Reducing Salt for Blood Pressure
Dear Dr. Roach: I have type II diabetes and high blood pressure, which I generally keep below 130/80 with medication. My doctor is concerned about my salt intake. When I pointed out that my sodium level from a recent blood test was in the middle of the normal range, my doctor stated that that was something different. Can you explain why? — G.A.
Answer: Sodium levels in the blood are not affected by salt intake in people with normal kidneys and access to water. This is because sodium intake is balanced by increasing water intake, so that the level of sodium in the blood stays tightly regulated. It’s why we get thirsty after having a salty meal.
However, that extra salt and water in the body puts stress on the blood vessels and raise blood pressure. Most people have a small effect; however, in some people, the blood-pressure effect of salt is quite pronounced. People with diabetes may be more likely to have a pronounced blood pressure effect with salt intake.
Reducing your salt intake reduces your blood pressure, and it probably reduces the risk of heart disease and stroke. Recent evidence suggests that even in people with normal blood pressure, increased salt intake leads to a higher risk of stroke. The major societies would recommend no more than 1.5 grams of salt per day for someone who has been diagnosed diabetes or high blood pressure.
Dear Dr. Roach: I’ve been diagnosed with Peyronie’s disease and have had it for more than a year with no relief from the problems that it has caused. The trauma that caused the problem was minimal, and I didn’t think much of it at the time. My urologist suggested vitamin E on a daily basis, but nothing has happened that makes me think it’s helping. Is there a cure short of surgery? I’m 60 years old and in fairly good health. I’d hate to think that this will be with me forever. — A.
Answer: Peyronie’s disease is caused by scar tissue within the penis. It affects about 5 percent of men. Symptoms include penile pain, curvature of the penis or difficulty with sexual function. This can lead to psychological problems, including depression. The scar tissue can usually be felt on exam, but it is not related to cancer or to cholesterol plaques.
Medical treatments for Peyronie’s disease include vitamin E — which by itself isn’t helpful for most men, but may be helpful in combination with another medication, colchicine. Pentoxifylline, another prescription medication, has been useful for many men with Peyronie’s. However, the longer you have the condition, the less likely the medication is to work.
For background information and further details on treatments, I found a helpful website at www.peyronies.org.
Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth@med.cornell.edu or write to P.O. Box 536475, Orlando, FL 32853-6475.