DEAR DR. ROACH: I am a woman aged 58, and I have very high blood pressure from a fall that dissected my aorta. Well, the last time I checked my blood pressure about a week ago, it was 193/119 mmHg, which is low for me. Kidneys respond to this by secreting a substance (renin), which ultimately causes a person’s blood pressure to go up. It’s important to consider the long-term effects of prednisone on your immune system, blood sugar, blood pressure, and risk of osteoporosis when considering alternative treatments. — Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible.