High Blood Pressure Is the World’s Biggest Killer | Hacker News Reader

High Blood Pressure Is the World’s Biggest Killer

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36 pointsalwillis20 comments

The thing is, you go to the Doctor's office and they weight you, measure your height and take your BP, irrespective of time of day and rarely giving you five minutes to sit and relax. If it reads high your doctor gets the report and reaches for his prescription pad.

Its a single momentary snapshot in time taken under less than ideal conditions on which a long term medication decision is based, often with attendant side effects. My understanding is that the proper way to chart for a BP problem is to take BP twice a day, once before lunch (after sunrise metabolic amplification affects are have waned) and again before right dinner time. These readings done daily for a week, and averaged are your real blood pressure readings. And then of course there are also the confounding effects of white-coat syndrome.[1]

So, not to downplay the absolute importance of detecting hypertension and treating it asap, but the way it gets done is both perfunctory and quite prone to false positives. This methodology sells extra meds for spurious reasons...

[1]https://www.wikiwand.com/en/White_coat_hypertension

Your claim sounds pretty spurious to me. The only reason I even know you're right about the measurement and diagnosis issue is from listening to a medical podcast in which medical doctors the correct way to measure blood pressure and diagnose hypertension, in order to encourage listeners not to get over-excited about a single high reading and go ask for drugs. My wife is on blood pressure, and it was definitely not prescribed on the basis of a single reading. She was given instructions for how to measure it herself from a list of reliable devices and did so twice a day for a week before going back.

It's saddening to see this discourse on the Internet where the half the people are out there saying "doctors won't take my condition seriously and tell me to eat better and exercise more" and the other half saying doctors just prescribe meds and never recommend lifestyle interventions. Damned if they do, damned if they don't. All the doctors I actually know absolutely prescribe lifestyle interventions. But if the patients won't eat better and exercise more, what else are they supposed to do? This doesn't seem like some kind of wild mystery where the rise in population average blood pressure is being caused by false positives and people being scared of the office. The population is fatter, exercises less, sleeps less, and drinks more alcohol, all causes of elevated blood pressure. We can tell them not to do those things, but we already do and that clearly makes no difference.

My experience with blood pressure measurements is that no matter what I’ve ate/drank, or how fast I walked down the hall in the Dr’s office my BP is never over 120/80. If mine did jump, even at one appointment, it would stick out pretty quickly.

I cant remember where but I saw an interview with a 'qualified professional' ... it may have been on here actually, but their overall argument was "whatever condition you have, diabetes, alcoholism, the works ... youll be better off in the long run if you exercise". Long story short, get off the couch *obviously, im speaking of those that can and/or havent fallen too far

How many of you add salt to their meals without tasting it first?

I'm on a low-salt diet and it's true that at first it's tasteless without salt, but after a few weeks you get used to it (like all tastes).

I don't quite understand hypertension medication.

It treats high blood pressure to lower the number for its own sake, but isn't hypertension really a symptom stemming from a root cause?

Not a doctor, but blood pressure is not just a proxy measure, it can be a dangerous condition in its own right that needs to be reduced. It puts stress on the circulatory system and raises the likelihood of strokes, for example.

I have a good diet, do lots of exercise (ride 16-20 ks every day, weights 2-3 times a week), don't smoke (never have), hardly drink (a beer every few weeks), thin (mid BMI), not skinny, not fat and have high blood pressure.

It's a bad vibe that I have to take pill every morning. If there was some way to avoid it I would. If I stop my high goes up to 180.

What's the root cause? Born that way?

Do your hands and feet swell? If so, try drastically cutting your salt (20% of DVA) for a few days and test your pressure again. Salt sensitivity is real.

Yes. It's actually not as simple as it sounds and involved preparing all my own meals. This said. A bottle of salt lasts a long long at home. Eating out is a quick way to get 100% of your DVA in one meal.

Disappointingly, it made no difference to my blood pressure over at least a month.

What it did do is reset my taste for salt. Any outside food tasted so salty at first it was yucky. That wore off after a while.

There is one thing that seems to make a difference and that is consciously drinking a lot of water. This lowers by BP but it has other affects I don't like.

I was diagnosed with hypertension at 10. I am probably an edge case but after extensive testing they have yet to find a root cause for my high blood pressure.

They've concluded that continuing to study me will cause more stress and that I am otherwise healthy - I just need to continue taking my blood pressure medications.

Sometimes it is just something that happens and needs treating by itself

It depends.

As the article mentions, some people have a genetic mutation that makes them much more likely to have hypertension even if they're doing everything "correctly".

Sure, in some cases it's lifestyle related; the medications lower the risk of heart disease, stroke, dementia, etc. while someone deals with their obesity, diet or other issues.

It's the primary actual cause of heart and stroke related disease, to my understanding. Worse than high cholesterol, obesity, etc. So, yes, hypertension is something that should absolutely be primarily treated.

The symptom is a cause of other problems

Dr. Rick Johnson, Prof. of Nephrology (kidney) at U. of Colorado, on a Peter Attia podcast, https://www.youtube.com/watch?v=V02z9mqTWzg&t=6856s , states that high blood pressure is an inflammatory kidney disease.

What causes the inflammation? There are several causes, including vaso-constrictive drugs like cocaine, but one major cause is high uric acid due to high fructose (caused by high fructose dietary intake or high sodium intake, which over a long enough time, will cause the body to convert glucose to fructose, which then goes along the high fructose dietary intake path)

obesity, diabetes, hypertension, etc. ..it all goes together

So the cause is sedentism, sedentary lifestyles? The cure is reorganising towns to limit the usefulness of (and even the ability to use) cars.

There is a strong correlation between highly processed food intake and metabolic diseases.

1960s and 1970s Americans drove a lot, cars were a symbol of American culture. But they were a lot slimmer and healthier than today. Look at any video from NY or LA streets from that time. These guys and gals were normal office workers, not hunters and gatherers. But they looked completely different.

Perhaps not incidentally, their diet was completely different, too.

Isn't this a popular saying among health/fitness people: "You can't outrun a bad diet"? That would seem to prioritize reorganization of food/diet over any limitation of cars.

The cause is too much food/the quality of the food people eat.

Exercise plays a small role in weight loss / management, but people should still do it for the other benefits.

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