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Anchor lead: Paying attention to dropping blood pressure in later life is needed, Elizabeth Tracey reports

People with high blood pressure or hypertension have about a 50% increased risk for dementia as they age, a Johns Hopkins study by Keenan Walker and colleagues has confirmed. But in those with the condition, if blood pressure fell in late life – so called hypotension - the increased risk was 62%.

Walker: About 20% of individuals in our cohort have late life hypotension. I think the main takeaway from this study is that although you want to treat hypertension you don’t want to overtreat hypertension, because especially for older people who have a long history of hypertension dropping blood pressure too low in older adulthood seems to be associated with risk for dementia and mild cognitive impairment which is predementia phase. You want to preserve blood pressure within this range of normalcy, and not overtreat or undertreat hypertension.  :30

Walker says keeping a close eye on blood pressure and adjusting medications appropriately is critical. At Johns Hopkins, I’m Elizabeth Tracey.

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Anchor lead: A drop in blood pressure later in life may result in cognitive impairment, Elizabeth Tracey reports

High blood pressure or hypertension is a known risk factor for the development of dementia, but now a Johns Hopkins study shows that among those with the condition a late life drop in blood pressure is even more of a problem. Keenan Walker, the study’s lead investigator, explains.

Walker: People with midlife hypertension who then have late life hypotension, or a drop in blood pressure in late life after having hypertension in midlife, we suspected that this group may be particularly vulnerable to dementia. We found evidence to support that. The novelty of the finding lies there. Because chronic hypertension the finding has been demonstrated. The longer you have hypertension the worse off your brain is going to be. But this drop in blood pressure may also be problematic as well, especially for those who had hypertension in midlife.  :30

The study found about a 13% increased risk for dementia in those whose blood pressure dropped late in life. At Johns Hopkins, I’m Elizabeth Tracey.

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Anchor lead: How can you tell if your body isn’t responding well to high temperatures? Elizabeth Tracey reports

Using a fan when outdoor temperatures are high may actually be harmful if it’s also very dry, a recent study found. That’s because you may not be aware that your body isn’t cooling off since you feel air moving. Matthew Levy, an emergency medicine expert at Johns Hopkins, says when weather is hot, paying attention to body clues is important.

Levy: One of the most important things that we want people to be aware of is how their body, when they’re in high heat conditions, is how their body is going to respond to it, and markers of hydration, or dehydration. And those often times start off with subtle clues. One of the first ones being thirst. Another one being a headache or a mild headache. Or a generalized just not well feeling. Those are just some of the body’s early indicators that it might be feeling the stress or the negative effects of the heat.  :30

Levy says fans are usually okay if it’s hot but also humid, since the body doesn’t become dehydrated. At Johns Hopkins, I’m Elizabeth Tracey.

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Anchor lead: Does a fan help prevent heat-related health problems? Elizabeth Tracey reports

If you’re using a fan in very hot, dry conditions, you may be putting yourself at risk for heat related health problems, a recent study found. Matthew Levy, an emergency medicine expert at Johns Hopkins, explains the findings.

Levy: When the heat index, which is how our body feels in the heat, is high, we worry a lot about the physiologic stresses on people, and particularly those who are very old, very young, and those with chronic diseases. We were also concerned about the use of fans in heat related situations, particularly those lasting several days. Fans might actually in dry heat not at all cool someone down. Once the temperature gets in the 90s or higher, we then actually worry about the fans not cooling someone off. Although they might feel the air blowing on them it’s not cooling them off.   :32

Levy says fans can help when conditions are both hot and humid, but the best strategy is to seek air conditioning and drink a lot of water. At Johns Hopkins, I’m Elizabeth Tracey.

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Anchor lead: Some statins seem to reduce the risk of liver cancer, Elizabeth Tracey reports

Statin medications that dissolve easily in fats may lower the chance that people who are at risk for liver cancer develop the disease, a recent study found.  William Nelson, director of the Kimmel Cancer Center at Johns Hopkins, says in this case, there really may be something to it.

Nelson: There have been a series of reports for a very long period of time that people who consume statins appear to have a lower risk for almost every cancer you can name. Most of that doesn’t come out in the wash, if you will, and I think the reason for that is that people who took statins tended to be people who had better so-called health seeking behaviors. They were more likely to get screened and diagnosed with a cancer, they were more likely to have their blood pressure controlled, they’re more likely to have weight control. The reason this is interesting is that simple critique isn’t fully applicable to this analysis.  :29

Nelson notes that the reason people take statins is to lower their risk for cardiovascular disease, not cancer, and that isn’t changed by this study. He says hepatitis B and C infections placed people in this study at risk for liver cancer, and those can largely be prevented and/or treated. At Johns Hopkins, I’m Elizabeth Tracey.

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In this first episode, we cover the Johns Hopkins Nursing Evidence-Based Practice Model tools. We review where to locate the tools, how to access them and when to use the research or non-research evidence appraisal tools. Most importantly, we highlight the smart logic and helpful hints on each of the tools for easier use. In reviewing the "skip patterns" on each of the tools, we point out that you don't have to fill out the entire tool! Remember, practicing with the tools makes it easier and less time consuming each and every time.

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Anchor lead: How can we unlink stress and cognitive decline in women? Elizabeth Tracey reports

Stressful life events are linked to cognitive decline in women as they age, a Johns Hopkins study led by Cynthia Munro, a research psychologist, and colleagues has shown. Munro says most believe the effect is related to a hormone called cortisol.

Munro: Cortisol is the stress hormone that has gotten the most attention. It seems to have an effect on the hippocampus, which is really crucial for the ability to remember things. We don’t want the body to produce a lot of cortisol. It’s healthy to produce a lot of cortisol when there’s a stressor and then go back down to normal. What’s not healthy is when cortisol levels remain elevated. The way to intervene is to reduce the way people respond to stressful events, in a way that will then reduce cortisol levels.  :30

Munro says meditation is helpful in reducing stress reactions for some, and she also recommends simply paying attention to activities that individuals find calming and participating in them regularly. At Johns Hopkins, I’m Elizabeth Tracey.