My pressure reading is now normal, should I stop taking medication?

Dr Flo,

I am 52 years old. Six months ago, I was diagnosed with high blood pressure and put on medication. Since then, every time I go to hospital for a follow-up visit, my blood pressure reading is normal, yet I get a prescription for more drugs.

Shouldn’t I stop taking the medication or at least get a weaker dose since my blood pressure is now normal?

Henry

Dear Henry,

The blood pressure reading is a measure of the force at which your heart is pumping blood, and the resistance to the blood flow within the blood vessels. Normal blood pressure is between 90/60mmhg and 140/90mmhg. Anything above 140/90mmhg is considered high blood pressure.

In about up to 10 per cent of people diagnosed with high blood pressure, there is an exact cause such as kidney disease, hormonal disorders, pregnancy, anaemia, tumours or medication. Once the cause has been identified and dealt with, the blood pressure comes down. However, in most people with high blood pressure (90 to 95 per cent), there is no known cause. By the time they are diagnosed, the pressure has been rising steadily over the years and continues to do so. There are some things that are associated with the rise in blood pressure such as age (being over 40), being male, being African, having a close relative with high blood pressure, a high-salt, high-calorie, high-fat diet, lack of exercise, obesity, smoking, too much alcohol and a stressful lifestyle.

Most of the time, you cannot tell that your blood pressure is high unless it is measured. Therefore, you may feel fine, but the blood pressure is high and continues to cause damage to the blood vessels and can cause stroke, heart disease, kidney failure or even loss of vision. To prevent these long-term effects, you are put on medicine to lower the blood pressure to normal levels. If the readings are normal, then the medicine is working.

If you stop taking the medicine, the blood pressure goes back up, which is why it is very important to keep taking the medicine. In addition to that, reduce the amount of salt in your diet, reduce the amount of fat and starch in your diet to healthy levels, reduce alcohol intake, stop smoking, maintain a healthy weight, exercise, eat a lot of fruits and vegetables, have enough sleep and manage stress.

****** 

Dr Flo,

Parts of the skin on my lips and hands have turned white. This started five years ago and has been spreading slowly.

I don’t feel any pain or feel itchy. I was given some creams to apply but they don’t seem to work. Why am I turning white and is there a way to stop this?

Vitalis

*****

Dear Vitalis,

What you have is called vitiligo. It is a disorder where white patches occur on the skin due to destruction of melanocytes, which are the cells that make skin colour/pigment. It can also affect areas that are covered by mucus membranes e.g. inside the mouth or nose. The exact cause of the disorder is not known. It may happen due to someone’s genes, and someone with it is more likely to have a relative who has it. It may also be due to someone’s own immune system attacking the melanocytes, which is called an auto-immune disorder. People with other auto-immune disorders, e.g. affecting the thyroid gland, are more likely to have vitiligo, but not always.

Vitiligo can affect anyone, but is more obvious in those with darker skin. It can affect any part of the body, but is more common in areas that are exposed to the sun like the arms, the feet, the face and the lips. It can also affect the eyes, and the hair and you may notice that your hair becomes white early.  Some people get patches that never spread, while others get white patches that either spread gradually or fast. In some people, the white patches spread after a period of stress.

Vitiligo cannot be cured, but it can be managed. You can use make-up to cover up the patches, and if the white patches cover only a small area, tattooing can also be done to cover it up. Don’t forget to use sun screen to protect your skin.

Visit a skin specialist to help you figure out how best to manage the condition. You may be given some creams to apply, and phototherapy and laser therapy may be used to help the skin get back some colour. Specialised surgery can also be done in some people.

Dr Flo,

For the last four days I have been going to the toilet to pee many times. I even wake up once or twice a night to go to the toilet.

I get a burning sensation when I’m passing urine. I have had similar symptoms before and I was diagnosed and treated for a urinary tract infection. The last infection was two months ago. Why do I keep getting this infection and how can I keep it away for good?

Victoria

Dear Victoria,

Urinary tract infections (UTIs) are quite common in women, and in about 20 per cent of all women, the UTIs are recurrent. Some people get recurrent UTIs for no good reason, while in others, it may be due to abnormalities in the structures of the urinary system, or  due to diabetes, pregnancy, steroid use, spinal cord injury, nerve problems, kidney stones or some immune disorders.

In most cases, the bacteria that cause UTIs are the bacteria that live in the intestines, and they can travel from the anus to the urethral opening (where urine comes out), since the two are near each other. Women also have a very short urethra (the tube that carries urine to the outside), which makes it easier for bacteria to travel up the bladder and cause infection. Bacteria can also get to the urethra when using a dirty toilet due to splashing, and also due to close contact during sexual intercourse.

Having a UTI may cause a burning sensation when passing urine, feeling very pressed, urine leaking out before you get to the toilet, going to urinate many times, even though very little urine comes out; change in urine colour and/or smell, blood in urine, lower abdominal pain, lower back pain, fever and chills, nausea, bloating and feeling tired.

UTIs are treated with antibiotics after a urine test. Make sure you complete the dose and  take a lot of water. If you have recurrent UTIs, you may be given a low dose of antibiotics to take over a long time. You may also be advised to take an antibiotic every time after sex or take antibiotics for one to two days every time you get symptoms.