Blood Pressure, Common Sense & Salty Language

Firmly established conventional guidelines on blood pressure and salt are finally eroding. It’s about time. For decades I’ve guided my patients along a different path, telling them that I am not concerned by their blood pressure in my office and that they need salt to live. Both of these blood pressure-related opinions have gotten me in hot water with other docs. It’s time for another victory dance. You tell me. If you are worried, anxious, stressed or fearful what happens to your blood pressure? Do you feel as calm and relaxed in the doctor’s office as you feel at home? Is there some “body-wisdom”, a biologically wonderful reason why your blood pressure and pulse rate should increase when you are stressed? The answers are obvious. Well, the answers are obvious to you and I, but they have not been to conventional medicine until now. Just about anyone’s blood pressure will be unusually high in the doctor’s office. Our blood pressure and heart rate rises with stress, so that we can respond to the stress. Yes, that was much more functional for humans when the “stress” was an attack from a saber tooth tiger than it is now, when the stressor is finding a parking space or some conflict at work. Taking this one more step, the simple question is: “Do you think that checking your blood pressure in your doctor’s office is a decent way to determine if you have high blood pressure?” The organization that creates the guidelines for medical screenings for disease the United States Preventive Services Task Force - USPSTF has now achieved a level of common sense equal to your own. They made an official (although still preliminary) declaration that patients should not be diagnosed with high blood pressure on the basis of in-office measurements. Of course, in line also with your common sense, we should not ignore it when a patient has dangerously high blood pressure, even in our offices. Do check your blood pressure yourself. Make sure you are relaxed before you check it. If it is high (140 if you are young,160 if you aren’t, 130 if you have diabetes or kidney disease) talk to a doctor or other health professional about it. Do you remember Mahatma Gandhi, the grandfather of nonviolent resistance? One of his greatest strategic triumphs was when he organized a march to the sea to make salt from seawater. That might sound like a pleasant school outing, except for two facts. One was that the British government (at the time the...

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This video talk is exceptional. You will find it interesting and surprising. The presentation style is very cool and the information is accurate, overlooked and extremely important.

Coffee and Prostate Cancer

It is nice to report good news. In this case, the good news is that a recent study of prostate cancer found that drinking coffee reduced risk. It is always essential to view dietary studies skeptically. There are so many reasons they can be misunderstood, or just plain wrong. The world is too complicated to neatly study it. It is very difficult and ethically dubious to conduct ideally controlled dietary research. A little story about such presumptions might help. One day a student in the homeopathy class I used to teach in the UCSF medical school inadvertently dramatized the assumptions one can make about research overlooking the requirements of studies in the real world. Seeking to discredit my research credentials, he belligerently demanded to know where my lab was. I pointed out that, despite the advantages to science, people just do not like being locked up in cages for the convenience of scientists. Wild humans, living in their natural environment, have an annoying habit of eating a variety of mixed up food items with such unpredictability that their eating patterns seem almost whimsical. It is as if they actually select what they eat based upon some internal preference or external appearance. They/we are then extremely poor experimental subjects. I hope he went into basic sciences research or had some humanistically transformative experience. He did apologize, so there is hope for his wizened soul. Although still far from certain, the most reliable research data comes from intervention studies. One group of people, exactly the same as another group, is treated differently and watched to see what happens. Yes, this is potentially every bit as creepy as the medical student’s thoughtless question. Studies of the long-term effects of dietary differences are essentially impossible. Would you volunteer for a study where someone else would tell you what you could and could not eat for a decade or two? Despite the inevitable weaknesses, this study is relatively compelling. That is because the effect was proportional to the amount of coffee consumed. In other words, a bit of coffee reduced the risk, while a lot of coffee reduced risk a lot. Six cups a day (not unusual in Scandinavia where the study took place) reduced the risk of developing of prostate cancer by 20% and the death rate from prostate cancer by 60%. Coffee would seem then to prevent the worst forms of prostate cancer. As the risk reduction persisted when the coffee was decaf, the most likely anti-cancer effect is the antioxidants in...