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.

Notes from My Journal:

It’s kind of crazy how dumb smart people can be when it comes to making important decisions about their health. I’m thinking of so many friends and colleagues of mine that are taking medications or have undergone surgeries simply because one person, their doctor, told them they should.

Stupid people do that, too, but they have an excuse. They are stupid. But if one has an above-average IQ, I’ve got to wonder: Where is the doubt? Where is the skepticism?

This is something I began noticing about 40 years ago, when I was publishing books and newsletters on alternative health.

The first book I sold was called something like 365 Natural Cures from Around the World. It was a big book – maybe 12 x 16 inches and more than 200 pages. I was proud of that book because it contained so many natural remedies for so many health problems, both common and rare (e.g., the common cold and Ehlers-Danlos syndrome) and from serious to benign (e.g., prostate cancer and mosquito bites).

It took me and my team of researchers about 18 months to bring it to print. (Back then, research had to be done mostly in university libraries and by interviewing experts.) But it sold well enough to get me interested in publishing more information on natural health.

What I learned from all the research we did was that although drugs can be miraculous in treating all sorts of minor and major health problems, there is almost always a set of adverse side effects that are given very little attention. I also learned that dozens of the most commonly prescribed drugs are no more effective than some natural plant-based products that have no negative side effects.

Since then, I’ve made it a habit to read books and articles that challenge mainstream medicine, looking for remedies that may be as good as or better than the prescribed drugs – remedies that aren’t talked about by mainstream medicine because, being natural, they cannot be patented and, thus, produce profits for Big Pharma.

Occasionally, I will recommend what I believe to be a safe and effective alternative treatment to a friend or colleague, and the response is almost always the same. They look at me like I’m a crackpot and tell me that they prefer to take medical advice from “someone who went to medical school.”

When that happens, I’m at a loss. I don’t want to argue, because… who knows? I could be wrong.

And so it was that when I was first diagnosed with dangerously high blood pressure about a year ago, I was in a quandary. I was uncomfortable with my doctor’s solution, which was to put me on blood-pressure medication, and yet I was a long way away from having a better and safer idea.

“I’m going to write you a prescription,” Dr. B said as he took the wrap off my upper arm. “You came in at 180 over 90. You should begin taking this drug immediately, and then return here next month for another check.”

Dr. B’s certainty about what I needed to do made me feel that I’d be stupid to ignore his advice. “After all,” I told myself, “he’s a nice, honest guy. He’s smart. And he went to medical school.”

So, despite all the skepticism about pharmaceuticals that I had built up over the years, I went ahead and began taking the drug.

A few weeks later, when the side effects began to kick in (fatigue and brain fog, to name two), I had second thoughts. So, I started researching. And what I found was, unfortunately, what I feared I would find.

For starters, most people think high blood pressure is a disease. It is not. It’s nothing more than a set of symptoms. This misunderstanding became widely circulated when the medical industry, eager to monetize its treatment, gave it a disease-sounding name. They dubbed it “essential hypertension.”

Which means… well… exactly nothing.

If you want to understand how much the medical industry doesn’t know about hypertension but pretends to, take a look at this report, written by a doctor for laymen.

Nigel Checks the Facts 

To assess the risks and benefits of blood pressure medication, I gave Nigel about two dozen studies I had accumulated over the past several years and asked him to give me the pros and cons of taking that medication – especially over a long period of time.

Having learned a thing or two about AI prompts, I told Nigel to go to the various “government” and “big health” and other “official” health sites to gather facts about the side effects of blood pressure medication. I told him to trust no single source, to discount anything that was based on insignificant testing and/or questionable research, and to report the effectiveness of blood pressure medication in terms of both absolute risk (actual incidence) and relative risk (increase vs. control/placebo or alternatives).

This is what Nigel came up with:

Acute Kidney Injury (AKI)/Renal Dysfunction
* Absolute risk: Varies by population; generally ~1–5% in routine use, higher in elderly/dehydrated patients.
* Relative risk: Increased vs. placebo and with drug combinations (ACE/ARB + diuretics/NSAIDs).
* Details: ACE inhibitors and ARBs can reduce kidney filtration pressure; risk rises sharply with dehydration or drug combinations.
* Why serious: Can lead to sudden kidney failure, hospitalization.
            
Severe Hypotension (excessively low blood pressure)
* Absolute risk: Symptomatic hypotension reported in ~0.7% (ACE inhibitors) up to ~7–10% (some ARBs/diuretics). 
* Relative risk: Several-fold higher than baseline depending on drug class.
* Details: Especially common when multiple drugs are combined.
* Why serious: Leads to falls, syncope, reduced organ perfusion.
                        
Electrolyte Imbalance (especially hypokalemia or hyperkalemia)
*Absolute risk:
– Hypokalemia (diuretics): Common; clinically significant cases ~2–15% (varies widely).
– Hyperkalemia (ACE/ARB): Less common but clinically important.
* Relative risk: Clearly increased vs. placebo or non–electrolyte-altering drugs. 
* Details: Diuretics lower potassium; ACE/ARBs can raise it.
* Why serious: Severe imbalance can cause arrhythmias or muscle failure.
            
Angioedema (life-threatening swelling, especially with ACE inhibitors)
* Absolute risk: <1% overall; ARBs ~0.12% vs 0.07% placebo 
* Relative risk: ~1.5–2× higher than placebo (but rare)
* Details: Sudden swelling of face/throat.
* Why serious: Can cause airway obstruction and death.
            
Common but Non-fatal Effects 
 a. Dry cough (ACE inhibitors)
* Absolute risk: ~7–10% (up to ~13.9% in some studies) 
* Relative risk: ~7× higher than ARBs (~1–3%)
b. Dizziness/fatigue
* Absolute risk: Dizziness: 1.7%–14.8% depending on class. 
* Relative risk: Often 2–5× higher than baseline.
c. Adherence impact
* Real-world outcome: 23.5% discontinue within ~9 months; 40% partially non-adherent.
* Suggests side effects are clinically meaningful, not trivial (study of 370,000 patients).

If all this seems overly technical to you, you’re right. (Nigel’s results often feel that way to me.) So I asked him a simple question – the same question I asked about statin drugs and the COVID vaccines…

Question: Nigel, Do blood pressure medications extend life? 

His answer (like the answer I got when I asked about statin drugs): Yes, there is evidence that these drugs can extend life. But not by all that much. And there are offsetting risks – especially if you are my age (75) or older – that should cause you to pause.

And he gave me this breakdown…

1. For High-Risk Patients – including older adults or those with a high BP number – a modest but clear benefit. (But the net benefit, I would argue, is not impressive.)
            
2. For Average-Risk Patients – moderate hypertension without high short-term cardiovascular risk – a modest benefit. 
* Relative risk reduction (events): ~12% to 22%
* Absolute reduction: ~0.5%–1% over ~5 years
* Estimated life extension: likely months, not years (on average)
* Evidence strength: moderate
Bottom line: Benefits exist but are small in absolute terms.
            
3. For Low-Risk Patients – otherwise healthy individuals with mildly elevated BP – uncertain benefit. 
* Relative mortality reduction: not proven.
* Absolute mortality reduction: not demonstrated.
* Estimated life extension: 0 years proven.
* Evidence strength: weak (Cochrane reviews).
Bottom line: No clear evidence that treatment prolongs life.

Takeaways from Nigel’s Research 

* In Short: BP drugs do not directly “add years.” They reduce the probability of fatal events. High-risk patients may gain years. Average-risk patients may gain months. Low-risk patients may gain nothing measurable.

* There are some serious risks in taking blood pressure medication. They include kidney injury, hypotension, and electrolyte imbalance. However, these are not common.

* The most common unwanted side effects are bouts of coughing and dizziness (both of which I experienced when I was taking them). These can be annoying to some people, In fact, because of these side effects, 10% to 15% of those who take them eventually decide to stop.

My Own Experience 

I’m lucky. I didn’t have to make the tough decision about whether to continue taking blood pressure drugs or abandon them, hoping that I was statistically better off. But that’s because, in the middle months of last year, I lost 40 pounds, from 228 to 188, thanks to taking semaglutide shots, eating healthy, and exercising twice a day. Once I got the weight off, I kept it off. And that put me in the good-to-very-good range in everything one is normally tested for in a comprehensive blood test.

For the past two months, my resting pulse is in the 50 to 60 range. With strenuous exercise, I can get it to about 160 beats a minute. Three minutes later, it drops below 100. All of my biomarkers for heart health improved dramatically. My HDL, LDL, triglycerides, calcium, homocysteine, etc. numbers are all good-to-very-good for my age. Even my overall cholesterol count, which was the established metric for decades, is now below 150. So, it didn’t surprise me when my doctor agreed that I didn’t need to take the statins anymore. I stopped taking them about six months ago, and have not had a reason to start again.

One More Thing… 

I finished the above essay last night. This morning, I came across this article as I was sorting through the approximately 200 news sources, opinion pieces, business messages, and personal emails that overfill my inbox every day.