Jim has had high blood pressure for as long as I've known him. I don't think he took any pills when we got together but I do recall when we were living in Atlanta and he was at the doctor's one day, his systolic pressure went up to the 240's and they almost admitted him to the hospital but did not and put him on drugs. I don't remember what he started taking, but I do recall he has been taking labelatol for many years. He was also on quinipril for many years. When quinipril was taken off the market he started taking Lisinopril and then Amelodepine. When he was on Amelodepine his legs and feet would swell up real bad. Our friend who was a nurse told him to stop taking it immediately -- and he did!
Now (2026) he just takes one pill - labelatol, and he does good with it. His blood pressure has stabilized and does not skyrocket.
M. Brandon Pettke, DC, also known as A Midwestern Doctor, unmasks what is really causing high blood pressure ~~ Unmasking the Great Blood Pressure Scam:
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Story at a Glance:
•Elevated blood pressure is the most common chronic disease, and as the decades go by more and more people are declared hypertensive.
•Remarkably, at least 25% of all hypertension diagnoses are due to inaccurate measurements, and there is still no known reason for why over 90% of people are hypertensive.
•Aggressively treating everyone’s blood pressure is justified under the belief it prevents cardiovascular disease. However, in most cases it has never been proven to reduce heart disease—rather it only leads to a small reduction in strokes (hence why these medications were rebranded to treat “cardiovascular disease”).
•Many of the misunderstandings with heart disease arise from the fact that impaired circulation or damage to the blood vessels will cause blood pressure to go up and their correlation being misinterpreted to instead believe high blood pressure causes cardiovascular disease.
•In this article, we will discuss the actual causes of high blood pressure, the dangers of commonly used blood pressure medications, the safest pharmaceutical and natural ways to reduce blood pressure directly, and our preferred methods for treating the underlying causes of high blood pressure.
Since the cause of hypertension isn’t known, medicine thus focuses on specific risk factors that are known to be associated with it such as being over 65, having diabetes, eating too much salt, insomnia, obesity, not exercising, stress, being an alcoholic or other people in your family having high blood pressure.
Dr. Ken Berry discusses high blood pressure ~~
See why most “essential hypertension” is not a mystery once you look at food and lifestyle. These steps help if you take one to three blood pressure pills and want a real shot at needing less. Watch if you have been told this only gets worse. Then give the basics a few months before you accept a bigger pill box.
1. Lower your insulin -- hyperinsulinamia. How to lower your insulin? Eat low carb -- sugar.
2. Lower your chronic inappropriate inflammation. Eat low carb, sugar, grains, vegetable seed oils.
3. Get plenty of magnesium.
4. Get plenty of potassium.
5. Learn how to cope with chronic stress.
6. Maximize your sleep hygiene.
7. Cut out the alcohol.
8. Get more sunlight.
9. Stop using mouthwashes that are anti-bacterial. These kill the bacteria in your mouth. The bacteria make nitric oxide, which helps lower blood pressure.
Myths ~~
(1) Eating less salt. Salt has nothing to do with high blood pressure.
(2) Stop drinking caffeine. Caffeine does not contribute to high blood pressure.
(3) Avoid saturated fat in your diet. Saturated fat does not cause high blood pressure.
High blood pressure is not a disease but a warning flag that something bigger is going wrong in your body. Blood pressure meds have significant side effects:
Erectile dysfunction
Fatigue
Headaches
Dizziness
Muscle spasms
Tingling in hands
Convulsions
Irregular heartbeats
Itchiness
Ringing in the ears
Rashes
Uncontrollable coughing
Problems that can develop from high blood pressure: atherosclerosis - hardening of the arteries; stroke; kidney damage and aneurysms.
What are the symptoms of congestive heart failure?
Shortness of breath or difficulty breathing
Swelling in the legs, abdomen or internally
Chronic cough
Weakess in legs, especially after exercise or activity fatigue
Weight gain from fluid retention
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Also need to address secondary hypertension, which is chronic inappropriate inflammation. A medical cause that the doctor should be looking for:
(1) Endocrine problem with hormones
(2) Kidney problem
(3) Thyroid problem
(4) Adrenal problem
Things to look for should be based on age, on your condition -- how high your blood pressure is, how your blood pressure responds to the medications.
Investigate, diagnose, treat > Tests ~~ Symptoms:
(1) Arm to leg systolic blood pressure is more than 20 point difference
>measure upper arm (brachial artery)
>measure in the leg - at ankle
(2) Delayed or absent femoral pulses -- pulses in your groin
(3) Heart murmur
(4) Abdominal murmur - brewery over the kidney arteries
(5) Any increase in your creatinine level
(6) Kidney malfunction or dysfunction
(7) Fast or slow heartbeat; heart palpatations
(8) If you're always cold or hot
(9) Chronic constipation or diarrhea
(10) Potassium measurement that is 1/10 of a point low
(11) Sleep apnea
(12) Daytime sleepiness
(13) Episodes where you sweat for no reason
(14) If you pass out or almost pass out and are repetative
(15) Very obese right in the middle of your body but your arms & legs are kind of skinny
(16) If you have a very round face
(17) Age 70+
Atherosclerotic kidney disease -- looking at renal arteries to see if there's a plaque buildup that's blocking the blood flow and that can cause severe hypertension -- look for signs of renal failure. (Renal blood flow = volume of blood that is delivered to the kidneys per unit time.)
(18) Primary aldosteronism = condition where the adrenal glands produce too much of the hormone aldosterone; plays a crucial role in regulating blood pressure and electrolyte balance. Primary aldosteronim is caused by an overactive adrenal gland. Secondary - heart failure, liver cirrhosis, certain medications.
Symptoms: high blood pressure, low potassium levels, muscle weakness, fatigue, headache, frequent urination
Blood tests: aldosterone levels, potassium levels
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What's the REAL Ideal Blood Pressure After 65? Dr. Elias - Senior Health
We focus on the physiological risks that come with aiming for the same targets used for younger populations, especially when considering the specific needs of senior health. The gap between your peak and resting numbers is a key indicator of your overall arterial health. We also analyze the mortality risks associated with falls and hip fractures, which can be exacerbated by blood pressure medications that cause dizziness. Instead of chasing a specific number, the most actionable step is to ask your doctor about your average diastolic pressure across several visits to ensure your treatment plan supports your long-term vitality.
I listened to Dr. Elias and took 6 pages of notes ~~ here is what was discussed:
The nurse takes your blood pressure and nods, it looks good, but for millions of adults over 65 that same "perfect" number is quietly damaging their kidneys - causing them to fall in the middle of the night and starving their brain of oxygen with every single heart beat.
The blood pressure target that most seniors are given is built on assumptions never designed for a body over 65 and what the research actually says your numbers should look like at your age and your stage of life.
Let's talk about blood pressure; what it actually is; why the standard way of measuring and managing it is failing older adults specifically and what you should genuinely be aming for.
Most people spend years getting blood pressure checked and never truly understand what either number means. First was an explanation of what the numbers mean:
Systolic (top number) pressure: captures the peak force your heart generates in the instant it squeezes & pushes blood out into your arterial network.
Diastolic (bottom number) pressure: reflects the pressure remaining in your vessels while the heart is between beats -- resting and refilling.
For most of the 20th century medical thinking treated the bottom number as the primary concern. By the early 2000s the medical community reached a consensus for adults over 50 that systolic is the stronger predictor of heart attack, stroke and cardiovascular death.
Elevated systolic pressure is genuinely dangerous over time. But here is where the medical establishment made a critical error in how it communicated this information to patients -- and specifically to older patients -- the logic that elevated systolic pressure is dangerous became compressed into a far simplier message -- lower is always better.
As you age, the large central arteries -- the aorta & carotid arteries gradually stiffin and lose elasticity. The mechanical change alone -- arterial stiffening -- naturally drives systolic pressure upward in older adults.
This pattern has a clinical name: Isolated Systolic Hypertension
>Characterized by high systolic blood pressure (> 140mmHg)
>With normal diastolic blood pressure (< 90mmHg)
>Common in older adults due to arterial stiffening
A measurement that gets almost no attention in routine blood pressure conversations -- despite the fact that it may be the most clinically meaningful number for adults over 65 -- it is called Pulse Pressure.
Calculating Pulse Pressure is the difference between your Systolic & Diastolic readings. For decades research accumulating in major cadriovascular journals
> elevated pulse pressure above 60 in older adults is a stronger independent predictor of heart disease than either number above.
A wide pulse pressure is a direct signal of arterial stiffness. It tells you that the gap between peak performance and resting pressure has grown too large -- meaning the arteries are not cushioning the pressure wave the way they should.
When a doctor only works on bringing the top number down without watching what happens to the bottom number in the process, the Pulse Pressure can widen even further, or the diastolic number can drop into territory that creates an entirely new category of cardiovascular risk -- a risk that has its own name in the medical literature called the J-curve phenomenon. At the lower end, as pressure falls below a certain threshhold -- the curve bends back upward.
The most dangerous expression of this J-curve for seniors centers is on diastolic pressure.
Major cardiology jurnals have found consistently that diastolic pressures below 60-65 are associated with increased risk of heart attack, kidney injury, and cognitive impairment. WHY? Between heartbeats -- the period reflected in your diastolic number -- is the only time the coronary arteries receive their full blood supply.
The heart muscle -- contracting constantly -- actually gets most of its blood flow not during a heartbeat, but during the rest between beats. When diastolic pressure drops too low, the hearts own blood supply becomes compromised. In an older adult whose coronary arteries may already have some narrowing from decades of normal aging, a diastolic pressure sitting at 57 is not a reassuring number.
It may represent genuine oxygen deprivation to heart tissue happening dozens of time per minute.
What is your blood pressure first thing after waking up? Could it drop down in the afternoon?
You can get a morning blood pressure surge -- most underdetected cardiovascular risk factor in adults over 65.
Here is what the research tells us about morning blood pressure:
In the hours before waking and in the first two to three hours after, the body undergoes a dramatic hormonal shift:
>Cortisol rises
>The sympathetic nervous system activates:
>pupils dialate
>inreases heart rate strengthens contraction
>lungs dialate bronchioles
>inhibits digestion
>adrenal gland - stimulates adrenaline release in blood stream
>liver stimulates glucose release
>skin stimulates sweating
>Heart rate increases
>Blood vessels contract
>Blood pressure climbs
In older adults, particularly those with any degree of arterial stiffness or existing cardiovascular risk, this same morning surge can represent the period of highest cardiovascular danger in the entire 24-hour cycle.
The morning surge is an independent predictor of stroke and cardiovascular events -- separate from average daytime blood pressure. An adult with average blood pressure readings that look acceptable may still be experiencing dangerous morning spikes that go completely uncaptured by a doctor visit.
This is your home blood pressure monitoring protocol:
Wake up; within 30 minutes -- before coffee and before meds. Sit quietly for 5 minutes and then take your blood pressure reading.
**This is the only way to capture this window.
Another hidden danger layer for seniors is called Masked Hypertension.
What is it? Blood pressure appears normal atthe doctor's office but is consistently high at home.
Why is it dangerous? It often goes undiagnosed and untreated, leading to increased risk of stroke and heart disease in older adults. It is recommended to take two readings every day: one in the morning and one in the evening. We'll go into that in a bit.
What should your blood pressure target actually be after age 65? The first and most important principle is that your target should be individualized. There is no single blood pressure number that is universally ideal for all adults over 65. Anyone who tells you otherwise is simplifying in a way that serves the system -- not the patient.
For adults between 65-74 with generally good functional status -- meaning you are mobile, not significantly frail, not managing multiple overlapping chronic conditions, a systolic target in the range of 130-140 is reasonably supported by the evidence.
For adults 75 and older and particularly for those managing fraility, significant mobility limitations, multiple medications, or any history of falls, the evidence supports a systolic target of 140 to 150.
Major geriatric medicine organizations, including the American Geriatrics Society, have been explicit that below 130 targets in this population carry meaningful harms that likely outweigh benefits for many patients.
There is also a diastolic floor that deserves attention. Regardless of systolic target -- diastolic pressure routinely below 65 (especially below 60) in an adult over 65 warrants immediate medication review.
What to do now:
(1) Review your recent health history and list any new symptoms
(2) Note any changes in medications, including dosages
(3) Write down the top three questions for your doctor
(4) Check your calendar for future appointment dates & follow-ups
(5) Organize any reports or test results you received since the last visit
(6) Start home monitoring:
Take two readings each morning within 30 minutes of waking and before medications and breakfast. Sit for about 5 minutes before taking your blood pressure ~~
1st reading
Rest 2-3 minutes
2nd reading
Take two more readings each evening before dinner, about 15 minutes apart, same as morning readings.
(7) Bring two full weeks of readings to your doctor appointment
(8) Know your bottom number. Diastolic shows the pressure in your arteries when your heart rests between beats.
Ask your doctor specifically what your diastolic pressure has been averaging over the last several appointments.
(9) Request a standing blood pressure test: first seated, then standing for two minutes.
If your systolic drops more than 20 points upon standing, that is orthostatic hypotension and it is a medication manageable fall risk.
(10) Calculate your pulse pressure -- ask: is arterial stiffness being factored into my management plan?
**If you are over 75 ask: What blood pressure target are you using for me and why? Is it accounting for my age, fall history, and kidney function? -- You are entitled to a specific individualized answer to this question.
The five point plan for empowerment:
(1) Ask your specific question clearly
(2) Expect an individualized response
(3) Understand your patient rights
(4) Seek clarity and detail
(5) Plan is fully realized
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