Top 10 Causes Of High Blood Pressure
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As Dr. Frita Fisher explains, these are actually the top 10 known causes of high blood pressure. Number zero on the list would be “primary hypertension”, which means high blood pressure with no clear underlying cause.
Superficially, this feels a little like the sometime practice of writing the catch-all “heart failure” as the cause of death on a death certificate, because yes, that heart sure did stop beating. But in reality, primary hypertension is most likely often caused by such things as unmanaged chronic stress—something that doesn’t show up on most health screenings.
Dr. Fisher’s Top 10
- Thyroid disease: both hyperthyroidism and hypothyroidism can cause high blood pressure.
- Obstructive sleep apnea: characterized by snoring, daytime sleepiness, and headaches, this condition can lead to hypertension.
- Chronic kidney disease: diseases ranging from diabetic nephropathy to renal vascular disease can cause high blood pressure.
- Elevated cortisol levels: conditions like Cushing’s syndrome or disease, which involve high cortisol levels, can lead to hypertension—as can a lifestyle with a lot of chronic stress, but that’s less readily diagnosed as such than something one can tell from a blood test.
- Elevated aldosterone levels: excess aldosterone from the adrenal glands causes the body to retain salt and water, increasing blood pressure, because more stuff = more pressure.
- Brain tumor: tumors that increase intracranial pressure can cause a rise in blood pressure to ensure adequate brain perfusion. In these cases, the hypertension is keeping you alive—unless it kills you first. If this seems like a strange bodily response, remember that our bodily response to an infection is often fever, to kill off the infection which can’t survive at such high temperatures (but neither can we, so it becomes a game of chicken with our life on the line), so sometimes our body does kill us with one thing while trying to save us from another.
- Coarctation of the aorta: this congenital heart defect results in narrowing of the aorta, leading to hypertension, especially in the upper body.
- Pregnancy: pregnancy can either induce or worsen existing hypertension.
- Obesity: excess weight increases blood flow and pressure on arteries, raising the risk of hypertension and associated conditions, e.g. diabetes etc.
- Drugs: certain medications and recreational drugs (including, counterintuitively, alcohol!) can elevate blood pressure.
For more information on each of these, enjoy:
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Want to learn more?
You might also like to read:
Hypertension: Factors Far More Relevant Than Salt
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Why ’10almonds’? Newsletter Name Explained
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It’s Q&A Day!
Each Thursday, we respond to subscriber questions and requests! If it’s something small, we’ll answer it directly; if it’s something bigger, we’ll do a main feature in a follow-up day instead!
So, no question/request to big or small; they’ll just get sorted accordingly
Remember, you can always hit reply to any of our emails, or use the handy feedback widget at the bottom. We always look forward to hearing from you!
Q: Why is your newsletter called 10almonds? Maybe I missed it in the intro email, but my curiosity wants to know the significance. Thanks!”
It’s a reference to a viral Facebook hoax! There was a post going around that claimed:
❝HEADACHE REMEDY. Eat 10–12 almonds, the equivalent of two aspirins, next time you have a headache❞ ← not true!
It made us think about how much health-related disinformation there was online… So, calling ourselves 10almonds was a bit of a tongue-in-cheek reference to that story… but also a reminder to ourselves:
We must always publish information with good scientific evidence behind it!
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The first pig kidney has been transplanted into a living person. But we’re still a long way from solving organ shortages
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In a world first, we heard last week that US surgeons had transplanted a kidney from a gene-edited pig into a living human. News reports said the procedure was a breakthrough in xenotransplantation – when an organ, cells or tissues are transplanted from one species to another. https://www.youtube.com/embed/cisOFfBPZk0?wmode=transparent&start=0 The world’s first transplant of a gene-edited pig kidney into a live human was announced last week.
Champions of xenotransplantation regard it as the solution to organ shortages across the world. In December 2023, 1,445 people in Australia were on the waiting list for donor kidneys. In the United States, more than 89,000 are waiting for kidneys.
One biotech CEO says gene-edited pigs promise “an unlimited supply of transplantable organs”.
Not, everyone, though, is convinced transplanting animal organs into humans is really the answer to organ shortages, or even if it’s right to use organs from other animals this way.
There are two critical barriers to the procedure’s success: organ rejection and the transmission of animal viruses to recipients.
But in the past decade, a new platform and technique known as CRISPR/Cas9 – often shortened to CRISPR – has promised to mitigate these issues.
What is CRISPR?
CRISPR gene editing takes advantage of a system already found in nature. CRISPR’s “genetic scissors” evolved in bacteria and other microbes to help them fend off viruses. Their cellular machinery allows them to integrate and ultimately destroy viral DNA by cutting it.
In 2012, two teams of scientists discovered how to harness this bacterial immune system. This is made up of repeating arrays of DNA and associated proteins, known as “Cas” (CRISPR-associated) proteins.
When they used a particular Cas protein (Cas9) with a “guide RNA” made up of a singular molecule, they found they could program the CRISPR/Cas9 complex to break and repair DNA at precise locations as they desired. The system could even “knock in” new genes at the repair site.
In 2020, the two scientists leading these teams were awarded a Nobel prize for their work.
In the case of the latest xenotransplantation, CRISPR technology was used to edit 69 genes in the donor pig to inactivate viral genes, “humanise” the pig with human genes, and knock out harmful pig genes. https://www.youtube.com/embed/UKbrwPL3wXE?wmode=transparent&start=0 How does CRISPR work?
A busy time for gene-edited xenotransplantation
While CRISPR editing has brought new hope to the possibility of xenotransplantation, even recent trials show great caution is still warranted.
In 2022 and 2023, two patients with terminal heart diseases, who were ineligible for traditional heart transplants, were granted regulatory permission to receive a gene-edited pig heart. These pig hearts had ten genome edits to make them more suitable for transplanting into humans. However, both patients died within several weeks of the procedures.
Earlier this month, we heard a team of surgeons in China transplanted a gene-edited pig liver into a clinically dead man (with family consent). The liver functioned well up until the ten-day limit of the trial.
How is this latest example different?
The gene-edited pig kidney was transplanted into a relatively young, living, legally competent and consenting adult.
The total number of gene edits edits made to the donor pig is very high. The researchers report making 69 edits to inactivate viral genes, “humanise” the pig with human genes, and to knockout harmful pig genes.
Clearly, the race to transform these organs into viable products for transplantation is ramping up.
From biotech dream to clinical reality
Only a few months ago, CRISPR gene editing made its debut in mainstream medicine.
In November, drug regulators in the United Kingdom and US approved the world’s first CRISPR-based genome-editing therapy for human use – a treatment for life-threatening forms of sickle-cell disease.
The treatment, known as Casgevy, uses CRISPR/Cas-9 to edit the patient’s own blood (bone-marrow) stem cells. By disrupting the unhealthy gene that gives red blood cells their “sickle” shape, the aim is to produce red blood cells with a healthy spherical shape.
Although the treatment uses the patient’s own cells, the same underlying principle applies to recent clinical xenotransplants: unsuitable cellular materials may be edited to make them therapeutically beneficial in the patient.
CRISPR technology is aiming to restore diseased red blood cells to their healthy round shape. Sebastian Kaulitzki/Shutterstock We’ll be talking more about gene-editing
Medicine and gene technology regulators are increasingly asked to approve new experimental trials using gene editing and CRISPR.
However, neither xenotransplantation nor the therapeutic applications of this technology lead to changes to the genome that can be inherited.
For this to occur, CRISPR edits would need to be applied to the cells at the earliest stages of their life, such as to early-stage embryonic cells in vitro (in the lab).
In Australia, intentionally creating heritable alterations to the human genome is a criminal offence carrying 15 years’ imprisonment.
No jurisdiction in the world has laws that expressly permits heritable human genome editing. However, some countries lack specific regulations about the procedure.
Is this the future?
Even without creating inheritable gene changes, however, xenotransplantation using CRISPR is in its infancy.
For all the promise of the headlines, there is not yet one example of a stable xenotransplantation in a living human lasting beyond seven months.
While authorisation for this recent US transplant has been granted under the so-called “compassionate use” exemption, conventional clinical trials of pig-human xenotransplantation have yet to commence.
But the prospect of such trials would likely require significant improvements in current outcomes to gain regulatory approval in the US or elsewhere.
By the same token, regulatory approval of any “off-the-shelf” xenotransplantation organs, including gene-edited kidneys, would seem some way off.
Christopher Rudge, Law lecturer, University of Sydney
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Could the shingles vaccine lower your risk of dementia?
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A recent study has suggested Shingrix, a relatively new vaccine given to protect older adults against shingles, may delay the onset of dementia.
This might seem like a bizarre link, but actually, research has previously shown an older version of the shingles vaccine, Zostavax, reduced the risk of dementia.
In this new study, published last week in the journal Nature Medicine, researchers from the United Kingdom found Shingrix delayed dementia onset by 17% compared with Zostavax.
So how did the researchers work this out, and how could a shingles vaccine affect dementia risk?
Melinda Nagy/Shutterstock From Zostavax to Shingrix
Shingles is a viral infection caused by the varicella-zoster virus. It causes painful rashes, and affects older people in particular.
Previously, Zostavax was used to vaccinate against shingles. It was administered as a single shot and provided good protection for about five years.
Shingrix has been developed based on a newer vaccine technology, and is thought to offer stronger and longer-lasting protection. Given in two doses, it’s now the preferred option for shingles vaccination in Australia and elsewhere.
In November 2023, Shingrix replaced Zostavax on the National Immunisation Program, making it available for free to those at highest risk of complications from shingles. This includes all adults aged 65 and over, First Nations people aged 50 and older, and younger adults with certain medical conditions that affect their immune systems.
What the study found
Shingrix was approved by the US Food and Drugs Administration in October 2017. The researchers in the new study used the transition from Zostavax to Shingrix in the United States as an opportunity for research.
They selected 103,837 people who received Zostavax (between October 2014 and September 2017) and compared them with 103,837 people who received Shingrix (between November 2017 and October 2020).
By analysing data from electronic health records, they found people who received Shingrix had a 17% increase in “diagnosis-free time” during the follow-up period (up to six years after vaccination) compared with those who received Zostavax. This was equivalent to an average of 164 extra days without a dementia diagnosis.
The researchers also compared the shingles vaccines to other vaccines: influenza, and a combined vaccine for tetanus, diphtheria and pertussis. Shingrix and Zostavax performed around 14–27% better in lowering the risk of a dementia diagnosis, with Shingrix associated with a greater improvement.
The benefits of Shingrix in terms of dementia risk were significant for both sexes, but more pronounced for women. This is not entirely surprising, because we know women have a higher risk of developing dementia due to interplay of biological factors. These include being more sensitive to certain genetic mutations associated with dementia and hormonal differences.
Why the link?
The idea that vaccination against viral infection can lower the risk of dementia has been around for more than two decades. Associations have been observed between vaccines, such as those for diphtheria, tetanus, polio and influenza, and subsequent dementia risk.
Research has shown Zostavax vaccination can reduce the risk of developing dementia by 20% compared with people who are unvaccinated.
But it may not be that the vaccines themselves protect against dementia. Rather, it may be the resulting lack of viral infection creating this effect. Research indicates bacterial infections in the gut, as well as viral infections, are associated with a higher risk of dementia.
Notably, untreated infections with herpes simplex (herpes) virus – closely related to the varicella-zoster virus that causes shingles – can significantly increase the risk of developing dementia. Research has also shown shingles increases the risk of a later dementia diagnosis.
This isn’t the first time research has suggested a vaccine could reduce dementia risk. ben bryant/Shutterstock The mechanism is not entirely clear. But there are two potential pathways which may help us understand why infections could increase the risk of dementia.
First, certain molecules are produced when a baby is developing in the womb to help with the body’s development. These molecules have the potential to cause inflammation and accelerate ageing, so the production of these molecules is silenced around birth. However, viral infections such as shingles can reactivate the production of these molecules in adult life which could hypothetically lead to dementia.
Second, in Alzheimer’s disease, a specific protein called Amyloid-β go rogue and kill brain cells. Certain proteins produced by viruses such as COVID and bad gut bacteria have the potential to support Amyloid-β in its toxic form. In laboratory conditions, these proteins have been shown to accelerate the onset of dementia.
What does this all mean?
With an ageing population, the burden of dementia is only likely to become greater in the years to come. There’s a lot more we have to learn about the causes of the disease and what we can potentially do to prevent and treat it.
This new study has some limitations. For example, time without a diagnosis doesn’t necessarily mean time without disease. Some people may have underlying disease with delayed diagnosis.
This research indicates Shingrix could have a silent benefit, but it’s too early to suggest we can use antiviral vaccines to prevent dementia.
Overall, we need more research exploring in greater detail how infections are linked with dementia. This will help us understand the root causes of dementia and design potential therapies.
Ibrahim Javed, Enterprise and NHMRC Emerging Leadership Fellow, UniSA Clinical & Health Sciences, University of South Australia
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Heart Attack: His & Hers (Be Prepared!)
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Heart attack symptoms vary by sex. This is governed by hormones, so if you are for example a postmenopausal woman and not on HRT, your symptoms might be nearer that of men.
The following symptom list is intended as a rough “most likely” guide. You may not get all of the symptoms you “should”. You could get symptoms from the “wrong” category. So don’t sweat the minutiae, but do be aware of…
Symptoms for everyone:
- Jaw, neck, and/or back pain
- Nausea and/or vomiting
- Shortness of breath
- Feeling of impending doom ← heart attack survivors assure us that you’ll know this one if you experience it
Additional symptoms (mostly) just for men:
- Pressure and/or pain in the upper chest
- Discomfort and/or tingling in the arms
- Sudden cold sweat
Additional symptoms (mostly) just for women:
- Pressure and/or pain in the lower chest and/or abdomen
- Feeling of fullness and/or indigestion
- Fatigue, dizziness, possibly fainting
In the event of experiencing symptoms…
Call 911 or your local equivalent.This is not the time to wait to see if it goes away by itself. If unsure, call. Better safe than sorry/dead.
If you are not alone, or if it is someone with you who is having the suspected heart attack, it may be quicker to go to the Emergency Room by car, than wait for an ambulance.
Even if you choose to do that, you should still call 911 anyway, as the responder will be able to instruct you in real-time, not something we can do in a newsletter.
Note that if available, this means three people in the car is ideal:
Driver, patient, and third person on the phone giving information and following instructions.
Emergency situations rarely go entirely by-the-book, but with a little foreknowledge and at least one person with a calm head, preventable deaths can be avoided.
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Hormone Replacement
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It’s Q&A Day at 10almonds!
Have a question or a request? You can always hit “reply” to any of our emails, or use the feedback widget at the bottom!
In cases where we’ve already covered something, we might link to what we wrote before, but will always be happy to revisit any of our topics again in the future too—there’s always more to say!
As ever: if the question/request can be answered briefly, we’ll do it here in our Q&A Thursday edition. If not, we’ll make a main feature of it shortly afterwards!
So, no question/request too big or small
❝I cant believe 10 Almonds addresses questions. Thanks. I see the word symptoms for menopause. I don’t know what word should replace it but maybe one should be used or is symptom accurate? And I recently read that there was a great disservice for women in my era as they were denied/scared of hormones replacement. Unnecessarily❞
You’d better believe it! In fact we love questions; they give us things to research and write about.
“Symptom” is indeed an entirely justified word to use, being:
- General: any phenomenon or circumstance accompanying something and serving as evidence of it.
- Medical: any phenomenon that arises from and accompanies a particular disease or disorder and serves as an indication of it.
If the question is more whether the menopause can be considered a disease/disorder, well, it’s a naturally occurring and ultimately inevitable change, yes, but then, so is cancer (it’s in the simple mathematics of DNA replication and mutation that, unless a cure for cancer is found, we will always eventually get cancer, if nothing else kills us first).
So, something being natural/inevitable isn’t a reason to not consider it a disease/disorder, nor a reason to not treat it as appropriate if it is causing us harm/discomfort that can be safely alleviated.
Moreover, and semantics aside, it is medical convention to consider menopause to be a medical condition, that has symptoms. Indeed, for example, the US’s NIH (and its constituent NIA, the National Institute of Aging) and the UK’s NHS, both list the menopause’s symptoms, using that word:
- NIA (NIH): What are the signs and symptoms of menopause?
- NHS: Common symptoms of menopause and perimenopause
With regard to fearmongering around HRT, certainly that has been rife, and there were some very flawed (and later soundly refuted) studies a while back that prompted this—and even those flawed studies were not about the same (bioidentical) hormones available today, in any case. So even if they had been correct (they weren’t), it still wouldn’t be a reason to not get treatment nowadays, if appropriate!
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Healthy Homemade Flatbreads
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Our recipes sometimes call for the use of flatbreads, or suggest serving with flatbreads. But we want you to be able to have healthy homemade ones! So here’s a very quick and easy recipe. You’ll probably need to order some of the ingredients in, but it’s worth it, and then if you keep a stock of the ingredients, you can whip these up in minutes anytime you want them.
You will need
- 1 cup garbanzo bean flour, plus more for dusting
- 1 cup quinoa flour
- 2 tbsp ground/milled flaxseed
- 1 tbsp baking powder
- 1 tbsp extra virgin olive oil, plus more for the pan
- ½ tsp MSG, or 1 tsp low-sodium salt, with MSG being the healthier and preferable option
- ½ tsp onion powder
- ½ tsp garlic powder
- ½ tsp dried cumin
- ½ tsp dried thyme
Method
(we suggest you read everything at least once before doing anything)
1) Mix the flaxseed with ⅓ cup of water and set aside for at least 5 minutes.
2) Combine the rest of the ingredients in a big bowl, plus the flax mixtures we just made, and an extra ½ cup of water. Knead this into a dough, adding a touch more water if it becomes necessary, but be sparing with it.
3) Divide the dough into 6 equal portions, shaping each into a ball. Dust a clean surface with the extra garbanzo bean flour, and roll each dough ball into in a thin 6″ circle.
4) Heat a skillet and add some olive oil for frying; when hot enough, place a dough disk in the pan and cook for a few minutes on each side until golden brown. Repeat with the other 5.
5) Serve! If you’re looking for a perfect accompaniment to these, try our Hero Homemade Hummus
Enjoy!
Want to learn more?
For those interested in some of the science of what we have going on today:
Take care!
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