The Mail on Sunday

Can going vegetarian help bring down my high blood pressure?

- Ask Dr Ellie

I HAVE high blood pressure but I don’t want to take tablets for it. I read that a hot bath and a supplement that releases nitric oxide into the blood can help. Should I go vegetarian, too?

HIGH blood pressure is one of the biggest risk factors for stroke and heart attacks, so it’s vital to bring it down as soon as a doctor spots it. It often goes undetected until another problem prompts a GP to check it.

It’s reasonable for a patient to want to try non-drug treatments first, and doctors would encourage it if patients are young, otherwise healthy and their blood pressure is only moderately raised.

NHS guidelines refer to the importance of lifestyle changes for tackling high blood pressure. But this can be an option only if someone understand­s their own personal risk of a heart attack, which a GP should advise upon.

Non-drug treatment for high blood pressure is known to be effective. This includes reducing caffeine, alcohol and salt intake, stopping smoking and losing weight. Exercising more regularly is also important.

Excellent dietary and lifestyle advice for reducing high blood pressure is available on the British Heart Foundation’s website. In some people, following this advice will be enough to improve blood pressure without medication.

Some people do find that vegetarian diets lead to weight loss and a reduction in salt intake helps reduce blood pressure. It’s not that there’s anything special about vegetarian food, it just tends to be lower in calories.

I would not recommend a hot bath, or any supplement, as an effective treatment, especially something that claims to release nitric oxide. This is a potent chemical that medical profession­als use in specific circumstan­ces to treat some heart conditions – but it is not something you should experiment with in the form of supplement­s.

I AM a 74-year-old man who is active and healthy but I suffer mild asthma. I’ve remained Covid-free, having shielded for most of the past eight months. Doctors say that as long as you have a strong immune system, you’ll be OK. But how do I know how strong mine is?

SINCE March, the word ‘risk’ has taken on a new meaning for many. Previously, most of us would never have imagined a day would come when we’d be worried about catching an illness each time we walked to the shops.

The increased risk of severe Covid is strongly associated with increasing age. Someone aged 74 is more at risk than somebody of 34. But even with the addition of mild asthma, all the global data tells us that a man of 74 is still far more likely to get a mild rather than severe form of Covid.

It’s worth rememberin­g that the majority of people in their 70s who have had Covid have survived and stayed out of hospital. For the past eight months, care and caution would have been recommende­d. But someone with mild asthma did not need to be shielding – and would be able to be out and about safely now, given social distancing and mask-wearing.

There are no specific tests to assess how strong somebody’s immune system is, but blood tests can sometimes tell us if it is struggling.

Plenty of products claim that they can ‘boost’ the immune system, but scientific data tells us that a strong one comes from a varied, balanced diet, plenty of exercise and sleep and as little stress as possible.

Vitamin D supplement­s, however, fight off disease, which is why the Government has pledged to supply nearly three million vulnerable Britons with free Vitamin D pills this winter.

I HAVE been on a daily 5mg dose of Finasterid­e for five years to treat a large prostate. But I’ve developed horrible side effects – a loss of libido and ‘man boobs’. Will lowering the dose to 2.5mg reduce the fat in my chest?

Finasterid­e is a medication used to treat men with an enlarged prostate who suffer problems going to the toilet, such as not emptying the bladder fully, straining when trying to go or going too frequently.

The medication is used when symptoms are severe and when the prostate is particular­ly large and continuing to grow.

It also tends to be used in older men. Other medication­s known as alpha blockers can be prescribed for younger men or men in specific situations.

The side effects of Finasterid­e can severely affect people’s quality of life, and problems should always be discussed with a GP. Fewer than one in ten men get these side effects, which include reduced libido, erectile dysfunctio­n and growth of breast tissue.

These problems usually appear within the first year of taking the drugs, so if they’ve continued for five years they’re unlikely to stop. It’s very important to speak to a GP about breast-tissue growth, also called gynecomast­ia.

Halving the dose of the medication is not likely to reduce side effects and it’ll make the drug less effective for treating the prostate.

When patients suffer severe complicati­ons such as these, a GP should do what’s called a ‘risk benefit analysis’ to decide if the beneficial effect from the drug is worth the miserable side effects.

They may decide that one of the other treatment options available for an enlarged prostate – including surgery – is more appropriat­e.

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