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Yahoo
2 hours ago
- Yahoo
New blood pressure guidelines: What we know about the American Heart Association's updates
The American Heart Association and the American College of Cardiology issued a new set of guidelines to help minimize high blood pressure, also known as hypertension, on Aug. 14. The new guidelines are the first set published since 2017. Updates include instruction for doctors to recommend treatment to those with Stage 1 hypertension rather than just Stage 2, and the recommendation that Americans limit the amount of alcohol they consume to a maximum of one drink per day for women and two for men. "By addressing individual risks earlier and offering more tailored strategies across the lifespan, the 2025 guideline aims to aid clinicians in helping more people manage their blood pressure and reduce the toll of heart disease, kidney disease, Type 2 diabetes and dementia," guideline writing committee Chair Dr. Daniel Jones said in a news release. The report notes that high blood pressure, including Stage 1 or Stage 2 hypertension, affects nearly half of all adults in the U.S. and remains the leading cause of death in the U.S. and worldwide. Here's what to know about the updated guidelines. New blood pressure guidelines Several highlights of the new guidelines were noted in the report. While the 2017 guidelines would prescribe lifestyle changes and medication to those with a systolic blood pressure level of 140 mm Hg or higher, clinicians are now advised to recommend lifestyle changes to those in the 130–139 mm Hg range. The blood pressure gauge uses a unit of measurement called millimeters of mercury (mm Hg) to measure the pressure in your blood vessels. The guidelines recommend close blood pressure management before, during and after pregnancy, as monitoring and treating high blood pressure can reduce the risk of serious complications including preeclampsia. Recent research has also confirmed that blood pressure affects brain health, meaning that early treatment is recommended for people diagnosed with high blood pressure to maintain brain health and cognition. The new guidelines reinforce several previously observed aspects of blood pressure health, including the importance of healthy lifestyle behaviors such as eating a nutritious diet, being physically active and maintaining or achieving a healthy weight. For more information, find the full report at What causes high blood pressure? The new guidelines list the various factors that influence one's blood pressure: Behavioral, environmental, hormonal and genetic influences. Diet quality Dietary factors including sodium intake (lower is recommended), potassium intake (higher is recommended), and alcohol consumption (little to none is recommended) Intake of fiber, calcium, magnesium and plant protein Weight and related metabolic issues Age, obesity and insulin resistance Sleep disturbances and psychosocial stressors Physical activity and fitness Environmental exposures and chemical toxins, including air pollution and heavy metals What counts as high blood pressure? Criteria defining normal versus elevated blood pressure remain the same, despite updated guidelines: Normal blood pressure is less than 120/80 mm Hg Elevated blood pressure is 120-129/80 mm Hg Stage 1 hypertension is 130-139 mm Hg or 80-89 mm Hg Stage 2 hypertension is ≥140 mm Hg or ≥90 mm Hg What are the symptoms of high blood pressure? Low blood pressure? Mayo Clinic notes that many people with high blood pressure do not experience any symptoms. Some symptoms associated with the condition can include: Headaches Shortness of breath Nosebleeds Symptoms of low blood pressure can include: Blurred or fading vision Dizzy or lightheaded feelings Fainting Fatigue Trouble concentrating Upset stomach Iris Seaton is the trending news reporter for the Asheville Citizen Times, part of the USA TODAY Network. Reach her at iseaton@ This article originally appeared on Asheville Citizen Times: New blood pressure guidelines: What to know about 2025 updates Solve the daily Crossword
Health Line
6 hours ago
- Health Line
Do GLP-1 Weight-Loss Drugs Cause Vision Loss? What to Know
Studies have linked GLP-1 medications to various eye conditions, some of which may lead to vision loss. Despite these findings, a clear link has yet to be established, and much of the evidence remains inconsistent. People should be aware of potential eye disease and blindness risks when discussing a GLP-1 with their doctor. The debate over whether GLP-1 medications raise the risk of eye conditions that could lead to vision loss continues. Scientists have been closely studying this association as more people turn to these widely prescribed drugs for weight management. Some studies have suggested a link, but the overall evidence has been inconsistent. However, when a potential side effect becomes as serious as vision loss or blindness, even a remote possibility is worth investigating. GLP-1 drugs are a class of medications used to treat obesity and type 2 diabetes that include semaglutide (Ozempic, Wegovy) and tirzepatide (Mounjaro, Zepbound). They work by mimicking naturally occurring hormones that help regulate blood sugar, promote satiety, and reduce appetite. While GLP-1s are generally well tolerated and offer numerous health benefits — from weight loss and better glucose control to a lower risk of cardiovascular disease — research suggests they could increase the risk of certain serious eye conditions. Previous research has linked GLP-1 drugs to a sudden, vision-threatening condition called nonarteritic anterior ischemic optic neuropathy (NAION) and to 'wet' age-related macular degeneration. The risk of developing these conditions is relatively low. However, they are serious and should be factored into the risk–benefit discussion when considering GLP-1 therapy with a doctor. As a flurry of new research offers a clearer picture of how GLP-1 drugs may affect eye health, Healthline spoke with experts to help break down the findings. GLP-1 drugs and eye disease Three new studies investigated the link between GLP-1s and eye disease, but each employed distinct methods and arrived at different conclusions. A new study compared the effects of semaglutide or tirzepatide with other antidiabetic medications — such as insulin and metformin — on optic nerve conditions, including NAION, in patients with type 2 diabetes. The retrospective cohort study, published on August 11 in JAMA Network Open, included nearly 160,000 patients, evenly split into two groups: one taking GLP-1s and one taking other antidiabetic medications. Over two years of follow-up, those taking a GLP-1 had higher rates of NAION and other optic nerve conditions than those in the comparison group. There were 93 patients with other optic nerve disorders in the semaglutide or tirzepatide group, and 54 patients with these disorders in the comparison group. The study did not specify the types of other optic nerve disorders. 'Newer GLP-1RAs have lots of benefits. This study provides evidence of their potential risks. For each patient, the risk-benefit tradeoff critically depends on a patient's clinical characteristics and their preferences and clinicians' recommendations,' senior study author Rong Xu, PhD, professor and director of the Center for AI in Drug Discovery at Case Western Reserve University, told Healthline. A separate retrospective study, also published in August in the same journal, reached a different conclusion. In a large cohort of patients with type 2 diabetes, researchers found that GLP-1 use was not associated with a higher incidence of NAION but was linked to another eye condition: diabetic retinopathy. During a two-year follow-up, 5,037 patients taking a GLP-1 developed diabetic retinopathy, compared with 4,938 who were not — a 7% increased risk. In a twist, the study found that although there was a small increase in diabetic retinopathy, GLP-1 use appeared to protect against the condition's progression and sight-threatening complications. A subgroup of patients in the study had pre-existing diabetic retinopathy. Those who took a GLP-1 had a lower risk of complications, including progression to proliferative diabetic retinopathy, diabetic macular edema, vitreous hemorrhage, and neovascular glaucoma. They were also less likely to require medical, surgical, or laser treatments for their eyes. Most notably, GLP-1 use was associated with a significantly lower incidence of blindness from any cause. Another study — a meta-analysis and review of 78 trials involving more than 73,000 participants — concluded that semaglutide was associated with an increased incidence of NAION but emphasized that evidence for a causal link remains inconclusive. The review, published on August 14 in JAMA Ophthalmology, found that semaglutide neither increased nor reduced the risk of eye disorders, including diabetic retinopathy. It's important to note that all three studies can only identify correlations and cannot establish that taking a GLP-1 causes these eye disorders. Studies so far have also focused almost exclusively on patients with type 2 diabetes, so it's unclear what effect GLP-1s have on eye conditions in individuals taking them for weight loss. Making sense of GLP-1s and eye health If you're having trouble making sense of what these conflicting findings mean — especially if you already take a GLP-1 or are considering one — you're not alone. Here's a quick summary on GLP-1s and various eye conditions, and what experts have to say about them: NAION NAION causes sudden blindness in one eye, usually after waking, that is caused by a lack of blood flow to the optic nerve. The condition is elusive, and not well understood. The condition is serious, but despite an apparent increased incidence among patients taking GLP-1s, the condition is still uncommon. 'NAION is rare in general,' said Xu. 'For patients with high risk of developing NAION (e.g., those with diabetes, hypertension) who are taking GLP-1RAs, ophthalmologists may increase vigilance,' she said. Linda Lam, MD, MBA, an ophthalmologist with Keck Medicine of USC, who wasn't involved in the research, tells Healthline that it's too early to make a 'definitive connection' between NAION and GLP-1s. 'To make a correlation that GLP-1s cause NAION would be a big leap,' she said. Diabetic retinopathy Diabetic retinopathy is a complication of type 1 and type 2 diabetes that may lead to vision loss. It is the most common cause of preventable blindness in the United States. Though it may seem counterintuitive, antidiabetic medications that improve blood glucose may worsen this condition. 'It's better to be cautious and protective with vision. So, if a patient has started on a GLP-1 and they already have some diabetic retinopathy, I would just have them come in sooner to see their eye care provider,' said Lam. 'Wet' age-related macular degeneration A recent study published in June found that patients with type 2 diabetes who took GLP-1s were more than twice as likely to develop wet AMD as those who did not. Researchers also identified a dose response, meaning that the longer the patients took a GLP-1, the more likely they were to develop the condition. However, there still needs to be more research to substantiate this link. 'We need to have a lot more studies before we can make these cause and effect determinations. But, anyone who has neovascular AMD and is on a GLP-1 needs to be monitored more closely,' said Lam. The bottom line: GLP-1s have many health benefits, and while there is some evidence to support an association between them and serious eye conditions, that link should not be overstated, and must be considered within the greater context of your individual health. Patients with diabetes should get regular eye exams, regardless of whether they are taking a GLP-1, but taking the medication may be one more reason to schedule an exam. 'GLP-1s have potentially good long-term effects for long-term health in patients with diabetes or obesity. But doctors should be much more cautious and aware of visual complications while they're on these medications, especially when their glycemic numbers go down rapidly. The threshold for when to see your eye care provider or retina specialist should be lower,' Lam said.
Medscape
7 hours ago
- Medscape
Bomb Shrapnel Tore a Doctor Apart: His Experience Remade Him
Eventually, every doctor becomes a patient. For many physicians, experiencing serious illness and treatment is humbling, eye-opening, and in the end transformative. Dr. Patient is a Medscape series telling these stories. In 2003, I was called to active duty in the military and, in early 2004, went to Iraq. I commanded a medical unit, running convoys in and out of our base providing medical support. During one of my missions, our convoy had stopped so a roadside bomb could be cleared. We dismounted and were pulling security when a car with a suicide bomber ran straight into us and blew up. The aftermath of the suicide bombing. Luckily, no one died in my unit. But three of us were seriously injured, including myself. I was bombarded with shrapnel, which caused most of my injuries. Some of the major ones impeded my blood flow, damaging my nerves and joints. I was holding a weapon aimed at the vehicle when the explosion happened, so both my thumbs were hyperextended and dislocated. Both my ankles dislocated. I also had a traumatic brain injury and a huge laceration on my head. I was knocked out, so I don't remember all this. I've pieced the story together through other people and pictures. Iraq was the most photographed war, so there are shots of me being treated in the field. Dr. Lee being treated after the explosion. I had several surgeries in Iraq to remove the biggest pieces of shrapnel. Then I was sent home to Walter Reed Army Medical Center and had additional surgeries over the next four months. Dr. Lee's shrapnel injuries were extensive. Initially, I was in a wheelchair, and I wasn't sure if I was going to walk. My nerves were shocked, and nothing was working. Being a spinal cord injury doc, I knew I didn't have spinal cord damage. It was all peripheral nerves. But I was still aware that I might be in a wheelchair all my life, if things didn't come back. Slowly, they did come back. I had to undergo physical and occupational therapy. PT and OT are a mainstay of my job with veterans, and I can tell you, it was the most boring thing I've ever had to go through. But boy, was it necessary. Without it, I wouldn't be where I am today. 'I'm That Guy' — Things Start to Change After three hours of therapy every day, there was nothing for me to do. So, I went to see the chief of staff at Walter Reed and asked if there was any way he could privilege me. And he did. I got an emergency credentialing privilege. I borrowed a white coat and started seeing patients while being a patient at the same time. I remember going to the clinic to see a patient. He kept looking at me after I introduced myself. Finally, he said, 'You look like the guy that was doing OT next to me yesterday.' 'Oh, yeah, I'm that guy,' I said. That's when things started changing for me as a physician. Being there put me inside what my patients were going through. I had learned from textbooks and in the clinic. I had learned from other docs. But after the injury, I was one of these guys. Now, when my spinal cord patients tell me that PT and OT are boring, I agree with them. I've been there. But I tell them, if it wasn't for that, I wouldn't be walking. Physically, I learned how to deal with the pain and everything else. But the mental recovery was really hard. As a physician, and after seeing the things I saw in the war, I didn't think it would affect me. When I was in Iraq during the Fallujah offensive, it was nonstop casualties coming in 24/7 for seven days. So many young marines were MEDEVAC to our unit that week, many of whom we could not save. I remember hallucinating because I hadn't slept. I'll never forget it. It took a mental toll on many of our medics and physicians. I couldn't lose our medics to mental health struggles. I needed them. I used to tell them, 'If you bleed every time your patient bleeds, you are going to run out of blood and die. You need to shut that out and move on, because the next patient's bleeding, and you need to be there to help.' But after I came back, PTSD hit me hard. Nightmares, flashbacks, anger. It crept up on me. For two years, I had no idea I was suffering through it, and it almost devastated my marriage and my family. The turning point for me was my daughter who was 10 years old at the time. We were playing some board game, and she put her pieces down and said, 'Dad, you don't smile anymore.' I started crying. I knew I had to get help. Dr. Lee with his wife and young children. A New Doctor Emerges From the Wreckage I used to joke with my psychiatrist, 'Why am I paying you? All I do is talk, and all you do is nod your head.' He would say, 'Ken, would you talk if I didn't make you?' He was right. I needed to bring it out, and I needed somebody to listen. Now, I fall behind in my schedule because I'm busy listening to my patients. During the dark times, when I was suffering, the only thing that made me happy was going to work. Coming to the VA was my solace, and the veterans were my healers. I think the medical students and residents that work with me now are a little shocked. Because I'm not only a physician for my patients; I'm also their buddy. I go in and give each guy a huge hug, and we share war stories. I open up my life to my patients. We have a bond as combat veterans, and I make that connection before we even talk about why they're there. They tell me about pretty much everything in their lives. And I make notes about the details like what unit they were in or their grandson's soccer team, so I can remember at the next visit. It's so important, because even though I'm a rehab doc, 95% of my patients don't have any other doctors, so we provide the primary care. I wasn't the most compliant patient myself when I was recovering. My physical fitness level wasn't good. One of my recreational therapists finally said, 'Hey, Dr Lee. You're my boss, but you're pretty pathetic. You need to get moving.' So, I started getting involved in sports. I realized that sports are part of us. It doesn't matter what type of disability you have. You see it in little kids; competition is in our DNA. So, why not use that to rehab ourselves? I started using adaptive sports as part of the rehab for our guys in chairs. Fortunately, I had great support from my bosses, and now we have the largest local sports program in the VA system. It became my sub-specialty, the legacy that I leave in this world as I go. When the wheelchair guys play sports, sometimes their tires pop. It sounds like a gunshot or a bomb blowing up. It can be a trigger. Some veterans go into a full-blown flashback. When that happens, I go over there and just hug them, hold them. I keep talking, 'Hey, you know what? It was a tire popping. I'm right here. You know me. Hold my hand. Come on back.' Is that the correct way to deal with PTSD? I don't know. But I do know they need human contact. I know touch is important. Often, when I talk to a veteran patient, my hand is on their shoulder. If I'm standing at a distance while they're talking, and they start to cry, I close that distance. I say, 'My hand is here, if you want to hold it as you go through this,' because I remember when I was a patient and a doctor would hold out his hand and tell me not to give up hope. Before my injury, I used to tell my patients to take it day by day. Then, there I was at Walter Reed telling myself 'day by day.' I realized how easy it had been for me to say those words and how hard they are to accept. Who am I to tell these guys what to do? Now, I put it as a question. 'I want to tell you that we have to work day by day, but how do you feel about it?' They say, 'I really want to walk.' And I say, 'We're going to shoot for that, but in case it doesn't happen, I want you to work on other things too.' And we make a promise to each other. Open Road, New Horizon My legs are still covered in burns and shrapnel scars. They look horrible. I remember when I would take my kids to a swimming pool, all the moms would start pulling their kids out of the pool. They thought I had some terrible disease. While I'm not paralyzed, I don't have a lot of sensation below my hip, except for deep pains. My ankles give out. I can't turn doorknobs, so I changed all our doors at home from knobs to handles. I still have flashbacks every three or four months. Suddenly, I'm in Iraq, and it's really scary. When I come back, my heart's racing. I'm angry. But it's less and less. And now when there's a trigger like a loud noise, I know how to control it. My family has been through all of this with me. It was tough on my kids. They were scared of me after I came back from the war, because I wasn't the same person. I didn't realize how damaging that was. But things got better, and they are both physicians now, so maybe this experience will help them. Like many veterans, I celebrate my Alive Day every year — September 12, the day I could have died. But I came back. Kenneth Lee, MD, is the chief of the Spinal Cord Injury Division at Zablocki VA Medical Center in Milwaukee, Wisconsin, and a tenured professor in the Department of Physical Medicine and Rehabilitation at the Medical College of Wisconsin.
