Wide pulse pressure is concerning

Dear Dr. Roach: Iam87 and have been jogging/ running for 35 years. I recently had a major upper-gastrointestinal bleed after collapsing and losing consciousness. The problem was found and corrected. Since that time, my average blood pressure is now 134/46 mm Hg. Should this low diastolic blood pressure be a concern?

E.D.

Answer: The difference between the systolic (the first number) and diastolic blood pressures (the second number) is called the pulse pressure, and yours is quite wide. It’s this number, rather than the low diastolic number, that is a bit concerning.

Low diastolic blood pressure is most commonly caused by stiff blood vessels. This tends to happen as we get older. However, a leaky aortic valve can also cause low diastolic blood pressures and wide pulse pressures. A wide pulse pressure does put people at a higher risk for heart attack. However, I don’t understand why these conditions would come after a gastrointestinal bleed.

Some blood pressure medications preferentially act on diastolic blood pressure more than systolic. If you are on medications, it is time to review them with your prescribing physician or an expert, like a cardiologist.

Dear Dr. Roach: Does creatine enlarge the prostate, and can it lead to prostate enlargement? A.A.

Answer: Creatine is a common supplement used by weightlifters and other athletes to boost physical performance. It has generally been considered safe.

One study a few years ago found that some volunteers developed high levels of dihydrotestosterone while using creatine. This substance is implicated in enlarging the prostate. However, other studies did not find this result, and I couldn’t find studies that directly implicate creatine intake with prostate enlargement. Both of these conditions are very common as men age, and it can be difficult to determine whether a person who has long used creatine would have developed these conditions regardless.