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.) Question: After educating others on the new guidelines, how does the author feel about the new guidelines implemented by AHA/ACC? === The answer to the above question is

OPTIONS:
- not enough information
- She completely agrees with the new guidelines
- She supports them and their research
- She doesn't agree with them, but wants to educate others

Answer: She doesn't agree with them, but wants to educate others

I have always been a "handyman" involved in various building projects around the house. One particular time I was refinishing a section of ceiling. I had laid in the wiring and insulation by myself and all that remained was nailing a number of heavy 4ftx8ft gypsum wallboard panels onto the rafters of the 8 ft ceiling. I had arranged for a paid assistant to help me since the height of the ceiling and the weight of the wallboard was more than I could handle. When the time came, the assistant didn't show up and did not even call. I was pissed as hell. After my messages were not returned, I had what can only be called a "rage" of determination. Using a six foot ladder, three 2x4s and my head(literally) I hefted the heavy wallboard, Using leverage I placed them one by one on the overhead rafters, held and braced them with my head, glued and nailed them there all by myself. About a half hour after I finished, I was standing there smugly trying to figure how I did it so easily when there was a knock at the door. Of course it was the assistant with a lot of excuses. He seemed surprised when I told him I was finished. He looked up at the ceiling and said "how in the world did you get those up there by yourself?" I said, "Oh, believe me, You helped more than you will ever know!" I learned a lot from that. Anger has its place in your life. You have to control it and use it directly to solve a problem. To this day I do not know how I accomplished what I did the way I did it. But, if I hadn't been so angry I would never have attempted it at all. Life is full of little lessons. Pay attention to them and learn. If you have to lash out, lash at solving the situation you are in instead the person who caused it. It is significantly more productive that way. Question: The handyman probably thinks the assistant is: === The answer to the above question is

OPTIONS:
- Not good with directions
- Can't read very well
- Not very reliable
- not enough information

Answer: Not very reliable

Relatives of a dying lady I was caring for kicking and screaming not to give their Mum pain relief because they were so terrified / knew it would probably be the thing to end her life. She had a horrible aggressive cancer that ravaged her whole body and needed very regular doses of strong pain relief which - as she had a terminal illness and was receiving end of life care - did not have an upper limit so to speak. She had pain relief as and when needed to make her comfortable and that often results in people ultimately overdosing. Mum had Alzheimer's and was howling and writhing in agony so we were giving her pain relief but daughters knew it would probably result in her death - which they were right about possibly happening and in their grief and panic, started trying to prevent us from doing anything. Didn't want us getting near her at all and we had to go through an awful scenario of trying to explain what we had to do for Mum and why and when they still wouldn't have it or allow us near, we had to do what nobody wants and go against their wishes by administering the pain relief anyway. One daughter screamed the place down, threatened to have me arrested and struck off / said she would go to the papers and tell them about how we killed her Mum and in the end she had to be removed from the bedroom. Her Mum was given the pain relief, immediately relaxed and fell asleep then died peacefully in her sleep about 15 mins later. The saddest thing is her daughter wasn't able to be there and see her Mum dropping off so peacefully and her last memory will forever be of her screaming and thrashing about as she (daughter) was physically removed from the room. Tragic. Question: The daughter was removed: === The answer to the above question is

OPTIONS:
- not enough information
- before her mother passed away
- while her mother was sleeping
- before someone got arrested

Answer:
before her mother passed away