Health
Chronic Pain Afflicts Billions of People. It’s Time for a Revolution.
“In the beginning, everyone thought they were going to find this one breakthrough pain drug that would replace opioids,” Gereau said. Increasingly, though, it’s looking like chronic pain, like cancer, could end up having a range of genetic and cellular drivers that vary both by condition and by the particular makeup of the person experiencing it. “What we’re learning is that pain is not just one thing,” Gereau added. “It’s a thousand different things, all called ‘pain.’”
For patients, too, the landscape of chronic pain is wildly varied. Some people endure a miserable year of low-back pain, only to have it vanish for no clear reason. Others aren’t so lucky. A friend of a friend spent five years with extreme pain in his arm and face after roughhousing with his son. He had to stop working, couldn’t drive, couldn’t even ride in a car without a neck brace. His doctors prescribed endless medications: the maximum dose of gabapentin, plus duloxetine and others. At one point, he admitted himself to a psychiatric ward, because his pain was so bad that he’d become suicidal. There, he met other people who also became suicidal after years of living with terrible pain day in and day out.
The thing that makes chronic pain so awful is that it’s chronic: a grinding distress that never ends. For those with extreme pain, that’s easy to understand. But even less severe cases can be miserable. A pain rating of 3 or 4 out of 10 sounds mild, but having it almost all the time is grueling — and limiting. Unlike a broken arm, which gets better, or tendinitis, which hurts mostly in response to overuse, chronic pain makes your whole world shrink. It’s harder to work, and to exercise, and even to do the many smaller things that make life rewarding and rich.
It’s also lonely. When my arms first went crazy, I could barely function. But even after the worst had passed, I saw friends rarely; I still couldn’t drive more than a few minutes, or sit comfortably in a chair, and I felt guilty inviting people over when there wasn’t anything to do. As Christin Veasley, director and co-founder of the Chronic Pain Research Alliance, puts it: “With acute pain, medications, if you take them, they get you over a hump, and you go on your way. What people don’t realize is that when you have chronic pain, even if you’re also taking meds, you rarely feel like you were before. At best, they can reduce your pain, but usually don’t eliminate it.”
A cruel Catch-22 around chronic pain is that it often leads to anxiety and depression, both of which can make pain worse. That’s partly because focusing on a thing can reinforce it, but also because emotional states have physical effects. Both anxiety and depression are known to increase inflammation, which can also worsen pain. As a result, pain management often includes cognitive behavioral therapy, meditation practice or other coping skills. But while those tools are vital, it’s notoriously hard to reprogram our reactions. Our minds and bodies have evolved both to anticipate pain and to remember it, making it hard not to worry. And because chronic pain is so uncomfortable and isolating, it’s also depressing.
Health
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Dementia risk signals could lie in simple blood pressure readings, researchers say
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Simple measurements taken during routine blood pressure checks could predict dementia risk years before symptoms appear.
That’s according to new research presented this week at the American College of Cardiology’s Annual Scientific Session in Louisiana.
The findings draw on two studies led by researchers at Georgetown University, which suggest that monitoring how blood vessels age and stiffen over time can provide a window into future cognitive health.
LURKING DEMENTIA RISK EXPOSED BY BREAKTHROUGH TEST 25 YEARS BEFORE SYMPTOMS
Data shows rates of dementia and aging-related cognitive decline are expected to increase as populations age, and half of U.S. adults have high blood pressure (hypertension).
Scientists believe that efforts to better address hypertension, a key contributor to heart disease and a risk factor for dementia, could affect both cardiac and brain health.
Data shows rates of dementia and aging-related cognitive decline are expected to increase as populations age. Meanwhile, half of U.S. adults have high blood pressure. (iStock)
“Blood pressure management isn’t just about preventing heart attacks and strokes; it may also be one of the most actionable strategies for preserving cognitive health,” Dr. Newton Nyirenda, the study’s lead author and an epidemiologist at Georgetown University in Washington, said in a press release.
The research focused on two metrics, the pulse pressure-heart rate index and estimated pulse wave velocity. Both were calculated using data collected during standard doctor visits, such as heart rate, age and blood pressure.
“Blood pressure management isn’t just about preventing heart attacks and strokes; it may also be one of the most actionable strategies for preserving cognitive health.”
Researchers examined five years of data patterns for more than 8,500 people in the SPRINT trial, a large study of adults 50 years and older with hypertension. In the follow-up, 323 of the participants developed probable dementia.
HIDDEN BRAIN CONDITION MAY QUADRUPLE DEMENTIA RISK IN OLDER ADULTS, STUDY SUGGESTS
In one study, the team found the pulse pressure-heart rate index was a strong independent predictor of dementia risk in adults over 50. For participants under 65, every one-unit increase was associated with a 76% higher risk of developing dementia.
For participants under 65, an increase in the pulse pressure-heart rate index was associated with a 76% higher risk of developing dementia. (iStock)
The second study found that adults with consistently elevated or rapidly increasing pulse wave velocity were more likely to develop dementia than those with stable velocity, even after accounting for factors like smoking, gender and cardiovascular history.
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“Our findings suggest that vascular aging patterns may provide meaningful insight into future dementia risk,” said Nyirenda. “This reinforces the idea that managing vascular health earlier in life may influence long-term brain health.”
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The team emphasized that clinicians should tailor risk assessments and treatment strategies to the individual.
Further studies are needed to confirm these parameters and determine whether changing vascular aging trajectories reduces dementia risk. (iStock)
“You don’t want to wait until a patient starts manifesting cognitive decline before you act,” said senior study author Sula Mazimba, an associate professor at the University of Virginia.
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Researchers noted the study could not establish causation. Other limitations included the fact that participants already had hypertension and elevated cardiovascular risk, meaning the findings may not apply to people without those conditions.
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Further studies are needed to confirm these findings and to determine whether improving blood vessel health over time could reduce dementia risk.
Health
Everything You Need To Know About Zepbound for Weight Loss, Including Costs
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