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Wrong arm position can result in false blood pressure reading, Study says

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A recent study has found that a wrong arm position during blood pressure (BP) checks may lead to misdiagnosis and overestimation of hypertension.

BP is the pressure of circulating blood against the walls of blood vessels. It is measured in units of millimeters of mercury (mmHg). The reading consists of two numbers — with the upper (systolic) value first, followed by the lower (diastolic) value. A person is considered hypertensive if they have consistent readings of 130/80 or higher.

The new study, published on Monday in Journal JAMA Internal Medicine, analysed the blood pressure readings of 133 adults from August 2022 to June 2023. The study volunteers’ ages ranged from 18 to 80.

The blood pressure readings were measured and compared while the people held their arms in three different ways — leaning on a surface, resting on the lap, or hanging by the side of the body.

The researchers from Johns Hopkins University discovered that when participants had their arms hanging by their sides during the reading, their systolic pressure was 6.5 points higher than when their arms were resting on a desk, while the diastolic blood pressure — the bottom number — was 4.4 points higher than in the supported condition.

The experts also found out that when their arms were on their laps, the systolic blood pressure was 3.9 points higher than when their arms were supported by a surface, while the diastolic pressure was 4 points higher than in the supported condition.

For example, if a person’s actual blood pressure is 134, and blood pressure is measured on a dangling arm, the reading could end up over 140, which is considered to be stage 2 hypertension.

Tammy Brady, the vice-chair for clinical research in the department of pediatrics at the Johns Hopkins University School of Medicine, said the two other positions were tested because it was realised that they are the most used positions during blood pressure readings.

“I did not expect there to be that much of a difference when the arms were placed in the two alternative positions,” he said.

“We tested those positions because those are the positions that most people have their blood pressure measured, according to data and personal observations.

“We thought there’d be a difference, but I was surprised by how much of a difference there was.”

According to the study, the wrong positioning of the arm during BP readings leads to overestimation due to several physiological reasons.

First, there can be muscle contraction when the arm is not supported which can lead to an increase in BP reading.

Also, a greater vertical distance between the heart and where the cuff is placed can increase hydrostatic pressure in the arteries, or the blood pressure against the wall due to gravity’s pull. This can lead to an overestimation of blood pressure.

Brandy said the study was conducted to educate people on the appropriate arm position for BP reading.

“I just hope that it raises awareness regarding how important things like arm position are to blood pressure measurement accuracy,” he added.

“I also hope this study educates patients, empowering them to advocate for proper measurement when they’re in a clinic setting.

“But also, because so many patients rely on home blood pressure measurements for hypertension diagnosis, evaluation, and treatment.

“I hope this educates them on how to properly position their arms because our findings absolutely extend to measurements in the home.”

The researchers also gave the following steps to achieve an accurate BP measurement.

The steps include:

  • Wear the appropriate cuff size
  • Have your back supported
  • Keep feet flat on the floor with legs uncrossed
  • Have the appropriate arm position – the cuff should be positioned at heart level with the arm supported on a desk or table

Wearing the appropriate cuff size was found to be the most important step.

Because an improperly sized blood pressure cuff can distort blood pressure readings taken by automated blood pressure devices.

Also speaking, Gail Adler, a cardiovascular endocrinologist in the Hypertension Clinic at Brigham and Women’s Hospital, disclosed some steps that should taken 30 minutes for BP measurement.

“Before you take your blood pressure, you want no smoking, exercise, caffeine, alcohol, major arguments. Don’t be psychologically stressed,” Adler said.

“Sit in the chair, get in the right position. And for five minutes, you relax, you don’t talk, make sure you don’t have to pee. If you have to pee or urinate, that’s going to raise your blood pressure.”

Health

NAFDAC warns against purchase of counterfeit anti-malaria drugs

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The National Agency for Food and Drug Administration and Control (NAFDAC) has raised the alarm over the circulation of “counterfeit” Paludex tablets and suspensions in Nigeria.

The agency said the drugs, labelled as Paludex (Artemether/Lumefantrine), are manufactured by Impact Pharmaceutical Ltd, and Ecomed Pharma Ltd, Enugu and marketed by MD Life Sciences Ltd, Enugu.

The statement said laboratory tests conducted by a WHO-prequalified laboratory in Germany and NAFDAC revealed that the products contain zero percent active pharmaceutical ingredient (API), rendering them ineffective and potentially harmful.

NAFDAC warned that the products are not on its registered database and all NAFDAC registration numbers stated on the products are false.

“Genuine Artemether/Lumefantrine tablets or suspension is a combination of the two medications Artemether and Lumefantrine used to treat acute, uncomplicated malaria in adults and children,” the statement reads.

“The illegal marketing of medicines or counterfeit medicines poses a great risk to the health of people; by not complying with the regulatory provisions, the safety, quality, and efficacy of the products are not guaranteed.

“Also, poor-quality pediatric formulations or medicines in general have the potential of causing treatment failure when the API content is below the prescribed dose.

“All NAFDAC zonal directors and state coordinators have been directed to carry out surveillance and mop up the falsified products within their zones and states.

“NAFDAC implores distributors, healthcare providers, and patients to exercise caution and vigilance within the supply chain to avoid distribution, administration, and use of the products.

“All medical products must be obtained from authorized/licensed suppliers. The products’ authenticity and physical condition should be carefully checked.”

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Health

Less sugar in a child’s first 1000 days reduces risk of chronic disease, study says

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A new study has found that reducing the amount of sugar children get in the womb and as toddlers can protect them against diabetes and high blood pressure in adulthood.

Published in the journal Science, the research reveals a critical period for healthy nutrition in the first 1,000 days of a baby’s life — from conception to age two.

The study found that cutting sugar intake in this window decreased the type 2 diabetes risk by about 35% and the risk of high blood pressure by roughly 20%. The researchers also discovered a delay in disease onset of four and two years, respectively.

The research team anaylsed data from before and after the end of the United Kingdom’s world war II-era sugar rationing in September 1953.

In January 1940, the UK government began food rationing to ensure fair shares for all during the wartime shortage.

Access to sugar, fats, bacon, meat and cheese was limited. When the rationing of sugar and sweets ended in September 1953, the average adult’s daily sugar consumption nearly doubled almost immediately, from about 40 grams to 80 grams.

Analysing the UK BioBank database of 60,000 people, the scientists compared health in middle age for 38,000 people conceived and born during rationing and 22,000 people conceived soon afterward.

The analysis showed a 30% reduction in the risk of obesity among sugar-rationed babies.

The study by the team at the University of Southern California also found that the risk of type 2 diabetes and high blood pressure increased with age. However, it increased faster in those conceived after sugar-rationing ended.

The results showed type 2 diabetes started on average four years later in adult life where there had been sugar-rationing during early childhood, and blood pressure two years later.

There was a 35% reduction in type 2 diabetes for those babies conceived during sugar rationing and a 20% reduction in high blood pressure.

“Sugar rationing created an interesting natural experiment,” said Tadeja Gracner, the study lead author and a senior economist at the Center for Economics and Social Research at the University of Southern California.

“We all want to improve our health and give our children the best start in life, and reducing added sugar early is a powerful step in that direction.

“With better information, environment and the right incentives, parents can more easily reduce sugar exposure, for kids and themselves.”

Also speaking, Keith Godfrey, a professor from the University of Southampton, said: “This is convincing new evidence, providing further support that reducing exposure of the unborn baby and newborn infant to sugar has lasting benefits that include lowering the risk of diabetes and high blood pressure in later adulthood.

“The findings are in keeping with our research showing lower rates of obesity in the children of mothers who eat low glycaemic index foods during pregnancy that are digested and absorbed more slowly, causing a slower rise in blood sugar levels.”

A previous study also suggested that high sugar intake during pregnancy may affect a child’s intelligence.

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Health

Five health benefits of aloe vera

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Aloe Vera is a spiky succulent plant that grows naturally in dry, tropical climates like Africa, Asia, Europe, and southern and western parts of the United States. Over the years, this scrubby and pointy plant has been cultivated for its medicinal purposes.

Here are the health benefits you get from aloe vera as gel and juice.

  • Aids digestion

Aloe vera, particularly aloe vera juice, has been proven to be a natural laxative.

The outer part of this plant contains a compound called anthraquinone glycosides which has laxative effects.

study discovered that this compound can help relieve constipation while another research found that aloe vera could help reduce the symptoms of gastroesophageal reflux disease (GERD) — a digestive disorder that often results in heartburn — and irritable bowel syndrome.

However, when trying aloe juice for constipation for the first time, consume little amount of it.

  • Reduces blood sugar levels

Both the gel and juice of aloe vera can help lower and control one’s blood sugar levels.

Several studies have indicated that taking aloe vera juice has some potential benefits for people with prediabetes and type 2 diabetes due to its effect on glycemic control.

  • Rich in antioxidants

Aloe vera gel contains powerful antioxidants called polyphenols, which also have anti-inflammatory effects.

Antioxidants are important to health as they protect your body from damage caused by free radicals. These antioxidants have benefits ranging from reducing one’s risk of cardiovascular diseases to improving the immune system.

Aloe vera also has antibacterial and antiviral properties which is why it is used to treat and relieve burns and wounds.

  • Promotes dental health

Due to its antibacterial properties, aloe vera juice and mouthwash improve various dental and oral conditions.

Aloe vera mouthwash is effective in reducing dental plaque. A study also showed that aloe vera mouthwash help reduces gum inflammation in people who had recently undergone tooth surgery to remove plaque.

  • Skincare

Aloe vera is perhaps one of the most widely used herbal remedies for topical skin conditions. This is because the gel-like components of the plant are known to heal the skin from a variety of minor ailments.

This plant is also a natural moisturizer that helps soothes dry skin. Its anti-inflammatory properties also make it a potential treatment for skin conditions like burns, acne, and eczema.

Aloe vera also helps reduce the appearance of blemishes and wrinkles.

A 2009 study of 30 females over the age of 45 also prove that taking oral aloe vera gel increased collagen production and improved skin elasticity over 90 days.

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Bodex F. Hungbo, SPMIIM is a multiple award-winning Nigerian Digital Media Practitioner, Digital Strategist, PR consultant, Brand and Event Expert, Tv Presenter, Tier-A Blogger/Influencer, and a top cobbler in Nigeria.

She has widespread experiences across different professions and skills, which includes experiences in; Marketing, Media, Broadcasting, Brand and Event Management, Administration and Management with prior stints at MTN, NAPIMS-NNPC, GLOBAL FLEET OIL AND GAS, LTV, Silverbird and a host of others

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