Dear Doctor: I'm about to turn 60, and when I spend the afternoon playing with my 7- and 9-year-old grandsons, I'm wiped out. Is there anything that I can do to feel and be more energetic? I want to be an active grandmother and not just sit on the sidelines.

Dear Reader: We'd like to begin by reassuring you -- it's the rare adult who can match the activity level of a young child, who is basically a marvel of perpetual motion. However, your question does address certain realities of older adulthood.

As we age, particularly when we reach our 60s and beyond, certain changes begin to take place in our bodies. We experience a decrease in muscle mass, which results in a loss of both strength and balance. A change to sleep patterns, including less deep sleep and more frequent awakenings during the night, can cause fatigue, a drop in mental sharpness and even lead to depression. Add in the various other changes that take place in the aging heart and brain, and the result is often a feeling of low energy.

Lifestyle plays a role as well. For many adults, older age or retirement means less daily contact with a variety of people, less decision-making, a lower level of physical activity and even less time spent outdoors.

As you suspected, there are some simple steps you can take to feel better.

-- Eating a diet based on lean proteins, healthful fats, a variety of high-fiber fruits and vegetables, and limited added sugars.

-- Drink enough water. It's easy to forget to stay adequately hydrated. (And no, diet and caffeinated beverages don't count. In fact, they can act as diuretics and result in net fluid loss.)

-- No smoking. Not only does smoking tobacco quite dramatically cut down on your lung capacity, it is a risk factor in heart disease and many cancers.

-- Get enough vitamin D, which is essential to bone health and helps with depression. Spending time in sunlight or taking a supplement are necessary for adequate vitamin D.

-- Make daily exercise a priority. Walking is an excellent way to get your blood flowing and your muscles moving. It takes no equipment, is low-stress, and can be done with a partner or in a group. Yoga is a great for both the body and the mind. Weight-bearing exercises are also important to muscle and bone strength, and to stability.

-- Avoid constipation. Diet, exercise and adequate water will put you on the path to regularity. If you find you're still having trouble, the occasional use of a fiber supplement and a stool softener can be helpful.

-- Be creative about getting enough sleep. Daytime naps can make a big difference. If napping isn't in your skill set, simply taking the time to lie down with your eyes closed for five or 10 minutes can leave you refreshed.

Taken as a whole, these changes to your daily routine can help you feel more energetic -- and help you to keep up with your grandsons.

(Send your questions to askthedoctors@mednet.ucla.edu, or write: Ask the Doctors, c/o Media Relations, UCLA Health, 924 Westwood Blvd., Suite 350, Los Angeles, CA, 90095. Owing to the volume of mail, personal replies cannot be provided.)

Dear Doctor: I know that high blood pressure increases the risk of heart disease, stroke and more. However, is it still considered a risk factor if it's controlled with medicine?

Dear Reader: High blood pressure is a significant risk factor for heart attacks and strokes because it damages the arteries that supply the heart and the brain, causing them to narrow. Additionally, the heart has to work harder to deal with the resulting elevated blood pressure, increasing the risk of eventual heart failure. There is no disputing these facts.

As for whether someone with high blood pressure controlled by medication has a risk equivalent to somebody without high blood pressure, that's a good question -- and no studies have specifically tried to answer it. But researchers have studied patients with high blood pressure and the attempts to bring the blood pressure to different levels.

A 2015 breakthrough study in the New England Journal of Medicine took 9,361 patients with systolic blood pressure greater than 130 and randomly assigned them to either treatment to keep the blood pressure between 130 and 140 or more aggressive treatment to bring the blood pressure down to 120. The aggressively treated group got their blood pressure down to 121 on average, while the less aggressively treated group had an average systolic blood pressure of 136. The study was stopped after three years because of a 27 percent decrease in the overall death rate in the aggressively treated group.

A 2016 study in The Lancet combined data from 123 studies of hypertension treatment with a total of 613,815 patients. This analysis showed that for every 10-point decrease in blood pressure, the death rate decreased by 13 percent, the stroke rate decreased by 27 percent and the heart failure rate decreased by 28 percent. Like the former study, the benefits were greater with blood pressure below 130.

Lastly, an analysis of 16 studies published in 2016 in the Journal of Hypertension looked at the benefits of more aggressive treatment versus less aggressive treatment of blood pressure. The authors found a 16 percent decrease in death rate with blood pressure below 130 versus blood pressure greater than 130.

Although these studies don't directly answer your question, consider the incremental benefits of lowering your blood pressure. If, on medication, your systolic blood pressure is in the 130s, I would say that you're at greater risk than someone who is not taking medication and who has a blood pressure of 120. If you're on medication and your blood pressure is 120, it's hard to say how that compares to somebody who has a blood pressure of 120 and is not on medication.

The most important lesson is that if you have high blood pressure, you should treat it.

Also, a message for my readers: A recent column on whether to give aspirin for a heart attack in progress referred to two studies in which users received aspirin at various times. In referring to one study, the article stated that earlier users received aspirin an average of 1.6 hours before the onset of symptoms. Obviously, this should have said "after the onset of symptoms."

In referring to the other study, the article stated that patients received aspirin at least 24 hours after the beginning of symptoms. This should have said "up to 24 hours after the beginning of symptoms."

(Send your questions to askthedoctors@mednet.ucla.edu, or write: Ask the Doctors, c/o Media Relations, UCLA Health, 924 Westwood Blvd., Suite 350, Los Angeles, CA, 90095. Owing to the volume of mail, personal replies cannot be provided.)

Dear Doctor: News reports are saying that researchers have figured out how stress causes a heart attack, and that it all starts in the brain. I quit smoking, I exercise and I've switched to a healthy diet. But how am I going to control my brain?

Dear Reader: The physical connection between the mind and the heart is something that, even in the absence of scientific data, humans have long intuited. Just take a look at our language. Feelings and events can be heartbreaking, heart-stopping and heart-rending. The guy everyone's crushing on is a heartthrob. When it doesn't work out, your heart aches.

Now a paper published in The Lancet offers scientific proof of what everyone from Shakespeare to Beyonce has been saying all along -- emotional stress directly affects the heart.

Drawing from two studies, researchers found that when people had high levels of activity in the amygdala, which is the region of the brain that telegraphs emotions like fear, stress and dread, they were more likely to develop heart disease. Participants with a hyperactive amygdala had more inflammation in their arteries, and the region of their bone marrow that creates red blood cells was more active.

Cardiovascular disease is the leading cause of death among adults, not only in the United States, but in the world. In 2013, one-third of recorded deaths in the U.S. were due to cardiovascular disease. All of which makes managing the mind-heart connection even more vital.

But how? You can begin right now by taking a slow, deep breath. If that felt pretty good, try it again. Now, let's talk about stress-reduction techniques.

Fortunately, with the advent of wellness programs in many workplaces, stress management is now taken seriously. Instruction begins with the basics -- no smoking, limit caffeine, drink less alcohol, cut down on screen time, get more sleep, take time to exercise and eat a balanced diet. If you recognize any of your own behaviors in that list, consider making a change.

Thanks to the mainstreaming of practices like meditation, tai chi and yoga, all of which have been proven to measurably reduce stress when practiced regularly, groups and classes are available practically everywhere. Whether it's at your gym, a community center, a senior citizens center or even on YouTube, there's a class that's right for you. When it comes to exercise, don't forget about oldies but goodies like a brisk walk or a gentle jog. You'll burn off some steam, work up some endorphins and quite likely feel refreshed.

And don't forget about fun. In a task-oriented world that has become fixated on success and results, doing something for the simple enjoyment of it has somehow fallen out of favor. In the same vein, reaching out to friends and family -- in person, not via text or Facebook -- can help you feel less stressed. Research shows that isolation is as toxic as some diseases, and the therapy can be as simple as a "hello."

(Send your questions to askthedoctors@mednet.ucla.edu, or write: Ask the Doctors, c/o Media Relations, UCLA Health, 924 Westwood Blvd., Suite 350, Los Angeles, CA, 90095. Owing to the volume of mail, personal replies cannot be provided.)