New year is a good time to control the silent killer.

Sunrise at Haleakala Volcano summit in Maui, Hawaii. (Dr. Noorali Bharwani)
Sunrise at Haleakala Volcano summit in Maui, Hawaii. (Dr. Noorali Bharwani)

In the new year, you can wish for many things and make many resolutions. But don’t forget to take care of the silent killer – your blood pressure.

The lifetime risk for developing hypertension (high blood pressure) among adults aged 55 to 65 years is 90 per cent. Our New Year’s resolution should be to keep our blood pressure under control.

More about that later. First, I have a question for you: when is the best time to take your blood pressure pill?

Currently, there are no guidelines on when to take your blood pressure pills – is it better to take it in the morning or at bedtime?

The answer is in an article recently published in the British Medical Journal (BMJ 23 October 2019) titled “Taking antihypertensives at bedtime nearly halves cardiovascular deaths when compared with morning dosing.”

A study of nearly 20,000 hypertensive patients in primary care has shown taking pills for high blood pressure at bedtime is associated with improved blood pressure controls. Besides, the risk of dying from cardiovascular causes is reduced by half when compared with morning dosing.

The Hygia Chronotherapy Trial randomly assigned 19,084 hypertensive patients (median age 60.5 years) to take their entire daily dose of one or more antihypertensives at bedtime or on waking in the morning. The patients were followed up with ambulatory blood pressure monitoring, for a median follow-up period of 6.3 years.

The results show these patients have better controlled blood pressure and, most importantly, a significantly decreased risk of death or illness from heart and blood vessel problems.

The researchers found there was enough evidence from this study to recommend patients consider taking their blood pressure medication at bedtime.

It should be noted that this recommendation does not apply to medicines that need to be taken more than once a day or to blood pressure medicines that are prescribed for other problems, such as angina or heart failure.

Do not change your medication schedule without consult your doctor.

What is considered to be high blood pressure?

Blood pressure that is consistently more than 140/90 mmHg is considered high, but if you have diabetes or chronic kidney disease, 130/80 mmHg is high, says Health Canada website.

High blood pressure significantly increases risk for stroke, ischemic heart disease, peripheral vascular disease and heart failure.

Some facts about high blood pressure (hypertension):

  1. Hypertension affects more than one in five people.
  2. Approximately 17 per cent of individuals with hypertension are not aware of their condition, the true prevalence of hypertension is likely higher.
  3. Hypertension is the most common reason to visit a doctor.
  4. Hypertension is the number one reason for taking medication.
  5. The lifetime risk for developing hypertension among adults aged 55 to 65 years with normal blood pressure is 90 per cent.
  6. It is estimated that almost 30 per cent of hypertension can be attributed to excess dietary sodium. Reduction in daily sodium intake to recommended levels could result in one million fewer Canadians with hypertension.
  7. Smoking, being overweight or obese, lack of physical activity, too much salt, stress, genetics and family history can induce hypertension.

That is it for this year. Let me wish you all Merry Christmas, Season’s Greetings, Happy Healthy Safe and Sober New Year! Remember what Earl Wilson (American Athlete) said, “One way to get high blood pressure is to go mountain climbing over molehills.” Talk to you next year.

Start reading the preview of my book A Doctor's Journey for free on Amazon. Available on Kindle for $2.99!

My Take on New Year’s Resolutions

Sunset in the Dubai desert. (Dr. Noorali Bharwani)
Sunset in the Dubai desert. (Dr. Noorali Bharwani)

“Many years ago, I made a New Year’s resolution to never make New Year’s resolutions. Hell, it’s been the only resolution I’ve ever kept!”
-D.S. Mixell, writer

My first column of 2019 happens to be my 700th column. I have written many columns on the subject of New Year’s resolutions.

In all honesty, I cannot say I have never made any New Year’s resolutions. But after failing to keep any or some of my wishes I quit making them.

New Year’s resolution is to reflect upon self-improvement annually. This tradition has been going on for centuries. Every year, millions of people make New Year’s resolutions, hoping to spark positive change. Studies after studies have shown the success rate of people following their New Year’s resolution is moderate to low.

In one study, 35 per cent of participants who failed their New Year’s Resolutions admitted they had unrealistic goals, 33 per cent of participants didn’t keep track of their progress and a further 23 per cent forgot about it. About one in 10 respondents claimed they made too many resolutions.

A 2007 study by Richard Wiseman from the University of Bristol involving 3,000 people showed failure rate to be 88 per cent.

People who make New Year’s resolutions are serious about self-improvement, or at least have the desire for it. Usually the goals are too ambitious.

Here is my take on it. I apply the KISS principal. I tell myself, “Keep It Simple Stupid.” Now I follow what I call a commonsense approach.

1. Avoid loneliness. Research has linked social isolation to increased risks of cardiovascular disease, dementia, depression and anxiety.

2. Enjoy life. According to an article in the Canadian Medical Association Journal (March 4, 2014) greater enjoyment of life was associated with reduced risk of developing impaired activities of daily living and with a slower decline in gait speed. Find humour around you.

3. Follow Mediterranean diet. Generally considered to be world’s healthiest diet. It is abundant in fruits, vegetables, whole grains, legumes and olive oil. It features fish and poultry over red meat.

4. Motion is lotion. Keep moving. It lubricates you joints and tightens up your muscles. It is important to walk fast. Slow walking speed is considered an early marker of disability and frailty, as well as a predictor of dementia, admission to a long-term health facility and death. Exercise regularly. There are many options – walking, stretching, treadmill, elliptical, swimming, gym, yoga, tai chi and many other activities. There is always something you can do that meets with your physical capacity. Treadmill is a very popular indoor cardio equipment. Keep your workout interesting by joining a group. Your body, use it or lose it.

5. Have a positive outlook. Positive outlook equals longer healthy life. Positive affective well-being (i.e. feelings of happiness and enjoyment) has been associated with longer survival and reduced incidence of serious illness. Meditate about 10 to 20 minutes each day.

Nearly 80 percent of American adults are not meeting the U.S. government’s physical activity guidelines. I don’t think the Canadian numbers are any different. That means millions of people are missing out on the benefits that exercise and healthy life style provides for heart health, cognition, sleep, mental health, cancer risk, blood pressure, and more.

Follow these five steps to good health. You will not regret it. Peace!

Start reading the preview of my book A Doctor's Journey for free on Amazon. Available on Kindle for $2.99!

New Year’s Resolution: Drive Safely and Prevent Motor Vehicle Collisions

Sunrise at Haleakala Volcano Summit in Maui. (Dr. Noorali Bharwani)
Sunrise at Haleakala Volcano Summit in Maui. (Dr. Noorali Bharwani)

“Only I can change my life. No one can do it for me.” -Carol Burnett

Most people are good and responsible drivers. They care about their own safety and they care about others. But some drivers are serious threat to safety.

A recent survey done by the Alberta Motor Association and published in their magazine (AMA Insider – Winter 2017) identified the following five actions to be serious threat to safety while on the road:

  1. Drivers texting or emailing
  2. Drivers talking on the phones
  3. People driving after drinking alcohol
  4. Aggressive driving
  5. Speeding on residential streets

It is estimated that traffic collisions would soon become the third major cause of death worldwide. The major victims of these traffic collisions are people between five and 44 years of age. That is tragic.

Let us briefly look at what Transport Canada has to say about road safety.

Although drivers aged 15 to 34 represent only about 30 per cent of the driving population, they accounted for 40 per cent of the fatalities and 45 per cent of the serious injuries, indicating that younger drivers are at greater risk.

The annual social costs of the motor vehicle collisions in terms of loss of life, medical treatment, rehabilitation, lost productivity, and property damage are measured in tens of billions of dollars. We can certainly use that kind of money treating other health issues.

Here are few examples where we can do better:

  1. Seat belts worn correctly can reduce the chances of death and disability. It is estimated about 300 lives could be saved every year if everyone wore seat belts.
  2. Aggressive driving includes speeding, running red lights, tailgating, weaving in and out of traffic, and failing to yield right of way, among other behaviours should be avoided. Forty per cent of speeding drivers involved in fatal crashes were 16 to 24 years of age.
  3. Young drivers, 16 to 24 years of age, continue to be at higher risk of being killed in motor vehicle collisions. One of the reasons being the use of cell phones or other similar devices while driving.
  4. In 2008, coroners’ testing showed almost 40 per cent of fatally injured drivers had been drinking some amount of alcohol prior to the collision.
  5. Drugs, other than alcohol, are also being found in about one-third of tested fatally injured drivers, similar to the prevalence of alcohol.

There are many other reasons why a driver can be distracted: using electronic devices, reading maps, eating, drinking, talking, or impaired by fatigue.

It is estimated about 20 per cent of fatal collisions involve driver fatigue. Everyone is subject to their body’s circadian rhythms such that they are less alert during certain times of the day, usually 2:00-4:00 a.m. and 2:00-4:00 p.m. Therefore, taking breaks from driving during these times could lower the risk of fatigue related collisions.

Let’s make a New Year’s resolution to drive safely and prevent death and disability.

Have a happy and healthy 2018.

Start reading the preview of my book A Doctor's Journey for free on Amazon. Available on Kindle for $2.99!

Simple Steps for Keeping Your New Year’s Resolutions

Happy New Year 2017 (Dr. Noorali Bharwani)
Happy New Year 2017 (Dr. Noorali Bharwani)

The year is almost over. If you are one of those individuals who believes in making one or more New Year’s resolutions then the time has come.

About 50 per cent of the adults will start off 2017 with at least one promise to change for the better.

Statistics show six in 10 people drink alcohol regularly but only three in 10 get involved in regular exercise. Men are more physically active than women. Sixty per cent of the adults are overweight (BMI 25 to 30) or obese (BMI over 30). Forty per cent of the adults do not have adequate sleep. So there is lot to change.

I believe one should keep New Year’s resolutions simple. Eating healthy, doing physical exercise regularly, not smoking, avoiding alcohol or only drink in moderation, maintaining a healthy body weight, and sleep at least eight hours each night would be a good start.

You need only one resolution, “In 2017, I want to be healthy and stay healthy. I will apply the KISS (keep it simple stupid) principle.”

If you do not have self-discipline to accomplish your goals then there are many organizations and individuals who can help. YMCA is a good place to start.

Do not forget to spend time with your loved ones. No goals are complete without the love and affection of your partner and family. In fact get the family involved in your pursuit of good health and make it more fun. Keeping those you love close and making time for your family can be an important goal.

You should be able to find 15 minutes in a day to meditate. May be during lunch hour or in the evenings before going to bed. There are many physical and mental benefits to meditation. You will find this will provide significant reduction in your stress level.

Listening to music and/or reading a book in a quite place can be very peaceful and healthy. I find spending few hours in the library very relaxing and I am able to stay focused in what I am trying to achieve.

Most people find losing weight very difficult. Again the principal is simple. Eat less and exercise more. Try to lose 10 pounds in a year (not in a week or a month) and then you will find you can lose 30 pounds in three years. It can be that simple. Slow and steady wins the race. And apply the KISS principle.

A new study released a few days ago (British Medical Journal, Dec 13, 2016) says a positive outlook is relevant to your future health. Enjoying life can reduce stress, which in turn may prolong life.

OK you get the point. Personally, I do what I say in my book, “Dr. B’s Eight Steps to Wellness” – healthy eating, no smoking, exercise, stress relief, sleep, sexual empowerment, laughter and meditation. That works for me.

Happy New Year and may you be blessed with good health, happiness and lots of love and laughter in 2017 and beyond.

Start reading the preview of my book A Doctor's Journey for free on Amazon. Available on Kindle for $2.99!