Blood pressure: how to measure, manage, and treat high blood pressure (AMA #48 rebroadcast)

**Peter Attia** (0:11)
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Welcome to a special episode of The Drive. This week, we're re-broadcasting a previous AMA, which focuses on blood pressure. Blood pressure is one of the most important and sadly overlooked risk factors for chronic disease. It's a topic that affects nearly everyone, yet many people either do not know their numbers or don't appreciate how profoundly blood pressure influences long-term health. While this AMA was originally released to subscribers, we felt it was important enough to make it available to everyone, while also giving those of you who aren't subscribers a chance to experience what our AMA episodes are all about. In this AMA, we talk about what blood pressure actually measures and why it matters for longevity, how to accurately measure blood pressure at home, and why office readings can often be misleading, the relationship between blood pressure, cardiovascular disease, dementia, kidney disease, and overall mortality. What the latest evidence says about optimal blood pressure targets, the lifestyle interventions including weight loss, exercise, nutrition, and sleep that have the biggest impact on lowering blood pressure, when medications become necessary, how they work, and how to think about the different treatment class options, and practical strategies for monitoring and managing blood pressure over the long term. So without further delay, I hope you enjoy this special rebroadcast of our AMA on blood pressure.

**Nick** (2:29)
Peter, welcome to another AMA, how are you doing?

**Peter Attia** (2:32)
Very well, thank you.

**Nick** (2:33)
Awesome. You know, before we get started on this one, some of the people who listened to one or two AMAs ago when we were going over your DEXA results, we were talking and telling the story about Reese's Pieces and how you had never heard of them. And we did a call out to say, hey, if anyone else has never heard of them, please reach out and you will be pleased to know.
We probably had about 30 to 40 people who were in the same boat as you and had no idea what Reese's Pieces are. So you are not the only one.

**Peter Attia** (3:03)
Not the only one on this planet.

**Nick** (3:05)
Not the only one. I mean, again, 30 to 40 compared to our listenership is not a good percentage. So you're definitely in the minority. But yeah, shout out to everyone who reached out and the person who was the first to reach out. We have something special going in the mail for them.
Ironically, they reached out to us before we even sent the email saying the podcast was live. So to say they are an active listener would be an understatement. So shout out to that person. They know who they are.
Today's AMA is going to be on one subject, but one important subject, which is blood pressure and all things blood pressure. And people who have listened to the podcast will have heard us talk about blood pressure before. Most recently, the episode we released with you and Ethan Weiss, Ethan coming back for the second time, you both spoke a lot about blood pressure. And as you said in that one, if you look at cardiovascular disease, three main risk factors for cardiovascular disease are going to be smoking, which we don't necessarily talk a lot about because, as you've said before, we're kind of under the impression. If you listen to this podcast and you still smoke, you probably should know you shouldn't. So that's nothing really we need to say there. The second is APO-B, which clearly is a topic that we cover a lot and has been covered. And then the third is blood pressure. And we kind of realized we hadn't done as much of a deep dive on blood pressure, and we get a lot of questions, so we compiled all those. And in today's AMA, we're kind of really going to talk about a few different sections, multiple questions in each section, which is what is high blood pressure, low blood pressure? Why should someone care? What does it affect? As it goes beyond just the risk of cardiovascular disease, as well as how do you know where you're at? This is one where, unlike ApoB, you can't give yourself an at-home blood test, but you can check your blood pressure, and you can understand how it changes throughout the day, what the different definitions mean. And then we'll end with really the main focus, which is, okay, what can you do to control your blood pressure?