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Comment by sph | Hacker News Reader

> And goes without saying, your blood pressure SHOULD go up and down based on your activity and time of day. You just aren't used to seeing it other than at true rest.

Yeah, people panic reading a single 150 systolic, yet routinely it can reach 220+ during heavy exercise. It's perfectly fine. The health metric is the BP at rest, i.e. how low it goes when you're completely idle.

I find it takes up to 20 minutes to reach its lowest sometimes, in state of absolute calm: no movement, no talking, no anxiety. Hence the 'white collar hypertension', i.e. high BP when measured in hospitals and GPs office, where they don't give you enough time to settle down, or are not spaces that induce calm mental states.

The way I take my BP reading is every 5 minutes, until I get a similar reading after 2 consecutive measurements. It takes longer than you'd expect.

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100% hard agree. I'm now paying most attention to my overnight rate, like in the middle of the night - but even that takes a few hours to get down to the minimum value. Fascinating to see the big spike prior to waking up that signals your body is preparing for rising.

Did I eat late before bed? Higher BP overnight. Drink any alcohol at all after, say, 12pm? Higher BP overnight. So it's still useful and interesting to see the overnight values change and shift around.

However, the contrarian in my mind says that it's not smart to ONLY pay attention to your deep rest state BP, since that only applies to a fraction of the day. And if you're running around at high values for the rest of the day, you're still potentially doing damage to your kidneys, retinas, etc - the sensitive blood vessel stuff.

So it's a useful device, it's useful to have the data, but it's also still a bit of black box.

The fact that 80% of all high blood pressure is of unknown physiological cause is a real head scratcher considering that cardiac misadventures are the leading cause of death in the Western world.

The cause is actually known: high amounts of fructose or sugar (which is 50% fructose) -> decrease in nitric oxide production in the liver -> high BP

Like many things, it is diet related. It seems "unknown" because GPs are still lagging well behind modern dietary research and are often nothing more than pill pushers. Lowering your sugar and simple carb intake over the long term, and fixing potentially hidden metabolic syndrome (see skinny fat people with unhealthy livers) is how you reverse it.

Hey I hear you, appreciate the perspective but I'm borderline keto most days -- almost zero sugar, very few carbs, etc -- and yet still here.

So while this may explain some amount (perhaps most?) of peoples idiopathic/essential HBP I doubt it's that simple.

"It's your potassium levels", "it's your homocysteine levels", "it's your fructose", "it's white-coat syndrome", "it's...." etc. Surely we're making progress but it's also not a silver bullet thing.

Good thing the treatments are so safe and effective.

During a recent visit, I mentioned my "White Coat Syndrome" was probably affecting me right there, so they selected their most attractive woman with the best perfume and a manual sphygmomanometer for a hands-on measurement, before releasing me.

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