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The Peter Attia Drive

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

The Peter Attia Drive

Peter Attia, MD

Health & Fitness, Medicine, Fitness

4.77.3K Ratings

🗓️ 12 June 2023

⏱️ 26 minutes

🧾️ Download transcript

Summary

View the Show Notes Page for This Episode

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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.

If you’re not a subscriber and are listening on a podcast player, you’ll only be able to hear a preview of the AMA. If you’re a subscriber, you can now listen to this full episode on your private RSS feed or our website at the AMA #48 show notes page. If you are not a subscriber, you can learn more about the subscriber benefits here.

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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Transcript

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0:00.0

Hey everyone, welcome to a sneak peek, ask me anything, or AMA episode of the Drive Podcast.

0:16.5

I'm your host, Peter Atia.

0:18.3

At the end of this short episode, I'll explain how you can access the AMA episodes in full,

0:22.9

along with a ton of other membership benefits we've created.

0:26.0

Before you can learn more now by going to peteratia-md.com forward slash subscribe.

0:31.5

So without further delay, here's today's sneak peek of the Ask Me Anything episode.

0:39.7

Welcome to Ask Me Anything episode 48.

0:42.2

I'm once again joined by an extensit.

0:43.8

In today's episode, we will focus on one topic and that topic is blood pressure.

0:47.5

If you listen to this podcast, you have heard me talk quite a bit about cardiovascular

0:52.3

disease and usually what I'm doing so I'm doing so in the context of talking about prevention,

0:57.4

vis-a-vis apob and lipoprotein manipulation.

1:01.5

But you've probably also heard me talk about blood pressure because high blood pressure,

1:05.8

along with high apob and smoking, is one of the three leading causes of atherosclerosis.

1:12.3

What's perhaps most insidious is that many of you listening to this don't actually realize

1:16.2

you have high blood pressure.

1:18.3

And we therefore kind of begin the discussion by talking about what high blood pressure

1:21.9

is, how common it is, and how you go about measuring it.

1:25.6

It turns out that the measurement you get in the doctor's office is probably not that

1:29.5

accurate for multiple reasons which I go into in this episode.

1:32.9

So what's most important for anybody who really wants to get under the hood of their own

1:35.8

blood pressure is that you get a cuff and you figure out how to do this at home.

...

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