To Your Good Health: Medicines used to prevent blockages aren’t perfect

Q: I am a 69-year-old woman. Three months ago, a 90-percent-blocked left renal artery was diagnosed and stented. Because my blood pressure was difficult to control after surgery, I was prescribed amlodipine and metoprolol.

About 10 years ago, I had a right carotid artery that was 65 to 70 percent blocked.

The vascular surgeon who stented my renal artery advised that I have a superior mesenteric artery that is 60 to 70 percent blocked but said he doesn’t want to address it until I have symptoms (abdominal pain after eating).

A former smoker who is slim, I exercise regularly and eat a balanced diet. I have elevated blood pressure and cholesterol; I see my physician twice a year and take medications as prescribed.

I am confused. Did my medications fail? Was I not prescribed a large-enough dosage? My primary-care physician and vascular surgeon haven’t answered these questions. The surgeon did say that, even though I quit smoking many years ago, “The damage was done.” It seems to me that, if I have these artery issues, I might be headed for a stroke — which scares me.

A: Atherosclerosis, the disease that causes blockages in arteries, is the leading cause of death in this country. Although we have good treatments, they aren’t perfect. They can slow down the progression, and in some cases even start to reverse it, but we don’t have a cure. You have had at least three partially blocked arteries: the internal carotid in your neck, the renal artery to your kidney and the superior mesenteric artery going to the pancreas and intestines.

I understand why you are concerned about a stroke. A stroke is caused by the death of brain cells, usually from not enough oxygen getting to them from a blocked blood vessel.

The control of blood pressure and cholesterol reduces the risk of a stroke. In high-risk people, aspirin or medications like it reduce the risk of a stroke.

It sounds as if you and your doctor have done everything right: You quit smoking and took your medications. These definitely reduced the risk of further blocked arteries, including those in your heart and brain.

Q: How should we view the expiration date on sunscreen? Is it there just to make us buy more?

A: All products lose effectiveness over time. Sunscreen generally lasts for three years. It will gradually lose effectiveness after that.

You are better off getting a fresh bottle soon after expiration, but you should use enough in each application — and reapply it frequently — so that a bottle is used up in less than three years.
