Why is it so important to keep blood pressure in check? | Ethan Weiss & Peter Attia
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- Опубліковано 9 чер 2023
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Watch the full episode: • 247 ‒ Preventing cardi...
This clip is from episode #247 of The Drive - Preventing cardiovascular disease: the latest in diagnostic imaging, blood pressure, metabolic health, and more
In this episode, Peter is joined by Ethan Weiss, M.D., a preventative cardiologist at UCSF, an entrepreneur-in-residence at Third Rock Ventures, where he is working on a project related to cardiometabolic disease, and a previous guest on The Drive.
In this clip, we discuss:
- The importance of blood pressure and how it stacks up with smoking, apoB, and some of the other heavy hitting risk factors
- What do we know about how much blood pressure changes in a healthy person across the course of the day?
- How the kidney can cause high blood pressure and be affected by it
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About:
The Peter Attia Drive is a deep-dive podcast focusing on maximizing longevity, and all that goes into that from physical to cognitive to emotional health. With over 60 million episodes downloaded, it features topics including exercise, nutritional biochemistry, cardiovascular disease, Alzheimer’s disease, cancer, mental health, and much more.
Peter Attia is the founder of Early Medical, a medical practice that applies the principles of Medicine 3.0 to patients with the goal of lengthening their lifespan and simultaneously improving their healthspan.
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keep your blood pressure in check. I had a beautiful mother, that had high blood pressure and it destroyed her kidneys. I want to make sure people know, this is a horrible disease. I miss my mother so much, she was the greatest mom.
my grandmother had high blood pressure from her late 20's and took medication her whole life. She died at 96. the big thing is 1. know your BP, 2. manage it with diet and exercise if you can. 3. manage it with medication if you can't. Then you just manage that. Same as managing diabetes. Healthy lifestyle first, medication second but do both if necessary
I like the short videos from Peter Attia more than the long ones. They are more focused and for the non medical people more digestibe! Thanks a lot for publishing!
Question, if u correct your BP to normal, is there any healing that takes place in the arteries/blood vessels/organs over time or is the damage done to that point, whereby u r stopping progression, but not healing, per se?
Dr Fung is a nephrologist. Would love to hear you guys talk about kidney health, diabetes, fasting etc
Dr Jason Fung was on Attia's podcast The Drive in 2019, episode 59. It's excellent, highly recommended.
Yeah, I'm not sure why Attia said he hadn't done an episode on the kidney when he's had Dr Fung on at least once. But perhaps he said that because they didn't address the kidney per se, but talked about glucose, insulin and diabetes.
@@patriciahoke4722 Dr Fung could actually talk cancer with Peter after his great book on it.
I'm 66 years old my blood pressure has not changed at all. I still do strength and cardio training at high level. Varies between 100/64 to 110 /75 resting. Have checked blood pressure after intense exercise 125/80 to my highest which was when I overtrained and could feel somthing was not right 145/120 More important to me is how fast I recover after. Also if you focus on relaxing you can drop blood pressure and heart rate.
I am 66 years old and my average is 100/60. I have been physically active all my life!
@@hansschenker Same. 82 years old.
@@patrickvanmeter2922 Oh there is something to do for me! Congratulations!
I am told that there is such a thing as blood pressure that is too low. (The morbidity rate of people with low blood pressure is as bad as with people with high blood pressure.) With me, I get dizzy on standing up. Not a good thing. I'm told that this can damage the brain, heart, and other organs. And my average blood pressure is 115/70. Occasionally, it gets as low as 90/60.
@@Kermit_T_Frog Same here. I have already lived passed the average life expectancy because I don't worry about it.
Thank you for addressing this.
I have to do everything right to have 120/80. My salt has to be low, my potassium high, no processed food, all home cooked meals, I have to keep a decent weight , sauna , exercise, sleep. All have to be on point
Yes but this is normal or at least what the human species should see as normal. I am age 64 with plenty of lean muscle mass, not excessive but athletic. The past 7 days I took my stats to obtain an average which is 100/64 blood pressure and heart rate 57 bpm. Blood sugar 5.6 mll. I eat high fat low to nil carb, lots of salt and meat with eggs, butter, some raw milk. Occasional coffee in the morning. This for me has become normal with nil cravings and feel great. I can run, sprint up sand dunes, 50 push ups are normal and regular judo. My metabolic age is apparently 35 to 40 but I think that's only because most other people eat processed junk and sit down most of the day. I just allow my body to be normally healthy. It doesn't feel like any effort at all.
@@trianglejudoclub5873 What's your body fat %?
Me too. Along with one meal a day eating, daily exercise and many foods just exed off my diet. I guess that’s the point of health living. Good luck and keep up the campaign
@@creativesource3514 I don’t have the means to measure body fat. It will be low but I don’t worry about how I look. Just good health. Certainly no visceral fat.
@@trianglejudoclub5873 how do you know that you have little visceral fat without a scan such as a dexa scan? Anyway it sounds like you are doing well. Well done👍🏾
I started eating clean this February with low processed, high vegetable and kind of keto. Total difference from my fast food only lifestyle for 50 years. Question, my job making UA-cam videos is quite physical and gets me out of breath. Is this considered zone 2 exercise?
Love the topic!
Diuretic made my cholesterol go up and my blood sugar from normal 80's to just into prediabetes. Made me get up frequently at night to go the bathroom. more heart palpitations/muscle things. Made my sodium and chloride go low. Losartan made me extremely fatigued and I couldn't sleep well on it-frequent night waking. Neither BP made addressed my BP being high at dr office and during the day. (120's /80 in morning upon waking). Atenolol gave me insomina, Propanolol muscle weakness (first pill scary and did no more). Lisinopril-brain fog, fatigue, lower gi pain etc. Though it's been many years since I've tried lisinopril. Doctor mentioned trying clonidine which I read also increased blood sugar /cholesterol and not a first line drug. My primary mentioned trying bystolic but cardiologist NP said that wasn't an option? Help! I'm normal BMI and I exercise and eat very well!
Please address blood pressure where one's systolic pressure is high but diastolic pressure is normal, and vice versa. For example, mine is typically about 145/70. High systolic, very good diastolic.
My sister's is typically 120/90. Good systolic, high diastolic.
Won't meds lower the good numbers, too? Is that detrimental?
Why do some people have split pressures like this, and how is the damage to kidneys different (if it is)?
I have isolated systolic bp just like you. I’m no medical professional, but my understanding through research is that dropping diastolic too low via bp meds can damage the heart over time. I’m prescribed Telmisartan 40 mg, but I’m usually 130-140/70 or sometimes mid 60’s diastolic before my meds
@@AudricMorrison Yeah, I do not choose to treat mine with drugs. I eat grapefruit every day. Get low intensity exercise. Not much stress in my life since I retired. My diastolic only rarely hits 70 so no drugs for me.
Yes I have same issue usually 145-60/75-85. I used to take Lisinopril only 5mg, but it messed w my Potassium levels to 6 which is bad. Thought Lisinopril worked great got me to 115-135 every time .. until my lastest Potassium level blood test. .Now I am back looking for a solution to the high systolic number,,
@@don2144 damn, are you eating potassium rich foods by any chance?
@@AudricMorrison Actually no I was eating 1/3 of a banana in a smoothie no potatoes or anything. Then eliminated the 1/3 banana. That is a common negative side effect of Lisinopril is it screws up Potassium levels.
Which really sucks because 5mg was giving me almost perfect BP daily.
Omega Speedmaster….excellent choice…👍🏻
Sprint trial showed higher incidence of acute kidney injury in the intensive treatment (
67, with lifelong BMI of 19.5. Lifelong organic gardener and home cook. Physically active my whole life (horses, biking, swimming, hiking, running).
Lately I’m obsessed with seeing how my BP fluctuates. So yeah it varies, depending on how much adrenaline I’m producing because of fight or flight emotional responses. Going to a doctor or dentist sends my BP off the charts but when I’m home I’m fine.
110/70 in the morning
128/76 in the afternoon
120/80 in the evening
So IDK, I tend to be a sensitive to stress factors as I exercise, eat clean, and not overweight.
For people like me I think adaptogenic herbs are helpful as well as the centuries old standby, hawthorn extract. I also take a tiny bit of Indian snake root which has been used for centuries for BP and helping calm the mind. (Not medical advise for anyone reading this. We are all different!)
you have GREAT numbers! Why are you worried. I wish I had those!
@@selma5885 gosh, thank you! I’m somewhat obsessive so I do kind of worry 😂
Currently 67. Have some cardiovascular issues (pediatric open heart for ASD repair, electrical, ablation and pacemaker since 2009. Fortunately, HBP has not been an issue. 90/60 over most of my adult life. At my last annual physical where I had my eGFR checked. It was 70. My PC was happy and said that was great. What the heck? Great for who? Shouldn’t I be closer to 90? I’ve made lifestyle changes , lost weight, walking/rucking some. 3-4 x per week Limited sugar, carbs
I think most docs just think it’s acceptable as we get older. I think this value can fluctuate greatly if you are dehydrated or recently did intense exercise. Mine was low and just by making sure I was hydrated before the labs and not doing intense exercise it came back at >90
@@jimg6970 I don't think kidneys improve, just stopping the functional decline is the goal AFAIK.
I'm not a MD I think getting 120 or below systolic means about 80% of us are doomed
i agree
we are all doomed.
I am an MD and I agree with this commenter because natural BP is higher than historically promoted; even the WHO/Europe has elevated the normal baseline BP to 140/90. I believe there will be increasing future evidence that anti-hypertensive medications (which are grossly over-prescribed) are a contributing factor for other issues, such as renal disease and brain health (dementia).
@@Burps___ Guess Im lucky then. 42, 181 cm, 100kg, something like 28% bodyfat and have a bp around 120/75-80.
100% agree. I have been put on various different blood pressure medications and have always felt like crap when taking them. You go back in and tell them how it makes you feel and it’s always the same answer. “Oh we just have to find one that works.”🙄. Bunch of drug pushers with a license
The INTERSALT study showed that the Yanomamo, who consumed no added salt in their diet, do not have increasing blood pressure with age. They were alone in that compared to groups who had even a modicum of salt intake.
The benchmark for blood pressure reading is in your doctor's office, where you were probably rushed to get to and nervous just being there. Perfect. Trust The Science!
My Doc says they always throw out the first two measurements. Nobody told the nurse, she only takes one and is very rushed. Mine is lower at home but how to calibrate my cuff to be certain?
I'm 47 and I'm on bp meds and they did bring my bp down. However, I've fainted twice. The first time was when I got covid and the second time, recently when I had food poisoning, and I hadn't slept for two nights and was dehydrated. But passing out was really scary. Fortunately I did not hit the back of my head on the pavement. This was how my father had passed. He ended up having a massive stroke after passing out and hitting his head on concrete floor.
I only know 3 on bp meds and 2 fell, one was serious.
falls are a real issue with seniors!
What if BP is on the low spectrum. For most of my adult life my BP was 110 /70. Ever since I went through menopause my BP has been in the in the 90s over 60s range. It has dipped as low as 82 /54. I exercise regularly and add salt to my diet to elevate my BP, but to no avail. Is there any supplements that can help elevate BP in to a more normal range?
Like you, my normal BP is below 90/60 in the morning when I wake up. And, my Resting Heart Rate dips to 37-38 when I sleep. My cardiologist says it’s due to my exercise. I don’t know if it’s correct.
Curious if Peter will talk about Forxiga/Farxiga. Apparently, it is a game changer for protecting the kidneys.
If that's an SGLT2 med, then he has.
Probably not good if your kidneys' if GFR is under 60. I'm thinking there's a mechanism of action I don't want even if it's >60.
"Prescribing SGLT2 inhibitors should be restricted if the patient has a history of type 1 DM, ketosisprone T2DM, and in those with a glomerular filtration rate of < 60 mL/min."
Risk v Benefit of SGLT2 Inhibitors
www.ncbi.nlm.nih.gov/pmc/articles/PMC6368009/#:~:text=Prescribing%20SGLT2%20inhibitors%20should%20be,of%20%3C%2060%20mL%2Fmin.
Europe standard does not treat until greater than 140/90-- risks of medication out weighing benefits?
Loving the videos
I'm currently taking 10mg of Lisinopril, but my BP is still too high. It was 159/107 first thing this morning!
Reduce your carbs intake.
@@robert111k agreed
@@robert111k that’s just it, I’m about 80% Carnivore.
Research hibiscus tea effect on BP.
@Mat Wolk dude, for real. I have an arm cuff and have been checking it first thing in the morning since April. I had an EKG about a week ago and he said everything looked fine. But it does run in the family on my mother’s side.
I have an Aktiia 24/7 BP monitor. It's a digital bracelet that requires calibration to cuff once a month. I find it great but I'm wondering if anyone else here has tried it and what they think of it?
Looks interesting but it's not available in my country.
It’s the MAP ( Mean Arterial Pressure) that is most accurate measurement.
And seeing a short period of severe Hypotension can cause severe damage to Kidneys.
The guest is great but a little muffled sound over the microphone
What about if my wifes pressure is like 98/55? Its her standard... how to get it up?
Love how the expert dodges the question of what is the variability of blood pressure throughout a day during a variety of activities. You also forgot / failed to address differences between systolic and diastolic pressures. The more I study the topic of blood pressure, the more I see that too little is actually known and too many have an opinion unsupported by objective data. What is the basis for 120/80? Why not 125/75? The analogy of sarcopenia during aging is poorly applied. While it is true that we needn’t accept sarcopenia, there is some measure of muscle mass that accompanies age. With blood pressure, it is not unreasonable that some measure of rise with age is normal and not pathological.
I completely agree, they simply don’t understand blood pressure at all.
So all these half truths they give might as well be lies in terms of effectiveness.
I think they should first admit that they have so low understanding of this topic and anything they say is just conjecture because that’s basically where this science is at this point in my view.
How do you keep BP in check when you can't tolerate the medications and they also don't really address the issue /help but still high-and cant tolerate 1 medication versus additional? Always exercised--normal BMI-- high plant based mediterranean diet, no dairy. Little to no added salt.
my gfr is 73 but I am only in my early 30s. Can it be reversed or is the damage permanent? I don't drink. but eat a lot of red meat and don't drink that much water and have been mostly a couch potato for the last 2 years. Are my nephrons fried or if I start exercising and drinking more water and cutting down my protein load can it reverse the damage?
In all likelyhood, that is your estimated GFR. I just went thru this earlier this year. My e gfr was 47, stage 3 chronic kidney disease. I got referred to a nephrologist. Here is the individual circumstances that made my estimation far lower than it truly is. I am tallish, at 6' 1.5". Like BMI, the calculation for e GFR squares the height. Most labs use an assumption of 5' 8". That makes a difference. If you eat a lot of meat, that raises your creatinine levels, which is the marker that the use to estimate kidney function. If you are a weightlifter, as I am, that raises your creatinine levels. I did a 24 hour creatinine clearance test and my measured GFR came back at 97. So, at 72 years of age, I quit worrying about my kidney function.
Also, I learned that the e GFR becomes less precise at levels above 60.
My levels have been in the 70’s and went back to >90. As the other person mentioned lifting weights can impact labs. I know refrain from heavy lifting 48 hours before labs and make sure I’m hydrated
Blood pressure medications raise blood sugar and cholesterol--many of them --than what and thus far I can't find one I tolerate.....I'm stuck. My diet is high plant based/organic /mediterranean/no dairy. I exercise daily walk 2 mile hilly walk and do yoga and some strengthening exercises. Also have osteporosis -just diagnosed at age 61. Also have fibro, neurologial symptoms/chronicillness issues but managing it best I can for 30 years.
It is quite uninteresting when they start flexing who they worked with and where, specially for us laymen outside their industry and even on other countries like me. Thanks for the video!
This in my opinion is unattainable for most people. Even people who have perfect numbers while resting for 5 minutes before and in between each measurement with no stimulus, will not have this crazy optimal 120/80 when they are moving around and being stressed out on and off throughout the day of their lives, especially when working out.
Peter asks that exact question in the interview. We don't know what BP is like throughout the day and we won't find out until we have a continuous BP monitor that we can easily wear.
I am 66 years old and have an average of 100/60! I have been physically active all my life!
It’s normal for blood pressure to go up under intense exercise or stress. If you are 120/80 at rest your body can handle this. If you’re starting out with high blood pressure while resting and no stress that is when you have issues
@@Greg_Chock They exist.
0:31 bodybuilding podcasters do, because kidney health might be a problem with all that protein and exogenous hormone consumption.
I’m eating 1000 grams of protein and on 10 grams of hormones and I’m 96 years old and feel great !! I’m not sure what your saying ??
@@nickdipietro7797 I don't know how you manage. But what I said was "might be a problem". Not it is a problem. In fact, there are some studies that chronically low T might be detrimental to the kidneys.
@@nickdipietro7797 Btw how do manage 1000 grams of protein per day? Brain Shaw eats less then 700.
i really wonder why my right arms systolic value is 10 points higher 😂
Peripheral narrowing?
Coarctation of aorta?
if have a heart attack left arm goes numb. whys that?
@@nikitaw1982 shouldn't go numb lol
@@creativesource3514 yeah when you google your symptoms and go with the worst
Cannot understand Ethan, bad mic.
What?
you just don't get it....maybe hang out with old women in okinawa..they aren't getting surgery for overusing their shoulders.
🩵
Every time Ethan speaks, the first part of sentence is clear but the second half is just mumbling. So hard to follow him.
This guess was not very confident on his statements.
I wish the guy would have answered the question. Irritating.