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Safest way to normalise high Blood Pressure


laislica

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On 3/23/2017 at 9:44 AM, laislica said:

Many thanks.

My weight is now about 75.5Kg (naked and breathing out lol).

It was hovering up to about 80Kg but I am not a muscular build so my %fat may still be close to 30%.

I stopped smoking about 45 years ago but I usually drink several cups of coffee daily......

I have a Thai Bicycle, no gears and I ride it for a 20 minute session round the block, more or less daily but it is very flat where we live.

I do not eat bread, potatoes, rice, cheese, milk (though I use the Nestle coffee mate).

I avoid any processed foods like sausages and street food.

In my veggies I do not use any sauces, no MSG and only a little locally made sea salt and we use coconut oil and there is usually some fresh turmeric in the mix.

I eat plenty of raw garlic with every meal.

I have almost totally cut out beer and drink very little spirits.

I do however have a very enlarged prostate and take Lopress for that. (My Dad had prostate problems)

The Lopress also lowers BP but I have been reading that medications that lower BP can actually have death as a side effect and lower numbers don't cure heart disease.

Since my PSA results are in the high end of normal, I am now starting to think I might be better off with no medication????

My Cancer Markers are:-
Prostate marker    1.97    ng/ml    (0-4)
Liver Marker    5.08    ng/ml    (0-9)

So despite having :-

Multiple cysts in both hepatic lobes, more at left lobe.
About 4 lesions at left lobe, of which the largest one seen at lateral segment at subcapsular area showing lobulated contour and tihn septation, about 5.1x3.3 cm. The rest are up to 3.4 cm in maximal dimension.
A lobulated 1.3-cm one with septation at segment VIII.
A 0.9-c, one at segment VI.
A 0.4-cm gallbladder polyp.
A 2.3-cm poorly calcified gallstone.
A 0.9-cm CBD stone with mild dilated proximal CBD (1.0 cm).
A 0.8-cm cortical cyst at lower pole of right kidney.
Few cortical scars at left kidney.
Markedly enlarged prostate gland, 83 ml.

(Sorry about the translation)

 

I consider it's not too bad for 75 years old and if I continue with my diet and lose those last few pounds, some of the aforementioned problems may actually start to bet better?

 

The blood tests were a little dissapointing as they only showed the total cholesterol without the split for HDH and LDL so they are not a lot of use.

 

 

 

 

 

 

 

 

You can die worrying.

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10 hours ago, Moonlover said:

On your first point, I do have to agree with you. It is not for everyone. If one is not motivated then it would be a waste of time. It would be like buying a lottery ticket then not bothering to check the results. Motivation is the key word.

 

Regarding your friend, is this not a classic case of cause and effect? If he were to tackle his stress issues, he would probably resolve his B/P issues. It's a case of tackling the cause rather than the symptoms. And here's what Rodin Sharma of 'The Monk Who Sold his Ferrari' fame had to say on this matter. 'Stress is not the enemy. A lack of refueling, renewing and recovery against the stress is the enemy'. I think that also covers your third paragraph.

 

Regarding B/P readings. 140/90 is regarded by the WHO and the International Society for Hypertension (ISH) the limit above which hypertension is assumed and, interestingly is regardless of age! And that is why I chose it as my upper limit. I took my reading this morning and it was 136/81 and my average just happens to be same. But you're quite right, it does swing around somewhat. I had a reading some time ago of 157/90! What was I on that day I wonder :smile:.

 

Now, just suppose I had seen the doctor on that particular day, he would have been reaching for his script pad. Were I able to show him my average readings, he would have had no choice but to put his pen away. I would have left with a :smile: on my face and he would be left mumbling about his loss of bonus from the med company!

 

In summery it is the average B/P readings that are important, not the occasional 'snap shot' reading and only self monitoring can establish that. But, one has to be motivated!

 

Good luck and good health. I'm going swimming now.

 

No it is not called cause and effect: it's called self fulfilling phrophecy.  In white coat syndrome one gets anxious about bad news, and it is this very thing that brings it about.

 

No the doctor would not be reaching for the script pad, not in UK anyway: in my experience he would likely make a comment and possibly arrange for further readings as you say.  157/90 is hypertensive for sure but there could be any number of innocent explanations.

 

The odd thing is that you do not appear to be hypertensive at all! 

 

Last time I checked advice, BP readings should be taken upon wakening and in a relaxed state.  You should not be dehydrated. While 120/80 is the ideal, it is not regarded as the norm throughout the day, and depending on what you are doing could rise markedly.

 

 

 

 

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I'm in my mid 50's and am very active.  I've been running and competing for most of my life since high school.  I still train and compete in long distance running events.  I compete against men in their 50's and 60's who can put to shame some college level athletes.  Age is not always a limiting factor to heart health.

 

Let me share a few points of advice, if I may.  You need to take multiple readings of your BP over several days to get an accurate figure.  Mine varies between 107-118/77-82.  My resting heart rate, which is a measure of heart health/strength, is around 43-45 bpm when I'm in my best shape.  Currently it is around 48-50 bpm.  Don't expect your numbers to be this low, unless you have been training for some time.  But getting your resting heart rate into the 50's is doable for many of us.  Btw, I live on mostly fruit and grains.  Very little if no meat in my diet.  And absolutely no junk food, pop, etc.  I can't stand eating it or drinking it nor can my stomach digest it either.

 

I strongly recommend getting on some kind of exercise program that you find somewhat enjoyable in order to be motivated to continue to do it.  It doesn't have to be running or anything too strenuous - walking and cycling is sufficient.  If you can do both, great.  Cross training is best.  But it needs to be done between 3-5 times per week.  Exercise and following a healthy diet will do more for you than pills.  It's a life style change and a desire to live.

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10 hours ago, mommysboy said:

 

No it is not called cause and effect: it's called self fulfilling phrophecy.  In white coat syndrome one gets anxious about bad news, and it is this very thing that brings it about.

 

No the doctor would not be reaching for the script pad, not in UK anyway: in my experience he would likely make a comment and possibly arrange for further readings as you say.  157/90 is hypertensive for sure but there could be any number of innocent explanations.

 

The odd thing is that you do not appear to be hypertensive at all! 

 

Last time I checked advice, BP readings should be taken upon wakening and in a relaxed state.  You should not be dehydrated. While 120/80 is the ideal, it is not regarded as the norm throughout the day, and depending on what you are doing could rise markedly.

 

 

 

 

Yes, my para about the doctor is 'tongue in cheek'. I will acknowledge that.

 

And no, I am not hypertensive, at least, I am not now.

 

But like most folks in my age group I know I am prone to it and ten years ago I was. But instead of going down the medical route, I chose to use natural methods. I had a course of acupuncture and massage by a TCM doctor. (I was living in China at the time so it was easy to find). Once my pressure was down he then recommended Qigong as a way of keeping it down.

 

Since then I have controlled my own B/P by the methods that I have outlined previously and self-monitoring, using a good quality monitor is one of the primary tools that motivate me. (A nod to EvenSteven in post No 51on that one. Stick with it mate!)

 

Of course I do acknowledge that it is not for everyone. As I’ve already said, one has to be motivated, but I stick to my guns. I believe that natural methods are safer than relying on meds. It is also cheaper and a lot more fun.

 

 

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On 25/03/2017 at 4:19 PM, recycler said:

You could try taking turmeric or curcuma in your food in some way, start with a large teaspoon a day and see how you feel. There are many ways of taking it, you can search for tips on internet.

 

It works very well for me and others I know, it's natural, not many negative side effects and you can't overdose.

 

You can get it in bags of 250 grams at Makro for 50 or 60 Baht.

Thanks and I do.

We buy fresh turmeric at our local market when we are in Thailand and use the powder in Spain.

I eat lots of raw garlic and ginger as well.

No cooking sauces, just sea salt and with the turmeric, ginger and garlic, it is very tasty.

I don't like to eat out because street and restaurant food usually tastes terrible, also full of rancid omega 6 oil.

 

 

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On 25/03/2017 at 9:39 PM, Khon Kaen Dave said:

My dad had high bp all his adult life. He also had a blocked heart valve.He was on verapamil for his problems.When he was 76, after my mum had been dead some 10 years, he met a young lady, and the upshot was that they were going to marry. he went to his doctor and told him that he was about to marry again, and that the lady in question was a stripling of 30.His doctor said "you do realise that this woman is at the height of her sexual cycle, and this could be fatal" my dads answer was, "if she dies, she dies":shock1:

 

How true and I know the feeling.

I married again 5 years ago and we were walking in the town and the Dr saw us.

I introduced my new young wife and he was shocked because he'd said I had a heart murmer and should rest up.

Hey, I thought he said I needed a hot mamma and and don't let up!

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On 25/03/2017 at 6:52 PM, White Christmas13 said:

yes  correct my bp goes up when I visit the doctor I don't know what Atenolol is

I take Perindopril  and my bp is a normal 110 over 80 or there about I don't have

a German monitor the one I use called OMRON which is used by every doctor here

or chemist, my biggest problem was my heartbeat which was very high and irregular

about 130 so I went to hospital for a Cardioversion took only a few hours

in early morning out at lunch time best thing ever done my heartbeat is down

to a normal 60 to 65 and every thing free of course

 

I eat sensibly, am not too fat and enjoy life to the full.

We live half time in Spain and Thailand and it's always summer lol

 

We return to Spain at the end of next month and I will visit my Dr there cos my heart rate has always been fast.

Maybe something that needs to be looked at.

About BP, what I find interesting is that the difference at the ideal of 120/80 is 40.

When we get older the difference seems to increase to more like 60.

Why is this and does it matter?

 

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On 25/03/2017 at 11:49 PM, Kabula said:

I like the quote, "dead, brainwashed, misinformed doctors can't convey inaccurate information." Author unknown.

 

Every body is different to some degree.

 

The human body will repair itself.  However, it requires the 90 essential minerals and trace elements which is rare in most foods today.  Without the 90 essential minerals and trace elements, the human body will break down over time. 

 

American Indians lived in the United States for 10,000 years and when they were sick they watched what the wild animals ate and consumed what they consumed. 

 

Many Indian women while pregnant, consumed clay  to supplement the required minerals and trace elements for their developing baby. This is why many children have their natural instinct to eat dirt, however they should be eating clay.

 

The rivers back in the day provided much of the minerals and trace elements along with the antibacterial silver particles.  Unfortunately, much of the bottle water today has been filtered providing few if any of the essential minerals and trace elements.

 

Many farmers,  particularly large corporations seldom prepare soil properly. The flooding of the land limits the minerals and trace elements so supplements are a must.

 

Many vitamin pills are not absorbed into the body unless there are trace elements present to bind them.

 

Eat healthy, some fats are o.k., but should be limited, limit sugar, avoid soft drinks, processed and fast food.

 

A daily brisk walk is recommended.

 

Sunshine is important, but should be limited.

 

Drink lots of filtered water.

 

I also consume colloidal silver liquid drops and nascent iodine daily.

 

I consume many natural herbs, drink green tea, and organic apple cider vinegar.

 

I occasionally take baking soda with fruit juice or water to oxygenate my system to control acid and maintain the correct ph.

 

 Dental hygiene is extremely important. Seniors should consider getting teeth root  scraping when gums start to get inflamed.  Overtime, bacteria can go into the brain from unhealthy gums.

 

I'm 69 and threw all my toxic prescriptions away years ago and have never felt better.  All lab reports along with blood pressure are normal.

 

Ignore all negative comments and do your own research.

 

The consumption of some  prescription drugs should not be stopped immediately.   Especially, anti-depression pills. 

 

 Be careful mixing herbal remedies with prescription drugs. 

 

Thanks, pretty much what I have been doing for years.

Most people don't believe that I am 75 and many think late 50's.

I suppose having hair  and not that much grey helps he he

 

 

 

 

 

 

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On 26/03/2017 at 0:01 AM, sanukjim said:

According to The Us Medical Dept. One of the best ways to reduce the risk of a stroke or heart attack is to take a small or baby asprin of 81 mils.almost all doctors in the US tell their patients over 50 years old to do this regularly.I do this while taking my other heart meds and I am 79 years old.

 

Not wishing to muddy the water but who should we believe?
http://www.medicalnewstoday.com/articles/243265.php

 

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11 minutes ago, laislica said:

 

Thanks, pretty much what I have been doing for years.

Most people don't believe that I am 75 and many think late 50's.

I suppose having hair  and not that much grey helps he he

 

 

 

 

 

 

Some excellent suggestions from lay people.

 

I have had excellent physicians in my home

country and here in Thailand....most are very well

informed and, if you, are proactive with your health

they are eager to help you.   Sounds like you ran

across a bad physician.....  mine have been great

and deserve every Baht I paid them.

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On 26/03/2017 at 0:54 AM, emilymat said:

I am the same age as the OP.  I have always had 'highish' blood pressure as did my mother. It fluctuates from week to week and even from arm to arm!. However, my pulse is usually about 55/57 bpm.

 

I'm Active and feel well except for the occasional skin rash caused by sweating. I smoke but do not drink alcohol at all and just eat sensibly. My weight at 5'11' is around 80 kg - which, if you believe the BMI charts places me as overweight by several kilo's. I know I'm not over weight, but if I worried about all the 'charts' and 'standards' of the ideal person I would go nuts.

 

My reason for posting is to offer up to the OP this.   You may well worry yourself to an early grave with all these issues of concern. I would relax and try to just get on with life. I'll come to your 90th birthday party!     :smile:

 

 

Please don't think that HBP worries me.

It doesn't. I am simply interested in gathering more info on the subject.

I am very interested in what Dr's call Alternative.

In a former relationship, my partner (an English woman) practiced 5 element Chinese Acupuncture and she was very good.

She did her training at Uni as a Nutritionist and was the Chief Nutritionist at a large hospital near Manchester for many years.

So she was able to help many people to improve their lives with changes to their diet, plus the Acupuncture.

 

The lure of a quick fix with a pill from Big Pharma has seduced us into beliving that Big P is the first and only way.

We need to return to our roots and start thinking about cause and effect.

This is not worrying, it's learning and taking corrective action.

 

IMHO, Nutrition should be a core subject at school. Everyone needs to understand it.

Instead, they teach algebra and I ask, who of you ever used algebra in life?

 

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On 26/03/2017 at 4:31 AM, Taggart said:

Well we've known since the 1920's that in rural Africa for those over the age of 60 the average blood pressure was 106 over 67.  For Europeans and Americans at that time it was 140+ over 90+.  If you can find it somewhere free the research study is titled "Blood Pressure In The African Native" by C. P. Donnison.

 

Yep, and this suggest that lifestyle is the root of the problem.

So that's the first thing to think about.

I have grandchildren and I encourage their Mum's to learn about nutrition and th teach their children.

 

 

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43 minutes ago, laislica said:

 

I eat sensibly, am not too fat and enjoy life to the full.

We live half time in Spain and Thailand and it's always summer lol

 

We return to Spain at the end of next month and I will visit my Dr there cos my heart rate has always been fast.

Maybe something that needs to be looked at.

About BP, what I find interesting is that the difference at the ideal of 120/80 is 40.

When we get older the difference seems to increase to more like 60.

Why is this and does it matter?

 

I'm 69 and will be 70 soon.  My blood pressure is 119/40.

 

The secret is consuming the essential 90 essential minerals and trace elements and your body will not break down.  The body needs that to repair it.  I take Youngevity Products, Beyond Tangy Tangerine 2.0.  www.youngevity.com

 

It's in powder form to be mixed with water or juice so it is absorbed quickly in the body.

 

It increases for people because they are not consuming the essential minerals, vitamins and trace elements.

 

Your skin is your biggest organ and I noticed a dramatic difference in my skin 3 weeks after taking this the first time many years ago.  It now gives me better protection from sunburn.  I can be in the direct sun for two hours and no change. They keep adding more ingredients to make it better over time.

 

Take a brisk walk daily....10,000 steps.  I use a smart phone app to count the steps.

 

Drink lots of water, no soft drinks; limit alcohol to no more than 2 drinks daily.

 

Good Luck...

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49 minutes ago, laislica said:

About BP, what I find interesting is that the difference at the ideal of 120/80 is 40.

When we get older the difference seems to increase to more like 60.

Why is this and does it matter?

 

I have never read or heard anything that indicates that the difference between Sys and Dia is of any significance.

 

According to the WHO and the IHS, consistent readings higher than 140 sys and/or 90 dia is considered hypertension and is independent of age.

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11 minutes ago, Kabula said:

I'm 69 and will be 70 soon.  My blood pressure is 119/40.

 

The secret is consuming the essential 90 essential minerals and trace elements and your body will not break down.  The body needs that to repair it.  I take Youngevity Products, Beyond Tangy Tangerine 2.0.  www.youngevity.com

 

It's in powder form to be mixed with water or juice so it is absorbed quickly in the body.

 

It increases for people because they are not consuming the essential minerals, vitamins and trace elements.

 

Your skin is your biggest organ and I noticed a dramatic difference in my skin 3 weeks after taking this the first time many years ago.  It now gives me better protection from sunburn.  I can be in the direct sun for two hours and no change. They keep adding more ingredients to make it better over time.

 

Take a brisk walk daily....10,000 steps.  I use a smart phone app to count the steps.

 

Drink lots of water, no soft drinks; limit alcohol to no more than 2 drinks daily.

 

Good Luck...

 

 

Great stuff, cept they don't seem to ship to Thailand or Spain.

 

There are other suppliers who do and yes, great idea and worth following up.

 

Cheers

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14 minutes ago, Moonlover said:

I have never read or heard anything that indicates that the difference between Sys and Dia is of any significance.

 

According to the WHO and the IHS, consistent readings higher than 140 sys and/or 90 dia is considered hypertension and is independent of age.

I ignore everything  from WHO and IHS and most published articles.

 

I'm so sick of fake content so I trust non of it.  Some is good most is bad.

 

I do my own research and sample this and that and what I published works for me.  I recommend readers do their own research and confirm everything.  Experimentation is a must.

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9 minutes ago, Sheryl said:

A baiting post and flaming reply to it have been removed. Please keep it civil.

Thanks, it would be nice if you post when you delete a problem post every time.

Cheers

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1 hour ago, Kabula said:

I ignore everything  from WHO and IHS and most published articles.

 

I'm so sick of fake content so I trust non of it.  Some is good most is bad.

 

I do my own research and sample this and that and what I published works for me.  I recommend readers do their own research and confirm everything.  Experimentation is a must.

In broad terms I agree with you, but when it comes to the actual definition of 'what is hypertension?' surely one has to have a benchmark. Or do prefer to invent your own?

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59 minutes ago, Moonlover said:

In broad terms I agree with you, but when it comes to the actual definition of 'what is hypertension?' surely one has to have a benchmark. Or do prefer to invent your own?

 

Inventing Ones Own Might Not Be Such A Bad Idea if you consider the RDA recommendations for vitamins and minerals.

80-90 mg for Vitamin C is a joke. Enough to stop you getting really sick, but not to full health.....

It should be more like 5,000+ taken in smaller doses over the whole day, just like we would have got when our bodies could make it's own Vit C.

 

The "Alternative" people often use large doses of vitamins and minerals to alleviate many modern diseases.

I'm not saying that people should do this in the face of advice from their MD, always good to find out what pills are available.

But everyone is different, there is no one size fits all.

 

 

 

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2 hours ago, Moonlover said:
3 hours ago, laislica said:

About BP, what I find interesting is that the difference at the ideal of 120/80 is 40.

When we get older the difference seems to increase to more like 60.

Why is this and does it matter?

 

I have never read or heard anything that indicates that the difference between Sys and Dia is of any significance.

 

According to the WHO and the IHS, consistent readings higher than 140 sys and/or 90 dia is considered hypertension and is independent of age.

 

Well I found this:-

The difference between systolic (the upper number) and diastolic (the lower number) pressures is known as the pulse pressure:

Systemic pulse pressure = Psystolic - Pdiastolic

For a typical blood pressure reading of 120/80 mmHg the pulse pressure is therefore 40 mmHg.

It is proportional to stroke volume, the amount of blood pumped from the heart in one beat, and inversely proportional to the compliance or flexibility of the blood vessels, mainly the aorta.

A low (also called narrow) pulse pressure means that not much blood is being expelled from the heart, and can be caused by a number of factors, including severe blood loss due to trauma, congestive heart failure, shock, a narrowing of the valve leading from the heart to the aorta (stenosis), and fluid accumulating around the heart (tamponade).

High (or wide) pulse pressures occur during exercise, as stroke volume increases and the overall resistance to blood flow decreases. It can also occur for many reasons, such as hardening of the arteries (which can have numerous causes), various deficiencies in the aorta (mainly) or other arteries, including leaks, fistulas, and a usually-congenital condition known as AVM, pain/anxiety, fever, anemia, pregnancy, and more. Certain medications for high blood pressure can widen pulse pressure, while others narrow it. A chronic increase in pulse pressure is a risk factor for heart disease, and can lead to the type of arrhythmia called atrial fibrillation or A-Fib.

 

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23 minutes ago, laislica said:

 

Well I found this:-

The difference between systolic (the upper number) and diastolic (the lower number) pressures is known as the pulse pressure:

Systemic pulse pressure = Psystolic - Pdiastolic

For a typical blood pressure reading of 120/80 mmHg the pulse pressure is therefore 40 mmHg.

It is proportional to stroke volume, the amount of blood pumped from the heart in one beat, and inversely proportional to the compliance or flexibility of the blood vessels, mainly the aorta.

A low (also called narrow) pulse pressure means that not much blood is being expelled from the heart, and can be caused by a number of factors, including severe blood loss due to trauma, congestive heart failure, shock, a narrowing of the valve leading from the heart to the aorta (stenosis), and fluid accumulating around the heart (tamponade).

High (or wide) pulse pressures occur during exercise, as stroke volume increases and the overall resistance to blood flow decreases. It can also occur for many reasons, such as hardening of the arteries (which can have numerous causes), various deficiencies in the aorta (mainly) or other arteries, including leaks, fistulas, and a usually-congenital condition known as AVM, pain/anxiety, fever, anemia, pregnancy, and more. Certain medications for high blood pressure can widen pulse pressure, while others narrow it. A chronic increase in pulse pressure is a risk factor for heart disease, and can lead to the type of arrhythmia called atrial fibrillation or A-Fib.

 

Ok I will go for a slight rephrasing.

 

I have never read or heard anything that indicates that the difference between Sys and Dia is of any significance in a normal, healthy person. Even one with hypertension, unless  there are symptoms indicating otherwise.

 

Surely, any of the conditions indicated above would produce symptoms that would see the sufferer in hospital pretty damn quickly!

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1 hour ago, Moonlover said:

In broad terms I agree with you, but when it comes to the actual definition of 'what is hypertension?' surely one has to have a benchmark. Or do prefer to invent your own?

Perhaps another illusion or fake definition for the last thousand years.

 

5555

 

I'm half American Indian!  When was the last time you met one? 

 

America and and half the world is living on the reservation now.  Much of the world has left the constructive time and now is in a destructive time.  Very similar to what the America Indian experienced.

 

History always repeats itself.  Be very careful what you perceive to be true or you will be walking the trail of tears!

 

Most of everything you have learned to be true was an illusion.  The smoke and mirrors are beginning to rise finally to see the wizard behind the curtain pulling the levers. 

 

Many are are now being arrested in the American medical government community for fake reporting.  You will probably not see that in the main stream news.

 

I'm thankful I'm here.

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1 hour ago, Kabula said:

Perhaps another illusion or fake definition for the last thousand years.

 

5555

 

I'm half American Indian!  When was the last time you met one? 

 

America and and half the world is living on the reservation now.  Much of the world has left the constructive time and now is in a destructive time.  Very similar to what the America Indian experienced.

 

History always repeats itself.  Be very careful what you perceive to be true or you will be walking the trail of tears!

 

Most of everything you have learned to be true was an illusion.  The smoke and mirrors are beginning to rise finally to see the wizard behind the curtain pulling the levers. 

 

Many are are now being arrested in the American medical government community for fake reporting.  You will probably not see that in the main stream news.

 

I'm thankful I'm here.

This is waffle.

 

The way "hypertension" is defined is through epidemiological studies and is quite logical.

 

In principle: you take a very large group , say 1000 people and measure their blood pressure. You then follow them up through an extended period, say  10 years or longer  (prospective study) recording deaths, heart attacks, strokes and all observable serious health outcomes.

 

At the end of the study period (the Framingham study that alerted clinicians to the association of high cholesterol with heart disease was followed up for more than 30 years), you group the study population into levels of blood pressure, and you statistically analyse the probability of developing any condition that you find seems to be associated.

 

Statistically you can then  demonstrate what the 10 year risk of developing, a stroke, say, is for a person in the 100-120/80 group compared to the 160-190/80 group. Lets say it's 1 in 30 for the 120/80 group and  1 in 5 for the 190/80 group, just to make it clearer.

 

You then, if you are a National Health service, for example simply define what you think is an unacceptably high risk for getting a stroke, and therefore where you choose to call a person "hypertensive" and urge treatment. A 1 in 5 risk is huge therefore you decide this is the cut-off.  

 

I am making these figures up, but you can see how it is done.  

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