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85 year old having hypertension, swollen ankles and kidney problem. What should be the normal BP?

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Practicing since : 1981
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i have question about 85 years African American male health situation.

actually his blood pressure 175/100 today and he took the one blood pressure pill he is prscribed aboout 3 hours ago .

I think his blood pressure is higher than other nomarl blood pressure his age, is not it?

I also want to know what a normal blood pressure should be for a man his age.

How to explain to him why he has swelling in his ankles?

Also, how many pack-years has he acquired (he smoked about a pack a day for 45 years)?

Actually, he wants to know if the hypertension has been responsible for his kidney problems. How can I explain for him?

should i aks the docotr whether or not he may need more medication or an increase in his dosage?

when I walk with him around the block, the doctor wANTs I to monitor his Pulse. The doctor says it is okay for him to walk at an optimal pulse rate. What would that pulse be ?
Posted Sun, 5 Aug 2012 in Hypertension and Heart Disease
Answered by Dr. Anil Grover 47 minutes later
Hi there,
I answered your first question:
Thanks for writing in.
I am qualified and certified in medicine and cardiology. I read your question with diligence.
In general, I recommend honestly telling about illness especially, to an elderly person.
Facts can be cruel one need not be in cruel in telling them.

How do you know he has renal disease as a result of hypertension? What diagnosis the doctor has told you? What is his creatinine and urea? How much urine he brings out a day? What kind of diet he should take? These are the questions, answers to which is entitled to know, rather than what caused his renal damage or his blood pressure. If for some reasons doctor can not communicate to him properly, you understand from the doctor and then explain to him in your own way. That would be my suggestion. Be truthful whether hypertension had been responsible first you find out it is so, explain to him that doctor says so.

Swelling in legs in kidney disease is because of two reasons. One is loss of protein and second is rise in total body fluid volume. Most which can not be retained inside the vascular space. It is then accommodated in outside the vascular space and called edema. Causes swelling of ankles.

Number of pack years is no packets of cigarettes he has smoked per day on an average multiplied by number of years he had smoked. One packet a day for 30 years is 30 pack years.

Please let me know more facts in your follow up query, I shall be able to help you in answer nearest to truth and not so hurtful. For example cigarette smoking has not much role to play in kidney disease past or future, so it can be downplayed.
With Best Wishes.

Dr Anil Grover,
M.B.;B.S, M.D. (Internal Medicine) D.M.(Cardiology)
http://www/ WWW.WWWW.WW
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