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Anchor lead: What can you do if you’ve just been told you have high blood pressure? Elizabeth Tracey reports

130 over 80. That’s the new guideline for defining high blood pressure, or hypertension, and it places many more people squarely into the group who have the condition. Does this mean you need to begin a medication right away? Not necessarily, says Michael Blaha, a cardiologist at Johns Hopkins.

Blaha: Importantly the new guidelines don’t suggest that all of these stage 1 hypertensives need to be on medical therapy. You can use diet and exercise and lifestyle therapy first for these patients. The guidelines recommend that those patients with stage one hypertension and elevated cardiovascular risk do start on medications. And really the main part of these guidelines is to raise awareness of the importance of elevated blood pressure and try to get patients earlier before they become extremely hypertensive. And to get those patients in to their doctor earlier to talk about potential medical therapy.  :33

Blaha notes that many people in this stage one category will be able to manage their blood pressure themselves by losing weight, changing their diet, and exercising more. At Johns Hopkins, I’m Elizabeth Tracey.

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Anchor lead: What do changes in high blood pressure guidelines mean for you? Elizabeth Tracey reports

If you have a blood pressure reading where the top number, the systolic number, is over 130, or the lower number, the diastolic number, is above 80, you are now officially in the group of people considered to have high blood pressure, or hypertension. Michael Blaha, a cardiologist at Johns Hopkins, describes the new guidelines.

Blaha: The biggest change in the new blood pressure guidelines is the definition of elevated blood pressure. Whereas in the past you had to have a systolic blood pressure of over 140 or a diastolic blood pressure above 90 to be considered to have elevated blood pressure, now stage one hypertension is considered anyone with two readings separated in time of above 130 systolic and 80 diastolic. This brings millions more American adults into the group who have hypertension.   :30

Blaha reiterates that high blood pressure is a known risk factor for strokes and heart attacks, so catching it early is crucial. At Johns Hopkins, I’m Elizabeth Tracey.

 

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Anchor lead: Should people with chest pain get stents placed in their heart? Elizabeth Tracey reports

People who have chest pain and are shown to have some blockage in their heart arteries are often treated with stents, a type of scaffold that helps keep the artery open. But now a new study shows that stents may not be that helpful. Michael Blaha, a cardiologist at Johns Hopkins, reviews the data.

Blaha: A recent study took patients with chest pain, took them to the cardiac catheterization laboratory, and in half the patients put in stents, and in half the patients did a sham procedure where no stents were placed. And remarkably, after two months there were no differences in the symptoms of chest pain between the group that got the stents and the group that got the sham procedure. This suggests that stents don’t necessarily relief symptoms in the short term, and it still stands to question in patients with stable coronary artery disease whether stents are always needed.  :32

Blaha says each person who is recommended to have stents should be individually evaluated to assess the suitability of the devices for their particular condition. At Johns Hopkins, I’m Elizabeth Tracey.

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Anchor lead: Should you worry about being infected with human papilloma virus? Elizabeth Tracey reports

Should people who are infected with human papilloma virus, or HPV, be worried about their risk of mouth and throat cancers, as a recent study reveals just how common infection is? No, says Carole Fahkry, a head and neck surgeon and HPV expert at Johns Hopkins.

Fahkry: Overall, levels of oral HPV infection are actually very low in the population. The behaviors which put individuals at risk for infection are exceedingly common, yet the infection is rare. And when you look at the cancer that’s associated with infection it’s even more rare, and so I don’t think that worry is justified necessarily. Most people are exposed, very few go on to get the infection, and even fewer go on to get cancer. Both boys and girls should be vaccinated, that way we can decrease exposure to infection for everyone. :33

Fahkry notes that vaccination should reduce both cervical cancers and head and neck cancers over time, and that smoking is also a well known risk factor for head and neck cancers that acts in addition to HPV to increase risk. At Johns Hopkins, I’m Elizabeth Tracey.

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Anchor lead: Just how common is human papilloma virus infection? Elizabeth Tracey reports

Human papilloma virus, abbreviated HPV, is known to cause cancer. Both cervical cancer in women and cancers of the mouth and throat in both sexes are most often related to HPV infection. Now a new study looks at just how prevalent the infection is. Carole Fahkry, an HPV expert at Johns Hopkins, describes the data.

Fahkry: What it really showed is that oral HPV infection is more common among men than women and that it increases with increasing sexual exposure. Among vaccinated men the rates of oral HPV are lower, than among unvaccinated individuals. They also showed that oral HPV infection increases in people who have genital HPV infection. They also showed which is somewhat novel, that among people who have same sex partners infection is increased.  :32

Fahkry notes that risk factors for infection are well-known and point the way to intervention. At Johns Hopkins, I’m Elizabeth Tracey.

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Anchor lead: Are doctors an endangered species? Elizabeth Tracey reports

How would you feel about a computer providing your medical care? Proponents predict that in just a few years, this will be a reality, and physicians will be largely obsolete. As artificial intelligence improves and is integrated with telemedicine, a computer may even be superior in its diagnostic ability. Not so fast says Timothy Niessen, an internal medicine expert at Johns Hopkins.

Niessen: My doctoring is really anchored in the presence and the humanity of being at the bedside. I have no real concerns that a machine is anywhere close to replacing the sort of human compassion we’re able to achieve in a person to person interaction. I still think that humans have a good deal better sense of achieving a diagnosis now and for the foreseeable future in addition to the humanity of being at the bedside, so I’m not that concerned that Isabelle, Watson, or any other fancy machine is going to replace us anytime soon.   :31

At Johns Hopkins, I’m Elizabeth Tracey.

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Anchor lead:  Would you be willing to take the newly approved electronic pill? Elizabeth Tracey reports

A pill capable of reporting electronically that you’ve taken your medicine has been approved by the FDA. Are you willing to take such a medicine? For the moment you get to decide if you’ll share information collected by the pill with your care provider, but could it become compulsory? Timothy Niessen, an internal medicine expert at Johns Hopkins, says such strategies to compel behavior exist right now.

Niessen: I can get $40 a month off my insurance premium if I can prove to my insurer that I do not smoke. I can use those portable devices that monitor how far I walk to get a discount off my health insurance if I gather more than 10,000 steps a day and engage in other things. We’re already seeing the intersection of the increased ability using small electronic devices and other technology to survey our behaviors, and how that effects real things, our bottom line and our pocket health.   :30

Niessen says he’d rather volitional incentives remain in place to engage people in choosing their own healthier behaviors. At Johns Hopkins, I’m Elizabeth Tracey.

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