What used to be considered a healthy blood pressure is now a death sentence. Two groundbreaking studies have completely changed how we should approach blood pressure. In this video, I'll show you the new blood pressure targets, how much we can reduce the risk of heart attacks, strokes, and death if we get this right, and go through an easy step-by-step guide to help us achieve the perfect blood pressure. These studies show that we as doctors got it wrong. For decades, we knew that high blood pressure was dangerous, but we didn't realize just how dangerous it was.
even at levels that seemed okay. Let's imagine your blood vessels are like a garden hose. When the pressure inside that hose is just right, water flows smoothly. Everything is fine, but if you turn up the pressure too much, the hose begins to strain. Over time, it wears out, and if you keep cranking up that pressure, it might even burst.
In the same way, high blood pressure puts strain on our blood vessels. This constant pressure damages the inner lining of our arteries, making them less flexible and more likely to get blocked. which can lead to heart attacks and strokes. So what's the real safe number and why is the old normal so dangerous?
For a long time doctors believed that having a systolic blood pressure, that's the top number on your reading, up to 140 was perfectly fine. You may have even heard your doctor say that as long as your blood pressure is under 140 on 90 you're in the clear. We used to think 120 on 80 is the textbook ideal but 140 that's still okay isn't it? Well, we now know that having a systolic blood pressure near 140 is actually risky.
It's not just okay, it's putting our lives in danger. The reason doctors thought that 140 is fine is that blood pressure tends to go up as we get older. So we figured that a little higher was normal.
But new research shows that even that little extra pressure can have big problems. The first wake-up call came from the SPRINT study, which stands for Systolic Blood Pressure Intervention Trial. The study was massive. over 9,000 participants, so the findings are hard to ignore. The goal was to figure out if lowering systolic blood pressure to below 120 would protect against heart attacks, strokes and other problems better than just sticking with the old target of 140. The people in this study were at high risk of heart disease, but they didn't have diabetes or a history of a stroke.
They were split into two groups, one that aimed for a blood pressure of 140 and another group that aimed for a blood pressure of 120. now here's where it gets really interesting the results were so clear that they had to stop the study early the study was supposed to last four to six years but after just 3.3 years it was obvious that lowering blood pressure to below 120 it made a huge difference there was a 27 percent lower risk of having a heart attack stroke or dying from these causes each year and when it comes to death rates alone there was a 25 percent lower risk of dying in the group that aimed for 120. So let that sink in for a moment, a 25% reduction in the risk of death just by lowering blood pressure more aggressively. This isn't a small improvement, it's a game changer. But the story doesn't stop there.
Recently another study in China tested these findings on an even larger and more diverse group, over 11,000 people, and it included those with diabetes and those who had already had a stroke. Think of the study as the sequel to the Sprint study, but an even bigger one. bigger cast and guess what the results were just as powerful lowering systolic blood pressure to less than 120 reduced the risk of heart attacks strokes and death from cardiovascular causes by 12 plus it cut the overall risk of death from any cause by 21 over three and a half years so what's the catch and how do we get our blood pressure down to these safer levels well like anything in medicine there's always trade-offs lowering blood pressure this much it can come with side effects like dizziness or fainting, but the benefits, they far outweigh these risks.
And don't worry, I'll share some tips on how to avoid these side effects and who should be more cautious about aiming for 120 later in the video. But the takeaway here is clear, the old normal of 140 is no longer good enough. Most of us should aim for a systolic blood pressure of less than 120 to really help protect ourselves. So how do we reach these new, safer blood pressure targets? Well, here's a step-by-step system.
First, We need to know where we're starting from. I suggest to all of my patients to buy an at-home blood pressure monitor, and I'll link one in the pinned comment. While we're optimizing the blood pressure, I ask my patients to take a reading in the morning and then another one later in the day. We need to be seated, place the cuff on our skin rather than over clothing, and relax.
Then record the result. I personally use the Apple Health app. Now that we've got our starting point, it's time to talk about how to lower that number.
Diet is the foundation of good blood pressure and to start we need to talk about potassium. Potassium is like a superhero when it comes to fighting high blood pressure. It balances out the sodium in our bodies and helps our blood vessels relax. Think of potassium as the counterbalance to sodium.
So while sodium raises the blood pressure, potassium brings it down. Some great high potassium foods include peas, spinach, avocados and beans. Eating these regularly can help lower our blood pressure.
So while potassium is the hero, sodium is the villain. Most of us eat way too much sodium and that's a big reason why many people have high blood pressure. The American Heart Association says that we should have no more than 1,500 milligrams of sodium per day.
That's less than a teaspoon of salt. A study combining 85 different trials show that as sodium intake goes up, so too does blood pressure. And it's not just the salt shaker on our tables.
Most of the sodium that we eat come from processed foods and eating out. So start reading those labels choose low sodium options and cook at home where possible so that we can control the salt intake. But if a patient of mine is struggling to get rid of the salt from their diet, there's a trick that can help.
Salt substitutes. Regular salt is sodium chloride, but a salt substitute has some potassium chloride instead. In a study with over 20,000 people, those who used a salt substitute had a 14% lower risk of stroke and a 12% lower risk of death.
Now let's talk about another key player. Protein. Protein isn't just for bodybuilders, it's important for everyone, especially when managing blood pressure. Protein helps us keep fuller for longer, which means we're less likely to snack on unhealthy foods.
Lean proteins like chicken, fish and plant-based options like beans, lentils and chickpeas are wonderful choices. And let's not forget about fiber. A high fiber diet not only helps with digestion, but it plays a significant role in blood pressure management.
Foods like whole grains, whole fruits and vegetables and chickpeas again are packed with fiber and are a staple in my diet. And of course we need to cut out the sugary drinks and replace them with water. Alcohol can also raise blood pressure so I work with my patients to reduce or quit drinking. But diet is just one part of the picture.
Let's move on to exercise. Exercise is one of the best ways to lower our blood pressure and we don't need to be a marathon runner to see the results. Walking, jogging, swimming or cycling are wonderful for our heart.
Aim for 30 minutes a day, 5 days a week. So personally, I love to go for a run, or if the weather isn't great, I'll use my exercycle bike at home, which I bought second hand for $60. And don't forget about strength training.
Muscle building helps to burn more calories and keeps our metabolism strong, which is directly linked to blood pressure. But what if you're super busy? Well, here's a quick tip. On busy days, I do something called exercise snacks.
These are short bursts of exercise, split throughout the day, like push-ups, sit-ups or other bodyweight exercises. So at the clinic during a quick 15-minute paperwork break I'll fit in some exercise and these snacks they can add up to make a massive difference in our health. But it's not just about what we eat and how we move. Sleep is another critical component of blood pressure management.
Poor sleep whether it's not enough or low quality sleep can increase our blood pressure so most adults need seven to nine hours of high quality sleep per night. But here's a tip Optimizing your sleep, it doesn't just start when we're ready to fall asleep. It starts when we wake up.
Wake up the same time every day, even on weekends. The body loves a routine. Get outside and expose your eyes to sunlight. Early sunlight in the day helps to regulate our sleep-wake cycle.
Caffeine should be limited to the first three to four hours after waking up. Even if you feel like caffeine doesn't affect your sleep, it can still lower your sleep quality. And my full sleep protocol is in a video here.
Next is stress management. Chronic stress can contribute to high blood pressure and finding ways to manage stress is essential. So mindfulness, deep breathing, meditation, all of these techniques can help to lower our stress levels and in turn lower our blood pressure. Even simple practices like taking a few minutes out each day to sit quietly and breathe deeply can make a huge difference. Now hopefully if our diet, exercise and sleep are optimized, our weight will be perfect.
Weight loss has a powerful effect on reducing blood pressure. But if our weight is still above target, despite optimizing our lifestyle factors, we can consider medications such as a Zempik to help on our weight loss journey. Taking medications are not a failure.
They're just another tool to help us reach our health goals. And finally, if our lifestyle factors are dialed in, our weight is perfect, but we still have a blood pressure above 120, then I have a discussion with my patients about the pros and cons of blood pressure medications. I emphasize that medication should be an addition to, not a replacement for, all of the other steps that we've gone through. Some people have their lifestyle in check, but still need medications because of their genetics. So at the clinic we usually start with a type of medication called an ARB or an angiotensin receptor blocker.
Regarding the dose, we start low and go slow, increasing the dose gradually until we get to a half-strength dose. If that's not enough, then instead of continuing to crank up the dose of that existing medication, we'll introduce a second class of medication called a calcium channel blocker. So by using these combination therapies at low doses, we achieve a greater blood pressure response with reduced risks of side effects. compared to just jacking up the dose of that one medication.
Now that's a massive oversimplification of the approach used in clinical practice and if you want me to do a dedicated video to blood pressure medications please let me know in the comment section. So for example to add to the complexity not everyone should aim for a blood pressure of 120 on 80. For older adults if we use that as a target we can significantly increase the risks of dizziness and fainting so we need to tailor the management and individualize the targets. we may accept 130 or 140 depending on the circumstance. And that complexity is what I find really interesting and is part of the reason why I love practicing at the clinic.
Overall though for most of us aiming for around 120 is a smart goal and we do that by measuring our blood pressure at home, optimizing our diet, exercise, sleep and stress, managing our weight and considering medication if needed. And speaking of sleep, make sure to check out the next video here that goes through my full sleep protocol. and a massive thank you to all of the Patreons supporting the channel.