Feet First

“It is much more important to know what sort of a patient has a disease than what sort of a disease a patient has.” - Sir William Osler

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    Monday, July 21, 2003
    DASH diet - It Works!

    I saw a patient today who I diagnosed with high blood pressure a few months ago. She was reluctant to take medication (they all are), so we discussed options and I gave her information about the DASH diet and its role in controlling hypertension. I didn't have high hopes, not because I don't believe the diet can work but because very few people can actually stick to it. After all, we're talking about nine servings of fruit and vegetables a day when most people barely get down two.

    Her blood pressure in April was 154/92. Today, it was 138/80 (I took both measurements myself). She had lost a little weight but only about three pounds, so I don't think that was a contributing factor. I congratulated her and told her to keep up the good work!

    This is a rare case of patients actually following advice - I realize that may sound snotty, but believe me, it's rare that people do cut down on their food intake and increase their exercise. I find that patients are looking for "natural" ways to treat their problems, which is fine; but what they don't realize is that this usually entails a major revamp of their lifestyles and habits. That's a difficult thing to accomplish and many people cannot or will not do it. It's easier to give the pills, yes, but at least we know they will work reliably.

    I do still try to get people to eat right and lose weight if they're taking meds. When the patient asks if they'll ever be able to get off the medication, I counter, "If you lose twenty-five pounds I'll be happy to take you off the medication for a while and see how you do." Sadly, it's rare that the person loses the weight.



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