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Do you know your blood pressure numbers? Dr. Michael Bloch explains how maintaining healthy numbers are important for good quality of life and increasing longevity. High blood pressure, or hypertension, affects 85 million Americans – that’s one in three people. Left untreated, it can lead to serious and sometimes life-threatening health concerns such as vision loss, kidney disease, heart failure, heart attack and stroke. But what is it, exactly, what makes it go up and why is that increase in pressure so dangerous? All About Blood Pressure In order to function properly, your body requires a continual supply of oxygen rich blood, which is goes to organs and tissues via blood vessels called arteries. Your beating heart produces the force (or pressure) your vessels require to move blood. This is your blood pressure. Your blood pressure numbers reflect two forces at work – the pressure created as blood is pumped throughout the body (systolic) and the pressure when your heart is at rest in between beats (diastolic). A normal, healthy reading shows a systolic level at 120 or below over a diastolic level of 80 or less: 120/80. An increase in pressure occurs slowly over time, straining the circulatory system and forcing the heart, blood vessels and tissues to work harder. This friction damages blood vessel walls and lets plaque buildup from LDL cholesterol, setting the stage for hardening of the arteries. As more and more plaque builds up, your blood vessels narrow, further raising blood pressure, damaging the circulatory system and increasing your risk of serious health conditions. The Silent Killer High blood pressure is known as a “silent killer,” as most people with it have no symptoms. In fact, one in six of those affected don’t even know they have the condition. That’s why it’s so important to know your numbers. The only way to find out if you have high blood pressure is to have it measured, either by a health professional or using a home monitor. If your numbers are high, there are things you can do to help lower it – it is treatable, but not curable. You can manage it with medications and lifestyle changes including: Adhering to the Mediterranean diet Decreasing sodium intake Avoiding excessive alcohol consumption Increasing exercise and activity levels Losing weight Prevention and Genetics Even better? High blood pressure doesn’t just happen. You can prevent the condition altogether. How? Know your numbers and know your risk. Look at your family medical history. Genetics certainly increases the risk of it, but those same lifestyle choices that can improve poor blood pressure can also prevent you from developing it. So if your numbers are good, keep them that way – eat well, move your body, maintain a healthy weight and drink alcohol in moderation.

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If you’re a parent, you’ve probably been there — the sometimes-nightly struggle to get your little ones off to bed. Elaina Lantrip, an APRN with Renown Pediatrics, offers some tips and explains how your child’s electronics may be getting in the way of a good night’s sleep. These days, kids are consuming media from a very early age on all types of devices — from tablets and phones to TVs. While they can benefit from some media use, it can have a negative impact on bedtime. We asked Elaina Lantrip, an advanced nurse practitioner with Renown Pediatrics, for some advice on downloading a better bedtime routine. What are the most important practices for parents to establish for their children’s bedtime routines? I often have parents tell me that their child won’t go to bed — or to sleep. Parents frequently ask for tips on bedtime routines that work. My first question is whether their regular bedtime routine involves television, iPad, tablet, phone or anything with a screen. It’s very important that bedtime includes a bath, reading a story, talking, singing and bonding with young ones, rather than using any devices. Why shouldn’t children have a device at bedtime? A growing body of research supports that screen time at bedtime contributes to delays in a child’s falling to sleep; overall inability to reach the important REM, or deep sleep; waking up during the night; nightmares and night terrors. For older youth, engaging with social media before bedtime can bring up stresses, emotions and relationship issues with peers that don’t exactly create peaceful bedtime thoughts. Bedtime should be a screen-free, stress-free, peaceful time of day. It’s a great time for parents to promote self-esteem, talk through things going on in the child’s life, to encourage and build them up. Children grow up fast — bedtime is a great the opportunity with younger children to cuddle up and read a story or sing a lullaby. What are other major considerations in making bedtime smooth and relaxing for kids and their parents? Another factor that contributes to positive sleep habits includes children getting enough activity during the the day so they’re genuinely tired at night. Also helpful are ambient noise makers, peaceful music, avoiding sugar two hours prior to bedtime, consistency in bedtime routine, comfortable pajamas and comfortable temperature in the home. Is it important to keep the child’s bedroom dark? Dimming the lights is important, regardless of the time of year. This is another reason to ban screens, as they emit light that stimulates wakefulness.

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Dr. Max J. Coppes, Physician-in-Chief Renown Children’s Hospital, and Nell J. Redfield Chair of Pediatrics, UNR Med, talks about how much is too much when it comes to teens and social media. Social apps (Facebook, Instagram, Twitter, WhatsApp, Snapchat, TikTok, etc.) have become an integral part of most people’s lives. In contrast to traditional media — where one source goes to many receivers — social media operates in a dialogic transmission system. Many sources interact, sometimes simultaneously, with many receivers and provide for superior interactivity between its users. Not surprisingly, it also plays a significant role in our children’s lives once they are old enough to understand how to access and use these apps. On average, children start exploring social media at around ages 10 to 12. They rapidly discover that electronic communication allows for unique and personalized ways to make and keep friendships. They also use it to develop and expand family ties, get help with homework, share music, art, and experiences, and learn and discover the world. Social Media and Teens Surveys suggest that more than 90 percent of teenagers use social media. Additionally, approximately 75 percent have at least one active profile by age 17. Access to social media is greatly facilitated because more than two-thirds of teens have their own mobile devices with internet capabilities, a substantial change relative to previous generations. The use of social apps can have many positive aspects. But we now also recognize that it can also have negative impacts. The use of hazardous sites or the inherent risks of using social media (identity theft, being hacked, cyber-bullying, etc.) are indeed damaging to children. Any use of hazardous social apps is too much and carries serious hazards. But what about the use of “normal” and/or “safe” social media? Well, data suggest that too much use of “non-hazardous” apps can indeed affect health. How Much Do Teens Use Social Media? First, some basic data. For example, how much do normal teenagers use social media? A study from Pew Research found that more than 50 percent of 13- to 17 year-olds go online several times a day. This quickly increases during the teenage years to more than 70 minutes per day. Teenage girls have the highest usage at just over 140 minutes per day. It is important to recognize that non-school related use of the internet and social media is often beheld by teenagers as important for developing their self-esteem, their acceptance among peers, and their mental health in general. As parents, we recognize that the use of social media can indeed contribute, in many positive ways, to our children’s growth. At the same time, we also worry about them spending too much time online. We worry about their ability to communicate effectively in face-to-face settings or in writing. Many of us also feel and/or worry that our children are addicted. Social Media and Addiction Recent studies suggests that the overuse of social media indeed mirrors addiction. Reports now show that teenagers and college kids experience anxiety when deprived from their connected devices and consequently feel a compulsion to access their social applications. The emotional symptoms they experience are very similar to those seen in substance abuse. In fact, the American Psychiatric Association is considering making internet addition a bonafide diagnosis. Pediatricians therefore encourage limits on the use of social media, a recommendation more easily suggested than accomplished. So when should a parent consider seeking help? Aside from unhealthy use of these apps (cyber-bullying, sexting, online users asking for sexual relations, etc.), which should always trigger concern, the use of social media for more than 120 minutes per day should trigger parental concern. If you feel unable to address the overuse of social media, contact your pediatrician for help and guidance. Renown Children’s Hospital Whether it’s seeing a pediatrician, getting a sports physical or looking for advice, our care is centered around supporting and nurturing patients and families at our many locations. We have pediatricians dedicated to children who have experience recognizing children’s illnesses. They also have knowledge about tests and treatments for young ones to ensure your child gets the best care possible. Explore Children’s Services

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Many factors are contributing to the rise of early onset puberty in girls. Learn what they are below and how you can support your daughter. The number of girls experiencing early puberty has increased dramatically over the last few years and continues to grow. More and more girls in the U.S. are starting to show signs of development before the age of 8. Recent studies show that up to 10 percent of Caucasian girls and 23 percent of African American girls are showing signs of puberty by age 7. What’s Contributing to Early Puberty in Girls? Determining the exact cause is difficult. But experts agree that several factors may be contributing to these growing numbers. Increasing rates of childhood overweight and obesity. Excess body fat alters the levels of hormones responsible for the acceleration of pubertal timing. Physical inactivity may decrease melatonin levels, which can also trigger pubertal development. Increased animal protein intake. Higher total protein, animal protein and meat intake in children ages 3 to 7 have been associated with earlier onset of menstruation. High protein intake elevates IGF-1 levels and promotes growth, which could accelerate the onset of puberty. Poor diet. Children with lower-nutrient diets tend to enter puberty earlier. A diet rich in processed foods and meats, dairy, and fast food is disruptive to normal physical development. Exposure to EDCs (endocrine-disrupting chemicals). EDCs are synthetic chemicals found in plastics, pesticides, fuels and other industrial chemicals that inhibit or alter the action of natural hormones. Because EDCs accumulate in the fatty tissues of animals, animal foods contain higher levels of these chemicals than plant foods. Exposure to BPA (bisphenol A). BPA is an industrial petrochemical found in a variety of products including plastics, tin-can linings and even cash register receipts. Because it acts as a synthetic estrogen it may speed up pubertal development. Soy products. Soy contain isoflavones which are converted to phytoestregens in the body, and are similar to the hormone estrogen, Dr. Chelsea Wicks says. “Soy consumed from natural food sources is likely safe and will not cause abnormal hormones levels. However, when consumed in large amounts, such as with soy supplements or in more processed foods, there have been links to chronic medical problems due to elevated estrogen levels. I feel a good answer to this is to continue working on eating fresh foods and trying to avoid the processed, packaged foods as this will be best for overall general nutrition as well,” she adds. What You Can Do While some genetic factors play a role in the early onset of puberty, parents can help lessen environmental causes of the condition. Encourage and help your child to maintain a healthy weight with proper nutrition and exercise. Avoid exposure to hormones such as estrogen and testosterone that may be found in hair products, medications and nutritional supplements. Avoid exposure to EDCs and BPA. Offer your child a diet centered around whole plant foods rather than animal foods, which will help keep protein intake within a safe range and reduce consumption of EDCs. Create a supportive environment for your daughter. Avoid commenting on her appearance and instead focus on her achievements, academic successes or artistic talents. Speak to her openly and honestly about the physical changes she’s experiencing — that although these changes are normal, she’s simply developing early — and that ultimately her peers will undergo the same changes. Encourage your daughter to continue participating in social activities and pursuing her interests, and reassure her you are always open to discuss any questions or worries. If you are concerned that your child may be going through these changes before expected, speak with your pediatrician. Sources: Early Puberty: Causes and Consequences When Is Puberty Too Early? Precocious Puberty (Early Puberty) Precocious Puberty

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There are some important numbers to know when it comes to good health. Learn more and receive a free blood pressure check at a primary care open house Feb. 27 at Renown Medical Group – Double R. Know Your Numbers Adults are pretty good at knowing and memorizing numbers — from passwords and PINs to addresses and phone numbers. But what about the numbers that could help save your life? Heart disease remains the leading cause of death in the U.S., with 633,842 deaths attributed to the disease in 2016, according to the National Center for Health Statistics. The American Heart Association lists the vital numbers you need to monitor to help prevent heart disease as blood pressure, total cholesterol, blood sugar and body mass index (BMI). With these numbers, your doctor can assess your risk of developing heart issues such as atherosclerosis, which can lead to other serious heart conditions. Atherosclerosis is a condition wherein plaque builds up in the arteries — the blood vessels that transport oxygen-rich blood to cells, the heart and other organs. These fatty deposits clog the arteries, inhibiting blood flow and reducing the amount of much-needed oxygen the body receives. These blockages can lead to angina, coronary heart disease, peripheral artery disease and even heart attack or stroke. But knowing your numbers and keeping them in healthy ranges can mitigate your risk of atherosclerosis and other heart conditions. First things first: Make an appointment with your healthcare provider to see how you’re doing. Learn your numbers and discuss how they may increase your personal risk of heart disease: Total Cholesterol Because cholesterol contributes to the buildup of plaque, keeping your numbers in check means keeping your arteries free of blockages. Check LDL (bad) cholesterol and HDL (good) cholesterol. Your body needs low levels of LDL, but not enough good cholesterol in your system can also increase risk. You can maintain healthy numbers by staying physically active and consuming a heart-healthy diet low in cholesterol and sodium. Statins, the class of drugs used to reduce LDL cholesterol, have proven so effective that the U.S. Preventive Service Task Force recommended in November that all adults older than 40 with one or more risk factors consider taking them. Blood Pressure High blood pressure places undue strain on your heart and arteries to move blood and oxygen throughout the body. And a heart that’s working too hard can lead to stroke, heart attack and heart failure. High blood pressure cannot be cured, but it can be managed by eating a heart-healthy diet low in alcohol, staying active and maintaining a healthy weight. Blood sugar Given that the body converts most of the food we eat into glucose, or blood sugar, for energy, adding sugar to the diet can raise blood sugar to unhealthy levels and damage the heart, increasing risk of cardiovascular disease and obesity. Opt for foods that are low in fat and added sugars and, instead, get your sweets in naturally occurring foods. Let added sugars be a treat and not the norm. Body Mass Index (BMI) Your BMI is used to determine whether you’re at a healthy weight. If you’re carrying extra pounds, the heart has to work harder, which increases risk of heart disease. Losing those pounds and maintaining a healthy weight reduces the burden on your heart and blood vessels and improves your blood pressure and cholesterol levels. So eat a heart-healthy diet and get active — even if you simply walk for 30 minutes a day. Because no symptoms indicate that you have poor cholesterol numbers, high blood pressure or high blood sugar levels, getting screened and learning your numbers is vital. Your doctor can determine what healthy levels look like for you individually and work with you to develop a plan for staying in optimum ranges. That plan will include heart-healthy eating, exercise, abstaining from smoking and, in some cases, medication. It’s up to you to stick with that plan between doctor visits. Do it for yourself, but consider making a pact for a more heart-healthy, active life with a buddy. Research shows people stick with exercise plans longer when they have a partner. This article also appeared in the Reno Gazette-Journal’s Health Source Aug. 27.

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