Why am I carrying beta thalassaemia? Can I drop BP pills?

A Genetic Legacy

"I've been having tests for anaemia, and the laboratory has discovered that I carry beta thalassaemia. I've been told that this won't cause me any problems, but my parents and grandparents were born in the UK and, as far as we know, there is no Mediterranean or Middle Eastern ancestry in our family, so how is it possible that I have this condition, which is supposed to affect only people from other parts of the world?"

Beta thalassaemia is a genetic blood disorder that is common is some parts of the world – Mediterranean countries, the Middle East, and Asia. It is relatively rare among native "British" people. If you are a carrier of beta thalassaemia, you will have inherited it from one of your parents. So, if your parents are still alive and willing to have blood tests, you might be able to trace which side of the family it has come from. The likelihood is that someone in a previous generation had a partner who was originally from a part of the world where thalassaemia is common. The important point for you is that, if you have children with a partner who is also a carrier of beta thalassaemia, there is a one-in-four chance that a child could inherit the gene from both of you, and this would cause the child to have the serious form of the disease – beta thalassaemia major. Before you have children, it is important to find out if your partner is also a carrier. You can find out more from your local Sickle Cell and Thalassaemia Centre, or the UK Thalassaemia Society ( www.ukts.org).

Controlling blood pressure

"I have been taking blood-pressure tablets of one kind or another for more than 20 years. Over the past year, I've lost nearly a stone, and have been able to stop one of my two daily tablets. I am now only taking ramipril. I would like to stop the tablets altogether, and control my blood pressure with diet and exercise. Is this an unrealistic hope? What should I be eating? And what exercise should I do? I am 49, female, and my BMI is now just below 25. I don't smoke, but probably drink a bit more than recommended, some weeks at least. My favourite exercise is walking."

The Dash study in America – Dash stands for Dietary Approaches to Stop Hypertension – showed that it is possible to lower blood pressure by changing your diet. The key factors in the Dash diet were low salt, low fat and high calcium, potassium and magnesium. People who stuck to the Dash principles had lower blood pressure than those on high-salt, high-fat diets. Regular exercise that raises your pulse rate and makes you slightly out of breath will also bring your BP down. Walking is fine, but you have to walk fast enough, far enough and frequently enough to leave your comfort zone.

Please send questions and suggestions to: A Question of Health, 'The Independent', Independent House, 191 Marsh Wall, London E14 9RS; fax: 020-7005 2182; e-mail: health@independent.co.uk Dr Kavalier is unable to respond personally to questions

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