← The Peter Attia Drive
<p><a href="https://peterattiamd.com/ama48/?utm_source=podcast-feed&utm_medium=referral&utm_campaign=%20230612-pod-ama48&utm_content=230612-pod-ama48-podfeed"> View the Show Notes Page for This Episode</a></p> <p><a href="https://peterattiamd.com/subscribe/?utm_source=podcast-feed&utm_medium=referral&utm_campaign=230612-pod-ama48&utm_content=230612-pod-ama48-podfeed"> Become a Member to Receive Exclusive Content</a></p> <p><a href="https://peterattiamd.com/newsletter/?utm_source=podcast-feed&utm_medium=referral&utm_campaign=230612-pod-ama48&utm_content=230612-pod-ama48-podfeed"> Sign Up to Receive Peter's Weekly Newsletter</a></p> <p>In this "Ask Me Anything" (AMA) episode, Peter delves into the critical subject of blood pressure, which is one of the three primary causes of atherosclerosis, along with high apoB and smoking. He begins by unraveling the nature of high blood pressure, its prevalence, and why it often goes undiagnosed. Peter describes in detail the proper way to accurately measure blood pressure and what determines a diagnosis. Next, Peter discusses the actionable steps one can take in response to high blood pressure, shedding light on the extent to which factors like weight loss, exercise, and nutrition can make an impact. He also explores the pharmacological options available and offers valuable insights on how to approach them.</p> <p>If you're not a subscriber and are listening on a podcast player, you'll only be able to hear a preview of the AMA. If you're a subscriber, you can now listen to this full episode on your <a href="https://peterattiamd.com/members/private-podcast-feed/?utm_source=podcast-feed&utm_medium=referral&utm_campaign=230612-pod-ama48&utm_content=230612-pod-ama48-podfeed">private RSS feed </a>or our website at the <a href="http://peterattiamd.com/ama48/?utm_source=podcast-feed&utm_medium=referral&utm_campaign=230612-pod-ama48&utm_content=230612-pod-ama48-podfeed">AMA #48 show notes page</a>. If you are not a subscriber, you can learn more about the subscriber benefits <a href="https://peterattiamd.com/subscribe/?utm_source=podcast-feed&utm_medium=referral&utm_campaign=230612-pod-ama47&utm_content=230612-pod-ama48-podfeed">here</a>.</p> <p><strong>We discuss:</strong></p> <ul type="disc"> <li>Blood pressure and other risk factors for cardiovascular disease [2:30];</li> <li>Defining blood pressure and the purpose and meaning of a blood pressure measurement [5:45];</li> <li>The implications of high blood pressure and the importance of maintaining an optimal level [10:30];</li> <li>The importance of accurate measurements of blood pressure and how Peter approaches the care of patients at the very top range of "normal" [21:45];</li> <li>The prevalence of high blood pressure—a hidden epidemic? [24:30];</li> <li>The consequences of high blood pressure on cardiovascular health, brain health, kidneys, and more [27:45];</li> <li>Low blood pressure: symptoms and consequences [35:30];</li> <li>How to properly measure blood pressure [37:45];</li> <li>Daily variance in blood pressure and the transient changes in blood pressure during exercise [48:00];</li> <li>Primary hypertension vs. secondary hypertension: what to look for [51:45];</li> <li>Lifestyle factors impacting blood pressure: weight loss, exercise, and sodium [57:45];</li> <li>Impact of insulin resistance and type 2 diabetes on blood pressure [1:04:45];</li> <li>How sleep impacts blood pressure [1:06:45];</li> <li>Pharmacologic options for managing blood pressure [1:08:00]; and</li> <li>More.</li> </ul> <p>Connect With Peter on <a href="https://twitter.com/PeterAttiaMD">Twitter</a>, <a href="https://www.instagram.com/peterattiamd/">Instagram</a>, <a href="https://www.facebook.com/peterattiamd/">Facebook</a> and <a href="https://www.youtube.com/channel/UC8kGsMa0LygSX9nkBcBH1Sg">YouTube</a></p>
Actionable Insights
1. Target Optimal Blood Pressure
Aim for a normal blood pressure, defined as systolic below 120 mmHg and diastolic below 80 mmHg, as aggressive management to this target has shown significant reductions in cardiovascular and all-cause mortality.
2. Address Elevated Blood Pressure
If your blood pressure is elevated, it is non-negotiable to address it due to its significant impact on cardiovascular disease and dementia risk.
3. Measure Blood Pressure at Home
Obtain a blood pressure cuff (automated or manual) and learn to measure your blood pressure at home to gain an accurate understanding, as doctor’s office readings may not be precise.
4. Accurate Blood Pressure Protocol
To ensure accurate blood pressure readings, sit for five minutes without talking or activity, with your back supported and legs uncrossed. Then, take three readings five minutes apart using a properly sized automated cuff and average the results.
5. Avoid Smoking Completely
Do not smoke, as it causes a chemical disruption to the endothelium, which is a primary risk factor for blood vessel diseases like ASCVD and cerebrovascular disease.