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The Blood Pressure Readings You Never See · Doctor Turned Health Coach

• 0:22
  When it comes to high blood pressure, you've certainly known someone or maybe
• 0:26
  even yourself have been diagnosed with high blood pressure or what we call in
• 0:31
  Western medicine, hypertension.
• 0:34
  It's such a tricky medical condition. It might seem super easy and straightforward,
• 0:39
  but it's one of those truly silent health problems that we were very fortunate to discover.
• 0:45
  When your blood pressure stays high or spikes a lot, unfortunately it causes
• 0:50
  a lot of pressure on the heart, even on the lungs, and the kidneys and the vessels themselves.
• 0:58
  So that's really what's going to drive chronic kidney disease.
• 1:03
  Kidney failure is what's going to drive your increased risk of heart disease,
• 1:08
  heart attacks, and strokes.
• 1:10
  Fortunately, the treatment is incredibly easy. There are numerous lifestyle
• 1:16
  choices that you can make to lower your blood pressure. We already know that.
• 1:19
  But there are also great medications you can use that, for the most part,
• 1:24
  will either get rid of all the extra salt that's in your body,
• 1:27
  or they will dilate your blood vessels, or they'll make your heart pump a little bit less.
• 1:32
  Essentially, all they're doing
• 1:34
  is decreasing the amount of pressure in the hose, so to say, so to speak.
• 1:40
  Unfortunately, a lot of patients still will walk around with what they believe
• 1:44
  is normal blood pressure.
• 1:45
  However, what they're missing is that on occasion their blood pressure is spiking without them knowing.
• 1:52
  So a good way to describe it is when you first wake up in the morning,
• 1:55
  usually that's when your blood
• 1:57
  pressure seems to be the highest for most people. Not true for everyone.
• 2:01
  Some people actually get a little bit higher towards the end of the night.
• 2:05
  And once you go to sleep at night, that's when your blood pressure usually drops
• 2:10
  quite a bit so imagine if your daytime blood pressure is in the 120s the top
• 2:16
  number 120s the bottom number 80s,
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  at night you might be in the 80s over 40s or 90s over 50s,
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  and that's pretty normal for most people again some people will be switched
• 2:28
  around a little bit about 10 to 12 percent of,
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  of adults however some people spike really bad at night,
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  either from sleep apnea or because they're grinding their teeth or they're having
• 2:40
  nightmares or other sleep disorders, their blood pressure will shoot up to 160,
• 2:46
  150, over 90, and it might stay up there for quite some time.
• 2:53
  Also, during the day, they might have occasions when their blood pressure is
• 2:57
  in the 160s over 100 for quite some time because they're stressed.
• 3:01
  They maybe had a lot of salt or they didn't sleep well the night before.
• 3:06
  But when they do check their blood pressure a few times a year,
• 3:09
  during those times, their blood pressure is perfectly fine. Now,
• 3:12
  this is by no means supposed to be a fear-mongering podcast episode.
• 3:17
  Instead it's meant to give you an idea into what is currently not functioning really well,
• 3:25
  in how we measure blood pressure to give you an example when it comes to blood sugar
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  we can actually get your average blood sugar by checking your hemoglobin a1c
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  it's called a1c it's a very cheap five dollar blood test that i order from quest
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  diagnostics pretty regularly,
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  and it will you what the average blood sugar number of this adult is.
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  And from that, I can say, okay, well, you probably have some high numbers and
• 3:50
  some very low numbers, but your average is a little bit high.
• 3:53
  We don't have that for blood pressure. We don't have an average blood pressure.
• 3:57
  Now, there is a device that does it. It's called the Ambulatory Blood Pressure Monitor, or ABPM.
• 4:03
  Unfortunately, it's not readily available. It's incredibly expensive devices
• 4:07
  that have to be FDA regulated, and the device manufacturer has to be willing to take on the risk.
• 4:13
  Usually they're around $3,000 to $5,000. You give this device to the individual,
• 4:19
  they wear it for several days,
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  and essentially it's a blood pressure cuff that goes on the arm,
• 4:25
  and it auto-inflates every 30 to 60 minutes.
• 4:29
  This is a fantastic way. This is the gold standard, the best way to know if
• 4:34
  your blood pressure is in range or out of range.
• 4:38
  Again, if you're only doing it for one or two days, well...
• 4:41
  You know, if you're going on vacation, it's probably really good.
• 4:44
  And if you're having a stressful meeting, it's probably not that great.
• 4:46
  If you're dealing with your two-year-old toddler, probably not that good.
• 4:51
  So I still prefer to do it for several days in a row or do several days in a month.
• 4:57
  But it is a great device. Now, fortunately, there are some kind of consumer-grade devices.
• 5:03
  The most recent one that I tried with two of my patients is the Huawei D2.
• 5:09
  Huawei is a pretty big company. It's kind of like our Samsung or Apple in other parts of the world.
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  And they make some incredible devices. So this one is a wristwatch that also
• 5:23
  has a built-in blood pressure cuff.
• 5:26
  As in, it literally inflates. So it's not like the PPG light sensors that a
• 5:31
  lot of the devices have, where they use software to determine what your blood
• 5:36
  pressure is, but they're incredibly inaccurate. Incredibly inaccurate, actually.
• 5:41
  So not something that I would advise for most people.
• 5:45
  A arm cuff is always the best. Second best is a wrist cuff.
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  So this device, the D2, we were able to measure his nighttime blood pressure.
• 5:54
  And guess what? It was in the 150s over close to 100.
• 5:58
  And I'm really glad that we checked it because it didn't make sense that he
• 6:04
  was having such perfect blood pressures at night, and yet he was having so many,
• 6:08
  heart-related issues and problems, and his EKG was abnormal.
• 6:12
  So I really wanted to investigate it further, and this gave us the last bit of clue that we needed.
• 6:17
  And of course, now, the next step is to just figure out what to do. So what should you do?
• 6:22
  Example one, you have perfect blood pressures throughout the day,
• 6:26
  no issues whatsoever. Should you get a blood pressure?
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  Should you get an ambulatory blood pressure cuff? Should you check your blood
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  pressure at night? I don't think so.
• 6:34
  If your daytime blood pressure numbers are pretty good, look, just leave it as is.
• 6:39
  As long as you're eating well, exercising, and you're managing your stress,
• 6:43
  there's really no need to take any action.
• 6:46
  If you on occasion get a few high numbers, and even your lowest numbers are
• 6:52
  not that great, I think it's valuable to know what your nighttime numbers might
• 6:56
  be. It might help you determine what real actions to take.
• 7:01
  Now, if you are somebody at very high risk for kidney disease,
• 7:05
  stroke, atrial fibrillation, heart attack, or any other cardiovascular condition,
• 7:12
  I definitely recommend talk to your doctor, have them refer you for an ambulatory
• 7:17
  blood pressure monitor.
• 7:19
  Just check your 24-hour blood pressure. Get your average number.
• 7:22
  And if you can't do that with your insurance, you can certainly purchase this
• 7:26
  device or any other device, honestly, that does a similar job.
• 7:31
  And I wasn't able to find a lot of them, but the Huawei D2 was one of them.
• 7:36
  So I was fortunate to be able to use that for my client. But again,
• 7:39
  it's not available in the US. I don't know if I mentioned that.
• 7:42
  So we had to get it from the UK and it was about $500. dollars.
• 7:46
  I think for most people listening to this podcast, it will be easiest to just
• 7:50
  get a referral to a cardiologist who, and your insurance usually will pay for it.
• 7:54
  So that's the best way. That's of course the best strategy. I have other great
• 7:58
  podcasts on how to lower your blood pressure.
• 8:01
  I have a fantastic newsletter talking about all of the most effective evidence-based
• 8:06
  strategies that will lower your blood pressure.