Avery Dennison to sell business units for $500 million









Avery Dennison Corp. has agreed to sell two of its businesses for $500 million in cash to CCL Industries Inc., a Canadian maker of specialty packaging, the Pasadena company said.


The proposed sale announced Wednesday comes three months after Minnesota-based 3M abandoned its plans to purchase Avery Dennison's office and consumer products unit. The U.S. Department of Justice had opposed that deal because of antitrust concerns.


Now, Toronto-based CCL has agreed to acquire the unit, which had sales of $730 million in 2012. The division's products include Hi-Liters and Marks-A-Lot markers as well as binders. CCL also agreed to acquire Avery's designed and engineered solutions division, which makes pressure-sensitive labels for packaging and posted 2012 sales of $180 million.





"CCL is one of our largest customers, and we have a long-standing relationship with them," said Avery Dennison Chief Executive Dean A. Scarborough. "We are pleased that they will become the steward of the Avery brand for office products."


Quiz: How much do you know about California's economy?


The transaction, expected to close this year if approved by regulators, would be CCL's largest acquisition.


"This acquisition has the potential to transform our company at many levels," said Geoffrey Martin, chief executive of CCL.


Avery Dennison on Wednesday also reported fourth-quarter net income of $49 million, or 48 cents a share, up from $22.2 million, or 21 cents, a year earlier. Excluding certain items, earnings were 54 cents a share compared with the 48 cents expected by analysts. Sales rose 5.3% to $1.53 billion.


Avery Dennison shares rose $2.30, or 6.4%, to $38.44.


ricardo.lopez2@latimes.com





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LaHood will resign as Transportation secretary









WASHINGTON — Transportation Secretary Ray LaHood, a former lawmaker from Illinois and the last Republican left in President Obama's first-term Cabinet, announced Tuesday he was stepping down once a replacement was confirmed.


Among those mentioned as a possible successor is Los Angeles Mayor Antonio Villaraigosa, whose second and final term ends June 30. He has sought to establish himself as a national leader on transportation and made improving L.A.'s transit system a cornerstone of his tenure.


Villaraigosa played a key role in crafting a provision in last year's federal transportation bill designed to speed up projects around the country, including in Los Angeles. He was also one of the most prominent Latino supporters for Obama, who has been under pressure to appoint Latinos to his Cabinet. The former California Assembly speaker was chairman of the Democratic National Convention in Charlotte, N.C., last summer.





The mayor is traveling in South Korea; his office said he could not be reached for comment about the opening.


A longtime ally and another former Assembly speaker, Fabian Nuñez, would not confirm whether Villaraigosa had been approached about a Cabinet position but said he believed the mayor would, if one was offered, serve his full term.


"He has his two feet solidly placed on the ground," Nuñez said, adding that Villaraigosa feels he would "have an obligation to finish out his term as mayor. That's first and foremost."


The White House declined to discuss potential Cabinet nominees, but former Michigan Gov. Jennifer Granholm also has been mentioned as a replacement. Like Villaraigosa, Granholm was a key surrogate for Obama and a speaker at the last Democratic convention.


In a note to department staff, LaHood said he would remain until he was officially replaced to ensure "a smooth transition for the department and all the important work we still have to do."


The former seven-term congressman from Peoria, Ill., has led the department since 2009, but stated in 2011 that he did not plan to serve in the president's second term and would retire from public service. The president has another Republican on deck for his second term — former Sen. Chuck Hagel of Nebraska, whom Obama has nominated to lead the Pentagon. The other Republican in Obama's first-term Cabinet, Defense Secretary Robert M. Gates, left in 2011.


Despite his party affiliation, LaHood's views were often out of step with those of his former Republican colleagues, and his appointment did little to boost the president's standing with the opposition.


In his note, LaHood named among his top accomplishments his work to reduce distracted driving and combat pilot fatigue. He also listed his support for high-speed rail and more than $50 billion spent on transportation projects as part of the president's stimulus measure, a program reviled by Republicans, who see it as an example of wasteful federal spending.


"We helped jump-start the economy and put our fellow Americans back to work," LaHood wrote. "Our achievements are significant."


In an interview, LaHood said the biggest battle for his successor would not be over policy but money. The new secretary will have to find a way to fund highway construction and maintenance when the federal 18.4-cent-per-gallon gasoline tax isn't bringing in as much as it used to because vehicles are more fuel-efficient. There is strong opposition to raising the tax, which was last increased in 1993.


LaHood had pushed a five-year transportation funding bill, but had to settle for a two-year bill.


"The funding is the big question. Everyone knows what needs to be done in transportation in America. But the debate will be how to pay for it," LaHood said. "The American people are way, way ahead of the politicians on this. They're ready to have their potholes fixed … and they know it takes resources."


kathleen.hennessey@latimes.com


Richard Simon in Washington, Jon Hilkevitch in Chicago and Cathleen Decker in Los Angeles contributed to this report.





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New BlackBerry to Be ‘Most Comprehensive in Mobile History’






RIM is finally ready with its answer to Apple’s iPhone and the many Android smartphones. After months of delays, RIM CEO Thorsten Heins, along with others from the company, will take the stage Wednesday in New York to unveil the final version of BlackBerry 10, the next version of RIM’s phone software, and the phones that will run it.


“We expect tomorrow to really be the kickoff for the introduction of Blackberry 10,” RIM’s Chief Marketing Officer Frank Boulben told ABC News in a phone interview. “We have been engaged for quite a period of time with the two main constituents — the carriers and the developers — and we’ve already said we are in the labs of more than 150 carriers around the world.”






Column: BlackBerry Burden: What RIM Must Do to Come Back


With more than 150 wireless carriers around the world planning to offer the latest BlackBerry, Boulben says it will be the most “comprehensive launch,” not only for the company, but in the history of the mobile industry.


“This makes it the most comprehensive launch in mobile history. There has never been a platform launching with that many carriers,” he said. When the iPhone 5 made its debut in September it actually had more — Apple said there would be 240 carriers by December. But Boulben points out that BlackBerry 10 is an entirely new operating system that doesn’t share a single line of code with previous BlackBerry software; the iPhone 5 and iOS 6, by contrast, was essentially an upgrade.


At Wednesday’s event the company will show its new handsets in detail. RIM is expected to release a touch-screen device called the Z10 and another with a physical keyboard. AT&T, T-Mobile and Verizon have said they will carry devices that run the new software. Boulben also said RIM will highlight major differences between BlackBerry 10 and the other leading mobile phone platforms.


“We are highly differentiated in four areas,” Boulben said. The first is with communications — RIM has designed the software around a messaging hub and new multitasking features. The second: the touch keyboard, which predicts words as you are typing them. Lastly, RIM says its BlackBerry Messenger and its BlackBerry Balance feature, which separates work from personal uses on the phone, set it apart.


Boulben would not address specifically how much market share RIM is hoping to gain back in the U.S., having lost the lead it had in the last decade. According to Kantar Worldpane ComTech’s data released in November 2012, the BlackBerry brand only had 1.6 percent of the American smartphone market. The iPhone had 48.1 percent of the market and Android had 46.7.


“It’s a change in smartphone experience — the dominant paradigm, introduced six years ago, was great and revolutionary at the time. But six years is a long time for a technology cycle, with a new user experience with a clear focus we have the opportunity to take market share back,” Boulben said.


RIM CMO: BlackBerry 10 Will Make Others Look Outdated


While RIM is of course bullish about its new products, it faces one big challenge it might not be able to control: apps. While the platform might be innovative, it will trail behind the Apple App Store and Google Play Store in variety of apps. Boulben says the momentum around apps is strong and that Wednesday the BlackBerry World store will launch with 70,000 new apps.


RIM BlackBerry 10 Launch


Apps that worked on previous BlackBerry 7 devices won’t work on the BlackBerry 10 platform, since it is completely new. Analysts say that apps are bound to be the pain point for the platform, but it’s not too late to rule out RIM from taking back at least some of what it has lost.


“Given the speed that the market is moving, it’s hard to be dismissive of RIM given the strength of their brand and continued loyalty of many users,” Michael Gartenberg, Gartner Research Director, told ABC News. “It will be important for RIM to show tomorrow how they’ve evolved the BlackBerry to meet the challenges of other platforms and at the same time show positive differentiation.”


And that seems to be exactly RIM’s plan. “The time was right to switch to a new platform, one that will allow us to continue true to our DNA but also take it to the next level,” Boulben said. “It is a major undertaking for the company. It has been two years in the making, but we are ready.”


RIM’s BlackBerry 10 event begins at 10:00 a.m. ET on Jan. 30, 2013. ABC News will be reporting on the news throughout the day.


Also Read
Wireless News Headlines – Yahoo! News





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Judd announces separation from Franchitti


LOS ANGELES (AP) — Ashley Judd and Dario Franchitti are separating after 11 years of marriage.


Judd's spokeswoman confirmed a Tuesday report from People magazine that the 44-year-old actress and 39-year-old Scottish race car driver are ending their marriage.


The star of such films as "Double Jeopardy" and "Kiss the Girls" says in a statement that the pair will "always be family" and will continue to cherish their relationship based on love, integrity and respect.


Last year, Judd starred in the ABC series "Missing" and attended the Democratic National Convention as a Tennessee delegate.


Franchitti has won the Indianapolis 500 race three times.


The couple wed in a private ceremony in Scotland in 2001.


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Super Bowl — At Media Day, Spotlight on Head Injuries Grows





NEW ORLEANS — It has become a staple of Super Bowl week, as much a part of the pregame to the N.F.L.’s biggest event as the annual media day: a discussion of how football is being affected by head injuries and the mounting evidence that long-term brain damage can be linked to injuries sustained on the field.




Years ago, players rarely spoke about the issue and league officials dismissed suggestions that on-field injuries could lead to life-altering health problems. Now, however, the league is facing lawsuits from thousands of former players, rules are being instituted in an attempt to diminish injuries on the field and even President Obama has said that the way football is played will have to change. This week, Bernard Pollard, a hard-hitting safety for the Baltimore Ravens, created a stir by saying that the N.F.L. would not exist in 30 years because of the rules changes designed with safety in mind, but that he also believed there would be a death on the field at some point.


At media day Tuesday, players reacted to the comments made by Pollard and Obama, with some agreeing with Pollard that recent rules changes would change the sport to such an extent that it would be less entertaining and lead to a loss of popularity. Pollard stood by his comments. He added, however, that while he was comfortable with the physical risk he was taking by playing football, he was not sure he would want future generations, including his 4-year-old son, to follow his example.


“My whole stance right now is that I don’t want him to play football,” Pollard said. “Football has been good to me. It has been my outlet. God has blessed me with a tremendous talent to be able to play this game. But we want our kids to have things better than us.”


He said he did not want his son to go through the aches and pains caused by the physicality of the game.


“You keep playing football, you’re going to have your injuries, no one is exempt from that,” he said. “You’re going to have concussions. You’re going to have broken bones. That’s going to happen. But I think for the most part, we know what we signed up for.”


The sentiment was echoed by Baltimore quarterback Joe Flacco. “I play the game and I understand that I’m going to get hit,” Flacco said. “Just because they fine the guys is not going to stop them from hitting me. I find it tough to fine people who are doing their job.”


In a recent interview with The New Republic, Obama expressed concern about on-field injuries, though he added that N.F.L. players were grown men who are “well-compensated for the violence they do to their bodies.”


The president added: “I think that those of us who love the sport are going to have to wrestle with the fact that it will probably change gradually to try to reduce some of the violence. In some cases, that may make it a little bit less exciting, but it will be a whole lot better for the players, and those of us who are fans maybe won’t have to examine our consciences quite as much.”


While many current players seem focused on rules changes and how they will affect the nature of the game, more than 4,000 former N.F.L. players have filed a lawsuit against the league, contending that it knew hits to the head could lead to long-term brain damage but did not share that information with players. The judge in the case said Tuesday that she would hear oral arguments April 9 regarding the league’s motion to dismiss the lawsuit. The family of Junior Seau, a former star linebacker who shot and killed himself last year, has also sued the N.F.L., claiming it failed to inform players about the risks of brain injury.


Pollard’s counterparts on the San Francisco 49ers, safeties Dashon Goldson and Donte Whitner, considered one of the hardest-hitting tandems in the N.F.L., thought the key was not removing big hits, but making sure the hits that are delivered are legal.


“You can be vicious and you can hit people hard, but do it the right way,” Whitner said. “For the most part, you know what you can and cannot do. Do you want to go out there and do the right things or do you want to make that big hit to gain a big name? That’s what it comes down to.”


Ravens guard Marshal Yanda said he thought the topic was so personal for Pollard because of the unique nature of being a hard-hitting defensive back, one of the positions most affected by the league’s attempts to increase player safety.


“I think Bernard is frustrated because he plays a tough position where it’s a bang-bang play and he’s getting fined,” Yanda said. “That’s a tough deal as far as him playing football his whole life knowing how to play one way and then all of a sudden you have to change.”


One of the few people to disagree entirely with Pollard’s view that skewing the rules to protect offensive players would harm the league was Warren Sapp, a retired defensive tackle who at one point went by the Twitter handle @QBKilla. He said a desire for points would always result in defenses being limited.


“They like points,” Sapp said. “I like it too. You’re going to have to make some key stops here and there but it’s an offensive game, no doubt about it.”


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Amazon.com sales jump 22% but profit drops 45% in fourth quarter









Amazon.com Inc. saw big sales during the holiday season, reporting Tuesday that fourth-quarter revenue rose 22% to $21.27 billion from a year earlier.


But the Internet retail giant's sales and earnings missed Wall Street's estimates. Profit for the three months that ended Dec. 31 declined 45% to $97 million, or 21 cents a share, compared with $177 million, or 38 cents, in the same quarter of 2011.


Analysts had expected the e-commerce company to post revenue of $22.26 billion and earnings of 27 cents a share.





Nonetheless, Amazon's stock surged in after-hours trading, rising more than 9% on signs the company's operating margins were improving. During regular trading before earnings were released, shares closed down $15.69, or 5.7%, at $260.35.


Operating income was a highlight of the company's quarterly results, increasing 56% to $405 million in the fourth quarter, compared with $260 million a year earlier.


For the current quarter, Amazon expects sales of $15 billion to $16.6 billion, a 14% to 26% growth from the first quarter of 2012.


It was a good Christmas for Amazon's Kindle family. The company said that for the second year in a row, its tablet was the most popular item for customers, with the Kindle Fire HD the "No. 1 bestselling, most gifted and most wished-for product" across the company's merchandise lineup.


"At year-end, Kindle Fire HD, Kindle Fire, Kindle Paperwhite and Kindle held the top four spots on the Amazon worldwide bestseller charts since launch," the company said.


As is typical for Amazon, it did not break out sales figures for its tablets and e-readers.


Jeff Bezos, founder and chief executive of Amazon, said the company had seen huge growth in its electronic book business as consumers shift to digital texts.


"We're now seeing the transition we've been expecting," he said in a statement. "After five years, eBooks is a multibillion-dollar category for us and growing fast — up approximately 70% last year. In contrast, our physical book sales experienced the lowest December growth rate in our 17 years as a book seller, up just 5%. We're excited and very grateful to our customers for their response to Kindle."


Amazon also said its digital media selection grew to more 23 million movies, TV shows, songs, magazines, books, audio books, apps and games in 2012, an increase from 19 million at the end of 2011.


andrea.chang@latimes.com





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Reporters tweet the Los Angeles mayoral debate

About L.A. Now



L.A. Now is the Los Angeles Times’ breaking news section for Southern California. It is produced by more than 80 reporters and editors in The Times’ Metro section, reporting from the paper’s downtown Los Angeles headquarters as well as bureaus in Costa Mesa, Long Beach, San Diego, San Francisco, Sacramento, Riverside, Ventura and West Los Angeles.



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His cat, his lunch and a high five: Harper’s day chronicled on Twitter






OTTAWA – One of the cardinal rules of social media: no one cares what you had for lunch. Unless, perhaps, you’re the prime minister.


The people behind Stephen Harper‘s Twitter account are using the first day of Parliament’s winter sitting to provide an intimate look at how the prime minister spends his day.






The posts include a video of Harper’s ride to work, photos of breakfast with his cat Stanley and a lunch that included fruit and a Diet Coke at his desk.


The behind-the-scenes look is the latest move by Harper’s team to bolster his presence on social media platforms.


Digital public affairs analyst Mark Blevis says it’s likely an effort to rebrand Harper in the lead-up to the next election, where he’ll face off against politicians far more adept online.


Social Media News Headlines – Yahoo! News





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Conference suggests ways Broadway can be better


NEW YORK (AP) — A conference on how to make the Broadway experience better for theatergoers has come up with some prescriptions: Be brave in the stories that are told onstage and embrace youth and technology.


"Broadway, I don't think, has boldly gone where it needs to," said "Star Trek" actor George Takei, riffing off his old show's motto. "I have a sense that Broadway hasn't entered into the 21st century."


The second TEDxBroadway conference on Monday brought together 16 speakers — producers, marketers, entrepreneurs, academics and artists — to try to answer the question: "What is the best Broadway can be?"


"We use the word 'best' because the goal of today is to go right past better all the way to the extent of what is possible, even if it seems a little bit outlandish," said co-organizer Jim McCarthy, the CEO of Goldstar, a ticket retailer.


TEDx events are independently organized but inspired by the nonprofit group TED — standing for Technology, Entertainment, Design — that started in 1984 as a conference dedicated to "ideas worth spreading." Video of the Broadway event will be made available to the public.


While the health of Broadway is good, with shows yielding a record $1.14 billion in grosses last season, some speakers noted that total attendance — 12.3 million last season — hasn't kept pace, meaning Broadway isn't always attracting new customers.


Three speakers — one the sister of Facebook's founder Mark Zuckerberg — argued that new technology means the stage experience doesn't need to be confined to the four walls of the theater and so can grow new audiences.


David Sabel, who has helped drive the National Theatre of Great Britain into the digital age, pointed out that broadcasts of his stage shows on movie screens across the world haven't dampened demand at the box office and have actually have themselves become profitable.


"I think in our business, digital is uniquely not a threat but an opportunity," he said. "What if we could open it up and invite a much greater audience in to speak with us?"


Randi Zuckerberg said the Broadway community could increase visibility by having auditions for minor parts via YouTube, have live tweeters backstage, offer crowd funding to knit people to productions, give walk-on parts for influential figures or even make the Playbills electronic.


"Why should Broadway be limited by physical space? By ticket prices? By the same shows, over and over?" she asked. "Instead of having just a small sliver of the world come to Broadway, why not bring a small piece of Broadway to the entire world?"


And Internet guru Josh Harris said producers need to open the entire process to the outside world, including video cameras backstage to capture actors getting ready and even having the orchestra pit filled with people interacting with the audience via their electronic devices.


The annual gathering centered on Broadway is the brainchild of three men: McCarthy; Ken Davenport, a writer and producer; and Damian Bazadona, the founder of Situation Interactive. It drew 400 people to the off-Broadway complex New World Stages and into the theater where "Avenue Q" usually plays.


Takei in the past few years has grown 3.3 million Facebook friends and leveraged them into audience members to "Allegiance," his new musical about Japanese-Americans during World War II,


"If I can do it, Broadway certainly can," the 65-year-old said. "Broadway is at its best when it embraces all of the technological advancements of the time and starts making a lot of friends on social media. Then, as we say on 'Star Trek,' Broadway will live long and prosper."


Thomas Schumacher, the president of the Disney Theatrical Group, slammed the pretentious way some in the theatrical community look at more mainstream shows and scoffed at their disdain for making the audience experience more fun.


"Populism has its own manifest destiny and we need to embrace that," said Schumacher, who called for a big tent of theatrical options on Broadway and especially shows for children who will return as adults. "What I ask you to do is embrace this audience and maybe even embrace the sippy cup."


Terry Teachout, drama critic at The Wall Street Journal, soberly pointed out that 75 percent of all Broadway shows fail and then asked that more producers roll the dice on quality.


"If you can't count on getting rich, then forget playing it safe. Why not take a shot at being great?" he asked. "If there's ever a time for you to shoot high, this is it. Don't start out settling for safe. Gamble on great."


Kristoffer Diaz, the playwright of the Pulitzer Prize finalist "The Elaborate Entrance of Chad Deity," urged producers to embrace different voices, as they did with "In the Heights" and "Rent."


"Women, writers of color, transgender, lesbian, gay and bisexual — we need to keep hearing these stories. We need to hear them on Broadway," he said. "It becomes a lot harder to dismiss somebody out of hand if you've spent a couple of hours investing in their story."


Two speakers with specialty knowledge outside Broadway urged the community to not just focus on putting on a great show.


Susan Reilly Salgado, who has worked with famed restaurant owner Danny Meyer, said his success is not only about creating tasty dishes. Meyer, she said, makes the whole evening fun.


"To say that, in a restaurant, it's all about the food discounts everyone else who touches the customer experience," she said. "The best way to get people to come back to you over and over is to create an all-encompassing experience."


Erin Hoover, the vice president of design for Westin and Sheraton Hotels & Resorts, said Broadway theaters could take a page out of the innovations brought to hotel lobbies, which are now comfortable, inviting and offer new sources of revenue. "The experience for the show really starts at the door."


Customer service was also a theme touched on by Zachary A. Schmahl, an actor-turned-baker who created Schmackary's Cookies in his apartment and has watched it grow into a thriving business.


"Customer service is something that people are missing in New York," he said. "It's so important in our single-serving culture to be that business that has a heart and a soul alongside a quality product."


One returning speaker was Vincent Gassetto, the principal of a high-performing public middle school in a tough area of the Bronx, who urged those in attendance to make sure Broadway was on the radar of his best and brightest students.


"It's in everybody in this room's best interest that they have an awareness of this industry or we're never going to win that talent war," he said. "We're all going to be competing for them."


Though the speakers came from different backgrounds and emphasized different prescriptions, they did seem to agree with Daryl Roth, the Pulitzer Prize-winning producer of seven plays, including "Clybourne Park." She challenged the crowd to think of Broadway in more than just dollars and cents.


"If we share the deep belief that theater matters, that theater can change us and ultimately change the world, then isn't that the best Broadway can be?" Roth asked.


___


Online:


http://www.goldstar.com/tedxbroadway


___


Follow Mark Kennedy on Twitter at http://twitter.com/KennedyTwits


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Personal Health: Keeping Blood Pressure in Check

Since the start of the 21st century, Americans have made great progress in controlling high blood pressure, though it remains a leading cause of heart attacks, strokes, congestive heart failure and kidney disease.

Now 48 percent of the more than 76 million adults with hypertension have it under control, up from 29 percent in 2000.

But that means more than half, including many receiving treatment, have blood pressure that remains too high to be healthy. (A normal blood pressure is lower than 120 over 80.) With a plethora of drugs available to normalize blood pressure, why are so many people still at increased risk of disease, disability and premature death? Hypertension experts offer a few common, and correctable, reasons:


Jane Brody speaks about hypertension.




¶ About 20 percent of affected adults don’t know they have high blood pressure, perhaps because they never or rarely see a doctor who checks their pressure.

¶ Of the 80 percent who are aware of their condition, some don’t appreciate how serious it can be and fail to get treated, even when their doctors say they should.

¶ Some who have been treated develop bothersome side effects, causing them to abandon therapy or to use it haphazardly.

¶ Many others do little to change lifestyle factors, like obesity, lack of exercise and a high-salt diet, that can make hypertension harder to control.

Dr. Samuel J. Mann, a hypertension specialist and professor of clinical medicine at Weill-Cornell Medical College, adds another factor that may be the most important. Of the 71 percent of people with hypertension who are currently being treated, too many are taking the wrong drugs or the wrong dosages of the right ones.

Dr. Mann, author of “Hypertension and You: Old Drugs, New Drugs, and the Right Drugs for Your High Blood Pressure,” says that doctors should take into account the underlying causes of each patient’s blood pressure problem and the side effects that may prompt patients to abandon therapy. He has found that when treatment is tailored to the individual, nearly all cases of high blood pressure can be brought and kept under control with available drugs.

Plus, he said in an interview, it can be done with minimal, if any, side effects and at a reasonable cost.

“For most people, no new drugs need to be developed,” Dr. Mann said. “What we need, in terms of medication, is already out there. We just need to use it better.”

But many doctors who are generalists do not understand the “intricacies and nuances” of the dozens of available medications to determine which is appropriate to a certain patient.

“Prescribing the same medication to patient after patient just does not cut it,” Dr. Mann wrote in his book.

The trick to prescribing the best treatment for each patient is to first determine which of three mechanisms, or combination of mechanisms, is responsible for a patient’s hypertension, he said.

¶ Salt-sensitive hypertension, more common in older people and African-Americans, responds well to diuretics and calcium channel blockers.

¶ Hypertension driven by the kidney hormone renin responds best to ACE inhibitors and angiotensin receptor blockers, as well as direct renin inhibitors and beta-blockers.

¶ Neurogenic hypertension is a product of the sympathetic nervous system and is best treated with beta-blockers, alpha-blockers and drugs like clonidine.

According to Dr. Mann, neurogenic hypertension results from repressed emotions. He has found that many patients with it suffered trauma early in life or abuse. They seem calm and content on the surface but continually suppress their distress, he said.

One of Dr. Mann’s patients had had high blood pressure since her late 20s that remained well-controlled by the three drugs her family doctor prescribed. Then in her 40s, periodic checks showed it was often too high. When taking more of the prescribed medication did not result in lasting control, she sought Dr. Mann’s help.

After a thorough work-up, he said she had a textbook case of neurogenic hypertension, was taking too much medication and needed different drugs. Her condition soon became far better managed, with side effects she could easily tolerate, and she no longer feared she would die young of a heart attack or stroke.

But most patients should not have to consult a specialist. They can be well-treated by an internist or family physician who approaches the condition systematically, Dr. Mann said. Patients should be started on low doses of one or more drugs, including a diuretic; the dosage or number of drugs can be slowly increased as needed to achieve a normal pressure.

Specialists, he said, are most useful for treating the 10 percent to 15 percent of patients with so-called resistant hypertension that remains uncontrolled despite treatment with three drugs, including a diuretic, and for those whose treatment is effective but causing distressing side effects.

Hypertension sometimes fails to respond to routine care, he noted, because it results from an underlying medical problem that needs to be addressed.

“Some patients are on a lot of blood pressure drugs — four or five — who probably don’t need so many, and if they do, the question is why,” Dr. Mann said.


How to Measure Your Blood Pressure

Mistaken readings, which can occur in doctors’ offices as well as at home, can result in misdiagnosis of hypertension and improper treatment. Dr. Samuel J. Mann, of Weill Cornell Medical College, suggests these guidelines to reduce the risk of errors:

¶ Use an automatic monitor rather than a manual one, and check the accuracy of your home monitor at the doctor’s office.

¶ Use a monitor with an arm cuff, not a wrist or finger cuff, and use a large cuff if you have a large arm.

¶ Sit quietly for a few minutes, without talking, after putting on the cuff and before checking your pressure.

¶ Check your pressure in one arm only, and take three readings (not more) one or two minutes apart.

¶ Measure your blood pressure no more than twice a week unless you have severe hypertension or are changing medications.

¶ Check your pressure at random, ordinary times of the day, not just when you think it is high.

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