Your ‘Healthy’ Blood Pressure is Killing You
Summary
TLDR这段视频揭示了关于血压的新研究,挑战了过去的健康标准。以往认为140的收缩压是安全的,但现在研究表明将血压降至120以下可以显著减少心脏病、卒中和死亡的风险。视频介绍了如何通过调整饮食、锻炼、睡眠和减压等生活方式来降低血压,并讨论了药物治疗的必要性,特别是对于生活方式无法控制血压的人群。视频还提供了实用的指南,帮助观众实现新的血压目标,从而有效保护心血管健康。
Takeaways
- 😀 新的研究显示,曾被认为正常的血压水平(140/90)现在被认为存在风险,目标应是120/80。
- 📉 Sprint研究表明,将收缩压降低到120以下可以显著减少心脏病发作、中风和死亡的风险。
- ⚠️ 另一项来自中国的大型研究证实,降低血压可以降低12%的心血管病发作和21%的全因死亡率。
- 🥑 饮食是控制血压的关键,增加高钾食物的摄入,如豌豆、菠菜、牛油果和豆类,有助于降低血压。
- 🚫 减少钠的摄入至每天1500毫克(约一茶匙),避免加工食品和外出就餐可以帮助控制血压。
- 💪 适度的运动,如步行、跑步和骑自行车,每周五天30分钟,可以显著降低血压。
- 🛏️ 充足的高质量睡眠对控制血压至关重要,建议成年人每晚睡7到9小时。
- 🌞 规律作息,尤其是早晨晒太阳,有助于调节睡眠周期和降低压力。
- 😌 管理压力,如冥想、深呼吸等放松技术,有助于降低高血压。
- 💊 若生活方式调整后血压仍高,可考虑药物治疗,首先考虑血管紧张素受体阻滞剂和钙通道阻滞剂。
Q & A
为什么过去的血压标准现在被认为是危险的?
-过去医生认为收缩压(即血压的上限值)高达140是可以接受的,尤其是随着年龄的增长,血压往往会升高。然而,最新的研究表明,哪怕是略微升高的血压都会增加心脏病、卒中和死亡的风险。
收缩压保持在120以下对健康有什么好处?
-降低收缩压至120以下可以显著降低心脏病、卒中和死亡的风险。根据Sprint研究,收缩压低于120的组每年心脏病和卒中风险降低了27%,死亡率降低了25%。
Sprint研究的主要结论是什么?
-Sprint研究发现,降低收缩压至120以下相比保持在140,可以显著减少心脏病、卒中和相关死亡的风险。研究甚至因为结果过于明显而提前结束。
中国的研究是如何验证Sprint研究的?
-中国的研究测试了更大、更多样化的人群,包含了糖尿病患者和曾经中风的人。结果同样表明,降低收缩压至120以下可以减少心脏病、卒中及其他原因导致的死亡风险。
为了降低血压,饮食中的关键是什么?
-钾对于降低血压至关重要,它可以平衡体内的钠,帮助血管放松。增加豌豆、菠菜、牛油果和豆类等高钾食物的摄入有助于降低血压。
钠对血压的影响是什么?
-摄入过多的钠会升高血压。美国心脏协会建议每天钠的摄入量不要超过1500毫克,超过这个量会增加高血压的风险。
如何通过饮食调整来控制钠的摄入?
-减少加工食品的摄入,选择低钠食物,并尽可能在家做饭以控制盐的使用。盐替代品也是一种帮助减少钠摄入的有效方法。
除了饮食,还有哪些方法可以帮助降低血压?
-运动是降低血压的最佳方法之一。每周五天,每天30分钟的步行、慢跑、游泳或骑行都对心脏有益。力量训练也有助于保持新陈代谢强健,从而帮助控制血压。
压力管理对血压控制有什么作用?
-长期的慢性压力会导致血压升高。因此,学习如何管理压力,如通过冥想、深呼吸或正念练习,可以帮助降低血压。
什么时候应该考虑使用降压药物?
-当生活方式优化、体重管理良好但血压仍高于120时,患者可以考虑药物治疗。常见的药物是血管紧张素受体阻滞剂和钙通道阻滞剂,通常从低剂量开始逐渐增加。
Outlines
💉 高血压新标准:健康与危险的界限
最新研究表明,曾被认为是健康的血压现在被认为是致命的。医生过去错误地认为收缩压达到140是安全的,然而研究显示,这一数值带来了很大的健康风险。通过将目标收缩压降至120以下,可以显著减少心脏病发作、中风和死亡的风险。视频将介绍如何通过分步指南帮助实现这一理想血压水平。
🥦 钾与钠的对决:饮食对血压的影响
钾在对抗高血压方面表现得像超级英雄,它可以帮助放松血管,抵消钠的负面影响。富含钾的食物,如豌豆、菠菜、鳄梨和豆类,能够有效降低血压。而大多数人摄入过多的钠,导致血压升高。通过控制饮食中的钠摄入,选择低钠选项,并使用钾盐替代品,可以进一步降低中风和死亡的风险。
🏋️♂️ 运动与睡眠:维持健康血压的关键
运动是降低血压的重要方式,每天进行30分钟的中等强度运动,如散步、跑步或游泳,都有助于心脏健康。力量训练也能帮助加快新陈代谢,直接影响血压。此外,充足的睡眠对血压管理同样关键。视频中建议保持规律的作息时间,减少咖啡因摄入,并通过简单的放松技巧来控制压力。
Mindmap
Keywords
💡血压
💡收缩压
💡SPRINT研究
💡中国研究
💡钾
💡钠
💡蛋白质
💡运动
💡睡眠
💡减压
Highlights
长期认为140的收缩压是正常的,但最新研究表明,这种血压水平实际上存在风险。
Sprint研究显示,将收缩压降至120以下,可以将心脏病、中风和死亡风险降低27%。
研究早期终止,因为结果非常明确,低于120的血压大幅降低了死亡风险。
另一项在中国进行的研究也证实了Sprint研究的发现,涵盖了更多样的人群,包括糖尿病和中风患者。
该研究显示,低血压目标将总体死亡率降低了21%。
降低血压的方法包括调整饮食,增加钾摄入和减少钠摄入,钾能有效平衡钠水平。
研究表明,钠摄入增加会直接导致血压上升,因此减少加工食品和餐外饮食非常重要。
盐替代品,如含有氯化钾的替代品,也可以帮助降低血压,相关研究显示中风和死亡风险明显降低。
增加蛋白质摄入有助于控制血压,特别是植物蛋白,如豆类、扁豆和鹰嘴豆。
纤维丰富的饮食不仅有助于消化,还可以有效控制血压。
适度的运动对降低血压非常有效,建议每周进行五天,每天30分钟的有氧运动。
睡眠质量对血压的控制至关重要,建议成年人每天保持7到9小时的高质量睡眠。
保持一致的作息时间,早晨接触自然光,限制咖啡因摄入都可以帮助改善睡眠质量,从而降低血压。
慢性压力会导致血压升高,管理压力的技巧如正念、深呼吸和冥想可以有效降低血压。
如果生活方式调整后血压仍然偏高,医生会考虑低剂量的血压药物,通常先采用血管紧张素受体阻滞剂,然后再结合钙通道阻滞剂。
Transcripts
what used to be considered a healthy
blood pressure is now a death sentence
two groundbreaking Studies have
completely changed how we should
approach blood pressure in this video
I'll show you the new blood pressure
targets how much we can reduce the risk
of heart attacks strokes and death if we
get this right and go through an easy
step-by-step guide to help us achieve
the perfect blood pressure these studies
show that we as doctors got it wrong for
decades we knew that high blood pressure
was dangerous but we didn't realize just
how dangerous even at levels that seemed
okay let's imagine your blood vessels
are like a garden hose when the pressure
inside that hose is just right water
flows smoothly everything is fine but if
you turn up the pressure too much the
hose begins to strain over time it wears
out and if you keep cranking up that
pressure it might even burst in the same
way high blood pressure puts strain on
our blood vessels this constant pressure
damages the inner lining of our
archeries making them less flexible and
more likely to get blocked which can
lead to heart attacks and strokes so
what's the real safe number and why is
the old normal so dangerous for a long
time doctors believed that having a
systolic blood pressure that's the top
number on your reading up to 140 was
perfectly fine you may have even heard
your doctor say that as long as your
blood pressure is under 140 on 90 you're
in the clear we used to think 120 on 80
is the textbook ideal but 140 that's
still okay isn't it well we now know
that having a systolic blood pressure
near 140 is actually risky it's not just
okay it's putting our lives in danger
the reason doctors thought that 140 is
fine is that blood pressure it tends to
go up as we get older so we figured that
a little higher was normal but new
research shows that even that little
extra pressure can have big problems the
first wakeup call came from the Sprint
study which stands for systolic blood
pressure intervention trial the study
was massive over 9,000 participants so
the findings are hard to ignore the goal
was to figure out if lowering system IC
blood pressure to below 120 would
protect against heart attacks strokes
and other problems better than just
sticking with the old Target of 140 the
people in the study were at high risk of
heart disease but they didn't have
diabetes or a history of a stroke they
were split into two groups one that
aimed for a blood pressure of 140 and
another group that aimed for a blood
pressure of 120 now here's where it gets
really interesting the results were so
clear that they had to stop the study
early the study was supposed to last 4
to 6 years but after just 3.3 years it
was obvious that lowering blood pressure
to below 120 it made a huge difference
there was a 27% lower risk of having a
heart attack stroke or dying from these
causes each year and when it comes to
death rates alone there was a 25% lower
risk of dying in the group that aimed
for 120 so let that sink in for a moment
a 25% reduction in the risk of death
just by lowering blood pressure more
aggressively this isn't a small
Improvement it's a game Cher but the
story doesn't stop there recently
another study in China tested these
findings on an even larger and more
diverse group over 11,000 people and it
included those with diabetes and those
who had already had a stroke think of
the study as the sequel to the Sprint
study but an even bigger cast and guess
what the results were just as powerful
lowering systolic blood pressure to less
than 120 reduce the risk of heart
attacks strokes and death from
cardiovascular causes by 12% plus it cut
the overall risk of death from any cause
by 21% over 3 and 1/2 years so what's
the catch and how do we get our blood
pressure down to these safer levels well
like anything in medicine there's always
trade-offs lowering blood pressure this
much it can come with side effects like
dizziness or fainting but the benefits
they far outweigh these risks and don't
worry I'll share some tips on how to
avoid these side effects and who should
be more cautious about aiming for 120
later in the video but the takeway here
is clear the old normal of 140 is no
longer good enough most of us should aim
for a systolic blood pressure of less
than 120 to really help protect
ourselves so how do we reach these new
safer blood pressure targets well here's
a step-by-step system first we need to
know where we're starting from I suggest
to all of my patients to buy an aome
blood pressure monitor and I'll link one
in the pin comment while we're
optimizing the blood pressure I ask my
patients to take a reading in the
morning and then another one later in
the day we need to be seated place the
cuff on our skin rather than over
clothing and relax then record the
result I personally use the Apple Health
app now that we've got our starting
point it's time to talk about how to
lower that number diet is the foundation
of good blood pressure and to start we
need to talk about potassium potassium
is like a superhero when it comes to
fighting high blood pressure it balances
out the sodium in our bodies and helps
our blood vessels relax think of
potassium as the counterbalance to
sodium so while sodium raises the blood
pressure potassium brings it down some
great high potassium foods include peas
spinach avocados and beans eating these
regularly can help lower our blood
pressure so while potassium is the hero
sodium is the villain most of us eat way
too much sodium and that's a big reason
why many people have high blood pressure
the American Heart Association says that
we should have no more than 1,500 Mig of
sodium per day that's less than a
teaspoon of salt a study combining 85
different trials show that as sodium
intake goes up so too does blood
pressure and it's not just the salt
shaker on our tables most of the sodium
that we eat come from processed foods
and eating out so start reading those
labels choose low sodium options and
cook at home where possible so that we
can control the salt intake but if a
patient of mine is struggling to get rid
of the salt from their diet there's a
trick that can help salt substitutes
regular salt is is sodium chloride but a
salt substitute has some potassium
chloride instead in a study with over
20,000 people those who used ass salt
substitute had a 14% lower risk of
stroke and a 12% lower risk of death now
let's talk about another key player
protein protein isn't just for
bodybuilders it's important for everyone
especially when managing blood pressure
protein helps us keep Fuller for longer
which means we're less likely to snack
on unhealthy Foods lean proteins like
chicken fish and plant-based options
like beans lentils and chickpeas are
wonderful choices and let's not forget
about fiber a high fiber diet not only
helps with digestion but it plays a
significant role in blood pressure
management foods like whole grains whole
fruits and vegetables and chickpeas
again are packed with fiber and are a
staple in my diet and of course we need
to cut out the sugary drinks and replace
them with water alcohol can also raise
blood pressure so I work with my
patients to reduce or quit drinking but
diet is just one part of the picture
let's move on to exercise exercise is
one of the best ways to lower our blood
pressure and we don't need to be a
marathon runner to see the results
walking jogging swimming or cycling are
wonderful for our heart aim for 30
minutes a day 5 days a week so
personally I love to go for a run or if
the weather isn't great I'll use my
exercycle bike at home which I bought
secondhand for $60 and don't forget
about strength training muscle building
helps to burn more calories and keeps
our metabolism is M strong which is
directly linked to blood pressure but
what if you're super busy well here's a
quick tip on busy days I do something
called exercise snacks these are short
BS of exercise split throughout the day
like push-ups sit-ups or other body
weight exercises so at the clinic during
a quick 15-minute paperwork break I'll
fit in some exercise and these snacks
they can add up to make a massive
difference in our health but it's not
just about what we eat and how we move
sleep is another critical component of
blood pressure management poor sleep
whether it's not enough or lowquality
sleep can increase our blood pressure so
most adults need 7 to 9 hours of high
quality sleep per night but here's a tip
optimizing your sleep it doesn't just
start when we're ready to fall asleep it
starts when we wake up wake up at the
same time every day even on weekends the
body loves a routine get outside and
expose your eyes to sunlight early
sunlight in the day helps to regulate
our sleep wake cycle caffeine should be
limited to the first 3 to 4 hours after
waking up even if you feel like caffeine
doesn't affect your sleep it can still
lower your sleep quality and my full
sleep protocol is in a video here next
is Stress Management chronic stress can
contribute to high blood pressure and
finding ways to manage stress is
essential so mindfulness deep breathing
meditation all of these techniques can
help to lower our stress levels and in
turn lower our blood pressure even
simple practices like taking a few
minutes out each day to sit quietly and
Bre breathe deeply can make a huge
difference now hopefully if our diet
exercise and sleep are optimized our
weight will be perfect weight loss has a
powerful effect on reducing blood
pressure but if our weight is still
above Target despite optimizing our
lifestyle factors we can consider
medications such as AIC to help on our
weight loss Journey taking medications
are not a failure they're just another
tool to help us reach our health goals
and finally if our lifestyle factors are
dialed in our weight is perfect but
still have a blood pressure above 120
then I have a discussion with my
patients about the pros and cons of
blood pressure medications I emphasize
that medication should be an addition to
not a replacement for all of the other
steps that we've gone through some
people have their lifestyle in check but
still need medications because of their
genetics so at the clinic we usually
start with a type of medication called
an AR or an Angiotensin receptor blocker
regarding the dose we start low and go
slow increasing the dose gradually until
we get to a half strength dose if that's
not enough then instead of continuing to
crank up the dose of that existing
medication we'll introduce a second
class of medication called a calcium
channel blocker so by using these
combination therapies at low doses we
achieve a greater blood pressure
response with reduced risks of side
effects compared to just jacking up the
dose of that one medication now that's a
massive oversimplification of the
approach used in clinical practice and
if you want me to do a dedicated video
to blood pressure medic medications
please let me know in the comment
section so for example to add to the
complexity not everyone should aim for a
blood pressure of 120 on 80 for older
adults if we use that as a Target we can
significantly increase the risks of
dizziness and fainting so we need to
tailor the management and individualize
the targets we may accept 130 or 140
depending on the circumstance and that
complexity is what I find really
interesting and is part of the reason
why I love practicing at the clinic
overall though for most of us aiming for
around 120 is a smart goal and we do
that by measuring our blood pressure at
home optimizing our diet exercise sleep
and stress managing our weight and
considering medication if needed and
speaking of sleep make sure to check out
the next video here that goes through my
full sleep protocol and a massive thank
you to all of the patreons supporting
the channel
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