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.) What event led the author to write an article about blood pressure? Pick the correct answer from the following options: A. not enough information B. a cardiovascular event C. Scientific evidence D. The new AHA/ACC guidelines
D

GoDaddy has pulled the plug on another online peddler of violence. The popular internet registration service last week shut down altright.com, a website created by white nationalist leader Richard Spencer and popular with many in the so-called alt-right movement. The takedown is the latest example of how companies like GoDaddy are increasingly responding to growing public pressure to clamp down on violent sites in the wake of the deadly Unite the Right rally in Charlottesville, Virginia, last summer. GoDaddy, which registers domains for more than 75 million websites around the world, said it generally does not delist sites that promote hate, racism and bigotry on the ground that such content is protected as free speech. But it said altright.com had "crossed the line and encouraged and promoted violence in a direct and threatening manner." "In instances where a site goes beyond the mere exercise of these freedoms, however, and crosses over to promoting, encouraging or otherwise engaging in specific acts of violence against any person, we will take action," GoDaddy said in a statement emailed to VOA. The company would not say whether it canceled altright.com's domain registration in response to pressure but it stressed that "we take all complaints about content on websites very seriously, and have a team dedicated to investigate each complaint." The Lawyers' Committee for Civil Rights Under Law, a Washington-based civil rights organization, said it filed such a complaint with GoDaddy last month, citing several instances in which altright.com carried content that advocated violence. In one example, a January 26, 2018, article encouraged "use of live ammunition at the border, in order to create a substantial chance that they [immigrants crossing the border] lose their life in the process," according to the organization's complaint. Kristen Clarke, the group's president and executive director, said the shutdown of altright.com was part of her organization's campaign to combat a recent "hate crime crisis" in the... Who is GoDaddy Pick the correct answer from the following options: A. a company that registers websites B. not enough information C. a company that curbs violence D. a company that pulls down websites
A

Staying in our apartment on the North Shore of Vancouver, we were tucked into a sleepy, suburban idyll where once off the busy highway, kids played ball games in the street and cats strolled around their own home territories without a care in the world. It is also home to the famous Capilano Suspension Bridge, but warned that the crowds in mid-August would be overwhelming, we were given the tipoff that the Lynn Canyon Suspension Bridge and the surrounding park is a lovely place to while away an afternoon. Smaller, free and with loads of walks and picnic areas, I sent my intrepid husband ahead to brave the canyon bridge whilst I sipped a much-needed coffee in the local cafe. It was beautiful. It's mostly because the thought of hopping onto a swaying bridge above the ravine gives me the heebie-jeebies, whereas he will stride across panels of transparent glass suspended metres above busy streets (like Tower Bridge) or gondola rides that skim well above the treetops (like Japan lake or the Bavarian Alpine range.) Watching the shower of golden pine needles drift down from the redwoods whilst I typed out a blog post, I enjoyed seeing squirrels scamper and birds twitter their way around the boughs and branches. That blur below? A local black squirrel who was foraging amongst the cooing tourists for snacks About 20 minutes later his grinning face floated back into view, and he brandished his phone with images of his quick wander through the trails. Lynn Canyon Park officially opened to the public in 1912; there are several trails throughout the park to choose from for a leisurely hike including the popular Baden Powell Trail and there are also many breathtaking waterfalls and popular swimming holes which are perfect during the summer months. Lynn Canyon Park covers 617 acres today and comprises of second growth forest with most of the trees aged approximately 80 to 100 years old. Why was the narrator describing the park so much? Pick the correct answer from the following options: A. Because she found it to be beautiful B. Because she found it to be dirty C. not enough information D. Because she found it to be dangerous
A

I once went out to have fun with a friend of a different nationality, and she wanted to go to a place that featured the music of her culture. Since I have always been interested in other cultures, I was happy to go along. While we were sitting at a table together, an older man came up and asked to buy me a drink. I told him "no thank you, I do not drink". My arm was laying on top of the booth because I was sitting sideways since my big old pregnant belly would not fit under the table. He reached over and took my hand and said " Come dance with me then". I again told him I was not interested in dancing. He began to squeeze my hand and insisting I get up and dance with him. I kept telling him no, and pointing to my belly and saying I would not be dancing with anyone. He just kept squeezing my hand harder and trying to pull me out of the booth. I got angry when I felt something break in my hand and screamed at him "Get your effing hands off me!" The bar owner came over to see what the problem was. I explained that "this jerk just hurt my hand because I would not drink or dance with him!" The owner looked at me crying, and the man laughing, and kicked my friend and I out of the place! Seems the rude SOB was his best friend. I got a bad taste for places of that culture (although I do love the cuisine) and a broken bone in my left hand for my trouble. She and I never went out again because she was so embarrassed about what the guy did to me, but she did take me to the ER on the way home. When did they go to ER? Pick the correct answer from the following options: A. After an older woman came up and asked to buy a drink B. not enough information C. After an older man came up and asked to leave the table D. After an older man came up and asked to buy a drink
D