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Comment by voisin | Hacker News Reader

> 8. Manage Blood Pressure

Anyone on here have advice on this? I eat primarily vegan and run for at least an hour a day (70-90km/wk), have a resting heart rate in the low 40s, have good (middle of healthy range) cholesterol, blood glucose, and A1C, and yet my blood pressure is persistently in the 130-140 over 70 range. I can’t figure out how to get the top number down and my doctor just sort of shrugs that it’s nothing to worry about but I suspect this is less about the science (which seems to support even lower than 120/80 is healthier) and more due to the baseline blood pressures he sees have been increasing over time due to obesity, inactivity, poor diets, etc.

Anyone in a similar boat who has managed to achieve improvements?

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I have the same problem and so does my dad. Since you have everything zipped up, there's good reason to assume it's genetic.

You can squeeze a few more points of BP by losing weight if you aren't already bottomed out. While it was the last intervention I tried, going from 20-25% to 15% body fat dropped my systolic 10pts consistently. When I go back to 20% BF, I'm back up 10pts of systolic. It's very sensitive.

The first reason I went plant-based was to optimize my cholesterol since it felt like the only lever I could pull since I'm already jacked and thin. If I'm going to hover around 125/70, I figure I might as well have optimal cholesterol, and I definitely was able to really shrink my LDL (ApoB).

I realized I'm sensitive to sodium. I've mostly replaced sodium salt with potassium salt. But I also noticed that caffeine can add 10 points to the top BP number even a day later. My best BP numbers have been when I've avoided caffeine and sodium for 48 hours.

I've considered experimenting with BP meds but never was motivated enough to pull the trigger.

Hey I really appreciate the comment on Caffeine. I have been talking my measurements in the morning before having coffee, assuming 24 hours without caffeine would be sufficient to eliminate the effect but perhaps I am a slow metabolizer too and should try going without coffee for a few days and seeing if that changes anything.

For body fat, are you doing Dexa scans or how do you measure? My bathroom scale spits out numbers but I doubt they are trustworthy.

Do you drink filtered or unfiltered coffee? Unfiltered coffee is known to raise cholesterol because it contains high levels of cafestol.

There was a study[1] recently about isometric exercises (wall sits, planks, etc.) being most beneficial type of exercise for lowering blood pressure.

I've also anecdotally found that supplementing magnesium glycinate seemed to help.

Perhaps consider getting some thyroid blood tests? (T3/T4 free, TSH) Mine was elevated which contributed to higher blood pressure.

Also since you're vegan, perhaps check for vitamin, mineral, and nutritional deficiencies.

[1] https://bjsm.bmj.com/content/early/2023/07/02/bjsports-2022-...

The magnesium glycinate is good for your bowels too. I take Magnesium L-Threonate and I think it helps. And in general, ER doctors add Magnesium intravenously when people have a hypertensive crisis.

I dealt with something similar, struggled for years wondering why no dietary intervention would touch my systolic which would sit around 125-130 over 60.

As hard as it was I finally ditched caffeine which instantly dropped my systolic down to the 110-115 range. Also feel much better overall. I wasn't even consuming an egregious amount either, always limiting myself to a max of 400mg, typically in the range of 250mg a day.

Another commenter mentioned caffeine. I have been taking my BP measurements in the morning before having a coffee, but perhaps I am a slow metabolizer and the effects linger for a few days. I am going to listen to you and the other commenter and try ditching caffeine to see what impact this has on my BP over several days. We’ll see! Thanks!

I'm in the same boat as you. My diet is mainly Mediterranean, and blood tests show no abnormalities (I do it 1-2 times yearly). I don't exercise but score 250-400 Heart Points weekly by walking or intense hiking. I firmly believe that stress is a primary factor in hypertension. If you are an anxious person, maybe even more so. Another factor to blame can be loneliness; still hoping for credible research that shows any correlation.

Unfortunately, I don't see a path to eat, meditate or exercise out of it if you in the good shape already. But controlling sodium intake can help to offset some numbers. To control it, I take medications and must continue taking them permanently.

I have a feeling you're probably right about stress and HT.

I strongly believe everyone needs to lift weights. For me it helps with stress. It's a great way to funnel all the days work BS out of your body.

I feel super energized and at the top of the world, even after a quick 20 minute session.

As people get older and they lose muscle/bone density they have a habit of falling down and breaking things, so it's never to late to start. That's my main long term concern.

Exercising helps, no doubt. I see it as good stress, controlled stress that trains your body to deal with bad stress. There are other ways too. I get the same level of excitement when I take cold showers.

My back prevents me from lifting weights again. But I'm happy for those who can and do it.

I’ve been vegan for over 11 years, but my blood pressure has been a problem for a long time. Heart disease and high blood pressure runs in my family. My weight is fine. I walk about 4 miles a day. My CT calcium score is 0. My cholesterol is fantastic. I don’t smoke, I don’t use other drugs, I don’t use caffeine. Sodium is a big issue with me, but even when I keep it under 1500mg, BP is still too high. Alcohol is also a factor. It’s bad when I drink, but even when I go sober for a month it still just isn’t “normal”. One challenge is that no drinking, strict diet (particularly the sodium), etc. all at once is absolutely miserable to follow. I’m also a high stress and anxiety type of person with trouble sleeping. Perhaps correlating blood pressure with good sleep and less perceived stress would yield some insight there.

Admittedly, I am inconsistent in high intensity exercise. So in addition to improving that, I’d like to try the wall squats and planks in the recent articles others have mentioned.

My doctor has repeatedly had to remind me that there’s no shame or loss in having to take medication to control it, as long as I’m doing my best with all the other stuff. A low dose of atenolol sets me right (although I don’t like that it limits your heart rate). I’m currently trying lisinopril, doesn’t seem to work as well. I would still prefer to be off BP meds and I hope those other improvements will work, but using meds is better than letting high blood pressure run uncontrolled.

Recently I lowered my blood pressure to acceptable levels with a combination of

  - lower stress
  - DASH diet with low carbs in evenings
  - 1,5 grams Omega3 from seaweed oil per day
  - lower salt intake even more

Haven’t tried isometric exercises yet, but do exercise more (intense) than you seem to do. Drink low amounts (15grams beans) of top quality coffee, haven’t tried ditching it as suggested elsewhere in this thread. As I’m low on animal proteins, getting 25grams of a good combination of proteins per meal can be difficult, especially as I consider a good meal part of the pleasures of social life.

Get your doc to check your potassium/sodium levels. If your sodium is on the high end, and potassium low: check your aldosterone levels.

I had that, turned out to be an adenoma on my adrenal gland that was flooding me with aldosterone. That’s a hormone That controls your k/na balance - which controls your bp.

You’re running for fun/challenge, not for health. It’s not a surprise that your health isn’t improving. A single 10km run per week in 1h aiming for 40min, an interval run sprinting as hard as possible and casual short runs in between will improve your numbers while also not overexerting your body.

Something that's pretty easy and beneficial is to regularly donate blood, also helps to clear out things like heavy metal build up, although you might need to be careful of getting low in some like iron.

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