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An estimated 43.5 million Americans provide in-home, long-term care for older adult family members with a chronic illness. In a new JAMA survey, caregivers are typically women who spend about 20 to 40 hours a week providing care. Most caregivers feel abandoned and unrecognized by the health care system. Spousal caregivers face greater challenges than caregivers helping a parent for a variety of reasons, one of which is that they tend to be older. Many caregivers don’t know about, or take advantage of, services and support systems such as respite care, help with non-medical services such as housekeeping and cooking, counseling, and more. The Caregiver’s Handbook, a Special Health Report from Harvard Medical School, includes detailed information that can help women and men provide better care for their loved ones and take care of themselves.

The next time you have your blood pressure checked, ask your health care to check it in both arms, rather than just in one. Why? A big difference between the two readings can give you an early warning about increased risk of cardiovascular disease, a new study suggests. Harvard researchers found that people who have a 10-point difference in blood pressure from one arm to the other are 38% more likely to have a heart attack, stroke, or a related problem than those with arm-to arm differences less than 10 points. Small differences in blood pressure readings between the right and left arm are normal. But large ones suggest the presence of artery-clogging plaque in the vessel that supplies blood to the arm with higher blood pressure. Clogging there means there’s a good chance the arteries in the heart and brain are also clogged, boosting the odds of having a heart attack or stroke.

The grief of losing a spouse or partner affects not just emotional and mental health, but physical health as well. The surviving spouse or partner often develops health problems in the weeks and months that follow. A study published this week in JAMA Internal Medicine found that individuals who had lost a spouse or partner were more likely to have a heart attack or stroke within the next 30 days. Grief activates the sympathetic nervous system, which is responsible for revving up the body’s fight-or-flight response. That can lead to stress-induced changes in blood pressure, heart rate, and blood clotting. There is also a tendency after such a profound loss for the surviving spouse or partner to disregard his or her own health. It can take several months to a year to work through grief and grieving. If it lasts much longer, and is interfering with daily life鈥攕eeing friends, doing once-pleasurable activities鈥攊t’s possible that grief has morphed into something more serious, like depression.

Even after intensive rehabilitation therapy, many people who break a hip still can’t do things they used to do with ease, like dressing, rising from a chair, or climbing stairs, after . A report in this week’s Journal of the American Medical Association shows that simple exercises done at home can make a big difference in recovering from a broken hip. A set of “functional exercises” that mimic the kinds of things people normally do in their daily lives improved function and mobility among people who had broken a hip. It’s important :just do it.” At-home rehab is of no use if you don’t stick with it. These kinds of exercises can also help ward off post-fracture complications like blood clots, pneumonia, wound infections, and more. Extended bed rest after a major injury or surgery can feed a downward spiral of physical deconditioning and additional health problems.

The first-ever guidelines for preventing stroke in women don’t fool around. They offer ways to prevent this disabling and potentially deadly event from adolescence to old age. More than half of the 800,000 Americans who have strokes each year are women. Nearly 4 million American women are living with the aftermath of a stroke. And because women live longer than men, their lifetime risk of having a stroke is higher. Those numbers are why stroke prevention is especially important for women. The guidelines cover the use of oral contraceptives, high blood pressure during pregnancy, the use of hormones after menopause, and migraine with aura. They also cover the fundamentals of stroke prevention, like controlling blood pressure, exercising more, eating a healthy diet, and not smoking.

Cigarettes, cigars, and the like are the most deadly product that consumers can legally buy. It’s sadly ironic that they are sold in pharmacies, which are meant to dispense medications and other things designed to heal or promote health. The American Pharmacists Association, the American Medical Association, and other groups have urged pharmacies to stop selling cigarettes. Several major pharmacy chains have been mulling whether or not to take this advice. Today, one of them has acted. The CVS chain has decided to stop selling tobacco products, and will phase out their sales over the next year. The news came in a press release from CVS and an opinion piece published today in JAMA, the journal of the American Medical Association. Pharmacists will likely cheer the decision鈥攐ne survey of pharmacists showed that only 2% of them favor the sale of tobacco products in their stores.

Mass marketing of testosterone therapy may have men eager to try this seemingly simple fix. But the latest science should have them scratching their heads and putting away the credit card鈥攁t least for now. A new study published in the online journal PLOS One shows an increase in the risk of having a heart attack in the months after starting testosterone therapy. The potential for danger was highest in older men. A report in the November 6, 2013, issue of JAMA showed that men who used testosterone therapy didn’t fare as well after artery-opening angioplasty as men who didn’t take testosterone. Neither was the type of study that can prove cause and effect. They can only show associations, or links. That means there’s no smoking gun here that testosterone therapy is harmful. But the studies do suggest caution. Given the uncertainly over the benefits and risks of testosterone therapy, what’s a man to do? Take a cautious approach, advises the Harvard Men’s Health Watch.

Many Americans spend most of each workday sitting in a chair, their fingers the only part of their bodies moving with any intensity. The ease of this modern workday could come at the expense of longevity. A new study of older women in the American Journal of Preventive Medicine finds that sitting for long stretches of time increases the odds of an untimely death. And here’s the kicker: Regular exercise doesn’t do much to diminish the risk of sitting all day. When you sit, you expend fewer calories than you would while standing, and you demand little effort from your muscles. This can help set the stage for diabetes and heart disease. One way to avoid prolonged sitting during the workday is to switch to a standing desk, or one that can adjust to sitting and standing positions. An easier, no-cost solution is to set your smartphone timer to go off every 30 to 60 minutes during the day, and move around when the alarm rings.

A landmark clinical trial done in Spain, known by the acronym PREDIMED, continues to support the health benefits of following a Mediterranean-style eating pattern. Last year, PREDIMED researchers reported that Mediterranean-style eating鈥攔ich in fruits, vegetables, and healthy plant oils鈥攑revents heart attacks, strokes, and death from heart disease. This week in The Journal of the American Medical Association, they report that a healthy Mediterranean-style diet can also help prevent peripheral artery disease (PAD), a form of “hardening of the arteries.” It’s an important finding, since as many as 12 million Americans have PAD. It can cause leg pain when walking that goes away with rest (called intermittent claudication); a weakening of the aorta, the main pipeline that delivers blood to the body; pain after eating; erectile dysfunction; and other problems.

For some people, like those with an addiction, any amount of alcohol is too much. For others, drinking alcohol is something of a balancing act 鈥� a little may be healthful, while more than a little may be harmful. A new report in the journal Neurology highlights the dual effects of alcohol in men. As part of the Whitehall II study in Britain, researchers assessed the drinking habits of middle-aged men and women three times over a 10-year period. The study participants also took a mental skills test three times over the next 10 years. Compared with men who didn’t drink or who drank moderately, mental decline began to appear one to six years earlier in men who averaged more than 2.5 drinks a day. (There weren’t enough heavy drinkers among women to show any clear differences.) How does a person know if he or she is drinking too much? The CAGE and AUDIT tests can help.

Diverticulitis, an unpleasant condition that occurs when tiny pouches inside the large intestine become inflamed, can cause intense lower abdominal pain, diarrhea, constipation, a fever, and sometimes a good deal of rectal bleeding. Following a liquid diet for a while can help treat it, but antibiotics, and sometimes even surgery, may be needed. A new study in JAMA suggests that these treatments may be overused.
University of Michigan researchers reviewed the results of 80 studies of diverticulitis and its treatment. While the team agreed that antibiotic use and surgery are sometimes necessary, it concluded that there should be a lesser role for aggressive antibiotic or surgical intervention for chronic or recurrent diverticulitis than was previously thought necessary. Some studies suggest that exercising, controlling weight, and eating a high-fiber diet can prevent diverticular disease. It can also bring relief from constipation, better cholesterol control, and make for more filling meals. Adults should get 25 to 30 grams of dietary fiber every day. It’s best to get it from high-fiber foods, such as beans, whole grains, vegetables, and fruits. Some people need a fiber supplement.

On a Saturday morning 50 years ago tomorrow, then Surgeon General Luther Terry made a bold announcement to a roomful of reporters: cigarette smoking causes lung cancer and probably heart disease, and the government should do something about it. Terry, himself a longtime smoker, spoke at a press conference unveiling Smoking and Health: Report of the Advisory Committee of the Surgeon General of the Public Health Service. That press conference was held on a Saturday in part to minimize the report’s effect on the stock market. The 1964 Surgeon General’s report, and others that followed, have had a profoundly positive effect on the health of Americans, despite the tobacco industry’s concerted and continuing efforts to promote smoking. By one new estimate, the decline in smoking triggered by the 1964 report and others that followed prevented more than 8 million premature deaths, half of them among people under age 65. But we still have a long way to go. Some 42 million Americans still smoke, and tobacco use accounts for millions of deaths each year around the world.

Many people practice meditation in hopes of staving off stress and stress-related health problems, even though the evidence for doing so is spotty. A new study that analyzed the results of nearly 50 solid clinical trials of meditation shows that mindfulness meditation can help ease psychological stresses like anxiety, depression, and pain. One way it does this is by training you to experience anxious thoughts or stresses in completely different and less emotionally disturbing ways. Mindfulness-based stress reduction training, developed by Dr. Jon Kabat-Zinn at the University of Massachusetts Medical School in Worcester, MA, is now widely available in cities throughout the United States. You can also learn it yourself from books or online recordings. Or try this short meditation, from the Zen Buddhist monk Thich Nhat Hahn: “Breathing in, I calm my body. Breathing out, I smile. Dwelling in the present moment, I know this is a wonderful moment.”

A recent article in Parade magazine caught my eye because it has lessons for us all. The article was about Olga Kotelko, a 94-year-old woman, who is a competitive runner and track star. Her age alone is impressive. The fact that she didn’t enter her first Master’s competition until she was 77鈥攁n age when many people are hanging up their sneakers鈥攊s amazing. The article offers six lessons that anyone can learn from Ms. Kotelko’s daily life. She can be an inspiration for anyone, at any age, who wants to start exercising or to exercise more. You are never too old or too frail to start exercising. Start out with a safe, easy program. Gradually add more and harder exercise. Who knows where you might end鈥攑ossibly in an event challenging the likes of Olga Kotelko.

Could tea be a health beverage? Eleven new studies in the American Journal of Clinical Nutrition highlight the many ways that tea may improve health: Tea drinking appears to lower the risk for heart disease and stroke, may strengthen bones, and appears to improve mood, concentration, and performance. Natural compounds called polyphenols in tea might protect against several cancers, including those of the prostate, GI tract, lungs, breast, and skin, and may also increase metabolism and promote weight loss. Those possible benefits apply to tea, not tea extracts condensed into pills. If you’re a tea drinker, enjoy your favorite brew with the added satisfaction that it may be good for your health. If you aren’t, there’s no reason to start.

A longer lifespan can be a double-edged sword. You live for more years, but the later years may not necessarily be what you had in mind. We’ve known for some time that about 25% of older Americans can’t perform some activities of daily living without help. But we don’t know much about the other 75%. A new study suggests that two-thirds of Americans over age 65 need help doing everyday activities such as eating, bathing, and getting in and out of bed or a chair. Things you can do to help ward off becoming frail or disabled include staying active, managing weight and eating a healthy diet, preventing falls, making connections with others, and seeing your doctor(s) regularly.

Sleep apnea鈥攑auses in breathing while sleeping followed by snoring-like gasps for breath鈥攃an cause daytime drowsiness and mental fatigue. It can also boost blood pressure and the risk for developing heart disease. A new study suggests that treating sleep apnea by using a breathing machine during sleep can make a difference for people with hard-to-treat high blood pressure. Although blood pressure medications offer a bigger bang for the buck to reduce blood pressure, treating sleep apnea can help, and offers other benefits as well. Getting used to using a breathing machine, which delivers continuous positive airway pressure (CPAP), may take some work. One key is to find a mask that works, which may be a trial-and-error process.

If you have trouble finding the motivation to break away from the television and exercise, try couchersizing鈥攕taying on or near your couch and exercising during commercial breaks. Why bother? A growing body of evidence links the amount of time spent sitting to illness and even death. And just minimizing long periods of inactivity, like exercising during commercial breaks, can help reduce the risk of injury and may even help you live longer. You can work many different muscle groups while seated upright on a couch. Want to get your heart rate up, work the oblique muscles on the sides of the abdomen. To whittle your waist, try twisting your torso from side to side for the length of a commercial break. You can even exercise while lying on the couch.

Overeating during the holidays is practically a tradition. But overindulging can lead to weight gain, fatigue, and guilt. There are several tactical strategies you can employ to get you through the season of eating. Plan ahead: Find out when you’ll be eating, and plan your day around the meal; if you can bring a dish for the buffet, bring something healthy. At the buffet: Grab a salad plate instead of a dinner plate, and choose wisely; don’t waste calories on foods that aren’t special. At the table: Pace yourself by taking small bites, chewing slowly, and sipping water in between bites. Slowing down helps your brain get the message that you’re full. If all else fails: Don’t beat yourself up. Just get back to a healthy eating plan as soon as possible.

In many ways, women are different from men. One way in which they are alike is how they “feel” a heart attack: with similar kinds of chest pain. Other heart attack symptoms may differ, but chest pain is pretty standard, according to European study of nearly 2,500 men and women. Few differences in chest pain were seen between the sexes. What’s more, the kind or duration of chest pain didn’t help tell a heart attack from some other problem. The conclusion? A careful medical history, an electrocardiogram, and blood tests are the best way to diagnose a heart attack in men and women. During a heart attack, more than three-quarters of men and women experience chest pain or discomfort. In the run-up to a heart attack, chest pain with exertion is a more common warning sign in men, while women often have other types of symptoms, such as fatigue and disturbed sleep.