Kerry is easily confirmed as secretary of State

WASHINGTON — The Senate voted overwhelmingly Tuesday to confirm Sen. John F. Kerry (D-Mass.) as secretary of State, filling a crucial national security spot in President Obama's second-term Cabinet.

Kerry, who ran for president as the Democratic nominee in 2004, will replace Hillary Rodham Clinton, who steps down as America's top diplomat Friday.

After the 94-3 vote, Kerry submitted a letter of resignation, effective Friday, to give up the Senate seat he has held since 1985. He will take the oath of office in a private ceremony.

In a White House statement, Obama praised Kerry as "a champion of American global leadership."

"John has earned the respect of leaders around the world and the confidence of Democrats and Republicans in the Senate, and I am confident he will make an extraordinary secretary of State," Obama said.

Obama's nominee for secretary of Defense, Chuck Hagel, has his confirmation hearing Thursday. Unlike Kerry, the former Republican senator from Nebraska is expected to face considerable opposition in the Senate.

Kerry failed to win only three Republican votes — from Sens. John Cornyn and Ted Cruz, both of Texas, and Sen. James M. Inhofe of Oklahoma.

A spokesman for Cornyn said Kerry supported liberal positions that most Texans opposed. Cruz has criticized Kerry, a decorated Vietnam combat veteran, as anti-military.

Earlier Tuesday, Kerry received the unanimous endorsement of the Senate Foreign Relations Committee in a voice vote. He served on the committee for 28 years and was chairman for the last four.

Sen. Bob Corker (R-Tenn.), the ranking Republican on the committee, praised Kerry as a "realist" on foreign affairs issues, and said he had always been "open to discussion" with members of the other party.

Several Republican senators had promoted Kerry for the job as an alternative to Susan Rice, the U.S. ambassador to the United Nations. Rice withdrew her name from consideration amid mounting Republican criticism of her statements on TV talk shows after the deadly Sept. 11 attacks on the U.S. mission in Benghazi, Libya.

Kerry faces formidable challenges in his new job.

Obama's first administration made little headway at solving foreign policy problems in Iran, Syria, North Korea and elsewhere. Kerry also will deal with a White House that prefers to keep decisions on key issues of war and peace in its own hands.

During his confirmation hearing last week and other appearances, Kerry gave some signals of what he intends to emphasize.

He said he would begin an effort to renew Israeli-Palestinian peace negotiations, a process that has been nearly dead since the Obama administration's opening initiative was abandoned two years ago.

Kerry also said he intended to work toward preventing global warming. The momentum of that effort also slowed in Obama's first term.

His resignation from the Senate starts the clock on a special election in Massachusetts to fill his seat until his term expires in January 2015. Gov. Deval Patrick, a Democrat, is expected to call the election on June 25.

Patrick will name an interim senator to serve until voters go to the polls. Possible candidates include Victoria Reggie Kennedy, widow of the late Sen. Edward M. Kennedy; and former Rep. Barney Frank, who has publicly expressed interest in the temporary posting.

Former Republican Sen. Scott Brown, who lost an expensive 2012 reelection bid against Democrat Elizabeth Warren, has yet to signal whether he will run again. He is said to be considering a 2014 campaign for governor.

As Kerry moved toward his new role, Clinton did a final televised group interview with students and journalists at locations around the world. She was asked whether she intended to run for president in 2016.

"I right now am not inclined to do that," she said. Her immediate priority, she said, was "catching up on about 20 years of sleep deprivation."

paul.richter@latimes.com

michael.memoli@latimes.com

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BlackBerry 10 said to be inadequate for helping RIM overcome its ‘demons’

After hitting a seven-year low of $ 6.22 this past summer, shares of Research in Motion (RIMM) have rebounded and climbed more than 100% in the past six months. The company that was previously written off by Wall Street investors has seen a significant boost in recent months as anticipation grows for its BlackBerry 10 operating system. But while a number of analysts have voiced their support for RIM, not everyone is convinced.

[More from BGR: Apple’s 128GB iPad shows the world exactly what Apple does best]

Jan Dawson of Ovum explained, per Benzinga, that RIM continues to “face the twin demons of consumer-driven buying power and a chronic inability to appeal to mature market consumers,” and he believes BlackBerry 10 won’t change this. The analyst said that due to a strong user base of 79 million subscribers and profitability still in the black, the company will remain for years to come. He was quick to note, however, that its glory days are in the past and “it is only a matter of time before it reaches a natural end.”

[More from BGR: Apple unveils new 128GB iPad]

Dawson previously wrote that RIM’s strategy seems to be focused on building the best devices for current BlackBerry users “rather than something that will necessarily win converts from other platforms.”

“The points of differentiation RIM has focused on in teasers for the new platform confirm this – better multitasking, productivity, email, contacts and calendar applications and so on, rather than a better gaming, content consumption or social networking experience,” he said.

Shares of RIM are down more than 6% on Monday, a day before the company is set to unveil its BlackBerry 10 operating system.

This article was originally published on BGR.com

Gadgets 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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Report Links Rodriguez and Others to Clinic and P.E.D.’s

Investigators for Major League Baseball created an improvised war room in the commissioner’s Park Avenue offices in Manhattan in recent months, mapping out potential evidence that would tie an anti-aging clinic in Coral Gables, Fla., to the possible use of performance-enhancing drugs by some of baseball’s more prominent players. 

But because the investigators cannot compel witnesses to talk, they could do nothing more than scrutinize the clinic. As a result, they found themselves mere spectators Tuesday as a weekly Miami newspaper reported that it had obtained medical records from the clinic that tied a half-dozen players — Alex Rodriguez, Melky Cabrera, Gio Gonzalez, Bartolo Colon, Nelson Cruz and Yasmani Grandal — to the use of banned substances like human growth hormone.

The newspaper, Miami New Times, said it had received the records from a former employee of the clinic, which is now closed, and that they included handwritten notations listing various drugs that were reportedly distributed to various players. At least some of those documents were displayed online by the newspaper. However, the documents have not been independently authenticated, and Rodriguez, the Yankees slugger, and Gonzalez, a standout pitcher for the Washington Nationals, both issued statements denying they had been patients at the clinic.

Anthony Bosch, the operator of the clinic, known as Biogenesis of America, also issued a statement of denial through his lawyer, saying the Miami New Times article was “filled with inaccuracies, innuendos and misstatements in fact.”

“Mr. Bosch vehemently denies the assertions that MLB players such as Alex Rodriguez and Gio Gonzalez were treated or associated with him,” the statement added.

Nevertheless, despite the denials, Major League Baseball, long suspicious of the clinic’s actions, will continue to proceed in the belief that the assertions in the article have merit. Major League Baseball has been particularly curious about Rodriguez, who admitted in 2009 that he used performance enhancers from 2001 to 2003, but who has denied in several meetings with baseball’s investigators that he has done so since.

But what exactly baseball can do about Rodriguez, or any of the other players named, is unclear.

Because the potential evidence does not involve failed drug tests, baseball is back where it has been in the past, seeking perhaps to punish players without having the necessary evidence to do so. In the case of the Biogenesis clinic, baseball’s investigators did travel to Florida to meet with members of the Drug Enforcement Administration, who were taking a close look at the facility.

But whether federal authorities would share with baseball any evidence they develop on the clinic is unclear. In other instances over the last decade, that has not happened.

“If the feds are not going to prosecute this case, it would be much better for us for them to give us some usable evidence like the documents so we can do our job and suspend the players,” a baseball official said. “We could be in discipline hell if that doesn’t happen.”

That official knows that baseball has had little success in suspending players for violating the drug testing program when the players have not actually tested positive. Of the roughly 40 players who have been suspended for violating the testing program since 2005, only a handful have been suspended based on evidence developed by baseball’s investigators or from medical records or court documents.

The most high-profile instance of a suspension without a drug test occurred in 2005 when relief pitcher Jason Grimsley was barred for 50 games after federal authorities unsealed court documents that showed that Grimsley admitted to a federal agent that he had used human growth hormone.

As for the Florida clinic, it has been on the radar of both baseball and the federal government since at least 2009, when investigators uncovered evidence that the slugger Manny Ramirez had received a banned drug from the facility. Ramirez was ultimately suspended 50 games for that infraction.

Last summer, baseball’s investigators began to take another look at the clinic after Cabrera, then leading the National League in hitting as the San Francisco Giants’ starting left fielder, tested positive for elevated testosterone. In the course of that positive test, two people in baseball said, baseball’s investigators uncovered evidence that an employee for Cabrera’s agents, Sam and Seth Levinson, had hatched a cover-up scheme to deceive a baseball arbitrator and have the suspension for the positive drug test thrown out.

Angered, baseball officials began investigating the employee, Juan Nunez, and the Levinsons.

Steve Eder and Alain Delaquérière contributed reporting from New York, and Lizette Alvarez from Miami.

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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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Bipartisan group sees change in politics on immigration reform

A bipartisan coalition of senators said Monday they have created a set of principles based upon which they hope lawmakers will pass immigration reform by summer.

WASHINGTON — Declaring that the politics of immigration  “have been turned upside down,” a bipartisan group of senators Monday outlined common principles for comprehensive immigration reform and expressed optimism that legislation granting legal status to most of the country's 11 million illegal immigrants could be realized by this summer.

One day before President Obama launches a campaign-style push for his vision of immigration reform, representatives of the so-called Group of Eight senators acknowledged previous false starts on the issue, and obstacles that probably lie ahead — particularly in determining how to increase the flow of legal immigration.

But, after an election in which the share of the nonwhite vote continued to grow and swung overwhelmingly toward Obama, the lawmakers said that the path forward was as clear as ever.

Arizona Sen. John McCain, the GOP’s 2008 presidential nominee and a past proponent of comprehensive reform, said the change in favor of taking action came down to one word: “Elections.”

PHOTOS: President Obama’s second inauguration

“The Republican Party is losing the support of our Hispanic citizens. And we realize that there are many issues in which we think we are in agreement with our Hispanic citizens, but this is a preeminent issue with those citizens,” he said at a Capitol Hill news conference. 

“For the first time ever, there's more political risk in opposing immigration reform than in supporting it,” added Sen. Charles E. Schumer (D-N.Y.).

The Senate blueprint, drafted during weeks of closed-door meetings by leading senators from each party, is more conservative than Obama's proposal, which the president plans to unveil Tuesday in a speech in Las Vegas. But its provisions for legalizing millions of undocumented immigrants go further than measures that failed to advance in Congress in previous years — a reminder of how swiftly the politics of immigration have shifted since the November election.

The Senate proposal would allow most of those in the country illegally to obtain probationary legal status immediately by paying a fine and back taxes and passing a background check. That would make them eligible to work and live in the U.S. They could earn a green card — permanent residency — after the government certifies that the U.S.-Mexican border has become secure, but might face a lengthy process before becoming citizens.

Obama is expected to push for a faster citizenship process that would not be conditional on border security standards being met first. The structure of the citizenship process will probably be among the most hotly debated parts of any immigration plan.

PHOTOS: A look ahead at 2013’s political battles

Less controversial provisions would tighten requirements on employers to check the immigration status of new workers; increase the number of visas for high-skill jobs; provide green cards automatically to people who earn master's degrees or PhDs in science, technology or math at U.S. universities; and create an agricultural guest-worker program.

Schumer said lawmakers are aiming for full legislative language to be put forward by March, which will then work its way through the committee process. A vote in the Senate could come by late spring or summer, he said.

“We still have a long way to go, but this bipartisan blueprint is a major breakthrough,” he said.

Though their effort was running parallel to the president’s, Democratic Sen. Richard J. Durbin of Illinois said he and Schumer spoke with Obama on Sunday and that the president “cheered us on.” McCain said Obama’s public campaign for it would be helpful to their cause.

Still, many conservatives on Capitol Hill remain skeptical about sweeping immigration legislation and could prove a major obstacle to any compromise.

“The last time we talked about this in 2007, it sounded very seductive. When we saw the details, it was clear it wouldn’t work,” Sen. Jeff Sessions (R-Ala.) said in an interview Monday. Sessions said he was particularly concerned that the Obama administration is not committed to securing the borders against future illegal immigration.

Similar criticism from Republican lawmakers doomed a 2007 immigration bill pushed by President George W. Bush and seniors Senate Democrats.

PHOTOS: President Obama’s past

Today, 22 GOP senators who opposed the 2007 plan remain in the Senate, including Minority Leader Mitch McConnell (R-Ky.). By contrast, just two of the 12 Republicans who backed the compromise six years ago are still in Congress — McCain and South Carolina's Lindsey Graham.

Republican resistance to an immigration overhaul promises to be even more intense in the House, where many conservative lawmakers are leery of any proposal that would provide a mechanism for immigrants here illegally to gain citizenship, a key demand on the left.

“When you legalize those who are in the country illegally, it costs taxpayers millions of dollars, costs American workers thousands of jobs and encourages more illegal immigration,” said Rep. Lamar Smith (R-Texas), the former chairman of the House Judiciary Committee. “By granting amnesty, the Senate proposal actually compounds the problem by encouraging more illegal immigration.”

Staff writers Brian Bennett and Lisa Mascaro contributed to this report.

Follow Politics Now on Twitter and Facebook

noam.levey@latimes.com

Twitter: @noamlevey

michael.memoli@latimes.com

Twitter: @mikememoli

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Yahoo revenue rises on search advertising

(Reuters) – Yahoo Inc posted a 4 percent gain in net revenue to $ 1.22 billion in the fourth quarter, when an increase in search advertising sales offset weakness in the Web portal’s display ad business.

The company forecast net revenue — which excludes fees shared with partner websites — of $ 1.07 billion to $ 1.1 billion in the current quarter, trailing the $ 1.1 billion that Wall Street analysts expect on average.

Shares in Yahoo, which is trying to stave off declines across much of its business and revive growth, were up 1.5 percent in after hours trade. They had risen 4.5 percent before the revenue projections were disclosed on an analysts’ conference call.

“We got the revenue acceleration we were hoping for. Display was down, but search is doing better” said Sameet Sinha, an analyst at B. Riley Caris.

“As long as in the near-term things are not bad, I think the stock will generally act positively while we wait for Marissa Mayer to deliver,” said Sinha.

The company said on Monday its fourth-quarter net income was $ 272.3 million, or 23 cents per share, versus $ 295.6 million, or 24 cents per share in the year-ago period.

Excluding certain items, Yahoo said it had earnings per share of 32 cents, versus the average analyst expectation of 28 cents according to Thomson Reuters I/B/E/S.

Chief Executive Marissa Mayer is moving to revive the company’s fortunes after several years of declining revenue. Yahoo’s stock has risen roughly 30 percent since she became CEO, reaching its highest levels since 2008.

Yahoo said it repurchased $ 1.5 billion worth of shares during the fourth quarter. Shares in the company were up 1.5 percent at $ 20.61 in extended trading from a close of $ 20.31 on the Nasdaq.

(Reporting by Alexei Oreskovic; Editing by Phil Berlowitz)

Tech 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:

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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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Housing advocates push for new type of subprime loan

With home prices rising, interest rates falling and builders building, some prominent housing advocates are calling for a new kind of loan for buyers with lower incomes or bad credit.

They'd like to call it the Dignity Mortgage, but it has another name — one that's become more of an epithet since the housing crash: subprime.

Applicants might include people caught in the early stages of the mortgage meltdown who have since rebuilt their finances, said Faith Bautista, who heads the National Asian American Coalition.

"They lost their work, their homes and their credit scores four or five years ago," Bautista said.

Since then, she said, many have found new jobs and saved up enough for a 10% down payment. But they can't get a loan because lending standards remain tight — even for the Federal Housing Administration mortgages designed to help lower-income borrowers, Bautista said.

Quiz: How much do you know about mortgages?

The proposal starts with the classic subprime trade-off: a higher rate for a higher-risk clientele. Borrowers would pay 1.25 percentage points above the going interest rate, maybe 4.75% if more creditworthy borrowers were paying 3.5%.

But the deal would get better if borrowers made timely payments for five years. At that point, the extra money they had paid in interest would be used to reduce the mortgage balance, and their rate would be cut to whatever borrowers with sterling credit and 20% down payments were charged at the time the loan was made.

Pattie Sibug of San Diego is among those who got caught short by the housing crash. By early 2010, the property improvement company she and her husband had owned for a dozen years had already seen its business fall off. Then a stream of work repairing foreclosed homes for a big bank dried up.

BID Construction wound up owing suppliers about $60,000 it could never fully repay, which ultimately ruined the couple's personal and business credit scores. "It was 585 the last time I checked," Sibug said of her score.

Sibug and her husband, Ollie, would like to buy the Scripps Ranch town house they are renting for $1,750 a month, and could come up with a 10% down payment. But they had to decline the owner's recent offer to sell because they knew they couldn't get financing.

"There's got to be some kind of program to help you reestablish yourself," Sibug said. "I'd be the first person in line if there was."

Situations like hers are why Bautista and other activists have been talking to bankers and regulators, proposing the new type of loan. Those activists include Bob Gnaizda, a longtime minority rights attorney who co-founded Berkeley's Greenlining Institute, and financial literacy activist John Bryant, whose Operation Hope — founded in South Los Angeles after the 1992 riots — now operates nationally and in South Africa and Haiti.

The proposal comes as home lenders remain besieged by demands that they pay billions of dollars in damages for defaulted housing-boom loans. Regulators have required banks to increase reserves against losses.

And the lenders also are evaluating new mortgage rules from the Consumer Financial Protection Bureau, which they say will determine how freely they can lend.

In reaction, many banks have imposed higher standards for writing new home loans than those required by the FHA or by Freddie Mac and Fannie Mae, the finance outfits that have kept the mortgage market afloat since the financial crisis — thanks to $137 billion in taxpayer assistance.

Edward J. Pinto, a former Fannie Mae chief credit officer who argues that lax FHA lending helped feed the foreclosure crisis in low-income neighborhoods, said the Dignity Mortgage proposal "is a stupid and crazy idea — a poison pill."

"Haven't we learned anything from the cratering of our housing finance market?" said Pinto, a resident fellow at the American Enterprise Institute, a free-market think tank.

Bank officials continue their soul-searching over the mortgage misdeeds of the past and the prospects of the business.

"By being overly aggressive, the entire housing system caused a great deal of damage to the very people we were trying to help attain homeownership," said Brian T. Moynihan, chief executive of Bank of America Corp.

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