Dear Doctor: I heard about a study that says working overtime gives you high blood pressure. My husband just joined a competitive company, and he’s expected to work a lot of extra hours. He’s already a Type A kind of guy, and I’m worried.

Dear Reader: You’re referring to the results of research published last December that found a connection between putting in long hours at work each week and an increased risk of developing high blood pressure. More specifically, the study uncovered a link to a condition known as “masked hypertension.” This is when blood pressure readings in the doctor’s office are normal but then rise to elevated -- and even dangerous -- levels outside of the clinical setting. That makes diagnosis and treatment difficult and may put someone at higher risk of heart problems and stroke.

In the study, published in the journal Hypertension, researchers in Canada followed 3,500 office workers for five years. Participants in the study wore a device that measured their blood pressure every 15 minutes. The researchers also obtained daily blood pressure readings while the workers were at rest. The goal was to identify periods of normal blood pressure, sustained high blood pressure and masked hypertension. After adjusting the resulting data for lifestyle factors such as weight and smoking, existing medical conditions such as diabetes, family medical history and job strain, the researchers found a correlation between how much overtime someone worked and their blood pressure.

Overall, the study found a 70% higher risk of masked hypertension among workers who put in 49 or more hours per week as compared to those with a workweek of 35 hours or fewer. They also found that the overtime group had a 66% higher risk of sustained high blood pressure. These are blood pressure readings that remain high and can be measured in a clinical setting. As little as one to nine hours of overtime was linked to a significant increase in risk of both types of hypertension. The results held true for both women and men.

Analysis of previous research, which also finds a connection between a long workweek and developing high blood pressure, suggests stress and loss of sleep as potential causes. But because the number-crunching in the Canadian study takes those factors into consideration, the authors suspect some other mechanism is at work. Considering that the study looked at white-collar workers, who spend the lion’s share of their time behind a desk, recent revelations about the adverse health effects of prolonged sitting may hold a clue. These include weight gain, increased risk of developing metabolic diseases like Type 2 diabetes, and, yes, hypertension. It will be interesting to see if these parallel avenues of research converge.

Meanwhile, considering the demands of your husband’s new job, as well as your description of him as a driven Type A personality, we think it would be wise for him to check in with his health care provider. He may be advised to monitor his blood pressure with a wearable monitor, which would allow a diagnosis, and, if needed, appropriate treatment.

(Send your questions to askthedoctors@mednet.ucla.edu, or write: Ask the Doctors, c/o UCLA Health Sciences Media Relations, 10880 Wilshire Blvd., Suite 1450, Los Angeles, CA, 90024. Owing to the volume of mail, personal replies cannot be provided.)

Dear Doctor: Why do you have to wash your hands with soap and warm water for at least 20 seconds? Are they not getting clean if you’ve only got cold water? And why is 20 seconds the magic number? What about hand sanitizers?

Dear Reader: Handwashing is in the news right now due to the coverage of the new coronavirus, COVID-19, as well as our ongoing flu season. It’s an important topic because, although the exact means of transmission of the new coronavirus isn’t clear yet, we do know how influenza spreads, and COVID-19 is likely to be similar.

In addition to inhaling aerosolized droplets from an infected person’s cough or sneeze, influenza spreads through contact with surfaces that have been contaminated by the virus. This can be direct contact, such as when you shake hands with someone infected with the virus, or indirect contact via a contaminated surface or object. If you come into direct contact with the virus and then touch your own mucous membranes, you risk infecting yourself. This includes rubbing your eyes, nose or mouth; biting your nails; eating with your hands; dabbing on makeup; or just resting your chin in your hands. All of this leads to two bits of important advice -- don’t touch your face, and do wash your hands. The first relies on awareness, while the latter is all about technique.

Start by wetting your hands with clean, running water. The temperature of the water doesn’t play a role in efficacy; it’s just that warm water is more comfortable to use. If cold water is the only option, that’s fine. What matters most is that you work up a lather with soap -- any kind of soap will do -- and carefully clean all of the surfaces of your hands. Be sure to wash the palms and backs of the hands, the fingers, the knuckles, the webs between the fingers and the areas around and beneath the nails. Doing this carefully and thoroughly, with gentle pressure to create friction, takes in the neighborhood of 20 seconds. Then rinse well and dry thoroughly. Frequent handwashing can dry out the delicate skin on your hands, so carrying a travel-size moisturizer can be a good idea.

As for hand sanitizers, studies have shown that although they can be helpful, washing with soap and water is the most effective at removing a variety of pathogens. Hand sanitizers may not be as effective when used on hands that are dirty or greasy.

When using a hand sanitizer, it’s important to choose one that is alcohol-based, at a concentration of no less than 60%. The product label will state the concentration of alcohol. Don’t skimp. Always use the amount of sanitizer that the label recommends. Then spread the liquid over all of the surfaces of your hands and rub gently until they are dry.

Hands clean? You’re not quite done yet. There’s another object that that makes frequent contact with your hands and face -- your phone. Check manufacturer directions, and add cleaning your phone to your daily routine.

(Send your questions to askthedoctors@mednet.ucla.edu, or write: Ask the Doctors, c/o UCLA Health Sciences Media Relations, 10880 Wilshire Blvd., Suite 1450, Los Angeles, CA, 90024. Owing to the volume of mail, personal replies cannot be provided.)

Dear Doctor: How do I know if I need a hip replacement? My right hip gets so stiff after I’ve been sitting at work for a few hours that I can hardly walk, and then it aches for the rest of the day and night.

Dear Reader: The hip is one of the largest weight-bearing joints of the body. Its unique structure lets humans stand and walk upright and gives our legs and torso an impressively wide range of motion. It is a ball-and-socket joint, which means that the rounded head of a bone fits neatly into a cuplike hollow. In the case of the hip joint, the ball-shaped head of the femur, which is the upper leg bone, sits inside a socket within the hip, known as the acetabulum. The surfaces of the femur and the hip socket are lined with cartilage, a smooth and springy connective tissue that cushions the joint and helps reduce friction. A membrane known as the synovium produces a thick liquid that lubricates and nourishes the interior of the joint. Fluid-filled sacs known as bursae act as cushions and protect the muscles and tendons as they move over bony areas within the joint. Muscles, ligaments and tendons anchor the hip joint and provide power, stability and flexibility.

The most common reason for a hip replacement is damage to the parts of the joint that reduce pressure and eliminate friction. This often occurs due to osteoarthritis, a degenerative condition in which the tissues of the joint begin to deteriorate, and rheumatoid arthritis, a chronic inflammatory disorder. Injuries, fractures, wear-and-tear due to overuse or being overweight, and cancer, while less common, also can lead to the need for a hip replacement.

One of the main symptoms that the joint may need to be replaced is significant and persistent pain. This occurs while walking, sitting, standing or bending over, and often is severe enough to wake you from sleep. It interferes with the ability to carry out daily activities and impairs quality of life. Imaging tests that reveal arthritis, or damage to the bone or tissues of the joint from other causes, also may signal the need for joint replacement.

A hip replacement is major surgery. It entails removing the damaged or diseased tissues and replacing them with an artificial joint. Post-surgical physical therapy is a big part of a successful outcome, and full recovery can take from six months to a year. It is important to note that the new joint lasts about 15 years, after which it will need to be replaced again. Before diving into the deep end, your health care provider is likely to ask you to explore noninvasive interventions. These include rest, physical therapy, weight loss, using a cane and a range of anti-inflammatory or pain medications. If these fail to provide adequate relief, or if the medications are not tolerated, then a new joint may be the best option.

If you do opt for a hip replacement, find a reputable and experienced surgeon. You want someone who is board certified in orthopedic surgery, specializes in hip replacement, has experience with your specific condition and accepts your insurance.

(Send your questions to askthedoctors@mednet.ucla.edu, or write: Ask the Doctors, c/o UCLA Health Sciences Media Relations, 10880 Wilshire Blvd., Suite 1450, Los Angeles, CA, 90024. Owing to the volume of mail, personal replies cannot be provided.)