Is multi-tasking bad for your brain?
Multi-tasking has rapidly taken over our lives, to the point where we look woefully lax if we’re doing just one thing at a time.
We think nothing of texting while also watching television, surfing the internet and talking to our family.
Indeed, drug companies are busy developing products to enhance our mental efficiency so that we can do even more.
Overload: Ironically, doing many things at once can make us less efficient
But scientists are discovering that today’s mania for cramming everything in at once is creating a perilous cocktail of brain problems, from severe stress and rage in adults to learning problems and autism-like behaviour in children.
It also, ironically, often makes us less efficient. Advances in medical-scanning technology mean we can now watch what happens in the brain when people try to perform more than one complex task at a time. And the news isn’t good.
The human brain doesn’t multi-task like an expert juggler; it switches frantically between tasks like a bad amateur plate-spinner.
The constant effort this requires means that doing even just two or three things at once puts far more demand on our brains compared with if we did them one after another
Saturday, May 31, 2014
What should we die from? Healthy Natural Death BMJ 2014;348:g3380
Views & Reviews
What should we die from?
BMJ 2014; 348 doi: http://dx.doi.org/10.1136/bmj.g3380 (Published 27 May 2014)
Cite this as: BMJ 2014;348:g3380
Respond to this article
Recent rapid responses

Re: What should we die from? Healthy Natural Death
30 May 2014
In this world everyone requires a healthy natural death at any age. Each and every country should give a healthy environment and healthy food for a healthy community and population at all ages and for both sexes. Everyone should adopt a healthy lifestyle to live a healthy long life. Cost effective investigation and treatment of disease with the end result of definite cure will definitely gives us the healthy natural death which we all want.
Competing interests: None declared
Mohaamed A Aleem, Neurologist
Kapv Govt medical college MGM Govt hospital ABC hospital Trichy 620018 Tamilnadu India, Kapv Govt medical college MGM Govt hospital ABC hospital Trichy 620018 Tamilnadu India
What should we die from? Healthy Natural Death
Views & Reviews
What should we die from?
BMJ 2014; 348 doi: http://dx.doi.org/10.1136/bmj.g3380 (Published 27 May 2014)
Cite this as: BMJ 2014;348:g3380
Respond to this article
Recent rapid responses

Re: What should we die from? Healthy Natural Death
30 May 2014
In this world everyone requires a healthy natural death at any age. Each and every country should give a healthy environment and healthy food for a healthy community and population at all ages and for both sexes. Everyone should adopt a healthy lifestyle to live a healthy long life. Cost effective investigation and treatment of disease with the end result of definite cure will definitely gives us the healthy natural death which we all want.
Competing interests: None declared
Mohaamed A Aleem, Neurologist
Kapv Govt medical college MGM Govt hospital ABC hospital Trichy 620018 Tamilnadu India, Kapv Govt medical college MGM Govt hospital ABC hospital Trichy 620018 Tamilnadu India
Thursday, May 29, 2014
World No Tobacco Day - 31 May 2014- Raise taxes on tobacco
World No Tobacco Day - 31 May 2014
Raise taxes on tobacco
The global tobacco epidemic kills nearly 6 million people each year, of which more than 600 000 are non-smokers dying from breathing second-hand smoke. Unless we act, the epidemic will kill more than 8 million people every year by 2030. More than 80% of these preventable deaths will be among people living in low-and middle-income countries.
Key facts
Tobacco kills up to half of its users.
Consumption of tobacco products is increasing globally, though it is decreasing in some high-income and upper middle-income countries.
Leading cause of death, illness and impoverishment
The tobacco epidemic is one of the biggest public health threats the world has ever faced, killing nearly six million people a year. More than five million of those deaths are the result of direct tobacco use while more than 600 000 are the result of non-smokers being exposed to second-hand smoke.
Approximately one person dies every six seconds due to tobacco, accounting for one in 10 adult deaths. Up to half of current users will eventually die of a tobacco-related disease.
Nearly 80% of the more than one billion smokers worldwide live in low- and middle-income countries, where the burden of tobacco-related illness and death is heaviest.
Tobacco users who die prematurely deprive their families of income, raise the cost of health care and hinder economic development.
In some countries, children from poor households are frequently employed in tobacco farming to provide family income. These children are especially vulnerable to "green tobacco sickness", which is caused by the nicotine that is absorbed through the skin from the handling of wet tobacco leaves.
Gradual killer
Because there is a lag of several years between when people start using tobacco and when their health suffers, the epidemic of tobacco-related disease and death has just begun.
Tobacco caused 100 million deaths in the 20th century. If current trends continue, it may cause one billion deaths in the 21st century.
Unchecked, tobacco-related deaths will increase to more than eight million per year by 2030. More than 80% of those deaths will be in low- and middle-income countries.
Second-hand smoke kills
Second-hand smoke is the smoke that fills restaurants, offices or other enclosed spaces when people burn tobacco products such as cigarettes, bidis and water pipes. There are more than 4000 chemicals in tobacco smoke, of which at least 250 are known to be harmful and more than 50 are known to cause cancer.
There is no safe level of exposure to second-hand tobacco smoke.
In adults, second-hand smoke causes serious cardiovascular and respiratory diseases, including coronary heart disease and lung cancer. In infants, it causes sudden death. In pregnant women, it causes low birth weight.
Almost half of children regularly breathe air polluted by tobacco smoke in public places.
Over 40% of children have at least one smoking parent.
Second-hand smoke causes more than 600 000 premature deaths per year.
In 2004, children accounted for 28% of the deaths attributable to second-hand smoke.
Every person should be able to breathe tobacco-smoke-free air. Smoke-free laws protect the health of non-smokers, are popular, do not harm business and encourage smokers to quit.
Over 1 billion people, or 16% of the world's population, are protected by comprehensive national smoke-free laws.
Taxes discourage tobacco use
Tobacco taxes are the most cost-effective way to reduce tobacco use, especially among young people and poor people. A tax increase that increases tobacco prices by 10% decreases tobacco consumption by about 4% in high-income countries and by up to 8% in low- and middle-income countries.
Even so, high tobacco taxes is a measure that is rarely used. Only 32 countries, less than 8% of the world's population, have tobacco tax rates greater than 75% of the retail price. Tobacco tax revenues are on average 175 times higher than spending on tobacco control, based on available data.
Indian Scenario
Experts predict 1.5 million smoking deaths in India by 2020
There are approximately 275 million tobacco users in India. Tobacco use accounts for nearly half of all cancers among males and a quarter of all cancers among females and it is estimated that there will be 1.5 million tobacco-related deaths annually by 2020
World scenario
The World Health Organisation (WHO) has called on countries to raise taxes on tobacco to encourage users to stop and prevent other people from becoming addicted to tobacco, ahead of “World No Tobacco Day” on May 31.
Raise taxes on tobacco
It is estimated that by increasing tobacco taxes to about 50 per cent, all countries would reduce the number of smokers by 49 million within the next three years and ultimately save 11 million lives based on 2012 data.
Today, every six seconds someone dies from tobacco use, tobacco kills up to half of its users. It also incurs considerable costs for families, businesses, and governments, while treating tobacco-related diseases like cancer and heart disease is expensive.
And as tobacco-related diseases and death often strike people in the prime of their working lives, productivity and incomes fall.
Raising taxes on tobacco is the most effective way to reduce use and save lives, determined action on tobacco tax policy hits the industry where it hurts.
High prices are particularly effective in discouraging young people (who often have more limited incomes than older adults) from taking up smoking.
Its also encouraged that the existing young smokers to either reduce their use of tobacco or quit altogether.
Price increases are two to three times more effective in reducing tobacco use among young people than among older adults.
Tax policy can be divisive, but this is the tax rise everyone can support, as tobacco taxes go up, death and disease go down.
WHO also calculates that if all countries increased tobacco taxes by 50 per cent per pack, governments will earn an extra 101 billion dollars in global revenue.
These additional funds could and should be used to advance health and other social programmes.
Conclusion
Tobacco use is the world’s leading preventable cause of death.
Experts predict 1.5 million smoking deaths in India by 2020
Tobacco kills nearly 6 million people each year, of which over 600,000 are non-smokers dying from breathing second-hand smoke.
If no action is taken, tobacco will kill over 8 million people every year by 2030, over 80 per cent of them among people living in low and middle income countries. Tobacco taxes are the most cost-effective way to reduce tobacco and tobacco products uses.
Raise taxes on tobacco
The global tobacco epidemic kills nearly 6 million people each year, of which more than 600 000 are non-smokers dying from breathing second-hand smoke. Unless we act, the epidemic will kill more than 8 million people every year by 2030. More than 80% of these preventable deaths will be among people living in low-and middle-income countries.
Key facts
Tobacco kills up to half of its users.
Consumption of tobacco products is increasing globally, though it is decreasing in some high-income and upper middle-income countries.
Leading cause of death, illness and impoverishment
The tobacco epidemic is one of the biggest public health threats the world has ever faced, killing nearly six million people a year. More than five million of those deaths are the result of direct tobacco use while more than 600 000 are the result of non-smokers being exposed to second-hand smoke.
Approximately one person dies every six seconds due to tobacco, accounting for one in 10 adult deaths. Up to half of current users will eventually die of a tobacco-related disease.
Nearly 80% of the more than one billion smokers worldwide live in low- and middle-income countries, where the burden of tobacco-related illness and death is heaviest.
Tobacco users who die prematurely deprive their families of income, raise the cost of health care and hinder economic development.
In some countries, children from poor households are frequently employed in tobacco farming to provide family income. These children are especially vulnerable to "green tobacco sickness", which is caused by the nicotine that is absorbed through the skin from the handling of wet tobacco leaves.
Gradual killer
Because there is a lag of several years between when people start using tobacco and when their health suffers, the epidemic of tobacco-related disease and death has just begun.
Tobacco caused 100 million deaths in the 20th century. If current trends continue, it may cause one billion deaths in the 21st century.
Unchecked, tobacco-related deaths will increase to more than eight million per year by 2030. More than 80% of those deaths will be in low- and middle-income countries.
Second-hand smoke kills
Second-hand smoke is the smoke that fills restaurants, offices or other enclosed spaces when people burn tobacco products such as cigarettes, bidis and water pipes. There are more than 4000 chemicals in tobacco smoke, of which at least 250 are known to be harmful and more than 50 are known to cause cancer.
There is no safe level of exposure to second-hand tobacco smoke.
In adults, second-hand smoke causes serious cardiovascular and respiratory diseases, including coronary heart disease and lung cancer. In infants, it causes sudden death. In pregnant women, it causes low birth weight.
Almost half of children regularly breathe air polluted by tobacco smoke in public places.
Over 40% of children have at least one smoking parent.
Second-hand smoke causes more than 600 000 premature deaths per year.
In 2004, children accounted for 28% of the deaths attributable to second-hand smoke.
Every person should be able to breathe tobacco-smoke-free air. Smoke-free laws protect the health of non-smokers, are popular, do not harm business and encourage smokers to quit.
Over 1 billion people, or 16% of the world's population, are protected by comprehensive national smoke-free laws.
Taxes discourage tobacco use
Tobacco taxes are the most cost-effective way to reduce tobacco use, especially among young people and poor people. A tax increase that increases tobacco prices by 10% decreases tobacco consumption by about 4% in high-income countries and by up to 8% in low- and middle-income countries.
Even so, high tobacco taxes is a measure that is rarely used. Only 32 countries, less than 8% of the world's population, have tobacco tax rates greater than 75% of the retail price. Tobacco tax revenues are on average 175 times higher than spending on tobacco control, based on available data.
Indian Scenario
Experts predict 1.5 million smoking deaths in India by 2020
There are approximately 275 million tobacco users in India. Tobacco use accounts for nearly half of all cancers among males and a quarter of all cancers among females and it is estimated that there will be 1.5 million tobacco-related deaths annually by 2020
World scenario
The World Health Organisation (WHO) has called on countries to raise taxes on tobacco to encourage users to stop and prevent other people from becoming addicted to tobacco, ahead of “World No Tobacco Day” on May 31.
Raise taxes on tobacco
It is estimated that by increasing tobacco taxes to about 50 per cent, all countries would reduce the number of smokers by 49 million within the next three years and ultimately save 11 million lives based on 2012 data.
Today, every six seconds someone dies from tobacco use, tobacco kills up to half of its users. It also incurs considerable costs for families, businesses, and governments, while treating tobacco-related diseases like cancer and heart disease is expensive.
And as tobacco-related diseases and death often strike people in the prime of their working lives, productivity and incomes fall.
Raising taxes on tobacco is the most effective way to reduce use and save lives, determined action on tobacco tax policy hits the industry where it hurts.
High prices are particularly effective in discouraging young people (who often have more limited incomes than older adults) from taking up smoking.
Its also encouraged that the existing young smokers to either reduce their use of tobacco or quit altogether.
Price increases are two to three times more effective in reducing tobacco use among young people than among older adults.
Tax policy can be divisive, but this is the tax rise everyone can support, as tobacco taxes go up, death and disease go down.
WHO also calculates that if all countries increased tobacco taxes by 50 per cent per pack, governments will earn an extra 101 billion dollars in global revenue.
These additional funds could and should be used to advance health and other social programmes.
Conclusion
Tobacco use is the world’s leading preventable cause of death.
Experts predict 1.5 million smoking deaths in India by 2020
Tobacco kills nearly 6 million people each year, of which over 600,000 are non-smokers dying from breathing second-hand smoke.
If no action is taken, tobacco will kill over 8 million people every year by 2030, over 80 per cent of them among people living in low and middle income countries. Tobacco taxes are the most cost-effective way to reduce tobacco and tobacco products uses.
World No Tobacco Day - 31 May 2014Raise taxes on tobacco
World No Tobacco Day - 31 May 2014
Raise taxes on tobacco
The global tobacco epidemic kills nearly 6 million people each year, of which more than 600 000 are non-smokers dying from breathing second-hand smoke. Unless we act, the epidemic will kill more than 8 million people every year by 2030. More than 80% of these preventable deaths will be among people living in low-and middle-income countries.
Key facts
Tobacco kills up to half of its users.
Consumption of tobacco products is increasing globally, though it is decreasing in some high-income and upper middle-income countries.
Leading cause of death, illness and impoverishment
The tobacco epidemic is one of the biggest public health threats the world has ever faced, killing nearly six million people a year. More than five million of those deaths are the result of direct tobacco use while more than 600 000 are the result of non-smokers being exposed to second-hand smoke.
Approximately one person dies every six seconds due to tobacco, accounting for one in 10 adult deaths. Up to half of current users will eventually die of a tobacco-related disease.
Nearly 80% of the more than one billion smokers worldwide live in low- and middle-income countries, where the burden of tobacco-related illness and death is heaviest.
Tobacco users who die prematurely deprive their families of income, raise the cost of health care and hinder economic development.
In some countries, children from poor households are frequently employed in tobacco farming to provide family income. These children are especially vulnerable to "green tobacco sickness", which is caused by the nicotine that is absorbed through the skin from the handling of wet tobacco leaves.
Gradual killer
Because there is a lag of several years between when people start using tobacco and when their health suffers, the epidemic of tobacco-related disease and death has just begun.
Tobacco caused 100 million deaths in the 20th century. If current trends continue, it may cause one billion deaths in the 21st century.
Unchecked, tobacco-related deaths will increase to more than eight million per year by 2030. More than 80% of those deaths will be in low- and middle-income countries.
Second-hand smoke kills
Second-hand smoke is the smoke that fills restaurants, offices or other enclosed spaces when people burn tobacco products such as cigarettes, bidis and water pipes. There are more than 4000 chemicals in tobacco smoke, of which at least 250 are known to be harmful and more than 50 are known to cause cancer.
There is no safe level of exposure to second-hand tobacco smoke.
In adults, second-hand smoke causes serious cardiovascular and respiratory diseases, including coronary heart disease and lung cancer. In infants, it causes sudden death. In pregnant women, it causes low birth weight.
Almost half of children regularly breathe air polluted by tobacco smoke in public places.
Over 40% of children have at least one smoking parent.
Second-hand smoke causes more than 600 000 premature deaths per year.
In 2004, children accounted for 28% of the deaths attributable to second-hand smoke.
Every person should be able to breathe tobacco-smoke-free air. Smoke-free laws protect the health of non-smokers, are popular, do not harm business and encourage smokers to quit.
Over 1 billion people, or 16% of the world's population, are protected by comprehensive national smoke-free laws.
Taxes discourage tobacco use
Tobacco taxes are the most cost-effective way to reduce tobacco use, especially among young people and poor people. A tax increase that increases tobacco prices by 10% decreases tobacco consumption by about 4% in high-income countries and by up to 8% in low- and middle-income countries.
Even so, high tobacco taxes is a measure that is rarely used. Only 32 countries, less than 8% of the world's population, have tobacco tax rates greater than 75% of the retail price. Tobacco tax revenues are on average 175 times higher than spending on tobacco control, based on available data.
Indian Scenario
Experts predict 1.5 million smoking deaths in India by 2020
There are approximately 275 million tobacco users in India. Tobacco use accounts for nearly half of all cancers among males and a quarter of all cancers among females and it is estimated that there will be 1.5 million tobacco-related deaths annually by 2020
World scenario
The World Health Organisation (WHO) has called on countries to raise taxes on tobacco to encourage users to stop and prevent other people from becoming addicted to tobacco, ahead of “World No Tobacco Day” on May 31.
It is estimated that by increasing tobacco taxes to about 50 per cent, all countries would reduce the number of smokers by 49 million within the next three years and ultimately save 11 million lives based on 2012 data.
Today, every six seconds someone dies from tobacco use, tobacco kills up to half of its users. It also incurs considerable costs for families, businesses, and governments, while treating tobacco-related diseases like cancer and heart disease is expensive.
And as tobacco-related diseases and death often strike people in the prime of their working lives, productivity and incomes fall.
Raising taxes on tobacco is the most effective way to reduce use and save lives, determined action on tobacco tax policy hits the industry where it hurts.
High prices are particularly effective in discouraging young people (who often have more limited incomes than older adults) from taking up smoking.
Its also encouraged that the existing young smokers to either reduce their use of tobacco or quit altogether.
Price increases are two to three times more effective in reducing tobacco use among young people than among older adults.
Tax policy can be divisive, but this is the tax rise everyone can support, as tobacco taxes go up, death and disease go down.
WHO also calculates that if all countries increased tobacco taxes by 50 per cent per pack, governments will earn an extra 101 billion dollars in global revenue.
These additional funds could and should be used to advance health and other social programmes.
Tobacco use is the world’s leading preventable cause of death.
Tobacco kills nearly 6 million people each year, of which over 600,000 are non-smokers dying from breathing second-hand smoke.
If no action is taken, tobacco will kill over 8 million people every year by 2030, over 80 per cent of them among people living in low and middle income countries, experts warned.
Raise taxes on tobacco
The global tobacco epidemic kills nearly 6 million people each year, of which more than 600 000 are non-smokers dying from breathing second-hand smoke. Unless we act, the epidemic will kill more than 8 million people every year by 2030. More than 80% of these preventable deaths will be among people living in low-and middle-income countries.
Key facts
Tobacco kills up to half of its users.
Consumption of tobacco products is increasing globally, though it is decreasing in some high-income and upper middle-income countries.
Leading cause of death, illness and impoverishment
The tobacco epidemic is one of the biggest public health threats the world has ever faced, killing nearly six million people a year. More than five million of those deaths are the result of direct tobacco use while more than 600 000 are the result of non-smokers being exposed to second-hand smoke.
Approximately one person dies every six seconds due to tobacco, accounting for one in 10 adult deaths. Up to half of current users will eventually die of a tobacco-related disease.
Nearly 80% of the more than one billion smokers worldwide live in low- and middle-income countries, where the burden of tobacco-related illness and death is heaviest.
Tobacco users who die prematurely deprive their families of income, raise the cost of health care and hinder economic development.
In some countries, children from poor households are frequently employed in tobacco farming to provide family income. These children are especially vulnerable to "green tobacco sickness", which is caused by the nicotine that is absorbed through the skin from the handling of wet tobacco leaves.
Gradual killer
Because there is a lag of several years between when people start using tobacco and when their health suffers, the epidemic of tobacco-related disease and death has just begun.
Tobacco caused 100 million deaths in the 20th century. If current trends continue, it may cause one billion deaths in the 21st century.
Unchecked, tobacco-related deaths will increase to more than eight million per year by 2030. More than 80% of those deaths will be in low- and middle-income countries.
Second-hand smoke kills
Second-hand smoke is the smoke that fills restaurants, offices or other enclosed spaces when people burn tobacco products such as cigarettes, bidis and water pipes. There are more than 4000 chemicals in tobacco smoke, of which at least 250 are known to be harmful and more than 50 are known to cause cancer.
There is no safe level of exposure to second-hand tobacco smoke.
In adults, second-hand smoke causes serious cardiovascular and respiratory diseases, including coronary heart disease and lung cancer. In infants, it causes sudden death. In pregnant women, it causes low birth weight.
Almost half of children regularly breathe air polluted by tobacco smoke in public places.
Over 40% of children have at least one smoking parent.
Second-hand smoke causes more than 600 000 premature deaths per year.
In 2004, children accounted for 28% of the deaths attributable to second-hand smoke.
Every person should be able to breathe tobacco-smoke-free air. Smoke-free laws protect the health of non-smokers, are popular, do not harm business and encourage smokers to quit.
Over 1 billion people, or 16% of the world's population, are protected by comprehensive national smoke-free laws.
Taxes discourage tobacco use
Tobacco taxes are the most cost-effective way to reduce tobacco use, especially among young people and poor people. A tax increase that increases tobacco prices by 10% decreases tobacco consumption by about 4% in high-income countries and by up to 8% in low- and middle-income countries.
Even so, high tobacco taxes is a measure that is rarely used. Only 32 countries, less than 8% of the world's population, have tobacco tax rates greater than 75% of the retail price. Tobacco tax revenues are on average 175 times higher than spending on tobacco control, based on available data.
Indian Scenario
Experts predict 1.5 million smoking deaths in India by 2020
There are approximately 275 million tobacco users in India. Tobacco use accounts for nearly half of all cancers among males and a quarter of all cancers among females and it is estimated that there will be 1.5 million tobacco-related deaths annually by 2020
World scenario
The World Health Organisation (WHO) has called on countries to raise taxes on tobacco to encourage users to stop and prevent other people from becoming addicted to tobacco, ahead of “World No Tobacco Day” on May 31.
It is estimated that by increasing tobacco taxes to about 50 per cent, all countries would reduce the number of smokers by 49 million within the next three years and ultimately save 11 million lives based on 2012 data.
Today, every six seconds someone dies from tobacco use, tobacco kills up to half of its users. It also incurs considerable costs for families, businesses, and governments, while treating tobacco-related diseases like cancer and heart disease is expensive.
And as tobacco-related diseases and death often strike people in the prime of their working lives, productivity and incomes fall.
Raising taxes on tobacco is the most effective way to reduce use and save lives, determined action on tobacco tax policy hits the industry where it hurts.
High prices are particularly effective in discouraging young people (who often have more limited incomes than older adults) from taking up smoking.
Its also encouraged that the existing young smokers to either reduce their use of tobacco or quit altogether.
Price increases are two to three times more effective in reducing tobacco use among young people than among older adults.
Tax policy can be divisive, but this is the tax rise everyone can support, as tobacco taxes go up, death and disease go down.
WHO also calculates that if all countries increased tobacco taxes by 50 per cent per pack, governments will earn an extra 101 billion dollars in global revenue.
These additional funds could and should be used to advance health and other social programmes.
Tobacco use is the world’s leading preventable cause of death.
Tobacco kills nearly 6 million people each year, of which over 600,000 are non-smokers dying from breathing second-hand smoke.
If no action is taken, tobacco will kill over 8 million people every year by 2030, over 80 per cent of them among people living in low and middle income countries, experts warned.
66th AAN Philadelphia USA 2014
Attended 66th. 2014 annual meeting of American Academy of Neurologist at Philadelphia Pennsylvania USA
Saturday, May 24, 2014
Increase In Night Blood Pressure Increase the Risk of Brain and Heart Attack
Nighttime blood pressure was associated with a risk of adverse clinical outcomes.
For every 10-mm-Hg increase in nighttime systolic blood pressure, the risk of cardiovascular outcomes was increased 25%.
There has been some suggestion that nighttime blood pressure is the most predictive of cardiovascular events and maybe the best target for antihypertensive therapy.
Nighttime Hypertension at the Risk of MI and Stroke.
Individually, each 10-mm-Hg increase in blood pressure assessed during nighttime, daytime, and clinic was associated with a 25%, 20%, and 11% increased risk of MI and stroke, respectively. However, after adjustment for multiple confounding variables, including age, gender, diabetes, smoking status, and drug treatment, among others, only the nighttime measurement of blood pressure was predictive of MI and stroke.
Future Research
At present, there are ongoing clinical trials testing whether treating nighttime blood pressure reduces cardiovascular events when compared with treating daytime or clinic blood pressure, but as yet the answer to that question is unknown.
It is not yet known why nighttime blood pressure is more predictive of clinical outcomes compared with the other two measurements.
One of the possibilities is that nighttime hypertension is a marker for something else. "For example, usually the blood pressure drops because the sympathetic tone declines at night. But we know that too much sympathetic tone increases stroke and heart-attack risks. So maybe elevated nighttime blood pressure is just a marker for elevated sympathetic tone? Another possibility is that when the vessels dilate at night and patients maintain high blood pressure in the face of dilated nighttime arterioles, it could be they are exposing their brain and heart to an increased blood-pressure load. These are just some of things that might be going on.
For every 10-mm-Hg increase in nighttime systolic blood pressure, the risk of cardiovascular outcomes was increased 25%.
There has been some suggestion that nighttime blood pressure is the most predictive of cardiovascular events and maybe the best target for antihypertensive therapy.
Nighttime Hypertension at the Risk of MI and Stroke.
Individually, each 10-mm-Hg increase in blood pressure assessed during nighttime, daytime, and clinic was associated with a 25%, 20%, and 11% increased risk of MI and stroke, respectively. However, after adjustment for multiple confounding variables, including age, gender, diabetes, smoking status, and drug treatment, among others, only the nighttime measurement of blood pressure was predictive of MI and stroke.
Future Research
At present, there are ongoing clinical trials testing whether treating nighttime blood pressure reduces cardiovascular events when compared with treating daytime or clinic blood pressure, but as yet the answer to that question is unknown.
It is not yet known why nighttime blood pressure is more predictive of clinical outcomes compared with the other two measurements.
One of the possibilities is that nighttime hypertension is a marker for something else. "For example, usually the blood pressure drops because the sympathetic tone declines at night. But we know that too much sympathetic tone increases stroke and heart-attack risks. So maybe elevated nighttime blood pressure is just a marker for elevated sympathetic tone? Another possibility is that when the vessels dilate at night and patients maintain high blood pressure in the face of dilated nighttime arterioles, it could be they are exposing their brain and heart to an increased blood-pressure load. These are just some of things that might be going on.
Subscribe to:
Posts (Atom)