Q. I

Read a lot about the dangers of high blood pressure...

March 03, 1999|By Dr. Allen J. Douma.

Q. I read a lot about the dangers of high blood pressure. But what about low blood pressure, along with a low pulse? I'm a woman, 61 years old, 110 pounds with a blood pressure of 95/55 and a pulse of 46. I walk 3 miles daily, never overexert myself and don't feel faint. But my feet and hands are always cold. And my apparently equally healthy brother died of a heart attack at 56 and my father at 74.

A. It's easy to understand how your brother's death would cause you a lot of anxiety, especially with your blood pressure and pulse being low, and with having cold extremities.

But your symptoms may not be related to each other and may not be an indication of a higher risk of heart attack. In fact, they may be the beneficial result of your good health and daily exercise. I'll try to sort this out for you.

For most people in North America with our diet and lifestyle, normal systolic (the first/higher number) blood pressure is about 120 mm Hg. But many people, and the average person in some cultures, have blood pressures less than 110, or even less than 100, without any negative consequences.

In like manner, the lower number or diastolic blood pressure is normally between 70 and 80, but lower numbers occur frequently without problems.

There are situations when blood pressure falls so low that blood flow to the brain is lowered enough to cause fainting and even shock. This can be caused by many things, including heart problems and reactions to drugs--both legal and illegal.

This most commonly occurs in a condition called postural hypotension. With this problem, a person's blood pressure drops too low only when he or she stands or even sits up rapidly. Not enough blood reaches the brain and the person will feel faint or even pass out.

Almost all people will experience this from time to time, when they are stressed by other physical or emotional problems. But it's more likely to happen in people who have heart problems or are taking certain drugs.

Systolic blood pressures below 100 and even below 110 can mean that something is wrong, especially in an older person, if the pressure has suddenly dropped from a much higher number. An explanation could be a weakening heart that has resulted from loss of muscle power due to painless heart attacks.

But if lower blood pressures have been present for awhile and the person has no symptoms of low blood pressure such as dizziness and cold, clammy hands and feet, it's a sign of good health, not disease.

Your cold hands and feet could result from lower blood pressure. But it's usually the result of a restriction of blood flow in the arteries to them. This restriction may be caused by arteriosclerosis -- the same condition that is responsible for most heart attacks.

I don't mean to alarm you. Many people with your condition find that they have no major problems with their heart or blood vessels. But especially because of your brother's early death from a heart attack, I strongly recommend that you see a cardiologist and get a complete medical examination.

Update on nearsightedness: Advisers to the FDA have recommended approval of a new surgical procedure to correct near-sightedness (myopia). A lens (brand name Intac) is implanted like lens implants in cataract surgery.

Like radial keratotomy, the surgical flattening the cornea of the eye, the main objective is to remove the need for glasses. Although the procedure is fairly simple, it's expected to cost around $2,000.

