Q: My husband is 72. What’s a normal blood pressure for someone his age? – Anita, Australia A: It’s typical to experience a gradual rise in blood pressure as you age, especially once you’ve been around for six or seven decades. Notice we said typical. Not healthy. The typical person dies of heart disease or stroke. Not optimal, not normal. And we’re in favor of optimal, because you and your husband aren’t typical; you’re exceptional. Like all our readers!
Yet after 70, only one in three men and one in four women have healthy blood pressure. The American Heart Association’s target is under 140/90 if you’re 65 to 79, and a top number (systolic pressure) of 140 to 145 if you’re 80 or older.
We have a more aggressive rule of thumb: We like to see blood pressure as low as you can get it without keeling over. Optimal is 115/75. Dr. Mike’s is 115/75; Mehmet’s blood pressure stays around 110/75. Join our club! Your blood pressure is quite responsive to lifestyle changes, such as keeping your weight in check, staying physically active and not smoking. If that’s not enough to get your husband’s blood pressure in the optimal range (yours, too), talk to your doc about adding medication. Then take it like your life depends on it. It does. After age 80, it can lower your stroke risk by 30 percent and your odds of heart failure by 64 percent. A normal blood pressure makes you younger.
Q: My 20-year-old daughter has had granuloma annulare for two years. Is there anything she can do to get rid of these spots? – Lynn, via email
A: The rings of red bumps called granuloma annulare are no picnic, especially for a 20-year-old woman (and young women and girls are its favorite targets). Even though the condition is harmless, the bumps aren’t pretty and often are mistaken for ringworm, a contagious fungal infection. They’re usually seen on the extremities and often are associated with diabetes or thyroid disease, but they can pop up anywhere on the body and are quite common in healthy people.
Most cases disappear on their own within two years, but your daughter’s spots sound pretty stubborn. The treatments with the fewest side effects include:
» steroid creams or corticosteroid injections;
» cryotherapy, which involves freezing the bumps with liquid nitrogen to remove them and stimulate new skin cell growth;
» psoralen, a drug that makes the skin extra-receptive to ultraviolet rays combined with medical exposure to ultraviolet A light.
Just be aware that like that granuloma annulare is like Newt Gingrich’s presidential ambition: It has a penchant for recurring, sometimes years later. Since the spots where it likes to erupt are usually exposed to the sun, your daughter should always apply plenty of sunscreen before heading outdoors. Just like the rest of us.
Q: Could the frequent muscle pulls in my calf be attributed to taking Zocor? I’ve heard that it and other cholesterol-lowering statin drugs can cause muscle pain in some people. I get into a good rhythm of running about 20 miles a week, but then pull a muscle that takes a month to heal. No other muscles hurt anywhere in my body. – Dan, via email
A: Congrats on being aware of your drug’s possible side effects. We wish everyone were this tuned in. However, we’ve got a different theory about your calf: Perhaps a month isn’t long enough for your muscle pulls to heal. You could have what sports medicine docs call grade 2 micro-tears, meaning a partial tearing of the muscle fibers in your calf. Or it could be a grade 3 micro-tear, a complete rupture. A grade 2 injury can take two months to heal; a grade 3, three months or more.
There are more causes for micro-tears than there are TV reality shows, including worn-out footwear, having one leg shorter than the other (which is very common) and simple overexertion. We recommend seeing a sports medicine specialist, and then doing everything the nice doc tells you to do. That might include getting your blood tested for raised levels of creatine phosphokinase, which sometimes indicates muscle damage. If your CPK is up there, get your sports doc and your family doc together. The next step might include both extra healing time and switching to another statin drug to see if your calf trouble disappears.
