#258 - AMA #48: Blood pressure—how to measure, manage, and treat high blood pressure

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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.

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We discuss:

• Blood pressure and other risk factors for cardiovascular disease [2:30];
• Defining blood pressure and the purpose and meaning of a blood pressure measurement [5:45];
• The implications of high blood pressure and the importance of maintaining an optimal level [10:30];
• 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];
• The prevalence of high blood pressure—a hidden epidemic? [24:30];
• The consequences of high blood pressure on cardiovascular health, brain health, kidneys, and more [27:45];
• Low blood pressure: symptoms and consequences [35:30];
• How to properly measure blood pressure [37:45];
• Daily variance in blood pressure and the transient changes in blood pressure during exercise [48:00];
• Primary hypertension vs. secondary hypertension: what to look for [51:45];
• Lifestyle factors impacting blood pressure: weight loss, exercise, and sodium [57:45];
• Impact of insulin resistance and type 2 diabetes on blood pressure [1:04:45];
• How sleep impacts blood pressure [1:06:45];
• Pharmacologic options for managing blood pressure [1:08:00]; and
• More.

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