How can I lower my high blood pressure without medication?

Dear doctor,

For the past eight months, I have been struggling with high blood pressure. Sometimes when I check I am told it is high and when I’m given medicine, it goes down. When I stop taking the medicine, the pressure goes back up. I am 44 and I don’t want to be taking medicines all the time. What can I do to get rid of this problem?

Ngare

Dear Ngare,

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 a few people, about five to 10 per cent of those with high blood pressure, there is an exact cause for it such as kidney disease, hormonal disorders, pregnancy, anaemia, tumours, drugs or some medications. For this group of people, once the cause has been identified and dealt with, then the pressure can be sorted out

In majority of the people, about 90 to 95 per cent of those with high blood pressure, there is no known cause why the pressure went up. It goes higher with age and by the time it is being said to be high, it has been rising slowly over many years, and continues to do so. There are some things that are associated with this rise such as age (being over 40), being male, being African, having a close relative with high blood pressure, high-salt intake, high-calorie foods, high-fat diet, lack of exercise, obesity, taking too much alcohol, smoking and a stressful lifestyle.

Unfortunately, most of the time you cannot tell that your blood pressure is high unless it is measured. Therefore, you may be feeling fine, but the pressure is high and it continues to cause damage to the blood vessels and can cause stroke, heart disease, kidney failure and even loss of vision.

To prevent these long term effects, you are put on medication to lower the blood pressure to normal levels. If the blood pressure readings are normal, then the medicine is working. If you stop taking the medicine, the pressure goes back up, which is why it is important for you to keep taking the drugs. In addition to that, reduce the amount of salt in your diet, the amount of fat and starch in your diet to healthy levels, reduce alcohol intake, stop smoking, reduce weight to healthy levels, exercise, eat a lot of vegetables and fruits, have enough sleep and manage stress.

Hi Dr Flo,

My feet have been smelling whenever I put on shoes for several weeks now. What could be causing this? Grace

Dear Grace,

Smelly feet are usually caused by sweating and wearing the same shoes every day. Everybody can have sweaty feet but this is common in teenagers and pregnant women due to hormonal changes. Your feet may also sweat more if you are on your feet all day, if you wear tight shoes, if you are stressed or if you have a medical condition that makes you sweat excessively (hyperhidrosis). When this sweat is absorbed by the shoes and they are not cleaned or aired appropriately before being worn again, they make the feet smell. This sweating also makes it easier to get a fungal infection on the feet and between toes, which also contributes to the smell.

To manage it, clean your feet at least once a day with anti-bacterial soap if possible then dry your feet well, especially between the toes. Wear cotton socks, change socks daily, wear leather or canvas shoes and avoid plastic shoes; do not wear the same pair of shoes two days in a row so as to give the shoes at least 24 hours to dry. You can use foot powder to absorb sweat and keep toenails short and clean and remove any hard skin from under the toenails. If you have any infection, it should be treated.

What causes scratching of the skin immediately after bathing and during hot temperatures? Which are the suitable drugs to use?

Dear Reader,

You may have cholinergic urticaria, which means that you itch when you feel hot, anxious, when you sweat from exercise, when you eat something hot or spicy, when you take a hot shower or when you get angry. This causes an itchy red rash with wheals around the pimples, starting within six minutes and lasting between 30 minutes to two hours. It may also lead to headache, dizziness, hypersalivation, abdominal cramps, palpitations or shortness of breath. Rarely, the symptoms can be severe and life threatening. It has no known cause, but is thought to occur either because of a dysfunction in the nerve fibres in the sweat glands or due to an allergy to sweat. It is more common in people who have other allergic conditions

You may also have aquagenic pruritus, which just means itching caused by water, a kind of allergy to water. Contact with water produces an intense itching of the skin, usually with a prickling sensation, without any observable rash or swelling. The symptoms can last anywhere from 10 minutes to two hours and it usually resolves on its own.

There is no good reason why some people develop this problem though sometimes it may be associated with some underlying blood conditions. Showering with hot water for some people actually prevents the itching because the heat affects the cells (mast cells) that trigger the allergic reaction. But if you take a hot shower that is too hot and for too long, you can also get itching because of drying out of the skin.

You can use anti-allergy tablets and creams/lotions for the itching. Avoid using harsh soaps for bathing or harsh detergents for your towels because the chemicals in the soap can also cause the itching; and clean your towel regularly, like once or twice a week, to avoid growth of bacteria on a damp towel. Wear absorbent, loose fitting clothes and stay cool as much as possible. Cool your skin when you feel hot and avoid any exercises that trigger the itching. Stress management and relaxation techniques can help reduce stress and anxiety. If you have severe symptoms like difficulty in breathing, you may need emergency medication like an epinephrine shot.

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