Gotta Control Your Blood Pressure

It's no small thing, especially for your BRAIN!

Baba Ram Dass was a critical teacher in my early spiritual and psychological teachings. He was born Richard Alpert and became a Harvard Ph.D. professor “drop-out” who encouraged us to “drop in” to our inner selves, our truer selves. Baba Ram Dass used to hang out at the ashram I lived at with Swami Satchitananda and 200 other spiritual “seekers”.

Dr. Alpert apparently had high blood pressure for some time, but he didn’t take medications for it as they made him feel “funny”. (Today we have so many choices for medications, you can certainly find some that do not make you feel “funny” if you inform and work closely with your doctor). So Richard just kept trucking on. And eventually, shockingly, stroked out. Big time. Dr. Alpert ended up paralyzed along one entire side of his body, permanently. Ram Dass was in a wheelchair for the rest of his life.

When Ram Dass first stroked out, he sent out a message that he had no idea how long he would now live. Plus, he had, at first, lots of trouble speaking (he was an amazing orator known for his verbiage and wit let alone in-depth knowledge about consciousness).

Nonetheless, Ram Dass decided to hold a meditation workshop in Costa Rica. He invited us to come and hang out with him. He literally said, “I have no idea how long this incarnation will last, come surf the silence with me. In Costa Rica.” So, I went. It was a meditation retreat of a lifetime and held many answers for me.

I clearly remember Ram Dass started out saying, very, very slowly… “Please, learn from what happened to me. If you have high blood pressure, take your medicine. Strokes are real risks of high blood pressure. I am in this chair because I chose not to take appropriate medication.” Baba Ram Dass became immobilized for the rest of his life from not controlling his blood pressure.

We all worry that uncontrolled blood pressure causes two major ways we exit these incarnations: stroke and/or heart attack. But uncontrolled blood pressure can cause many other nasty downstream issues. Poorer memory, concentration, and other cognitive functions decline faster among middle-aged and older adults who have high blood pressure, compared to those who do not. Even seemingly slight blood pressure elevation during middle and older age is linked to a faster decline in cognition. And this is also seen, now, in younger kids who have, crazily, high blood pressure.

Nearly half of American adults have high blood pressure or hypertension. And more and more young obese American kids also have high blood pressure. How crazy is that? (We used to only see this in older folks).

Having high blood pressure is a risk factor for cognitive decline, which includes such things as memory, verbal fluency, attention, and concentration.

• Sustained blood pressure of 120 mmHg -- 129 mmHg systolic (the top number in a reading) or higher is considered elevated.

• Systolic pressure above 130 mmHg or diastolic pressure (the bottom number) of 80 mmHg or higher is considered hypertension.

"We initially anticipated that the negative effects of hypertension on cognitive function would be more critical when hypertension started at a younger age, however, our results show similar accelerated cognitive performance decline whether hypertension started in middle age or at older ages," said study author Sandhi M. Barreto, M.D., M.Sc., Ph.D., professor of medicine at the Universidade Federal de Minas Gerais in Belo Horizonte, Brazil.

"We also found that effectively treating high blood pressure at any age in adulthood could reduce or prevent this acceleration."

Sometimes losing weight, avoiding highly processed foods, living in a more mindful relaxed manner, and regular exercise, may improve your blood pressure without meds. Also,

How you measure blood pressure matters.

Standardized testing means sitting for 5 minutes with your back against a chair, relaxed. Not just running into a docs office after dealing with grid-locked traffic.

Then uncross your legs, place the arm with the cuff on it over your heart, and don’t talk or be doing other things while you take your reading.

Barreto and colleagues analyzed findings from an existing study that included blood pressure and cognitive health information for more than 7,000 adults in Brazil, whose average age was about 59 years old at the study's start.

The study participants were followed for an average of nearly 4 years.

Their analysis found:

• Systolic blood pressure between 121 and 139 mmHg or diastolic blood pressure between 81 and 89 mmHg with no antihypertensive medication use was associated with accelerated cognitive performance decline among middle-aged and older individuals.

• The speed of decline in cognition happened regardless of hypertension duration, meaning high blood pressure for any length of time, even a short duration, might impact a person's speed of cognitive decline.

• Adults with uncontrolled hypertension tended to experience notably faster declines in memory and global cognitive function than adults who had controlled hypertension.

Dr. Mark Houston owns and runs the Hypertensive Institute of Nashville. Dr. Houston is an iconic functional cardiologist. (I worked 20+ years with the first functional cardiologist in Palo Alto in the early 1980s, Dr. Carl Ebnother).

Dr. Houston is teaching a one-of-a-kind 100-hour functional cardiology program (sponsored by A4M). I took the first 24-hour weekend. Yes, Dr. H. spoke for 24 hours, and the 11 other docs, one PA, and I sat for 24 hours!

Dr. Houston informed us that new studies have clearly shown that some blood pressure-lowering meds do lower blood pressure but do not necessarily protect us from heart attacks or strokes. Dr. Houston clearly went over meds in detail, and I share this information with my patients and their docs. Not all cardiologists know this information.

Take this in - “high blood pressure” for even short periods of time, at any age, at any time duration, ding your brain. Wow!

Blood pressure monitoring and healthy maintenance are critical for staying the best you can be. The diagnosing and controlling hypertension in patients of any age can help prevent or slow down cognitive decline.

Of course, weight loss, exercise, diet, and healthy sleep all of it contribute to the rate of your blood flowing through your biological pathways. Alcoholic beverages, even one drink a day regularly, are linked to higher blood pressure. And remember, hormones help keep blood pressure healthier and safe (they boost nitric oxide which dilates blood vessels, like “yoga classes” for blood vessels, and much more).

But you should all know your blood pressure. And keep it healthy.

My ex was an ER doc at St. Luke’s in Houston. He saw many young patients, 6 years old and up, with obesity, high blood pressure, and many other issues often, in the past, only seen in the elderly.

So checking blood pressure in high-risk young kids is critical, too.

Knowledge is power. Know your blood pressure. Take it three days in a row, approximately at the same time. After resting for 5 minutes, with a supported back, and with arm cuffs, as wrist cuffs are not very accurate.

Dr. B.

---

Reference:

Hypertension, Prehypertension, and Hypertension Control Association With Decline in Cognitive Performance in the ELSA-Brasil Cohort. Hypertension, 2020 DOI: 10.1161/HYPERTENSIONAHA.120.16080