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Comment by hertzian56 | Hacker News Reader

some people just have a bad genetic soup and do exercise and diet and such and still have hbp well beyond the numbers designated as meaning "high" ultra high etc I didn't see any hard numbers of reduction in the article either, I've read that smoking raises bp by 5-10points which is largely marginal when you look at how inaccurate most bp readings are. I'm skeptical in this selling environment we live in that this isn't all just to sell drugs to people for their whole lives, these are the same people who want to decimate human populations btw

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5-10 points isn't marginal just because there is measurement variance to account for. And just because there's variance doesn't mean you can't fuzz out real numbers. It's like thinking you can stop a timing attack with sleep(random()).

I'd be very skeptical of defending something like high blood pressure. People do the same with high cholesterol. It's a bunch of cope and wishful thinking that they're very different from everyone else who gets heart disease, our #1 killer.

There was a point in history where medics were not aware of concept of “normal body human temperature”.

Then somebody took a sample of people, and measured their body temp and also asked if they were feeling well.

Average among those who felt well was 36.88 °C (98.38 °F) and that was declared normal. (Then in geneal education books it was rounded+shifted and any variation found by the study forgotten)

I found it quite interesting, because I knew normal temp value whole my life, but never even stopped to think where it came from. (I guess in passing thought I imagined that this value was fundamental constant of the universe derived from quantum physics)

My conclusions:

- Studies by necessity are performed on groups on people.

- when it comes to healing an individual, medical knowledge is huge and complex network of rules of thumb (that work on average but there is no such thing as whole medicine field tailored for you)

- there is no better way (listening to your doctor is a good idea)

Except those two don't really matter when predicting heart attack or stroke risk. HRV results, EKG results, labile hypertension; these are the indicators of whether or not you're at a risk for a heart attack or stroke. Getting a regular stress test is more important than blindly throwing anti-hypertensives at someone who may not need them in the first place.

My smart ring detects if there are potential arrhythmia, same with the Apple Watch. Wearables are far more effective at determining heart attack risk than measuring blood pressure which fluctuates in correspondence with your circadian rhythm.

High blood pressure is independently predictive of heart disease and stroke. We see this over and over again in prospective cohort and RCT data the same way we know that your favorite metrics also predict heart disease.

The problem with your wearables example is the same problem you have with angiograms and CAC scans: by the time you're seeing results, it's probably too late.

Even if the Apple Watch could tell you 7 days before you're going to have a heart attack, it's the result of decades of cumulative exposures to factors including hypertension that have lead to the plaque, stenosis, ventricle hypertrophy, and fibrosis that underly your heart attack.

> Except those two don't really matter when predicting heart attack or stroke risk.

Some cursory googling leads to recent research showing that they do: "According to new research, both high systolic and high diastolic blood pressure can lead to heart attack and stroke." [1]

> HRV results

I feel there is hype over HRV. Mainly a new thing that watches and other monitors can measure, and the number is being hyped. That put aside, the sources I've listened to have concluded that HRV is not really that valuable. Do you know of research showing otherwise? (grant it, some research is good here, for most things medecine and science there needs to be a lot of research. My impression there is a lot of research around blood pressure, thus I am not digging out more sources to show the counter-point).

[1] https://www.medicalnewstoday.com/articles/325861

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