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

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


– 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)

100 Replies to “What is High Blood Pressure? | New Hypertension Guidelines! | Doctor Mike”

  1. I had hypertension in my pregancies my obgyns were worried so they had ordered blood for a blood transfusion just in case if i bleed to much but after my pregnancys i had to take medication for my blood pressure .

  2. What about people who have low blood pressure? Or fluctuating blood pressure between very high and low such as myself? Can you make a video about these two other conditions please?

  3. Guys I had a scare yesterday. I hadn't eaten anything all day and I was very tired so I drank a 300mg caffeine Rockstar on an empty stomach. And normally I'm not caffeine sensitive but I got so jittery and shaky and my coworkers made me go get my blood pressure taken at the pharmacy in our grocery store. It was 151/96 and they were worried and told me it's not bad enough for the ER yet so I needed to calm down and take a seat. I went back 30 minutes later because they said to come back if I felt any worse and I did. They check it and it was 171/99. Almost heart attack range. Do not drink energy drinks on an empty stomach!! I'm only 16…. btw

  4. Ask a doctor why two men, both with 135/85 and all other things being equal…but one has a resting pulse of 95 and the other 55, why is the 2nd guy not in a much better situation? Best case scenario the doctor will change the subject, worst case his head will explode. Either way your question won't get answered.

  5. I'm deathly allergic to white light. I have to wear a leather outfit head to toe to survive leaving the house. At home in my light-controlled environment, my blood pressure is generally 120/80. Even after a workout. When I go to the doctor's office, I take off my leather shirt for a minute to take my blood pressure, and I can immediately feel my blood pressure and pulse rate spike. My blood pressure reads 145/95.

  6. It's good to Know ThingsTM, but how do u make an obnoxious old lady go the doctor and get checked left alone regularly take the pills 🙁

  7. Kidneys and blood pressure can be intricately related. I had kidney failure of both kidneys as a toddler. The doctors were able to get both kidneys working again after much effort. Back then, my kidney doctor warned my mother that I would have hypertension some day. Many years later, both my kidneys are functioning at full capacity. (Monitored yearly by blood tests.) As predicted, I developed hypertension at 15, and immediately began medication which I have been on ever since. For medications, if you aren't used to them, just make it part of your routine. Get up, brush teeth, brew coffee, take meds, eat breakfast….

  8. My doctors have blown me off when it comes to high blood pressure. My usual has ALWAYS been around 100/70. But this last year, it’s been averaging around 140/90. Their “diagnosis?” “White Coat Syndrome.” 🤦🏼‍♀️ I work in acute care…I’m not afraid of the doctors office. Guess it’s time for yet another change of physician.

  9. When i was just 10 i was having high blood pressure problems. i was (and still am) a very active girl and ate healthy (somewhat lol). They said it was anxiety, and in a few years I would be diognosed with High Blood pressure. Its been almost a year since then

  10. If you're on high blood pressure medication, can you move up to the next stage? Since the medication is working in your system can they get a reading of how bad your high blood pressure is without medication.

  11. I wish someone could figure out my blood pressure. No matter what diet I have tried it doesn't matter I'm what my Dr. Calls the walking dead. I have never smoked a day in my life and as for drinking it is very rare that I do.

  12. Normal blood pressure for humans is 110/70 mmHg.

    Before you say that's crazy or unreasonable… Centenarians, hunter-gatherers, and subsistence farmers maintain this BP for life!

  13. Love your videos and the way you break down information. Easy to follow your videos and actually understand what you are explaining. Please keep it up and be.. more on topic than off. Cheers

  14. My moms boyfriend drinks every single day, there isnt one day I dont see him drinking. My mom smokes too…so yea

  15. I’m honestly asking because I’m confused.. how can something be “per day per week” I thought it could be per day or per week.

  16. I have elevated blood pressure because apparently I have sleep apnea but I'm scared of getting the Tonsillectomy because I have Gerd and worry about the healing process of the surgery. Complications and such.

  17. I generally have hypotension right now but for a good while I had hypertension (clearly my body hates me). My blood pressure once went up to 200/140 at the highest mind you I’m 19 right now.. for a good year or more my blood pressure would maintain a higher level. It random points it would spike. Even if I was completely relaxed and asleep BOOM SPIKES UP. Now it was trending high because of a medicine but why it spiked and still does no one knows. After not taking the medicine my blood pressure is now low and gets very low. Just yesterday it was 90/40. At my first super high blood pressure event I had all kinds of symptoms. The next time for my highest ever I felt fine. You would assume when your blood pressure is really high you would have a migraine and vomit and other symptoms but I felt great.. honestly that time I could of died and never would of felt a thing. Just happen to have a nurse come that day. I think my body is very interesting and so many crazy things happen to me that simply can’t be explained. I would love if you did more research on POTS (Postural Orthostatic Tachycardia Syndrome). Most doctors aren’t fully informed on this and should be. It’s sooo common yet doctors don’t know what it is. It varies in severity and no one really knows what exactly it is. The more doctors who know about this I feel is the better. Since you do YouTube videos and you read this I would love you to inform others on this. I can always give my own personal experience.

  18. Love your video! ❤❤I would like to know about low blood pressure explanations and treatments by you, Doctor Mike 😊😁😁

  19. I have a question, you said that we don’t diagnose a person with hypertension if they have two elevated rankings from two separate visits but what if the external factors play a role in both of the visits?? 🤔

  20. My father and his father have hypertension. My grandfather's father had it and died of it when my grandfather was 11 years old.

  21. Please make a video on… How eating more 🍴 meat 🍗 affect your brain and other part of our body…

  22. Can you do a video about smoking and the effect it can have on the body (not the blackened lungs. We are not in preschool). I have been trying to figure out if I should go to my doctor. I quit smoking almost 2 years ago and haven't noticed any positive effects on my health, but I have noticed a few negative effects. The only positive effect I have had was the bank balance. 🤷🏻‍♀️

  23. Watching this content about two year after its posted. Really need these info and discourse for our country. More power and please make more common knowledge medicines. 💜

  24. My late husband died from severe untreated high blood pressure. At the time of his death he was on 3 or 4 meds and it was finally barely under control, but his kidneys were only functioning at 8% by that point and he was refusing dialysis, the only treatment he would consider was a kidney transplant which the doc said he was an excellent candidate for (but never said he wasn't putting him on the list, but in retrospect I realize it was because he wouldn't follow medical advise). He also needed a transfusion he refused. Eventually heart stiffened causing his blood to back up into his lungs and he basically drowned to death. While he still had a heartbeat, I had the docs do all the things he was refusing, but it was too late. He needed 3 pints of blood and the dialysis removed 5 liters of fluid from his body. His color changed from grey back to pink. Unfortunately, by that point hear brain dead so I had him removed from life support.

    So, if your doc is saying you're having this drastic of a problem, take it seriously! My late husband was only 37 when he thought he knew better than the medical professionals and insisted it could be controlled with diet and exercise. It was a heart wrenching way to watch someone die, and I assume it was painful for him as well.

  25. Hi Doctor Mike. In the last 3 visits to my PCP, my BP has been elevated at around 130s/80s, and my Dr. emphasizes the importance of getting regular exercise. Do you have any suggestions to slowly incorporate exercise into my daily life? I used to be fairly active, but completely neglected any physical activity once I entered nursing school. I am really worried about being diagnosed with hypertension, and I don't want to rely on medication when I could modify my lifestyle. My weight used to be healthy, but I have become overweight, which is one of the reasons why my BP is elevated.

  26. I'm 21 and I was diagnosed with mild hypertension when I was 17. I'm not overweight, but instead I inherited it. I hope I get to a point where I don't have to be on meds one day!

  27. Does the new BP scale apply also to the elderly (>65) or those with chronic disease? I have read somewhere that the new target BP for age > 60 is 150/90 and for people with diabetes/kidney disease is 140/90. I am a bit confused. Thank you!

  28. Can BP go up temporarily by stress and or poor sleep? I never been told I had high blood but I went to the doctor and my BP was 134/107. I slept real bad that night and was agitated because I didn't
    Get enough sleep.

  29. Since implementing Heron methods a months ago, I just wanted to let you know that I did just one day of the 3 exercises and went from 155/95 to a reading, the very next day, of 121/82. I’m so excited, and I hope to be even lower by the end of the week. I’ve been on Amlodipine and Lisinopril for months, and haven’t been able to get it lower than 135/90. I am now sleeping much more soundly and my head is much more clear, etc. For more information about Heron method, click here healthighway.com/eikc

  30. Hey dr Mike, I'm a nurse and deal with HTN all the time and actually wrote a research paper on it while in school. Your video is so great to talk about this topic, but I'd like to bring up something that isnt talked about as much. Vascular dementia is the second most common type of dementia (behind alzheimers disease), vascular dementia number one risk factor is high blood pressure. A person's blood pressure can cause micro vascular changes in the brain if untreated for a long period of time.
    High blood pressure is so important to talk about because it's such a preventable condition but can cause so many complications in the future if gone un treated, or untreated for too long. Great video!!

  31. What are your thoughts around a high resting heartrate? 120/80 bp. Cup or two of coffee in the morning 🤷🏻‍♂️

  32. There are literally hundreds of blood pressure meds, I know because Ive tried a great number of them and they all have unpleasant side effects…..which I hate. I have no choice but to take meds, and even with those meds my bp is not well controlled, but between the meds I take for heart failure and the bp meds I feel like Im crawling through mud to get through my days. My mother refuses to take bp meds, she has been hypertensive for more than 60 years now and at 80 years of age she sees no reason to limit her enjoyment of life in order to control a condition that she has survived just fine for so long.

  33. Age 61 4 weeks ago drinking alot caffeine using pre workout with caffeine fat burner with caffeine my blood pressure was 195/125 stopped caffeine and supplements went to 177/87 next 4 weeks i will reduce more with cardio

  34. I started sticking with this blood pressure level method “zοtοsο Yuku” (Gοοgle it) a few days ago and have already witnessed a positive difference in my blood pressure! It has stabilized my blood pressure, no question about that. I have noticed major advancement within 20 days of using this strategy. After Twenty-five days my pressure is normal (for me) 120/55.. .

  35. I have a smoke before my doctors visit and my blood pressure is always good. So I tell him “see I don’t need to quit” and he goes “yes you do” lol. My pulse is always 98-101 though 🤔

  36. What about hypotension?? I was diagnosed with hypotension a few years ago but no one really talks about it at all, it really confuses me and other people around me

  37. I feel like dog shit when I hear this.
    I’m a Vegetarian, don’t drink/smoke at all and I work out somewhat.
    So why the fuck do it feel like this…

  38. I had been content with all the effects I see. The treatment plan “zοtοsο Yuku” (Gοοgle it) that I implemented has got my high blood pressure to 152/92 at my check-up at a healthcare clinic. As soon as I acquired a fresh supply and initiated utilizing it again I discovered my blood pressure level come back to normal. I utilize this to control my hypotension. It performs great!. .

  39. I have had hypertension & getting prescriptions from the time I was 26 yrs . old. Of all treatment I’ve tested out, “zοtοsο Yuku” (Gοοgle it) certainly is the one that has proven to work with my blood pressure. The medicinal drugs recommended to me to have were not of used any more after a calendar month of loyally making use of this guide. .

  40. This blood pressure level treatment “zοtοsο Yuku” (Gοοgle it) is very clear, helpful, and simple to study. In a matter of Only two nights, I was able to get all details I desired from it. On keeping track of my blood pressure levels, the actual outcome went from 148/98 on thanksgiving holiday occasion to 116/78 within just Four weeks.. .

  41. I don’t know if Doctor Mike will see this but I am wondering if I have a problem with my heart if there is a big gap between my systolic and diastolic pressures like 125/55 or something around there?

  42. This is among the perfect high blood pressure treatment I`ve read “zοtοsο Yuku” (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. .

  43. All this time, “zοtοsο Yuku” (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.. .

  44. 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 …

  45. 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.🤙

  46. 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.

  47. #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

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