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23 Kislev 5761 - December 20, 2000 | Mordecai Plaut, director Published Weekly
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Home and Family
Your Medical Questions Answered!
by Joseph B. Leibman, MD

Diplomate, Board Certification of Emergency Medicine

Chairman, Department of Emergency Medicine Ma'ayenei Hayeshua Hospital

Blood pressure treatment is a fast changing field. New medications arrive daily and we have progressed a lot from the time when we used powerful medications to reduce blood pressure that caused all sorts of side effects such as depression, weakness and excessive urination. Indeed, one medication that used to be given had the troublesome side effect of growing hair. This very effective blood pressure reducer was a nightmare for women. Soon a scientist was able to change the drug enough so that it grew hair without reducing blood pressure, and this drug, minoxidil, became the first drug approved for use in male baldness in the U.S.A.

Now one takes a pill once a day or even a patch on the skin once a week, and doesn't even notice the change. But even so, every class of drugs has its side effects and some work better for some groups of people than others. The current range is a class called ACE inhibitors, which can really help in patients with heart failure, but is also a good first drug for all people with high blood pressure.

The tried and true beta blockers are cheap and effective in younger patients, and help also to control heart rate and extend life after heart attack. The calcium channel blockers have come under a lot of fire recently; I tend to avoid them for the treatment of high blood pressure. If you are taking a pill for this problem, learn all you can about the drug.

There should be one that is perfect for you.

Low blood pressure is a different problem. If the upper number falls below 80, the kidneys are in danger of dying. Usually falling blood pressure in a sick person is a terminal event, and high power medications are necessary to maintain blood pressure. We also can see low blood pressure in dehydration and various poisonings. However, many people, especially pregnant females, athletes, and young women have low blood pressure all the time. This should not be a concern unless there is extreme weakness or fainting, especially when one is rising from a sitting position to a standing one.

I would, however, state that blood pressures that are lower than 85 are usually abnormal, but each case must be evaluated individually. This discussion of low blood pressure was in response to a correspondent from Bnei Brak. I hope I answered your question. Write me in care of the Yated.

A message from Glaxo, the sponsor of this column. Flu season will be upon us soon and I still recommend the flu shot as the first and best therapy. However, Relenza is effective medicine against this debilitating disease and is the first of its kind. If you don't have the time to be sick - - and who does -- then consider Relenza.

 

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