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Dear Dr. Roach: I’m currently taking 10 mg of lisinopril once a day to control my blood pressure. I no longer have health insurance due to being laid off. Is there an over-the-counter medication I can use, similar to lisinopril?

C.L.

Dear C.L.: I am sorry to hear about your situation. I am sure it must be both frustrating and frightening to have no health-care coverage. Unfortunately, there aren’t any over-the-counter treatments for high blood pressure similar to lisinopril. Further, since lisinopril can in rare cases cause serious side effects, it is important to be in the care of a physician or other provider when on this treatment. Your blood pressure should be checked and other blood tests done periodically. There often are many resources in a community to get this done at low or no cost. Your local department of health may be a good place to start.

Dear Dr. Roach: I usually walk 45 minutes daily for a cardio workout. However, the Florida heat can be brutal, so instead of walking, I swim and walk one hour in the pool. Is that as good a cardio workout as walking?

R.G.

Dear R.G.: I think that having several different ways to exercise is a good idea, since the muscles used will always be at least somewhat different and it can keep you from being bored when doing the same thing day after day. In your situation, I think that it makes a great deal of sense to avoid the heat by getting in the pool.

The intensity of a cardiovas­cular workout can be measured simply by your pulse rate. A rough but commonly used guide is that moderate cardiovascular exercise is 50 percent to 70 percent of your age-predicted maximum of 220 minus your age. So for age 50, your maximum is 170, and moderate exercise is a pulse of 85 to 119. You can check your pulse at the wrist with a clock, or wear a heart monitor.

Swimming almost always is a more-intense workout than wal­king (race walkers can get a very fast pulse rate), and walking in the pool is a good exe­rcise for your heart and many muscles.

If the pool is outdoors (usual in warm, sunny places, you need to wear and reapply plenty of sunscreen to protect your skin.

Dr. Roach writes: Several people have asked who should not get the shingles vaccine. Who should NOT get the vaccine are those with immune system problems. This includes people with HIV or AIDS, people on chronic steroids with doses greater than 20 mg per day, people with cancer who are undergoing chemotherapy or radiation, or people with bone marrow cancer such as leukemia. However, the vaccine is safe for people with an egg allergy.

Email questions to ToYourGoodHealth@med.cornell.edu.

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