DEAR DR. DONOHUE: My roommates and I are in constant disagreement on the correct blood pressure we’re supposed to maintain. We take blood pressure medicine. I tried to maintain a pressure close to 120/80. Our health care person tells us differently. Today my pressure was 164/122, and she said, “That’s good.” Will you tell us what a good pressure reading is? – P.M.

ANSWER: Blood pressure norms have changed. Normal blood pressure is one in which the first number is less than 120 and the second number is less than 80. A first number of 140 or higher or a second number of 90 or higher constitutes high blood pressure. Numbers between those two readings are considered prehypertension.

The goal of blood pressure treatment is to achieve a reading lower than 140 over 90. Both numbers are important. If a person has diabetes, kidney disease or heart problems, the goal is a pressure less than 130 over 80 to 85. Your pressures are far too high.

The way blood pressure is taken greatly influences the reading. A person should be seated in a chair, with feet on the floor and resting for five minutes before the pressure is registered. The person should not have smoked or drunk a caffeinated beverage for 30 minutes before the reading. The arm around which the blood pressure cuff is wrapped should have no clothing between it and the cuff, and the cuff should be at heart level. Another pressure reading ought to be recorded two minutes after the first.

All that happens in the best of all worlds. Sometimes, in a rush, a few of the above steps are overlooked, but most should be followed.

DEAR DR. DONOHUE: I have a 36-year-old granddaughter who snores so loudly that she can be heard all over the house. She keeps everyone awake. She has had her tonsils and adenoids removed. Can you suggest anything that might help? – M.L.

ANSWER: Snoring results when air rushes past excess tissue in the back of the mouth and throat. It causes the tissues to vibrate like a reed in a wind instrument does, but it produces a far different sound.

If your granddaughter is overweight, weight reduction can dampen or eliminate her snoring. She ought not to take any alcohol before going to bed. Alcohol relaxes those tissues and increases the snoring volume. Sleeping on her side or stomach can put a stop to the racket. Sewing a pocket on the back of her pajamas and putting either a tennis ball or marble in it prevents her from turning on her back during the night.

If none of the above works, she can have the excess tissue pared away. Lasers can get that job done.

Does her snoring get louder and louder and then suddenly stop for a short time? If it does, she should see her family doctor, as that’s a sign of sleep apnea, a serious condition that has a profound influence on many aspects of health.

DEAR DR. DONOHUE: Why do older men have blood blotches on their arms and backs of their hands and wrists? Can we take something? If old age is the golden years, someone has a peculiar view of things. – E.B.

ANSWER: Don’t limit this just to older men. Older women have the same problem. Partly it’s an aging issue, and partly it’s damage that comes from exposure to sunlight over the years.

They both conspire to thin the skin, increase the fragility of tiny blood vessels and decrease the amount of tissue that cushions those vessels. A slight bump, therefore, causes the vessels to break, bleed and form a bruise.

The only solution I know is protecting the skin by padding it. I realize what a banal answer that is.

Few people pad their arms and hands. It would be like putting on a suit of armor, but I don’t have any other solution.

In a few instances – very few – bruising can be due to deficiencies of blood platelets or clotting factors. Platelets are blood cells that initiate a clot when a blood vessel breaks. Clotting factors are blood proteins that also participate in clot formation. Such deficiencies are rare.

They should be considered if a person notes an increase in bruises, has painful bruises or has bleeding from other sites, like the gums.

DEAR DR. DONOHUE: I had a dispute with my friend. I told him that dementia is not Alzheimer’s disease. He says they’re the same. I told him that, as a kid growing up, we called these illnesses “senility.” I might be wrong. – B.U.

ANSWER: You’re right that dementia used to be called senility. You’re wrong about Alzheimer’s disease not being a dementia.

“Dementia” means there is an impairment of brain function – particularly in the ability to think, remember and clearly express what’s going on. Quite often, personality changes are also present, and dementia frequently leads to inappropriate emotional outbursts. It’s a general term that includes many different illnesses.

Alzheimer’s disease causes the greatest proportion of dementia. It accounts for about 60 percent of all dementia patients. It’s not the only cause, however.

Lewy body disease is another dementing illness. Vascular disease of the brain – many small strokes – is a third example of a condition that generates the signs and symptoms of dementia.

A fourth example is frontotemporal dementia, which features, in addition to memory impairment and a decline in mental function, hallucinations and behavior that can be rude and sometimes sexually explicit.

All of these illnesses and more are included under the heading of dementia.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Readers may also order health newsletters from www.rbmamall.com