Healthy Aging Archive

Q. I am a 50-year-old woman with newly diagnosed high blood pressure. As diets go, mine is definitely on the healthy side. I do not exercise at a health club, but I do a lot of housecleaning and gardening, and I do walk a fair amount, which I feel is equal to what I would accomplish at a health club. I weigh 150 pounds and my height is 5 feet, 6 inches. I take Toprol-XL. My blood pressure seems to be normal in the morning, averaging 121/74, but in the afternoon the upper number is often in the 140s to 150s. Is it normal for blood pressure to rise like this as the day goes on, especially while on a medication?

A. It's great that you are paying close attention to your blood pressure readings. Beta blockers like metoprolol (Lopressor, Toprol-XL) are not great medications for lowering blood pressure when used all by themselves. So, as the day goes on, and you eat and exert yourself physically, my guess is that the metoprolol is just not strong enough to control your blood pressure. One option is to switch to another medication, such as a diuretic or an ACE inhibitor. If your doctor thinks you need the beta blocker for some other cardiac condition, adding a diuretic or ACE inhibitor to the beta blocker makes sense. In fact, combining low doses of medications that fight high blood pressure in different ways is probably a more effective way to do it than with a high dose of a single medication.

The Industrial Revolution changed America forever, and the Information Era has changed it still further. More than ever before, men are working with their brains instead of their backs. It's great progress, but it does have unintended consequences, including global economic competition and unprecedented levels of stress. Another consequence is diminished physical activity. Now that most men don't need to exercise to earn their keep, many view exercise as kids' stuff, the fun and games that fill childhood — or used to in the days before video games and flat-screen TVs.

America has become a nation of spectators. That deprives men of the exercise that improves cholesterol levels, lowers blood sugar, burns away body fat, strengthens muscles and bones, improves mood and sleep, and protects against diabetes, dementia, certain cancers, and especially heart attacks and strokes.

Q. I recently had a right hip replacement and my doctor says I'm now ready to use a cane. Do you have any recommendations about the best way to use it?

A. Congratulations on your progress! A proper cane can be very helpful. It will reduce pain by taking some of your body's weight off the hip. It can also improve your stability and balance and reduce the demand on muscles and tendons that might still be inflamed or weak after surgery. A cane will get you on your feet and allow you to be more active, helping you strengthen your body and giving you some independence while your hip heals.

The American Heart Association is predicting a big increase in cardiovascular disease over the next 20 years, fueled largely by the aging of baby boomers. Greater attention to heart-healthy living among boomers, their children, and grandchildren, could prove the AHA wrong.

Early introduction of palliative care (well before hospice) improves mood and quality of life — and may help people live longer.

Hospice and palliative care are often talked about as if they are the same thing, but they're not. Hospice is for people who are expected to live for a short time (usually defined as six months or less) who have agreed to stop getting treatment aimed at prolonging life. Palliative care is medical care that aims to relieve pain or suffering and, more generally, to improve a person's quality of life during a serious illness. Palliative care is certainly a major component of hospice care, especially the efforts to relieve pain, but it's not limited to hospice. People who are actively being treated for a disease can receive palliative care at any stage of their illness.

Every man desires to live long," wrote Jonathan Swift, "but no man would be old." Much has changed over the centuries, but the desire to retain youthful vigor during the golden years has endured. Fortunately, modern medicine has developed a plan for successful aging. It includes getting regular physical activity and mental stimulation; eating right; controlling blood pressure, cholesterol, and blood sugar levels; staying lean; building strong interpersonal relationships; and avoiding tobacco and other risky exposures and activities.

A wise lifestyle can help extend life and slow the aging process — but it takes effort and discipline, especially for gents who have started down the wrong path. So it's no surprise that men continue to look for a medicinal shortcut. One of the most tempting is testosterone.

Our noses grow a bit longer as we grow older, and gravity tugs down on the tip, so it droops more. Those nicely curved outside walls of the nostrils — they tend to weaken, so when we inhale, they're more likely to cave in, making it harder for the incoming air to get through. These and other subtle changes in nasal architecture can make it increasingly difficult to breathe through the nose.

But a study conducted in Germany shows that there may be some age-related changes to the nose that offset those that interfere with nasal breathing. Researchers inspected the noses of 80 volunteers with an instrument that uses sound waves to measure cross-sectional areas and volumes inside the nose. The nasal cavities of the older people (average age, 70) in the study turned out to be quite a bit larger than the cavities of the younger group (average age, 27). Moreover, there was no difference between the older and younger groups on questionnaires designed to identify problems with nasal breathing and other nose-related problems. (A sense of humor is evident: one of the questionnaires is called Sino-Nasal Outcome Test, or SNOT.)

Q. My daughter gave me a pedometer and told me to walk 10,000 steps a day. When I wore it for a while, I realized I was taking only about 3,000 steps a day. Is 10,000 a realistic number for someone my age (70 years)?

A. If you are reasonably healthy, 10,000 steps a day is a good goal for you. It is the equivalent of walking two to three miles per day. You can cover this distance with a walk of 45 minutes or so, and get in your 10,000 steps even if you do nothing else for the rest of the day. Ten thousand steps a day may not be feasible if you have arthritis, heart failure, or other health issues.