Author Archives: Dave

3 Ways to Check Your Blood Pressure

To keep the body in good health is a duty. —Buddha

Blood pressure should be checked every 2 years. If your blood pressure is above normal then it should be checked more often, even every week for people with the highest blood pressure readings (>180/110).1

Here are 3 ways to check your blood pressure:

1. See a Doctor

Seeing a doctor is a good option because doctors know how to accurately take a blood pressure reading. All you need to do is schedule the appointment.

2. Use a Monitor at Home

If a doctor is unavailable or you want to check your blood pressure more frequently then you can use a blood pressure monitor at home. Follow these steps carefully to avoid errors in your blood pressure reading:

  1. Recommended Device
    Use a device recommended by the dabl Educational Trust
  2. Validated Device
    your device by taking it to your doctor about once per year to verify that its readings are accurate and repeatable.
  3. Twice Daily
    Measure twice a day, once in the morning and once at night. In the morning, try to allow some time after waking but measure before eating or doing exercise.
  4. 30 Minutes Beforehand: No Food or Drink
    Avoid food, caffeine, tobacco and alcohol for 30 minutes before taking a measurement
  5. 5 Minutes Beforehand: Sit Quietly
    Sit calmly for 5 minutes beforehand without crossing your legs or ankles. Don’t think about anything stressful.
  6. Arm Position
    Always use the same arm, and position it correctly so that it is resting on a table or pillow at the same height as your heart.
  7. Bare Skin
    Place the cuff over bare skin, not clothing
  8. 3 Readings 3 Minutes Apart
    Take two or three readings to make sure they are accurate, and wait for one to three minutes between readings.
  9. Record the Reading
    Some monitors automatically record the reading so you can show it to your doctor later. If yours doesn’t do this then you can just make a note in a journal on paper or your phone.

Mayo Clinic also has a good guide for using a monitor at home.

3. Use a Local Pharmacy

Some pharmacies offer blood pressure readings on site. For example, Walgreens let you schedule an appointment ahead of time to have your blood pressure checked at one of their stores.

Conclusion
  • See a doctor to have your blood pressure checked
  • You can use a monitor at home for more frequent checks, but make sure you have a recommended device and that you follow the right steps for an accurate reading
  • Some local pharmacies can take your blood pressure for you too

 

16 Blood Pressure Supplements with Mayo Clinic Grades

Research is formalized curiosity. It is poking and prying with a purpose. —Zora Neale Hurston

I think it’s a problem that there is a lack of consistency around what supplements people think might help blood pressure. If you want to use supplements to help blood pressure, then how do you know where to start? How can you know what the most important supplements are?

For example, if I google “blood pressure supplements” then the first page tells me to take CoQ10, Omega-3 fatty acids, and Olive Oil. But the second page tells me to take French Maritime Bark, Anthocyanins, and more.

Who is right? Which supplements are more important? Even if the claims for all of the different supplements are referenced to a seemingly credible medical study, am I supposed to compare all these studies and evaluate the results just to see which one is the most promising? How am I supposed to organize all this information so that I can make the best decisions to prioritize my blood pressure supplementation stack?

One strategy that I think is useful is to review comprehensive lists of supplements that some sources maintain, so you can see most (or all) of the options compared side-by-side to help you make a decision.

One such source is the drugs and supplements guide from Mayo Clinic. I reviewed their evidence grade for all supplements that might help with high blood pressure by creating a google search term that would show the evidence page for every supplement that references blood pressure and exclude prescription drugs.

After going through the roughly 3 pages of results, here’s what I found. There were only three supplements with strong evidence for their use (chocolate; flaxseed oil; omega-3 fatty acids, fish oil, alpha-linolenic acid). Two had “good” evidence (CoQ10 and soy). The rest had “unclear” evidence, even though initial results may seem promising. Why Protein scored an “F” because of evidence against its effectiveness.

I plan on using these grades to help inform research on my own supplement stack and focus on what supplements to prioritize researching more thoroughly.

Grade A

Strong scientific evidence for this use.

  1. Chocolate
    Since chocolate contains caffeine, eating large amounts may increase blood pressure. However, research has shown that dark chocolate or chocolate with high flavonols decreases blood pressure by a small amount in people with elevated blood pressure.
  2. Flaxseed and flaxseed oil (Linum usitatissimum)
    Early evidence suggests that higher levels of ALA in fat tissues may be associated with lower blood pressure. Flaxseed-supplemented diets have lowered blood pressure in human studies. However, future research is needed in this area.
  3. Omega-3 fatty acids, fish oil, alpha-linolenic acid
    Many studies report that omega-3 fatty acids may help reduce blood pressure. However, effects have generally been small, and other trials reported no benefit. Effects may be greater in people who have higher blood pressure and may depend on the dose. DHA may have greater benefits than EPA.
Grade B

Good scientific evidence for this use.

  1. Coenzyme Q10
    There is good evidence to support the use of CoQ10 in the treatment of high blood pressure. However, more studies evaluating a higher dose for a longer treatment period are needed
  2. Soy (Glycine max)
    Research in humans generally shows that soy lowers blood pressure. Further research is needed to determine the ideal soy preparation for lowering blood pressure.
Grace C

Unclear scientific evidence for this use.

  1. Arginine
    Early research reported that arginine taken by mouth reduced blood pressure in people with high blood pressure. Larger, high-quality studies are needed before a conclusion can be made.
  2. Dong Quai
    Dong quai may improve high blood pressure in the lungs, blood thickness, and red blood cell volume. Further research is needed.
  3. Evening primrose (Oenothera spp.)
    Research with EPO has shown a lack of significant beneficial effects on heart function and health. Early research suggests that EPO may decrease blood pressure. Additional research is needed in this area.
  4. Folate
    Some study suggests that folic acid supplementation may decrease high blood pressure. Further study is needed to confirm these results.
  5. Honey
    Early study suggests that honey may benefit people who have high blood pressure. However, more studies are necessary to confirm these findings.
  6. Lycopene
    While some studies report that lycopene may help lower blood pressure, others suggest a lack of benefit or association between lycopene levels and high blood pressure risk. Most of the therapies studied have contained mixed ingredients. More information is needed on the possible effects of lycopene alone. More high-quality studies are needed in this area.
  7. Melatonin (N-acetyl-5-methoxytryptamine)
    Studies report that melatonin may lead to small reductions in blood pressure. Melatonin may also improve cholesterol and reduce oxidative stress in people with metabolic syndrome. A combination treatment for heart disease that included melatonin was found to have blood pressure-lowering effects. Melatonin has been studied with other agents for high blood pressure in elderly people. Further research is needed.
  8. Vitamin B6
    Early research suggests that vitamin B6 may lower blood pressure. More research is needed to confirm these results.
  9. Vitamin C
    In human research, vitamin C supplementation has been shown to decrease blood pressure. Further research is needed in this area.
  10. Vitamin D
    Low levels of vitamin D may be linked to high blood pressure. Blood pressure is often higher during the winter season, at a further distance from the equator, and in people with dark skin pigmentation. However, the evidence is unclear. More research is needed in this area. People who have high blood pressure should be managed by a medical professional.
  11. Vitamin E
    Vitamin E has been studied for the prevention of high blood pressure in pregnant women. However, most studies have been in combination with vitamin C or other micronutrients. Evidence on vitamin E alone is lacking, and further research is needed.
Grade F

Strong scientific evidence against this use (it likely does not work)

  1. Whey Protein
    Although early studies suggested that whey protein may help reduce blood pressure in people with high blood pressure, higher quality research suggests a lack of effect. More research is needed.
Uses Based on Tradition Or Theory

These supplements are used based on tradition or theories only, aren’t proven to work, so they might even be dangerous.

  1. Black cohosh (Cimicifuga racemosa, Actaea racemosa)
  2. DHEA
  3. Milk Thistle
  4. Niacin (vitamin B3, nicotinic acid), Niacinamide
  5. Red Yeast Rice
  6. Saw palmetto (Serenoa repens, Serenoa serrulata)
  7. Thiamine (Vitamin B1)
Conclusion
  • The 3 most reliable supplements for lowering blood pressure according to Mayo Clinic are chocolate; flaxseed oil; omega-3 fatty acids, fish oil, alpha-linolenic acid
  • There is also good evidence to show that Coenzyme Q10 and Soy help lower blood pressure.

What is Normal Blood Pressure? 120/80 vs 115/75

If you don’t know your blood pressure, it’s like not knowing the value of your company. –Mehmet Oz1

I’ve been re-reading much of Ray Kurzweil’s fascinating TRANSCEND recently with a focus on his explanations on blood pressure. The book claims that “optimal” blood pressure is anything under 120/80. You’ve probably heard 120/80 referenced as “normal” blood pressure by your doctor, and you might think you only need to worry about reducing blood pressure if it’s over 120/80 or even 140/90. But the truth, as backed up by the reports that introduced 120/80 as the “normal” standard 15 years ago, is that the risk of cardiovascular disease starts increasing at 115/75, and the healthy range is between 90/60 and 115/75.

Where does 120/80 come from?

In the early 1900s, insurance companies in the USA wanted better ways to predict when and why people would die. In 1906, suspecting the clinical significance of high blood pressure, they started measuring the blood pressure of applicants for life insurance. In the coming years this idea spread, and by 1925 there was a study published by the Actuarial Society of America that involved over 10 million participants and measured the relationship between blood pressure and mortality. One of its key findings was that

mortality increases rapidly with the increase in blood pressure over the average2

Many studies have been run since then. Some focus on mortality, while others focus on heart disease and other outcomes. A notable study from 19933measured stroke, cardiovascular diseases, life expectancy, and mortality from all causes, including coronary heart disease. The authors claim they found a strong relationship between blood pressure, and these outcomes, suggesting 120/80 as the upper bound on “optimal” blood pressure.

Then in 2003, new guidelines45were published in JAMA that classified normal blood pressure as anything under 120/80 instead of the previous 129/84.These guidelines have been adopted by many reputable sources that now claim anything under 120/80 to be normal.678

However, the report also stated that

The risk of cardiovascular disease begins at 115/75 mm Hg and doubles with each increment of 20/10 mm Hg9

This is why the upper bound on blood pressure readings that you should consider healthy for yourself is 115/75 instead of 120/80.

These reports do not focus on a single number that they claim to be perfect for everyone. Instead there are ranges of numbers that are classified as normal or otherwise.

What’s Wrong with 120/80?

There’s nothing wrong with using 120/80 as a bound on ranges with classifications. It makes perfect sense if that’s what the data suggests to be meaningful. The problem lies with giving the number more meaning than it really has, or believing that you have nothing to worry about just because your blood pressure is under 120/80. This problem is exacerbated by the common belief, reinforced by reputable sources, that anything under 120/80 is great.

For example, a 2003 article from Harvard Medical School10stated that if your blood pressure is less than 120/80 then you should “Keep up the good work!”

Is it really as simple as that? How do they know what “work” you’ve been doing?

What if over the last 5 years your blood pressure has slowly risen from 110/70 to 119/79? That’s an increase of about 9%, and at that rate your blood pressure would be 129/86 in another 5 years, which is too high. Results like this should concern you, and you shouldn’t “keep up the good work”. This is a simplistic example, but it stands to reason that if you are experiencing a significant upward trend in your blood pressure, and you don’t know why it is happening or have any reason to believe that it will plateau, then you should probably take action (with help from your doctor, of course).

This means that it can be helpful to keep track of your blood pressure over time, and consider taking action if you notice significant or sudden upward trends, even if you’re still under that 120/80 bound.

Why is 90/60 the lower bound?

Blood pressure readings of 90/60 or lower are a sign of low blood pressure11which carries its own health risks such as confusion, weakness, and fatigue.

What other factors affect normal blood pressure?

Even with data to show that a healthy range is 90/60 to 115/75 there can be exceptions. Your age can be an important factor in what is considered normal blood pressure. For children, the Blood Pressure Tables for Children and Adolescents12show that normal blood pressure readings for boys range from 85/37 to 118/67 from ages 1 through 17. For the elderly, normal blood pressure readings can be higher, and there is data to suggest13 that 140/80 is a healthy reading for people aged 70 and older.

Conclusion
  • For most people, normal blood pressure should be under 120/80
  • Factors like age can affect your expected normal blood pressure
  • Health risks start increasing for blood pressure over 115/75
  • Don’t wait until you get a high reading to take action. If your blood pressure rises significantly over time then it can help to address it before it gets too high.

This site does not provide medical advice, diagnosis or treatment. See additional information.