Notes from My Journal: 

Yesterday afternoon, feeling a bit edgy, I pulled out the little blood pressure device I keep in my desk drawer and took a reading. 
 
I was using the device several times a day after Paulo, my fitness trainer, noticed that my blood pressure had soared to something like 180 over 110. But when I lost 40 pounds and increased the intensity of my workouts, it dropped to the very healthy range of about 110 over 70, and it has stayed in that range. 
 
Yesterday, however, I noticed that my breathing was a bit labored and my pulse seemed elevated. I wondered if the stress of dealing with some recent (unexpected) business challenges might have affected my blood pressure. And… whoa! My blood pressure now measured 140 over 85!
 
“Well, look at that,” I thought. “That’s one commonly held medical belief that seems to be true. At least for me. At least for now.” (I know that the correlation between stress and elevated blood pressure is widely accepted, but I am skeptical about virtually all generally accepted beliefs about health science.)
 
The hopeful part of my brain was disappointed. It must have convinced itself that since my transition to the new me, I would no longer be susceptible to the physical degradations of the common man. 
 
But then I had a happy thought: If stress can raise my blood pressure, is it possible that I could lower my blood pressure by somehow lowering my stress? Was there some way to de-stress my brain and lower my blood pressure back to a healthy range?
 
I was aware of one method that was purported to do that – a breathing technique that I had read about. I went to my journal and found it. A protocol so simple, quick, and easy that I doubted it could work.
 
Sitting comfortably in a chair, I closed my eyes and inhaled slowly for several seconds, then held my breath for several seconds, and then exhaled for several more. Each repetition of the exercise took about 30 seconds, so I did six of them in three minutes. Then I opened my eyes, looked around the room, and strapped on my little BP device.
 
I was down to 120 over 80!
 
I’m far from ready to endorse this miracle fix. I’m going to test it out another dozen times or so before I can believe it may be true. When I’ve done that, I’ll share the results with you. But for the moment, I’m feeling pretty good about it.
 
And that’s not all… 
 
I remembered that I had discovered another way to lower my blood pressure that is almost the polar opposite of this breathing technique. Since I began exercising at a high intensity about six months ago, Paulo has pointed out that after I train my legs, my blood pressure drops significantly – like below 110 over 70! 
 
If you lift heavy weights and you do so without pausing, you know that training your legs is extraordinarily taxing. You not only demolish your quadriceps and hamstring muscles, you break into a sweat as your heart rate climbs up to its peak beats per minute. (For me, at age 75, it’s about 160.)
 
When it first happened, Paulo and I were both surprised. We are no longer surprised, but it still feels wrong. If intense mental stress raises my blood pressure, shouldn’t intense physical stress do the same?
 
It’s been a mystery. 
 
Nigel Checks the Facts 
 
I asked Nigel to do some preliminary research on the correlation between intense exercise, especially leg work, and blood pressure. Here’s what he found:

What you’re seeing is well known – and actually one of the most reliable effects in exercise physiology.
                        
After a hard workout – especially big muscle work like legs – blood pressure often drops for hours. Sometimes quite a bit. It’s called post-exercise hypotension.
                        
Here’s what’s going on, as best we understand it:
                        
First, your blood vessels open up. During intense exercise, your body increases blood flow to working muscles by dilating the arteries. That dilation doesn’t snap back immediately when you stop – it lingers. Wider pipes, lower pressure.
            
Second, your nervous system shifts gears. Exercise temporarily reduces sympathetic (“fight or flight”) tone and increases parasympathetic activity. That tends to relax the cardiovascular system.
                        
Third, there’s a chemical effect. Exercise boosts things like nitric oxide, which improves how well your blood vessels relax. That effect can last for hours after you’re done.
                        
Leg work seems especially potent because you’re using the largest muscle groups in the body. More muscle mass involved = bigger vascular response.
            
In terms of magnitude, studies generally show:
            
* A drop of 5–10 mmHg is common.
* In people with hypertension, it can be 10–20 mmHg or more.
* The effect can last several hours, sometimes up to a day.
                        
Over time, repeated bouts of this seem to “reset” your baseline lower, which is why regular exercise is one of the most consistently effective non-drug ways to reduce blood pressure.

Readers Write: 

From AS re two of my recent essays: “Why I Don’t Trust Statins” (in the Feb. 28 issue) and “What They Don’t Tell Us About Blood Pressure Meds” (in the April 4 issue)

Mark, you are so right about the medical field shrinking the qualification for high BP. In the 70s, when I was working in the ER, if someone’s BP was 140/90, the doctor would tell them to change their diet or lose some weight. They didn’t put them on BP meds.

Now, if the diastolic is in the high 120s or low 130s, boom, they prescribe blood pressure medicine.

In the emergency room one day, I took the resting blood pressure of a man in his late 30s. It was 80/50. Alarmed, I told the doctor. He asked me to see if the patient was a long-distance runner. He was. I told the doctor. He said that his resting pulse was that low because his blood pressure when he was running was probably down to 120/80.

“I guess his body thinks running 10 miles a day is his normal,” I said.

I thought that was interesting.

Since we’re on the subject…

I’ve been on BP meds for a long time. Gradually, over the last seven years, I lost about the same amount of weight as you did – 35 pounds. I suppose I had the same question you had when you decided to go off your BP meds. I asked my doctor if I could go off the BP meds. He said, “Why do you think it’s 120/80?”

Oh, and here’s another question. How do they treat stiff arteries or other causes of BP?

My Answer: You posed two questions that I’m sure anyone on BP meds might have right now if they have lost the kind of weight we are talking about. First, should they stay on the medication now that their pressure is in the healthy range? And second, is there anything that can be done once your arteries are damaged – when they are “stiff,” as doctors say?

Your doctor’s answer – “Why do you think it’s 120/80?” – seems logical. I got the same answer from my doctor after he put me on statins and my heart-related blood metrics moved into the healthy range.

But it’s not logical if he hasn’t taken in all the relevant inputs, such as losing a ton of weight and training your heart and lungs with intensive cardiovascular exercise.

I made the decision to wean myself off the meds (first the BP medication and then the statins), contradicting my doctor’s very conventional advice. I didn’t make that decision irrationally. I’ve been reading about natural ways to treat high blood pressure and bad blood metrics for 30 years, and I was well acquainted with studies that concluded it was possible to get back to good cardiovascular health through diet, weight loss, and exercise. (There are also natural supplements that are recommended, but I didn’t take any of those.)

The studies I remember seeing concluded that it is perfectly possible to lower systolic pressure by 5, 10, and sometimes even 20 points. That’s what happened to me.

I’m glad I disregarded my doctor’s advice (carefully), because now I don’t have to worry about the serious side effects which are, admittedly, rare. More importantly, I don’t have to endure the most common side effects, which are feeling physically sluggish and brain-fogged.

I’m not going to give you medical advice here – and I’m sure you wouldn’t take it, anyway, since I’m an amateur health expert at best. But if you want to see if you could do what I did, you’ll have to find a doctor who is a true expert in this area of medicine and also inclined to prefer natural cures to drugs.

And if you do find one like that, he’ll probably suggest that you do what I did: Wean yourself gradually off the drugs by lowering the dosage incrementally over time, checking with him regularly to be safe.

As for stiff arteries, the usual story is that high blood pressure damages arteries over time. Many doctors take that as gospel. But it’s a chicken-and-egg problem. There’s ample evidence that the stiffness often comes first – from eating badly and not exercising and becoming obese. (In other words, from the usual mix of inflammation, insulin resistance, and oxidative stress.)

If you take that view, as I do, you see the higher blood pressure as a perfectly sensible way for the body to respond to the stiffness of the arteries. (The problem with drug therapy is that there is little to no evidence that drugs restore arterial flexibility. What they do is lower the blood pressure number, which may be helpful in the short term, but doesn’t extend life because they don’t seem to fix the underlying mechanics.)

The body must get blood into the capillaries one way or another. If they are partially blocked, the heart must push harder. Thus, to answer the question I think you were asking: What can be done to repair artery damage naturally, rather than simply thinning the blood?

The answers I’ve seen from my side of the chicken-and-egg question are:

1. Keeping a healthy weight
2. Regular aerobic exercise
3. Regular strength exercise
4. Better blood sugar control
5. More whole foods
6. Fewer ultra-processed foods
7. An adequate consumption of potassium, omega-3s, and leafy greens

Remember, the goal isn’t to get a good reading in the doctor’s office. It’s to have the best cardiovascular health you can manage with the least downside over time.