Medical Questions & Answers » blood pressure

Are sleeping pills harmful?

medicalquestions — Mon, 11 Aug 2008 06:00:27 +0000

Question: Are sleeping pills harmful?
Most sleeping pills are very safe, provided they are taken in the recommended manner, but if used constantly for many weeks or months, patients may find it very difficult to stop them as they become dependent upon them. The greatest problem with the use of sleeping pills is that they are taken unnecessarily, particularly by elderly people who do not need large amounts of sleep. These pills are better taken intermittently when really needed, and they will work far more effectively.

Question: As a 77 year old, my doctor has suggested that I take 100 mg of aspirin every day to reduce my risk of having a stroke or heart attack, but I have had a stomach ulcer in the past and take Zantac every day. I was told that I should never take aspirin again because of my ulcer. What should I do?
Aspirin is a marvelous medication, and one of the oldest in current medical use, having being first marketed by a German chemist (Bayer) in 1899. It may be used to relieve pain, reduce inflammation (eg. in arthritic joints), decrease the risk of bowel cancer and reduce the ability of blood to clot.
This last use makes it suitable to reduce the risk of blood clots in the brain (stroke) or coronary arteries (heart attack), and as a result it is widely recommended by doctors to be taken regularly by all patients over 50. When used to relieve pain, aspirin is taken in doses of 600 mg (two tablets), four times a day, but when used to reduce blood clotting, only a very small dose of 75 to 100 mg a day is necessary, and strangely, higher doses may be less effective in reducing the risk of clots.
Aspirin also has side effects, most commonly resulting in stomach pain, and sometimes bleeding from the stomach, but this effect is dose dependent, and the higher the dose, the greater the risk of side effects. Low-dose aspirin is available in special formulations that reduce, but do not entirely eliminate, the risk of stomach side effects. These are marketed as Astrix, Cartia and Cardiprin, and are subsidised by the government for pensioners under the pharmaceutical benefits scheme.
It is possible that you will suffer stomach side effects from taking low dose aspirin long term, and if this occurs there is a substitute medication (Plavix), that is much more expensive than aspirin, but it does not have some of the added benefits of aspirin (eg. against bowel cancer). It is only subsidized by the government under very stringent conditions.

Use of Tampons

medicalquestions — Sun, 08 Jun 2008 06:00:27 +0000

Question: I am concerned about using tampons after reading about the toxic shock syndrome. Is this a significant risk for women, or can I still use tampons safely?
The toxic shock syndrome, despite all the publicity, is actually a very rare condition, and most general practitioners have never seen a case. The people who do develop the condition are extremely ill, and about 5% of them die, despite the best efforts of doctors. Some bacteria, and particularly one called Staphylococcus aureus (the golden staph) which is a common cause of vaginal and other infections, may produce a toxin or poison. Most people have antibodies to protect them from this problem, but in a very small number of people, the toxin may cause severe effects.
The symptoms of toxic shock syndrome are a high fever, dizziness, severe diarrhea, vomiting, muscle aches, fainting and sometimes a rash. An examining doctor will find the blood pressure to be low. The syndrome can occur in anyone, but seems to be more common in women and particularly in women who are menstruating. Treatment involves antibiotics to treat the bacterial infection, and hospitalization to replace the fluids lost with the severe diarrhea and vomiting. There is no specific antidote to the toxin, and so the earlier the diagnosis is made, the better the chances of recovery.
There is no reason why women should not use tampons, as the risk of developing toxic shock syndrome with them is infinitesimally small. Only if the tampon becomes infected is there any chance of developing the syndrome. To reduce the risk to a minimum, ensure your hands are clean before unwrapping and inserting the tampon; use the lowest absorbency tampon necessary for your flow; never insert more than one tampon; do not leave the tampon in for any longer than necessary; and pads may be a better alternative overnight. Make sure you don’t forget to remove the last tampon of your period. There is no evidence that any one brand or type of tampon is more likely to cause the syndrome than any other.
Relax and use the menstrual hygiene product that best suits your needs.

All you know about Depression

medicalquestions — Wed, 30 Apr 2008 06:00:37 +0000

Question: I have depression, and it is taking years to clear up. What is this illness, what can be done for them, and what is the long term prognosis?
There are many different types of depression. Some forms are a reaction to stresses in your life such as loss of a job or a death in the family, while others are caused by biochemical imbalances in the brain that occur for no apparent reason. Sometimes it can last for just a few weeks, while in others it may recur, or persist for years. Psychiatrists will attempt to determine the type of depression that is affecting you before starting any treatment, but this is often very difficult, as there are no blood or other tests that can help the doctor, and s/he must depend on his/her clinical skills.
Once the diagnosis is made, the correct treatment will be started. This will usually involve the use of one or more medications, counseling, psychotherapy, and occasionally shock treatment.
There are some cases that can be cured, but others may only have their depression controlled. There are many diseases that cannot be cured, but are effectively controlled, and good examples would be diabetes and high blood pressure, where medication must be used life long.
Provided the patient is prepared to carefully follow a doctor’s advice, the majority of cases of depression can be cured or controlled, so that the patient can lead a normal life with minimal side effects from the treatment. Only in cases where there is poor compliance with treatment, poor family support or other adverse factors does the patient face a life of continued depression and risk suicide.

Worrying about Blood Pressure

medicalquestions — Thu, 17 Apr 2008 06:00:48 +0000

Question: Why do doctors keep worrying about my blood pressure. Is it really that important to keep it low?
Ariy plumber will tell you that if a pipe carries water at a pressure higher than the pressure it was designed for, it will eventually rupture. If the pressure in the pipe is not only to high but varies rapidly in its level, the rupture will occur even sooner because of the excessive stresses on the pipe.
Exactly the same situation occurs in the human body when the pressure of blood in the arteries becomes too high. The arteries of a person with high blood pressure will become hardened, brittle and eventually rupture, causing a stroke, heart attack or other serious injury to vital organs.
The majority of people with high blood pressure have no symptoms of the problem for many years, and by that time it may be too late. Once diagnosed, tests will be done to see if there is any specific cause for the increased blood pressure, but the majority of people have ‘essential’ hypertension, for which there is no single identifiable cause. Treatment is necessary in all cases of hypertension to prevent the serious long-term problems that may occur.
There is no cure for high blood pressure, but it can be very successfully controlled in the majority of patients by taking one or two tablets a day.

Treatment for high blood pressure

medicalquestions — Thu, 17 Apr 2008 06:00:29 +0000

Question: I am a very fit, healthy and normal weight 32 year old, but my doctor wants to start me on treatment for high blood pressure. Why?
Unfortunately, hypertension (high blood pressure) does not always respect youth or fitness, although these factors certainly help. 80% of people with hypertension have no specific cause for the condition, although it does tend to run in families. If a high level of blood pressure is found on several occasions, tests will be done to exclude any specific cause, and if none can be found, it is necessary to start treatment to control the pressure level of the blood.
This treatment must be continued for many years, as it does not cure the condition, but controls it only while the medication is taken. It is important to control the blood pressure adequately, despite the fact that you may have no symptoms now, because a high level for many years will greatly increase your risk of strokes and heart attacks. The only things that you can do to help the situation are keep your weight at a reasonable level, avoid salt and stop smoking.

Correct figure for Blood Pressure

medicalquestions — Thu, 17 Apr 2008 06:00:27 +0000

Question: What is the correct figure for blood pressure? Mine is 140/90 and my doctor keeps checking it every time I see him. He says it is alright, but this constant checking worries me.
The actual values for blood pressure vary with many things such as exercise, anxiety, age, fitness, smoking and drinking habits, weight and medications. This is why doctors never give absolute values for what is normal and abnormal in blood pressure values.
It is a good idea to have your doctor check the pressure at regular intervals, particularly if you are over 40. Your general practitioner is a good and careful one. It is very easy to forget that a patient might have a blood pressure problem, and not take it regularly. Your blood pressure is bordering on being too high, and that is why he is checking it every visit.
There are two figures quoted when blood pressure is measured. When the heart contracts, blood is moved around the body under high (or systolic) pressure. When the heart relaxes between beats, the blood continues to flow due to the lower (or diastolic) pressure exerted by the elasticity of the artery walls. In your case, your systolic pressure is 140, and diastolic 90.
When one, or both, of these pressures exceeds a safe level, the person is said to suffer from high blood pressure or hypertension. It is more dangerous to have the diastolic pressure high, as the systolic pressure can vary considerably due to exercise or stress. You can help prevent and treat hypertension by keeping your weight within reasonable limits, not eating excessive amounts of salt, not smoking and exercising.

Chelation therapy

medicalquestions — Fri, 28 Mar 2008 06:00:15 +0000

Question: I am 65 years of age, and my problems are controlled by tablets, but I don’t want to take them forever. Have you any information regarding ‘chelation therapy’, which I would like to use to cure my high blood pressure, high cholesterol and coronary artery disease?
The medical profession quite freely admits that it cannot cure all diseases, but patients often do not want to believe this, and sometimes have a far higher expectation of medical science than is reasonable.
Because of this, a few desperate people turn to the alternative forms of health care, where the words incurable and impossible are unknown.
One alternative therapy that pops up every few years is chelation.
Proponents of chelation claim that it will cute, or dramatically improve, everything from hardening of the arteries and strokes, to senility and cancer. It involves a series of 30 or more, three-hour-long intravenous injections of a chemical called EDTA.
The injections are undertaken only after a long and expensive series of high-technology investigations, that are designed more to impress the patient, than enlighten the naturopath.
The total cost of a course of chelation treatment may exceed $3000, and most of these clinics’ demand cash in advance.
As well as the course of injections, treatment may include large doses of mineral supplements, vitamins, thyroid extract and hormones, all of which may have serious side effects. EDTA is actually used in rare instances by doctors to treat heavy metal poisoning.
There is no scientific evidence that chelation therapy will achieve the numerous claims made for it. The claims are made by a skillful combination of accepted facts and reasonably accurate statements about theories concerning many diseases, interleaved with a subtle mixture of statements which are not supported by any scientific evidence.
Anyone contemplating undertaking a course of chelation therapy, or any other form of alternative treatment, would be well advised to discuss the matter further with their own general practitioner.