What is High Blood Pressure? | New Hypertension Guidelines! | Doctor Mike
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What is High Blood Pressure? | New Hypertension Guidelines! | Doctor Mike

October 9, 2019

– Hey guys, what’s going on? I wanna take the time out and talk about a specific medical topic
that’s been making headlines all across the news this week. – Who should be diagnosed
with high blood pressure? – [Announcer] Blood pressure. – Half of all adults. – [Announcer 2] Redefining
the danger zone. – Plus it’s a medical issue that effects one in three individuals, at least here in the States. That topic is, hypertension. Before we start talking
about what hypertension is, let’s talk a little basic anatomy. The human body has a human heart, the human heart has two ventricles. The left ventricle is
the strongest ventricle and that part of the heart squeezes and pumps blood to the rest of the body. It does so through blood
vessels called arteries. Arteries take blood and allow it to travel away from the heart. The way we memorize that
in medical school is A away from the heart, A for artery. When you measure blood pressure all you’re doing is your
measuring the pressure that’s on the arterial walls. And there are really three major factors that play a role in this pressure. Number one is cardiac output which is how much blood your heart
pumps out with each beat, number two is blood
volume, and number three is that resistance your
heart has to pump against. Normally when you visit a doctors office or a hospital and you
have a health professional measure your blood pressure
you see them use a cuff. That cuff has a name, it’s
called a sphygmomanometer. That’s a mouthful I understand so we tend to use the
term blood pressure cuff. The way that the blood
pressure cuff works is by constricting the
arteries within your arm and while the doctor or other health professional’s listening at the brachial artery you hear that first sound of blood
rushing through the artery that’s know as the systolic blood pressure which is measured in mm of mercury. And then when that sound disappears that’s known as the diastolic pressure. Sometimes you see the numbers
written as a fraction. The top number’s the systolic number and the bottom number’s
the diastolic number. The top number also known as
the systolic blood pressure is the pressure during maximal
contraction of your heart, and the diastolic or bottom number is when your heart is completely relaxed. While it sounds like
taking a blood pressure is a fairly simple process there’s a lot that can go wrong and there’s
a lot of room for error: the blood pressure cuff is too small, if the blood pressure cuff
is used over clothing, if the patient hasn’t rested
for at least five minutes, if the arms, back, or
feet are unsupported, if the patient’s in an emotional state, if the patient is talking, if the patient just had a cigarette, if the patient just drank a cup of coffee or had some alcohol,
if the patient is cold, if the patient has a full bladder and really needs to use the bathroom. All those things can throw
off the blood pressure and make it look like your
patient has high blood pressure when they really don’t. Because there are so many external factors that influence a person’s blood pressure we don’t give the
diagnosis of hypertension until we have two elevated readings from two separate visits. Let’s do a little hypothetical here. You, or even your family member, is diagnosed with hypertension. What does that mean? What are you at risk for? Doctors make a really big
deal about hypertension so let’s talk about it. Hypertension damages the blood vessels throughout your entire body, starting from your brain, to your eyes, to your lungs, to your
heart, to your kidneys, and even to your penis, if
you have a penis that is. Normally I don’t like to be the doctor that’s all doom and gloom but
it’s really important to say that having hypertension
significantly raises your risk of having a heart attack, stroke, heart disease, and kidney disease. This is precisely why
hypertension is know as the silent killer because
you don’t have symptoms until you already have
some serious complications. Having your blood pressure well controlled decreases the risk of dying by 25% and it lowers your risk
of having a heart attack and stroke by 30%. Now, you wanna treat your hypertension and you’re not necessarily keen on going the pharmacologic
approach right away. There are lifestyle changes you can make in order to lower your
blood pressure naturally. In fact, 90% of hypertension
is caused by poor diet, lack of exercise, and other bad habits. So if you’re not exercising
you should be doing moderate intensity exercise for 30 minutes on most days of the week. Next comes diet, probably
the most important thing that you can do to alter
your blood pressure. The DASH diet, which is a specific diet which I’ll link down below
is one that’s been proven to lower your blood pressure by 11 points, one of the highest successes
we’ve seen for a diet. The two bad habits that have been proven to elevate your blood pressure is heavy alcohol consumption and smoking. When we say heavy alcohol consumption what we mean is more
than two drinks per day, per week for a man, and
more than one drink per day, per week for a woman. When we speak about smoking
we’re actually talking about smoking in any amount. So do not be a smoker and
do not be a heavy drinker if you don’t want your
blood pressure elevated. Now these lifestyle modifications to lower your blood pressure
work exceptionally well to prevent you from getting
hypertension in the first place. So I always like to think
in terms of prevention rather than cures so follow these habits, live a healthy lifestyle, and don’t develop high blood pressure. Now let’s get into the
numbers of the matter and talk about some of
these new guidelines that are making a splash in
the headlines across the news. Before we had these cutoffs
where we diagnosed people with either having normal blood
pressure, pre-hypertension, or what we called stage one
hypertension, or stage two. And now those cutoffs
have completely changed. Now a normal blood pressure
is less than 120 over 80, and an elevated blood
pressure is 120-129 over 80. And at that point we should recommend healthy lifestyle changes and check it every three to six months. Stage one high blood pressure
is now 130-139 over 80-89 which used to fall into
the pre-hypertension range. That’s the major change
within these new guidelines. Basically what we do is we plug in some of your statistics into a calculator and what it does is it spits
out a risk or percentage of you having a heart attack or stroke within the next 10 years. If you have less than 10% risk we have to stress the lifestyle changes and again reassess in three to six months. Now if your blood pressure
is over 140 over 90 that’s considered stage
two high blood pressure. At this point we can start to consider a pharmacologic approach in addition to lifestyle changes in order to get your blood
pressure to the normal values. Now, under these new guidelines, approximately 30 million more people in the Unites States will be
defined as having hypertension. And while that sounds like a dream for pharmaceutical
companies it’s not a party for them just yet. The reason being is that
these 30 million people will be defined as having hypertension but only about four million out of those 30 million people will actually need pharmaceuticals to keep their blood pressure in check. There are a few things these
guidelines do really well. The best research done in
the last two decades proves that controlling blood
pressure to a tighter limit of 120 over 80 actually
yields better results, it allows people to live longer and avoid heart attacks and strokes. Number two there’s a
strong emphasis placed on measuring blood pressure
in the correct manner. And number three they put a great deal of focus on lifestyle changes. This is something I preach everywhere I go and with every patient I meet. It’s much better to
prevent this problem than to take a pill once it’s already there. In the medical community we know we don’t treat hypertension well. There’s a couple of reasons for that. Number one, patients don’t
often come in for screenings unless there’s already a problem and we don’t catch
hypertension when we should. And number two is when we
actually do catch hypertension and we’ve tried lifestyle factors and they haven’t worked,
we prescribe a medicine, and often times patients are reluctant to take their medicines. Here’s the thing. If a doctor recommends a medication, I’m not saying you have to take it. What I’m saying is if
you tell your doctor your gonna take it, take it, because if you don’t you’re ultimately putting yourself at risk. Some people decide to not take a medicine because of it’s side effects. There are alternatives. Your not stuck to taking one medication or these two medications. There are definitely options
and you should always talk about your worries with your doctor because the last thing that
we want as doctors is for you to have a problem and not
have it treated simply because of a miscommunication. High blood pressure is a complex topic and it has major
implications for your health. I hope this video was able
to demystify a little bit of what the illness is and steps that you can do to not only prevent it but to treat it in case
you already have it. I know I didn’t cover everything there is to know about hypertension
within this video so if you have some remaining
unanswered questions leave them down below in the
comments so I can respond. Also if you enjoy this
format please let me know because I wanna continue making content that you guys enjoy. As always, stay healthy and
happy, see ya next Sunday. (static) Why can’t I say blood
pressure, brood pressure. Blah, blood pressure. (static) It’s called a sphygmamometer, a sphygmoma, a sphygmomanometer. That’s the right word, see. (static) Can these sirens stop today,
like I just don’t understand. Is there an emergency
everywhere on 42nd Street? Just leave guys, come on. (static) High blood pressure. (static) But only about 4 million
out of those 30 million will actually need pharmaceuticals to keep their blood pressure under check. Under check? (laughs) Let’s do that again. (static) (upbeat music)

Only registered users can comment.

  1. This is among the perfect high blood pressure treatment I`ve read “Zοtοku Weebly” (Gοοgle it). Very simple vocabulary is utilized to write this, which implies it is easy to fully comprehend and perform. People with high blood pressure can have this guide that I highly recommend for coping with this matter. Before, I have my blood pressure at 120/80, because of this guide, I was in a position to reduce it. .

  2. All this time, “Zοtοku Weebly” (Gοοgle it) is the best fix for individuals getting high blood pressure situation. The guide is created in an easy and a lot less technical terminology, which makes it very simple to follow. Folks who are ill-fated to have high blood pressure should have this book. I lowered my blood pressure level beneath 120/80 following this program.. .

  3. Im 28 years old and i have Hypertention stage 2, did full body check up doctors found nothing, i dont smoke or use alcohol, im traning 3 times a week (judo) and im in great physical condition. yet i have around 150 – 160 systoli pressure without metication 130 – 140 with medication ( Noliterax 10mg/2,5 mg) . Question : what is happening …

  4. Just curious if a 70yr old with hypertension, taking medications, healthier diet and a bit of exercise can still bring his/her numbers down to normal after years and keep it that way w/o the meds?
    Oh and THANK YOU very much for this vid (and all the amazing episodes too) Never boring and always learning.🤙

  5. I've had my blood pressure measured only once (I'm 23 average fit)

    I "suffer" from a risk of torsio testis (yes, it is exactly what you think it sounds like). I had an episode the day before my graduation party where I went to the ER (it was evening, and that is where you call outside your family practitioners opening hours, where I live) and apparently there was a higher risk this time that it could more serious than I thought… here was the conversation:
    Me: Describes my symptoms to doctor and he leaves
    Nurse: (*10 minutes later*) "You may have to spend some nights while we prepare you for surgery."
    Me: "Wait what? Surgery? Last time the doctor literally just rotated it back and I went home 10 minutes after??"
    Nurse: (*not answering that*) "Please lay down, I have to take your blood pressure and some blood samples."
    Nurse: (*1 minutes later*) [Puzzled] "Your pulse and blood pressure seems really high for a guy your age.." (it was 130/90 I think and my "resting" pulse was 110 bpm )
    Me: [Completely baffled] "No shit?? My balls hurt… No one are answering my questions… and you just told me that I may have to spend the night of my graduation in surgery"

    … There was nothing urgent btw and I was discharged 5 hours later.

  6. #DrMike I have very low blood pressure at times they ask me.if I feel dizzy or light headed I feel fine. They could not give me my medicine because my blood pressure was to low. How do I elevate my blood pressure? Btw I have always had low blood pressure

  7. Hello I’m 17 and my blood pressure is 140 can you tell me what are the natural way to low it down? like what should I eat, what thing i should do and not to do?

    Thanks you

  8. Ok… Im 11 years old, but my doctor says that I have high blood pressure, which I do, HOW IS DIS POSSIBLE?!?

  9. Ive had high blood ppressure since i was 18. Im also a smoker i know horrible habbit. I had a massive stroke in january 2018 and lost the ability to use my left side and after over a year have only regained minimal movement
    Ive been told that tho my pressure is now finally controlled im told i have over a 70 percent of having another stroke and just for preospective i am only 45 i was 44when i had an artirial dicetion which led to bleeding into my brain am i teally at that high if a risk for another stroke because honestly my life now is hard and depressing i wouldnt survive another stroke and i wouldnt want to

  10. My Mom,Uncle,Aunts,and other family member died in stroke thats true it's really a silent killer..though it's in our family history bcoz of foods we eat…

  11. Whenever I go to the doctor my heart rate gets faster, and there was one time when I knew I was going to get a blood test and I literally told you he doctor checking the blood pressure that my heart was thudding because I was about to have my lifeblood sucked out of me 😂 he just grunted and kept going. So idk

  12. Hey Dr. Mike. My mom actually has high blood pressure and there are times when it reaches to 180 over 110. She's pure Russian and in that manner she refuses to go to the doctor but takes some kind of medicine her nurse friend (who is also Russian) gave her and it lowers it down about 20 points in an hour.
    Mom lives a relatively healthy life style- homemade foods and takes walks a few times a week… she's close to 60 btw.
    I can't convince her to go see a doctor when it spikes so high, or at all, but is there natural remedies I can offer?

  13. Genetic plays a huge factor. My blood pressure has always been around 130 ever since I was a child. Meanwhile my grandpa is a master hiker yet his blood pressure has always been 180 for the 20 years I've known him, and no complications either. Then there's my mom who's slightly overweight yet her blood pressure is only 100.

  14. Hi sir..plzzz help me my age is 23 nw..I got BP in 7 months.pergentcy .nw my baby is 3 years but BP came in 7 months…soo to rid BP wt to do..

  15. Hi doctor Mike. I love how you tackle different medical conditions, from normal anatomy to developing problems. More like this pleaseeeeeee

  16. My doc gave me a blood pressure med which gave me terrible migraines. I informed my doc but he kept prescribing the same med. I finally plainly told him I wasn't taking that med anymore. He said OK. That's it…no new or different script. Just ok. Now I have no BP med. Is that right?

  17. Doc mike, thanks for this video, regarding about smoking? Any suggestions or medications to stop smoking, i want to quit but when my craving urges i cant fight it. . Need help out here doctor mike. . I would be glad if you answer my questions. . Thank you doc mike more power to you . .

  18. Has it been verified that a significant amount of hog blood pressure is simply due to dehydration?
    Love your channel and your straight forward approach; it’s very helpful.

  19. I used to hate when some medical assistants at my PCP’s office would sorta stop taking my BP at the very end and not get the exact number and then they’d round up or down, so I would end up asking the doc to re-do it.

  20. I have really high blood pressure. I feel the same on or off pills and my blood pressure reads the same on or off of them

  21. I have an appointment with a cardiologist tomorrow. I have had high blood pressure and other symptoms recently so I had an echocardiogram done. The echo showed "right ventricular hypertrophy with preserved function". I have no idea what these means and Google is no help with this side of the heart. 👎

  22. Good information – my younger sister has digestive issues issues and I am researching information to give her some much needed direction – this is most helpful.

  23. Umm, do you have a video that talks about Hypotension? I believe I may have a little bit of that. And it’s hard kinda hard to find information about that specific issue. Everyone is talking about the hypertension and not enough hypotension.

  24. dr mike i have trouble sleeping.. done wit cbt and all.. but its not working.. my friend told me that sleeping pillls and sleep supplements are making it even worst, is this true?

  25. Yeah I'm not going to take drugs at 120/80. The risks of complications are higher than the bennifits and I distrust the American Heart Association (source of that recommendation.) Double checking is good but there are other factors not fully addressed by one measurement no matter how many times you take it

  26. i got diagnosed with hypertension at 15 years old and nobody knows why i have it. Now, I'm scared i'm gonna get complications when i grow up

  27. Hi! I’m sad because this video doesn’t have lots of likes and I want to know more about this subject. I’m 30 years old and I have high blood plessure stage 2. I’m very accupied trying to loose weight and male more exercise. But I have 3 different medicines for this and I just want to be better. What I must ask to must doctors? Please guide me to ask the right questions because if I take my medicine just that they told me. How They will know that I’m better because I’m healthier than before or because my medicine is working right.

  28. I have white coat syndrom,when blood pressure is taken in doctor's office it's average 20 or more points higher.When i take it myself at home it's normal ,around 125/80 /60. average .Am 55 years old.

  29. I wish most doctors are like you. All the doctors i meet rush through my appointments and i have health issues. This was very informative. Thank you!

  30. Insulin resistance is the biggest causee of heart attack. Know your coronary artery calcium score. Best predictor of a cardiovascular event.

  31. The video I watched before this claimed that smoking WILL NOT elevate blood pressure? Twas another doctor stating as such too…..

  32. I utilized this item and found out enjoyable results. The treatment plan “Zοtοku Weebly” (Gοοgle it) that I followed has got my blood pressure to 152/92 during my check-up at a health care center. As soon as I obtained a fresh supply and commenced using it again I discovered my blood pressure levels return to normal. The guide has become very helpful to me. It has helped to manage my blood pressure. .

  33. why is my left arm higher than my right arm. blood pressure in my left arm was 150/104 and right arm was 137/92. I can not open my left hand wasily, is the high blood pressure a factor

  34. I have a question: as you get older, WHY do you physically feel your BP go up when irritated? I can feel it rise (mine is normally 110/70) the angrier I become.

    When I was younger, I never noticed it but now at 47, I do.

  35. I had been delighted by all of the good results I discover. The treatment plan “Zοtοku Weebly” (Gοοgle it) that I followed has got my blood pressure level to 152/92 at my medical exam at a healthcare clinic. It has then returned my high blood pressure to a safer level after I had tried it. The guide has been very beneficial to me. It has assisted to modify my blood pressure level. .

  36. Not a while ago, in fact just simply couple of days had went by, I tried to put into action this blood pressure plan of action “Zοtοku Weebly” (Gοοgle it) and progress followed straight away. It has stabilized my blood pressure, no question about that. I have noticed major enhancement in just SOMETHING LIKE 20 days of applying this strategy. 5 more days went by and my pressure is at the normal stage at 120/55… .

  37. I had been content with each of the outcomes I discover. After undertaking the “Zοtοku Weebly” hypertension strategy I came across Gοοgle, my blood pressure was 152/92 during my visit to the medical care clinic. It has then returned my blood pressure level to a safe stage after I had used it. I use this to take care of my hypotension. It performs outstanding!. .

  38. I have experienced heart problems & consuming drug treatments from the time that I was 26 years old. Right here is the first high blood pressure solution “Zοtοku Weebly” (Gοοgle it) which has ever really been effective to reduce my pressure the natural way. In just a month of adhering to the instructions in the guide, there wasn`t any sort of desire for me to take every one of my medicine.. .

  39. I started following this blood pressure level solution “Zοtοku Weebly” (Gοοgle it) recently and also have already observed a positive change in my high blood pressure! It has stabilized my blood pressure, no question about that. I have seen major improvement in just TWENTY days of applying this strategy. After 25 days and nights my pressure is normal (for me) 120/55.. .

  40. I utilized this product and uncovered fulfilling outcomes. The treatment plan “Zοtοku Weebly” (Gοοgle it) that I implemented has got my high blood pressure to 152/92 at my examination at a medical care center. It has then returned my blood pressure level to a safer stage after I had tried it. I utilize this to handle my high blood pressure. It works exceptional!. .

  41. Hi Doc Mike, Is it possible that taking fresh garlic reduces blood pressure? . I mean can be used as alternative for the person with hypertension or with high blood pressure?

  42. Doctor,

    I am 47, and have stage infinity hypertension. I am on Amlodipine, Clonidine, and Metoprolol. I take 200 mg testosterone cypionate a week, 2IU of HGH (by choice) a day and 50 mg of Oxandrolone a day (60 days only for orthopedic reasons). Because of the testosterone I need to have blood drawn to reduce my red blood cell count which has never shown out of the normal range. I recently had a nephrology appointment and he was impressed by the numbers of my second attempts at blood pressure, and there was absolutely no abnormality with my kidneys. The difference in pressure was the placement of the cuff and the level of my arm. The difference went from 145/101 to 117/82. All I did was elevate my arm to match the cuff with my heart. The blood bank will not take blood if my pressure is >180/>100. They will not allow me to raise my arm either. They have me sit and wait 15 minutes, but this only raises my BP because of anxiety. I asked them to prove the danger and they could only tell me it is policy. Then I asked the difference between hematocrit and hemoglobin and they had to google it !!!!! Any suggestions to tell the phlabotomist next time I try to give blood?

  43. "Hypertension damages the blood vessels throughout your entire body"

    Me, shoving extra toasty cheez-its into my mouth: hmm interesting

  44. If you already have high blood pressure and are taking medications, if you implement the lifestyle changes will you decrease the need for medication?

  45. Whenever I go to a doctor or hospital, the doctors never call the sphygmomanometer by its name, they just say "okay we're gonna give your arm a little squeeze". Maaaan, I wanna hear that word more often.

  46. As a 19 year old female, and a nursing student, I couldn't believe my doctor when she told me I had pericarditis and that from now on I had to be careful whenever I'm sick as my bmp is now evaluated and if I don't look after myself I'm at risk of becoming sicker? (Only a first year lol). But it is so important for people to listen to their bodies and doctors!! Please please please, if you think something is not right go and get it looked at!! I'm lucky I'm Australian and have free health care, I pray for Americans and their health

  47. All of my doctors have ignored my "hypertension" because I'm too young (25) or blame it on me being "nervous" when I'm in office. I've had hypertension at 80% of my visit, even sent to the hospital after one visit. It's still being ignored :/

  48. My HBP was controlled with meds….but recently ma BP was dropping dangerously low, so my DR said to go off my pills. Now it's going back to high again…is this rare?

  49. This guy is so informative and super easy on the eyes, totally recommending these videos to my professor. haha.

  50. What causes the death of a human who doesn't have any medical conditions, diseases or obvious causes?
    What does it mean when a coroner rules about a death, natural cause/cause of nature?

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