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August 31, 2006
Blood pressure medicine
Q I am a 63-year-old woman, five feet ten inches tall and weighing 159 pounds. I bicycle two miles a day and walk on a treadmill everyday for half an hour. I also lift weights. I had my ovaries and appendix removed a few months ago, and ever since, my blood pressure has gone up. My doctor put me on medicine. I hate pills.
I have attached a summary of my pressures. What do you think? Everyone says not to start blood pressure medicine ––– like it would kill you. I don't know what to do.
A Blood pressure medicines don't kill. They save lives. High blood pressure kills.
Normal blood pressure is a reading below 120/80. Readings of 120/89 fall into a category called prehypertension. Most of your blood pressure measurements fall into this category. Treatment for people with prehypertension usually is conducted without medicine. People are told to lose weight. You don't need to. Your body mass index ––– a better indicator of healthy weight than what the scales show ––– is normal. I calculated it. Prehypertension people are also told to exercise. Your programme is as good as they come.
What's left? You have to cut back on your salt ––– not just pushing away the salt shaker but paying close attention to the amount of salt (sodium) in all foods. Your diet is one that should consist mostly of fruits, vegetables, whole grains and low fat dairy products. After two to six months of following such a regimen, your pressure should drop considerably. Ask your doctor if you can try this before stopping medicine on your own. Some people in the prehypertension category must go on medicine if they have an illness, such as diabetes, that predisposes them to heart trouble. Perhaps this is why your doctor has you on medicine.
Q I am 75 and about 30 pounds overweight. My last blood sugar reading was high. My doctor put me on a 1,800 diet and told me to watch my intake of carbohydrates. I count my calories, but I have no idea of how many carbohydrates I can eat a day. Can you help me on this?
A Standard diabetic diets call for a carbohydrate amount that is 50 per cent to 55 per cent of the total daily calories. For you, that would be 900 to 990 carbohydrate calories a day. A gram of carbohydrates has four calories. Therefore, you can eat 225 to 247 grams of carbohydrates a day ––– 7.8 to 8.6 ounces.
Most of the carbohydrates you eat should be ones that release their sugar content into the blood slowly. The rapidity of sugar release into the blood is the glycemic index. Foods with high glycemic indexes include white bread, white rice, potatoes, pretzels, honey and raisins. Eat such foods sparingly.
You can eat small amounts of table sugar. A teaspoon of it has 16 calories.
It's impossible for the average person to understand a diabetic diet without instructions from a dietitian. Your local hospital might sponsor a programme of instruction, or the local chapter of the American Diabetes Association can tell you where to locate such people.
If you manage to lose that extra 30 pounds, you might find that your blood sugar has returned to normal. Fat interferes with the action of insulin.
Q Can a person eat too much calcium? If dairy products provide the calcium we need, how do they affect cholesterol? Is it better just to take calcium pills?
A If you can get your daily calcium requirement in food, it's best to go that route, since food provides other nutrients.
The upper daily limit of calcium is 2,500 mg. Between ages 19 and 50, people should get 1,000 mg of calcium a day; older people, 1,200 to 1,500 mg.
Dairy products are the best sources of calcium. Your cholesterol won't go up from eating and drinking low fat dairy products. One cup of non-fat yoghurt has 350 to 400 mg of calcium; a cup of skim milk, 300; an ounce of low cheese, 200 to 270; 3/4 cup of fortified orange juice, 225; three ounces of sardines with bones, 324; one cup of cooked rhubarb, 348. It's not too hard to meet the daily requirement with foods and dairy products.
Dr Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write to him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853Readers may also order health newsletters from www .rbmamall.com.
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