Diseases & Conditions Archive

Ask the doctors

Q. I have a lot of varicose veins. Do they present any sort of a health risk?

A. Varicose veins are typically viewed as a mild, non-life-threatening condition that is more of a cosmetic annoyance than a serious health problem. That said, varicose veins can be associated with some health-related issues, such as swelling in the legs, blood clots, or damage to the skin caused by pressure from the veins. They may also make you more prone to skin damage, infections, and ulcers.

Allergic rhinitis, commonly called hay fever, can be a minor seasonal nuisance or a troubling year-round problem. Most people can find relief by taking an antihistamine and by avoiding the allergens that trigger the irritation.

Also called painful bladder syndrome, this frustrating disorder disproportionately affects women.

Interstitial cystitis is a chronic bladder condition that causes recurring bouts of pain and pressure in the bladder and pelvic area, often accompanied by an urgent and frequent need to urinate — sometimes as often as 40, 50, or 60 times a day, around the clock. Discomfort associated with interstitial cystitis can be so excruciating that, according to surveys, only about half of people with the disorder work full-time. Because symptoms are so variable, experts today describe interstitial cystitis as a member of a group of disorders collectively referred to as interstitial cystitis/painful bladder syndrome. (In this article, we'll call it interstitial cystitis, or IC.)

Among the one to two million Americans with IC, women outnumber men by as much as eight to one, and most are diagnosed in their early 40s. Several other disorders are associated with IC, including allergies, migraine, irritable bowel syndrome, fibromyalgia (a condition causing muscle pain), chronic fatigue syndrome, and vulvodynia (pain or burning in the vulvar area that isn't caused by infection or skin disease).

Timing may improve potency and help you cope with side effects.

We all want our medicines to be as effective as possible, and that requires effort on our part. It may be necessary to avoid taking pills with certain foods or drinks, and to check that medications won't interfere with each other.

And in some cases, it may be important to take a drug at a particular time of day. This approach, known as chronotherapy, is gaining attention as research suggests a relationship between when we take medications and how well they work.

Ask the doctor

Q. I've taken blood pressure medicines every morning for many years, and they keep my pressure under control. Recently, my doctor recommended taking them at bedtime, instead. Does that make sense?

A. It actually does make sense — based on recent research. For many years, there have been at least three theoretical reasons for taking blood pressure medicines before bedtime. First, a body system that strongly affects blood pressure, called the renin-angiotensin system, has its peak activity during sleep. Second, circadian rhythms cause differences in the body chemistry at night compared with daytime. Third, most heart attacks occur in the morning, before medicines taken in the morning have a chance to "kick in."

People monitor their cholesterol levels, but they should also watch their triglycerides.

Most people have heard of the two main kinds of cholesterol: the "good" HDL and the "bad" LDL. Doctors focus on controlling LDL, as high levels can lead to a buildup of fatty deposits in the arteries and block blood flow, which can trigger a heart attack or stroke.

A blood test called a lipid profile measures your HDL, LDL, and total cholesterol levels. But within that test is another number you should not ignore: your triglyceride levels.

Ask the doctors

Q. I recently started experiencing a lot of pain in my hand from osteoarthritis. Can I reverse this condition?

A. You can't reverse osteoarthritis, but there are things you can do to manage your pain and improve your symptoms. Osteoarthritis occurs when the protective cartilage that acts as cushioning between your bones starts to fray and wear down over time. Eventually this enables the bones to rub together, which causes the pain you are experiencing as well as swelling and stiffness that makes it difficult to move your hand freely. Typically, when you have arthritis, the pain and symptoms will be worse at some times than at others. You may experience a flare-up one day and feel better the next. To help reduce the discomfort of a flare-up, talk to your doctor about medication to relieve pain. She or he may recommend an over-the-counter pain reliever. Some people also get symptom relief using a topical pain reliever that is rubbed into the skin. Other strategies that can ease pain are splints or braces, heat or cold therapy, activity modification, and exercises or physical therapy to increase flexibility and strengthen your hand muscles.

Research we're watching

Late in 2019, the FDA approved a new use for icosapent ethyl (Vascepa), a drug that is a highly purified form of eicosapentaenoic acid (EPA), an omega-3 fatty acid found in fish.

The drug was originally approved in 2012 for treating people with very high levels of triglycerides, a type of fat in the blood. Now, icosapent ethyl is approved for people with triglyceride levels greater than or equal to 150 milligrams per deciliter who also have an elevated risk of cardiovascular disease despite taking the highest tolerable dose of a cholesterol-lowering statin. A large trial found that the drug decreases the risk of heart attack, stroke, and death from cardiac causes by 26% when compared with a placebo.

There is a lot you can do to lower your chances of having a stroke. Even if you've already had a stroke or TIA ("mini-stroke"), you can take steps to prevent another.

Controlling your weight is an important way to lower stroke risk. Excess pounds strain the entire circulatory system and can lead to other health conditions, including high blood pressure, diabetes, high cholesterol, and obstructive sleep apnea. But losing as little as 5% to 10% of your starting weight can lower your blood pressure and other stroke risk factors.