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Could Cardiologists be Endangering Patients by Pushing Blood Pressure Meds?

re: ethics in medicine
re: overdiagnosis

re: Modern Medical Practice: Overdiagnosis, Ignoring What Matters
re: Overdiagnosis is Damaging Health and Happiness America

In Over-Diagnosed, the authors comment on well-documented cases of severe life-changing injuries caused by patients blacking-out on blood pressure medications (falling down, essentially).

Meds based on irresponsibly little data of questionable objectivity

I’ve just recently been told by a cardiologist that I need a blood pressure med. That recommendation is based on zero (zero!) inquiries about my history, activities, diet, familial history, etc. Based on three (3) samples taken when I was stressed and out of sorts (4PM, 3PM, and 12:30 AM in ER). That’s all this cardiologist based his meds recommendation on. I am a dehumanized database entry, having no characteristics other than a few numbers—assembly line medicine.

Time of readings

I confirm that my BP can be high later in the day (eg 145/89 or similar). I also confirm that I have been out of sorts for several weeks—something has been nagging at me. Is it any wonder that my BP could rise given that?

I am told by another cardiologist that what really matters is blood pressure in the morning, since that reflects a long period in which BP is crucial—sleeping. And yet, the diagnosing cardiologist has zero insight into BP readings anywhere prior to 3PM! And zero interest in that or anyhing about me, since zero questions were asked in my initial consulatation farce.

Body weight

Due to the lingering damage from Long-Haul COVID or EBV (still cannot do more than 1/3 my traditional training workouts and still at relatively slow pace), I am 25 pounds heavier— heaviest in 12 years.

With blood pressure directly related to body weight, wouldn’t it make sense for a physician to recommend getting body fat down, before putting someone on a lifelong medication? Particularly someone who has until relatively recently been an ultra endurance athlete 25 pounds lighter?!

My condition has made it difficult to exercise consistently and therefore drop body fat via my usual method: riding 50 miles a day for 3 weeks straight for an average daily caloric deficit of ~1350 calories each and every day. So with the new year and hoping to avoid a relapse into last year’s pathetic low-energy state, I will drop some body fat as best I can, if my body does not betray me with a 3rd major relapse.

UPDATE Feb 19 2022: a month of tracking shows that I do not have a chronic blood pressure issue. Proof that this irresponsible cardiologist should not be allowed to see patients. I do see daily variations that track against fatigue as one factor, and perhaps other factors in diet, which I am working on isolating. What *is* clear is that I can range from 116/72 to 135/88 from day to day here at my relatively heavy weight, now down to 193, from 196.

Real data

Cardiologist I saw had no clue about this paper: BMJ: “Subclinical magnesium deficiency: a principal driver of cardiovascular disease and a public health crisis”

I will not go on BP meds before I confirm with solid data that accurately evaluates where my BP stands. I find it shockingly irresponsible that a physican, who should follow real data and real science, just paints by numbers off a few haphazard readings.

So I’ve started morning and evening BP readings, charting them.

Ditto for examining dietary factors. As well as whether magnesium can be of help in lowering blood pressure (it acts as a vasodilator). But since I am not deficient in Mg (having supplemented heavily for 18 months), maybe it would not help much at this point.

Would any responsible cardiologist prescribe BP meds for these blood pressure readings?

Eight morning blood pressure reads + heart rate, left arm and right arm, seated 9:45 AM:
L: 119/72 @ 46
L: 111/73 @ 45
L: 118/74 @ 46
L: 113/74 @ 47
R: 116/79 @ 46
R: 129/78 @ 46
R: 125/73 @ 45
R: 124/73 @ 47

My HR has been low my entire life; I don’t think it ever rested above 52, and 20 years ago when highly fit it would go as low as 33 at night and rest at 37-39 in the morning (these days, ~43 bpm).

Of course this same cardiologist tags my low heart rate as bradychardia (slower than “normal” HR), which is intellectual malfeasance: applying epidmiological statistics for a grossly overweight/unfit population to arrive at a “normal” heart rate for everyone? Do these physicians comprehend what a normal curve is (Gaussian distribution), let alone the massive variation based on diet and activity? It’s as stupid as when I was tagged “borderline obese” at 8% body fat ~11 years ago. Assembly-line medicine doesn’t give a damn what personal characteristis and history you might have.

Injury or death from too-low blood pressure?

What happens to me with BP meds on a morning when my normal BP would be 116/72? It would be lower, maybe a lot lower. Especially if there are gyrations in homeostatis from ascending or descending in altitude by 10K feet or more.

And so maybe I’m traveling out in the backcountry, wake up, step out of my van to take a piss and tumble to the ground after blacking-out (it’s a big step down), and die from a head injury, or just freeze to death with an broken something? Ditto for moving around on class 3 stuff, resting a bit, standing up, and tumbling. No one would ever trace it back to the irresponsible cardiologist prescribing that death-causing medication.

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