Women and the cost of heart failure; knee replacement timing

— By Michael Roizen, M.D.

and Mehmet Oz, M.D.

King Features Syndicate

Q: My mom is 62 and has been taking high blood pressure meds and statins for a few years. I looked at her meds the other day and I don’t think she’s taking what she’s been prescribed. How should I talk to her about it? -- Audrey C., Camden, New Jersey

A: We’re glad you uncovered this. Skipping heart meds can have serious repercussions. Unfortunately, it’s very common. A study published in Circulation reveals that around 14% of folks with atherosclerotic cardiovascular disease (or an estimated 2.2 million Americans) are skipping prescribed doses, taking lower doses of the meds than prescribed or putting off filling their prescriptions altogether, and we think that’s a low


That can cause a whole bushel of problems, from rebound ultra-high blood pressure spikes and an increased risk for heart failure to a greater risk for blood clots, heart attack and stroke. So encourage your mom to

take her meds as the doctor recommends and then look for cost savings: Check online for patient assistance programs. Great info is available at: Sharecare Rx (www.sharecare.com/rx), Partnership for

Prescription Assistance, RxAssist, Good Rx, and NeedyMeds. Ask her doc about generic drugs, pharma company support programs and coupons and samples he or she might have.

One other thought: Your mom may not be aware that women her age are at increased risk of heart and vascular disease and need to be vigilant about taking care of themselves. A new study from the University of Bergen in Norway reveals that high blood pressure is more common among men than women under age 60, but after 60 the numbers flip. That’s probably because as a woman’s so-called estrogen advantage

fades after menopause, the vascular system loses flexibility. Heart disease and heart failure become a greater risk; in fact, more women than men die of heart failure. So talk to your mom and make an appointment to see her doc(s) to explore ways to make it easier for her to be


Q: I think it’s time for a knee replacement. I had hyaluronic acid injections about six months ago, but the effects are gone, and I’m in pain when I walk. Should I just go have it done? -- William R., Memphis, Tennessee

A: If you want to go “Walking in Memphis” without pain a year from now, here are the

steps you have to take. First, see your orthopedic surgeon for up-to-date scans (X-ray and MRI) to check on progression of your arthritis and talk about timing for the replacement; then get a second


As is so often the case in life, timing is everything, and it turns out many folks get the timing wrong when it comes to total knee replacements. A new study from Northwestern University points out that fully 90% of folks wait too long for the surgery, so long that their deteriorating knee function compromises how mobile they will be post-surgery, and their progressing inability to get around increases their risk for obesity, heart disease and other disorders related to becoming sedentary. There are some folks who get it too soon, meaning they may need to replace the replacement at some point, but that’s far, far less common.

So how do you know it’s time? Your surgeon will have a checklist; ask about it. Generally, it is time when pain is frequent or constant, your mobility is beginning to be seriously compromised, and physical therapy and hyaluronic acid injections do not provide meaningful relief. One day soon there may be a more precise way to time them: The Northwestern researchers are developing an algorithm that factors in pain, joint function, radiographic assessment (X-rays, MRI) and age to determine the timing of

a TKR.

If you do have the TKR, remember to stick with your physical therapy. It’s tough but essential, and going through it conscientiously will make all the difference between a successful outcome and one that’s less than totally


Mehmet Oz, M.D. is host of “The Dr. Oz Show,” and Mike Roizen, M.D. is Chief Wellness Officer and Chair of Wellness Institute at Cleveland Clinic. Email your health and wellness questions to Dr. Oz and Dr. Roizen at [email protected].

(c)2020 Michael Roizen, M.D. and Mehmet Oz, M.D.