Dear Dr. Roach: Ive read mixed reviews as to whether the flu shot can contribute to Alzheimers disease. Im anxious to see your input. J.W.
Answer: There is no reliable evidence, nor any good biological plausibility, that influenza vaccination increases the risk of either Alzheimers disease or other types of dementia. In fact, there are several studies showing a reduced risk of dementia in people who get regular influenza vaccines. I have read well-done studies looking at people with heart failure, people with kidney disease and overall people over age 65 - all show a decreased risk of dementia among those who regularly get the vaccine.
There is a risk in these kinds of studies, because people who get regular vaccines are more likely to see their doctors, have blood pressure and blood sugar well-controlled, eat better and exercise more, all of which help protect against dementia. However, the authors did their best to statistically control for these factors and still found a benefit from regular vaccination.
One might think that reducing the risk of death by influenza vaccination would be enough motivation, but still too few people get the vaccine. Maybe knowing that there is no increased risk, and possibly a decreased risk, for dementia will encourage people to get their vaccine.
Dear Dr. Roach: My doctor heard a heart murmur and sent me for an echocardiogram. This showed that I have some heart thickening due to high blood pressure, but that my valves are OK. The doctor said the murmur came from aggressive heart muscle contractions.
Im 68, and my blood pressure is around 140/76. What can I expect my heart health to be as I age? Is this progressive? I exercise 150 minutes per week. Should I still push myself? B.G.
Answer: I looked at your echocardiogram report, and it showed your ejection fraction (the percent of blood the heart squeezes out every beat) was 75 percent (just on the border of too high), and the report noted abnormal relaxation of the thickened wall of the left ventricle. These findings are indeed consistent with hypertensive heart disease.
Fortunately, this condition is usually treatable. At the time of the echo, your blood pressure was 158/76. Perhaps you were nervous, or perhaps your blood pressure isnt under as good control as it could be. Meticulous blood pressure control, ideally with an ACE inhibitor and often a beta blocker, is the best treatment for your condition. With good control, the heart can start to return to normal. Sometimes a 24-hour blood pressure monitor can help decide whether the medication is enough.
Regular exercise is absolutely still indicated, but I dont recommend overexerting yourself until you speak with your cardiologist about it.
