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Monthly Archives: August 2016

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Friends help make our lives special. They are fun to be with, we like the person we are when we are with them, they share activities with us, they offer an ear when we need to talk over important matters, they cheer us up when we are down, they lend a hand when we need help, they broaden our horizons with their intelligence, knowledge and experience — and, most critically, they are there for us in times of crisis. Those are typical answers when we ask people, “What is a friend?”

But what if our friend doesn’t like us as much as we like him or her?

According to an article in The New York Times and other media, recent research on the subject of friends would suggest that only about half of our friendships are mutual. Whoa! That means someone you think is a close friend might not feel the same way about you. Now that is a thought to make you feel instantly abandoned. And, according to the Times, through experts interviewed, “the authenticity of one’s relationships has an enormous impact on one’s health and well-being.”

Who are our friends? Where do they come from? How many real friends can we have? How do we judge whether they are true friends? And are we a true friend in return?

Certainly a true friend is more than someone on Facebook. Alexander Nehamas, a professor of philosophy at Princeton, told The Times that friendship is more like beauty or art, which kindles something deep within us and is “appreciated for its own sake.” It’s a lovely thought.

Ronald Sharp, a professor of English at Vassar College, edited a book, “The Norton Book of Friendship,” with his friend, Eudora Welty in 1991. Sharp is quoted in The Times as saying, “The notion of doing nothing but spending time in each other’s company has, in a way, become a lost art,” to be replaced by volleys of texts and tweets.

To have a friendship with someone has several requirements. First is time. It takes time to understand the other person and to trust that person enough to let him or her understand you. So trust is another requirement. Lucky are those who have friends from elementary school or college, for those have withstood the test of time. Additionally those friends are witnesses to our lives as we are to theirs. That is a relationship to be treasured and not replaced, and it may be resumed even after years have gone by with no contact. Honesty is another. You have to be able to respond honestly to a friend, even if it is not what he or she wants to hear, and to receive the same in return.

But there is more. A close friend is one with whom you interact almost daily because you would otherwise miss the contact. That person is one whose sentences you could reliably finish because, to some extent, you live within each other’s heads. That person is someone who, you absolutely know from prior evidence, has your back. And that is a person who knows and accepts your shortcomings even as you accept theirs because you protect each other’s vulnerabilities. I have only experienced that kind of friendship with one or two people because there isn’t enough time really to get to know that many people, however interesting they may seem.

Then there are perhaps four or six others with whom I maintain ongoing friendships. These are good friends whom I enjoy common ground with, and feel concern and affection for. These friends provide a support system and a social circle to which we all contribute. Others are more casual friends, dependent on circumstances, and they may move in and out of my world at any given time.

Friends and friendships are tested by crises. I have had my share, as have my friends, and we have been there for each other. We will be there again because we are best friends.

  

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Abraham Lincoln did it. So did Jon Stewart, Dave Letterman, Walter Cronkite and Lou Gehrig.

On July 4, 1939, as he announced that he considered himself “the luckiest man on the face of the earth,” the Yankees’ Gehrig, known as the Iron Horse, reached up to the bridge of his nose and wiped away tears.

The list of those who cry in public includes influential men with impressive pedigrees. Yet it is the exception rather than the rule for men to cry.

Recently, I attended a wedding where not only the groom cried as he read his vows, but the father of the bride also shed tears when he gave a speech during the reception. The groom was barely a few words into his vows when his voice cracked.

The audience waited, willing him to go on and all of them, except my son who was at his first wedding and was studying his image in the mirrored ceiling, appreciated the struggle to speak.

The man on the threshold of becoming a husband stopped several times, as he made fun of the tears and the mess he’d become, giving the audience a chance to laugh with him.

I have experienced larger moments, both positive and negative, when I felt such a strong flood of emotions that filled my eyes with tears and made it difficult to speak. Clearly, however, it’s not a regular occurrence because my son asked me when, or if, I cried. Part of that, I suppose, comes from my reflexive need to turn off the tears in public.

I grew up at a time when boys and men had to experience something extraordinary — either positively or negatively — to shed public tears. We had examples like the actor Alan Alda, who shed gut-wrenching tears in the final episode of “M*A*S*H.”

I recall being unable to say more than a few words to my mother when I called her from a pay phone to tell her that she had a granddaughter. Facing the corner of a phone booth, I shed tears of joy, especially when I said my daughter’s name for the first time. My mother must have heard my unsteady voice and asked, in the silence that followed, if I’d like her to come visit us in the hospital. Wiping away tears and nodding, I grunted something like “uh-huh.”

Men cry and, for the same physiological and psychological reasons as women, we benefit from that release, giving us an outlet for the literal flood of emotions.

At that recent wedding, the father of the bride knew when I spoke to him at the cocktail hour that he’d struggle to get through his speech. When the time came, he thanked everyone for coming and described the connection he felt with his daughter. He could barely finish a sentence before his lips turned down and the tears fell beneath his glasses.

He and his new son-in-law clearly started off this marital connection with something in common: tears at the wedding.

I was sure when his first daughter was born that he felt the same way at the beginning of her life, as he contemplated the excitement and terror at the responsibility that came from becoming a father.

As he considered the start of her married life he seemed, like Steve Martin in “Father of the Bride,” to have an awareness of these new steps which, some day, may include her coming to terms with a little life wrapped in her arms.

His voice broke at the end of his speech when he said his daughter would “always be my girl.”

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The Nightingale phone helps connect patients with their nurses immediately, no matter where the nurse is in the hospital. Photo from Alexandra Zendrian

Huntington Hospital is breaking new ground in patient care with the Nightingale phone, a communication system that helps put patients in connection with nurses quicker than ever before.

The hospital has been piloting the new phone in the oncology wing of the hospital since 2015, and has seen a significant improvement in patient care and a decrease in wait time from when a patient calls for a nurse and when the nurse arrives to give treatment.

Patients are raving about the new invention.

Mary Ellen Cantone, a patient at the hospital, said the response to her call was immediate.

“I hit the button and someone was talking to me instantly,” she said in a statement. She said once at 2 a.m. she called for her nurse for ice chips, and the nurse came in right away with them.

“It has really improved nursing care and nursing work.” — Shanell Blanchard

“It’s a wonderful thing to use, it saves them time and they just know everything,” Cantone said. “They’re the best nurses here, and God picks the nurses for this floor, the oncology floor.”

The phone, created by Marie Roggenkamp, nurse manager at Huntington Hospital, has a red nurse button on the back that, when pressed directly, calls the device the patient’s nurse is wearing so that the patient can talk to his or her nurse immediately without the typical wait time.

Stephen Smith, manager of site communications at the hospital, worked with Roggenkamp to create the phone, which is an improvement from the call bell system hospitals use now.

“The call bell system requires a nurse to be close enough to hear the call bell or see the light go off outside the patient’s room, and may take longer to get a response,” he said in a statement. “This allows the patient to connect with the nurse no matter where they are on the unit.”

Roggenkamp said she saw success in patient satisfaction scores in the oncology wing after the Nightingale was implemented back in July 2015. She said call bell responses could take anywhere from seven to eight minutes, but with the Nightingale, a nurse could be in the room with medication within two minutes.

One of the most important features of the Nightingale phone is the call forward feature.

A concern with having nurses wear a device that can immediately connect them with a patient is the opportunity for increased error if the nurse is already performing a procedure when a call comes from a new patient.

“In the event a nurse is hanging chemotherapy [drugs from an IV], she can have a call [from the Nightingale] forwarded to a nursing assistant,” Roggenkamp said. If the assistant is also busy, the call will then go to the nurse manager, and then the call desk.

This pilot program is also cost effective; to add a speed-dial button to the hospital phones only costs an extra 50 cents.

The nurse manager said Huntington Hospital hopes to have the Nightingale phone installed in every unit by the end of 2016.

Nurses at the hospital like the new system as much as management.

“It has really improved nursing care and nursing work,” nurse Shanell Blanchard said. “I know what they need before going in there. Before, a call bell could be going off in another room, but it might take me five minutes to answer it. I need to finish with the patient I am with, wash my hands, ask what they need and then go get it.”

Blanchard said patients have also enjoyed the fact they have more control in their care.

“It’s a great feeling of independence,” she said. “To know if I press that button I can get to my nurse directly.”

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File photo

Suffolk County Police Sixth Squad detectives and Sixth Precinct Crime Section officers are investigating multiple incidents of criminal mischief that occurred on Aug. 10.

Approximately eight vehicles and one residential garage door were vandalized with white spray paint some time around 2 a.m. The markings included tags related to the Young Guns gang, which is associated with the Bloods. The vandalism occurred on Himmel Circle, Hawkins Path, Route 112, Avalon Pines Dr. and Iroquois Ave. in Coram.

Anyone with information is asked to call the Sixth Squad at 631-854-8652, Sixth Precinct Crime Section at 631-854-8626 or Crime Stoppers at 1-800-220-TIPS.

 

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Three Village booster club hosts eighth annual outing

Golfers take practice shots prior to the start of the the eighth annual golf outing at St. George’s Golf and Country Club. Photo by Kevin Redding

By Kevin Redding

Feeding upwards of 50 hungry, growing boys is a gigantic undertaking.

According to head coach Chris Boltrek, the Ward Melville football team receives a meal before each game.

“Before every game, we give them a meal, so that they don’t go through school all day without eating, and then have to play a game at night,” he said.

The school also provides the team with new equipment to make sure the players are properly suited up and stay safe each game.

None of that would be possible if not for the school’s booster club, and on Aug. 1, the Three Village community grabbed their golf clubs once more in an effort to raise money for the Patriots.

Golfers tee off in support of the Patriots. Photo by Kevin Redding
Golfers tee off in support of the Patriots. Photo by Kevin Redding

“It’s a great fundraiser for the kids,” said Boltrek, who is one of the event’s main organizers. “This helps provide us with things that we otherwise wouldn’t receive, whether it’s uniforms or meals or whatever else the athletes might need.”

The eighth annual golf outing at St. George’s Golf and Country Club commenced at 10 a.m., as roughly 100 parents, educators and community members hopped in their carts for a day of golfing, fundraising and friendly competition. They were all there with one thing in mind: supporting the football team.

“Football is a sport I think few people understand unless they’re in it,” the head coach said. “They might not realize just how big a deal it is when we talk about practice equipment, or how much a sled costs, and how much a shoe costs. Those are huge expenses. It’s about trying to give these [athletes] the best possible experience they can have.”

Last year’s fundraising efforts bought the team new uniforms and practice equipment, and it’s a huge advantage. This year, the outing raised over $10,000, which will go toward sideline replay equiptment.

Before Boltrek took over the team, the Three Village Football booster club had been running the outing for six years with the previous coaches at the helm. For Boltrek, it’s important to build a football-friendly environment in an area that isn’t traditionally known as a football community, and this event shows Three Village’s strides to be a little more gridiron-oriented. It brings everybody together to rally behind a common bond.

Christina Stavropoulos, director of the booster club, couldn’t agree more. Doing everything under the sun to help benefit the football team, she loves seeing the community rally behind them in whatever way they can.

“What’s even better is so many alumni are here — some that played, and some that didn’t, but had friends who did,” she said. “It’s wonderful to see the kids all coming back from college just to play golf and help their school out.”

Gift certificates and bottles of wine donated from local businesses were raffled off.

Ward Melville head football coach Chris Boltrek gets in the zone during the golf tournament. Photo by Kevin Redding
Ward Melville head football coach Chris Boltrek gets in the zone during the golf tournament. Photo by Kevin Redding

“There are corporate sponsors here and, of course, we love all the corporate sponsors, but there are local businesses as well,” Stavropoulos said. “They have the 50/50 raffle; the Chinese auction baskets. We have donations from different restaurants, parents. It’s all part of the fundraising effort. Everything is for the kids.”

Before hitting the green, the golfers, donning Ward Melville’s green and gold logo on their hats and shirts, took some practice swings and shots in the warm-up section. Many talked football and the importance of playing multiple sports in school, and how the golf outing helps with that.

“My kids are in the district and one plays football,” said resident John Treder. “This is good for the school. I think the better teams the high school can put out, like with more money to buy equipment and extra coaches, the greater things will be for the kids. It will bring [them] more spirit, you’ll get more people at the games. It gives them the tools to win.”

A representative from Endzone Sports, a Seaford-based football equipment store and proud sponsor of the event, was especially supportive of the team.

“We’re for Melville football,” said Anthony Polo, a representative with the organization. “They have a good coach, nice people involved, and we’re excited for the kids. We’ll do anything for the kids. We want to give back to the school and make sure they’re well-equipped, well-supported in the program and encourage their extracurricular activities. It gives them something to look forward to.”

Beyond the football field, there’s a consistent overall feeling of unity among Three Village because of the team’s growing success.

Charlie Fernandez, coach of the girls’ varsity volleyball team at Ward Melville, wouldn’t have missed the outing for anything, extending his support for Boltrek and the team.

“The best thing that happens at Ward Melville is when we have a good football team,” said Fernandez. “It makes everything better for everybody. It just fires the school up, gets everybody excited. You start seeing all the green and gold around and as the coach of another team, it’s good for us, too.”

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A vintage European car from a previous event at the Stony Brook Community Church. Photo from Malcolm Bowman

Stony Brook Community Church, 216 Christian Ave., Stony Brook will host the 12th annual Vintage European Sports Car and Motorcycle Show on the lawn in front of the church on Saturday, Aug. 13 from noon to 4 p.m. This popular, free event, for all ages, will display a wide variety of interesting cars and motorbikes from all over Europe. There will be a People’s Choice vote for the best cars and bikes along with live music by the Barking Men and food and refreshments for sale. All proceeds go to the outreach of the church and the scholarship fund of the annual children’s Performing Arts Camp. Rain date is Aug. 14. For more information, call Malcolm at 631-751-1381.

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Those visiting the exhibit can hop on this Harley and inside its sidecar for an interactive 'ride.' Photo by Kevin Redding

By Kevin Redding

For as long as they’ve been around, motorcycles and their riders have encapsulated the American spirit. Beyond the fact that anybody straddling a chrome-plated hog immediately becomes unanimous with “cool,” the motorcycle has always represented independence, escape, toughness, rebellion and freedom. Unlike drivers encased in their cars, bikers glide down the open road with a ferocious and liberating intimacy with themselves and all that surrounds them, surveying the world in a constant state of high-speed danger and adrenaline all at once. The ultimate thrill seekers, the motorcycling community is certainly a breed apart from the rest. And they’ve helped shape American culture as a result.

Whether it was Steve McQueen jumping over barbed wire fence on his iconic Triumph TR6 Trophy in “The Great Escape” or Peter Fonda cruising on his “Captain America” Harley Davidson in “Easy Rider,” the allure of hopping on a chopper and putting the pedal to the metal has sustained generations.

The times may have changed and the bikes might look different, but motorcycle culture is still alive and well and is currently being celebrated in Stony Brook Village.

The rare 1911 Harley Davidson is one of the oldest bikes on display at the Motorcycles and the Open Road exhibit. Photo by Kevin Redding
The rare 1911 Harley Davidson is one of the oldest bikes on display at the Motorcycles and the Open Road exhibit. Photo by Kevin Redding

Devoted bikers and nonbikers alike can go explore Motorcycles and the Open Road, a summer exhibit that will run through Sept. 5 at the Ward Melville Heritage Organization’s Educational & Cultural Center. Building on the success of its two previous motorcycle exhibits, the center offers over 50 bikes on display and will contain a completely different batch than the ones seen last year, with the exception of a crowd-pleasing 1911 Harley Davidson.

Visitors will be treated to a wide variety of motorcycles throughout history — ranging from 1904 to 1997 — as well as iconic artwork by David Uhl, bronze sculptures by Jeff Decker and vintage memorabilia like helmets and signs.

The earliest bikes on display are a 1904 Rambler courtesy of Jim Giorgio, which looks like a regular bicycle with a motor attached, and a 1907 Indian, which once belonged to Henry Wing Sr., one of the founders of the Antique Motorcycle Club of America. This particular bike is known for its “camelback” look.

“[The motorcycles] are very artistic, and there’s a lot of historical importance between different decades and different manufacturers,” said Stephanie Ruales, special events coordinator for the center. “Older generations obviously love seeing them because it reminds them of something they maybe grew up with. And the younger kids … can’t really deny that the bikes are just cool to look at. I think when you start in the early 1900s and see what they were and what they evolved into, older and younger generations can appreciate them,” she added.

As visitors continue through the gallery, they will notice the aesthetic evolution of the motorcycles. Heading into the ’30s and ’40s, manufacturers bulked up the bikes, spruced up the designs and started engineering the motorcycles for what the public may have wanted at that specific time. Motorcycle brands were, and still are, constantly changing year to year due to ever-evolving styles, so it’s fascinating to see the gradual change over the course of the 20th century.

Among the most noteworthy bikes on display are a 1931 Indian Four, which is a rare Depression-era motorcycle that scored a 97 out of 100 at its judging at the Antique Motorcycle Club of America, making it quite the elite ride; a 1934 Harley Davidson, which was featured at Harley’s factory in Milwaukee in 2003 for its 100th anniversary; and a 1950 BMW R51/2, which came in the aftermath of Germany’s ban on producing motorcycles of any sort post-World War II. Even though the ban was ultimately lifted, all of their designs, blueprints and schematic drawings were gone and they had to start from scratch, left to use surviving prewar parts to build a new bike.

Aside from Suzukis and Ducatis, fans of newer designs will enjoy the 1982 Honda CX500 Turbo, which looks like something straight out of a sci-fi film. “[All of the motorcycles] come from Long Island. They all come from different Long Island collectors and private owners. We also have a dealership that was very gracious to loan us some of their bikes as well. And people are very enthusiastic about putting their motorcycles on display for everyone to appreciate,” said Ruales.

One of the more unique displays is the “Precious Metal,” a custom motorcycle made by Copper Mike from Lindenhurst and chosen by Lady Gaga to be onstage at her “Born This Way” album release at Union Square in 2011.

Visitors can also take part in a virtual ride of sorts, when they sit down on an old Harley and inside its sidecar and cruise past the rolling hills of Ireland, which is projected on the screen in front of them.

Not being a motorcycle enthusiast is no reason to skip this exhibit. “We get people that come in and say they don’t know anything about the motorcycles … and they come through and find something they can appreciate,” said Ruales.

The Ward Melville Heritage Organization will present Motorcycles and the Open Road now through Sept. 5 at its Educational & Cultural Center, 97P Main Street, Stony Brook. The exhibit, partially sponsored by Astoria Bank, is open seven days a week from 10 a.m. to 5 p.m. Admission is $5 for adults, and $3 for children under 12. For a full schedule of exhibit events, call 631-689-5888, or visit www.wmho.org.

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File photo by Michael Tessler

By Michael Tessler

Admittedly my definition of fun has always been a bit out-of-sync with my fellow millennials. What do I mean by that? Well, my perfect evening entails a glass of scotch whiskey, a small group of friends and an invigorating game of Risk (yes that board game from Seinfeld). We wouldn’t just play with normal rules either, we’d add elements of intrigue, diplomacy and politics. It’s quite literally the nerdiest way someone could spend an evening BUT there are plenty of valuable life lessons to be learned from the game: camaraderie, collaboration, but most importantly … never fight a land war in Asia! (Napoleon and Hitler probably wish they had gotten that memo). So yes, I’m not your average 23-year old, not by a long shot.

In the name of faux investigative journalism, I decided to venture outside of my comfort zone and into the sprawling mini-metropolis that is Port Jefferson Village after dark. Together with my partner-in-crime and honorary investigator, Sarah, we began our journey. Being an avid “Pokémon trainer” Sarah insisted we visit Port Jeff’s biggest Pokémon location, Harborfront Park.

For those who don’t know, Pokémon GO is a mobile game that connects the real world with the digital one, allowing people to “catch” animated Pokémon by visiting real places across the country and globe. It’s a whole lot of fun and rewards players for exercising by giving you special access to rare Pokémon. With that being said: Madam Mayor, I strongly urge you to establish a Pokémon Preserve near Harborfront Park so that we can protect the rare indigenous Pokémon that call Port Jefferson home!

Honestly though, it was pretty wonderful seeing all those families and young people outside. After some 15 years of hibernation, the children of the ’90s have finally reemerged in search of pikachus and pizza!

Afterward we made our way over to Theatre Three. This wonderful local theatre offers not just mainstage musicals and concert series but is also home to an excellent troupe of improv artists. Each week they put on a tremendous live show known as Friday Night Face Off (FNFO). These professionally trained comedians break up into two teams and battle each other in various improv games. Styled similarly to the “Whose Line Is It Anyway?” I can guarantee it’ll leave you in stitches! Having seen their shows well over a dozen times, I can tell you that each performance is unique and filled with new hysterical material. Although the show isn’t child friendly (16 years old and up please), it is the perfect way for adults to end or begin an evening! There’s even a bar right in theater so you can enjoy a drink during the performance.

After a great show we visited several of Port Jefferson’s late night hot spots. Schafer’s was a real treat. Complete with a DJ, dance floor and all of the latest party equipment, it felt less like your conventional bar and more like an upscale club in Manhattan. Following some dancing, catching up with old friends and an impromptu freestyle rap battle (I owe my skills to “Hamilton the Musical”), it turned out to be a pretty wonderful evening. Port Jefferson, while a quaint village by day, truly transforms into a popping late-night paradise when the sun goes down. There’s no age limit to the fun as there’s a venue for everyone!

Now I’ve already made my plans for next weekend! Anybody wanna join me for a rousing game of BATTLESHIP? No? That’s alright. I strongly advise taking a visit to beautiful Port Jefferson during one of these beautiful summer nights!

Michael Tessler is the Special Projects Manager for TBR News Media, a former political consultant and Disney cast member and mostly unsuccessful Pokémon trainer.

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Above, members of the Rythmos Hellenic Dance Group perform for festivalgoers in a previous year. File photo

By Heidi Sutton

Lovers of all things Greek will gather at the Greek Orthodox Church of the Assumption, 430 Sheep Pasture Road, Port Jefferson, next week when the church holds its 55th annual Greek Festival from Aug. 18 to 28.

Running for two consecutive weekends this year, the event will feature carnival rides, face painting, games, music by Asteri Entertainment, traditional Hellenic dance performances by the Rythmos Hellenic Dance Group and culinary delights. Authentic mouth-watering foods such as gyros, moussaka, tiropita, souvlaki and spanakopita will be served up, along with sweet desserts such as melomacrona, galaktoboureko, kourabiedes, koulourakia, baklava and loukoumades, a fried dough pastry favorite. Guided tours of the church will be available throughout the day, and vendors will be offering Greek art, jewelry, souvenirs, icons and much more.

One of the main attractions at the festival is the over-the-top sweepstakes that the church holds. This year 315 prizes will be awarded. Prizes range from cars —a 2017 Mercedes Benz GLC 300 4Matic is first prize — to an Apple watch, cash prizes, 15-inch Tablet Laptop, a Bose Home Theater System, Xbox One, Mets tickets, Yankees tickets, a digital camera, gift cards and much more. Tickets for the sweepstakes are $100 each, limited to 4,999 tickets — meaning that one out of 16 will win a prize. The drawing will be held on Aug. 28 at 7 p.m.

The festival will take place on Aug. 18 from 5 to 10 p.m., Aug. 19 from 5 to 11 p.m., Aug. 20 from 1 to 11 p.m., Aug. 21 from 1 to 10 p.m., Aug. 26 from 5 to 11 p.m., Aug. 27 from 1 to 11 p.m. and Aug. 28 from 1 to 10 p.m. Fireworks will be held on Aug. 19, 20, 26 and 27 at 9:30 p.m. Free shuttle buses will pick up festival attendees from Ward Melville High School, Earl L. Vandermeulen High School, Port Jefferson Ferry and the Long Island Rail Road station to transport them to festival grounds, making parking at this popular event a breeze.

Admission to the festival is $2 per person, children under 12 free. For more information, call the church office at 631-473-0894 or visit www.portjeffgreekfest.com.

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Consider monitoring blood pressure on both arms. Stock photo

This week, I’d like to discuss some of the nuances of hypertension, or high blood pressure, a contributing risk factor for heart disease. Hypertension affects approximately 33 percent of Americans, according to the latest statistics from the Centers for Disease Control and Prevention, and only 52 percent of these have it controlled (1). What could we possibly learn about blood pressure that we have not heard already? New information is always coming out about this common disease. Studies are teaching us about diagnostic techniques and timing, as well as consequences of hypertension and its treatment. Let’s look at the evidence.

Technique

When you go to the doctor’s office, they usually take your blood pressure first. But do they take readings in both arms and, if so, have you wondered why? I take blood pressure readings in both arms, and when one of my longtime patients asked me why, I joked that I need to practice. In truth, it’s because there may be significant benefit from taking readings in both arms.

An analysis of the Framingham Heart Study and Offspring Study showed that when the blood pressure was taken in both arms, when there was a difference of more than 10 mm Hg in the systolic (top number) blood pressure, then there may be an increased risk for the development of cardiovascular disease — stroke and heart disease (2).

This is a simple technique that may give an indication of who is at greater cardiovascular disease risk. In fact, when this interarm blood pressure comparison showed a 10 mm Hg difference, it allowed the researchers to identify an almost 40 percent increased risk of having a cardiac event, such as a stroke or a heart attack, with minimal extra effort expended.

So, the next time you go to the doctor’s office, you might want to ask if they would take your blood pressure in both arms to give you and your doctor a potential preliminary indication of increased cardiovascular disease risk.

Timing

When do we get our blood pressure taken? For most of us it is usually at the doctor’s office in the middle of the day. This may not be the most effective reading. Nighttime blood pressure readings may be the most accurate, according to one study (3). This was a meta-analysis (a group of nine observational studies) involving over 13,000 patients. Neither the clinical nor daytime readings correlated significantly with cardiovascular events when multiple confounding variables were taken into account, while every 10 mm Hg increase at night had a more significant predictive value.

Twenty-four ambulatory blood pressures readings were taken with these patients, which means these were standardized readings. Does this mean that nighttime readings are more important? Not necessarily, but it is an interesting finding. With my patients, if blood pressure is high in my office, I suggest that patients take their blood pressure at home, both in the morning and at night, and send me readings on a weekly basis. However, at least one of the readings should be taken before antihypertensive medications are taken, since these will alter the readings.

Salt impact

There has always been a debate about whether salt really plays a role in high blood pressure and heart disease. The latest installment in this argument is a compelling British study called the Health Survey from England. It implicates sodium as one potential factor exacerbating the risk for high blood pressure and, ultimately, cardiovascular disease (4). The results show that when salt intake was reduced by an average of 15 percent, there was a significant blood pressure reduction and that this reduction may be at least partially responsible for a 40 percent reduction in stroke mortality and a 42 percent reduction in heart disease mortality.

The graphs of sodium reduction mimicked the line graphs for the reductions in deaths from stroke and heart disease. One potential study weakness was that physical activity was not taken into account. However, a strength of this study was that it measured salt intake through 24-hour urine tests. Most of our dietary salt comes from processed foods that we least suspect, such as breads, pastas and cheeses.

Age-related macular degeneration

When we think of blood pressure-lowering medications, we don’t usually consider age-related macular degeneration as a potential side effect. However, in the Beaver Dam Eye Study, those patients who were taking blood pressure medications were at a significant 72 percent increased overall risk of developing early-stage AMD (5). It did not matter which class of blood pressure-lowering drug the patient was using, all had similar effects: calcium channel blockers, beta blockers, diuretics, and angiotensin receptor blockers.

However, the researchers indicated that they could not determine whether the blood pressure or the blood pressure medication was the potential contributing factor. In addition, another study actually suggests the opposite — that blood pressure medications may reduce the risk of AMD (6). However, this was a retrospective (backward-looking) study, and it has yet to be published.

This is a controversial topic. If you are on blood pressure medications and are more than 65 years old, I would recommend that you get yearly eye exams by your ophthalmologist.

Fall risk

As we age, falling risk seems to increase. One study shows that blood pressure medications significantly increase fall risk in the elderly (7). Overall, 9 percent of these patients on blood pressure medications were seriously injured when they fell. Those who were considered moderate users of these medications had a 40 percent increased risk of fall. But, interestingly, those who were consider high-intensity users had a slightly less robust risk of fall (28 percent) than the moderate users. The researchers used the Medicare database with 5,000 participants as their data source. The average age of the participants in the study was 80.

Does this mean that we should discontinue blood pressure medications in this population? Not necessarily. This should be assessed at an individual level between the patient and the doctor. Also, one weakness of this study was that there was no dose-response curve. In other words, as the dosage increased with high blood pressure medications, one would expect a greater fall risk. However, the opposite was true.

In conclusion, we have some simple, easy-to-implement, takeaways. First, consider monitoring blood pressure in both arms, since a difference can mean an increased risk of cardiovascular events. Reduce your salt intake; it appears that many people may be sensitive to salt, as shown by the British study. If you do take blood pressure medications and are at least 65 years old, take steps to reduce your risk of falling and have annual ophthalmic exams to check for AMD.

References: (1) CDC.gov/blood pressure. (2) Am J Med. 2014 Mar;127(3):209-215. (3) J Am Soc Hypertens 2014;8:e59. (4) BMJ Open 2014;4:e004549. (5) Ophthalmology online April 30, 2014. (6) ARVO 2013 Annual Meeting: presentation. (7) JAMA Intern Med. 2014;174(4):588-595.

Dr. Dunaief is a speaker, author and local lifestyle medicine physician focusing on the integration of medicine, nutrition, fitness and stress management. For further information, visit www.medicalcompassmd.com or consult your personal physician.

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