And once again, high blood pressure is making headlines in the news: the American Heart Association and the American College of Cardiology (AHA/ACC) have just released new guidelines about hypertension. Since this development is likely to cause confusion and concern for many, I'm writing this post to help you understand the debate and what this might mean for you and your family. By the way, if you've read any of my other blood pressure articles on this site, let me reassure you: I am not changing my clinical practice or what I recommend to others, based on the new AHA/ACC guidelines. The core principles of better blood pressure management for older adults remain the same: * Take care in how you and your doctors measure blood pressure (more on that here), * Start by aiming to get blood pressure less than 150/90 mm Hg, as recommended by these expert guidelines issued in 2017 and in 2014, * And then learn more about what are the likely benefits versus risks of aiming for more intensive BP control. Perhaps the most important thing to understand is this: treatment of high blood pressure in older adults offers "diminishing returns" as we treat BP to get lower and lower. Scientific evidence indicates that the greatest health benefit, when it comes to reducing the risk of strokes and heart attacks, is in getting systolic blood pressure from high (i.e. 160-180) down to moderate (140-150). From there, the famous SPRINT study, published in 2015, did show a further reduction in cardiovascular risk, when participants were treated to a lower systolic BP, such as a target of 120. However, this was in a carefully selected group of participants, it required taking three blood pressure medications on average, and the reduction in risk was small. As I note in my article explaining SPRINT Senior, in participants aged 75 or older, pushing to that lower goal was associated with an estimated 1-in-27 chance of avoiding a cardiovascular event. (The benefit was even smaller in adults aged 50-75.) According to the above context, choose the correct option to answer the following question. Question: When did the AHA release new guidelines? Options: A. While the article was being written. B. not enough information C. Before the SPRINT study. D. Before the article came out.
D

(Question)
My Pa disappeared somewhere in the wilds of 1975, when I was just fourteen years old. He was the Ambassador to 1975, but back home in 1898, in New Jerusalem, Utah, they all thought he was Ambassador to France. When he disappeared, Mama and I came back through the triple-bolted door that led from our apt in 1975 to our horsebarn in 1898. We returned to the dusty streets of New Jerusalem, and I had to keep on reminding myself that I was supposed to have been in France, and 'polly-voo' for my chums, and tell whoppers about the Eiffel Tower and the fancy bread and the snails and frogs we'd eaten. I was born in New Jerusalem, and raised there till I was ten. Then, one summer's day, my Pa sat me on his knee and told me we'd be going away for a while, that he had a new job. 'But what about the store?' I said, scandalised. My Pa's wonderful store, the only General Store in town not run by the Saints, was my second home. I'd spent my whole life crawling and then walking on the dusty wooden floors, checking stock and unpacking crates with waybills from exotic places like Salt Lake City and even San Francisco. Pa looked uncomfortable. 'Mr Johnstone is buying it.' My mouth dropped. James H Johnstone was as dandified a city-slicker as you'd ever hope to meet. He'd blown into town on the weekly Zephyr Speedball, and skinny Tommy Benson had hauled his three huge steamer trunks to the cowboy hotel. He'd tipped Tommy two dollars, in Wells-Fargo notes, and later, in the empty lot behind the smithy, all the kids in New Jerusalem had gathered 'round Tommy to goggle at the small fortune in queer, never-seen bills. 'Pa, no!' I said, without thinking. I knew that if my chums ordered their fathers around like that, they'd get a whipping, but my Pa almost never whipped me. According to the above context, choose the correct option to answer the following question. Question: When did the children of New Jerusalem gather around Tommy? Options: A. After Tommy returned from Salt Lake City B. not enough information C. After Tommy went to the Eiffel Tower D. After Tommy had received a tip from James Johnstone
(Answer)
D

This week could turn out to be pivotal for the Trump White House as both major parties get ready for midterm congressional elections in November. President Donald Trump's decision to reverse a policy of separating families coming across the U.S. southern border came in the wake of a political firestorm that fired up opposition Democrats and alarmed even some Republicans. At the very least, it likely set the stage for immigration to be a key issue in November. Trump was in combat mode Wednesday during a political rally in Duluth, Minnesota, where he vowed to make immigration a central focus in the upcoming congressional campaign. "If you want to create a humane, lawful system of immigration then you need to retire the Democrats and elect Republicans to finally secure our borders," Trump said to an enthusiastic crowd, some chanting, "Build the wall!" Just hours earlier, the president reversed his controversial policy of separating children from their parents by signing an executive order in the White House. "We are going to have strong, very strong, borders. But we are going to keep the families together," he said. Trump decided to back away from the controversial policy of separating families after an outcry from around the country that included protests in several states, including Arizona, Texas, Pennsylvania and Massachusetts. Also driving the outrage was a recording of children crying out for their parents released by the investigative journalist group ProPublica. The separation policy drew condemnation from Republicans including former first lady Laura Bush and a host of Democrats. "We should be able to agree that we will not keep kids in child internment camps indefinitely and hidden away from public view," said Maryland Democratic Congressman Elijah Cummings. "What country is that? This is the United States of America!" Advocates for a tough border policy sided with the president including Art Arthur of the Center for Immigration Studies. He cited a recent upsurge in attempted border crossings. According to the above context, choose the correct option to answer the following question. Question: Who said that we are going to keep families together? Options: A. President Trump B. Art Arthur C. not enough information D. Laura Bush
A