16 Burst results for "Essential Hypertension"
"essential hypertension" Discussed on The Dictionary
"Hello words welcome to the dictionary. Yeah if you wanna make me a little theme song seriously. Five seconds ten seconds. I know you've got some skills out there. You can email it to me. Dictionary pod at gmail.com make short little theme song. I would so appreciate that because it would be fun to put in an episode or seven Should i tell you anything about my life. Do you care about that stuff. I don't know maybe. I'll just do it every once in a while. We have been watching shins. Some shows we started key and peele from the beginning because we haven't really watched a lot of that and that is such a good show The fourth season of atypical is out which is a great show and You know it's it's kinda goofy but it has a ton of heart and drama and deals with some real life stuff. So i really liked that show That's good for now. Okay the first word in this episode is colona dean or colona dean or kalana dine or colona dine c. l. o. n. i. d. i n. e. noun from nineteen seventy and anti hypersensitive. No an anti hypertensive drug c nine h nine c. l. two and three used especially to treat a central yes essential hypertension to prevent migraine headache and to diminish opioid and nicotine withdrawal symptoms list. Seems pretty good. I hope there are no side effects. Next is clunk. Clunk clunk c. l. o. n. k. verb from nineteen thirty starting with in transitive to make a dull hollow thumping sound. When i knock on my brain case it makes a clunk sound transitive says to cause clunk clunk is a noun next is colonus noun from eighteen. Seventeen a rapid succession of alternating contractions and partial relaxations of a muscle occurring in some nervous diseases. Colonus Colonic is an adjective cologne. Necessity or club. Necessity is a noun so of alternating attractions impartial. So you know this. I don't have a disease. But i know this happens with a lot of people. Sometimes your finger might twitch or your your eyelid might twitch or something and i guess those are called colonus with the plural. Be clone i. It doesn't say what the plural is. is from the greek close which means agitation. And there's more at the word. Hold next is klute c. L. ot t. noun from seventeen twenty five one is scottish. And it is a cloven hoof. Or who klute and number two would be plural and capitalized and it is also scottish. And the synonym is the word qaluti which actually is going to be our next word This is perhaps it into the old english klatt. And there's more of the word clete so here we go with colucci with a c It's got an i. E. at the end by the way. So you can imagine what this word looks like in your head. Noun from seventeen eighty five chiefly scottish and it is used as a name of the devil. Oh that actually makes sense with the cloven-hoofed thing because you know they say that the devils got some woods the goat legs or you know those kinds of legs with the hoofs at the end so they call the devil qaluti. It doesn't have quite the same ring right. satan devil be els above whatever. I don't know bills above this kind of a silly word. But qaluti doesn't doesn't draw the same scariness are okay..
"essential hypertension" Discussed on Good Life Project
"Just don't really do anything they don't work. So and which makes it easier again to go down. That road of this is just the person like an. It's that's the person pro-life whereas and it sounds like you. You've actually serve what you're doing your approach to it is is designed to really a change the way that people are actually treated but also again reverse that whole set of assumptions had start this negative spiral. Yeah that's exactly right so it unfortunately is true. A lot of the things they we traditionally do for addiction are not effective. They do not work but that is not an indictment on the people who have addiction. That's not even an indictment on the illness of addiction itself. That's an indictment on the systems that we have built that are not evidence base that we then wonder why they don't work and so i talk about this from a couple of different one. The research studies show us. One of these is my favorite that compares asthma type two diabetes and type one or essential hypertension which is disliked. The general high blood pressure that people know about and it had people that came into the hospital for treatment for addiction or diabetes or hypertension or asthma and is set at one year because all four of those chronic medical illnesses at one year. What percentage of those people had had a relapse in their illness and it was the same across all four. the other thing it said was what percentage of people were following the medication recommendations and the lifestyle recommendations one year later so the relapse rate for all four of those illnesses was right at sixty percent at one year and so relapse for high blood pressure mitt..
"essential hypertension" Discussed on Good Life Project
"You've actually serve what you're doing your approach to it is is designed to really a change the way that people are actually treated but also again reverse that whole set of assumptions had start this negative spiral. Yeah that's exactly right so it unfortunately is true. A lot of the things they we traditionally do for addiction are not effective. They do not work but that is not an indictment on the people who have addiction. That's not even an indictment on the illness of addiction itself. That's an indictment on the systems that we have built that are not evidence base that we then wonder why they don't work and so i talk about this from a couple of different one. The research studies show us. One of these is my favorite that compares asthma type two diabetes and type one or essential hypertension which is disliked. The general high blood pressure that people know about and it had people that came into the hospital for treatment for addiction or diabetes or hypertension or asthma and is set at one year because all four of those chronic medical illnesses at one year. What percentage of those people had had a relapse in their illness and it was the same across all four. the other thing it said was what percentage of people were following the medication recommendations and the lifestyle recommendations one year later so the relapse rate for all four of those illnesses was right at sixty percent at one year and so relapse for high blood pressure. Mint your blood pressure was controlled and then the symptoms came back. That's how he defined relax in medicine. Asthma your symptoms were controlled. Asthma attacks came back diabetes. Your blood sugar was controlled and then your blood. Sugar went up addiction. You were not using and then you started using. That's relaxed define sixty percent across the board all of them. The percent following medication recommendations forty percent thirty percent right across all of them right the person. Oh i'm sorry sorry. Say the percent following medication recommendations was fifty to sixty percent. The percent following lifestyle recommendation right was thirty percent across the board. It was equal for all of them. But if i asked the crowd of a hundred people right now the treatment for asthma work they would say yes. This treatment for diabetes work. They would say yes to treatment for high blood.
"essential hypertension" Discussed on Dr. Drew Podcast
"This is amy. you're going to a different path. Amy what's up well. I can't believe i'm talking to you. hi thank you for being so available we are okay. I got some. I got a master of science infringe psychology in an attempt to prove my sanity and as it turns out there's no legal definition of sanity No one can prove they're saying in. And the definition of insanity is completely divorced from the clinical reality of what we might call insane but understanding that anyone with a mental disorders. Socially seen as not same disordered. Now the thing that gets me about psychology and this is the reason. I wanted to talk to you specifically Because you're very involved in twelve step programs and The major difference that i noticed. Is that twelve step. Programs require a belief in a higher power and that opposes a psychology psychology leaves. The individual is all powerful and responsible for their reality and in fact praying to beings talking to spirit is seen as a symptom of mental disorder. Twelve step programs in psychology oppose. Each other in psychology has infiltrated twists up. Now these people trying to get sober drug. They're all on pharmaceutical. Judges daughter has has infiltrated as it often. Does the this over community but so so let's talk about how imprint so Yes in some groups and in some situations the higher power concept is is a religious or god concept includes praying to somebody that is not how tall step is intended to be practiced if somebody wants to go that way. They're at their liberty to do so if that works up put it. I'm not talking about praying to somebody. I'm saying that i'm other i'm not you. I'm saying that the law attraction and the secret is site psychology bs. There's an interaction. I'm the other and you and i are contained in all. It is in my opinion. God is all it is so i i. It's not about some guy. It's about believing in other people. It's about allowing existence other than yourself and psychology goes into twelve step in drugs. All these people just just insidious and not helping humanity and honestly you keep saying psychology psychologist can't prescribe. So you're talking about right. They got psycho cycle. They got psychiatrist friends like you. Were they say oh. This person has this disorder. Can you give you know. Can you see him for one session. And then the psychiatrist season for one session gets the drug according to the disorder that psychologists recommend it so i get what you're saying what you're doing semantics or whatever it's called shock but so i don't disagree with anything you're saying so let's go back to the concept of higher power. How it's supposed to practice the problem with addicts alcoholics as they are very controlling and they have a they can't. They can't stop controlling their environment. They can't stop focusing out there and trying to manipulate things and we are trying to get them just to stop doing that. And how did it but step one belief in power greater than yourself and once you do that. You can't be self obsessed if you really if you if you believe if you really know that you are not the center of the universe. That's all it's about. And then and psychology depends on that belief that you are the center. You are self obsessed your ocd. You're what's that one odd. Your here's another drug and it's just it's it's it's how do we have looking at humanity. I'm wondering if we can't focus on positive aspects. i mean. I'm all for mental health but giving people with a liberal arts degree the power to define anyone they want is disordered based on multi variable manipulated confidence interval statistics. It's it's thick. It's set ninety percent of psychology. Gosh so yes so. People gossip he. It's gossip the study of human behavior is gossip. Well if you look at the dsm five. It's it's really designed to be able to set up categories for research right and so treatment is always kogo sir stood your okay hold on i gotta say one thing before you talk about the psychological studies There's three things three foundational things. I wrote this down because it's one sentence psychological opinion erroneously and willfully denies three foundational loss in math statistics and critical thinking to sell. Its dogma number. one you're not. I'm far using doctors confusing doctors and psychologists. So here's how can you put you on hold. So here's how doctors think. Doctors tried to find a constellation of symptoms. That have a co. Listen listen to me if you don't stop talking i'm going to hang up on you ready. I'm gonna put you back on. You're gonna listen. Are you ready to listen. Or am i gonna hang up on you you ready. Okay so just listen. So the way. Physicians work in all disease states. We find a common genetics and a common biology that are reflected in a cluster of signs and symptoms assault unique. That's how i mean medicine. Well then medicine doesn't exist so you're saying this year my let's talk about. Let's talk about how medicine works. Let's talk about medicine. Works medicine is common. He's not medicine psychology. I i have no opinion. Pinnacle doctor on psychology. You're taking issue with diagnosis. And i wanna. I want to emphasize about how diagnosis works. I know says much of a common genetics. A common biology and a cluster of signs and symptoms that reflect that common genetics and biology and possibly and inciting environment common inciting environmental influence. Gene environment specific biology definable specific pathophysiology that creates signs and symptoms. That's it that's medicine and we try to change that pathophysiology in a good way. We call that treatment. But if you don't have a specific genetic commonality triggering an abnormal physiology. You do not have a diagnosis. You do not have treatment. You might have a syndrome which is a complicated array of biology's that manifests similarly and it's possible you could come up with some treatments that are common like hypertension is a syndrome. That is not a diagnosis that is a syndrome. Essential hypertension this kind of it has multiple different biology's associated. But you can define that and you can treat hypertension all causes hypertension with common pharmacology. Even though you don't have a specific diagnosis so it's possible to treat syndromes with pharmacology. Common pharmacology but diagnosis is always founded on reproducible. Specific biological processes. And if you don't have that you don't have you don't have anything to go by and you're right then you're just using statistics and you're analyzing clusters and things like that and you and then the big problem with psychology of course is they can't reproduce the data so repeating yeah or repeating they ca-. You can't even repeat a moment in time. You can't replicate it. But i thank you for clarifying Because you are medical. You are a physician and i and i appreciate your perspective Just real quick For the liberal artists psychology way. We diagnose people it's it. It violates foundational laws in mass statistics and critical thinking i. Humans aren't mathematically equivalent human behavior. Our thoughts are thought. Patterns are unique. That's the first one in math. We're not equivalent the second one. It's an errand. Statistics correlation is not causation. That's for sure that the and plus by the way you're not even addressing all the assumptions upon which some of that materialists studied the assumptions last on the real quick is that there's an errand critical thinking called affirming the consequent And this is what liberal art liberal artists you know. I didn't take a science class. Not a single science class for my master of science. By the way. I prefer to identifies mistress. The science In forensic psychology you would think there would be. I mean. there was a biological psychology class in my bachelor's degree with like what was that guy who had a spike in his head. That's all we frigging learn about restaurants opinion. It's it's destroying trump step programs. People aren't silver anymore. Oh manual on that. And and i don't and i think you know there's i think honest. Psychologists would agree with you about the weaknesses and and they're trying to struggle with it in terms of how it's influencing twelve step. I've been through so many cycles of twelve stepping infected too much by professionals in ruining some of the process. You have no idea logically follow. Got him keith. Humphreys at stanford. Keith is the best advocate i know of. He's he's a scientist and he is the best advocate. I know of for really looking at the relationship between twelve step and the clinical world and sciences amy. I appreciate that call very very much. Well done thank. You amy tyler. Go ahead dr drew. Thanks for Thanks for everything you do. And thanks for taking my call I have a quick question to my wife. Recently had no-bid And i'm vaccinated. Island had very mild symptoms. She a little more flu like for a couple of days..
"essential hypertension" Discussed on The Exam Room by the Physicians Committee
"I would put work Don't forget your fruits and vegetables on tree reading them a lot but the their potassium bring blood sugar. A blood pressure down as well and bought the last thing is to say some people have what we call essential hypertension which meet essential is a word. Meaning i don't know why you have it And so for people who have that and they see their doctor and In that situation you're correct to be following doctor's advice about medication because high blood risky all right. We'll talk a little bit about type two diabetes earlier in the show. But now we have a question from sonnet at twelve twenty eight. Wondering what do vegans with type one diabetes need to avoid. They will first of all if you have type one diabetes. A vegan diet is still the way to go on. In fact you follow the same diet. Cre- much that's used for type two and that will make your doctor nervous because you're eating things like beans and sweet potatoes. That have a lot of carbohydrates but we published a case report Several months ago where we showed that when people go on people with type one When they go on to plant based. I completely healthy plant based diet very often. They need dramatically lessons and even better. Their cholesterol levels are healthier and their weight is healthier. Which means that. They're at less risk for cardiovascular complications. So it's a great way to go. The thing i would say is keep your diet as healthy as possible meaning Not so much overly refined things but you're carbohydrate intake will come up because you're having whole grains and beans and root vegetables and that's okay. You're gonna continue to need insulin. Because you've got type diabetes. Your body's not making insulin anymore. But hopefully the amount that you need will be reduced because Your own insulin resistance. Which yes you haven't even though you've got type one. You also have some insulin. Resistance to everybody has a little bit that will be diminished. and so the insulin. You're administering will go that much further and hopefully you'll need lesson. Don't forget to see your doctor I encourage everybody listening to this program that a die changes important lifestyles important but it doesn't substitute for making sure that you are talking with your givers and and following there is all right. Last question of the day comes from re shang. This is at twelve twenty eight. Let's see if we can get them here. Dr bronner says. I have just started to eat vegan diet. I'm twenty two years old. What supplements should i be taking over questioned. And thank you for asking. Because i'm sure the people that question to Number one is vitamin b. Twelve you need it for healthy nerves healthy blood and go to any drugstore or any health food store and get the smallest one you can find The the amount you actually need to point four micrograms a day in all the supplements are much higher. On you'll see five hundred thousand micrograms. Get the smallest one hundred two hundred eighty five hundred if you're getting one that's much bigger than that. You might take it every other day but b twelve dublin. Frankly does the only one that you really do. Have to take But you might want to take vitamin d. Vitamin d normally comes from sunlight on your skin. I use a sunscreen. Are your endorse all the time. And you're not getting some light on your skin. A vitamin d supplement will make up for it. Most doctors nowadays recommended by two thousand international units day That's about as far as i would go There are sometimes reasons for people to consider supplements the iodine or supplementing omega threes. But generally i wouldn't go there.
"essential hypertension" Discussed on SuperTalk WTN 99.7
"And you can, um Leave your name and number on that one. That's a voicemail. It's a little different number than the other one. Leave your voicemail and I'll have one of the staff call you and we'll get you scheduled next week for that. All right. So, Doc, that's all I got here on this side. Let me read this quick improvement report. So here's a quick improvement report. What was it like before you came to see us sleep was interrupted several times a week, So they were waking up several times a week and couldn't have any get any good quality sleep. Now The reason we're concerned about sleep is 86% of all your healing goes on when you're sleeping. You can't wake up in this interrupted, sleep all the time and expect to heal up and 92% of your fat is burned when you're sleeping, So if we get people in, they want to lose weight. Guess what The biggest thing is to get them to sleep. Good quality sleeps. So he said, We asked him What was it like before you came to see us sleep was interrupted several times a week. How are you? Now? Sleep is an interrupted once a month. There you go. All right. That's why whole food doesn't get you sleeping Well, and he is short and sweet on his improvement report. Okay, So, Doc, what do you got over there on high blood pressure here? We're gonna get close to wrapping this up on Beacon start shifting over toe. Maybe some supplements and stuff that we used to. Handle heart conditions, liver conditions, those kind of stuff the things that we see that we need to handle to get these this blood pressure down. Sure. So, Uh, when we talk about the adrenals, we've just mentioned the to the drink. Um, adrenal, desiccated and the, uh Brennaman. And and those, of course, are if your blood pressure is coming from the adrenals, which is more likely than it's coming from the liver or the kidneys. Um, but But yes. Oh, that's for for the adrenals connection. Um, we also could support the adrenals with another one called G, a adrenal. Um especially if a person has. We used those ones kind of interchangeably. But, um, that's a you know, an herbal that does a similar thing. Um, and then others that are good for just the benign essential hypertension would be things that relax your body like organically bound minerals. Um Ah, and also like to look at a cat appliques G, um, you know, instead of taking something that relaxes your drug that relaxes your arteries, and it opens them up. You can take cattle plex G, which is a vitamin, Um, It's it's part of the be family and and that will do that Same thing but in a natural way. That's right. Yeah, we We use a lot of that cattle plex G, especially when we do. The heart sound recorder will find that the heart sound recorder that lot of people are are low on their B vitamins. So this is part of getting that blood pressure down is just making sure your heart is in good. Nutritional order, So there's two types of vitamins. The one you mentioned two types of vitamin B. He's the one that you mentioned, which is your cattle plex G. And that is vitamins that strengthen but they kind of relax things and then we got kind of plex. Be core is what we call it can complex be core strengthens and then revs things up. But these air all natural they're coming out of the ground. Now, Doc, What happens is somebody's taking a A cat, A plant? Not a can of plex, but a B complex A synthetic B complex. What happens on that heart sound recorder when we're checking them? Yeah, so it's going to be reading things up. Um, but it's not a actual food. It's It's coming from some chemical. Uh, you know, it's a chemical itself. And, uh And so it looks like it, Z. Noise all over the place. It's you know, read out like a graph, and it's gotten kind of scratches all over it. That's right. Looks like some somebody. Some kid took crane and just scribbled all over it. So every time Dr Rob and I see that when we do the heart sound recorder when you come in for your evaluation, we do the heart sound recorder. I I always ask. Are you taking, uh be complex and 90% of the time? They say yes. And that will actually make the heart sound recorder look worse. And here, they're trying to help themselves. So the others could be, um other types of synthetic vitamins that are also causing that, But it's mainly the cantor plex. Be hurt, not caterp. Lex. Be that would fix it. But you've got to get him off of those synthetic vitamins. The B complex. The Synthetic B complex or the nutraceuticals in order to clean up that heart sound recorder Because those really irritate I didn't realize until we got this heart sound recorder. We've had it for maybe a year, but I didn't realize how much Synthetic vitamins really affect that heart until I actually saw it on the graph and it's It's amazing. You get somebody off of that and just doing that, Just that one thing getting him off. Off of that would improve that Graff Graff, greatly the other thing about the not just the big complex vitamins, But if you're getting those five hour energies or those monster drinks, they're doing a similar thing. Yeah, I had a lady come in, and I asked her what she wanna be complex. And she says no, I wasn't on a B complex. I shoulder that explained it to her. And she says, Well, I drank one of those Red bulls are those monster drinks before I came in. And I says, Well, that's probably what did it so we had to actually rerun it? I said, Did you did you have one now? And she said No. And we re re ran the hearts on recorder on that visit, and it was completely different. All those lines were diminished. So so, yes, What we put in our body really makes a difference to what is going on in there. And with the heart, it's really, really quick. If you came in on the heart sound recorder, and we found out that you were low on vitamin B. We gave you the right vitamin B, We wait 10 minutes. We'll have you chew it up. Let's say we wait. 10 minutes, we rerun the hearts on recorder. And guess what It's already changing in about 10 Minutes is all it took to change it, so this stuff happens pretty fast in your body. All right, Doc. What else you got over there on high blood pressure that we haven't talked about. Okay. Um oh. Sounds like we're gonna take a.
"essential hypertension" Discussed on News Talk 1130 WISN
"Are now continuing our program on high blood pressure. In the second segment of this program. We welcome back Dr Jack one Kalinsky, and she will be joined by Dr J. Fiddling and Dr Tracy Wang. Dr. Filling is a graduate of Notre Dame University and Northwestern University Medical School. He completed his medicine residency here, it M. C W and then went to the University of California, San Francisco for his fellowship in endocrinology. J joined them, M C W faculty in 1988 and is an international expert on the pituitary adrenal gland and all asked all aspects of steroid physiology. Patients come from all over the world for Jay's expert opinion, and it is really a special privilege to have J joined our program today. Dr. Tracy Wang is a graduate of Brown University received her medical degree from Albert Einstein College of Medicine in New York, and she received a master's degree in public health from Colombia. She completed her fellowship and endocrine surgery at Yale University and joined the M C W faculty in 2000 and seven where she is currently chief of the section of endocrine surgery and vice chair for strategic and professional development in the Department of Surgery. Dr Wang is slowly becoming a Packers fan due to her many years in New York City, But I think we're slowly making progress. So based on our our last segment Where we talked about largely essential hypertension or or hypertension, due to the many factors that doctor's Kalinsky and whittle talked about weight, the salt shaker and various other things as a transition, Jackie could could you let let the listeners know when do you become concerned? That the blood pressure may be caused by something else, not just essential hypertension. Sure Doug s O first of all essential hypertension, most common form of high blood pressure. But you know, as a clinician when I do get concerned, and when I think about, you know, is something else going on in my patient. One thing I think about is the extremes of age. Typically, So, um Onset of hypertension at a young age or sudden onset of hypertension kind of later in life as well. In addition to those two things if there's odd symptoms involved, so, for example, episodes of Sweating, palpitations, headaches, things like that that are also knew an onset. Then you really got to think about secondary causes of hypertension. On Ben. Finally, when you have a patient that appears to have what we kind of call resistant type of attention on their requiring multiple agents to get good control of the blood pressure..
"essential hypertension" Discussed on News Talk 1130 WISN
"Is taking some sort of medication. Elevated blood pressure. In the first segment of this program. We welcome Dr Jack one. Kalinsky and Jeff Whittle doctor Kalinsky received her medical degree from M. C. W. She completed her medicine training at the University of Washington. Followed by a fellowship in cardiology at the University of Texas Southwestern Medical Center in Dallas. She joined our faculty in 2014. Talk to Jeff Whittle is a graduate of the University of Wisconsin and the Medical College of Wisconsin. He completed his medicine training at the University of Alabama, followed by a fellowship at Johns Hopkins. He joined the M C W faculty in 2005 and currently is director of Health services Research. That there's a block E V, a medical center. Well as many of you know, we tend to use first names, even for physicians on the word on medicine. So, Jackie Dr Kalinsky, I'll start with you. Most of our listeners know that blood pressure has two numbers. A top number on the bottom number. What are those numbers and when is it too high? Sure, Doug. So let's start with the definition of blood pressure. So what is blood pressure? Blood pressure is really the force of the blood against the walls of the arteries as blood circulates throughout the body. So the first number of the top number eyes referred to a systolic blood pressure. That is that refers to the pressure in the blood vessels when the vessels contract To push blood along the diastolic blood pressure, which is that bottom number that refers to the pressure and the vessels or the force and the vessels when the blood vessels relax. And then when, when is either the top number or the bottom of the systolic and diastolic one of those numbers too high? Those numbers are basically too high when the top number is over 120 millimeters of mercury, and when the bottom number is over 80 millimeters of mercury, and we're going to get we're going to get to potential tumor conditions that cause That caused high blood pressure in the next couple segments of the show, but just toe in a general term, what's probably the most common cause of high blood pressure? Sure, the most common cause of high blood pressure is what we call essential hypertension or sustained hypertension. And, you know, quite honestly, The path of physiology of essential hypertension is not Well established, however, we think it's probably a result of numerous genetic and environmental factors that worked together on and have impacts detrimental impacts on the cardiovascular system and on the kidneys. So the so the those those rumors that my blood pressure's a little high just because my wife yells at me all the time. That's probably not correct. Exactly. I would agree with that. Now toe me clinical criteria for hypertension. You basically have to have it on two separate occasions before that diagnosis is made on in general. We also like to confirm the high blood pressure readings outside of the office setting when able to Great Jeff Dr Whittle. How common is his high blood pressure, and now they're certain populations in the United States were which arm or at risk for high blood pressure, actually a question and I think it's ah, I'll feed off of Jackie's comments on What the high rate of blood pressure is. That's too high, and we used 120 over 80, and that's certainly the best number to be at below that number. But what I graduated medical school. This is quite a while ago. We used to say your age plus 100 was the right number for the top number. And at that time, not that many people had high blood pressure. Older ages. As we've learned that even somebody who's in their seventies or eighties benefits from getting their blood pressure lower. We now call it hypertension. Even if you're 80 years old and you're 140 over 80, and that is translated to a lot larger numbers of people who have the diagnosis of hypertension. So when I finish medical school, it was 35 million. Now it's 70 million and probably more, as the latest guidelines have come in, and we're really treating more and more people because more and more people are known to benefit from the research that's been done here. The medical college as well as across the country, So really, I'd say an increasingly common problem. Mentioned age is one group that's really at high risk within other groups that are readily identified. Race is a big predictor of high blood pressure. And so people who are African American. Have a much higher rates of high blood pressure than people who are white, particularly in the younger age groups. People who are Asian oftentimes are less likely to have high blood pressure. Some of that's confounded by the fact that agents tend to be somewhat smaller. And in general, being bigger is associated with high blood pressure and in particular your your obesity levels. So somebody who happens to be 7 FT. Tall isn't at much higher risk than somebody who's 6 FT. Tall but to 6, ft. Tall people, one of whom ways to 50. One weighs 200 that £250 person is much more likely to have high blood pressure and the and the number again just for our listeners to reinforce that. So the the systolic blood pressure 1, 40 or above, actually, as Dr Kalinsky, Center, Jack, you said. 120. We have pretty pretty confident that if your pressure's over 120 you are worse off than if your precious below 120. We've decided Based on the trade off between treatment with picky with medications that it is on Lee Worth treating people once that top number gets above 140, although we would like it to be if we decide to treat Get it below 130. That's an area where we've had a lot of you know, I think people who have had high blood pressure for a while, probably complained that doctor keeps on wanted to be lower. It's because our understanding of the benefits of treatment have really increased. So we would say anything over 120. You have higher risk things that you could do like losing weight Being more physically active. You can't stop from getting older, but you can drop your way to be more physically active, perhaps eat less sodium. Or make some other dietary adjustments that your doctor could help you.
"essential hypertension" Discussed on Thrive Bites
"So we know that genetics has maybe about a five percent play and that's very empowering for someone to know that. Yes. So basically, what the medical diagnosis of high blood pressure, we call essential hypertension. And for us we you know we liked to make diagnoses where You know we don't really sometimes we don't really know where it's come from you know and the medical literature you know sometimes you know we try to be as up to date as possible and when will either have one clear cut cause or we'll have multiple you know and so we'll call that multifactorial and you know for high blood pressure you know it is relating for the most part to diet and lifestyle, and so yeah, I agree with you on me like if you're able if we have the best of the date signs to say this is you know able to be prevented a treated in reverse. Why not why does everyone not know about it and I think it's maybe because the marketing of Big Pharma you know in all these different types of procedures and medications that make a lot of money. They just kind of push all this to the wayside and you know they just make their own headlines and so you know marketing and media does play in a line, and so you know we I like to call health champions do our best to be able to promote good science, and so you know there are some genetic causes not to say one hundred percent is related. Die Lifestyle, but there are some genetic causes but you know we were able to turn off certain genes that that's what's called the epigenetics. So let's talk about you know how you've created. You know what you've created in terms of how you help people and You know we were talking about this a little bit offline, but you created an online platform for yourself. I believe it is called Health Yourself and that's health with in know H. E. A. L. T. H. and I like that because it puts the autonomy like we're talking about the power and autonomy into your own hands. Before. We talk about what it is and what you offer an you know the services that you provide what were the initial like obstacles and challenges. In terms of creating this because obviously, there is know the health and wellness space is very large in you dated, you know from people from all over what were the obstacles and challenges you faced early on or maybe that you're currently facing you know in terms of you know in terms of keeping this going or maybe in terms of you know what people perceive as good general health with us. Hey guys were to be taking a short break, but don't go anywhere we right back. Welcome back to thrive bytes. Let's get back to the interview. Yeah. Yeah. No, it's great question. So the reason I did health yourself by J. P. was because I had a lot of people coming to me asking for nutrition help Diabetes Hell weight loss helped for was most of my requests that I was getting help with weight loss. And so I knew I knew I could teach it. I knew I had thirteen years of doing it in employee wellness corporate setting where I I had my track record of success. So I knew I had good vetted information and I would was killing me is that people were going out there finding stuff on the Internet and.
"essential hypertension" Discussed on The Over 40 Alpha Podcast
"So that's personally played a role is and you gotta figure that if somebody lives to be the age of ninety they're going to spend thirty years sleeping if you if your body says that you spent that much time sleeping is probably pretty important in. It's worthwhile Often the quickest and biggest wins in terms of health are through just sleep. Any previous are so fast so easy so cheap that. I don't see a reason not to. Everyone overlooks because it. So like you know. I'll sleep when I'm dead or that's the big thing but you know of too busy. Or what have you but for me like you know. I RUN TWO COMPANIES Malls training and I'm not sponsored by this but I've got the whoop strap my wife and I did It's just a a strap from UC by the reason why we got. It was because we understood that. How important sleep is we want you know using HR V. Hardware variability gives us. You know what our sleep is. What are you know if whatever recovery is because for us again? It's very important. We're always training all exercise roles working out so I wanNA know like okay today. Even though I was in bed for seminars and only told me I have four and a half hour sleep. It gives me out. Ram Sleep gives me my light. Room sleeps was really really good but it also allows me to really focus on sleep right like I'm so obsessed with with my whoop because I'm always in tune with what if I'm getting enough sleep and sure sometimes you know I'll be. I'll be in bed for eight hours. Or what have you may say. Have five hours but my recovery is still pretty high. It will say hey. Menu covers high. So yeah you'll still and it tells you you need nine hour sleep still but your recovery's high so you can still you can still do stop But yeah you'RE I? It's so important to be in tune with your sleep because just like you said I mean if you just get seven nine hours sleep and you didn't change anything else. You didn't change nutrition. You didn't go to the gym but you just got more sleep. You'RE GONNA you're literally your cortisol levels are GonNa go down. You'RE GONNA probably start to lose a little bit more weight. They're going to have more energy Some of these health problems are going to are going to slowly dissipate. Somebody gotTa have everything but right away the sleep will will change your start to change your life said to make you feel better that will allow you to start saying. Hey Man I'm maybe I'm getting my sleep. I'm feeling good. I'm a productive work. I've got energy to run off my kids now. I can go to the jammed. You know what I mean like so huge in something that we can control like we can cost a little too like nutrition for a lot of people they go from eating. You know fast food to eat your veggies. I mean at first. It's not so pleasant to argue. Don't exercise the start. Exercising is not so pleasant your muscles burning autograph etc way. It's as immediate gratification. Assure so sleep guys seven nine hours. Lebeau case we hid diabetes. Let's move onto. We're GONNA move onto blood pressure and I'm going to talk a little bit about supplements because he said there are some supplements. You can take blood pressure now because again. This is something that a lot of men have high blood pressure right. And that's that's something again with that. We can combat with with what you're interested me. I wrestle talk about that Sharp so in in medical. They had the classic blood pressure into two different categories. They they call one one category essential hypertension the other day called idiopathic hypertension essential means. We know why somebody has high blood pressure kidney damage hyperthyroidism or some other reasons. And that's about ten percent of the cases of hubbub the upper categories. What the goal idiopathic in. You'll Pathak means we don't know the reason and that's ninety percent of cases of high. Well there's no kidney damage there's no hyperthyroidism and yet they're still up and they don't have the cost however largely competition response very very well to all this stuff the diabetes to Exercise Nutrition Sleep. Now it's different extras different. Nutrition strategies compared to diabetes. But it's the response very well to that and so let's just talk about. Some numbers is very much. A numbers person So optimal blood pressure is they. They used to say one twenty over eighty modern day they say about one hundred eighty five one ten over seventy somewhere in that range. These days one twenty over eighty is the cutoff for pre hypertension entity becomes a stage. One hypertension want somebody reaches one forty over ninety days to ensure one sixty or a hundred In Soa some sunglasses one of my is in one. Category in another number is in a different category The classic by the Higher Number Somebody has a blood pressure off. Let's say one thirty eight over one hundred two that's the desert stage to hypertension which is Which is very very high risk for a lot of things including stroke heart attacks. I damage in others. so that's in a nutshell. What blood pressure is and again ideo? Idiopathic hypertension is largely Alexa petition. TRICIA exercise stress. So you can. I feel a lot older older men older women older people at my local Ayala Shoppers drug mart. Which is a pharmacy here in. Canada are Toronto Ontario And you know they sit in the chair and do all diabetes. The blood pressure test. Is that accurate? Yes accurate. I still prefer. Nike is both Vices Eddie Old. School advisory pumping up manually with your hand. I still prefer device because I've with electronic ones. They've done it on the same person literally thirty seconds apart and gave me a difference of Lake fifteen kilometres whereas never happened before with a handheld device system. Prefer those so okay. So let's talk about exercise for people who have high blood pressure. So there's there are quite a few differences between extras Like that East Brunswick High Blood Pressure in here is the exercise prescription for Pressure here is one very little known exercise that is better than Cardio. Strength Training and it only takes eight minutes per day in by the way In my article on assured that tower giveaway. To your where's the dollar? The entire protocol for free if they just go to fitness solutions plus dossier slash up conflict. Here's exercise is very simple. Squeeze both both fists with about thirty percent forecasts for two minutes and then arrested for three minutes in that again. Three more times that's it. Balik and in studies dot has to draw blood pressure by as much as fifteen over eight millimeters of mercury with these perspective is on par with best medications out there with your ten laws but topper laws In other unpowered or better than some of the best medications as Cardio more active for reductions in blockbuster doesn't have the same heart health benefits Benefits buffer That's the one most active thing. Somebody can do. Cook them knowing how come not enough people know about this. Like if it is a simple doing squeezing your hands how come no one or do people do it. And I'm just not because I don't have shown know even with high blood pressure. It's very little known because while there's nothing to sell there there's no there's no drug there's no supplement. There's nothing to sell their. You literally considered home while you watch. Tv is your face with thirty percents force. That's IT and so a lot of people are asking. Well what's the next behind when it's something so simple were so well and although there's no No real agreement in the research. I have my own theory. My theory is the body response to whatever dressy you put on it. For example. The reason you get stronger after straight straight as because you're stressing muscles the reason you gain endurance after Cardi Stressing heart now. What's being stressed? You're squeezing your fits. Your muscles are being. Stressed is only thirty percent force. It's not stressful muscles. Your heart is certainly not being. Stressed is just your forearm. Flexes is not large muscle groups so was stressed when you're squeezing with anything more than about twenty percent force. You're cutting off almost one hundred percent of the loss of lied to that muscle and so when release sunny a huge surge of muscle go. Blood goes into that muscle in long without are reasonable. Blood vessels open up and so the stresser is primarily on blood pressure. And that's why I think This type of exercise has the largest impact on blood pressure. Now that's just gotten somebody does want to exercise on top of that Cardio is Be about equally effective. That can draw blood pressure by Saturday. Between Eight and twelve meters of Mercury and the Nice is is the higher. The blood pressure degraded the reductions in blood pressure from exercise in other words. If somebody's blood pressure is one twenty five or eighty five. It will just small reductions in. Somebody's Berkshires want sixty five overrun with five encouraging. That the I hate to say this but the worship. You're in the faster you get the shape of the foster healthy today to see draws in those reductions pressure after cardio will stick around for up twenty four hours the name for that is called host exercise hypo tension as well so hypertension okay so the cardio you have new about three to five times. Four hundred hundred zero reductions and then people are wondering like if I stop doing cardio Or go back up or are they long term chronic effects than bills off as a result of trading any answer. Unfortunately is Jessica Medication as soon as you stop doing cardio blubber up inhumane. Doing ten years the day stop is the day goes up one st however the events are more long lasting not as where people have done trae for at least three months in his For to their bumptious stays down. Not I mean not indefinitely maybe after four or five six months ago up but with the treasury stays for up to two months afterwards. What happens to be on two months? We don't really know it hasn't been studied But we do know that up to two months to stays stays low. So that's pretty cool again. Just like we have the prescription for diabetes with their shirts prescription for hypertension and so on the cardio side of things was the duration. It appears to be about thirty minutes three deaths per week as the minimum you do get greater reductions with more than that frequency and three to five times per week intensity Again with intervals. They do seem to be more effective than stay. State is not to say steady state is ineffective it is effective is just. Israel's are more effective even when calories are equal you when time is equal it again. That's because with intervals. Blood pressure goes higher and therefore the the opposite must happen but pressure must go lower DO CDs Restrict trae side of things? I this time we want to go for higher ups so whereas these ten fifteen wraps with hyper for Sri moral in the fifteen twenty rep rage to start with in as somebody gets ward best reps should drop over time to about Eight to twelve reps in hypertrophy rage because heavier with lift the higher blood pressure goes jury emphasized which means that if higher cise the opposite must happen after sized remember. Somebody's jaws gay started with exercise. And they haven't they haven't done any is three plus months with higher-ups fifteen to twenty and then every every two to three months dropped off their espionage boss. Three or four percents. I love it so If a couple of things I want to touch on first thing you said that rarely You know was an Aha moment for me because you said that and I agree one hundred percent so that people who are vastly obese or vastly overweight or out of shape can quickly get back into shape a lot faster than someone who's kind of out of shape and trying to get back in let's huge because the mindset of people who are obese and vastly outta shape is totally the opposite. They're like there's no way I can get back into shape. I'm too far. God when in fact all you start all you have to do was start doing these things and you're going to start to see results quicker. I see that every single. Nsa Week because every week the guys on my membership. They're always posting their before. And after depending on what phase? I'm telling you man like it every single time someone who's really over like one hundred two hundred pounds lose or whatever it is because if you get those guys in the membership There before and after is our insane like compared to someone compared to someone who's like are in the same phase and I also have to tell them guys look so and so this much weight to lose you only have this much weight to lose so the difference is going to be. You know you're not going to lose a hundred pounds when you only need to lose twenty like you know what I mean even if you're doing the same program because they're doing the same program but some people are going to get different results. Obviously because they start by the message I want to say is like is like if you're like have diabetes or high blood pressure will be like so out of out of shape you definitely want to Start BECAUSE YOU'RE GONNA lose all of that stuff right..
"essential hypertension" Discussed on News Talk 1130 WISN
"Joined them M. C. W. faculty in nineteen eighty eight and is an international expert on the pituitary adrenal gland and all aspen all aspects of steroid physiology it's come from all over the world for Jay's expert opinion and it is really a special privilege to have J. join our program today Dr Traci **** is a graduate of Brown University received her medical degree from Albert Einstein college of medicine in New York and she received a master's degree in public health from Columbia she completed her fellowship in endocrine surgery at Yale University and joined the M. C. W. faculty in two thousand and seven where she is currently chief of the section of endocrine surgery and vice chair first for strategic and professional development in the department of surgery Dr **** is slowly becoming a Packers fan due to her many years in New York City but I think was slowly making progress so based on our our last segment where we talked about largely ascential hypertension or or hypertension due to that the the many factors that doctors Kaminski and went all talked about weight the salt shaker and various other things as a transition Jackie could could you let let the listeners know when do you become concerned that the blood pressure may be caused by something else not just essential hypertension Sherdog is soul first of all essential hypertension and most common form of high blood pressure but you know as a clinician when I do get concerned and when I think about you know is something else going on in my patient one thing I think about is the extremes of aids typically so onset of hypertension at a young age or sudden onset of hypertension kind of later in life as well in addition to those two things if there's odd symptoms involves so for example episodes of sweating palpitations headaches things like that that are also knew when on set then you really got a think about secondary causes of hypertension and then finally when you have up Houston's that appears to have what we kind of call resist stint hypertension and they're requiring multiple agents to get good control of the blood pressure great well thanks thanks so much Jackie and and one of the organs that can be responsible for high blood pressure is the adrenal gland J. doctor filling maybe you can help our listeners understand what the adrenal gland does and and how it can be involved in in high blood pressure because as as I'm sure you'll you and Tracy we'll talk about it it's it's really and I'm a misunderstood and oftentimes misdiagnosed because of of serious blood pressure problems yes thank you Doug did you know lance reside comfortably above the kidneys and there really are make three two types of hormone steroid hormones cortisone is one of the most of yours are probably a listeners are familiar with another story called aldosterone they also make adrenaline so it's a stress landed in response to stress so when you're stressed adrenaline and cortisone comes out of your journal glance and help you sustain your blood pressure during a stressful event and the and the adrenal gland response to the to the all the all of the stimuli from the body so it knows how in when it's normal it knows how much their right to make how much L. das drawn to make and how much adrenaline to make correct absolutely and then what what happens when things go awry well what what's probably not well understood are pretty well appreciated I should say is that many times are tumors in the adrenal gland beckons produced too many steroids or adrenalin they can cause hypertension in fact about five to ten percent of all patients with hypertension have an adrenal dependent because of their hypertension is our core is all out a strong Joan secreting tumor so it's five to ten percent is a large number of patients and I we think that critically patients have journal models are tumors should be carefully screened for these very serious at an easily treatable disorders what we could probably we could probably have you and and doctor Klein skiing engage in a little debate here but if if the five to ten percent number seems like a big number so Jackie why shouldn't shouldn't we checked the adrenal gland either by a chemically or radio graphically with the with some kind of scan in everyone who has high blood pressure wow that's a that's a great question dog you know to be honest the work up for secondary causes of hypertension is only indicated when there's that clinical concerned that something else is going on so I think just having you know a high index of suspicion getting good history from the patient you know kind of took her bounce off of that we are fall you know we are finding a lot of what we call incident alone was right so with so much Imogene happening in for other reasons than we sometimes will pick up on these adrenal masses or tumors nobody really knows what they are in a lot of times there are but nine right here and there on related it's related and we could we could probably talk about this forever but it's the the it's a huge conundrum in Madison how extensive an evaluation do you do how do you also become relatively cost responsible resource responsible what what do you think Jay what's what's your opinion since you're you're you're basically at the at the end of the line here where where patients come to see you as well here in the next segment who often times have stories of high blood pressure for a long time that that often times is not addressed well I I I I agree with Jackie there are certain things that I think should stick out one is patients who have on multiple drug therapy three to four drugs of anti protest of therapy villagers pretty clear about fifteen to twenty five percent of those patients have an aldosterone secreting tumor in their journal that are hot too much out of strong they can be treated here either surgically or with specific medications and many of those patients will have low potassium levels not all but many so a patient who is having to recall requires potassium replacement in addition to their anti hypertensive therapies are much greater rests for having one of these adrenal tumors and it's Jackie pointed out earlier patients who have symptomatic sweating palpitations and headaches are also at risk for having adrenaline secreting tumor so I think patients are having symptoms patients arriving low potassium and patients who have three or four more drugs for their blood pressure and still do not have very good control should be screened for these disorders and maybe it's worth talking from a little bit for a few minutes on primary old Austronesian because that now is gaining a fair amount of traction as an under diagnosed entity in the United States correct I think there are even some there are even some support groups and and public awareness campaigns etcetera maybe you can introduce the topic of primary L. das drone is and and and and provide a little background for our listeners yes this condition was actually described in the nineteen fifties by Dr conduct university of Michigan and he predicted there would be a common cause of hypertension in his in his he was dismissed for many many years until the nineteen nineties and and the sentry when it became clear that many patients with hypertension at least five percent of all patients with hypertension and this is been studied all over the world and it doesn't matter what populations looking at have this condition where that you drill grants make too much of the steroid aldosterone and that is responsible for life retention half the time or even maybe more than half the time it comes from a specific tumor whose removal may actually cause complete remission of the hypertension or certainly significant improvement in blood pressure control or it can be treated with specific medications a medication called sprawl actor which blocks the effect of the steroid aldosterone fantastic William everyone who's listening to us you're listening to doctor J. filling Jacqueline Colin skinny and Tracy **** on the word on medicine and Tracy that was a perfect segue to you as a as an endocrine surgeon who removes the adrenal gland in patients who have the adrenal gland as a cause of hypertension it's a whole New World now the adrenal surgery is often times almost outpatient surgery can you can you tell our listeners how you would remove an adrenal gland sure thanks Doug so as was mentioned before by doctor filling the adrenal gland sits on top of the kidney and they're relatively small and sometimes these tumors especially with prime male dusters in which we were just talking about can actually be quite small nowadays in the era of minimally invasive surgery we can do this several ways either laparoscopic Lee or using the robot which I think you've had a previous radio show on and it can be do through the abdomen abdomen what we call the trends of domino approach and in some patients even perhaps from the post your approach so going on from what we call from the back and these these pick patience with the surgery do great we sometimes to keep him overnight but but they really have minimal pain related to that and are are back to their normal activities pretty shortly afterwards and fortunately almost all patients with adrenal cut with an adrenal because of hypertension have a benign tumor it's a it's a tumor that does not have the ability to spread to another part of the body correct correct and when you use the robot even though it we've had a couple should programs of the word on medicine now that have focused on the robot for those for those even physicians who have never seen the robot it it becomes very confusing and I I would encourage all of our listeners to maybe just Google a robotic surgery and they can at least see that the that the surgeon Dr **** is still doing the operation even though the instruments happened to be linked to the robot would you like to expand upon that maybe in our last two minutes sure so as you said we are the surgeons are still doing the operation with a robot is is a is it is a big instrument that we bring in above the patient and the current one that we have has four different arms and it allows us to use instruments with what we call three hundred sixty degrees that mimic the movement of our wrists which allow for a little bit finer movement and can make the operational little bit technically easier and we control this by city in the same room as the patient usually just a few feet away but using the similar instruments through a three D. visualization so allows us to see better and allow slightly finer movements of the instruments that we use for the surgery great and Jackie I'll give you the last word so at maybe two just to repeat this one more time because I think it's just such an important message so our listeners who have high blood pressure when should they be concerned that it's not simply essential hypertension just review that again I think you talked about number of medications symptoms at cetera but but we can't I don't think we can hear that enough of course so probably first things first number of medications so if you continue to have high blood pressure despite three or four medications that that would raise suspicion for a secondary ideology such as an adrenal tumor so also one or two is kind of not that uncommon contracts three is kind of that critical number exactly and three from different classes as well and then the second to probably being a sudden onset so sudden onset of hypertension and typically a younger or an older age should raise suspicion for a possible secondary because and then I would say the third thing to kind of look for are unusual symptoms soul episodes of palpitations sweating in dire for recess you mentioned headache too and headaches yeah yeah great well thank you all so much we'll be back after a very short break sometimes.
"essential hypertension" Discussed on News Talk 1130 WISN
"Start with you most of our listeners know that blood pressure has two numbers I top number and bottom number what are those numbers and when is it too high Sir thank you so let's start with the definition of blood pressure so what is blood pressure blood pressure is really the force of the blood against the walls of the arteries as blood circulates throughout the body so the first number in the top number is referred to as systolic blood pressure that is the reverse of the pressure in the blood vessels when the vessels contract to push blood along the diastolic blood pressure which is that bottom number that refers to that pressure and the vessels are the force in the vessels when the blood vessels relax and then when it when his son either the top number or the bottom of the systolic or diastolic one of those numbers too high those numbers are basically too high when the top number is over one hundred twenty millimeters of mercury and when the bottom number is over eighty millimeters of mercury and we're gonna get we're gonna get to potential tumor conditions that cause the cause high blood pressure in in the next couple segments of the show but just to in a general term what's probably the most common cause of high blood pressure sure the most common cause of high blood pressure is what we call essential hypertension or sustained hypertension and you know quite honestly the pathophysiology of essential hypertension is not well established however we think it's probably a result of numerous genetic and environmental factors that work together and have impacts detrimental impacts on the cardiovascular system in on the kidneys so the so the those those rumors that Tom my blood pressure is a little high just because my wife yells at me all the time that's probably not correct exactly I would agree with that now so it took me clinical criteria for hypertension you basically have to have it on two separate occasions before that diagnosis is made in general we also like to confirm the high blood pressure readings outside of the office setting one able to great I'm Jeff doctor will how common is is high blood pressure and other certain populations in the United States which which are more at risk for high blood pressure excellent question and I think it's a I I'll feed off of Jackie's comments on what the rate the high rate of blood pressure is that's too high and which we used a hundred and twenty over eighty that certainly the best number to be at the low that number but when I graduated medical school this is quite a while ago we used to say your age plus a hundred was the right number for the top number at that time not that many people had high blood pressure older ages as we've learned that even somebody's in their seventies or eighties benefits from getting their blood pressure lower we now call it hypertension even if you're eighty years old and you're a hundred and forty over eighty and that is translated to a lot larger numbers of people who have the diagnosis of hypertension so when I finish medical school it was thirty five million now it's seventy million and probably more as the the latest guidelines have come in and we are a really treating more and more people because more and more people are known to benefit from the research has been done here at the medical college as well as across the country so really I'd say increasingly common problem I mentioned H. is one group that's really a high risk within other groups that are readily identified race is a big predictor of high blood pressure and so people who are African American have a much higher rates of high blood pressure than people who are white particularly in the younger age groups people who are Asian often times are less likely to have high blood pressure some of that's confounded by the fact that agents tend to be somewhat smaller and in general being bigger is associated with high blood pressure and in particular your Europe obesity levels so somebody who happens to seven feet tall isn't at much higher risk than somebody who six feet tall but to six feet tall people one of whom was two fifty and one weighs two hundred that to a fifty pound person is much more likely to have high blood pressure the end the number again just for our listeners to reinforce that so the the systolic blood pressure one forty or above I actually as doctor Kolin ski said Jack you said a hundred and twenty we we have pretty pretty confident that if your precious over a hundred twenty you are worse off than if your precious below a hundred twenty we've decided based on the trade off between treatment with picky with medications that it's it's only worse treating people once that top number gets above a hundred and forty although we would like it to be if we decide to treat to get it below a hundred and thirty and that's an area where we've had a lot of you know I think people who've had high blood pressure for awhile probably complain that actor keep someone to be lower it's because our understanding of the benefits of treatment have really increased so we would say anything over a hundred twenty you have a higher risk of things you can do like losing weight be more physically active are you can't stop from getting older but you can drop your weight be more physically active perhaps eat less sodium or make some other dietary adjustments that your doctor can help you with you should do that when you're a hundred and twenty we don't start using medication typically until a hundred and forty but once we do we'd like to below a hundred and thirty and then and Jeff one more question for you so what's the deal the difference between that the systolic being too high the top number and the diastolic being too high because someone with hypertension do they always the both numbers always going the same direction that sometimes can they be different yeah that's an excellent question and I think the this simple thing for people who are older adults so people over the age of fifty if we really pay the most attention to the systolic number so in general people with a systolic pressure of say a hundred and fifty even if they're diastolic is seventy you are a fine number by itself we would say no we need that a hundred fifty to go down and we push that one hundred fifty down the seventy goes down to the Americans medicines tend to work the same direction and there's no problem with being a hundred and thirty even over fifty or over forty in general that top numbers going to drive us for some people who are younger they have only the bottom number being high in that situation there's much less experience because it's a less common situation and those folks tend not to have their problems until they're older but in general we do treat people whose bottom numbers over ninety that's as threshold will typically used to treat sure Jackie what what's the what's the big deal if I have mild hypertension or or my blood pressure is mildly up I feel great my energy level is good and and you know it's just it's virtually impossible for me to lose another ten pounds it just isn't isn't going to happen why can't I just stay a little bit chubby and happy so like that's that that's a great question well first of all high blood pressure or hypertension is the most common modifiable risk factor for cardiovascular disease and as you mentioned my backgrounds in cardiology I'm a cardiologists and soul cardiology cardiology diseases are the number one killer of for both men and women in the country and you know to be honest in other countries as well in Seoul when we look at hypertension which is the most prevalent risk factor it's very important to to control that number in the scary thing about high blood pressure is that it's called the silent killer because as you mentioned not everybody has symptoms and most people I would argue don't have symptoms of high blood pressure and this is why becomes very important to know your numbers we use this term it from the American heart association know your numbers and know what your blood pressure is now what your cholesterol is no those things because it's you're a symptomatic in most cases and I think Jeff commented briefly on on the importance of of wait a couple of the other a couple of the other things that are talked about at least in the in the lay press and you hear about them in the news are certainly this the salt shaker the morning coffee is is copy good bad and alcohol maybe maybe either your Jeff could touch on those sure so I can touch on a few of those and then Jeff can add as well so we'll start off with the the salt so salt intake in the United States is is two X. is excessive it's too much soul you know the recommendations really for healthy blood pressure or to stay under twenty three hundred milligrams or alas you know to maintain our get to normal blood pressure and then in that in some patients that you know need further assistance you know pushing that down even below so how how actually do you do that because no one can I mean other than like never using in the salt shaker is there is there is simple do you need dietary counseling or is there a simple way for our listeners to know how to keep the salt intake down Sir so one you know one easy diet to kind of goal buyer learn more about is this dash diet so it's it stands for dietary approaches to stop hypertension and there is a lot of information on the internet on this diet and it really gives sample meal plans that keep you with then good ranges of steely sodium intake to prevent hypertension and following that diet can result in lowering of blood pressure by as much as twelve points that top number well that's fantastic Jeff I'll give you I'll give you the last word in this segment it just goes by so quickly but for our listeners you're listening to doctor Jack one Collins king and Jeff will on the word on medicine and and just give us the truth about coffee and alcohol okay because everyone everyone who's listening doesn't drink very much coffee or alcohol least in their own in their own opinion that's a good point that people who drink less than me are are at the right amount that's right where I used to cut off at the note really it turns out that the stories are different for those two two beverages so in general when we study it it's been hard to show a bad impact of coffee so even capitated coffee in somebody who drinks it regularly doesn't seem to have much of an impact on blood pressure even though somebody who's never seen caffeine before that has a couple of coffee with caffeine it will have a a slight increase in both the heart rate blood pressure in the the general use that we see in the population doesn't really affect your blood pressure much at all so that's one thing you can relax about is your coffee consumption at least as far as blood pressure is concerned not necessarily so good for your digestion and some other things the alcohol is a different story really of high levels of alcohol intake and and not very high levels so we would say that a woman drinking more than one standard alcoholic drink a day and so in in Milwaukee that maybe most often be pierced what twelve ounce standard of potency beer or five ounces of wine or a shot of spirits all mean just one drink a woman may have one man for a couple days mostly because they're bigger probably have little effect on their blood pressure at maybe one and a half or even two but if you get over to for a man of one for a woman that's that's going to be causing you to have a at high risk of cardiovascular events in particular blood pressure but it's basically not good for almost anything in your body so getting over to for a man one for women is bad well as usual we just scratch the service but I'll assure everyone that.
"essential hypertension" Discussed on WMAL 630AM
"Six twenty five loved to talk to you. Perhaps. You've had a problem you've tried. You've applied you've done all kinds of things that you thought was going to be useful. Guess what didn't work right? Well, here's an opportunity. Let's figure it out was put a different spin on the subject so to speak and see if you're going to do it and turn your life around and and regain your health and wellness. That's why we do this program on a weekly basis. And we do it live because we want to take your questions triple eight six zero ninety six twenty five we have a topic for your one that is very important one that's ignored over a period of time can actually kill you. What am I talking about? Well, we're talking about something that makes your blood pressure is we're talking about high blood pressure and. Defected has on the nervous system affected has on your heart, and cardiovascular system, the fact that there's about one out of every three adults in the United States that have high blood pressure. And they're saying that there's about twenty to twenty five percent of you that don't even know it. Well, that's unfortunate. Because there's a lot of things that can happen. And you cannot end up here tomorrow morning, if you don't understand the ramifications that we're gonna talk about that today. But in studio somebody to help me out somebody to walk us through this. You know, the the brightest of the family at the results center. Dr Scott lamp like again checks in the mail. Thank you very much. I I was briefed. Well before the program, just remember yeoman. You got it. Yeah. This is a this is a hard hitting thing. That's interesting. The last class of did was we had to do a lot of things with sugar. And it's just how the impaction on top of this plays a lot with the cardiovascular and hypertension, and in these things in blood pressures and things strokes, and you know, you're talking about you're talking about the statistics, they're looking at hypertension leading cause of cardiovascular disease worldwide, we have things like, you know, like fifty two percent of the people seek out treatment and big silent killer. So it's there's a lot of things here that extremely important. I mean oxygen is good. I need to get things flowing. Well, you gotta get things opened up and moving and flowing dynamic as human beings, and we do so many things as we talk about probably throughout this. This our that we have that that get in the way of that. Dr Scott, let me ask you a question. What is normal blood pressure? This is all over the place from the time. I went to school. So now, it's like the the parameters like so many things have expanded and expanded. What do you consider in your opinion, clinically as being normal? It Stolac diastolic pressure is there usually when you hear the numbers. The first number is the systolic pressure Navan, monitor number is a diastolic number. And then you have an average of the first one between one hundred hundred and forty they start saying benign, hypertension starts happening at one forty nine. This historic number. And you know, everybody's saying it'd be one twenty to one twenty over eighty is supposed to be the perfect number for it. There's a lot of very abilities that I mean on the diastolic sixty to eighty is supposed to be reasonably good. Again, that's kind of it's constantly changing through the years. So I haven't pan I'm probably going to mention it before the programs over. But once you listless listen to it. Yeah. But here's the interesting thing. I we have to understand what blood pressure really is. And blood pressure is the proportion as you said, the stolid pressure is the amount of pressure that the heart exerts trying to push the blood through the arterial bed the bottom pressure, the diastolic. So you can remember diced systolic diastolic diastolic means down to the lower pressure is what's left in the arterial bed after the heart contract. So it's a relaxation phase of that situation. So we have this contraction relaxation type of situation now years ago. Blood pressure parameters were higher. Now, we're seeing them shrink down. So my question becomes is it because that that's that. We're really in a much more deleterious dangerous situation that they've monitored and documented over a period of time saying that if you get your blood pressure up to one, you know, one twenty eight a lot of a lot of physicians your precious to hide if we don't get it. You know, we we're going to have to medicate, you really, I don't think so and in when an older person's pled pressure comes up, and they and older people need slightly higher blood pressure for a lot of reasons. Right. Well, well, well, I think one of the big things is when people don't realize is that if we start restricting the blood pressure in an older person than we start creating falls getting into oxygen to the brain. Sometimes they make lightheaded. And so then the question is is what takes you out if you get too severe on that particular, you falls you hit your head. That's that's a ticket out. Yeah. You're done it. But a lot of that blood pressure situation is it because you know, you're passing out because of blood pressure drops. Right. As you just suggested. Or is it get too high where you get that throbbing pulsing disorientation feeling and you can happen either way either way. Right. So you're ending up with a situation that you really have to understand. And the problem is is that we have so many other medications in today's world that are causing hypertension high blood pressure. You know, how many people take a seat of medicine side effect of acetaminophen is high blood pressure. So you're taking a seat of medicine for whatever reason. And now you put alcohol causes high blood pressure. You can continued going onto here's one of the things how many people do you know that walk into our clinic to on a regular basis that are on any kind of exile anti-depressant medication. Probably seventy five percent seventy five hits crazy. Yeah. And guess what? That causes high blood pressure, hypertension. So here we are. We're we're in this catch twenty two. We're chasing our tail and we're trying to figure out how to have so one medication puts into another puts into another puts in another and pretty soon, you've got all kinds of I call it a self serving drug potpourri right because now you need one over the other. There's there's people that are walking in today with medications there's twelve fifteen eighteen twenty I think the record our office is a guy that was out in twenty two different medications twenty three something like that. And guess what he worked for the FDA? You've gotta be kidding me. Right. Right. So let's talk about this. Let's let's talk about some of the triggered mechanisms generally of hypertension. I know this Wednesday evening seven PM at the results center for healing in. Fairfax. You're going to be presenting this topic high blood pressure and its effect. On cardiovascular and logical systems and so forth. And listen, folks, if you're on any kind of hypertension medication and you want to figure out what's causing it. Number one, what's causing the blood pressure problem, and how to fix it? And how to get off his medications that are killing you. This is an opportunity that you should not set aside because I promise you you're going to learn a whole lot. Well, I think the one of the things too is. I think there's an understanding that people in our realize when you talk about essential, hypertension. What's the cause? It's unknown Titu Pathak. What idiot you Pathak video video ethic. I thought you said it. I'm not I'm not saying you think too groggy story towards Utah. Just remember you have the drive home with me. That's right. But ninety percent of these two ninety five percent, depending on what study you're looking at artists essential, hypertension, which means is unknown. So we're gonna give you some medication. Hopefully, I'm hitting hitting the right way that can bring that number down. We're playing a game bringing numbers down where there's a secondary. Also, we know can you dance damages or some in different problems that might be having on the secondary. But we're looking at the majority of these about ninety percent of our idiopathic, so idiopathic. Unknown. I don't know why it happened. Right. I don't buy it. You know? So when a patient comes in, you know, we're talking about a medical diagnosis of idiot, Pathak, hypertension, and you'll hear that term applied to so many other things as well idiopathic, visit Pathak that is simply means that they don't know what the causes within the realm of how they're looking at. Through that lens. Correct. And you know, this is a situation where you really truly have to look at our paradigm structural chemical motion has the body neurologically been injured in some way. Either biochemical influences that are outside exaggerates the body that are acting the body's normal physiology subsequently causing us are their stress patterns. You know, we are a society that are masterful putting stress in our back pocket. Right. I mean, you know, you talk about some of the things I look at the the bodies almost like the hardest almost like a train and certain amount of tracks. Let's say, let's talk about obesity. If I've got extra weight around my body. I've got more capillary beds. I gotta fill. I gotta push more blood flow. I to keep up with demand that the cells need from me from the heart. And so blood pressure can go from that on just the the physical basis of that. You've got things like stress stress is what's interesting when you take a look at the anatomy of how the blood vessels are. It's not just the heart pumping. It you got blood. Vessels are actually embedded in the muscles. So everytime. You squeeze the muscle. It helps move the blood along that if I'm tense tight and everything stressed out. My muscle is tight gives me more of a resistance, so stress mechanism is one way that way physically then there's also things called sympathetic Tara sympathetic. There's these these terms that are there when we're flight a flight and running away that the bodies organized in such a way to make your body's survive at that particular point, but it could also raise blood pressure. And if you've got things in that constant state it can push for a hard on that to make actually that hard work harder. There's also a Paris pathetic, which is the rest and digest. And like you said time, you know, technology. Boy, I tell you it's it's pushing us pushing us in pushing us to do more and more and more and more and more. If you want to stay ahead of the game in whatever business, you might be in. Everything's expedient today. We're we're having a stay on the Mark constantly years ago. Meet knowledge knowledge and made it response. Somebody somebody text you something view don't text back. In Ananta moment. Right. You have somebody on the other end who is irritated is offended. Right. It's it's an incredible situation. I used to have a flip phone and I used to have an ipad. And I thought it was good to go until dumb phone, right? The dump? I'd like my dumb phone until I was I took over for as chairman of the international college of applied kinesiology. Then I got smartphone. I'm not sure how smart that is. Because now it's tethered to my my dairy air, and I've got to use it all the time. It was like craziness. You know, here's the situation, and we're gonna talk about this more specifically. I know we're setting the stage for not only today's program. But this this coming Wednesday evening may the first seven PM at the results center for killing Fairfax. Here's the deal..
"essential hypertension" Discussed on Dr. Drew Podcast
"That's no big deal. But then you had as inhibitor in the cloudy, and it's like man, they're having trouble controlling your blood pressure. I wonder why is that been looked at? No one. Can we figured out? I I was mean. about twenty five thirty pounds, overweight, you know, not gross. You know Brazi, but yet no one can figure it out. And it's now singly things happening. It's just really freaking me out. Yeah. What would you suspect? If you put your finger on what do you think it is? If I were VM s. He your diabetic, no L. But I'm just enough. I'm you know, a symptom. Yeah. It is. But you that's an easy blood test. Either have that you don't. I just feel like whatever's causing your hyper-tension needs a better diagnosis we ever worked up. We we have a worked up for something called feel chromosome Toma. I mean, there's what are called secondary causes of hypertension that are not essential, hypertension, which is just sort of the routine like what I have. But some people have narrowing the artists the kidneys some people have adrenal staff. Some people have feel like I mentioned, and that's I feel like you ought to see a an immigrant specialist to get this properly worked up, and if you have something like field that would explain all the tingling stuff. Just you said. Yeah. An integral just does a lot of hypertension work. 'cause it just it feels like we should be able to tie this all up under one diagnosis. Why should you have multiple things going on? You know what I mean? Right. It just unusually for your age. Unusually high blood pressure unusually.
"essential hypertension" Discussed on WCBM 680 AM
"It helps the press that urge to eat. It has white kidney bean dry extracts, which is very very important in this whole process by open is a bar type of food extract actually helps the option of this product. So at the dietary supplement one capsule two times a day thirty minutes before now hit these specific instructions, you don't just take this anytime of the day, you take it a half hour before breakfast, and before dinner, exactly the way, it says on the bottle. If you take it any other way. Not gonna be as effective. So I love ideal weight, and I've been using it at least year. That's what was it came out of the marketplace. I gotta tell you. My patients are so happy because number one that cravings for sugar has gone down to the they have more energy. They feel better they feel like they're actually their waistline to getting better. Then more active because now they're not as heavy to that. They got more energy. So ideal weight encompasses not only a weight issue. But also makes you feel better. So get on deal. Wait to great product. I love it. If he overweight, not overweight, you'd be more energy ideal wings, really, go to Sean. Can we talked a little bit earlier about the physical activity, of course, getting started while or quarter power can help you with that as far as your energy levels? And you know, once you get started. And of course, once you start working out, and you're walking and doing whatever you're doing maybe lifting a little bit, the low impact, as we doctor mentioned, you might feel a little soreness, you might feel somewhat of a deterrent. So what about active flex is that a supplement that you should consider? Now, listen feeling sore after you exercise is different levels of this. But the reason why that your story is because you taking them also you take muscle fiber. And you you stretching beyond its limit. And that's why is a little bit of information. But that rebuilds woma. Muscle. So in order, if you have a good workout you wanna feel a little soya after work. I if you don't feel sorry after my workout. He didn't do it all so case in point. So active flex sometimes people go to each thing, and they really they don't just lightly tear that they really whipped in office. They just point where you gotta take two three days to get back in order. So now, we have a five foot active flex, which is a powerful anti-inflammatory product that helps with cartilage and joint activity increases your flexibility, mobility, so that comes from exercise strenuous exercise, but let me tell you. So I like active as a natural way to reduce inflammation because what do people mostly both what they go for the Advil. They go to the ibuprofen. That's all well and said, but you know, what those medicines have major made side effects. So even if you have a little bit of what he can have a lot of times if you've taken on soil, and boy, you're going to get a bleeding. Also, you won't even know about present yourself with a little blood vessel that top Saudi your stomach and thoughts using blood. Now you being rushed to the hospital emergency. So because of the nuns. Duroy those get on something that can actually not only help you joins we do simplification, but active flex great product. They fought all the way Bruce has written into the show of amazing how effective ideal weight is as with no change in eating pattern or food choice. I've lost six pounds been trying to shed those pounds for full year with zero success. Thanks Bruce for for waiting under the show here. Pardon the pun. So blood pressure is that something we should be getting checked at an early age all and and again, what are the concerns of high blood pressure for a younger person a middle aged person and a elderly person. Now that of what you are young old. You have to make sure that he look normal. It has the same effect except when the younger has an effect over your whole lifetime. So let more time to know what blood pressure does over the next thirty years. But no, it's very very important even as a youngster because there is something called essential, hypertension. Essential hypertension is the Nashville elevations in your blood. Pressure as you eight. However, there are other secondary sources of high blood pressure. Sometimes you can have a child you didn't have what is called. It said it's a very long time. It's fully field from which is a it's a tumor. That's it's it's not it's not it's not on the leading to. But the tomb of gland. That's pretournament. So at the youngster seventeen is all your book to be two hundred hundred thirty like, whoa, what's going on you? So your other differences. Why people that have high blood pressure young kids can get a push in there. Any order for the Colocation that can lead you that blood pressure before you ten years old to a level that is just not losing. So you have to check the buck throughout your life. And then see? Yeah. Young a one year old two year old five year old. So just make sure everything is is different ranges for blood pressure. As as as young blood pressure is is obviously much low pressure. So as young I don't know, let's say one year old if their blood pressures above..
"essential hypertension" Discussed on KGO 810
"Dr drew has been joining me. As he watched President Trump speaking now. Minority leader Kevin McCarthy speaking he of course, thought of Cuba. That's where I was. I was in Cuba over the over the holidays, and it was wonderful was beautiful. Yeah. But it's doesn't really work though, doesn't I wish I admire their revolution commitment and spirit. It's a lovely place of wonderful people. But what do Niro fiddling while across Vollbracht? What about all the people who argue that their healthcare works? Oh my God. There were so many medical disaster is on the street. I will take great issue with that lots of begging lots of homeless homeless, but there were lots of beggars on the street in various states of horrible, medical misadventure. So interesting, please don't don't don't just remember. I talked to our guy. They would. Oh, yeah. We can get anything when we can even get Tylenol if we want we could probably get that. You're not you're not getting exotic medication. You're are just not not happening. Speaking of exotic medication a lot of Americans. Dr drew Pinski hosted midday live. At Dr drew on social media dot com. Yes. Yes. A lot of Americans are on blood pressure medication to why tell me about this. I'm dead serious. Walk me through. Why do we need blood pressure medicine because hypertension is hypertension is a syndrome disease manifestation of many different things. One of the common manifestations is as we get older our arteries, get more stiff, so flexible, any less, flexible joints, right? So if you take a hose, and it's plastic, and you push and pressure on one side of the plastic it absorbs a certain amount of that pressure on the other side. It's not as intense as what's coming in the the entry part. But if it's a pipe steel pipe, it stays the same all the way across and so that's the way as we get older. It is a calcification or what exactly less? Let's just say. Call less is more complicated than that is less extensive is more rigid. That's what we see systolic hypertension things that that in the early patient, but the more common cause of essential hypertension is prime. Merrily genetic phenomenon of a miscommunication between you're right, atrium, and your kidneys. It just as you get older abnormally sets the pressure. It's slightly higher than it. Should it's a genetic thing. It's a very airing conflict. What's the communication between the heart and the kidney? That's how you book pressure works. It's the renter now the Australian system, that's how your blood pressure works. That's why we interrupt the reading now Dostram system with some of these medications that you're concerned about that have carcinogen is associated with now. But but the the this is a phenomenon look I for years resisted this in my own situation. And finally, a doctor I was running and keep my weight down and find out. Michelle is you can only outrun your genetic so far. I was like oh my God. She's so right. So you had a predisposition netted predisposition. Absolutely. And so our hypertension. Correct. And so I got on the medicine that interrupts that communication and immediately, but pressure was normalized, so but hang and help me understand this. Then why do I care if my blood pressure is a little bit high then sets it puts shear forces on these same vessels that I've been talking about the arteries and they start to break down, particularly branching points. They can start to literally develop clots there or sclerosis there that clip them off. So you can start losing vessels, particularly in your brain. Okay. And so you start losing parts of your brain the larger vessels to your your heart hates to look at hype high blood pressure. The muscle can actually get sick, and you can develop something called hypertensive cardiomyopathy, very common heard of leverage circular hypertrophy. The muscle can thicken, which is terribly common. And then it goes into cardiomyopathy, which is. Is a horrible condition. And so your heart. Can't look at that pleasure. Very long without adjusting and adjusting ways that are pathological. It's not it's not a muscle. Like your skeletal muscle cardiac muscle does not like high blood pressure. So you have destruction of arteries, you have hardening of our or narrowing of arteries, you have destruction of heart muscle, even with relatively small levels of blood pressure increase. So it is extremely important that you get it down. And there's all actuarial data that shows the lower. You get it the better you do. Okay. And interestingly enough, we have drugs that are being recalled they're related to blood pressure. Right. The lazard. And I think there was a new one today. It just came. That's why opened I was like, wait. I wanna talk to you yesterday yesterday. Excuse me. Yeah. Because all my patients called me yesterday. I thought oh my God. Yeah. No. No. Yeah. So you gotta check the lots go to your pharmacy. Make sure you didn't get one of these law. And if you did turn it in for the stuff, and it has a residual it's not harmed anybody yet. But it exceeds the level of which we can carcinogen we consider safe in this country doesn't necessarily gonna cause cancer who wants to increase that wrestle. But no blood pressure medicine. And by the way, when you take butter blood pressure medicine, Natalie do they show increase in cognitive benefits, but also erectile function things like that all sorts of vascular phenomenon that are highly sensitive to blood pressure can really I had a piece of good news because I like my whole life. I've had slightly high blood pressure. Just even since I was a child, right? And I had a retinal scan at the doctor. Yeah. And I had something anyway. Hypertensive vessels. No, no, I had. I had a hemorrhage. I know. But it's the only place we can look at our blood vessels the eyes. So he looked and he's like he's like the full questionnaire. And then he looks like there's no sign of high blood pressure and you'll maybe you don't even have fish. Maybe it's just a measuring white road. You should get a monitor check yourself. I'm waiting for my watch to do that. For me wrist bothers me get something for your arm. Get an online and just follow. But I was so happy to hear him say, oh, you're vessels fan. Yes. You should be happy about that. Would. That's exactly what I want know. If somebody's so. Yeah. So so these are very serious issues and people should not delude themselves that they can manage us with Dieter becoming vegans or anything else, we are biological. We live many decades beyond what we're designed to live. And we and our job is physician is to extend that were designed that can optimally one hundred twenty five years, please go look, Dr drew talk to a ninety year old and see if you want to stay my wife's grandfather was so vibrant until his late nine. That's good. That's genetics highly unusual, but talk to most nine year olds. And see if you wanna stay like that for thirty years. You just tell me about that. Okay. So but be that as it may we will be pushing back. We we we we will we will be pushing back the age combination of debt by attending to these phenomenon of aging that are inevitable inevitable, and we can make them back into right pretend. We're not biological is just bizarre or that we can control. Well, it with good wishes and lettuce wishes and let we are we we know we have to really fight this. We have to fight it back. I I'm I feel like I'm fighting see that you have your fighter flight is. No, no. I mean in terms of my how I manage my diet and exercise and all that stuff. I feel that's all part of it and essential. But it's not it's not enough. What about the number of xrays you receive flying to Cuba? Did I get a bunch x-ray flying a commercial aircraft so much worse than from the sun? I I did not fly there one on a cruise ship. You can get it. And you didn't get legionaires. I did not. But we were very we. We my second call I wanted. And so we are very careful about hand washing. And I was actually really impressed with Royal Caribbean, washing your hands, and using pure L all the time every time you would end a ruined they go watch you watch. Okay. Prevent those giant outbreaks Dr wish physicians had a similar disciplined with Washington. I agree with you. By the way, my stethoscope. I was thinking about it yesterday morning when I was seeing patients of that kinda wipe it down every time even here down every time. That's right. Happy two thousand nine so great happy new year. Coming you feel so good to talk about medical stuff. I've talked to I love you had so much fun. Jimmy. I thank you so much doctor appreciate coming up in just a moment. Congressman ro Khanna is gonna join me. We're talking about peg or guitar about the partial government shutdown. That's next four one five eight hundred eighty.