#Middlebury #ToYourGoodHealth
DEAR DR. ROACH: You have written many articles about high blood pressure, but I want to know about low blood pressure. What is normal? What is low, and what is dangerously low? I have a heart issue for which I take medication. I want to know if my blood pressure is too low. – Anon.
ANSWER: Among young adults, only 5 percent of men will have a blood pressure below 110/60 or so, and for young women, it’s 90/46. Blood pressure tends to go up with age, so low blood pressure numbers are higher for older adults.
For people with healthy hearts, the only time we worry about low blood pressure is if there are symptoms, and the most common symptoms are lightheadedness and fainting.
In people with congestive heart failure, low blood pressure usually is not concerning in itself, but because it might indicate that the heart is getting weaker. However, many of the medications used for CHF reduce blood pressure, which can even limit the amount of medication that can be used. In people with blockages in their arteries, too low a blood pressure can cause inadequate blood flow to parts of the heart and cause angina symptoms.
The blood pressure is dangerously low when a disease process is causing the low blood pressure. In extreme cases, low blood pressure is one of the most dangerous signs of shock. But in general, for healthy people, low blood pressures are not worrisome.
DR. ROACH WRITES: I have received more letters about hearing loss than I would have believed possible. Most of the advice was consistent, so let me review what both professionals and people who have been through the process of getting hearing aids have advised.
First, have realistic expectations about what a hearing aid can do. It does not make your hearing what it was 50 years ago. Loud noises can be painfully overamplified.
Second, find someone who really knows what he or she is doing. The people whose technicians spent a lot of time teaching, discussing the different options and adjusting them after purchase were the most satisfied. (The adjustment period can take weeks.) A referral from a satisfied friend could be a good place to start. Several professionals recommended that your audiologist be certified by the American Speech, Language and Hearing Association.
Third, be prepared to spend some money. Good hearing aids are expensive. More expensive doesn’t always mean better, but most of my readers felt that the money they spent on hearing aids was well worth it. I’m sure there are some great ones, and some not as great. Many veterans wrote me to tell me about their (mostly) good experiences at the Department of Veterans Affairs.
Fourth, try many models. Some people prefer in-the-ear, some over-the-ear. Because it takes a long time to get used to them, you need to wear them pretty much constantly. Both your ears and your brain need time to adjust, so be patient.
Finally, several people and one chapter president wrote to me about the Hearing Loss Association of America (www.hearingloss.org) and the benefit they gained from visiting their local chapter and sharing their experiences.
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 ToYourGoodHealth@med.cornell.edu. To view and order health pamphlets, visit www.rbmamall.com, or write to Good Health, 628 Virginia Drive, Orlando, FL 32803.
(c) 2018 North America Synd. Inc.
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