I used to work in a doctor's office - pediatrics. I would see my family practitioner right next door, and my BP was invariably high. He would just say "go back to Peds, and have one of your colleagues check it". It was always normal. White coat syndrome, certainly, but only for white coats that treated adults, not children :-)
Gaining weight caused it to go up over time, losing weight has brought it down again

I have disregarded the PB numbers for years.....way too high IMO. If my bottom number hits 80 my doc says nothing. BUUUUTTTT I know I have not been following LC for too long. Back on LC, and I can drop my BP numbers in days......NO MEDS!!!

Modern medicine is still behind the times.

Reading Dr Kendrick on changing the BG numbers to diagnose diabetes. Apply same for BP.

My blood pressure and blood sugar were edging up before I went low carb. Now, the PA is amazed at how "perfect" both are.

Which is sad, really, that I'm so rare.

I agree, it makes no sense to change a BP reading when the underlying problem is still there.

I’m another one who gets super high readings at the doctor’s office! Really high, although decent at home. A former doctor wouldn’t believe me so she did have me wear one of those 24-hours monitors. As she said “sure enough, your BP was through the roof here when we put the monitor on. Twenty minutes after you left it had dropped a lot. Forty minutes after you left it was normal, ( remained normal the next 24 hours despite traffic jams and emergencies at work), then twenty minutes before you were due back here it began to rise, and by the time you got back here it was through the roof again”.

I was also thinking about Welch’s book when I heard of this new guideline. Anyone remember when the guideline for the top number was your age+100? Were there really tons more strokes and heart attacks then?

I’m 65 now! Hah, that would work for me even at the doctor’s office sometimes! Alas being older my BP is a bit higher, and goes up sooner when I’m seeing a doctor, and takes longer to come back down afterwards.

Several times in the last few years I’ve had to fill out health questionnaires and never know how to answer the “do you have high blood pressure” question. How do you answer when it’s normal 95% of the time but high 5% of the time, and the high is always when a medical professional is taking it!

Debbie, with those 24-hr test results, I'd say "normal".

It makes you wonder how many people with normal readings at the doctor's office are really suffering from too-low blood pressure.

Here is my experience:
In my 30's my job required a commercial drivers license. That required a DOT physical once a year. The physical consisted of turn your had and cough, and a BP reading. Mine was always higher than allowed, so they would have me sit in the exam room for about 20 minutes and recheck. I always passed, but just under the wire.
In my 40's, I was getting dizzy, and very fatigued so after about a week of that, I went to an ER clinic. My top BP reading was over 200, so they gave me a prescription and told me to get a doctor to manage it.
In my 50's, I had a few instances when getting out of bed to use the bathroom caused me to pass out. The doctor did not find anything wrong, and theorized it could be caused by a drop in BP. He reduced my BP medicine.
In my 60's, after losing weight, I was getting dizzy while painting my hallway. I used a home BP machine and found my BP to be 89/64 with a pulse of 107. I contacted my doctor who told me to stop taking the BP medicine. I haven't taken medicine for about 6 months now, and always get a good BP reading.
The point, at least for me, is that checking BP once or twice a year at the doctors office is not really representative. Home testing is not very expensive, and is probably a good idea if you have any doubts.

Oh, wow, half is really bad. But waitagoddamnminnit, 1/3 is not bad? I mean, if I believe the stats and if I believe the implications of HPB, this means there's 100,000,000 people in the US on the brink of keeling over dead splat. Didn't happen over night that HPB thing, but no massive increase in funerals yet, must be a luck thing. I put a fiver on next Thursday, 'bout 6:30pm. Takers?

/Sarcasm off

But seriously, to what end should the numbers be adjusted? More drugs? OK, but why. More money? That's petty, but quite revealing. Means those drugs don't work for HPB, only for mo money. Let's take the high road. Maybe it's gonna work as a sort of incentive to take the drugs - or just more drugs - so that we take care of the existing 1/3 (cuz we failed, yet), never mind the remainder to make up that half. But then, if that's the plan, it implies that drugs must work, but that 1/3, their BP is still too high, that's why they in the 1/3, yet, so the drugs don't in fact work, back to petty.

I just see no other purpose or implication. On the other hand, personally, when I went LC initially, my BP dropped to 90/60. And, later, in spite of being sick for several years, BP went up to 110/80. Let's see:

Based on my experience, "normal" means being sick for several years. I prefer an abnormal 90/60, and healthy, and strong, and, and, and everything else that was abnormally good about it all.

I'm not saying a bunch of corporate types sat down at a big mahogany table with Dr. Evil at the head of it and decided to degrade our food supply and make us sick, while coming up with dangerous drugs to treat us, and make money at both ends.

It wasn't planned.

But it sure did turn out that way. Because their ultimate goal is to medicate every being on Earth, right up to the eyebrows.

To be fair, the several articles I read mentioned lifestyle changes to address this; and even mentioned that if necessary, bp meds are mostly off patent now and quite inexpensive (if that's true).

A friend and I used to walk our dogs together and when I moved away she had to go back on her bp med because left to her own devices, she walked slower and less far.

If these new guidelines get people exercising it could benefit their health in general.

https://www.sciencedaily.com/releas...71122131412.htm

Fun related study on the diet front. In the past, the Dash diet has been shown to be mildly effective in reducing blood pressure, from what I can remember looking at earlier studies, usually by around 4 points, just around the minimum needed to motivate a doctor to write you a prescription, but not enough to motivate a person to alter their whole diet and lifestyle. Ho-hum. The latest study gets a bigger benefit.

People were put on a "control" diet or the dash diet, with low, medium, or "high" salt intake. Highest salt intake was one and a half teaspoons, that explains the quotes around "high." I put quotes around "control" because while use of a control is laudable--if you have a control diet that increases blood pressure, you can get a greater reduction in blood pressure with your intervention than you'd get if you compared it to the patient's baseline. The control was the average American intake for macro and micro nutrition. "Macronutition" matching to average intake especially is problematic, because it depends on how you went about determining average American intake, this could very easily turn into an overfeeding control intake and an underfeeding Dash diet intervention. An intervention where people are given their food daily, with emphasis on whole grains, lowered meat and animal fat, and fruits and vegetables, and the proscribed portions are less than people'd eat of these foods ad libitum is going to have a different result than just sending people home with the advice to do these things. It doesn't matter if what you suggest is effective if it's highly unlikely that people will follow your advice.

Big Potato strikes again.

Yeah, it turned out that way. Not saying that's the goal, but there's a fine line between evil and keepmyjobism. Consider the real risk of low BP - faint, fall, injury, death. With other substances, like heroine for example, we'd call this an overdose. Don't know how it progressed elsewhere, but here we used to blame the user, now we know it's due to an inconsistent, unknown, unreliable dose. The user would get what he always gets, believe this amount is safe, but in fact it's 10-100x his usual dose, a fatal dose - overdose, death. Obviously, that's bad business, so there's a sort of rule to ensure a consistent dose to keep customers alive, so they keep coming back, so the profit keeps coming in, everybody happy, in spite of being an illegal substance for the most part. There's also the aspect of transmitted diseases, so here in Montreal we got several services, like free syringes and sterile water, free condoms, etc, all provided by non-professional volunteers - i.e. not doctors - people like you and me. In contrast, the real risk of low BP is handled - sometimes poorly - by genuine medical docs with a decade of higher education.

It's got nothing to do with evil, it's a sort of atmosphere that surrounds the whole thing. Maybe "do no harm" acts as a license to do exactly that, in a twisted way, interpreting it instead as "I can't do harm". Conversely, "profit first" ensures that customers stay alive, and considering the real risks of those substances, relatively safe otherwise.

In this case, recommendations for BP numbers are lowered, maybe with good intentions, maybe as if it could do no harm, but still with keepmyjobism in the background. Now put profit first. Suddenly, the real risk of low BP gets in your face. When a customer faints, falls, and dies, it's bad business. The dealer - doctor - ensures that he does not sell - prescribe - BP meds to this customer - patient - when this risk is acknowledged first, but most importantly when it's established for this specific customer, i.e. when there's no actual high BP cuz of white coat syndrome for example. Think of all the various interventions for high BP, now think of it as a single substance, like heroine is a single substance where we consider only the dose. So here, BP meds - as opposed to a few minutes of meditation for example - would be highest and most dangerous dose, with easy risk of overdose. White coat syndrome and the like, that's the factor that makes the dose inconsistent, unknown and unreliable, likely to result in overdose.

Yes, if there was even a whisper of "White coat syndrome" in all this, with guidelines about how to determine if someone's BP really was chronically elevated, or acknowledging the problem, I would feel a bit more confident. Most people don't know enough to request the 24 hour monitoring, or understand its importance, or insist on anything with their doctor.

I remember when I became enlightened about all the harm of statins, and started talking about it... and it was like I had suddenly grown an alien head I was using to mention it.

Some people practically bugged their eyes out of their head at the mere suggestion that this "life saving drug" was actually a death-dealing one. The concept of pharma overreach was so alien to them.

Kudos to Aaron Carroll at the NYT for calling out the new changed BP guidelines leading to over treatment.



https://www.nytimes.com/2017/12/18/...ad-to-harm.html