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DEAR DR. ROACH: I am an 89-year-old in good health. For the past six months, my systolic blood pressure was consistently at 113 mm Hg. However, about 10 days ago, it suddenly dropped to 88 mm Hg for a week. Now, for today and the last week, it's spiked to 187/93 mm Hg. I was taking medication for blood pressure, but my doctor discontinued it when my readings were low. Currently, I am not on any medications. What could be going on? -- D.J.
Blood pressure fluctuates throughout the day and night, exhibiting certain typical trends. Typically, there is an increase in blood pressure shortly after waking up, while it tends to decrease during nighttime hours.
In addition to those broad insights, it's important to note that blood pressure can fluctuate significantly even within a short span of time. Engaging in thoughts that evoke anxiety or discomfort can potentially elevate blood pressure by 20% or higher. For instance, if your typical systolic blood pressure is around 110 mm Hg, you might occasionally see readings that dip into the 90s or rise into the 130s. Ultimately, the average blood pressure is what matters most. To accurately determine this average, it's advisable to take multiple blood pressure measurements.
It seems to me that your blood pressure was well-managed, and you may have experienced some low readings, possibly due to random fluctuations or perhaps because you weren’t consuming as much fluid or salt as you typically do. It’s likely that your doctor may have overreacted by discontinuing the medication that your body genuinely required for blood pressure regulation.
Certain blood pressure medications may not provide 24-hour coverage, which means that if your blood pressure was taken during the time the medication was at its peak effectiveness, it could clarify why your readings appeared to be lower that week.
To effectively manage this issue, it's advisable to take several blood pressure readings daily using a home monitor. These devices are relatively affordable, and you can locate a reliable one at ValidateBP.org. You should adjust your medication dosage according to the average of your readings. For someone who is 89 years old, having blood pressure levels that fluctuate significantly -- such as between 88-187 mmHg -- can pose risks to your heart and brain health.
DEAR DR. ROACH: I have been diagnosed with diverticulosis, and I enjoy eating berries as part of a healthier diet. However, I'm concerned that consuming them might trigger pain. Are there any alternatives to supplements that I could consider? -- S.T.
RESPONSE: A nutritious diet for managing diverticulosis largely aligns with the dietary recommendations for the general population. I believe that obtaining fiber from food sources is more beneficial than relying on supplements. Berries make an excellent option as they are rich in fiber, lower in simple sugars, and incredibly tasty.
You might have concerns regarding the seeds present in berries. Traditionally, it's been advised to steer clear of these due to the belief that they could block the openings of diverticula. However, current understanding suggests that seeds, nuts, and corn are not responsible for causing diverticulitis flare-ups. That said, if you've experienced issues with specific foods leading to an attack, it’s wise to continue avoiding those.
Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to [email protected] or send mail to 628 Virginia Dr., Orlando, FL 32803.
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