DrMirkin's eZine: Sitting, controlling high blood pressure, more . . .
Published: Thu, 08/15/24
Updated: Fri, 08/16/24
August 15, 2024
Having a job that requires prolonged sitting is likely to be associated with Increased heart attack and premature death risks unless you also exercise. A study involving 481,688 people followed for an average 12 years found that those who had jobs that required prolonged sitting had a 16 percent higher risk for death and a 34 percent increased risk for death from heart attacks, compared to those who had jobs that required them to move actively about. To reduce their risk for premature death to those who do not have jobs that require prolonged sitting, they needed to move actively for at least 15 to 30 minutes per day (JAMA Network Open, 2024;7(1):e2350680).
Another study of nearly 12,000 people ages 50 years or older found that those who sat 12 or more hours a day had a 38 percent higher risk of death than those who sat eight hours a day. Just 10 minutes of moderate exercise reduced the risk of death by 35 percent, and exercising for 22 minutes or more completely eliminated their increased risk (British Journal of Sports, October 2023).
Prolonged Sitting Has Not Been Shown to Shorten Lives of Vigorous Exercisers
Extensive data show that for the average person, increased sitting time is associated with an earlier death. However, extra sitting time does not increase risks for exercisers who get Z-line muscle fiber damage that takes extra time to heal. Vigorous exercisers and competitive athletes recover faster for their next workout if they lie or sit down after their intense workouts. To make muscles stronger, they need to exercise intensely enough to damage the muscles. You can tell that you are
damaging muscles when you exercise vigorously enough to feel soreness in those muscles 8 to 24 hours later, which is called Delayed Onset Muscle Soreness or DOMS (Strength & Conditioning Journal, October 2013;35(5):16–21).
Another study followed 5836 adults, average age 56, and found that people in a group that exercised more and sat less were 47 percent less likely to die in 14 years than those in the group that exercised less and sat more (Amer J of Prev Med, July 23, 2024:S0749-3797(24)00254-X).
A review of 16 major studies found that just thirty minutes a week of strength training is associated with up to a 20 percent reduced risk for dying from any cause, or from cancer, heart disease or diabetes. Adding aerobic exercise reduced risk for dying by 40 percent (British J of Sports Medicine, June 16, 2022;56(13):755-763).
Lack of Exercise is Worse Than Prolonged Sitting
Sitting Will Not Harm Vigorous Exercisers
My Recommendations
If you have a job that requires that you sit for long periods of time, you should have some program in which you get up and move about and also have a moderate exercise program. Otherwise you may be at increased risk for a heart attack and premature death. If you do not want to have a regular exercise program, you can help to protect yourself just by getting up every half hour or so and moving about.
One of every two North American adults has high blood pressure, and only 40 percent of those taking medications have their hypertension well-controlled (Int J Cardiol Hypertens, July 31, 2020;6:100044). It is established that high blood pressure markedly increases a person’s chances for heart attacks, strokes, kidney damage, dementia and premature death. Ideally, blood pressure should be below 120/80 (JAMA, 2019;321(6):553-561). However, high blood pressure treatment often requires more than three drugs and significant side effects can come from getting high systolic blood pressure down to 120 mg Hg, so at this time most doctors treat high systolic blood pressure down only to below 140 or 130 mm Hg.
This month, a study reported on 11,255 patients, average age 65, with high blood pressure and at high risk for heart attacks from 116 hospitals in China (Lancet, July 20, 2024;404(10449):245-255). The goal was to find out whether intensive treatment aimed at a systolic blood pressure below 120 mg Hg was more effective than a target of 140 mg Hg in preventing heart attacks
, revascularization surgery or hospitalization for heart failure, stroke, or death from cardiovascular
causes. After 3.4 years, the authors found that:
• The intensive blood pressure control group had fewer serious life-threatening complications of high blood pressure. They had a 12 percent lower incidence of heart attacks and a 39 percent lower incidence of deaths from heart attacks.
• Both groups had the same rate of serious side effects of treatment with the drugs used to treat high blood pressure: dizziness, electrolyte abnormalities, injurious falls, or acute kidney injuries.
Controversy Over Treating to 120 Rather Than 140 mm Hg
The American Academy of Family Physicians (AAFP) recommends that you get your systolic blood pressure below 140/90 mm Hg (Am Fam Physician, Nov 10, 2022;106(6):721-722). They cite literature showing that taking medication to reduce blood pressure below 140 mm Hg did not further reduce your chances of dying overall or from heart disease, even though it did lead to a 16 percent reduction in heart attacks. The AAFP guidelines apply to adults with high blood pressure with and without heart
disease. To reduce high blood pressure from 140/90 to 120/80, a person often has to take at least three medications. See Aggressive Treatment of High Blood Pressure
Side Effects of Blood Pressure Drugs
Common side effects of blood pressure medications include:
Diuretics: frequent urination, weakness, leg cramps, fatigue, foot pain
Beta-Blockers: asthma, cold hands and feet, depression, erection problems, insomnia
Angiotensin Converting Enzyme Inhibitors (ACIs): cough, skin rash, loss of taste
Angiotensin II Receptor Blockers (ARBs): dizziness
Calcium Channel Blockers (CCBs): constipation, dizziness, headache, irregular or rapid heartbeat, swollen ankles
Alpha-Blockers: dizziness, lightheadedness, or weakness when standing up, rapid heart rate
Alpha-2 Receptor Agonists: sleepiness, dizziness
Alpha-Beta-Blockers: dizziness, weakness
Central Agonists: anemia, constipation, dizziness, drowsiness, dry mouth, impotence, fever
Peripheral Adrenergic Inhibitors: dizziness, erection problems, stomach burning, stuffy nose, nightmares
Vasodilators: excessive hair growth, swollen ankles, headaches, irregular heartbeat, joint pains
Renin Inhibitors: cough, diarrhea, stomach pain, skin rash
Lifestyle Changes to Lower Blood Pressure
You cannot cure high blood pressure with drugs, you can only control it as long as you continue to take the drugs (Hypertension, 2002;40(5):612-618). Most of the time, your blood pressure cannot be controlled with just one drug and most people end up with three or more drugs to treat their high blood pressure. However, some people are able to cure their high blood pressure just by making lifestyle changes. You should treat high blood pressure with lifestyle changes, whether or not you
are taking any of the blood pressure drugs.
• Eating a plant-based diet with lots of vegetables, whole grains, beans, nuts and fruits.
• Restricting mammal meat, processed meats, sugar-added foods and drinks, and fried foods.
• Limiting salt. Avoid the salt shaker and restrict processed foods because they often have added salt.
• Trying to get 7-8 hours of sleep every night.
• Trying to avoid habits and exposure to everything that increases cell damage such a smoke, alcohol, recreational drugs, herbicides, insecticides, air pollution and so forth.
• Exercising. Try to do aerobic and resistance exercise for at least 30 minutes daily. If you have heart-attack risk factors, check with your doctor first.
• Avoiding being overweight. If overweight, lose excess weight and try to restrict refined carbohydrates.
• Keeping blood levels of hydroxy vitamin D above 30 ng/mL
My Recommendations
If your average systolic blood pressure is over 130 or your average diastolic pressure is over 85, you should immediately make all of the lifestyle changes that will help to lower it. Your doctor may feel that you need medications to lower high blood pressure, but everyone can help to prevent and control high blood pressure with lifestyle changes, whether or not they are taking blood pressure medications.
Shannen Doherty was a television and film actress whose roles included Jenny Wilder in Little House on the Prairie (1982), Maggie Malene in Girls Just Want to Have Fun (1985); Kris Witherspoon in Our House (1986–1988), Brenda Walsh in Beverly Hills, 90210 (1990, 2008 and 2019), Prue Halliwell in Charmed (1998) and Dobbs in Fortress (2021). On July 13, 2024, at age 53, she died from breast cancer that had spread through her body.
During her years of acting, she had multiple health problems and many conflicts with the people with whom she worked and socialized. She had three unstable marriages that ended in divorce. In 1999, at age 28, she was diagnosed with Crohn’s disease, a chronic inflammatory bowel disease that causes terrible belly pain and diarrhea.
Crohn’s Disease May Affect How a Person Relates to Other People
In her twenties, Doherty began to suffer the symptoms of Crohn’s disease: watery or bloody diarrhea, fever, fatigue, loss of appetite, weight loss, anemia, nausea and vomiting. Crohn’s disease is thought to be caused by inflammation, when your own immune system mistakes your cells for those of an invading germ and produces cells and chemicals that attack and try to destroy your own cells. Read more
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