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Monsoon bring with it fungal infections, other skin problems

F.P. Report

ISLAMABAD: One of the side-effects of monsoon, besides waterlogging, is the health hazard the rain brings with it, fungal, allergies and parasitic infections.

Patients, mostly children between the age group of 4-10, suffering from allergies and fungal infection, account for around 20% skin and dermatological ailment at the hospitals.

Taking adequate precautions is one of the best ways to avoid monsoon-related ailments. Consultant physician Dr Waseem Malik says “People must avoid getting drenched and should always carry an umbrella. Even when they are drenched, they must immediately follow preventive measures because if left untreated, it can leave permanent scars on the skin,” “In case of a skin infection, use an anti-fungal powder to avoid any further infection. Always keep your skin dry. Don’t wear wet clothes. Also, wet shoes should be changed instantly. These small precautions go a long way in having a healthy and infection-free skin,” he added.

There has been a rise in around 20% skin-related problems this monsoon compared to last year. Patients are complaining of skin rashes, itching and various other dermatological symptoms, he said.

Talking to dermatologist Noshhen Haider said that “ people with diabetic diseases are more prone to skin infections. They must see a doctor when symptoms like red skin rashes appear lest they leave scars and turn untreatable later.”

The commonest of infections during monsoon are facial folliculitis (an inflammation of the hair follicles), acne and ringworm. The cause of such infections is mostly bacterial or fungal. People are more susceptible to infections during this season due to excessive sweating, dehydration, photo-toxic effects of the sun and, of course, humidity, she added.

Allergies like non-bullous and bullous impetigo, fungal infections, recurrent attacks of folliculitis, tinea capitis (fungal infection of hair) are commonly detected in people, especially kids during the monsoons. An immediate bath after playing in the rain and application of an anti-bacterial soap is crucial. Besides, one must also drink filtered water to avoid dehydration, she said.

She advised that the ideal way to avoid such problems would be to try and keep dry and avoid excess perspiration. Taking regular and more frequent baths can help. Also, be careful of using public toilets, where due to lower hygiene one is exposed to infections. Keep the body hydrated by consuming 10-12 glasses of water and also apply plenty of moisturizers to keep your skin hydrated.

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Multi-drug resistant typhoid cases rising in Karachi

F.P. Report

KARACHI: Eminent pediatrician, Prof Dr Jamal Raza has revealed that the multi-drug resistant typhoid (MDRT) cases are on the rise in Karachi as well as in Hyderabad city as thousands of children have been infected from the disease in Karachi so far.

Prof Jamal Raza, who is also President of Pakistan Pediatric Association, Sindh, while talking to PPI, said MDR typhoid outbreak had gripped parts of North Nazimabad, Gulshan-e-Iqbal and its adjoining areas.

He explained that 80 per cent of the total reported cases, affected children were of less than 10 years of age. He said this bacterial infection continued to infect children all over Karachi and other parts of province.

He explained that typhoid fever, which is considered predominantly a paediatric disease with almost 70 per cent of all culture-proven cases occurring in children, can, however, prove equally hazardous to adults as delayed diagnosis and inadequate treatment may lead to complications.

He said symptoms of MDRT such as fever, headaches, coughs, abdominal pain and malaise, among others, are similar to those of ordinary typhoid. He said treatment of MDR typhoid is very costly as compared to common typhoid as conventional medicines have failed to cure the disease.

“Thousands of people have been infected from typhoid in Karachi this year so far; out of them 40 per cent are MDRT cases. Children are more vulnerable to this bacterial infection,” he added. He said majority of MDRT cases surfaced in North Nazimabad, Gulshan-e-Iqbal and their adjoining areas.  Prof Raza said contaminated water and food mainly that is sold by street vendors under extremely unhygienic conditions are generally identified as common contributory factors causing the infection. He said there is no national and provincial level data of typhoid cases but incidence of ordinary and MDR typhoid are high in Sindh province.  He informed that eminent pediatricians had approached relevant department for vaccination of children in the high risk areas of Karachi and Hyderabad besides ensuring provision of clean potable water to residents of province.

He said a special vaccination campaign had also been planned that would be launched in high risk areas of province soon as prevention is better than cure.

He advised the citizens to consume boiled water, wash hands before eating, properly wash vegetables before making food, avoid ice creams & other street food items to prevent them from common and MDR typhoid.

Initially, MDRT cases were reported in some parts of Latifabad and Qasimabad talukas in Hyderabad but these cases are now being reported in Karachi.






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Eating dinner late could increase cancer risk

Monitoring Desk

BARCELONA: According to a study that was conducted at the Barcelona Institute for Global Health in Spain, eating your final meal of the day too late can increase the risk of developing cancer.

The relationship between food and cancer has been investigated a great deal.

For instance, regularly eating fresh vegetables has been shown to reduce cancer risk.

Conversely, regularly eating red meat increases the risk of certain cancers.

Over the years, there have also been a number of studies looking at the links between obesity and cancer. However, the impact of when food is eaten has been much less studied.

A recent study investigated potential links between meal timing and two common types of cancer: prostate cancer and breast cancer.

These cancers are also known to be linked with night-shift work and disruption to the biological clock, which infers that they might be sensitive to the timing of lifestyle factors, too.

In all, the scientists had access to data from 621 men with prostate cancer and 1,205 women with breast cancer. As controls, they also included 872 males and 1,321 females without cancer.

Participants’ lifestyles were assessed, including information about their meal times and sleeping habits. They also defined their chronotype — that is, whether they are a morning or an evening person.

A new study suggests that gut bacteria influence the intestinal circadian clock to promote a higher intake and retention of fat.

Their findings, which are published in the International Journal of Cancer, make surprising reading.

People who ate their evening meal before 9:00 p.m. or at least 2 hours before going to bed had around 20 percent less risk of breast or prostate cancer than those who ate after 10:00 p.m. or went to bed soon after eating.

“Our study concludes that adherence to diurnal eating patterns is associated with a lower risk of cancer. [The findings] highlight the importance of assessing circadian rhythms in studies on diet and cancer.”

There will need to be follow-up work to confirm these startling conclusions, but if these results are replicated, they could have an impact on official guidelines — which do not currently take into account the timing of meals.

We already know that disrupting circadian rhythms influences tumor growth, and that meal timing impacts circadian rhythms.

As researcher Dora Romaguera explains, previous animal studies have shown that the timing of food intake has “profound implications for food metabolism and health.”

However, unraveling the precise interactions between these factors is likely to take a great deal of unpicking.

Eventually, this insight could have far-reaching consequences, as Kogevinas explains, “The impact could be especially important in cultures such as those of southern Europe, where people have [dinner] late.”

The results are striking, but Romaguera is cautiously optimistic, saying, “Further research in humans is needed in order to understand the reasons behind these findings, but everything seems to indicate that the timing of sleep affects our capacity to metabolize food.”

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Health department issues Congo alert

F.P. Report

KARACHI: Health Department of Sindh has issued a Congo alert in Karachi, before Eid-ul-Adha.

Provincial health department has decided to set up medical camps in all minor and major cattle markets of Karachi, including Super Highway Cattle Market.

According to Dr. Tahir Aziz, director of health, Karachi, all the district health officers and veterinary doctors will examine cattle in market. Also, instructions have been given to cattle owners and slaughter men to take precautionary measures.  Director health Karachi has also instructed visitors to take precautionary measures, especially with kids in order to avoid suffering. According to Dr. Tariq Aziz, Congo Virus transmits to humans from a particular animal.

Congo virus has claimed lives of five people in the past year.


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Keeping blood pressure in control could minimize the risk of Dementia

Monitoring Desk

NEW YORK: Every day, Dr. Walter Koroshetz, 65, takes a pill as part of his effort to help keep his brain healthy and sharp.

The pill is his blood pressure medication. And Koroshetz, who directs the National Institute of Neurological Disorders and Stroke, says controlling high blood pressure helps him reduce his risk of dementia.

He also keeps his blood pressure down by exercising, and paying attention to his weight and diet. “I’m a believer,” he says.

Koroshetz is urging other people with high blood pressure to follow his lead.

He’s responsible for the institute’s public health campaign called Mind Your Risks. Its goal is to let people know that there’s a link between high blood pressure, stroke and dementia.

When blood pressure rises, it strains the tiny blood vessels that keep brain cells alive, Koroshetz says.

“With every pulse of your heart, you are pushing blood into these very small blood vessels in the brain,” he says. And when the heart pushes too hard, as it does when blood pressure is elevated, it can cause damage that can lead to a stroke.

At least two large studies have revealed an alarming trend among stroke patients, Koroshetz says.

“If you had a stroke, even a small stroke, your risk of dementia within the next two years was greatly magnified,” he says. “So there’s something about having a stroke that drives a lot of the processes that give rise to dementia.”

The evidence is clearest for a type of dementia called vascular dementia. It occurs when something blocks or reduces the flow of blood to brain cells.

But high blood pressure also appears to increase a person’s risk of developing Alzheimer’s disease, which is associated with the accumulation of plaques and tangles in the brain.

If people knew about the link between dementia and high blood pressure, they might be more inclined to do something about it, Koroshetz says.

“Only about 50 percent of people who have hypertension are actually treated,” he says. “So I think there’s a lot to be said for trying to get high blood pressure under control.”

Koroshetz’s campaign is getting some help from the Alzheimer’s Association.

The group will present new research on blood pressure and Alzheimer’s at its annual scientific meeting in Chicago, which starts July 22. And the group is encouraging people to control high blood pressure.

“The good news is that we can control blood pressure now,” says Maria Carrillo, the group’s chief science officer. “We can do that with exercise, with lifestyle, with healthy eating and also with medications.”

Koroshetz is using all of these approaches. And he says other people with high blood pressure should follow his lead.

“When you get to be my age, you’re going to be very grateful that you controlled your blood pressure and exercised,” he says.



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Summer heat waves can slow human Brain: Research

Monitoring Desk

WASHINGTON: New research suggests heat stress can muddle our thinking, making simple math a little harder to do.

“There’s evidence that our brains are susceptible to temperature abnormalities,” saysJoe Allen, co-director of the Center for Climate, Health and the Global Environment at Harvard University. And as the climate changes, temperatures spike and heat waves are more frequent.

To learn more about how the heat influences young, healthy adults, Allen and his colleagues studied college students living in dorms during a summer heat wave in Boston.

Half of the students lived in buildings with central AC, where the indoor air temperature averaged 71 degrees. The other half lived in dorms with no AC, where air temperatures averaged almost 80 degrees.

“In the morning, when they woke up, we pushed tests out to their cellphones,” explains Allen. The students took two tests a day for 12 consecutive days.

One test, which included basic addition and subtraction, measured cognitive speed and memory. A second test assessed attention and processing speed.

“We found that the students who were in the non-air-conditioned buildings actually had slower reaction times: 13 percent lower performance on basic arithmetic tests, and nearly a 10 percent reduction in the number of correct responses per minute,” Allen explains.

The results, published in PLOS Medicine, may come as a surprise. “I think it’s a little bit akin to the frog in the boiling water,” Allen says. There’s a “slow, steady — largely imperceptible — rise in temperature, and you don’t realize it’s having an impact on you.”

The findings add to a growing body of evidence that documents the effect of heat on mental performance, both in schools and workplaces.

For instance, a 2006 study from researchers at the Lawrence Berkeley National Lab found that when office temperatures rise above the mid-70s, workers’ performance begins to drop off. Researchers reviewed multiple studies that evaluated performance on common office tasks. The study found that worker productivity is highest at about 72 degrees. When temperatures exceeded the mid-80s, worker productivity decreased by about 9 percent.

Another, more recent study compared worker performance in green-certified buildings and typical office buildings. They found a dip in cognitive function linked to conditions in the indoor environment, including higher indoor temperatures and poor lighting.

And, when it comes to performance in the classroom, a study funded by the Harvard Environmental Economics Program finds that taking a standardized test on a very hot day is linked to poorer performance. The study includes an analysis of test scores from students in New York City who take a series of high-school exams called the Regents Exams.

The author, R. Jisung Park, assistant professor at the University of California, Los Angeles, writes that compared with a 72-degree day, “taking an exam on a 90◦F day leads to a 10.9 percent lower likelihood of passing a particular subject (e.g. Algebra), which in turn affects probability of graduation.”

There’s still a lot to learn about how our brains and bodies respond to heat. “We all tend to think we can compensate, we can do just fine” during heat waves says Allen. But he says the “evidence shows that the indoor temperature can have a dramatic impact on our ability to be productive and learn.”


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Distress puts you at risk of chronic disease

Monitoring Desk

NEW YORK: Dealing with anxiety, depression, and stress at intense levels for a long time can impact our long-term physical health. But what if we are exposed to low levels of psychological distress? Does it still jeopardize our well-being? According to a new study, the answer is “yes.”

‘Even low levels of distress’ harm our well-being in the long run, warn researchers.

“Although the relationship between significant distress and the onset of arthritis, [chronic pulmonary obstructive disorder], cardiovascular disease, and diabetes is well established,” says Prof. Catharine Gale, from the University of Southampton in the United Kingdom, “there is a significant gap in knowledge regarding the link between lower and moderate levels of distress and the development of chronic conditions.”

Alongside Kyle McLachlan, at the University of Edinburgh in the U.K., Prof Gale conducted a study investigating whether exposure to low and moderate psychological distress — which includes symptoms of anxiety and depression — could increase the risk of developing a chronic disease.

The results, which have now been published in the Journal of Psychosomatic Research, indicate that we do not need to experience a lot of distress in order for our physical health to be endangered. A little distress will suffice, the authors warn.

Reducing distress may prevent disease onset

In the new study, the researchers analyzed relevant data collected from 16,485 adults for a period of 3 years. Prof. Gale and McLachlan obtain this information using the UK Household Longitudinal Study, which gathers data regarding the health status, well-being, and living conditions — among other things — of U.K. citizens.

They looked specifically for links between psychological distress and the development of four chronic diseases: diabetes, arthritis, lung disease, and cardiovascular disease.

They also investigated whether any such association could be explained by modifiable factors such as eating habits, exercise, or smoking, or by participants’ socioeconomic status.

Prof. Gale and McLachlan’s study found that, despite the fact that they are not considered clinically significant, even low to moderate levels of experienced distress can heighten the risk for a chronic condition later in life.

“Our findings show that even low levels of distress, below the level usually considered clinically significant, appear to increase the risk of developing a chronic disease, so intervention to reduce symptoms of anxiety and depression may help to prevent the onset of these illnesses for some people.”

Compared with people who reported no symptoms of psychological distress, those who reported low distress levels were 57 percent more likely to develop arthritis.

Also, those experiencing moderate levels of distress were 72 percent more likely to develop this condition, and individuals reporting high distress levels were 110 percent more likely.

Similar associations were also found for cardiovascular disease and lung disease (specifically, chronic obstructive pulmonary disease [COPD]).

In fact, people with low levels of distress were 46 percent more likely to develop cardiovascular problems, those with moderate levels had a 77 percent higher risk, and those exposed to high levels of distress had a 189 percent higher risk.

For lung disease, the risk did not rise in people reporting low distress levels, but it was heightened by 125 percent in those with moderate distress levels, and by 148 percent in people with high distress levels.

However, the researchers found no significant links between psychological distress and the development of diabetes.

Considerable public health implications’

The researchers note that the new study’s results could change the way in which public health policies consider risk factors for chronic diseases.

“These findings have considerable clinical and public health implications,” explains Prof Gale.

“Screening for distress,” she explains, “may help to identify those at risk of developing arthritis, COPD, and cardiovascular disease, while interventions to improve distress may help to prevent and limit progression of disease, even for people with low levels of distress.”

Distress is a potentially modifiable risk factor, so if the links found by this study are confirmed by further research, it could indicate a new pathway in terms of preventive strategies for chronic diseases.

Prof. Cyrus Cooper, the director of the Lifecourse Epidemiology Unit at the UK Medical Research Council, believes that Prof. Gale and McLachlan’s findings have “the potential to have a major impact on the development and management of chronic diseases.”

Dr. Iain Simpson, former president of the British Cardiovascular Society, states that “cardiovascular disease remains one of the major causes of death and disability,” so “[the] knowledge that distress, even at low levels, is also a risk factor is an important finding which could have significant clinical implications.”





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Govt bans use of mercury dental fillings for children

F.P. Report

PESHAWAR: The Khyber Pakhtunkhwa (KP) government has immediately banned the use of mercury dental fillings for children below 15 year throughout the province to protect them from catching serious diseases.

Directorate-General of Health Services, KP, in its notification (2405-70/Dev:/General File(SDPI) Dental) addressed to all district health officers, medical superintendents, Dean of Khyber College of Dentistry, Peshawar and quarters concerned said, “All health workers in the dentistry unit of KP province are requested to restrict  and do not prefer mercury dental fillings for children below the age of 15 years in KP to safeguard their health at their very early age with immediate effect.”

The action has been taken in the backdrop of a research-based campaign launched by Sustainable Development Policy Institute (SDPI) in print and social media throughout the country to ban or restrict the use of mercury dental amalgam, especially for children to safeguard their health.

The SDPI has warmly welcomed the provincial government’s initiative to safeguard children’s health, at their very early age.  “We are confident that the step taken in the very right direction would go a long way in phasing out dental mercury amalgam use not only in Pakistan but also in our neighboring countries, says Dr. Mahmood Khwaja, Senior Advisor on Chemicals and Sustainable Industrial Development, SDPI.

Mercury is a toxic substance and its use in all silver-coloured dental fillings has been linked to environmental harm, as well as increased risks of Alzheimer’s disease, multiple sclerosis, infertility, anxiety, depression, fatigue, and many other adverse health conditions. The use of viable mercury free alternatives for dental fillings is rapidly on the increase in many countries, including Pakistan.

Children are more vulnerable to this substance as its use causes neurological and reproductive problems, and damages kidneys and features. To protect human health and environment from emission from mercury and mercury compounds, global governments adopted Minamata convention on mercury to which more than 128 countries including Pakistan have signed and 93 countries have also ratified the convention.


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Healthful diet could prevent Asthma symptoms

Monitoring Desk

WASHINGTON: A diet rich in fruits, vegetables, and whole grains is associated with better asthma outcomes, according to a study recently published in the European Respiratory Journal.

A healthful diet consists of more fruit and vegetables, and less red meat.

Fruits, vegetables, and whole grains are the main components of a healthful diet, the benefits of which are hailed by medical researchers and nutritionists alike.

From a lower cancer risk to reduced weight and better cardiometabolic health, a better mood, and improved cognition, the benefits of a healthful diet are numerous.

New research adds improved respiratory health to the list. According to a new study led by Roland Andrianasolo, from the Nutritional Epidemiology Research Team at INSERM — or the French National Institute of Health and Medical Research in Paris — healthful eating may help to reduce the frequency of asthma symptoms and improve a person’s control of them.

He explains the motivation for the study, saying, “Existing research on the relationship between diet and asthma is inconclusive, and compared to other chronic diseases, the role of diet in asthma is still debated.”

“This has resulted in a lack of clear nutritional recommendations for asthma prevention,” he goes on, “and little guidance for people living with asthma on how to reduce their symptoms through diet.”

“To address this gap, we wanted to make more detailed and precise assessments of dietary habits and the associations between several dietary scores and asthma symptoms, as well as the level of asthma control,” says Andrianasolo.

To make this precise assessment, Andrianasolo and his colleagues examined the data of 34,776 French adults who participated in the 2017 NutriNet-Santé study.

As part of the study, the participants answered detailed questions about their respiratory health — specifically, it ensued that 25 percent of men and 28 percent of women had at least one asthma symptom.

The participants also reported on the frequency of their symptoms over a 1-year period and answered questions about their control of asthma symptoms over the course of 4 weeks.

These included questions about the use of emergency medication as well as the degree to which asthma symptoms interfered with daily activities.

The quality of the participants’ diets was assessed using three 24-hour dietary records that were collected randomly from each participant. Additionally, the participants’ nutrition was assessed using three dietary scores.

Overall, a healthful diet was considered to be high in fruit, vegetables, and whole grains.

A high intake of meat, salt, and sugar was thought to be unhealthful.

On the whole, the study revealed that men who adhered to a healthful diet were 30 percent less likely to experience asthma symptoms. For women, the likelihood was 20 percent lower.

Also, the men who ate healthfully were 60 percent less likely to have poorly controlled asthma, while women who stuck to a healthful diet were 27 percent less likely to have poorly controlled symptoms.

Andrianasolo weighs in on the findings, saying, “This study was designed to assess the role of an overall [healthful] diet on asthma symptoms and control, rather than identify particular specific foods or nutrients.”

“Our results strongly encourage the promotion of [healthful] diets for preventing asthma symptoms and managing the disease.”

“A [healthful] diet, as assessed by the dietary scores we used, is mostly made up of a high intake of fruit, vegetables, and fiber. These have antioxidant and anti-inflammatory properties and are elements in a [healthful] diet that potentially lower symptoms.”

“In contrast, […] meat, salt, and sugar […] are elements with proinflammatory capacities that may potentially worsen symptoms of asthma,” explains Andrianasolo.

He concedes that further studies are required to confirm the findings. However, he says, the new results “contribute to evidence on the role of diet in asthma, and extend and justify the need to continually support public health recommendations on promoting a [healthful] diet.”

Prof. Mina Gaga, the president of the European Respiratory Society, also comments on the findings, saying, “This research adds to the evidence on the importance of a healthy diet in managing asthma and its possible role in helping prevent the onset of asthma in adults.”

“Healthcare professionals must find the time to discuss diet with their patients, as this research suggests it could play an important role in preventing asthma.”


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High blood pressure could increase risk of dementia

Monitoring Desk

NEW YORK: According to the latest research, having elevated blood pressure as an older adult predicts an increase in one of the hallmarks of Alzheimer’s disease. The study authors also saw an increased risk of brain lesions.

A new study looks at hypertension and brain health in older age.

High blood pressure, or hypertension, is known to put pressure on the body, leading to disease.

Over the years, it has become increasingly clear that having higher-than-normal blood pressure for a sustained amount of time can impact the brain.

Causing impairments to memory, attention, and processing speed, hypertension has a key role in brain aging; it is also linked with dementia.

More than 100 million people in the United States have hypertension, and worldwide, it impacts almost a third of all adults.

Given the size of the affected population, understanding the risks associated with raised blood pressure is paramount.

Recently, researchers from the Rush Alzheimer’s Disease Center at Rush University Medical Center in Chicago, IL, set up a study to look for links between blood pressure and physical markers of brain health in older adults.

The findings are published this week in the journal Neurology. Study co-author Dr. Zoe Arvanitakis explains the types of pathology they were searching for.

“We researched whether blood pressure in later life was associated with signs of brain aging that include plaques and tangles linked to Alzheimer’s disease.”

They also looked for a type of brain lesion called an infarct. These are “areas of dead tissue caused by a blockage of the blood supply, which can increase with age, often go undetected, and can lead to stroke.”

Included in the study were almost 1,300 people who were followed until their deaths, which was an average of 8 years from the beginning of the study. In total, two thirds of the group had a history of high blood pressure, and 87 percent were taking drugs to manage hypertension.

Each year, the participants had their blood pressure assessed, and, after death, their brains were autopsied. Almost half were found to have at least one infarct.

High blood pressure is considered to be anything above 140/90 millimeters of mercury (mmHg). The first number is known as systolic blood pressure, which measures pressure in the blood vessels as the heart contracts.

The second reading is diastolic blood pressure — that is, the pressure in the arteries when the heart is at rest between beats.

Increased lesion risk

As expected, the researchers did find links between hypertension and brain health. They found that for every standard deviation above the group’s average systolic blood pressure, there was a 46 percent increased chance of having at least one brain lesion.

To put that into perspective, that is the equivalent of around 9 years of brain aging. In this study, an example of one standard deviation above average would be something like 147 mmHg compared with 134 mmHg.

Similarly, there was a 46 percent increased risk of large lesions and a 36 percent increased risk of smaller lesions with each standard deviation increase in systolic blood pressure.

The results were similar when they studied diastolic blood pressure; one standard deviation above the group average produced a 28 percent increased risk of developing one or more lesions.

On a slightly different note, the authors found that having a diastolic blood pressure that declined over time was also associated with an increased risk of lesions.

Declining blood pressure over time has previously been linked with increased mortality risk.

Hypertension and Alzheimer’s

When the researchers investigated possible links between hypertension and the neural features of Alzheimer’s, the picture was less clear. They looked at two neurological features: tangles, or twisted fibers within neurons; and plaques, or protein buildup between nerve cells.

Although higher blood pressure readings were associated with a higher number of tangles, they did not predict increased numbers of plaques.

Why this disparity between the two hallmarks of Alzheimer’s disease and blood pressure exists will need to be unpicked in future research.

The study authors are quick to note the study’s shortcomings. For instance, they only had access to blood pressure readings during the participants’ later life. Building a picture of how blood pressure changes throughout an individual’s lifespan would provide deeper insight.

Furthermore, their blood pressure readings were only taken once every year and therefore do not offer an accurate picture of how someone’s blood pressure may fluctuate over months, weeks, or days. As for conclusions, Dr. Arvanitakis is cautious.