A Midwestern Doctor

Elevated blood pressure is the most common chronic disease, and as the decades go by more and more people are declared hypertensive.
Remarkably, at least 25% of all hypertension diagnoses are due to inaccurate measurements, and there is still no known reason for why over 90% of people are hypertensive.
Aggressively treating everyone’s blood pressure is justified under the belief it prevents cardiovascular disease. However, in most cases it has never been proven to reduce heart disease—rather it only leads to a small reduction in strokes (hence why these medications were rebranded to treat “cardiovascular disease”).
Many of the misunderstandings with heart disease arise from the fact that impaired circulation or damage to the blood vessels will cause blood pressure to go up and their correlation being misinterpreted to instead believe high blood pressure causes cardiovascular disease.

In this article, we will discuss the actual causes of high blood pressure, the dangers of commonly used blood pressure medications, the safest pharmaceutical and natural ways to reduce blood pressure directly, and our preferred methods for treating the underlying causes of high blood pressure.

Ever since I first encountered the medical field, something struck me as off about their relentless focus on blood pressure. Before long, I began to notice that the blood pressures the same acquaintances (e.g., relatives or friends) shared with me varied immensely. As I was pondering this, a long-time Eastern spiritual teacher shared with me their belief that the West’s relentless focus on blood pressure was due to it being much easier to measure than blood perfusion (healthy blood flow).

Then, as I became more acquainted with the medical field, I began to notice a consistent pattern—whenever a drug existed that could treat a number or statistic, as the years went by, the acceptable number kept on being narrowed, making more and more people eligible to take the drugs that treated the number.

For example, as I discussed recently, once the statins drugs entered the market (which unlike their predecessors, could effectively lower cholesterol), the acceptable blood cholesterol levels kept on being lowered, and before long almost everyone was told they would die from a heart attack unless they started a statin—despite statins have an almost non-existing mortality benefit (e.g., taking them for 5 years at best makes you live 3-4 days longer) and causing (often severe) side effects for roughly 20% of users. Broadly recommending these drugs hence appears unconscionable, but as I showed in that article, these unjustifiable guidelines were a product of clever pharmaceutical marketing and targeted bribery of public officials.

In this article, I will attempt to show how something similar happened in the field of blood pressure. As this is an immensely controversial position to take (e.g., measuring and documenting blood pressure is one of the most routine procedures during a medical visit), I’ve done my best to clearly present the evidence for this perspective so you can make your own determination.

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Conventional Blood Pressure Perspectives

Since blood vessels are elastic structures filled with fluid, that fluid holds them under pressure. Blood pressure in turn is typically measured by determining how much external force is needed to exceed the artery’s pressure and compress it so that blood no longer flows through it. Low blood pressure (hypotension) is a problem because it prevents blood from reaching the areas where it’s needed (e.g., orthostatic hypotension or POTS describes a common situation where people become lightheaded as they stand up due to insufficient blood being pushed into the brain), but in most cases, medicine instead focuses on the consequences of high blood pressure. Within the existing model, those consequences are:

Weakened blood vessels become more likely to break open and leak as higher blood pressure pushes against them. This for instance is why Emergency Rooms aggressively lower the blood pressure of patients who show up with symptoms of “hypertensive emergency” such as a severe headache and a significantly elevated blood pressure. Likewise, whenever a critical blood vessel ruptures (e.g., the aorta or one in the brain), once the bleed has been confirmed, the first step in managing it is to lower the patient’s blood pressure (so less blood leaks out) after which they are sent to surgery.
Excessive pressure on the arteries strains and damages them, causing the lining of the vessels to become damaged and gradually develop atherosclerosis.
Excessive blood pressure damages the internal organs (termed end-organ damage), leading to premature failure and early death (e.g., from a heart attack or kidney failure).

Because of this, high blood pressure is viewed as one of the greatest preventable causes of cardiovascular disease and thus a chief focus of all medical visits is ensuring a patient achieves a sufficiently lowered blood pressure.

Unfortunately, that chain of logic has quite a few gaps in it (see if any jump out to you). We will now examine each of them.

Variable Blood Pressure

Blood pressure (BP) is immensely variable. For example, pressures at the periphery (where BP is typically measured), which when studied is found to vary by around 14 points This thus frequently leads to individuals being erroneously diagnosed with hypertension and put on blood pressure lowering medications despite having normal blood pressures (leading to those medications making them hypotensive).

This phenomenon in fact is so common (constituting 15-30% of hypertension diagnoses) that it is often referred to as “White Coat Hypertension,” a name derived from the fact stress is one of the things which commonly elevates blood pressure, and since visiting a doctor is a stressful experience, many patients hence have temporarily elevated blood pressures there. Because of this, the guidelines suggest having patients who are diagnosed with hypertension have multiple measurements to confirm it (e.g., with home blood pressure monitoring). Unfortunately, this often does not happen in practice.

Note: one common source of error when measuring blood pressure is the wrong sized cuff being used for the patient. Another is that patients frequently have significantly different blood pressures in each arm. This helps to explain why it is commonly estimated that 25% of those diagnosed with hypertension do not have it.

Likewise, there is a surprisingly poor correlation between peripheral blood pressure and the central blood pressure inside the aorta. For example, one large study found a significant difference between the blood pressure within the aorta and the arm, and that the aorta pressure had a much stronger correlation to the likelihood of cardiovascular disease.