If your systolic (heart contraction) blood pressure is above 120 mm/hg before you go to bed at night, you have high blood pressure and are at increased risk for heart attacks, strokes and premature death. You can protect yourself from premature death caused by high blood pressure with the DASH diet, exercising, avoiding overweight, and getting adequate amounts of vitamin D.
The DASH diet is based on fruits, vegetables, whole grains, fish, poultry, nuts and legumes, and low-fat dairy. Several studies have shown that the DASH diet lowers high blood pressure as effectively as most blood pressure drugs, prolongs life, and prevents heart attacks and strokes. The most common explanation for this success has been the high potassium, magnesium and fiber content of vegetables. However, a study from Medical University of South Carolina in Charleston (Journal of Human Hypertension, August 2009) shows that the DASH diet lowers blood pressure better than a diet supplemented with extra potassium, magnesium and fiber, so there must be other factors.
Now a study of 4706 men and women aged 40-59 in the United States, the United Kingdom, China, and Japan suggests that glutamic acid, an amino acid that relaxes blood vessels, may explain why a high-vegetable diet treats high blood pressure. (Circulation, August 2009.) A vegetable-based diet has five percent more glutamic acid than a diet rich in meat and prepared foods.
Calories do count; the DASH diet may not lower high blood pressure if you eat too much food. More on the DASH diet
Dear Dr. Mirkin: Is there any treatment for constant burning on urination?
One in three single, sexually-active Americans who have more than one partner carry a sexually transmitted disease that may not respond to treatment. These people may have no symptoms at all, or they may have pain during sexual relations, burning on urination, discomfort when the bladder is full, frequency, urgency and night-time urination, vaginal discomfort, difficulty starting the urinary stream, or discomfort in the pelvis. These people go from doctor to doctor, get lots of tests which fail to yield a diagnosis, and continue in their misery and spreading of disease.
This month, researchers in Greece showed that many of these people suffer from infections with intracellular bacteria: mycoplasma, chlamydia or ureaplasma (Urology, July 2009). Most cultures done in medical laboratories fail to pick up these infections. 153 patients had some of the above symptoms and had either failed a course of antibiotics or had negative routine cultures. The patients had cultures taken from their urine, urinary tube, vagina, and cervix. Fifty-three percent of these “incurable” patients were infected with ureaplasma urealyticum. Eighty-two percent of patients positive for ureaplasma urealyticum had other pathogens. A single dose of one gram of azithromycin was given to all culture-positive patients and their sexual partners. Those with a positive culture one month after therapy (4.9 percent) were successfully treated with seven days of doxycycline 100mg twice daily. All of the patients improved, but many continued to suffer pain in the pelvis.
Dear Dr. Mirkin: Should an athlete with atrial fibrillation (irregular heartbeat) take anti-clotting drugs?
Nobody really knows. Since atrial fibrillation is associated with increased risk for clots and strokes, almost all doctors prescribe an anti-clotting medication to their patients with this condition. Atrial fibrillation is far more common in older competitive athletes than in the general population (Europace, August 2009; British Medical Journal, August 2009). Atrial fibrillation means that the upper part of the heart (atrium) flutters and does not beat regularly as the lower part of the heart (ventricle) does. Endurance athletes have larger atriums and ventricles, which increases risk for atrial fibrillation. We don’t know if these older competitive athletes are at increased risk for clots as are their non-athletic counterparts. In 1998, another study reported in the British Medical Journal showed that athletes with relapsing cases of atrial fibrillation did well with drugs to make their hearts beat more regularly, and they continued to compete without suffering any serious problems. We do not have any good data on the consequences of atrial fibrillation in older endurance athletes.
Sports medicine doctor, fitness guru and long-time radio host Gabe Mirkin, M.D., and his wife, nutritionist Diana Mirkin bring you news and tips for your healthful lifestyle. A practicing physician for 50 years more
The Good Food Book
FREE! The Good Food Book: Live Better and Longer with Nature’s Best Foods, by Dr. Gabe Mirkin. With 100 of Diana Mirkin’s delicious, healthful recipes and lists of foods you can eat anytime.