Lifestyle changes will help reduce blood pressure

* I had a chest infection recently and visited my GP. He measured my blood pressure, it was 145/95.

This surprised me as I exercise regularly, eat healthily and watch my weight. He has advised me to come back next week for ambulatory blood-pressure monitoring. There is a family history of heart disease — does high blood pressure increase my risk? I am a 50-year-old male.

>>Half of adults in Ireland over 45 years of age have high blood pressure (hypertension). It often has no symptoms and a diagnosis can be a surprise. A worrying condition, it can increase your chances of developing heart disease, stroke, diabetes and kidney problems.

When you get your blood pressure measured there are two figures: the first (systolic) measures the pressure in the arteries when your heart beat pumps blood out; the second (diastolic) measures the pressure when the heart rests, allowing blood flow back into the heart between each heartbeat.

Treatment of high blood pressure includes, where possible, lifestyle changes and these would include:

* Having a healthy diet that includes plenty of fruit, vegetables and unprocessed cereals (e.g. porridge), and that is low in saturated (animal) fats.

* Eating 2-3 portions of fish a week, with at least one being an oily fish.

* Reducing your salt and caffeine intake.

* Cutting down on fried foods.

* Losing weight and maintaining a healthy weight.

* Taking regular exercise.

* Reducing alcohol consumption and keep within the recommended limits.

* Giving up smoking.

The lifestyle changes may reduce your blood pressure and can sometimes reduce mildly high blood pressure to a normal level.

One high reading doesn’t necessarily mean you have high blood pressure. Your GP will want to get a series of blood-pressure readings over a 24-hour period, via ambulatory blood-pressure monitoring.

A blood pressure machine will be attached to one arm and will measure your blood pressure a number of times each hour, at work and at rest. Your GP will discuss the results with you, look at your risk of heart disease, and advise on the best management plan.

You should tell your GP of your family’s history of heart disease, as this is very important.

* I had problems with my back recently and my GP prescribed pain-killers. These worked well and my back problem has resolved. However, while I was taking the tablets, and for a few days after I stopped, I had constipation. If I need to take the tablets again, for back problems, is there a way of preventing constipation?

>>Constipation is a common side-effect of some medications. Some painkillers contain codeine and this can cause constipation. If you have any further joint pain and attend your GP, he or she may be able to change the medication or give you a prescription for a laxative, which should ease the problem if the measures below fail.

Constipation can be both uncomfortable and painful, particularly if you are unwell. To avoid constipation, whether or not you are taking painkillers, I would advise:

* Eat plenty of fibre-rich foods (30g per day) such as fruit, vegetables, whole-grain cereal and wholemeal bread. This should be tried for at least a month, before its effects are determined.

* Include five portions of fruit and vegetables every day — aim for a variety.

* Make sure you have plenty to drink so you do not become dehydrated, ideally at least two litres (8-10 cups); avoid too much caffeine.

* Change to brown rice and wholemeal pasta.

* Never strain when sitting on the toilet or ignore the urge to go to the toilet.

* Increase mobility, if possible, as lack of mobility may be a contributing factor.

While an occasional bout of constipation is common, if it begins to happen more frequently, you do need to make an appointment to see your GP to discuss the symptoms and a possible underlying cause.

Dr Bernadette Carr is Medical Director, Vhi Healthcare For more information visit www.vhi.ie or lo-call 1890 444 444

If you have a question about your health email it to feelgood@examiner.ie or send a letter to: Feelgood, Irish Examiner, Linn Dubh, Assumption Road, Blackpool, Cork.

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