DEAR DR. ROACH: A good friend was recognized with hypertension a number of years in the past and has been on a hypertensive drug since then. Nevertheless, over the previous years, he has misplaced over 50 kilos and is not chubby. He works out each day. He by no means exercised previous to his analysis. He appears to be consuming more healthy meals now, too. Shouldn’t he be reevaluated relating to the necessity to proceed taking his drug? And what’s the process to see if he must proceed with the drug? — R.I.
ANSWER: Hypertension is often a situation folks have for lifetime; nevertheless, even when it requires remedy, it could typically be efficiently handled with life-style interventions. That is notably true when an individual has quite a lot of work to do to get to a more healthy place.
Shedding pounds has a variable impact on blood stress, and sometimes has a profound impact — that is true additionally of the impact of weight reduction on diabetes. A more healthy weight loss program, particularly salt discount, can decrease blood stress. Common train and stress discount methods can have an additional benefit.
His physician must be measuring his blood stress at each go to. If the blood stress is getting decrease than his objective, the physician ought to scale back the dose and even take it away fully. Nevertheless, there are some occasions when his physician would possibly wish to hold the blood stress medication going, akin to when the drugs has two useful results (say, beta blockers that work for hypertension and migraine, or an ACE inhibitor for an individual with diabetes and hypertension).
My expertise is that just a few folks actually hate taking medicines, even after years, whereas others simply get within the behavior and cease fascinated with it. In case your good friend actually needs to cease the drugs then he can speak to the physician a few trial of decrease dose or stopping the drugs.
DEAR DR. ROACH: Can a weak spot towards alcoholism be inherited and run by a household for generations? Or is every particular person a separate case, and topic to his personal conduct and well being profession? — N.M.G.
ANSWER: A household propensity to alcohol use dysfunction has lengthy been recognized. Each environmental results and genetic predispositions have been recognized. One examine on twins estimated that simply over half the elevated legal responsibility to alcohol use dysfunction is because of genetics. Nevertheless, it is very important know that there isn’t an “alcoholism gene” and that, as you say, an individual’s personal distinctive state of affairs has a serious impression on whether or not they may develop an issue with alcohol consumption.
There isn’t a certainty about who may have the predisposition to develop issues with alcohol, however an individual with a household historical past must be extra cautious than others to acknowledge when they’re starting to develop downside behaviors. Many individuals with downside consuming don’t acknowledge it, and will resent makes an attempt by members of the family to assist.
Many younger folks meet standards for downside consuming, however that conduct typically ceases. If an individual continues to downside drink after age 25 or so, particularly binge consuming (greater than 4 drinks at a time for a girl, 5 at a time for males), then they’re at vital danger for having issues all through life and may take into account getting assist. This can be some counseling from your loved ones doctor, a mutual assist group akin to Alcoholics Nameless, referral to a psychological well being skilled or habit specialist, and in some instances remedy.
* * *
Dr. Roach regrets that he’s unable to reply particular person letters, however will incorporate them within the column every time potential. Readers might electronic mail inquiries to [email protected] or ship mail to 628 Virginia Dr., Orlando, FL 32803.