So, here’s a thing then

Some years back told to start taking pills for high blood pressure. Hmm, OK.

More recently, thinking that things aren’t quite right. Excessive sleeping – 10 hours a night and a 90 minute siesta?

Also, drinking well down, weight off (few stone, and it has stayed off for years) and exercising properly. Not gym bunny but 20 to 40 km on a bike two, three times a week, or swim a mile same number of times. No, not all weeks but often enough still that none are a strain, they’re an enjoyment.

So, off to the Doc for the usual middle age tests, PSA, diabeetus and so on. Ask Doc, well, blood pressure? Test while on pills, perfect.

Come off for a week. Bounces up a bit, as is expected. But only to “pre-high blood pressure” on rebound.

And today? Below (admittedly, without coffee or cigarette/vape today at all) being on the pills (110/70).

So, don’t take them any more.

How likely is this that weight and exercise actually cure this?

35 comments on “So, here’s a thing then

  1. It’s not so much that you have “cured” HBP, rather that you might have less stuff causing it. Booze, fags, stress, Radio4… they are all contributory factors.

    My BP is all over the place, but ramipril has brought it under control. The slightest bit of stress causes it to rocket, though. And I REALLY feel the cold nowadays since I’ve re-started taking it.

  2. The only odd bit to me of that story is that – with no change in condition / fitness / weight – BP on the pills is actually higher than not being on the pills, ie the pills are not neutral but increasing it? Maybe that’s more of a one-off than “normal”?

    Otherwise what Rob said. And don’t the medics specifically also add the ciggies into that?

  3. Excess weight is a factor contributiong to high blood pressure and *regular* and *moderate* exercise will strengthen/restore the heart muscle and improve the circulatory system.
    So the answer is a vague “quite likely”. Any non-vague answer should come from a specialist doctor who understands your personal physique.

  4. Some people have HBP or LBP because of their genes. A friend of mine exercises regularly, drinks little, doesn’t smoke, eats well and is slimmer than I am, yet he is on HBP medication. I am two stones overweight, eat well, take two long country walks a week, don’t smoke, drink half a bottle of claret nearly every night, and I have the BP of “an Olympic athlete”, to quote my GP.

    Reducing weight and increasing exercise can reduce HBP, but not in all cases. Similarly, evidence is emerging that a few weeks of a starvation diet can cure type 2 diabetes – in some people.

  5. The oddest part of the story is that a doctor actually thought to check your blood pressure. In the UK you’d be told to go away for a few weeks and see if you feel any better.

  6. Yes – but do either of them realise what reading Tuber Times assiduously can do to your health? Do they know that you self harm in this way?

  7. My quack upped my Ramipril dose recently and I started feeling a bit light headed on occasion so I took my BP after my afternoon walk and it was at 105/55 which to me seemed too low. Then when I took it after a couple of glasses of wine and a G&T of an evening it was 90/50.

    I think part of the problem is I’ve been taking a magnesium supplement for other issues* and I recently read that Mg can lower BP. I shall try to convince the quack to put me back on a lower dose of Ramipril or maybe give it up altogether.

    * A daily Mg supplement really helps me sleep, (and get back to sleep after I wake up in the night for a pee), reduces the number of leg and foot cramps I get in bed and keeps me regular, so I don’t want to give that up.

  8. I used to enquire on medical blogs for a pointer to some compelling evidence of high BP (say 145/summat) being a shortener of life. I’ve pretty much given up because I never once got a satisfactory answer.

    It’s almost as if doctors know something to be true because other doctors know it to be true: what the evidence might be is unknown to them.

  9. KevinB
    My ma-in-law took Mg every night for the same reasons, said it solved all her sleep/cramp troubles. Also quinine sulphate, but we couldn’t get it in Austria.

    Docs and hosps in the Uk take BP at every conceivable opportunity. At least down my way. I think the idea of ramipril is to keep the BP at a constant level.

  10. Is it true that in Germany they also view *low* BP as a risk and will give pills for levels the UK views as healthy?

  11. ‘How likely is this that weight and exercise actually cure this?’

    Very. Sorta.

    I am a gym rat. Well, exercise freak.

    10 years ago, I broke a leg in a motorcycle accident. Zero exercise for a few months. Diabetes smacked me. My father had it; my older brothers have it. I got off sugar and processed carbs, and the symptoms went away. Since the leg healed, I have stayed off them, anyway.

    I have latent diabetes. It is not ‘cured.’ It’s still there, I’m sure, even though I have no symptoms, just like someone who doesn’t have it.

  12. I did read a comment on a blog somewhere talking about a study done on the effect of ACE inhibitors such as Ramipril which suggested that while these drugs did lower the incidence of heart attacks and strokes on people who had already had a similar attack, when looked at for all cause mortality the drugs made very little difference.

    It was a second- or third-hand account on the internet so take it for what it’s worth.

  13. GP’s in the UK are very aggressively targeting high blood pressure. I got put on calcium antagonists, diuretics, and ACE inhibitors. I felt like shit. Stopped taking them all, and feel much better. What’s the point of living years longer if you feel rubbish while you do. Blood pressure is one of those things where the goal posts have been moved over the years. My current levels are considered high, whereas a few decades ago they’d have been considered normal for a man my age. I think it was the diuretics which made me feel so rubbish. But I decided I don’t like being medicalised, and stopped them all. If pressed I might take the others, but NEVER diuretics again.

  14. Ian Reid, same here but for statins and cholesterol.

    My first knowledge of my cholesterol came in the Air Force in 1971. I was told it was 220, which was fine. At the high end, but fine. Two years later in a company physical, I was told it was 220, which was high (!). 200 was the new standard.

    FF> some 30+ years, and my doc decided to put me on statins. Worked okay for a few years – readings below 200 – but then side effects swamped me. Doc changed me to pravastatin. Which was okay for a few years, then the side effects from that became onerous. Doc cut my prescription in half, as he is more concerned that I take some than the number (about 240 now). Today I manage my intake from zero to half to full dose (that’s actually half) depending on the state of my side effects. Doctor is fully aware that I’m managing the balance between intake and side effects.

    He convinced me that statins have a beneficial effect, independent of managing cholesterol levels, so I do take it. Some days.

  15. “110/70”

    Congratulations!

    BP is never measured properly so aside from the to be expected variation, your numbers will almost always be wrong. 5 minutes supine is the standard, with a mercury sphygh and stethoscope by someone who knows how to use it. The electronic ones are less accurate.

    You can see why they do it though. GP clinics don’t have spacetime for you to lie down for 5 minutes. A top-20 pharma company trashed an entire multinational Phase 3 trial by not calibrating their BP measuring equipment and procedure cross-site a few years back, and this was one with tons of experience in the area. By the time they realised, it was too late to go back and fix it.

    “Is it true that in Germany they also view *low* BP as a risk…”

    Yes, but regrettably no one will advise you to take up smoking and eat burgers every day.

    “I did read a comment on a blog somewhere talking about a study done on the effect of ACE inhibitors such as Ramipril which suggested that while these drugs did lower the incidence of heart attacks and strokes on people who had already had a similar attack, when looked at for all cause mortality the drugs made very little difference.”

    BP meds don’t measurably affect all-cause mortality because no one looks at that in individual trials. You have otherwise healthy people at risk of some things that aren’t usually fatal (but are usually disabling), so change in blood pressure is taken as the endpoint, as it’s established as “a good thing” to cut BP regardless of clinical outcome and the size/duration of trial needed to show something on the real clinical endpoint (disability rather than death) is not feasible.

    “What’s the point of living years longer if you feel rubbish while you do.”

    If your personal side-effect profile isn’t worth the benefit then stop taking the drugs (as you did). An incorrigible fault of clinical research is it looks at (highly selected) populations, and variance in individual mileage gets averaged out in that. Your doc will make a decision based on the average that might not work for you.

  16. 20 years ago I had problems with angina, high-blood pressure and cholesterol. They ran an angiogram and decided it was a lifestyle thing. Advice was we can treat your problem with drugs but your body won’t be worth shit in a few years’ time, or you can shape up and behave yourself. Lost 50lbs and became a little more circumspect about my day to day activities, for a while…decided you’ve only one shot at the title. I’m not a total prat, however, and try to limit indulgences. Keeping the weight off has been more beneficial than statins et al, and the benefits of moderate exercise – my joints are too far gone for running anywhere far – are not to be underestimated. The woodpile thingy is stress. It’s effects outweigh most everything, in that it amplifies everything. As I was in a competitive industry I decided to give the job a break for a year or so – take a breather. 17 years later I’m still taking a breather. But then I am a fortunate individual; most people can’t do this and are obliged to suck it up, to crash and burn. For all too many, life is hard and then you die.

  17. Some years ago, I went into hospital outpatients for an appointment. A rather attractive young doctorette examined me ( not intimately, I hasten to add, but she all but climbed on top of me ). She took my BP and it was like Sid James’ in Carry on Doctor, kaboom. She prescribed some mega-strength drugs as a matter of urgency, I was too polite to explain the …err.. problem, took them for a few days, felt really ill and threw them away. Next time I went, some big African geezer saw me and my BP was ultra normal again…

  18. “He convinced me that statins have a beneficial effect, independent of managing cholesterol levels,” It turns out that there are drugs that do lower cholesterol substantially without having any beneficial effect on CVD. So the cholesterol doctrine is false, as many people suspected all along on quite different arguments.

    Among the nasty side effects of statins is the tendency to make you more likely to get Type II diabetes.

  19. Weight loss and exercise are likely helpful. I weighed 18 stone 6 years ago with BP 160/ 140. Even though I was in my late 40’s, the Doc never suggested medication, just that I needed to lose weight. I went on a diet and lost 3 1/2 stone and started lifting weights 3 times a week with 30 mins of exercise bike thrown in. BP now 120/80 and feel so much better. I don’t smoke and only drink a couple of pints at weekends.

  20. GD;
    “Is it true that in Germany they also view *low* BP as a risk and will give pills for levels the UK views as healthy?”

    Yes. Or least it was 20 years ago, when my GP, on measuring my BP said “Blimey, if we were in Germany, I’d be calling an ambulance right now.”

    Which was reassuring.

    The German in the office later that day basically confirmed it, she’d been treated for it just a year previous.

    Anyway, Tim – have you had more than one measurement – different DoW, ToD? BP can vary really quite a lot “naturally”, and they like to get a few measurements, even give you a portable monitor for a couple of weeks, these days.

  21. Not wishing to be preachy, but I’d recommend checking out the long-term health benefits of a ketogenic diet. Plenty of good stuff on Youtube.

    Essentially all modern conditions and diseases are promoted by the high-carb, low-fat diet which the medical profession has been pushing for the past few decades. Many stem from the insulin response to carbs, but many also result from an inflammatory response to those unsaturated vegetable oils we’re supposed to consume and cook with, since they readily oxidise. The results – beyond the obvious obesity and diabetes II – include the cancers, heart disease and dementia which are become rampant over the same period.

    Whilst on Youtube, take a minute also to check out the evidence for the widespread prevalence and serious health implications of vitamin D deficiency amongst those not living in equatorial latitudes. It has been said that if vitamin D supplements were a new drug it’d be hailed as a wonder drug, such are the benefits. People should be taking vitamin D, not statins (remember, doctors have been equally wrong about cholesterol all these years): specifically, vitamin D3 together with K2. High blood pressure is one of the conditions it can alleviate. Also Coenzyme Q10 (Coq10) – the most effective form being Ubiquinol – can address high blood pressure (and should be investigated by those who insist on taking statins.) Mileage various, obviously, as there are different causes of high blood pressure.

    Such an approach – nutrition and supplements – might sound like hippie free-love utopianism, yet the consequences for health and longevity are profound. Pills from doctors should generally only be used for short-term emergencies. Remember, these are the guys whose response to insulin resistance is injections of more insulin; and who are still pushing the diet which is crippling and killing people by the tens of millions, and bankrupting healthcare systems globally.

  22. Re Vitamin D

    I spend a fair bit outdoors, especially in summer but even in winter I was playing golf 2 or 3 times a week, running around 4 miles or going out on the bike for an hour 3 to 4 times a week as well as othe outside stuff like a bit of gardening. About this time last year I was really suffering when running or biking as my feet felt like blocks of ice, even when it was mild so I went to see the Doc.

    As part of the tests they measured my Vitamin D and it was so low they put me on a massive dose for a month and I now take the maximum strength supplement. I don’t feel any different, but who knows and much as I don’t like taking pills regularly I can’t see a supplement being a problem.

    At the same time he also did a 24 hour BP measurement as I’ve always been on the high side, even when a fit you squaddie. I’m still on the high side, even though my resting rate is ~53bpm, but I refused to go on Statins, which my Dr agreed with even though the advice if for someone my age to take them.

    I had really bad gout and was prescribed Alluprinol for life. That spurred me in to losing 15kg and now I’m off it and no gout.

  23. “the cancers, heart disease and dementia which are become rampant over the same period”: plain wrong, I think. Any increase in cancers and dementia will presumably be due simply to an ageing population: you gotta die of something.

    Age-corrected deaths from cardiovascular disease have tumbled since about 1970 in a way consistent with its being an infectious disease (though nobody knows what the infective microorganism might be), presumably with some extra help from the decline in smoking cigarettes.

  24. Sorry, wat dabney, I don’t accept the Magic Food™ bullshit.

    Replacing the low fat bullshit with low carb bullshit gets you nowhere.

  25. DiD

    — ” I don’t feel any different [on vitamin D supplements] but who knows…”

    Yes, it’s very much a prophylactic. Check out the requirement to take K2 at the same time to avoid problems.

    dearieme

    — “Age-corrected deaths from cardiovascular disease have tumbled since about 1970”

    The significant statistic here is not the death rate from heart disease – which is amenable to improved medical intervention – but rather the rate at which people contract it in the first place.

    “Despite the falling death rates, the number of people suffering from cardiovascular diseases is rising. Risk factors such as obesity, high blood pressure and unhealthy diets remain high, experts say. In the U.S., 82.6 million people are living with cardiovascular diseases, including the after-effects of heart attacks and strokes. Globally, heart disease and stroke remain the leading causes of death, with deaths projected to rise.”
    https://news.heart.org/heart-disease-death-rate-continues-to-drop/

    Gamecock

    — “Replacing the low fat bullshit with low carb bullshit gets you nowhere.”

    Just because one claim was a lie it clearly doesn’t follow that another automatically is. The low fat claim was false right since Ancel Keys first fabricated his infamous chart purporting to show a correlation between saturated fat and heart disease. By contrast your body’s insulin response to carbs, for example, is an undeniable fact.
    Given what’s at stake, I think you owe it to yourself to spend a couple of hours checking out the science. Searching Youtube for ‘ketofest 2017’, for example, will return some interesting presentations.

  26. Measured it each day over the week. Small rebound up first couple of days off the pills (top was 145 over 90, after coffee, ciggies and only 3 hours sleep). Settles down to 130 ish to 110 ish dependent upon coffee and nicotine. Results of course shown to Doc.

  27. Weight loss is best way to lower blood pressure: it also means you’re more likely to be measured with an appropriate size cuff giving a more accurate reading. I can’t help thinking, the way treatment guidelines have changed, that big pharma has published recommendations for aggressive treatment on very slender evidence. I have recently been in an ambulance with a head injury, a broken shoulder and a bp over 200 systolic to the consternation of the paramedic so I would add avoid head injuries, severe pain and stress as this is how the body’s defences work.

  28. @BiND

    I had really bad gout and was prescribed Alluprinol for life. That spurred me in to losing 15kg and now I’m off it and no gout.

    Most gout is familial (unless you have a lifestyle like the Prince Regent) – there’s a defective gene that reduces the bodies ability to eliminate uric acid. My maternal grandfather was a sufferer and he was thin as a whippet and spent his life as a riveter in the Hartlepool shipyards (when there was work), grouse and port did not feature heavily in his diet. I have it too and so does my little brother – I’ve been taking allopurinol, while he manages his diet, but that may leave him with elevated uric acid levels that are asymptomatic but may still be less than ideal.

    Allopurinol is one of the safest drugs around – there are millions who’ve been taking it for decades with no ill effects.

  29. I’ve tracked mine pretty well, and ended up unable to keep it down without medication.

    But I found something interesting. The only exercise that I did that seemed to be associated with lowering my blood pressure for a few days was … shoveling snow.

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