A 16-week program for HBP
Q: My doc says that if I don’t bring my blood pressure down I am going to have to take anti-hypertensive medications. I hate taking pills, so what should I do? — William T., Gloucester, Mass.
A: Getting your BP to normal is a key factor in avoiding a stroke or heart attack, let alone impotence. Even if your doc suggested medications (they are effective), we’re guessing lifestyle changes also were recommended. A 16-week study presented at the American Heart Association’s Joint Hypertension 2018 Scientific Sessions offers evidence that upgrading your daily habits can make a big difference pretty quickly in your cardiovascular health.
Researchers from the University of North Carolina worked with people who were overweight and had blood pressure in the 130-160/80-99 range.
For four months, the participants exercised three times weekly (150 minutes total) and followed the DASH (Dietary Approach to Stop Hypertension) diet. DASH basics are:
■ Six to eight servings a day of whole grains: brown rice, wholewheat pasta, whole-grain bread (one serving equals a half cup rice or pasta, one slice bread).
■ Four to five daily servings of fruits (one serving equals half an apple, one orange or eight strawberries).
■ Four to five servings of vegetables daily (one serving equals half cup cooked green or orange veggies or one cup leafy greens).
■ Two to three servings of low- or no-fat dairy (one serving equals one cup low-fat milk or yogurt).
■ Six ounces daily of lean meats like skinless poultry, salmon, ocean trout.
■ Four to five servings of almonds, walnuts, kidney beans, peas, lentils weekly (one serving equals half cup to one-third cup).
■ Use healthy oils, like extravirgin olive oil, and avoid saturated and trans fats, minimize alcohol and drink plenty of coffee. (For more details on DASH, visit https://bit.ly/2xX79Z7.)
The results: Study participants lost around 19 pounds, reduced systolic BP (top number) by 16 points and diastolic (lower number) by 10. Ask your doctor if you can try that approach first.
Remember, to avoid a stroke, you want your BP below 125/85.
Q: My dad is 75 and his recent PSA test indicates that he has prostate cancer. He’s been to several doctors and they have differing opinions about how to treat it. What guidelines should we pay attention to? — Glen J., Knoxville, Tenn.
A: The answer to your question depends on what other diagnostic tests he’s had and how the cancer has advanced. Each case is unique. That’s true for the more than 180,000 men in the U.S. who will be diagnosed with prostate cancer this year, and the more than 40,000 who will die of the disease. But here’s a basic overview:
The traditional tests for prostate cancer have been a digital rectal exam and the PSA (prostate specific antigen) blood test. But the PSA screening results in an astoundingly high number of false positives, which can lead to overdiagnosis, overtreatment and unnecessary risks for incontinence and impotence.
“Additionally, even if a diagnosis from a PSA test is correct, when prostate cancer is detected in men older than 70, it’s often very slow moving.”
Additionally, even if a diagnosis from a PSA test is correct, when prostate cancer is detected in men older than 70, it’s often very slow moving.
Watchful waiting, along with active monitoring, generally is the smart move, especially when bolstered by smart lifestyle choices such as stress management, good nutrition, physical activity and avoiding toxins, including tobacco. If, eventually, the cancer progresses, an MRI and a prostate biopsy provide information needed (a Gleason score) to make your best treatment decision.
A recent study from the University of North Carolina estimates that treating prostate cancer in men 70 and older has cost Medicare US$1.2 billion over the past three years.
And $451 million of that was spent on treatments for men with a Gleason score of 6, which the researchers believe should be “considered to be low-grade disease and best managed using active surveillance rather than aggressive treatment.”
So if and when your dad gets a Gleason score, that will be the time to talk with his prostate specialist about the balance of benefits versus possible harms of the many treatment options that are now available.
Mehmet Oz, M.D. is host of “The Dr. Oz Show,” and Mike Roizen, M.D. is Chief Wellness Officer and Chair of Wellness Institute at Cleveland Clinic. Email your health and wellness questions to Dr. Oz and Dr. Roizen at youdocsdaily@sharecare.com.