Health
Wrong arm position can result in false blood pressure reading, Study says
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
Fake Combiart antimalarial tablet in circulation, NAFDAC warns
The National Agency for Food and Drugs Administration and Control (NAFDAC) has alerted Nigerians to the circulation of counterfeit Combiart dispersible tablets 20/120 mg in the country.
Combiart is a combination of artemether and lumefantrine 20/120 mg used to treat malaria.
NAFDAC said in a statement that the product is manufactured by Strides Arcolab Limited in India.
The agency said its officers from the post-marketing surveillance directorate discovered the product in the federal capital territory (FCT) and Rivers state.
“The laboratory report of the analysis carried out on the product revealed that it contained zero APIs. The product was also observed to have two different date markings,” the statement reads.
“The NAFDAC database of registered products has confirmed that the product license has expired and the NAFDAC registration number on it is wrong and not for the product.
“Counterfeit or falsified medicines endanger people’s health because they do not comply with regulatory standards, which means the safety, quality, and efficacy of these products are not ensured.
“The use of counterfeit medicines often fails to effectively treat diseases or conditions, leading to serious health consequences, including death.”
The agency asked importers, distributors, retailers, healthcare professionals, and caregivers to exercise caution and be vigilant within the supply chain to avoid the importation, distribution, sale, and use of counterfeit products.
In another development, NAFDAC said its investigation and enforcement team uncovered a trove of counterfeit medicines during a raid at Tyre Village, Trade Fair Complex, in Lagos.
The agency said in a statement that the operation led to the seizure of fake pharmaceuticals, including amoxicillin 500 mg, ampiclox capsules 500 mg, and packaging materials for Augmentin capsules 625 mg.
“The facility has been placed on hold, and all illegal products have been evacuated,” NAFDAC said.
“These counterfeit medicines, estimated at over N300 million, pose severe health risks, including treatment failure, organ damage, and potential carcinogenic effects due to unknown compositions.
“The suspect has been invited for questioning, and investigations are underway.”
Health
Excessive daytime sleepiness may lead to dementia, Study says
A new study has suggested that older adults experiencing daytime sleepiness or a lack of enthusiasm for activities due to sleep issues may be at higher risk of developing motoric cognitive risk (MCR) syndrome, a condition that can precede dementia.
The new research, published on Wednesday in the journal Neurology, found that among participants who experienced excessive daytime sleepiness and a lack of enthusiasm, 35.5% developed MRC syndrome compared with 6.7% of people without those problems.
MCR is a predementia syndrome characterized by slow gait speed and cognitive complaints among older people who don’t already have dementia or a mobility disability. The risk of developing dementia more than doubles in people with this syndrome.
During the study, researchers examined data on 445 adults who were 76 years old on average and had no history of dementia. Participants took questionnaires for sleep and were asked about memory issues. Their walking speed was tested on a treadmill and then once a year for an average of three years.
The researchers assessed the participants’ sleep quality and quantity using the seven components of the Pittsburgh Sleep Quality Index.
The index included subjective sleep quality, time it takes to fall asleep, sleep duration, sleep efficiency (ratio of total hours asleep to total hours in bed), sleep disturbances, use of sleep-inducing medication, and daytime dysfunction, such as having trouble staying awake during activities or feeling less enthusiasm to get things done.
The researchers found that 177 participants met the definition of poor sleepers, while 268 were considered good sleepers. 42 people had MCR at the start of the study, and another 36 developed it.
The study found that people with excessive daytime sleepiness and a lack of enthusiasm for activities were more than 3 times more likely to develop MCR syndrome than people who didn’t have these sleep-related problems.
However, Tara Spires-Jones, professor of neurodegeneration and director of the Centre for Discovery Brain Sciences at the University of Edinburgh in Scotland, said the study has a few “serious” limitations.
“The sleep measurements were self-reported, not measured by a scientist, and these self-reports could be biased by people with memory issues,” Tara said.
“The participants in the study were also largely white, and the group was much smaller than similar single-timepoint studies, so the results will be stronger if confirmed in future studies.”
Victoire Leroy, the study author, said “more research needs to be done to look at the relationship between sleep issues and cognitive decline and the role played by motoric cognitive risk syndrome”.
“We also need studies to explain the mechanisms that link these sleep disturbances to motoric cognitive risk syndrome and cognitive decline,” Leroy, who has an MD, and PhD from Albert Einstein College of Medicine, added.
Food
Eight foods to avoid on an empty stomach
What you eat first thing in the morning sets the tone for your day. After a night of fasting, your body is ready for the right kind of fuel to boost your energy and get your metabolism going.
However, some foods can cause discomfort, bloating, or irritation when eaten on an empty stomach—especially acidic ones that can be tough on your stomach lining.
On the flip side, starting your day with a balanced breakfast that includes protein, healthy fats, and fibre can keep your blood sugar steady, sharpen your focus, and give you energy that lasts.
Here are eight foods you should skip on an empty stomach:
1. Citrus fruits
Citrus fruits like oranges, grapefruits, and lemons are packed with vitamin C and antioxidants, making them great for your health. But when eaten on an empty stomach, their high acidity can irritate your stomach lining. This can lead to acid reflux, bloating, or even heartburn. Plus, their tangy flavour can trigger your stomach to produce too much gastric acid, which may cause discomfort.
2. Coffee
For many, coffee is a morning ritual. However, drinking it on an empty stomach can be harsh on your digestive system. The caffeine in coffee can ramp up stomach acid production, which may cause acid reflux, heartburn, or even gastritis if there’s nothing in your stomach to balance it out. On top of that, coffee can dehydrate you, especially if it’s the first thing you drink in the morning.
3. Spicy foods
Spicy foods like chilli or hot sauce might be delicious, but they aren’t the best idea on an empty stomach. These fiery options can increase gastric acid production, which can lead to acid reflux and heartburn. Spices can also irritate the stomach lining, leaving it more susceptible to inflammation and discomfort.
4. Sugary foods
Sugary treats like pastries, sugary cereals, or sweetened drinks might seem like a quick way to start your day, but they can backfire. Eating them on an empty stomach causes your blood sugar to spike rapidly, giving you a short-lived energy boost followed by a crash. This crash can leave you feeling tired and cranky. Sugary foods can also disrupt digestion, causing bloating and discomfort.
5. Yoghurt
Yoghurt is generally considered a healthy snack, but it’s not ideal for an empty stomach. The natural acidity in yoghurt can irritate sensitive stomachs and may reduce the effectiveness of the probiotics it contains. These beneficial bacteria can struggle to survive in the highly acidic environment of an empty stomach.
6. Fried foods
Fried foods like doughnuts, French fries, or fried chicken are heavy and take longer to digest. Eating them on an empty stomach can overwhelm your digestive system, leading to bloating, indigestion, or even nausea. Their high fat content also slows down digestion, making you feel sluggish and uncomfortable.
7. Raw vegetables
Raw vegetables are undeniably healthy, but eating them on an empty stomach can be rough on your digestive system. Their high fibre content and certain enzymes can lead to gas and bloating. Vegetables like broccoli, cabbage, and cauliflower are particularly challenging because they are harder to digest when your stomach is empty.
8. Carbonated drinks
Starting your day with soda or sparkling water isn’t the best idea. The carbon dioxide in these drinks can create gas in your stomach, leaving you feeling bloated and uncomfortable. They can also irritate your stomach lining and disrupt digestion.
Conclusion
Choosing the right foods for an empty stomach is key to starting your day on the right note. Avoiding these eight foods can help you feel more comfortable and energized. Instead, reach for options that are easy on your stomach, like oatmeal, bananas, or whole-grain toast with eggs. These choices will give you a healthy and balanced start to your day.
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