1 clade 2.3.4.4b in farms, wild animals and a wider range of wild birds than ever before, creating more chances for H5N1 to mutate and cause a pandemic.

    Unlike the previous epidemiology of avian flu, where hot spots were in Asia, the new hot spots (and likely sites of emergence of a pandemic) are in the Americas, Europe or in Africa.

    Pandemics grow exponentially, so early warnings for animal and human outbreaks are crucial. We can monitor infections using surveillance tools such as our EPIWATCH platform.

    The earlier epidemics can be detected, the better the chance of stamping them out and rapidly developing vaccines.

    Although there is a vaccine for birds, it has been largely avoided until recently because it’s only partially effective and can mask outbreaks. But it’s no longer feasible to control an outbreak by culling infected birds, so some countries like France began vaccinating poultry in 2023.

    For humans, seasonal flu vaccines may provide a small amount of cross-protection, but for the best protection, vaccines need to be matched exactly to the pandemic strain, and this takes time. The 2009 flu pandemic started in May in Australia, but the vaccines were available in September, after the pandemic peak.

    To reduce the risk of a pandemic, we must identify how H5N1 is spreading to so many mammalian species, what new wild bird pathways pose a risk, and monitor for early signs of outbreaks and illness in animals, birds and humans. Economic compensation for farmers is also crucial to ensure we detect all outbreaks and avoid compromising the food supply.

    C Raina MacIntyre, Professor of Global Biosecurity, NHMRC L3 Research Fellow, Head, Biosecurity Program, Kirby Institute, UNSW Sydney; Ashley Quigley, Senior Research Associate, Global Biosecurity, UNSW Sydney; Haley Stone, PhD Candidate, Biosecurity Program, Kirby Institute, UNSW Sydney; Matthew Scotch, Associate Dean of Research and Professor of Biomedical Informatics, College of Health Solutions, Arizona State University, and Rebecca Dawson, Research Associate, The Kirby Institute, UNSW Sydney

    This article is republished from The Conversation under a Creative Commons license. Read the original article.

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  • These Top Few Things Make The Biggest Difference To Health

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    The Best Few Interventions For The Best Health

    Writer’s note: I was going to do something completely different for today (so that can go out another week now), but when reflecting on my own “what should I focus on in the new year?” (in terms of my own personal health goals and such) it occured to me that I should look back on the year’s articles, to take our own advice myself, and see what most important things I should make sure to focus on.

    In so doing for myself, it occured to me that you, our subscribers who like condensed information and simple interventions for big positive effects, might also find value in a similar once-over. And so, today’s main feature was born!

    Sometimes at 10almonds we talk about “those five things that affect everything”. They are:

    1. Good diet
    2. Good exercise
    3. Good sleep
    4. Not drinking
    5. Not smoking

    If we were to add a sixth in terms of things that make a huge difference, it would be “manage stress effectively” and a seventh, beyond the scope of our newsletter, would be “don’t be socioeconomically disadvantaged” (e.g. poor, and/or part of some disprivileged minority group).

    But as for those five we listed, it still leaves the question: what are the few most effective things we can do to improve them? Where can we invest our time/energy/effort for greatest effect?

    Good diet

    Best current science consistently recommends the Mediterranean Diet:

    The Mediterranean Diet: What Is It Good For?

    But it can be tweaked for specific desired health considerations:

    Four Ways To Upgrade The Mediterranean Diet

    Other most-effective dietary tweaks that impact a lot of other areas of health include looking after your gut health and looking after your blood sugars:

    Making Friends With Your Gut (You Can Thank Us Later)

    and

    “Let Them Eat Cake”, She Said (10 Ways To Balance Blood Sugars)

    Good exercise

    Most exercise is good, but two of the most beneficial things that are (for most people) easy to implement are walking, and High-Intensity Interval Training:

    How To Do HIIT (Without Wrecking Your Body)

    Good sleep

    This means quality and quantity! We cannot skimp on either and expect good health:

    Why You Probably Need More Sleep

    and as for quality,

    The Head-To-Head Of Google and Apple’s Top Apps For Getting Your Head Down

    Not drinking

    According to the World Health Organization, the only safe amount of alcohol is zero.

    See also:

    Can We Drink To Good Health? (e.g. Red Wine & Heart Health)

    and

    How To Reduce Or Quit Alcohol

    Not smoking

    We haven’t done a main feature on this! It’s probably not really necessary, as it’s not very contentious to say “smoking is bad for everything”.

    WHO | Tobacco kills up to half its users who don’t quit

    However, as a side-note, while cannabis is generally recognised as not as harmful as tobacco-based products, it has some fairly major drawbacks too. For some people, the benefits (e.g. pain relief) may outweigh the risks, though:

    Cannabis Myths vs Reality

    Final thoughts

    Not sure where to start? We suggest this order of priorities, unless you have a major health condition that makes something else a higher priority:

    1. If you smoke, stop
    2. If you drink, reduce, or ideally stop
    3. Improve your diet

    About that diet…

    When it comes to exercise, get your 10,000 daily steps in (actually, science says 8,000 steps is fine), and consider adding HIIT per our above article, when you feel like adding that in. As for that about the steps:

    Meta-analysis of 15 studies reports new findings on how many daily walking steps needed for longevity benefit

    When it comes to sleep, if you’re taking care of the above things, and set a regular early wake-up time that you do not deviate from, then this will probably take care of itself, if you don’t have a sleep-inconvenient lifestyle (e.g. shift work, just had a baby, etc) or a sleep disorder.

    For further pointers, see: 10 Tips for Better Sleep: Starting In The Morning

    Take care!

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