DEAR DR. ROACH: I have high blood pressure that’s under pretty good control with medicines. I recently read that the glass of wine I have per day may make blood pressure go out of control. Do I need to stop my glass of wine? I will if I have to, but I’d prefer not to. And what about salt? Do I really have to stop all sodium? — M.B.

ANSWER: Alcohol can increase blood pressure, but usually only when taken in larger doses — say, three or more glasses a day, and it doesn’t matter whether it’s wine, beer or hard alcohol. However, some people are more sensitive than others, so if your blood pressure is hard to control, you can try abstaining for a couple of weeks and check the blood pressure. I do recommend a home monitor, but you can always get it checked with your doctor or nurse. Three glasses a day is, on balance, harmful to health. The data still are not completely clear, but a glass of wine a day with food probably has more health benefits than harm for most people.

Salt also increases blood pressure, but for most people the effect is small. A few people, however, see dramatic effects from dietary salt, so if the blood pressure isn’t under perfect control (always less than 120 systolic and less than 80 diastolic), then I recommend a trial of salt restriction as well. Most people will find it lowers blood pressure by a few points. This may be important, especially if you don’t want to take any or more medication.

What’s right for most people may not be right for you, which is why I recommend finding out for sure what’s going on in your own body.

High blood pressure is one of the most common ailments for the general population. The booklet on it describes what it does and how it’s treated. Readers can order a copy by writing: Dr. Roach — 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. ROACH: I am an 80-year-old woman who is lucky enough to live next to a superb college and hospital with talented neurosurgeons. These physicians successfully treated a brain aneurism using a procedure called “stent-assisted coiling.” This sounds like science-fiction to me. I’m to have an MRI in a year to check on the stent’s status. Can you elaborate on this, particularly the coiling procedure? — L.E.

ANSWER: An aneurism is a balloonlike dilatation in a blood vessel. They are most concerning in critical areas, such as the brain. The weakened section is liable to bleed, and bleeding into the brain is potentially catastrophic. In the past, treatment of these has been done with surgical clipping of the aneurism. It’s a treatment that’s still done. However, a newer technique is the placement of metal coils into the damaged area, which causes the blood to clot and relieve pressure on the weakened area.

You had an even newer modification of this procedure, where a stent is placed into the blood vessel with the aneurism, and this allows blood to pass through the normal blood vessel while still clotting off the damaged section.

Only an experienced neurosurgeon or vascular surgeon is able to decide what the right procedure is in an individual situation.

Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth@med.cornell.edu or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Health newsletters may be ordered from www.rbmamall.com.

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