DEAR DR. DONOHUE: Shed some light on blood pressure. I got off blood pressure medication six months ago with my doctor’s approval. In the morning, my pressure is around 145/90 to 150/100. It varies during the day. I am a mechanic and work in a metal shop where temperatures reach 100 degrees. After I get home, shower, cool down and am rested, my readings are good: 127/73.

I have had five doctors in the past six years. One was adamant that my pressure be 110/70, 24/7. I told him this was impossible. I read where BP can reach 200/120 in someone doing strenuous exercise. I work strenuously. I am 51, 5 feet 11 inches tall and weigh 215 pounds, mostly muscle, very little fat. Are my readings acceptable, or am I at risk? — B.E.

ANSWER: You are absolutely right. Blood pressure jumps all over the place during the day depending on what we’re doing. It rises with hard physical labor and with emotional stress. It doesn’t stay at those high levels long.

To obtain a valid reading, the rules for taking blood pressure have to be followed. A person has to be comfortably resting and seated for at least five minutes. For you, while at work, you should make that rest period 15 minutes. The environmental temperature should be neither too hot nor too cold. The arm on which the blood pressure is taken has to be supported by resting it on a table or by the pressure-taker comfortably holding it. That arm should be at heart level. Two measurements ought to be taken, with their average being the official reading. You should not have smoked within half an hour of having your pressure taken or not have drunk caffeine for one hour. Normal pressure is less than 120/80. High blood pressure is equal to or greater than 140/90. Numbers between those two cutoffs are “prehypertension.”

Your evening readings are fine. Your morning ones are not so great. Take them as I have instructed. If they remain high, report them to your doctor.

The booklet on high blood pressure presents it and its treatment in greater detail. To obtain a copy, write to: Dr. Donohue — No. 104, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.75 U.S./$6 Can. with the recipient’s printed name and address. Please allow four weeks for delivery.

DEAR DR. DONOHUE: Recently I spent 10 days in the hospital after friends noticed I was turning yellow. Five of those days were in intensive care. I was told I had liver disease. Between my primary physician and the gastroenterologist, I never felt in better hands. I am still on medicines and still yellow. The doctors said the liver can heal. What are the odds that my liver will be back to normal? — M.R.

ANSWER: I can’t give you a dogmatic statement without knowing what your liver disease is. The liver does have the capacity to regenerate new liver cells. If liver destruction is vast, and if the liver has been infiltrated with scar tissue, the outlook is not so rosy. Your doctor wouldn’t lie to you. I believe your liver will recover and you will lose your yellow coloring soon.

DEAR DR. DONOHUE: How come we never hear of Reye’s syndrome these days? When my children were youngsters in the 1970s, it was talked about all the time. My daughter has children, and she doesn’t know what it is. Has it gone away? — W.C.

ANSWER: Reye’s (rye’s) syndrome hasn’t gone, but the number of cases has fallen dramatically. That’s because almost all mothers know not to give their young children aspirin to lower temperature. At one time, the use of aspirin for that purpose was almost an automatic reflex.

The use of aspirin in a child with certain viral infections, principally influenza and chickenpox, can lead to liver damage, which, in turn, increases brain pressure. Parents should not reach for aspirin when their children have a fever.

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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