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Ask the doctor.

Q I've heard that a supplement called Pycnogenol can be a natural way to manage high blood pressure. Can you tell me more about it and if it's safe to take?

A Pycnogenol is the U.S. registered trademark for a supplement extracted from the bark of a pine tree (Pinus pinaster) grown along the coast in southwest France. It's promoted as an anti-aging supplement that also treats many health problems, including those related to circulation, such as high blood pressure and disorders of the heart and blood vessels. The Natural Medicines Comprehensive Database is a scientifically investigated database that includes some evidence-based natural medicines. They rate effectiveness of supplements according to the following scale: Effective, Likely Effective, Possibly Effective, Possibly Ineffective, Likely Ineffective, Ineffective, and Insufficient Evidence to Rate. The database rates Pycnogenol as possibly effective for circulation problems because it may improve blood flow. According to the National Institutes of Health U.S. Library of Medicine, taking Pycnogenol supplements may reduce leg pain and heaviness, as well as fluid retention, in people with circulatory problems. The compounds in this pine bark include proanthocyanidins, which are also found in cocoa, grape skin and cranberries. Like all supplements, Pycnogenol can negatively interact with medications you are already taking. Be sure to consult with your physician before taking this or any other supplement.

Q I've seen commercials about medications that can treat type 2 diabetes (which I have) that also reduce risk for heart disease. Can you tell me more about these medications?

A Heart disease is made worse by type 2 diabetes, yet many treatments focus only on blood sugar control. Recent clinical trials suggest that using medications that offer glucose control while also reducing risk for cardiovascular disease could be a better approach for patients. Four randomized clinical trials tested blood sugar-lowering medications (empagliflozin, pioglitazone, liraglutide, and semaglutide) and all reported important benefits in preventing adverse cardiovascular outcomes in patients with established cardiovascular disease or at risk for type 2 diabetes. A large National Institutes of Health trial showed that controlling only blood sugar levels did not have any positive effect on cardiovascular outcomes. It's possible that these newer blood sugar-lowering medications, used alone or in combination, can help manage type 2 diabetes and prevent cardiovascular disease. So, if you have been taking the same diabetes medications for a long time, have a conversation with your doctor about switching to one of the newer medications.

Q A friend of mine recently had a stroke and ended up in a nursing home. What can I do to prevent the same from happening to me?

A Stroke is a leading cause of nursing home admissions because it can affect speech and the ability to care for yourself. But there are ways to reduce your risk, starting with living a healthy lifestyle. Eat healthfully (a heart-smart diet is good choice), exercise, don't smoke, and minimize stress. Equally important is controlling high blood pressure, high cholesterol, and diabetes. If you have a condition called atrial fibrillation, it's important to treat the condition.

If you experience any symptoms of a stroke, go to an emergency room immediately. A stroke is caused by the interruption of blood supply to the brain and can affect any part of the body. Signs include sudden weakness or numbness on one side of the face or body, difficulty with speech, changes in vision, severe headache or dizziness, confusion, and trouble walking. A stroke can be fatal, but it can also cause brain damage, paralysis, and other complications. Immediate treatment is crucial to minimizing damage. A drug called tPA (tissue plasminogen activator) can dissolve blood clots, but to be effective, it must be administered within three hours after the symptoms occur.



Jonathan Wanagat, MD, PhD, Assistant Professor, Division of Geriatrics
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Title Annotation:Pycnogenol for blood pressure management, type 2 diabetes medication for preventing heart disease, preventing stroke
Author:Wanagat, Jonathan
Publication:Healthy Years
Geographic Code:1USA
Date:Oct 1, 2017
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