BlackBerry 10 launches after long wait

Research In Motion Ltd unveiled the long-delayed line of smartphones it hopes will put it on the comeback trail on Wednesday but it disappointed investors by saying U.S. sales of its all-new BlackBerry 10 will start only in March.

Chief Executive Thorsten Heins also announced that RIM was abandoning the name it has used since its inception in 1985 to take the name of its signature product, signaling his hopes for a fresh start for the company that pioneered on-your-hip email.

"From this point forward, RIM becomes BlackBerry," Heins said at the New York launch. "It is one brand; it is one promise."

RIM, which is already starting to call itself BlackBerry, had initially planned to launch the new BlackBerry 10 smartphones in 2011. But it pushed the date back twice as it struggled to work with a new operating system.

Ahead of Wednesday's announcements, analysts had said that any launch after February would be a black mark for the Canadian company.

"The biggest disappointment was the delay in the U.S., that it will take so long before the devices get going there," said Eric Jackson, founder and managing Partner at Ironfire Capital LLC in New York.

Heins said the delays reflected the need for U.S. carrier testing, although carrier AT&T offered few clues on what that meant.

"We are very enthusiastic about the devices. We will announce pricing, availability, and other information at a later date. Beyond that, nothing to add," said spokesman Mark Siegel.

RIM launched its first BlackBerry back in 1999 as a way for busy executives to stay in touch with their clients and their offices, and the Canadian company quickly cornered the market for secure corporate and government email.

But its star faded as competition rose. The BlackBerry is now a far-behind also-ran in the race for market share, with a 3.4 percent global showing in the fourth quarter, down from 20 percent three years before. Its North American market share is even worse: a mere 2 percent in the fourth quarter.

RIM shares tumbled along with the company's market share, and the stock is down 90 percent from its 2008 peak.

The shares fell as much as 8 percent on Wednesday, although they are still more than twice the level of their September 2012 low, reflecting ever-louder buzz about the new devices.

TOUCH COMPETITION

The new BlackBerry 10 phones will compete with Apple's iPhone and devices using Google's Android technology, both of which have soared above the BlackBerry in a competitive market.

The BlackBerry 10 devices boast fast browsers, new features, smart cameras and, unlike previous BlackBerry models, enter the market primed with a large application library, including services such as Skype and the popular game Angry Birds.

The BlackBerry Z10 touchscreen device, in black or white, will be the first to hit the market, with a country-by-country roll-out that starts in Britain on Thursday.

A Q10 model, equipped with small "qwerty" keyboard that RIM made into its trademark, will launch globally in April.

The Z10 device won a lukewarm review from Wall Street Journal tech blogger Walt Mossberg, who complained of missing or lagging features and a shortage of apps.

But David Pogue, who writes for The New York Times, apologized for describing BlackBerry as doomed in the past. The Z10 touchscreen device was "lovely, fast and efficient, bristling with fresh, useful ideas," he said.

Announcements about pricing so far have been in line with expectations. U.S. carrier Verizon Wireless said the phone would cost $199 for a two-year contract, while Canada's Rogers Communications is quoting C$149 ($150) for certain three-year plans.

GLITZY LAUNCH

RIM picked a range of venues for its global launch parties, including Dubai's $650-a-night Armani Hotel, which occupies six floors of the Burj Khalifa, the world's tallest tower.

The New York event took place in a sprawling basketball facility on the Lower East Side of Manhattan, just north of the Manhattan Bridge. The BlackBerry has been "Re-designed. Re-engineered. Re-invented," RIM said.

RIM, which is splurging on a Superbowl ad to promote its new phones, also introduced Grammy-winning singer-songwriter Alicia Keys as its global creative director.

"I was in a long-term relationship with BlackBerry, and then I started to notice some new, kind of hotter, attractive, sexier phones at the gym, and I kind of broke up with you for something that had a little more bling," Keys said at the New York launch.

"But I always missed the way you organized my life, and the way you were there for me at my job, and so I started to have two phones - I was kind of playing the field. But then … you added a lot more features … and now, we're exclusively dating again, and I'm very happy."

RIMM data by YCharts

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Teen girl killed, boy wounded in shooting near high school

A 15-year-old girl was fatally shot and 16-year-old boy wounded about three blocks from King College Prep on the South Side this afternoon, authorities said.

The shooting occurred around 2:20 p.m. in the 4500 block of South Oakenwald Avenue, police said. A 16 year-old boy was shot in the leg and a 15-year-old girl was wounded in the back, police said, citing preliminary information.

The Cook County medical examiner's office has been notified that the girl died.

One of the teens was taken in serious to critical condition to Comer Children's Hospital, according to Chicago Fire Department spokesman Will Knight.

The other victim also was taken to Comer and police at first believed both victims' conditions had stabilized by a little after 3 p.m., said Chicago Police News Affairs Officer Veejay Zala.

Neighbors reported hearing shots about 2:20 p.m. Neighbors said students from King hang out at Harsh Park, 4458-70 S. Oakenwald Ave., and that students were there this afternoon before the shooting took place.

Desiree Sanders said she heard six gunshots and called 911 after a neighbor told her that some teens had been shot.

Chicago Police crime data show no serious crimes happened in the 4400 or 4500 blocks of South Oakenwald Avenue Dec. 19 to Jan. 20.

“It’s a great neighborhood. Nothing like this has happened since I’ve been here,” on the block, said Roxanne Hubbard, who has lived in the neighborhood for 19 years.

Tribune reporter Liam Ford contributed

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RIM faces its day of reckoning with BlackBerry 10 launch

NEW YORK (Reuters) – The innovative line of BlackBerry smartphones that Research In Motion Ltd will formally unveil on Wednesday has already succeeded on one crucial count – getting RIM back in the conversation.

The new BlackBerry 10 has created a buzz among technology watchers and financial analysts, thanks to nifty features that may set it apart in an overcrowded smartphone market. RIM stock has almost tripled over the past four months on hopes the devices can restore RIM to sustained prosperity.

Reviewers like the browser speed and the intuitive keyboard on RIM’s new touchscreen. A feature called BlackBerry Balance, which keeps corporate and personal data separate, could help RIM rebuild its traditional base of big business customers.

It’s a welcome start for RIM, the smartphone pioneer that has teetered on the brink of irrelevance. But success will come only if consumer and business customers embrace the new technology in the weeks and months after CEO Thorsten Heins takes the wraps off the phone at a glitzy New York launch.

RIM is gambling its survival on the much-delayed BlackBerry 10, hoping to claw its way back into an industry now dominated by Apple Inc’s iPhone and Samsung Electronics Co Ltd’s Galaxy.

The timing may be just right. The new phone hits the market just as the iPhone’s remarkable run is showing some signs of slowing.

“I really do believe that the consumer market as a whole is ready for something new,” said Kevin Burden, head of mobility at Strategy Analytics, an industry consulting firm.

“I have to believe that there is some level of user fatigue that plays into the longevity of some of these platforms,” he added, referring to Google Inc’s Android and Apple’s iOS, which are both more than five years old. “RIM is probably timing it right.”

U.S. BATTLEGROUND

To be sure, RIM shares are about 90 percent below a 2008 peak near $ 150 a share and the company still has a tough fight ahead. It may take investors some time to determine whether RIM’s big gamble on an untested technology has paid off.

RIM’s market share collapsed in the three years ahead of the launch. Strategy Analytics data shows RIM’s global share of the smartphone market was about 3.4 percent in the fourth quarter, down from around 20 percent just three years ago.

While RIM has done well in developing markets, it has hemorrhaged customers in the United States, a market that sets technology trends. RIM’s fourth-quarter North American market share fell to 2 percent from more than 40 percent three years ago.

Acknowledging that it is crucial to win back U.S. customers, RIM will hold its main BlackBerry 10 launch in New York, although there are simultaneous events in six cities across the globe.

Underscoring the point, RIM is splurging on a costly Super Bowl ad to tout its new devices and attempt to brighten its faded image in the U.S. market.

BIG QUESTIONS

Over 150 carriers already have tested the new devices and RIM has said the launch will be the largest ever global rollout of a new platform.

The two big questions the market expects RIM to answer on Wednesday are when the phones – a full touch-screen device and one with a traditional physical keyboard – will hit store shelves, and how much they will cost.

The company is expected to unveil specifics on pricing and availability in different regions at the launch.

“The Street is expecting mid-February for a launch. Anything earlier than that is a positive, anything later will be viewed as negative,” said RBC Dominion Securities analyst Paul Treiber.

That said, there are few mysteries to be cleared up on Wednesday. Leaked photos and specifications of the devices have been splashed across the tech world.

“We’ve had the beta devices for a few weeks and in terms of the devices, they are right up there with the competition,” said Andy Ambrozic, head of IT Infrastructure at Ricoh Canada. “The Balance feature is crucial for corporations that are becoming increasingly concerned about data security.”

Scotiabank analyst Gus Papageorgiou feels RIM has a good chance of a comeback. He says the new BB10 operating system outpaces Apple’s iOS platform and Google’s market-leading Android system in every category except app selection and content.

“There is, we believe, huge potential for the platform and devices to bring people back to BlackBerry or draw entirely new users into the platform,” said Papageorgiou, who has a “sector outperform” rating on the stock.

BlackBerry 10 will not be able to compete on the number of apps, but RIM says its operating system will have the largest application library for any new platform at launch, with more than 70,000 apps available.

It has already gathered big-name music and video partners for its BlackBerry 10 storefront, including Walt Disney Studios and Sony Pictures, Universal Music and Warner Music Group.

Wireless carriers already report strong demand for the new devices. Rogers Communications Inc, Canada’s top wireless carrier and the first globally to take pre-orders for the new devices, said orders are already in the thousands.

“Our customers are excited,” said John Boynton, Rogers’ head of marketing, adding that some users are holding off on upgrades in anticipation of the BB10 launch.

(Additional reporting by Alastair Sharp and Allison Martell in Toronto; Editing by Frank McGurty, Janet Guttsman and Andre Grenon)

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Singer Frank Ocean wants Chris Brown charged over brawl

LOS ANGELES (Reuters) – Rising R&B artist Frank Ocean wants fellow singer Chris Brown prosecuted following a brawl over a parking space at a Los Angeles-area recording studio, authorities said on Monday.

Brown is serving five years probation for assaulting his on-and-off girlfriend Rihanna in 2009 and risks having his probation revoked should charges be filed.

In the incident on Sunday, sheriff’s deputies responded to a call about a fight involving six men in West Hollywood. The deputies cited witnesses as saying that the Grammy-winning Brown, 23, punched Ocean during the brief altercation.

No charges have yet been filed, but Ocean “is desirous of prosecution in this incident,” said Los Angeles County Sheriff‘s spokesman Steve Whitmore.

Ocean, 25, who is nominated for best new artist and best record for “Thinkin Bout You” at the Grammys in February, said on Twitter on Sunday night that he “got jumped by Chris and a couple guys.” He said this resulted in a cut finger.

A representative for Brown has yet to comment.

The “Look at me Now” singer has attempted to rebuild his career and public image since 2009, but his entourage and that of Canadian rapper Drake were involved in a June 2012 brawl in a New York nightclub. No arrests or charges were brought in that case.

Brown and Ocean are both nominated in the best urban contemporary album category at the Grammys, which take place on February 10 in Los Angeles.

(Reporting by Eric Kelsey and Colleen Jenkins; Editing by David Brunnstrom)

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Well: Ask Well: Squats for Aging Knees

You are already doing many things right, in terms of taking care of your aging knees. In particular, it sounds as if you are keeping your weight under control. Carrying extra pounds undoubtedly strains knees and contributes to pain and eventually arthritis.

You mention weight training, too, which is also valuable. Sturdy leg muscles, particularly those at the front and back of the thighs, stabilize the knee, says Joseph Hart, an assistant professor of kinesiology and certified athletic trainer at the University of Virginia, who often works with patients with knee pain.

An easy exercise to target those muscles is the squat. Although many of us have heard that squats harm knees, the exercise is actually “quite good for the knees, if you do the squats correctly,” Dr. Hart says. Simply stand with your legs shoulder-width apart and bend your legs until your thighs are almost, but not completely, parallel to the ground. Keep your upper body straight. Don’t bend forward, he says, since that movement can strain the knees. Try to complete 20 squats, using no weight at first. When that becomes easy, Dr. Hart suggests, hold a barbell with weights attached. Or simply clutch a full milk carton, which is my cheapskate’s squats routine.

Straight leg lifts are also useful for knee health. Sit on the floor with your back straight and one leg extended and the other bent toward your chest. In this position, lift the straight leg slightly off the ground and hold for 10 seconds. Repeat 10 to 20 times and then switch legs.

You can also find other exercises that target the knees in this video, “Increasing Knee Stability.”

Of course, before starting any exercise program, consult a physician, especially, Dr. Hart says, if your knees often ache, feel stiff or emit a strange, clicking noise, which could be symptoms of arthritis.

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Chicago home price recovery lags

The Chicago area's housing recovery continued to lag that of other cities and the nation, as prices in November fell 1.3 percent from a month earlier, according to a widely watched barometer of the housing market.

On an annual basis, home prices in the Chicago area rose only 0.8 percent in November, the smallest positive gain recorded among the 20 cities included in the S&P/Case-Shiller home price index, released Tuesday.

Nationally, home prices rose 5.5 percent annually for the 20-city composite. Much of that  can be traced to market improvements in once hard-hit places such as Phoenix, where home prices have risen 22.8 percent in 12 months. Other cities recording strong yearly increases included Detroit, up 11.9 percent; Las Vegas, up 10 percent; San Francisco, up 12.7 percent; and Minneapolis, up 11.1 percent.

"Housing is clearly recovering," said David Blitzer, chairman of S&P Dow Jones Indices' index committee. "Prices are rising as are both new and existing home sales."

Most cities saw prices decline in November from their October levels, which Blitzer tied to the market's typical winter weakness.

Nevertheless, Chicago turned in the worst monthly performance among the 20 cities. It was the third consecutive monthly decline for local home prices, which showed signs of strength earlier in 2012. Local prices are on par with their June 2001 levels.

Condominium values in the Chicago market also fell for the second consecutive month. In November, they were down 0.9 percent from October but rose 2.7 percent from November 2011.

Strong foreclosure activity, and the resulting sales of those properties at steep discounts, has held down local home prices and the market's recovery. In 2012, Illinois had the fifth highest state foreclosure rate in the nation, topped only by Florida, Nevada, Arizona and Georgia, RealtyTrac reported last week.

Also hindering the local market's recovery is the foreclosure process in Illinois, a judicial state where all foreclosures are processed by the court system. RealtyTrac said it took an average of 697 days to complete a foreclosure in Illinois last year, meaning those properties may not be listed for resale for two years. During that time, their condition can deteriorate, bringing down the value of that home as well as others in the neighborhood.

Another report issued Tuesday showed some improvement in foreclosure activity in the Chicago area, although mortgage delinquencies and foreclosures here continue to outpace those at the national level.

Housing data provider CoreLogic said that 5.57 percent of mortgages in the Chicago area were in some stage of foreclosure in November, compared with 5.7 percent in October and 6.37 percent in November 2011.

Also, 10.10 percent of mortgages in the Chicago area were considered seriously delinquent, meaning they were at least 90 days past due in November. That compares with 10.19 percent in October and 10.72 percent in November 2011.

The national foreclosure and mortgage delinquency rates were 2.97 percent and 6.45 percent, respectively, in November.

mepodmolik@tribune.com | Twitter @mepodmolik

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CO leak caused 2 deaths: 'They were very good people'

Police are investigating whether a carbon monoxide leak led to the deaths of two people in West Rogers Park.

The first sign of trouble came around 3 a.m. Sunday when Shabbir Ahmed's sister-in-law woke up feeling ill.

"It started from there," Ahmed said. "She was feeling dizzy."

Four hours later his 77-year-old mother, Rasheeda Akhter, was so ill she could not get out of bed. "They took her to Swedish Covenant Hospital but before she got there, she died," Ahmed said.

A short time later, relatives tried to wake his 18-year-old niece Zanib Ahmed.

"She couldn't wake up," Ahmed said of his niece.  She was rushed by ambulance to the same hospital where "they tried their best to save her life but she did not come back."

In the afternoon, paramedics returned again when Akhter's 74-year-old sister-in-law was also overcome and was taken to the hospital in critical condition but she survived, said her son Choudhary Noeman.

"She's doing excellent, she's recovered about 75 percent," said Noeman.

The family is planning a funeral for Akhter and Ahmed for Tuesday.

Ahmed's brother then gathered five children ranging in age from 5 to 12 and took them to a hospital for observation. "We figured out something was wrong," said Ahmed, 49. "They were OK, they were eating and playing around."

Akhter died from carbon monoxide intoxication from faulty heating equipment in an accident, the medical examiner’s office determined this afternoon.

Heart disease and diabetes were listed as secondary causes of death. Ahmed died from probable carbon monoxide intoxication from faulty heating equipment in an accident, the medical examiner’s office determined.

Fire officials and workers from Peoples Gas have determined there was a leak in the exhaust system of the boiler in the basement of the four-flat in the 2500 block of West North Shore Avenue. Fire Department spokesman Larry Langford said officials believe people in the building had been exposed to low levels of carbon monoxide over a long period of time.

When fire officials first responded to the address, they checked the carbon monoxide levels and found no indication of a leak in the building, according to Fire Department spokeswoman Meg Ahlheim said.

When paramedics were called back to the scene, they checked again and still found no evidence of a leak, Ahlheim said. A carbon monoxide detector in a room near the boiler had not gone off, according to Langford, but high levels were found in the boiler room. Officials said the carbon monoxide detector was placed near a windwo which was often left open.

Langford said the building had no other working carbon monoxide detectors, though there were smoke detectors. City code requires carbon monoxide detectors on every floor where there are bedrooms, Langford said.

Ahmed said no work was done recently on the boiler. Officials said the boiler was older. "It was the same boiler we had, it was working perfectly, then all of a sudden like a car, cars break down," he said.

The four-flat building is owned by his family and was purchased by his father more than 20 years ago. He said relatives live in each of the units.  Fire officials said the two deceased woman slept in bedrooms which were directly over the boiler on the first and second floors. "We owned the whole building, nobody else was living there."

Ahmed said his parents came to the United States from Pakistan. His father died about two years ago from a heart condition. He said his mother had three sons and a daughter and 11 grandchildren.

He called his mother a "beautiful person." He said the grandchildren would call her "Dadyji," which is Urdu for grandmother. He said most of the grandchildren lived in the building and she was a constant presence in their lives.

"All of the kids loved her and played with her all of the time, they are going to miss her very badly," Ahmed said.

He said his niece was a senior at St. Scholastica Academy High School and was scheduled to graduate this year. She was considering going to Northwestern University, where she wanted to go into premed.

"She had planned to go to medical school, she always talked about being a surgeon," Ahmed said.

She was the oldest of three children, and leaves behind a sister and brother, Ahmed said. "They were very close."

Another relative said the family "is going through a tough time, they were very good people."

St. Scholastica's Head of School Lynne Farmer said Ahmed was a good student who was planning on attending college next year.

"Her goal was to have this quarter be the best quarter she has ever had."

Ahmed was a well-liked student among the tight-knit group. She was participating in a mentoring program for middle school students at a neighboring charter school, Farmer said.

Ahmed is the second student to die recently. Last spring another student drowned in lake michigan.

"It's hard," said Farmer. "There's been a lot of trauma in a short period of time."

Most students learned about her death in school today, Farmer said. Students left early and grief counselors were on hand to help them, she added.

"She will definitely be missed because she was part of this little family that has learned to...support each other," she said.

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What the ‘Bqhatevwr’ Did Scott Brown Tweet?

What do politicians do after losing their re-election bids? Take to Twitter, of course. Former Sen. Scott Brown of Massachusetts has been doing just that.

Brown has been tweeting about his everyday life post-politics, posting blurbs about house chores, football, and his family, but Brown’s tweets are somewhat less refined than those tweeted by his skilled staffers when he was serving in Congress.

On his verified Twitter account on Friday morning, the former senator tweeted about seeing his daughter, Ayla perform at Pejamajo Café in Holliston.

“Yes. Get ready.” The tweet read, but without the finesse of Brown’s tweeting staff, one of his followers misunderstood the message.

“Oh we are. You have no idea how ready #MaPoli is to vote to keep you in the private sector & out of #MASen” @MattinSomerville tweeted back.

Brown responded with a series of three tweets delivered after midnight.

“Your brilliant Matt,” he first tweeted.

“Whatever,” followed.

And finally Brown tweeted, “Bqhatevwr.”

Though he deleted his tweets, “Bqhatevwr” trended on Twitter nearly as quickly as #eastwooding.

The trending typo drew both bipartisan support and mockery. Some taunted the former senator for his late night slip-up, creating Internet memes and “Bqhatevwr” quips, while others defended Brown, saying that he is just an average Joe who committed a typical Twitter faux pas.

But what most Twitter enthusiast failed to recognize what that Brown’s first “Your brilliant” tweet was grammatically incorrect, too.

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Rock singer Morrissey postpones six more shows due to bleeding ulcer

LOS ANGELES (Reuters) – British rock singer Morrissey is postponing six performances on his U.S. tour due to a bleeding ulcer, his spokeswoman said on Sunday.

“Morrissey is expected to make a full recovery and thanks everyone concerned for their support during this time,” his representative Lauren Papapietro said in a statement.

Morrissey, the former lead singer for 1980s alternative rock band The Smiths, checked into Beaumont Hospital on Friday in the Detroit suburb of Royal Oak, Papapietro said.

She declined to say if he remains hospitalized.

Due to his bleeding ulcer, Morrissey is postponing his upcoming shows in Asheville, North Carolina; Nashville, Tennessee; Atlanta, Georgia; Lawrence, Kansas; Clear Lake, Iowa; and Lincoln, Nebraska, Papapietro said.

He plans to resume his tour on February 9 in Las Vegas.

Due to an illness in his band, Morrissey, 53, canceled his show Thursday in Flint, Michigan, and postponed a Friday night performance in Minneapolis and another engagement set for Saturday night in Chicago, Papapietro said.

Morrissey, whose hits include “First of the Gang to Die” and “Irish Blood, English Heart,” toured North America last fall, played some shows in Australia and New Zealand in December and returned to the United States this month.

He kicked off his latest tour with a performance of his unreleased song “Action is My Middle Name” on “The Late Show with David Letterman” in New York.

(Reporting by Alex Dobuzinskis; Editing by Kevin Gray and Stacey Joyce)

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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:

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Jane Brody speaks about hypertension.

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¶ 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.

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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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