Don’t let notions limit your potential

Dear Dr. Roach: I wanted to make older adults aware of their untapped reservoir of energy and ability.

I started weight training when I turned 50. It makes mebelieve that I still haven’t reached my potential. I am convinced that preconceived notions get in theway of our challenging ourselves and realizing our abilities. — A.M.

I thank A.M. for writing. I often write about the importance of exercise, especially at older ages. I think this letter expresses how much good exercise can do, but I would just add that the sense of confidence and well-being that comes from being more physically fit is very powerful.

Dear Dr. Roach: I have high blood pressure. My most recentechocardiogram said I have a “hyperdynamic left ventricle,” “concentric left ventricular hypertrophy” and“abnormalleftventricle relaxation.” Is this heart failure?— G.D.

When high blood pressure isn’t treated rapidly and properly, the heart undergoes changes to try to adapt to its increased workload. The heart muscle thickens (”hypertrophy”) and strengthens, so it can empty more blood (“hyperdynamic”). Unfortunately, there are several costs to these changes. One is that the left ventricle chamber wall can get so thick and stiff it cannot relax . That translates to higher pressures inside the heart.

Abnormal heart relaxation is found in a type of heart failure called heart failure with preserved ejection fraction.

The treatment is to get to and keep the blood pressure at a normal level.

However, it’s not clear to me whether youhave heart failure, which requires symptoms. The majorsymptomof heart failure with preserved ejection fraction is shortness of breath, especially with exertion, and fatigue. Ideally, treatment should be begun before symptoms start.