From the way back machine, “You bet your sweet bippy” was a standard line from LAUGH IN episodes with Dan Rowan and Dick Martin. Though the rowdy 1960s pre-dated the Urban Dictionary’s inception – this bippy phrase still means that one can be certain about a certain fact, figure, or sentiment.
Okay, I’m not blogging about Rowan and Martin’s heyday humor. Rather, I am writing about a very serious medical condition with the colloquial name “High Blood Pressure” if the label Hypertension gets you down. I am certain that high BP, or HBP, or Hypertension, is a bad bet for healthspan and lifespan. Absitively, posilutely…
You can bet your sweet BP that everyone, and I do mean everyone, should be aware of nasty arterial pressure effects from one’s diet, age, lifestyle, stress, and even exercise can have on overall healthspan.
The accomplished Michael Roizen, MD, wrote in his (1999) book titled Real Age that Blood Pressure (BP) was a public enemy #1. The World Heart Federation does too. Why?
High Blood pressure can mean a lifespan decrement of 20 years for those who do not work it downward. Two decades of life kissed off. Wasn’t it John Wayne who once offered on-screen, “Life is tough enough without being stupid.” – Does this lumberjack (below) appear to be smart to you? I equate being stupid about Hypertension to sawing a limb without regard for your own limb or digit.
Roizen also noted, “the older you are, the more your choices determine how long and how well you live.” In my 72nd year, my decisions about BP and counter-moves versus all 4 “Horsemen” of Chronic Disease become more time-critical for me. Younger folks should start making good choices as soon as possible – Duh! As I asked in STRONG to SAVE, who wants to die earlier and easier?
As with so many other metrics to evaluate and consolidate into overall wellness, blood pressure readings that suggest arterial stiffening can be satisfying, or alarming. Here is the big deal:
Increased aortic stiffness predicts higher probabilities of cardiovascular disease across a chosen population.
US death rates attributed to hypertension as the underlying cause of death have increased, and marked race-sex disparities persist.
A Billion people worldwide have hypertension, and sadly 80% of those billion do not have the disease under control!
Segue. We all know about the White Coat Effect or WCE which is cited in many articles about quizzical blood pressure spot checks.
Spoiler Alert: Your regular at-home or walking blood pressure checks are more accurate and fitting :). Am I implying that everyone should have access to a blood pressure cuff and monitor, and use it pretty darned often?
You bet your sweet bippy!
I also bet that many of you love the musical group Queen and its repertoire of melodies. I cannot count the gazillion times that Queen’s classic song, Under Pressure, has percolated in my own life from work stressors, a big athletic event, or a hyped visit to a Cardiologist…
Two Hypes
- Hypertrophy is a very good thing. Who doesn’t like a big trophy? By keeping skeletal muscle mass/size , you can offset that dreaded muscle loss disease – sarcopenia – as you age or after you regrettably neglect strength training motions.
2. Conversely, Hypertension, as that white-coat fancy term for elevated blood pressure, can be an evil thing for so many probabilistic reasons:
- Chronic hypertension causes hard labor for the only heart you have!
- 89% of Americans (including me) have blood pressure readings that are higher than the declared ideal reading of 115/76 millimeters of Mercury.
- For every 2 units of added blood pressure over the “youthful and vigorous 115/76 reading’s upper and lower numbers, the fitness age lowers by about 2 years. This is assuredly not a good 2:2 relationship!
- With normal healthy aging, the upper number in a BP reading – called the systolic pressure – does increase due to inevitable arterial stiffening. The upper systolic # reflects stiffer arteries, possibly from calcium deposits, or from that gooey, low density, soupy plaque we’d love to avoid. So, someone like me – a male in his 8yh decade – may have a “normal BP” as long as the upper systolic number doesn’t get to or stay above 130 mm/Hg.
- The lower number in a BP reading represents the arterial pressure at the measured spot between beats of your ticker. This “diastolic” pressure does not seem to rise at the same rate vs. time as does the systolic pressure. Thus, the focus on lowering blood pressure by any method is on systolic blood pressure.
- “Measuring PWV offers the chance to identify subjects at risk and to intervene timely through lifestyle modifications and medication. In contrast to classical cardiovascular risk factors, PWV is a more stable parameter that gradually becomes abnormal and represents vascular aging.”
- Stay tuned for my relay of practical ways to mitigate “pre-” or hypertension to lower one’s BP correlation to atherosclerosis (ASCVD) and mortality. As a takeaway for PWV merits,
Another Bippy Bet
A related measure of great value for Roizen’s real age or cardiovascular health (CVH) is known as pulse wave velocity, or PWV in shorthand.
Clinicians measure the distance between arterial points, then calculate the time for blood to travel that distance in a wave for one pulse. As we learned in science class, velocity equals distance divided by time, or V = D/T.
There is also a bit of fluid mechanics at work that helps us grasp whether one’s pulse characteristic is good for her or his age.
Good ‘ol Venturi analyzed constant flows of fluids or gases through restricted conduits. He realized that a constricted portion of a flow tube or pipe, or artery causes the fluid to move at an increased velocity. So, in my layman’s terms, a lower Venturi effect suggests wider and more elastic arteries. A higher measure suggests an arterial constriction to be evaluated with others in one’s age group and gender. A valuable health measure that you can store in your physical bank is this: a lower PWV is better than a high value.
Exploring the Venturi Effect |
Smart!
Technology can be wonderful when accurate and actionable information is processed for a user. I bring up technology in the form/fit/function of some smart watches, or rings like the Oura ring. These clever fitness devices use a different method to estimate and present one’s daily PWV.
This is a tiny sample size of 1 athlete; yet Tonometry and Oura ring estimates of PWV values were quite close for me.
- A Massachusetts General Hospital staff member recently measured my PWV at 8.7 meters per second.
- My Oura Ring estimates my PWV to be 8.9 – 9.0 meters per second. If this comparison works for many users, instead of little old me, then it seems like a good validation for affordable and convenient CVH monitoring.
Note: PWV generally increases with age, by about a tenth of a meter a year in adulthood. Men have a slightly higher mean PWV than women up to age 60, but women have a slightly higher mean PWV than men after age 60. Don’t ask me why 🙂 the small sample numbers in this PWV Table are what they are:
Age and gender-dependent values of pulse wave velocity for a small study
| Gender/Age | 20–29 (years) | 30–39 (years) | 40–49 (years) | 50–59 (years) | 60–69 (years) | 70–79 (years) |
|---|---|---|---|---|---|---|
| Female | N = 10 | N = 9 | N = 11 | N = 13 | N = 12 | N = 9 |
| PWV (m/s) | 4.41 ± 0.39 | 4.57 ± 0.67 | 5.24 ± 0.66 | 6.59 ± 0.70 | 7.38 ± 0.95 | 7.78 ± 0.93 |
| Male | N = 10 | N = 14 | N = 10 | N = 10 | N = 9 | N = 9 |
| PWV (m/s) | 4.64 ± 0.49 | 5.22 ± 0.50 | 5.57 ± 0.63 | 7.03 ± 0.84 | 8.05 ± 0.57 | 8.49 ± 1.09 |
A broader European study of PWV generated this graph showing PWV vs. both Age and Blood Pressure brackets – normalized for gender:
As this busy plot is a tad hard to follow or scrutinize, your Bottom lines about PWV are these 3:
- A lower velocity is better. For the average Baby Boomer or GenX, a PWV of less than 10 meters/second is considered okay.
- One committed adult may be able to lower PWV with regular aerobic exercise.
- Some fitness appliances are fairly accurate in their estimates of PWV.
Bippy bets to challenge Hypertension
Sure, a MD can prescribe drugs to deal with hypertension. Yet there are proven natural ways to lower hypertensive readings to safe(r) readings with effort.
- Lose fat and body weight! A guideline is that one’s BP reading drops a point for each pound loss of bodyweight. That is a good 1 fer 1!
- Exercise. I lobby for more weekly exercise than our Government mandates
- Limit overall and processed food salt intake. Scientists suggest following a Dietary Approaches to Stop Hypertension (DASH) diet and restricting table salt to 1.5 grams per day may lower systolic BP by 6-11 mm/HG and diastolic BP by 3-5 mm/Hg.
- Lower your Alcohol consumption.
- Go “cold turkey” on smoking.
- Don’t sweat or stress over things that you cannot control or affect.
Don’t get hyper, and Do keep hypertension at bay as you age.
Your life may depend on it.
DF