Moderators: JeffN, carolve, Heather McDougall
JeffN wrote:Now, the good news...
Diet and lifestyle is still the officially recommended first line of treatment
We always knew that those with “pre hypertension” were an issue as they were in a gray zone where the benefit of medication did not outweigh the risk and may have been leading to increased deaths. Dr Goldhamer reviews this issue nicely in the intro of his studies on fasting and HTN.
https://www.scribd.com/document/3272720 ... pertension
"Surprisingly, 68% of all mortality attributed to high blood pressure (BP) occurs with systolic BP between 120 and 140 mm Hg and diastolic BP below 90 mm Hg."
Apparently, they now believe the benefits of treatment outweighs the risk for this group. If the treatment is diet and lifestyle, we all win. Sadly, it probably won't be.
You suggest 110/70 as the target, and I'd like to mention that Dr. Goldhamer states that 90/60, and even 80/50 are healthy/optimal readings.
I wanted to point this out to people, so they mentally file 110/70 as the HIGH END of the truly healthy range (and definitely not "low," except by comparison with a sick population). In my experience, as soon as people drop below 100/70, they misguidedly begin to concern themselves with being "too low" ... when actually they are on a trajectory toward superb.
I also wanted to point out that 120 systolic is actually considered a hypertensive CRISIS ... framing it in these terms may awaken some from the slumber of imagining that "normal" equates with "healthy," which it certainly does not in a population in which virtually 100% of people are walking around with elevated blood pressure.
Would you agree with these statements?
JeffN wrote:It’s also important to make sure your blood pressure is checked correctly, and doing it yourself at home may be the best way.
On self monitoring
Efficacy of self-monitored blood pressure, with or without telemonitoring, for titration of antihypertensive medication (TASMINH4): an unmasked randomised controlled trial
The Lancet , Volume 391 , Issue 10124 , 949 - 959
http://www.thelancet.com/journals/lance ... 40-6736(18)30309-X/fulltext
"Self-monitoring, with or without telemonitoring, when used by general practitioners to titrate antihypertensive medication in individuals with poorly controlled blood pressure, leads to significantly lower blood pressure than titration guided by clinic readings. With most general practitioners and many patients using self-monitoring, it could become the cornerstone of hypertension management in primary care."
And, how to get an accurate BP
• Go the bathroom first.
• Don't drink a caffeinated beverage or smoke during the 60 minutes before the test.
• Sit quietly for five minutes before the test begins.
• During the measurement, sit in a chair with your feet on the floor and keep your legs uncrossed, and your back supported. Keep your arm supported so your elbow is at about heart level.
• The inflatable part of the cuff should completely cover at least 80% of your upper arm, and the cuff should be placed on bare skin, not over a shirt.
• Pull up your sleeve so that the cuff goes around your bare arm. Rest your arm on a table so that the cuff is at heart level.
• Don't talk during the measurement.
• Have your blood pressure measured twice, with a brief break in between. If the readings are different by 5 points or more, have it done a third time.
In Health
Jeff
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