Ask the doctor - blood and circulation

My blood pressure is too high

I have borderline high blood pressure. I’m exercising and I’m not overweight. What are the alternatives to tablets?

A number of lifestyle approaches can lower a raised blood pressure and help reduce the need for drugs. Eat more fruit and veg, cut back on salt, and select wholegrain foods rather than processed ones. Fish, garlic, nuts, olive oil, dark chocolate and red wine (in moderation) are beneficial. On the supplement front, antioxidants, garlic, omega-3 fish oils, co-enzyme Q10, magnesium and calcium could all help. My book, Overcoming High Blood Pressure (Duncan Baird, £12.99), provides three nutritional and exercise plans to help lower blood pressure naturally. Information is also available at my website www.naturalhealthguru.co.uk.

Dr Sarah Brewer, Prima 

Do I really need injections?

I'm about to have my second hip replacement, and the surgeon says I need daily injections to thin my blood. I didn't have these last time - are they necessary?

Clots on the leg, or deep vein thromboses (or DVTs) can travel to the lung and cause a pulmonary embolus (PE), which can be fatal. DVT and PE are common problems in patients who are immobile - especially after major surgery on a lower limb. Increasingly, doctors are giving preventive treatment to thin the blood just before and just after surgery. This treatment was offered less often in the past because the medicines were more difficult to administer. A single daily injection for one to two weeks after your surgery can protect you against such clots - I would certainly recommend that you have them.
Dr Sarah Jarvis, Good Housekeeping

 

Low blood pressure

I’ve been taking tablets for high blood pressure for several years. My GP always used to check my blood pressure every three months, but now she’s told me I only need to be seen every six months. I’m worried – is it safe to go that long without a check?

I understand why you're concerned, as many people are used to having their blood pressure checked every three months, but new research shows that blood pressure is just as likely to stay well controlled if it is checked every six months. However, if your medication is altered or you need blood tests, it may need to be checked more often.
Dr Sarah Jarvis, Good Housekeeping
 

Medication for high blood pressure

I have high blood pressure and was prescribed Lisinopril, but I suffered side-effects. After changing to Atenolol, the symptoms disappeared, but I now get very tired.

High blood pressure is a common problem that affects all age groups. It's a condition doctors find hard to treat - not because we don't have medicines that will help, but because most have side-effects. High blood pressure itself doesn't cause any symptoms, but it hugely increases your risk of suffering a heart attack or stroke. If you've been feeling fine and are started on tablets that make you feel unwell, it's tempting to stop them but, of course, that puts you back at increased risk of heart attack. Rather than stopping, ask your GP about alternatives. Atenolol is from a group of medicines called beta-blockers, which can make you prone to tiredness and breathlessness. Lisinopril is from a group called ACE inhibitors, which cause a nasty dry cough in up to one in five people. Talk to your GP about an alternative called an ARB, which has similar benefits but remarkably few side-effects.
Dr Sarah Jarvis, Good Housekeeping
 

Low blood pressure

I had my blood pressure checked recently and was told that it was extremely low – 95 over 51. Should I be worried?

Your blood pressure is a little low - the bottom of the ‘normal' range is 90/60 (the top is about 140/90). But I can reassure you that if you have no symptoms and don't have a history of heart problems, then you really don't need to be concerned. There's certainly no need to adjust your diet or your lifestyle, in fact, low blood pressure can be a sign that your heart is particularly healthy. You're very unlikely to have a stroke if it stays that way. If you're getting symptoms, however, such as lightheadedness (especially when you stand up quickly), dizziness, blurred vision, fainting or poor concentration, see your GP. There are a few medical causes of low blood pressure, such as underactive thyroid, a hormone condition called Addison's disease, diabetes and low blood sugar. All these can be checked out with blood tests. Many tablets can also cause low blood pressure, so remember to tell your GP about any you're taking.
Dr Sarah Jarvis, Good Housekeeping
 

Why have I got thread veins?

What's the cause and how can I get rid of them?I'm in my thirties and broken thread veins have started appearing on my legs. What's the cause?

Thread veins are dilated blood vessels just beneath the skin surface. They can be linked with over-exposure to extremes in temperature, sun damage, and can also be hereditary. They sometimes disappear on their own if the cause is removed - for example, try wearing sun block and avoiding strong sunlight. Supplements containing bilberry extracts or Pycnogenol help to strengthen blood vessels. Thread veins can be treated by special electric currents, pulsed light therapy or laser treatments in private clinics.
Dr Sarah Brewer, Prima
 

Tips to lower blood pressure

Natural remedies can reduce your blood pressureI have raised blood pressure. Is there anything I can take to treat it naturally?

Black grapes contain antioxidants, such as resveratrol, plus minerals, such as potassium and magnesium, which have a beneficial effect on blood pressure. One study shows that drinking half a pint of red grape juice a day for two months helps reduce blood pressure by 7.2/6.2 mmHg. In people with hypertension, taking 30g to 40g olive oil a day can halve the need to start antihypertensive drugs over a six-month period. Dark chocolate has blood pressure-lowering action, too, and garlic tablets can also be effective.
Dr Sarah Brewer, Prima
 

Ease varicose veins

Lately I have noticed that the veins in my legs are becoming more visible and pronounced. My legs have also started to ache, and in hot weather my ankles swell up. I want to be able to wear shorts and skirts but my legs look really awful. I'm only 35. Could I have varicose veins already?

Yes, it's possible to develop varicose veins at 35. They affect 30 per cent of adults, but are more common if there's a family history of them or you're overweight or pregnant. The veins appear, bulging and twisted, just under the skin. This occurs when the vein wall weakens, causing it to dilate. When this happens, valves that prevent blood flowing back down your legs stop working properly and this then affects the circulation.

Varicose veins are unsightly but often nothing to worry about. However, your aching and swollen ankles are classic problems. In severe cases, the skin on the lower legs may even develop ulcers.
Losing any excess weight will help keep them at bay, and graduated compression support stockings will stop your ankles swelling and ease some of the aching – Elbeo has some for £4 (The Leg-Care Company ; 01288 359599). Raise your feet when sitting to help reduce the swelling, and apply cool witch-hazel solution (Boots Witch Hazel, £2.19, www.boots.com to soothe. 

Sclerotherapy – injecting chemicals into the veins – can be a good solution for smaller ones. Surgical options include stripping out larger veins and making small cuts to remove the smaller ones (avulsion). Radio-frequency ablation or laser ablation destroy veins with heat. Speak to your GP about options, or find out more at www.besttreatments.co.uk
Dr Louise Selby, SHE
 

High blood pressure

My father has very high blood pressure and his brother died of a heart attack last year at the age of 58. My blood pressure has been normal until now, but has recently risen. I am 38 and although I don't exercise regularly, I'm not overweight. With my family history, should I be worried?

A one-off, above-normal blood pressure reading does not mean that you have 'high blood pressure'. Your reading will change throughout the day and can increase when you are more stressed or have just been exercising. However, it is important to monitor things to make sure that you don't have a medical problem.

In the UK, about half of people over 65 and one in four middle-aged adults have high blood pressure. It's not something you should ignore, as it can increase the chances of cardiovascular disease (such as heart disease or stroke).
Because you have a family history of high blood pressure, you may be more at risk. Ask your GP to arrange three further blood pressure tests, when you are relaxed. If it is consistently high then you should discuss treatment. This can include lifestyle changes and medication. There are several drugs available and the one chosen will depend upon any existing medical problems, age and ethnicity. In the meantime, you can help yourself by taking regular exercise, quitting smoking, eating a low-fat, low-salt diet and maintaining your current weight. If possible, reduce your stress levels by taking up yoga or some form of relaxation technique. Studies have also shown that garlic may have beneficial effects in managing hypertension. You can use it regularly to flavour your food or, if you don't like the pungent smell, buy odour-free garlic capsules. You could try Holland & Barrett, Odourless Garlic capsules, 100 capsules, £4.99. For more information, contact the Blood Pressure Association, www.bpassoc.org.uk. High Blood Pressure Foundation, www.hbpf.org.uk. British Heart Foundation, 0845 070 8070 (calls charged at local rate) or www.bhf.org.uk
Dr Louise Selby, SHE

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