DEAR DR. DONOHUE: I am concerned about my husband’s high blood pressure. He’s 24 years old, 6 feet 1 inch tall and weighs 220 pounds, with a bit of a beer gut. His blood pressure is consistently around 185/105. He has seen doctors and has medication, but I’m not sure how frequently he takes it. He exercises rigorously at least once a week. His diet is 50 percent seafood and 50 percent pizza, and he drinks beer regularly.

His mother says high blood pressure runs in the family due to an abnormally fast heart rate.

How dire a situation is this? What are the long- and short-term effects of high blood pressure at such a young age? – C.M.

ANSWER: Your husband’s blood pressure should be a concern to him, especially at such a young age. High blood pressure is called the silent killer. It gets that name because early on, it has no symptoms but it’s still hard at work and doing great damage to the heart, the blood vessels and the kidneys. Untreated, it leads to heart attacks, strokes and kidney failure. Your husband is in the period of no symptoms, but he is suffering great harm.

He needs to lose weight. He has to exercise regularly – i.e., daily – and the exercise should include such things as jogging, biking or swimming. His diet needs a revision. Pizza is not exactly a health food, and it contains lots of salt, which he should be avoiding. He should drink no more than two beers a day. Increasing the amount of potassium in his diet will help control his pressure. Potassium-rich foods include bananas, baked potato with skin, peas, beans, most fish and meats, orange juice, spinach, cantaloupe and raisins. He should invest in a home blood pressure machine. Such instruments are relatively cheap and take no special skill to use. If none of this brings his numbers down, he must take medicine faithfully.

I don’t understand your mother-in-law’s statement about a fast heartbeat and high blood pressure. Partly, the cause of high blood pressure is genetic. Fast heart rate has little or nothing to do with it.

DEAR DR. DONOHUE: MGUS – how long can a person have this before it’s diagnosed? – E.O.

ANSWER: Readers, unless they have had a personal experience with MGUS, will think it’s a curious and extraordinary condition. It isn’t. Up to 3 percent of people over 50 have it, and up to 5 percent of those over 70 have it. Many of these people are not diagnosed because MGUS often has no symptoms. It usually is discovered accidentally, when a person has blood work done for some unrelated reason. People can have it for years without knowing.

MGUS is monoclonal gammopathy of undetermined significance. “Monoclonal” indicates that it originated in one cell that replicates itself over and over. The cell is a plasma cell. Plasma cells produce antibodies – gamma globulins, huge proteins. The gamma globulin produced in MGUS is called an M protein.

So what’s the big deal if MGUS doesn’t cause symptoms? The big deal is its potential to progress into a variety of serious illnesses – the chief one being multiple myeloma.

Multiple myeloma is a cancer where there are large numbers of malignant plasma cells in the bone marrow, which disrupts the production of blood cells and which can destroy the surrounding bone.

Indications that a MGUS patient might be headed for trouble include a high number of plasma cells, a high level of M protein or both. Most affected people have to be checked from time to time to see what’s happening. If one of the MGUS complications is developing, then treatment is instituted.

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