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Comment by jdee | Hacker News Reader

The entire process of diagnosing people with hypertension needs a shake up. Managing blood pressure is such an important part of the human condition but the evidence as to what works and what doesnt can be confusing. Weight loss and stopping smoking works, but for exercise, cutting alchohol and cutting salt there are many conflicting reports.

Add in the fact that genetics plays such an important part, and the prevelence of White Coat Syndrome it's a shame that the medical world cannot make its mind up.

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The confusion around hypertension is really annoying. I have a bit of white coat hypertension, and my BP is usually around 145/80 when measured by a medical professional, but is still around 132/80 when measured automatically. Getting it down to 120/80, or lower (where everyone else who I know in my age group is, and which seems to be the safest in the long term) is stubbornly impossible, despite exercise and a healthy diet. A 24 hour workup by a doctor seemed to point to stress-induced hypertension, but I was told that there's no need to treat it.

Is hypertension brought on by being stressed/awake less harmful than "intrinsic" hypertension? That seems to be the opinion by my physician. But it's maddening that these issues remain unresolved.

I'm 25 and in the exact same situation as you, except that my baseline is probably a more like 135/80 or even 140/80. I know that weight loss works, because a couple of years ago when I weighed about 40 lbs. less, it tended to be more like 130/80. But then I quit smoking (which I had taken up for ~3 years by that point) and started eating the world. Yes, ironically by BP was lower when I abused the crap out of stimulants, smoking and drinking coffee around the clock like a champ. However, I think those things are unrelated; significantly lower weight might have offset all that.

I am very wary of physicians' periodic mumblings about putting me on hypertension meds soon because this could be doing "silent damage". I'm aware of that. But I know several hypertensive people, in otherwise good health and relatively young age, who had anomalous, out-of-the-blue heart attacks or strokes suspected to be linked to side effects of calcium channel blockers or other hypertension medication. It makes me very wary.

It seems to me the only safe adjustments to BP outside of a gerontological context can be made through lifestyle and weight changes.

I got a blood pressure monitor about a week ago. The men in my family have a history of high blood pressure, but my diet and exercise and body composition has been so dialed in the last six months that I was expecting my blood pressure to be at normal levels. But to my surprise, that wasn't the case. After going cold turkey on my Coke Zero habit and doubling my fish oil intake, I gradually went from 145/85 to around the 120/70 range over the course of a week.

I can't know if the drop was caused by those dietary changes. It could have been due to a few days of elevated stress, though that doesn't correspond to my subjective experience. It could have been due to the sodium content in the Coke Zero. It could have been due to the caffeine, except all the research I found states that caffeine intake only leads to a very short-term elevation in blood pressure. But I'm sleeping much more soundly now due to no caffeine, so that might be it. The extra fish oil could also have helped, but it's unlikely to account for most of the drop.

Sleep seems like the most likely candidate. I didn't have problems sleeping even when I was drinking a lot of caffeine, but there's no doubt the quality of the sleep was subpar.

What exactly do you eat / drink on an average day?

I usually have a cup of tea for breakfast and grilled cheese + tomato sandwitch for lunch. Dinner is either poached fish, grilled or curried chicken, steak or lambchops, and often features french fries or rice. Popcorn for a late snack. No alcohol. I avoid coffee, but have 2-3 packets of potato chips and the equivalent of 2 glasses of Coke a day (I think I'm hypersensitive to caffeine, and any caffeine after 4PM screws with my sleeping patterns). 2-3 eggs on weekends.

At one stage I had salad for lunch for about a year, and tried to eat vegetables 5 days a week, but it didn't seem to influence my BP.

I exercise a lot less than I used to, but when I exercised 4 times a week, I'd regularly check my BP before starting, and, if anything, it was higher than it is now. But I am trying to psych myself up for exercise for other reasons - I need to offset the general malaise that comes from being behind a desk the whole day.

While I don't know what such a diet means for hypertension, it sounds pretty poor in terms of nutritional value. You might have less malaise if you ate more fruits and vegetables, and weren't sending your blood sugar on a roller coaster with those two glasses of coke. Two cans of coke supplies over a quarter of the recommended daily carbohydrate intake!

Try eating nuts or seeds as a snack. The protein will help balance your energy levels and the fat will keep you satiated. Look at granola instead of potato chips -- not the top brand ones bars that are just sugar delivery mechanisms, though.

And really, you should eat breakfast! The first meal of the day has a lot of important effects. http://www.webmd.com/diet/guide/most-important-meal

I sleep ~6 hours per night, drink 6+ cups of coffee and 1-2 cups of tea per day, and only rigorously exercise for 25 minutes 2-3 times per month. My daily diet consists of 600+ calories from extra-virgin cold-pressed coconut oil and butter, 2-4 eggs a day, a handful of cherry tomatoes, 1000+ calories from beef/poultry/pork/fish, 400+ cals from hard cheeses (like swiss), a 1/2 pound - 1 pound of vegetables, maybe a handful of mixed nuts, and a whole lot of kitchen spices (including salt!).

I also try to take 5 - 10 minutes a day to do focused breathing/relaxation (i.e. meditation w/o the hocus-pocus).

With the above lifestyle, I have a resting pulse rate of 54, a bp of 122/70, and I have been losing 2-8 lbs a month for the past 18 months while maintaining strength, endurance, and muscle mass levels. Moreover, I feel wonderful!

I turn 30 at the end of the year, so my good results aren't because I am some youthful, exuberant teenager. I actually attribute them to my diet and lifestyle.

Traditional 'healthy' diet (low fat, low salt, high on carbs and grains) is very bad for health.

Your diet seems to be mostly keto (I assume your coffee and tea are sugarless). The diet of ern is very far from keto.

There are two very active community of redditors (keto and Paleo) with very good info on diets and foods that work to have good health, and bibliographies with explanations of why it works.

I like to think of my diet as "early-Neolithic". I am from one of the populations groups with adult lactose tolerance. So, I modeled it on the foods that might be available to what used to be called a "gentleman farmer".

I also recognize that scientific research has made real progress on determining what to eat in the past few years; so, I've also tried to incorporate some of those findings as well.

Read Gary Taubes - he makes a convincing case for reducing carbs (sugar, bread, potatoes, rice) drastically to combat high blood pressure.

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