DEAR DR. DONOHUE: I have had yearly physical exams since I was 50, and every year I have been told my blood pressure was “beautiful.” It lost its beauty this year. I am now 67, and my pressure is 137/88. My doc says I have prehypertension, and he wants me back for a recheck. I don’t relish the idea of taking medicines. Is my blood pressure so high that it calls for them? – R.B.

ANSWER:
Prehypertension isn’t high blood pressure, but it indicates that a person is headed in the direction of high blood pressure. Normal blood pressure is a reading below 120/80. High blood pressure, hypertension, is a reading of 140/90 or higher. Values between those readings are prehypertension.

If you make some changes in your life, you might be able to return to normal blood pressure. If you’re overweight, weight reduction can bring down pressure by five points.

Salt restriction lowers pressure for most. Salt restriction isn’t just not adding salt in cooking or at the table. Only 10 percent of our daily salt intake comes in those ways. Most of our salt is found in foods to which salt has been added before it arrives in our homes. You have to check food labels closely. If you can, limit daily salt to 1.5 grams. Reducing salt intake lowers pressure by five points.

Stick to a diet consisting mostly of fruits, vegetables, grains and low-fat dairy products. That kind of diet reduces pressure by about six points.

Exercise is another effective way to get pressure down. The goal is 30 minutes on most days of the week.

Finally, increasing your daily potassium can take four points off blood pressure. Foods rich in potassium include baked potatoes, sweet potatoes, tomatoes, beans (white, lima and kidney), prunes, squash, bananas, spinach, Brussels sprouts, oranges and orange juice, and milk.

Doing all of the above should put your pressure in normal ranges without medicines.

DEAR DR. DONOHUE: My twin sister is serious with a man who has Alport syndrome. I have read about this on the Web, and it sounds ominous to me. Can it be cured? My family and I feel it’s not wise for her to pursue this relationship. We are waiting to hear what you have to say. – L.P.

ANSWER:
Your sister and her friend are the ones to make a decision about their relationship. I don’t see anything wrong with it.

Alport syndrome is an inherited disorder whose prominent feature is kidney inflammation. Most Alport patients are men, because the gene for the common variety of Alport syndrome is on the X chromosome. Men have only one X chromosome. Women have two, and their second chromosome protects them.

There is no cure for this illness. Kidney dialysis and kidney transplant can give Alport patients a normal and long life.

DEAR DR. DONOHUE: I never could have believed what pain a kidney stone brings. I finally passed the stone, but it was an experience I don’t ever want to repeat.

My mother asked if I have been told to avoid calcium foods. I haven’t. Should I? The stone was a calcium stone. – R.C.

ANSWER:
The most common kind of kidney stone is a calcium oxalate stone. It’s logical to think that limiting calcium foods would be the appropriate thing to do. It isn’t.

For many years, doctors told their patients who had calcium oxalate stones to cut back on their calcium intake. It turns out, however, that calcium restriction isn’t necessary and can raise the risk of coming down with a second stone: Cutting back on calcium increases the absorption of oxalate, and that favors the formation of another stone.

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.


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