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You Docs: What blood pressure numbers are too low/high? do calcium pills cause kidney stones?

January 11, 2012

Q. How low is too low for the bottom blood pressure number, and how high is too high for the top one? My dad’s numbers have been shifting somewhat. I’m calling his doc tomorrow for an appointment to see what’s going on, but what’s so high or low that I should take him to the emergency room? — Teresa, via email

A. We get asked about blood pressure numbers more often than Sarah Jessica Parker gets asked if she’s wearing Manolos. (Our wives told us about that.) What’s too high for the top number (systolic) is simple: Anything above 160 is an emergency — head for the ER immediately.
What’s too low for the bottom number (diastolic) varies. It measures the pressure in the arteries when your heart muscle relaxes between pumps, so you want it to be low. The normal range is 60 to 80, but lower is better. Generally speaking, if your dad can stand up easily and talk to you, it’s not too low. Still, since both of his numbers are moving, you’re smart to get his doc involved.

You don’t mention your dad’s age, but we’re guessing he’s in his 60s or 70s. Blood pressure tends to creep up around age 65, but the American Heart Association’s recommendation doesn’t: Stay under 120/80. We’re even more aggressive: We like BP to be as low as you can get it without tumbling over — not just your dad’s; yours, too. Under 120/80 is good; 115/76 is optimal. People in that range have half as many heart attacks and strokes. Dr. Mike’s is 115/75; Mehmet’s stays around 110/75. Go for optimal!
How? Eat well (lots of fruits, veggies, 100 percent whole grains; next to no saturated/trans fats or added sugars/syrups). Walk 30 minutes a day. Sleep eight hours a night. Manage stress. If your dad needs meds (sounds likely), make sure he takes them as if his life depends on it. It does.

Q. I take a medication (Zonegran for epilepsy) that makes me prone to kidney stones. I’ve passed one and have another, though it’s not positioned to pass immediately. I know you suggest taking 600 mg of calcium daily, but won’t that make me more likely to form kidney stones? — Paul, via email

A. Since the most common type of kidney stones — calcium oxalate pebbles — are formed when calcium and oxalic acid hook up in urine (yep, pee is their idea of a singles bar), your question makes perfect sense. So our answer may sound a little crazy: Calcium pills, taken with meals, actually can be protective. Why? Calcium binds with oxalate in food, which keeps it from getting into your urinary tract.
There are other potent steps you can take to help prevent kidney stones. The most important is to drink quarts of water — yep, quarts. The rule of thumb if you’ve had a kidney stone is at least 3 quarts a day (other fluids count, too). Start by washing down your Zonegran with a big glassful. Then just keep at it.

It’s smart to measure your intake for a few days (3 quarts = 12 measuring cups) until you instinctively know how much you need. Every time you eat anything, drink a glass of water. Have a glass before you go to bed; if you get up to pee during the night, have another glass. Drink moderate amounts of orange juice, lemonade, coffee, tea, wine and beer, too; all can deter stones. But water is your kidneys’ BFF.
Salt is not. Sodium increases calcium in urine, which ups your chance of stones. Skip the highly processed “salt bombs” your body doesn’t need anyway: fast food, canned soups/vegetables, deli meats, premade frozen dishes, pizza, hot dogs, sausage. Grapefruit juice, cola and cranberry juice also may cause trouble. And definitely avoid spinach, rhubarb, nuts and wheat bran — these normally healthy foods increase oxalate in urine, exactly what you Zonegran takers and other kidney-stone-makers don’t need.

The YOU Docs, Mehmet Oz, host of “The Dr. Oz Show” and Mike Roizen of Cleveland Clinic, are authors of “YOU: Losing Weight.” For more information go to www.RealAge.com

Article source: http://www.oregonlive.com/health/index.ssf/2012/01/you_docs_what_blood_pressure_n.html


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