Ask the Doctor
I’ve read a lot in the news in the last two weeks scary stuff about Singulair. Should I stop taking it?
— Jeff K.
About two weeks ago the FDA released a communication that it was investigating the incidence of suicidal thinking and mood changes in patients taking Singulair, a medication used to treat asthma and nasal allergies. No connection between Singulair and these symptoms has been established. So there’s no reason to stop your medication, but obviously let your doctor know about any changes in mood or any thoughts of hurting yourself.
Please email me health-related questions that you think would be of general interest. Unless you ask me not to, I’ll identify you only by your first name and last initial.
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It’s Never Too Late to Treat High Blood Pressure
Preventive care in older patients is always a tricky balance. As patients get older, the conventional thinking goes, their life expectancy decreases, so there is less opportunity for preventive care to make a difference over many years. Also, older people tend to be more sensitive to medication side effects, so the likelihood of harm of any therapy is greater. For example, if lowering blood pressure only prevents strokes and heart attacks after many years, are older patients going to live long enough to benefit?
A study in the New England Journal of Medicine that will be published in the May 1 issue definitively answers that question. The study randomly assigned 3845 patients who were 80 or older and had high blood pressure to receive either blood pressure lowering medication or placebo. They were followed for an average of about two years.
Surprisingly, the patients on the blood pressure medications did quite a bit better without any increase in adverse effects from the medications. The patients on blood pressure medications had fewer strokes, heart attacks and death from any cause than those on placebo. For every about 60 patients taking medication instead of placebo for one year, one cardiovascular event was prevented. That’s much more benefit than was expected in this age range.
So don’t give up on your blood pressure because you think you’re too old to have to worry about it.