What causes heart disease part 58 – blood pressure

1st November 2018

A raised blood pressure, as a clinical sign, has always rather perturbed me. At medical school we were always taught – and this has not changed as far as I know – that an underlying cause for high blood pressure will not be found in ninety per cent of patients.

Ninety per cent… In truth, I think it is more than this. I have come across a patient with an absolute, clearly defined cause for their high blood pressure about five times, in total, and I must have seen ten thousand people with high blood pressure. I must admit I am guessing at both figures and may be exaggerating for dramatic effect.

Whatever the exact figures, it is very rare to find a clear, specific cause. The medical profession solved this problem by calling high blood pressure, with no identified cause, “essential hypertension”. The exact definition of essential hypertension is ‘raised blood pressure of no known cause.’ I must admit that essential hypertension certainly sounds more professional than announcing, ‘oh my God, your blood pressure is high, and we do not have the faintest idea why.’ But it means the same thing.

Doctors have never been good at admitting they haven’t a clue about something. Which is why we have a few other impressive sounding conditions that also mean – we haven’t a clue.

Idiopathic pulmonary fibrosis – progressive damage of the lungs – and we don’t know why

Cryptogenic stroke – a stroke caused by something – but we don’t know what

Essential hypertension – high blood pressure – we haven’t a clue why its high.

Can you turn something into a disease, simply by giving it a fancy Latin title? It appears that you can. Does it help you to understand what you are looking at? No, it most certainly does not.

So, why does the blood pressure rise in some people, and not in others. It is an interesting question. You would think that, by now, someone would have an answer, but they don’t. Or at least no answer that explains anything much.

Excess salt consumption has been blamed by some. However, even if you take the more dramatic figures, we are talking no more than 5mmHg. Indeed, the effect of reducing salt intake on people without high blood pressure is about 1mmHg, at most

‘Almost all individual studies of participants with normal blood pressure (BP) show no significant effect of sodium reduction on BP.’ 1

Which would mean that the effect of raising salt intake would be almost zero. So, if it is not salt, what is it? A magic hypertension fairy that visits you at night? Could be, seems as likely as anything else.

When you have a problem that is difficult to solve, I always like to turn it inside out, and see what it looks like from the opposite direction. Presently, we are told that essential hypertension increases the risk of cardiovascular disease.

Looking at this from the other direction, could it be that cardiovascular disease causes high blood pressure. Well, this would still explain why the two things are clearly associated, although the causal pathway may not be a → b. It could well be b → a.

I must admit that I like this idea better, because it makes some sense. If we think of cardiovascular disease as the development of atherosclerotic plaques, leading to thickening and narrowing of the arteries then we can see CVD is going to reduce blood flow to vital organs, such as the brain, the kidneys, the liver, the heart itself.

These organs would then protest, leading to the heart pumping harder to increase the blood flow and keep the oxygen supply up. The only way to increase blood flow through a narrower pipe, is to increase the pressure. Which is what then happens.

Over time, as the heart is forced to pump harder, and harder, the muscle in the left ventricle will get bigger and bigger, causing hypertrophy. Hypertrophy means ‘enlargement.’ So, in people with long term, raised blood pressure, we would expect to see left ventricular hypertrophy (LVH). Which is exactly what we do see.

LVH is often considered to be a cause of essential hypertension. I would argue that LVH is a result of CVD. This is not exactly a new argument, but it does make sense.

Two models strongly support the idea that CVD causes high blood pressure. The first is a rare condition called renal artery stenosis. This is where an artery to one of the kidneys narrows, or starts life narrowed. This causes the kidney to protest at a lack of blood supply and increase the production of renin.

Renin converts angiotensinogen, a protein made in the liver that floats about in the blood, into angiotensin I. Then angiotensin converting enzyme (ACE) turns angiotensin I into angiotensin II. And angiotensin II is a very powerful vasoconstrictor (narrows blood vessels), this raises the blood pressure.

Angiotensin II also stimulates the release of aldosterone, a hormone produced in the kidneys. Aldosterone increases the reabsorption of sodium and water into the blood from the kidneys, simultaneously driving the excretion of potassium (to maintain electrolyte balance). This increases the volume of fluid in the body, which also increases blood pressure.

This whole system is called the Renin angiotensin aldosterone system (RAAS), sometimes shortened to RAS. Activate at your peril. Angiotensin II is, amongst other things, a potent nitric oxide (NO) antagonist. Which, as you might expect, can do very nasty things to endothelial cells and the glycocalyx (glycoprotein layer that protects artery walls).

If you discover that the patient with very high blood pressure has got renal artery stenosis, the artery can be opened, and the blood pressure will – in most cases – rapidly return to normal. Which proves that narrow arteries can, indeed, lead to high blood pressure.

The other model is the situation whereby a number of blood clots build up in the lungs, a condition known as chronic thromboembolic pulmonary hypertension. It is not nice. The arteries are effectively narrowed by blood clots – in order to keep the blood flow up, the heart must pump harder. In this case the right side of the heart because it is this side that pushes the blood through the lungs.

So, you usually end up with Right Ventricular Hypertrophy (RVH). Eventually the heart cannot pump any harder and starts to fail, leading to Right Ventricular Heart Failure (RVF). Shortly after this, you die.

There is an operation that can be done to remove all the blood clots from the lungs. It has a very high mortality rate. Basically, you open up the lungs and pull out a great big complicated blood clot, that looks a bit like a miniature tree. If the operation is not fatal (pulmonary endarterectomy), the blood pressure drops, the LVF improves rapidly, and the outcomes are excellent.

This is another example which demonstrates that a rise in blood pressure is caused by narrowed blood vessels. Again, if you open the blood vessels the pressure drops, the stress on the heart falls, and rapid improvement can take place.

So, if CVD causes high blood pressure, is there any point in trying to lower the blood pressure with drugs. After all, you are doing nothing for the underlying disease.

Well, you would be taking pressure off the heart, so you might be improving left ventricular hypertrophy, and/or left ventricular failure. But, of course, you also lowering the blood flow to important organs, which is not so good. Indeed, it is well recognised that, in the elderly, you can increase the risk of falls by lowering the blood pressure – which can lead to fractured hips, and suchlike.

Also, if you lower the blood pressure too much the kidneys start to struggle, another major problem in the elderly. In fact, I often tell nurses working with me in Intermediate Care that dealing with the elderly can turn into a battle between the heart and the kidneys. Get one under control and the other one goes off.

Then, if you lower the blood pressure you are in danger of triggering the RAAS system into action as the body tries to bring the pressure back up again, and the RAAS system can be quite damaging to the blood vessel themselves. You will definitely disrupt the control of blood electrolytes such as sodium and potassium as aldosterone kicks into action.

I am forever battling to keep sodium levels up and potassium levels down, or vice versa, depending on which anti-hypertensive are being used. All of these are reasons why I do not bother to treat high blood with drugs, until it is far higher than the current medical guidelines would recommend.

What I do recommend to patients is:

  • Increase potassium consumption
  • Go on a high fat, low carb diet
  • Use relaxation techniques: mindfulness, yoga, whatever floats your boat
  • Take exercise
  • Get out in the sun – this stimulates NO synthesis
  • Try L-arginine and L-citrulline – as above
  • Increase magnesium consumption

This will often, if not always, do the trick.

If you must take medication, I was a very strong supporter of ACE-inhibitors, in that they blocked angiotensin II, and increased NO synthesis. Both good things. However, some research has come out recently, suggesting they may increase the risk of lung cancer. Not by a great deal, but there you go. Best to take nothing at all, if you possibly can.

1: https://www.cochrane.org/CD004022/HTN_effect-low-salt-diet-blood-pressure-and-some-hormones-and-lipids-people-normal-and-elevated-blood

398 thoughts on “What causes heart disease part 58 – blood pressure

    1. Dr Patrick Scully

      Malcolm…..it’s sugar.
      Affects endothelium in kidneys., insulin resistance etc.
      It’s occams razor. It’s sugar.

      1. Dr. Malcolm Kendrick Post author

        Then explain why the rate of CVD in young women with systemic lupus erythematosus is increased by 5,000% (relative risk). No raised sugar to be seen. I fully agree that high blood sugar is a cause of CVD. However, it is only a cause, and not THE cause. It is neither necessary, nor sufficient. The attempt to explain CVD as having a single cause will always fail.

  1. markie

    helpful piece, always prefer someone still trying to make sense of things, than someone content with cognitive dissonances, thanks

  2. Paola

    In the past the right blood pressure was 90+age, now it is 120/80 or Less. ..
    Do these 90 per cent ‘essential hypertensive’ people really esist?

    1. Mr Chris

      Think of the market if the 90 percent essential hypertensive people do exist!
      Health warning, this week there was an article in the Guardian, saying that THINCS to which Dr Kendrick belongs is a centre for statin denial and should be avoided!

      1. chris c

        The Guardian is a centre for vegan propaganda and should be avoided.

        Back in the day, science fiction writer John Brunner used the Guardian and New Scientist as scientific sources for use in constructing his dystopias. I’ve heard that the New Scientist is no longer a credible source of science either. Nor of course is Harvard, home to the finest science money can buy. The Lancet seems to be heading in the same direction, also Cochrane.

        Incidentally, Brunner’s books, written in the sixties and seventies, contained increases in cancer and drug-resistant infections but I don’t recall metabolic diseases featuring at all, one thing he failed to predict.

      2. David Bailey

        Whenever scientists talk about statin denial, climate denial, cholesterol denial, (maybe even HIV denial – who knows), it seems to be a sign that they don’t have strong arguments and obviously do not want to debate with the relevant denialists!

      3. Angelica

        The urge to be on the winning side, and to stay on the side of what’s assumed to be righteous is strong. I think that explains why so many ‘liberal’ publications publish such trash on health matters. They don’t even bother to give a balanced perspective anymore. They view all authority as good authority and medicine is full of authority structures. With all this political stuff happening, and the election in the US a few days away, I’ve discovered how this happens. Liberals love authority structures and assume the structures have people’s best interest in mind. I never questioned that myself until recently.

        People dropped out of tune with that image when they started to sense that authority is often malign today, especially in medicine. This drives people to become libertarian instead of to do housecleaning in the authority structures. It’s easier to tear down than build up, or clean up. So liberal news outlets have to stick with authority, even malign authority, because if they admit they’ve published marketing propaganda, then Trump is right, and the news is fake, at least some of it. I think the whole malaise of the current medical situation is due to people, even doctors, realizing that the authority figures aren’t putting public health first anymore, and naturally that’s confusing.

      4. Mr Chris

        yours is an interesting comment. When I started reading the article in “The Guardian” I had expected it to be trash, my only surprise was how much so. For a start, calling people ” statin deniers” is not exactly objective. They refer to Aseem Malhotra as “a cardiologist in private practice”. What does ‘in private practice” add, if not a slight attempt to denigrate. I never like ad hominem remarks in what is supposed to be informed journalism. Equally you get the impression, that Fiona Godlee, because she is the publisher of an obscure publication , the Journal of sports medicine is also a baddy.
        You liken this to liberal respect for authoritarian power structures.This is certainly a novel idea, but I have noted the tendency for people at the top of such power structures, such as Collins, such as the top man in Public health England to come out with pronouncements, in an evangelical manner, which are out of date.
        I don’t think this helps, these subjects are not cast in stone, and their role of journalists should be to stimulate debate, not crush it.

  3. Sarah

    So, if high blood pressure is an indicator of heart disease, how do you measure level and reversibility of that heart disease? Have merrily been popping blood pressure meds for nearly 20 years, currently being investigated for anaemia, which I find could possibly be linked to Candesartan. Which is pretty irritating if I have been addressing the wrong problem for the last 20 years….

  4. AhNotepad

    Thanks for another interesting episode. The benefits of increased mineral intake may be well known, but unless plants are grown organically, and using properly sustainable methods, the minerals are unlikely (read: impossible) to be obtained from plants. This is unfortunate for vegans as they are clinging on to sky hooks unless they source their plants properly, and with the world population we now have, that is unrealistic for most of them.
    If you look at the graphs in http://www.organictalks.com/bring-minerals-back-soil-food-supply/ it should be self explanatory. We do need the references for the data from which the graphs arise, so there is room for discussion.
    What this means is supplements are required to compensate for the plants short fall. I came across Barbara O’Neill’s videos on youtube (where she refers to Malcolm Kendrick as a cardiologist. Though possibly not a formal qualification, it is certainly technically correct as “someone who studies the heart” and there are plenty with the title who know a lot less than Dr. K. (Keep up the good work). Anyway, back to Barbara, her videos are easy to undestand and though sprinkled with religeous references, I don’t see that as a negative, just I don’t belive. I took up the suggestion of Celtic Sea Salt, though a luxury at £25/kg (eek!) The Hymalan salt is much cheaper, though with fewer minerals. The analysis of both show they have much sodium, much chloride, but amounts of other minerals which are way below the RDI. No matter, they are better than refined table salt. I have ordered some magnesium L-threonate as it is supposedly better absorbed into the system. The powder is much cheaper than ready loaded capsules, and since I load capsules for vitamin C, I have the kit.

    I just hope (my sky hook) that vitamin C will keep my blood vesells in reasonable condition, partcularly with regard to avoiding abdominal aortic aneurysm. A nasty complaint at the best of times, but with NICE’s decision to fund only open surgery, it’s almost means curtains.

    1. Gary Ogden

      AhNotepad: I stopped using sea salt because of micro-plastic contamination, and now use himalayan pink salt and Redmond Realsalt (mined in the U.S.).

      1. Gary Ogden

        AhNotepad: Yes. We’re all being poisoned, so eat, drink, and be merry! Most of the fish I eat comes from Alaskan fisheries, which I suspect are cleaner than most, but who knows.

      2. Gary Ogden

        AnnaM: I don’t know, but have a suspicion that eating them can’t be healthful. Petroleum has never been used as a human food, as far as I know, and plastics are made from petroleum.

      3. Frederica Huxley

        Sea salt only occurs when sea water is left in pans to dehydrate. As the oceans are now inundated with plastics, I would image that all seawater, and therefore, sea salt, has microplastics.

      4. AnnaM


        The Celtic salt is made fresh from current seawater whereas the pink salts are found in ancient deposits.

      5. Martin Back

        Jerome, a lot of salt is made fresh from the sea. I have flown over the salt pans near Walvis Bay in Namibia. They turn a beautiful pink colour, varying with the salt concentration. Incidentally, they pile up the salt using bulldozers specially fitted with aluminium tracks and blades because the steel ones rust so fast.

      1. Jean Humphreys

        “Gary – would the sea salt not have been.put down long before plastic became an issue ?”
        The thing about sea salt is that it has not been “put down” – it is no more than sea water with the water taken out. Which is good in some ways since there is a lot wider range of minerals in it than just sodium chloride.

    2. Göran Sjöberg

      I have felt fine on my ( actually Linus Pauling’s) 15g vitamin C/day. However I had a “warning” from Dr Mercola that constant high intake levels might deplete copper which we essentially need.

      What to do?

      Add a copper supplement to my “feel fine” but ridiculously big box of supplements is now what I did to be on the safe side even on this issue.

      1. Gary Ogden

        Göran Sjöberg: Beef liver is rich in copper. Oysters and chocolate are not too shabby, either.

      2. Janet

        On my side of the Land DownUnder, household water pipes have been copper since the 1950’s, with “plastics” only a recent aberration…
        I’d like to think my long showers / soaking baths would be enough to keep me suitably ‘nourished’.

      3. Göran Sjöberg


        Liver is full of essential nutrients. I guess the the hunting Eskimos new that when they shared the seal liver raw on the spot after a successful hunt.

        I’ve got 6 kg beef liver (from one animal!) myself in my freezer.

  5. Bill In Oz

    Thank you Malcolm. Once again written clearly and simply with a good dose of common sense. I would that the doctors I deal with ( only very occasionally now, due to this blog ! ) were the same.

    I have missed the daily conversation on this blog of late. I assume you have been busy.And hope all is well.

    1. Lynne Daymon

      Hello Bill in Oz, I am ex Oz here in Scotland hrre but soon changing countries to Republic of Ireland. Back to blood pressure! Am 68 ex Throat Cancer – very lucky was Grade 4!
      Lost my Thyroid Gland now on Levothyroxine. Has taken two years to get level of T4
      that suited me. Too much T4 ,- the high blood pressure!!! Couldn’t get it thru to Drs!!
      One VERY knowledgeable Dr informed me that blood pressure damage only occurs if it is consistently high – most sound rendition I had heard! Other Drs wanted me on BP pills,
      made me SO sick!! Didn’t take them, changed my Dr , he didn’t bother with BP pills! Yippee! One really has to research differing opinions from the Medical Fraternity!
      One really huge learning curve. Only on 50mcg daily of Levothyroxine instead of the suggested 100mcg daily which makes me ill!!!
      Malcolm is one great Dr & thinks outside of the pages of the Medical Book!

  6. sergeykushchenko

    IMHO magnesium is more important than potassium. And low carbohydrate diet is the main remedy against the metabolic syndrome
    which inclydes high BP. I would also add chi-running as a relaxation technique. And why didn’t you mention chelation therapy?

  7. Tom Welsh

    Many thanks, Dr Kendrick – yet another very interesting, provocative article. If nobody knows what causes hypertension, it certainly does seem risky to try treating it with drugs. And, to this layman, your suggestion that CVD causes hypertension rather than vice versa looks very logical.

    Surely the scientific establishment has gone off the rails – perhaps as much as 50 or 70 years ago. I would think it of primary importance to find out such basic facts as what causes CVD and hypertension – and, if that proves difficult, perhaps to study why it is so difficult. In other words, focus on the most important matters and attack them from all possible angles until answers are found.

    The same, of course, applies to diet. It’s at least 250 years since the first dietary research was undertaken with bomb calorimeters and suchlike – even if the original motive was to find the cheapest way of feeding expendable manual workers. And today quite intelligent and educated people are jabbering away about “calories in/calories out”! Surely if the real objective was to optimise human health, we would have got a long way further by now.

    We’re approaching the centenary of Dr Weston A Price’s groundbreaking work on “primitive” diets and lifestyles, with the astonishing insights into physical and dental health that he achieved. (People living on traditional diets, whether in New Guinea, Peru, or the Arctic did not get tooth decay or gum disease even though they never brushed their teeth or used mouthwash; while people living on the standard American diet in Illinois always got serious tooth decay regardless of how much they brushed, rinsed, etc.) Yet Dr Price’s research, and that of many others, has been systematically ignored for 80 years.

    1. Mark Sanders

      Note that before Columbus and after, Native Americans who ate corn had tooth decay much like modern people eating the standard American diet.

    2. JanB

      Tom Welsh – the problem with we humans is that we’re formidably clever and incredibly foolish, in almost everything we do.

      1. chris c

        As someone put it, we are the only species clever enough to manufacture food, and stupid enough to eat it.

    3. Göran Sjöberg

      Tom, I fully agree!

      Dr Weston A Price was recognized as the “best dentist in the world” at his time and a great “experimental” scientist. The only reason I can see for him being so completely ignored today is the obvious threat he poses to both Big Agro and Big Pharma.

      His book “Nutrition and Physical Degeneration” is a “must” reading for anyone seriously interested in the profound issue of nutrition on health. The only caveat here is that the language is colored by his time (1930th) during which it was written and so alien to the wording we are using today. E.g. “the white race” instead of “caucasians” which for sure can put anyone off today – it is a pity.

      1. AhNotepad

        Göran, if they are put off by something so trivial, they can continue being uneducated. People sensitive to non-PC language are too prejudiced to be open minded enough to learn. We all have to look at things we probably think we don’t agree with, in the off chance we may learn something new. Happens to me frequently, but then I don’t know a lot, so have much to learn, except perhaps from people who think carbohydrates as the main part of a diet is a healthy approach, oh, and the ones who think cholesterol is “bad”, er, and the ones who think blood pressure is something to be lowered without knowing why.

  8. Sylvia

    What a wonderful post, think outside the box always. Also remember that getting older increases the risk of dying! And keep not taking the pills! Of course drugs are needed for some of us but be choosy. Thank you.

  9. Andy S

    Limbic system is involved in blood pressure regulation. Dr. K. do you have any opinions regarding the endocannabioid system, cannabidiol (CBD), and legalization of cannabis for medical use?

  10. Göran Sjöberg

    Great input as always!

    With severe CVD my BP i amazingly low I guess at 120/60 and I seldom measure it nowadays..

    Yesterday, though, visiting a Halloween light festival in the botanic garden we were late and I was very stressed to find a parking lot. Then my angina popped up again “with it’s ugly face” and I am pretty sure that my BP then was off the limit. Half an hour later I was back to “normal” as usual.

    I have to avoid mental stress 🙂

  11. Marian Callender

    What about the action of insulin on arteries to produce atherosclerosis? Could this be an underlying cause as there is some mention in popular literature around type 2 diabetes and low carb, high fat diets, about excess insulin damaging artery walls.

    I have converted to this diet over the last year to help my raised BP. I didn’t need to lose weight but have lost about 4Kg and my BP has reduced (15-20 mmHg systolic). I have halved my Ramipril dose (with my GP’s approval). Can’t come off the medication entirely as BP starts to creep up again. Maybe have to reduce carbs further for this to happen?

    1. Gary Ogden

      Marian Callender: I suspect that, over time, with your dietary changes, and doing all the things Dr. Kendrick has suggested, your health will continue to improve, and you may be able to go off the drug. I did, and I think it was a good idea. Experiment!

      1. Marian Callender

        I do hope so. Consider myself to be fit and healthy: go to gym 3 times a week + walking the dog. Watch my alcohol intake otherwise it worsens my tinnitus. Not overweight, always eaten healthily.
        My mother had BP problems so thought it genetic and/or connected to menopause. Now convinced she had metabolic syndrome and I need to avoid this.

    2. Jo Roberts

      Try taking beetroot capsules. These have worked for my husband and sister who both had very high essential hypertension and whose results are now in ‘normal’ range. Cheaper and more effective than prescribed medication with no nasty side effects. Bought from Amazon.

      1. AhNotepad

        If we work on the basis the body has a reason for the blood pressure at any particular time, is taking any substance to change it, “natural” or not, a good idea if we don’t know why the pressure is as it is?

      2. Frederica Huxley

        AhNotepad, I would like to think that a food is more likely to target the cause of the raised BP, rather than just suppressing the symptoms!

      3. AhNotepad

        Surely you need to know what the cause is and what effect the particular food will have on the body and that it will treat the cause.

      4. Frederica Huxley

        I am naive enough to believe in homeostasis and the body’s innate ability to heal itself, given a nutritional diet. If so, beets may well contribute to healing hypertension.

      5. Andy S

        Frederica, medicinal properties of the cannabis plant is being rediscovered. Looking for ways to incorporate this plant into my diet.

        The ECS is one of the, if not the most, important systems in our body. Its role in the homeostatic function of our body is undeniable, and its sphere of influence is incredible. Additionally, it also plays a major role in apoptotic diseases, mitochondrial function, and brain function. 
        Its contribution is more than maintaining homeostasis; it also has a profound ability in regulation. Working in a retrograde fashion and with a generally inhibitory nature, ECS can act as a “kill switch.” However, it has been shown to play an inhibitory or stimulatory role based on the size of the influx of cannabinoids, resulting in a bimodal regulation. Furthermore, due to the nature of the rate of degradation of cannabinoids, it does not have as many long-term side effects as most of the current drugs on the market. 
        The ECS may not only provide answers for diseases with no known cures, but it could change the way we approach medicine. This system would allow us to change our focus from invasive pharmacological interventions (i.e. SSRIs for depression, benzodiazepines for anxiety, chemotherapies for cancer) to uncovering the mystery of why the body is failing to maintain homeostasis. Understanding the roles of ECS in these diseases confers a new direction for medicine which may eradicate the use of some of the less tolerable therapeutics.

      6. Frederica Huxley

        Dis-ease is the only way I can describe it. I make it my business to attend to symptoms and prime my immune system to cope.

      7. Jeffrey Dun

        In response to Jo’s recommendation of betroot capsules, AhNotepad asks: “If we work on the basis the body has a reason for the blood pressure at any particular time, is taking any substance to change it, “natural”…”

        Beetroot is supposed to lower BP because it is rich in nitrates, which the body converts to nitric oxide to relax and dilate the blood vessels.

  12. TS

    Thank you, thank you, thank you. It is disgusting that these issues are not generally voiced and known, but this is of no surprise given the financial holds, greed, irresponsibility, and I would go as far as to say, criminality.

  13. James DownUnder

    In times past, I found that BP tracked my weight, and was un-affected by “excessive” consumption of Pink Himalayan Salt.
    Being chronically stressed negates candesartan…
    My observations on n=1

  14. JDPatten

    I’ve been under the impression – though I can’t find it stated – that angiotensin II acts on the vascular musculature, causing it to contract and constrict. Yes??

    I’ve been told that atherosclerosis of the vessels feeding the kidneys is the cause of chronic kidney disease. You suggest here that hypoperfusion due to artificially lowered BP is the cause.
    Yes? Both??

    Do ARBs have any of the ACEi beneficial effects?

    1. AnnaM

      Interesting to see what Malcolm has to say but it looks like both would cause it. Very high arterial pressures I have been told will also ruin kidneys.

  15. Kathleen Robertshaw

    A bit of a sideways step here: Are figures re diabetes and pre-diabetes just as arbitrary as for other conditions? How does one magically turn into the other when the magic figure 6 is reached? Have you ever written a blog on this? I’d like your common-sense take, please.

    1. chris c

      Theoretically the criterion for diagnosis of diabetes is set where at least 50% of the beta cells are dead or dysfunctional. This leaves a huge window for improvement aka prediabetes to stop the damage from continuing to progress.

    2. AnnaM

      My opinion is that it is not an either/or, but a sliding scale. Two people with diagnosed diabetes also can be quite different in how resistant or brittle they are.

      1. chris c

        Yes it’s really a whole bunch of different diseases, not just Type 1 and Type 2. Beta cell loss (or in my case dysfunction) is one side of it, insulin resistance is the other.

        Hopefully the wider use of Continuous Glucose Monitors will provide more information, though already some dieticians and others are claiming that “nondiabetics” also have glucose spikes. A Continuous Insulin Monitor would be even better.

  16. Jim Jackson

    Great article Malcolm. I have a blocked arteries in my legs, PAD (at age 38) and whenever I go to the docs and they do a blood pressure test it is always high so I argued that the fact that I have just walked down the corridor using my legs with restricted blood being supplied to them, perhaps that would explain why my heart is working harder. When we did a 24 hour blood pressure test on me, the results were deemed perfectly fine on average. I am no doctor but I believe your article would support my theory. Thanks

  17. Ian Roselman

    I have always (as an adult) had blood pressure on the high side of what used to be considered the normal range. Now it seems everyone has either high or low BP, (part 56 of this series), so mine is “high”. I do not take medication. A few years ago I had a free NHS AAA ultrasound to check for risk of aortic aneurysm. I was told there was very little risk as my aorta was towards the narrow end of the normal range. As I thought at the time, this may explain my moderately high BP and why it doesn’t need treating. I hope I’m right.

  18. JR62

    Thank you for writing so that a layperson can understand.
    Changing blood pressure with drugs is like curing overheated car engine by manipulating temperature gauge in dashboard. Looks fine but it leads to disaster.

  19. Gary Ogden

    Thank you, Dr. Kendrick. Researched L-arginine and L-citrulline. A power lifting web site argues that citrulline malate (6-8g an hour before exercise) is better than L-citrulline for enhancing performance. He says that he always takes citrulline, but not always arginine, before exercise, because it metabolizes more quickly. One web site says we make all the L-arginie we need. Since the foods I eat are rich in it, I haven’t used it much, but I’m going to try it as an experiment, along with citrulline malate. All the sites I looked at talked about increasing NO production from these two, so what’s not to like about them? Working on relaxation techniques. Yikes, went to the local council meeting, and needed some relaxation techniques after that! Gardening, exercise, and just being outside works for me. All the rest I’m already doing. A good boy I am.

  20. BobM

    This: “When you have a problem that is difficult to solve, I always like to turn it inside out, and see what it looks like from the opposite direction” Is why I think you win some type of award. Most doctors, particularly those who believe in the lipid hypothesis of heart disease, never do this. And by “most”, I mean 99.9999…% of them.

    1. chris c


      It must be hard to be a GP, you have to know a bit about a lot of things, probably including diseases you have never seen, just in case. And of course nowadays you have to memorise all the “guidelines” and the official changes. Thinking out of the box becomes deprecated, so all power to everyone who still does.

  21. Fleur Brown

    Really interesting perspective of hypertension which makes so much sense – many thanks for posting thiis.
    What about Isolated Systolic Hypertension – so common as one ages. So difficult to reduce the systolic without reducing the already low diasbolic./ There is just no information on this and the majority of GP’s and Cardiologists don’t pay much attention to it and simply dish out hypertensive medications without consideration to the low diastolic pressure !!.
    Any views on this Dr Kendrick would be really great.

  22. Mark Waters

    Thank You.for an interesting read.Good to know that my friend Dr Wolfgang Lutz was on the right lines when he advised us to go on a Low Carbohydrate diet some many years ago.

    1. Frances

      Dr Lutz, an Austrian doctor, was probably the first to recommend a low carb eating style, i.e. max. 72 grams carb. a day to maintain health and eliminate chronic disease.

  23. Brett

    I have specific reasons for my high blood pressure. I am 68 years old. When I was 35 I was treated at Northwestern University for extremely high blood pressure AND cholesterol. Doctors stated they were concerned about me making it to 45.
    They also knew I began to sleep only 3-4 hours a night in my early 20’s. Something that continued until my mid 50’s for a period of time. The said the reason for my lack of sleep was “severe restless leg syndrome”. No studies done and I was labeled with these conditions from then on.
    In my mid 50’s the pain became so severe I began not to be able to fall asleep after being awake for 3 days. Doctors (PCP and Neurologists) wanted to put me on 2 weeks of oxycodone and then 2 weeks of methadone. I wouldn’t do that and did some research finding that marijuana could help. Tried it and for first time pain felt gone versus taking some Rx that just didn’t make me care about it. Started to sleep much better and within a short period of time I was no longer needed the blood pressure medicine nor cholesterol medication. The REASON for both of the high levels was sleep deprivation, frankly someone who could think and connect dots should have considered.

    Recently I was diagnosed with a heart murmur which was found to be due to being born with a bicuspid aortic valve, which was found before symptoms set in. That was replaced two weeks ago today using TAVR. I had to lay still for nearly 12 hours and struggled with O2 saturation staying above 90%. When I got up at 4pm and sat in a chair until 9:30 I had no problem with O2 saturation. I had extremely severe muscle pain while not moving. I was given oxygen shortly after going back to bed to go to sleep. That night I experienced very moderate muscle pain. Coming home on Friday, using an oximeter I discovered that I would wake in severe pain with an O2 sat from 80-85%. A week ago I started oxygen at night and the magnitude of the pain was minimal. Still have various types of full body muscle spasms, but for now are well controlled with Charolette;s Web original CBD tinture and cream applied to my leg muscles at night.

    When I am awake and moving my O2 saturation is in the 90’s, which in my opinion explains why I only slept 3-4 hours starting in my 20’s. I simply felt much better awake then asleep not know why. Thanks to the TAVR and being in the hospital I now know that a major component to my muscle pain, diagnosed originally as restless leg syndrome was logically the result of lower O2 saturation at night.

    I am extremely thankful for finding out about the O2 saturation – on my own. Last night I was up only 3 times, sleep is restful, brain is not fogged in morning and pain is manageable for know and hopefully for a long time to come. My muscles are beginning to relax and I am hoping fatigue will lessen and endurance will improve over time.

    1. mand Season

      Brett, this is really interesting to me as it parallels my own experiences – mine are on a much smaller scale (though the rest of my med history is pretty dramatic). I have morning stiffness, which is shorthand for saying if I go too long without moving it’s difficult to start moving – time of day isn’t relevant, nor is whether I’m asleep or awake. The longer I slept, the more hours this lasts when I get moving again… when I had surgery lasting 4 hours, so I was completely immobile without the movements of ordinary sleep, the stiffness was worst I’ve known, weeping with pain before the anaesthetic fully wore off (and I *never* cry) – while I could hardly feel the surgery wound!

      The last several years, I’ve had the luxury of following my own natural sleep pattern, never using an alarm clock. I sleep much less than the accepted norm, and when I do sleep longer, I do much worse during the day. If I have an exceptionally short night’s sleep, I have a fantastic day for energy and usually lower pain as well.

      I have too much on my plate at the moment to research thoroughly, so I’m paying attention to how I feel while theorising about the WHY without the facts to back it up. They say that in the long term, so few hours’ sleep every night affects the health. Seems to me that it must be different for some of us, either we’re built differently in some way (maybe there are two kinds of “sleep character”, or perhaps the healthy amount is a very much wider range than we’re told. My everday energy and capacity are so much better now that I’m not forcing myself to sleep “the correct amount”. I don’t see it as an insomnia problem, but a blessing.

      I do still need a long period of “null” time daily – taking it easy physically, mentally and emotionally. Nothing that needs concentration, and refusing to remember the various “oughts” and “musts” of real life, at least a couple of hours every day. This seems to give the benefits of sleep, while being awake.

      Also, I don’t dream now – I know “everyone does”, so instead I’ll say I don’t recall my dreams. I used to dream often and vividly and remember them well, in the days before my health went screwy… It all feels connected, instinctively. Oh for the capacity to study this properly.

      Looking at my life history, all these mystery symptoms, plus a few others, developed over the same period. Hard to believe they aren’t connected.

      Finally, and your description of sitting upright versus lying down made me think of this, when I do have trouble falling asleep (as opposed to simply not needing to), I find that raising the head of my bed just a little does the trick. I have a profiling bed (the “sit you up” kind). I’ve only noticed this recently. You make me wonder whether it’s about oxygen levels. I rarely get restless legs but…

      Well, sorry to take over your history! But it rings so many bells!

      Is there a cheap way to measure my own O2 levels at home? And then treat it, if that is indeed my problem? (One of my problems…) I’m sure I won’t get it on the NHS and besides, I already do plenty of doctor-battling without yet another request! 😉

  24. cameron Angus www.highfatlowcarbdiet.co.uk

    Outstanding as always Dr K.
    Can i suggest a different vantage point? Look to the kidney tissue itself. The parenchymal (outer) tissue necrotizes and the hypertension is compensatory to this necrosis, to secure urine production.
    In primary hypertension, you will find this necrotisation of the kidney tissue, which can be confirmed by a histopathologist.
    Then when the body has solved the ‘problem’ (see the second point below), the tissue is replenished which becomes a cyst ( or a ‘Wilm’s tumor). If you can find an exception to that first point i would be astonished. But i plead with you to look into this and prepare to be as astonished as i have been as a practitioner.
    Or to put this another way, if somebody had a diagnosis of primary hypertension and it strangely went away, this would be because they had resolved the biological conflict that started it AND they would have some evidence ( to a greater or lesser extent) of a cyst on the kidney which had previously necrotized, in 100% of cases.
    Secondly, the spark that starts this fire is an unexpected and traumatic life event involving water in 100% of cases:
    Near drowning experience, surviving a flood or tsunami etc.
    Again, In 100% of cases (!). Find me one exception and i will eat my hat.I can show you my own client’s notes (pretty please don’t dismiss this as quackery!) The hypertension will only go away when this conflict is resolved, otherwise it stays, and can only be lightly tweaked with dietary and drug/supplement intervention.
    I can’t claim original thought here, it was all discovered by Dr Hamer of Germany. Please look into German New Medicine Dr Kendrick. It provides all the answers because it is rooted in a system that is predictable, based on embryology.It fully explains heart disease. If you can debunk German New Medicine i will send you £1000 next day recorded delivery and a bottle of Crief’s finest (!)

  25. Paul Rosch

    Malcolm – great post as usual!! Might be interested in the attached Newsletter, which was written over 15 years ago but it still valid. Look forward to seeing you in California on December 15. Paul

  26. Frederica Huxley

    We missed you over the past fortnight; great to have you back with yet another excellent article. Years ago I had a small child in A&E with severe stomach ache, and when I questioned the Registrar the next morning as to what was wrong, he answered ‘mesenteric adenitis’. When I next saw my GP, he asked after my son, and I proudly told him the diagnosis. Oh, he said, they had no idea what the hell was happening!

  27. David Bailey

    Thanks for another interesting article, Malcolm.

    I saw the report about ACE inhibitors and lung cancer, and if this raises lung cancer rates by 18% (was that the figure?), it wouldn’t matter so someone like me, who has never smoked, and who is therefore at very low risk of lung cancer. However, if this is a totally independent cause of lung cancer that affects everyone who takes these drugs by the same absolute amount, it would be of more concern to anyone who has never smoked but has raised BP.

    1. AnnaM

      Hmm, I thought that a fair number of lung cancer patients are nonsmokers. The ACE inhibitors are famous for causing an annoying cough, and I can only assume that there is some chronic irritation which translates into a few cancer cases.

  28. David Bailey

    I remember when you couldn’t open a newspaper without reading about Bovine Spongiform Encephalopathy (BSE). It didn’t convey much extra medical information than “Mad Cow Disease” except that the brain would become spongy!

  29. Gary Ogden

    Today happened to be shopping day, so I picked up an L-arginine/L-citrullne combo, 0.5g each. They recommend 2 capsules 1-2 times per day, for 1-2g of each per day. Anyone have any other information about dosing?

    1. JDPatten

      It’s conventional “wisdom” that any of the L- (amino acids) taken for their own unique effects will disappear into the mix creating basic protein – – – when taken with a range of other Ls.
      L-(whatever) bottle labels generally say to take between meals. Vegetarians are told to eat corn with their beans to provide a “complete” protein from a meal.
      I’ve asked this before and never got an answer.
      Is this strictly true?
      Is it more complex than that?
      How complicated is your supplement regimen going to get before you start screaming??

      1. Gary Ogden

        JDPatten: The advice is to take it on an empty stomach, so perhaps it doesn’t get swept up in other metabolic processes. Who knows. This is the only pill I take, and if I can find a powder form I’ll get it.

      2. David Bailey

        That sounds a strong argument to me, but since the body is insanely complicated, perhaps the question is whether there is definite empirical evidence that consuming raw L-arginine (i.e. not in protein form) actually does some good. I guess a fair few supplements are probably just food fads.

    2. Bill In Oz

      Gary, I suggets buying the powder not the capsules.It’s a lot lot cheaper. I take a half teaspoon a day – usually just before bed…But that’s just me.

      1. Gary Ogden

        Bill in Oz: Thanks. I’ll look for it. What I got are actually tablets, rather than capsules, and pretty pricey.

      2. Jeffrey Dun

        Bill, is the powder you buy the one promoted by Dr Louis Ignarro (joint winner of the Nobel Prize for the discovery of NO) ?

        If not, does it contain both Arginine and Citrulline and, if so, what is it called and what are the proportions ?

      3. Bill In Oz

        I get my Citrulline powder from the local Gym supplements store. It comes in a 200 gram container from Primforce in North Carolina, USA. It cost me $48.00 Australian = $33.00 US. It is a well known and commonly used supplements by gym jocks because it boosts NO in the arteries.. For years I was buying L-Arginine pills from a pharmacy but at 7-8 times the unit cost.

      4. Gary Ogden

        Bill; in Oz: Thanks. I’ll look for it. I did indeed pay 8 times that price. By the way, why do you take it before bed?

      5. Jeffrey Dun

        Bill – thanks for the tip. I will check it out.

        Gary asked Bill why he takes it before bed. For what it’s worth, I note that Dr Ignarro recommends taking it before bed because most heart attacks occur at night and in the early morning hours, and that this is when our endothelial cells produce only minimal amounts of NO.

      6. Mr Chris

        Louis Ignarro’s book ” NO more heart disease” is an interesting read and he answers many of those questions, such as why take L-Arginine with L-Citrulline. It is slightly populist but a good summary nevertheless

      7. Jeffrey Dun

        Bill – just checked iherb on line. They are offering Primaforce, Citrulline Malate, Unflavored, 200g for A$17.58 (on special). Free delivery for orders over A$50. I’m assuming it’s the one you are speaking of. I think I’ll order some.

      8. Bill In Oz

        Gary, I read tht it is the best time to take it, ‘somewhere ‘a year or so ago and have done so out of habit ever since….I am not sure if it is the best time.But my bp has decreased so..When I’m on a good thing, stick to it.

      9. Bill In Oz

        Jeffrey, I just tried to rder some & that brand is out of stock..Wound upordering another brand at almost as good a cost. Thanks for the tip !

      10. Stuart

        Bill, you can buy Citrulline Malate powder from Bulk Nutrients in Tasmania, $20 for 250gm and $55 for 1kg (4x250gm packs) plus $7 postage. They also have a lot of other nutrients so you can amortize the flat-rate postage in a multiple buy.

  30. judefossett

    Dear Dr Kendrick Am I right in thinking the body is quite clever and manages to cope with all sorts of nasties for a long time before giving out?  Also, is it true that blood pressure rises when doing exercise or someone experiencing stress, illness and injury?  If the answer is yes, can raised blood pressure be the result of the body compensating or dealing with underlying issues that allopathic medics may simply not consider as being a good enough reason for the body to raise blood pressure?  Just asking:) Atb, Jude Fossett

    Sent from my Samsung Galaxy smartphone.

  31. Lynne Daymon

    Dr Kendrick,
    Your content is written in plain English – I love your style, your candid approach into the world of Doctoring!! Great information on looking at a Doctor’s assessment through the eye of a needle.
    I am on my third Dr, at last getting someone listening to my sensitivities to T4 Levothyroxine, high blood pressure, well more like fluctuating BP – overmedicated!
    am ex – Cancer – my system took a blow following Radiation & Chemotherapy, not at all moaning cos this optimal treatment saved my life, now six years later, I can say that I am back to normal and look pretty good at 68 years!
    Love your being a part of your ‘gang’!!

    1. JanB

      Yes, agreed. I love being part of the ‘gang’ too. The last two weeks of Kendrick Starvation has been tough. I need my daily fix.
      So glad (and relieved) you’re back, Dr.K.

  32. kenckar

    Another thing I have thought about. It is probably more than just narrowing, but also high blood pressure could be expressed from lack of flexibility of the arteries. Consider a pulse of water going into a ballon vs a pulse going into a lead pipe. The balloon will absorb the pressure better without a high-pressure hammering. This could also be one of the issues with aortal aneurysms–the vessels get brittle, lose flexibility, and break.

    1. Andy S

      Hi kenckar,
      Maybe aneurisms are a result of weak rather than rigid blood vessels. In that case solution would be vitamin C, D at the minimum.

  33. shirley3349

    Certainly, the neurology consultant I worked with 30 years ago, believed that a modest degree of hypertension, up to 160/100 in some cases, was needed to keep the brains of his elderly patients functioning reasonably well, and was very wary of lowering it too much. He took great care to treat each patient according to their individual needs rather than follow some arbitrary rule of thumb.
    Could the (?) increasing incidence of dementia in old age be due to the over enthusiastic use of medication to lower blood pressure, or is it just that these patients are no longer incarcerated out of sight in the geriatric wings of the huge, old, mental hospitals?

    1. JR62

      Too low pressure -> less blood and nutrients to brain -> brain decay -> dementia. Seems to be right-minded chain of events.

    2. Andy S

      Hopefully the elderly will expire from their low blood medications before they get dementia.


      “The researchers discovered a significant association between low SBP and treatment with 2 or more BP lowering agents, which resulted in a higher risk of mortality in patients with low SBP who had received multiple BP lowering medicines compared to the other participants.”

    3. AnnaM

      I’m pretty sure dementia in some cases is indeed linked to aluminum in modern life. Also statins and metabolic syndrome contribute.

    4. Helen

      Shirley3349, this is a very interesting point.

      In the 1990s, I had two SPET scans as part of some pioneering research into ME (not CFS), which has since been ignored by the medical establishment, because it didn’t fit with the Simon Wessely paradigm. My scans showed a pattern of cerebral hypoperfusion consistent with other patients diagnosed with ME according to the most stringent criteria (not the much wider criteria that lumps together disparate groups of patients under a CFS diagnosis, in order to dispose of us all in the same medical dustbin). This pattern was quite different from the healthy controls, and also from the patient group with clinical depression.

      Cognitive dysfunction has been, for me, one of the most distressing and difficult aspects of this condition. As you might imagine, I have not consented to medication of my moderate, middle-aged hypertension.

      1. AnnaM

        When people are immersed in a particular area of medicine they use convenient acronyms, but it would be helpful for me to know what CFS and ME you are referring to.

      2. JDPatten


        Usually, in research papers, they spell it out first, then use the acronym afterwards. Gives them a sort of cache with their fellows that they want to impress, I guess. Or, perhaps there’s a premium on article length? Seems to me though, that they generally want to stretch it out, again, to seem more important. Is it the researchers themselves who actually type it all out? Doubt.

        There was a gastroenterologist I went to who was actually gleefully proud about his illegible handwriting. Same sense of exclusivity that seems to abound in medicine. Dangerous. Fired him.

        There was a comment on a cardiology blog recently in which MI was mistaken for Myocardial Ischemia. Rather different from Infarction! Dangerous.
        (End of diatribe.)

      3. Frederica Huxley

        “Myalgic Encephalomyelitis (M.E.) is a long-term (chronic), fluctuating, neurological condition that causes symptoms affecting many body systems, more commonly the nervous and immune systems. … Chronic fatigue syndrome (CFS) Within the NHS, a diagnosis of chronic fatigue syndrome (CFS …”

      4. Gary Ogden

        AnnaM: ME: myalgic encephalomyelitis. CFM: chronic fatigue syndrome. They are different labels for roughly the same or similar condition. Both were initially pooh-poohed and considered psychiatric conditions by Medicine, as was autism (which is still in the DSM!). There is evidence of a retrovirus in the etiology. “Plague,” by Kent Heckenlively, JD and Judy Mikovits, PhD. goes into this in detail (as well as her career being destroyed by the politics of Science.

      5. mand Season

        I think it’s that people whose whole lives are about one of these conditions will forget that the acronyms aren’t as familiar to the rest of the world – rather than showing-off. 🙂 … In my case it’s FM for fibromyalgia – another that is (probably!) a cluster of related conditions and (probably!) of the same family as CFS and ME. And is neurological, and still dismissed as imaginary and/or unimportant by some doctors.

      6. Frances

        Shirley. Recently I was reading about an Irish lady who claims she reclaimed her brain by taking a supplement developed by Dr. Prof. B Puri in the UK. It contains EPA, evening primrose oil and a bit of Vit. E. No DHA.

    5. M. Martin

      Shirley3349 . This is interesting. Blood flow and connectivity in the brain is a particular challenge if damaged joints/ arthritis reduce mobilility as we get older. I wish I could convince Public Health Depts and Councils to pilot swings in parks for adults ! (Funded by local businesses ?) Possibly a Mental Health bonus too.

  34. paul helman

    Thank you again for this for your clear minded approach. I am reminded of two of my teachers in Ann Arbor inthe 60`s. One was  Jerome Conn of the eponymous syndrome. The other Nancy Furstenberg our proffesor of pulmonology who defined “Idiopathic”as meaning that there was no idiot who knew the reason.Regards,Paul Helman,MD, currently enjoying a trip to Paris

    Sent from Yahoo Mail on Android

  35. Mark Heneghan

    Re secondary hypertension, in our practice of 15000+ in my nearly 28 years there has been one new case of renal artery stenosis, one of Conn’s, NO primary Cushing (excluding the hundreds on steroids) NO coarctation of the aorta. So I agree with your assessment. In my battle against treating mild to moderate hypertension (along with the other battle against statins) stopping most or even all antihypetensives, especially in the elderly, makes them feel so much better, and I can’t be accused of contributing to an early demise, as by definition they’ve already had a long life.

  36. Sasha

    Regarding plaques, subsequent narrowing of arteries, and elevated BP as the result of this narrowing.

    From what I understand, arterial tree is quite extensive and plaques affect only a small portion of it. Is that correct? How can a few regions within arterial tree affect the BP systemically to such an extent? Of am I missing something?

    1. AnnaM

      But if an area such as the kidneys or perhaps many other areas are not getting enough perfusion, it must send out signals and the cardiovascular system will respond by upping the pressure. So it isn’t the plaque itself that causes the body to increase the pressure, but the body parts downstream from it that are underperfused.

      1. JDPatten

        Which makes me wonder if the body’s internal signalling and feedback mechanisms can localize increased pressure in that vascular tree where it’s needed and not so much elsewhere. More pressure just for those starved kidneys?

      2. JDPatten

        Still . . .
        To nail this:
        The need for ONE organ to enlist R A A S for a higher BP and more perfusion brings that heightened BP EVERYWHERE in the person’s body – even though not needed everywhere?
        No localization at all?
        BP varies according to need in the skeletal musculature, does it not? How does that work?

      3. JDPatten

        So a pill taken to reduce RAAS and, therefore BP and, therefore perfusion to that kidney, will have the effect of enlisting more RAAS.

  37. TS

    I have forwarded this current episode of the blog to my boys. Here is my accompanying letter to them, in case it is of interest to anybody:

    “Thought you might like to be aware of this because one day some doctor will probably suggest you need blood pressure pills!
    Good article but no need for any supplements in my opinion – a good diet gives everything you need in a useable form. (One food element relies on others in food to have an effect – too complicated for anybody to be properly savvy. So supplementation is probably unnecessary, useless and not without its risks in my opinion.) Of course, stress is generally the culprit so don’t worry about things and avoid medics and medicine unless emergencies. Too much vested interest in the whole medical field.
    Gran, at 95, has been put back on blood pressure pills. They will not help her brain nor her falling spells, even if they could reduce the risk of a stroke.
    Not even sure about vitamin D supplementation in winter. There are benefits from the sun other than vit D and they probably all work together too. The body stores vitamin D (which is actually a hormone and not a vitamin at all) for use in winter. Although in higher latitudes we don’t get much ultra-violet B in winter, we can get some and we might trust our bodies to grab as much as they can when it’s in shorter supply. After all, in summer and strong sunlight the body shuts off vitamin D production in the skin very quickly. (So no point in basking in the sun for long if vitamin D is the object.) In winter the long slanting rays may get more interfered with travelling through space but some UVB must get through (and snow and sea will enhance it).
    Taking vitamin D has not been the cure all it was hailed to be, in my opinion. Too many other atmospheric, electromagnetic factors are involved.
    Sorry if this annoys you. Just trying to help as I have more time than you to think about such things. Lots of love, Mum XXX”

    1. mand Season

      I’ve just been learning about Vit D and jumped on the bandwagon this year – very much a newbie still – for example, I’ve been wondering how long the body stores it, and how soon it takes to see effects from supplementing. From a severe deficiency discovered in January (since who knows how long ago), I’m now functioning tons better, taking the maximum amount daily.

      I haven’t (yet) come across anything that says the body quickly stops producing Vitamin D in strong sunlight. So far I’ve only heard advice to spend as long as possible soaking up the daylight during the six months of the year that the UK gets strong enough sun to provoke production of Vit D. Can you point me to studies (or something) on this?

      I’ve had extreme fluctuation of core body temperature (thyroid malfunction ruled out), and this year it became troublesome and I had a couple of spells of being really unwell for a few days – both following a binge of sun exposure. Not the shivery evening that can follow a day getting thoroughly sunned, but a week or so of startling swings of temperature (between 35.0 and 37.7 C, no infection, no sitting and getting chilled, weather still warm) which stopped me doing much of anything. I thought it could be my Vit D levels dropping steeply. If the body stores it for months, then it can’t be this. So, yet another fascinating unsolved mystery.

      1. Gary Ogden

        mand Season: Interesting. I have found, since I quit eating grains and lost 10-15 pounds of body weight about 3 years ago, that I have little tolerance for cold. I chalked it up to not enough body fat, but perhaps I have some sort of weird disease. Or just getting old. I have put on upper body muscle mass from strength training over the past 5 years, but it doesn’t seem to keep me warm.

      2. Sasha

        Gary, your body probably lowered its basal metabolic rate (BMR). It’s a common strategy the brain uses to prevent weight loss. For more on this, look up the podcast with Stephan Guyenet on Nourish Balance Thrive or check out his book.

      3. Andy S

        Cold intolerance likely a result of ageing mitochondria, need that ATP. Could be other causes as well.

      4. TS

        mand Season
        These may help?

        This is from the British Association of Dermatologists:
        The sunlight exposure time to make significant vitamin D varies according to a number of environmental, physical and personal factors, but is typically short and less than the amount of time needed for skin to redden and burn 2,3. In fact, long exposures can break down vitamin D, reducing benefit whilst increasing risk of skin cancer4. Casual brief sun exposures, while taking care not to burn and avoiding deliberate tanning, can help the body become vitamin D sufficient.

        Then there are lots of unknowns. E.g.:
        Mediators other than vitamin D are produced or released by exposure to UVR and may play a role in reducing weight gain and signs of cardiometabolic dysfunction. Exposure to ultraviolet radiation (UVR) results in the production of heme oxygenase, which causes the breakdown of heme, catalysing the production of carbon monoxide (CO), iron (Fe) and biliverdin; however, the role of this pathway on the development of obesity and cardiometabolic dysfunction is still to be defined. Nitric oxide stores in skin are released into the blood stream as nitrite potentially reducing blood pressure and increasing vasodilation. When skin and the eye are exposed to UVR there is a release of α-melanocyte-stimulating hormone (MSH), which activates pro-opiomelanocortin (POMC)-responsive neurons in the arcuate nucleus of the hypothalamus, and hypothetically could reduce appetite and food intake.

      5. Gary Ogden

        Bill in Oz: I just take it as it comes. Being alarmed about an unknowable future seems a silly way to live. The higher concentration of CO2, in any event, is sure good for the plants!

      6. mand Season

        @Gary et al, feeling the cold isn’t quite the same as having a low core temperature. They often go together but not necessarily. My own experience is that when the body temp is very low (mine has been 35.0C which is the cut-off for diagnosing hypothermia, according to Mr Internet) – I was going hot and cold, just like having a fever. At around 36.2 C i feel hot rather than cold, not unpleasantly, just a need to shed a layer or two of clothing. I don’t suffer with feeling chilly until it gets down to 36C or lower.

        The first thought when either feeling the cold more, or having lower readings on the themometer, is the thyroid. The NHS will only test TSH but that can give false reassurance and T3, T4 and antibodies should be checked too – Thyroid UK website and its forum have been my teachers on this and while it’s complicated, I’m really grateful to have learnt all this. My own thyroid is definitely ok, ironically!

        The only thing I’ve ever heard of causing a *fluctuating* core temp (not including variations from exercise etc) is Vitamin B12 deficiency. It seems I haven’t got that either, though still awaiting a couple of the “advanced/extreme”(!) blood tests… It’s one I really want to know about if I do have it, as B12 deficiency will keep causing neurological damage while it’s untreated, and I’ve had weird neurology since my thirties if not twenties. Lots of mysteries in my med history. Nice to be fascinating 😉 but I’d rather be well.

        So if my B12 turns out to be ok, and my thyroid is ok, I’m at a loss to explain the fluctuations in core temp but I have observed it’s worse after a huge dose of sunshine – only 2-3 times since this occurred to me, though, so it’s a bit of a straw poll and not exactly a vast double blind study. (Vit D deficiency also seems to do neurological damage, incidentally…)

      7. mand Season

        Oh, I just had another thought. While sunning myself I was careful to drink plenty of water. I have low(ish) sodium already – I wonder if I flushed too much sodium out of my system while keeping myself hydrated. Aha, another line of investigation to pursue.

        I enjoy a nice detective project – only wish I had the capacity to keep up with it. Maybe after I get my health fixed… oh, wait.

      8. Gary Ogden

        mand Season: You may need to increase your sodium (and potassium) intake, but it seems unlikely that staying well hydrated would flush sodium out. The Na/K balance is so critical, the kidneys reabsorb all the sodium they need to maintain it. Amazing organ, the kidney. I have increased both my Na and K intakes, so critical are these minerals (along with Mg, Zn, and Cu) to overall and heart health.

      9. mand Season

        @TS – thanks for those links. Interesting. In my case, I didn’t burn at all, despite having very fair skin and rarely using sunblock (I gave it up altogether some years ago), I’ve only burnt twice in my life. I also don’t tan particularly.

        This year I have noticed that as soon as our exceptional summer ended, which it did obediently by the calendar as September began, I am struggling with energy again – not as bad as last year, but much worse than when thoroughly sunned every day. I hoped that taking the max supplement of Vitamin D would prevent this.

        I’ll have to look at your second link a bit more as it brings in a variety of things; I know nothing about nitric oxide, for example. Iron catches my eye; it may be this and not the Vit D that I’m feeling. Though I know the body stores iron for months.

        It’s actually so much easier to observe what works and what doesn’t, eg “sunshine helps” and “enjoyment leaves me feeling better for days” rather than getting into biochemistry. On the other hand, over the years I think I’ve come as far on the “fun helps” path as it can take me.

      10. mand Season

        Thanks Gary – that is reassuring. It was just a theory based on knowing virtually nothing about how it all works. I “chain drink” water from habit rather than from thirst – thinking it’s probably the only thing i’m safe to ingest on this basis! and it would be a hard habit to break.

        I’m lucky that in 44 years of type 1 diabetes, my kidneys have always shown fine on tests.

        I know I have (a tendency to) low sodium, and luckily i like salt and eat as much as i can stand, with everything. Going to move onto the pink kind…

        Potassium is one of the “To be studied” things on my list. I’m going to study magnesium next and so I’ll allocate the “lesson” after that to potassium. I’m adding/changing one thing at a time, and it’s horrifying how slowly my studies go given their importance. Chemistry doesn’t come naturally to me so it’s like working for an A Level from scratch… I’m coaxing my linguist/mathsy brain to take it in – plus the various ways poor health obstructs the process of learning, it’s taking ages. Getting there though.

        I want to get my notes in order and eventually produce some kind of “dummy’s guide” for people who may be brainy and motivated enough, but are hampered by fatigue and/or brain fog… if I make it understandable for me on my low-capacity days, it’ll be easy for any level of idiot(!). and another for those who aren’t brainy or motivated (though I expect that needs to be the Official Line, I think that demographic is the lot who don’t act on information they find anywhere else). Oh, and also for people thoroughly put off nutrition as a subject by growing up diabetic and being force-fed dieticians’ advice throughout their childhoods. Now that’ll be a marketing challenge.

      11. Gary Ogden

        mand Season: Read Dr. Kendrick’s 2013 potassium blog post. This is where I started, although I don’t think I read it until about 2015. I also have a printout of “Potassium” from Alternative Medicine Review Monographs, pp. 344-349. For Mg, this is excellent, from BMJ Open Heart, “Subclinical magnesium deficiency: a principle driver of cardiovascular disease and a public health crisis.”
        DiNicolantonio JJ, et al. Open Heart2018;5:e000668doi:10.1136/openhrt-2017-000668

    2. Angelica

      That’s a wonderful and very loving letter to your children. I don’t disparage it at all.

      I hope you don’t mind if I mention that the concept of “a good diet gives you all you need” is not fully accurate. The food value of food you get while in a normal daily rush isn’t the same as that made at home from ingredients you choose. And the food value of organic food is higher than that grown in poor soil that has been replenished with only chemical fertilizers and no humus from compost.

      Since you’re in the UK, I will say that I agree with Prince Charles on that. I think the question isn’t, “Is organic workable?” it’s “How can we make it workable?” We’re currently throwing up our arms in mock helplessness instead of looking for solutions on that front. Our future generations will feel the brunt of that. I think we have a duty to care about them, even if they’re likely to forget us.

      Food today is different than food in the 1950s when our parents grew up. We need to adjust. A daily multivitamin never hurt anyone. And in some cases, like mine, a vitamin used like a drug, in large doses has saved me from a much lowered quality of life. Of course you must be sure your source is good (not contaminated) and that the vitamin you’re taking isn’t dangerous in such doses. But now we’re into details, and we know what’s in the details! 🙂

      1. TS

        Thank you Angelica. I agree that “a good diet” is not what it used to be. But I trust the body to adapt to a poorer intake.

      2. AhNotepad

        TS, I think if the intake is poor, the body does not adapt, it is unable to function properly and ward off disease. So ensuring adequate intake is a primary responsibility if you want to be disease free.

      3. Gary Ogden

        Angelica: Three cheers. Not only is organic “workable,” it is the only workable solution to feeding the vast hordes of humans while restoring the health of Earth’s ecosystems. As Alan Savory says, mimic nature. Nothing but hubris and ignorance (and money) to think we can improve on Her.

      4. TS

        I wrote “poorer” meaning “less nutritious” not “poor” (implying not very good). Our bodies have had to evolve to cope with variable food intake. Metabolism is flexible within certain limits and our bodies can be clever and deserve some respect I think. People have thrived post holocaust and concentration camps. Some medications, if taken for long enough, can start working in an opposing manner as the body’s reaction to them changes. If the body is short of one thing it might use something else in its stead. We flatter ourselves if we think we know better than our bodies. It is our fear that makes us want to take the upper hand. But I’m not suggesting that we don’t try to look after ourselves. Just that it may not be wise to overdo things.

      5. Andy S

        TS, good point about overdoing. This applies to food, supplements, and medications. An occasional withdrawal period might give the body a chance to catch up and sort things out.
        Seasonal eating is along this line. Five servings of fruits and vegetables every day of the year may be counterproductive. If in doubt take a break.

      6. AhNotepad

        Andy S and TS, five portions a day was a figure plucked out of the air. Where did I read that? “Doctoring Data” by a well known sceptic.

  38. AnnaM

    Sheesh. I do have high blood pressure and the ACE inhibitor stopped working anyway. Now I’m on amlodipine which also has a cancer connections.
    Meanwhile, I’m just reading the latest issue of Life Extension magazine. They are a company I have had a fairly high opinion of. The article on prostate cancer cites all sorts of studies showing that the more dairy you eat the more likely and more deadly your prostate cancer, the full fat dairy produces higher grade aggressive cancers than the low fat dairy. The more meat and red meat, the same, and now eating eggs seems to be the biggie. Strongly associated with prostate cancer. And I note that in these studies, the people in the lower risk category seem to eat very, very little of these foods. Like on eggs, half an egg a week.
    I got so irritated that I called them and asked if they are affiliated with the 7th Day Adventist Church – but of course those who answer the phone don’t know anything. The person suggested I look at the references. Well, this article has 96! But I do see a few that deal with the meat and dairy issue, and there are some names.

    Now, the thing is, if it is good for the heart health, it should be good for the general health and should not promote cancer. Likewise, if it is good for cancer, or diabetes, it should also be good for general and cardiac health.

    I am pretty firmly in the Weston Price camp and it is obvious that humans digestive systems are omnivorous. But I do get scared when I read this stuff. I am always ready to entertain that I might be wrong, but I don’t see logically how this research can be true. It is at odds with the way humans eat. And the dependence upon huge amounts of fruits and vegetables is probably a modern possibility anyway. Although, who knows, humans do appear to be a species that belongs in the tropics.

    I also spend a fair amount of time signing up for online seminars on cancer and other types of healing, and the same agenda is strongly pushed, also with many success stories. I could easily believe that a cancer patient could clean out their system and take a load off of their body’s energy usage by just juicing vegetables and eating very light food. For a time.
    But as a way of life I am not so sure. I listened to such a seminar recently, and I see that the whole (new) keto stuff is filtering down to them, so they put in plugs for not spiking one’s blood glucose too much with carbs – which is largely all that’s left when you are almost vegan. So this lady says to eat small meals all day. We know that isn’t good or if it is, Jason Fung is way up in the wrong tree. Hmm. And also, she says, eat very small portions at one time to avoid the blood sugar spikes. How much? She says 1/3 cup, cooked. So, you’re hungry for breakfast, you’re having oatmeal, and you should eat 1/3 cup! No milk in it! No eggs with it!

    C’mon, who are they kidding? But the barrage is relentless and comes amid much very good advice.
    I’ve actually cut way back on dairy and it seems to be good for me. I’m finding it easier to keep weight down. But that does make it harder to stay low carb. I try to eat low carb but I do eat carbs.

    1. Sasha

      Anna, I think dependence on huge amounts of anything (not just fruits and vegetables) is a modern possibility. It didn’t exist for hunter gatherers and even when agriculture became widespread, food was often scarce. And when it wasn’t, religious edicts put constraints on the amount of food consumed. For example, if one truly follows all the rules within Greek and Russian Orthodoxy, you end up being a vegetarian (or sometimes even vegan) for a large part of the year. But they space them out so you don’t develop nutritional deficiencies.

      You may be interested in a recent Joe Rogan podcast with Dom D’agostino and Layne Norton. They are both PhD’s and seem to know their stuff regarding nutrition. D’agostino is a big keto guy and Norton was challenging some of the claims. And at one point D’agostino himself says that keto in cancer treatment may work but you have to create caloric deficit.

      We are evolutionary adopted to periods of calorie restriction. Calorie dense food is everywhere in the modern world which may partially explain an increase in various cancers.

      1. Martin Back

        I read somewhere that primitive man ate something like 150 different species, but since agriculture became widespread, we only consume about 50 different species.

      2. Sasha

        Even now when you compare gut microbiome of modern hunter gatherers (or even rural Africans) to that of an average person in a developed country, their microbiome is much more varied.

    2. Dr. John H

      Interesting comments. I’m also a firm Weston Price believer, as I’ve seen it do wonders for myself and patients. When things like meat and dairy are demonized, they are always talking about factory farmed products. It seems reasonable that you can make a very good case that meat and dairy from factory farms cause all sorts of problems. If someone does a juice cleanse and there cancer goes away – great! But it is a mistake in my opinion to assume they should continue eating that way forever, which most of the time puts people in worse health.

      1. Dr. John H

        Anna, One other thing – you could try Linus Pauling Therapy which uses oral vitamin C, L-Lysine and some other nutrients to heal your arteries and make them flexible again along with clearing out plaque deposits. This could reduce your BP. Daniel Cobb, DOM in Santa Fe, New Mexico USA has had a lot of success with this. Linus Pauling Therapy is well known, so i’m sure you could find other resources to help too.

    3. Helen

      AnnaM, I have to admit it can be all too easy to be bamboozled and driven to anxiety by many of the ‘don’t eat this food’ reports. Most of us don’t have the time or the background knowledge to read all the references and work out whether or not they are sound. Do read Zoe Harcombe’s blog; she is adept at taking apart these studies and explaining why most of them are scientifically dubious.

      I still eat full fat dairy, but I’ve decided to moderate my intake. My concern is with over-consumption of a food containing insulin-like growth factors (IGF) that promote the development of infant mammals, when I’m already heading towards hyperinsulinaemia. My diet is mostly low carb now, but there’s still a good deal of room for improvement.

    4. chris c

      The question worth asking is “why is this only happening now?”

      As Pete Cleave wrote “it is ludicrous to blame old fashioned foods for modern diseases”

      We ate fats, some of which were saturated, for millennia but they suddenly started causing heart disease in the last half century. We ate meat for millennia but it waits until now to suddenly cause diabetes. Best to look at what actually changed recently, like perhaps meat IS a danger IF you eat it with the bun, and the fries, and the Big Gulp, with a side order of omega 6 oil . . .

      1. Helen

        I quite agree with you, Chris. My family on one side were farmers. My grandparents and other relatives of their generation ate a lot of meat and eggs, small amounts of vegetables, but fruit and dairy were considered weekend treats, apart from the splash of milk in one’s tea. Pastry, desserts, and even bread were not considered everyday foods either. Each main meal was a cooked one (sandwiches were for picnics!) and snacking between times was never even considered.

        I remember the bewilderment of my grandparents when my father was put on the new low fat diet after suffering a heart attack in the 1970s. That heart attack was probably induced by stress and autoimmune illness, but the diet led to central obesity and severe nutrient deficiencies, and the CVD progressed rapidly thereafter.

      2. chris c

        PeteR Cleave, typo not familiarity!

        Yes I think snacking is one of the biggest changes. I eat a small breakfast and spend the rest of the day walking round a nature reserve, metabolising the previous day’s meal(s) until I finally get hungry many hours later.

        I watch other people starting off in the cafe, where all the food is “healthy”, ie. high carb. Then they walk round half the reserve clutching their snacks and “energy drinks”, but still get so hungry/exhausted they have to go back to the cafe before attacking the other half. These people are usually fat, including the kids.

        OK I used to have to snack/carb up back in my “low fat” days or I would literally collapse (reactive hypoglycemia) but for most people it was meals and the occasional treat/sweet. IMO modern diets have killed satiety, and the ability to go more than a couple of hours without eating. Not only insulin but a whole bunch of other hormone systems are switched on chronically from the chronic eating. I suspect the CVD, hypertension, etc. are downstream effects. To a degree so is the chronic eating itself.

        You never see the fit healthy old folks around these parts carrying food and drinks like the middle aged and young ones. We should learn from them while they are still around.

  39. TS

    My 95 year old mother regularly had falls and broke both her hips whilst on long-term blood pressure lowering medication. Then a GP took her off them for many months and during that time she had no falls. Just a month ago she was put back on the pills. Yesterday she fell again.
    n=1, I know, but I think it worth mentioning.

    1. Angelica

      It’s not just n=1, this is an issue under study. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4125318/ The elderly are treated like walking wallets by the current system. Not just scams, although there are plenty of those, but doctors who, under the guise of ‘doing their best” for a patient are stuffing them full of drugs that are unnecessary, and any complaints are totally dismissed.

      Most geriatric care facilities have no thought to the quality of life of their patients. The assume their QoL would be lower elsewhere so they act as if they’re doing you a favor by “dealing with” your relative for you. It really gets them mad when they discover you are willing to care for them yourself.

      My mother in law triggered my protective instinct. She started to have falls and complained of feeling ignored by her doctor. She has a rare disease called Charcot feet, in both feet, and has no feeling in her feet. Some doctor thought it was clever to give her 3 bp meds at once! To a woman who can’t feel her feet on her best day! To make matters worse, neither the Ombudsman, nor the Medical Board, nor HHS (in US) took any notice of my complaints. The shrugging is deafening.

      1. chris c

        By the time my mother got to be 95 her repeat prescriptions ran to three pages. Strangely the only thing she never had was a statin so it could have been worse. Most old folks end up much the same, there’s almost no chance of avoiding bad outcomes and interactions.

  40. Soul

    I’ve continued experimenting on ways to raise nitric oxide levels, and seeing how that effects my health. So far i’m pleased. Currently I’m drinking beet juice which reportedly will raise nitric oxide levels. The juice has made me feel better overall. It has raised my NO levels according to a saliva test I’m using. I’m a little concerned that I’m drinking the equal to 3 to 4 beets a day but it doesn’t appear to effect me negatively, so far. I have not measured my blood pressure levels.

    i tried sun bathing some and then measured my nitric oxide levels. I’ll measure NO levels using a saliva test. I’ve been surprised in that sun bathing for me has not shown up in the saliva test as increasing my NO levels. Probably a better test would be to see if my BP levels drop from sun bathing. I’m thinking of trying that idea in the future out of curiosity.

    1. Gary Ogden

      Sasha: Thanks for the link. The gut micro-biome is the key driver of the immune system and brain function, perhaps an organ on par with the heart and liver in importance for health. Thoroughly under-appreciated, though, by Medicine.

  41. Derek West

    Hi Dr. Kendrick,
    You neglect to make reference to patients with adrenal adenomas that produce many times the normal amount of adosterone.
    In these patients the only way forward, apart from removal of a genuine Conn’s tumour, is to reduce sodium intake and block aldosterone receptors with Spironolactone or Eplerenone.
    It took the medics the best part of thirty years htn before they found I had Conn’s.

    1. Dr. Malcolm Kendrick Post author

      Yes, it is an interesting thing. I read an article recently suggesting that up to 25% of people with raised BP, resistant to most anti-hypertensives have undiagnosed Conn’s. This figure seems high, but I do often have a go with spironolactone if nothing else is working. I do not wish to neglect any subject, especially not one as interesting as Conn’s, but I cannot cover everything in one blog.

      1. Derek West

        Hi Dr Kendrick,
        That’s a good approach, try patients on Spironolactone. It short circuits a much longer process that leads to harms before the problem is eventually found.
        My tumour was discovered as result of a CT scan for something else.
        No doubt in my case it was the cause of Afib, needing a pacemaker, blood glucose issues and LVH.
        Luckily I am still here at nearly 80.
        Many thanks for your blog.
        Derek W.

      2. Angelica

        This is really interesting! Spironolactone is also used in the treatment of PCOS and I’ve been wavering whether or not to take it. I don’t understand enough about what it does to feel confident. The endocrinologist says it should lower testosterone levels in women who have too much (as I do because of PCOS). But that’s all they said. Since I have inflammation issues and T is anti-inflammatory, I have been wavering. This is a new aspect that I haven’t though of. Thanks.

      3. chris c

        I remember my Gran was on Spironolactone. She was also a rep for Spirella corsets and brassieres. I wonder if these things were connected.

        For a while I sported a nice pair of A cups. I suspect my thyroid was to blame: now it’s under control (well mostly) they have gone away again.

  42. Valerie

    Sorry to play the devil’s advocate here, but my experience does not fit at all with your CVD explanation.

    I have had essential, malignant hypertension for 11 years now (I am currently 38 years old). I have tried many things to hopefully improve my condition (low carb, low sodium, vegan, CoQ10, potassium, magnesium, etc.) The only thing that has truly lowered my blood pressure was extended fasting.

    After about three days of fasting, my BP started to drop. It kept dropping until day 18 or so of fasting. Then it stabilised at a low-normal level without medication. Fasting basically cut my BP by half.

    I started eating again on day 22, and my blood pressure increased right away. Three days later, I had to take all my medication again and my BP was higher than before I started.

    Too bad fasting is such a miserable experience. The unrelenting hunger drives me nuts (I am not one of those blessed souls who stop being hungry after a couple days of fasting). Otherwise, I would like to do it again and try to isolate what it is exactly about fasting that helps so much.

    1. Angelica

      It’s been my experience also that fasting works for bp reduction, but in my case it helps for a long time afterward also. Dr. Joel Fuhrman is doing self directed studies of people he puts on fasts for bp reduction. He used to have a website with all the results, but I can’t find it right now. He is the author of “Eat to Live” and is generally hostile to the Keto diet, or LCHF whatever its’ called now. But he does explain fasting in a fairly technical way in his book “Fasting and Eating for Health.” And he comes really close to explaining ketosis there.

      On a personal note, I’m so sorry you’re struggling with bp like this. I wish we had all the answers, but people still don’t fit clinical models, and probably never will. As long as your doctor helps your situation and recognizes you as distinct from an abstract example in a book, you’re probably in good hands.

      1. Valerie

        Thanks Angelica for sharing your experience. Like you, I heard about fasting for BP reduction from vegans. Which is quite ironic, I would say, since fasting is much closer to keto.

        Anyway, at the time I tried fasting, I followed the “protocol” that was published by Dr. Goldhammer (a vegan enthusiast). The protocol called for refeeding on a low salt, low fat, vegan diet. I have a hunch that is a bad idea, and maybe I would have been able to get long-term improvement in my BP if I had refed on keto instead. It’s all speculative, of course, since I have never been able to muster the courage to try extended fasting again.

        If I may ask, did you change anything to your diet after the fast? Maybe the timing of your eating too (my BP seems worse if I eat late at in the day)?

      2. Angelica

        Valerie, yes I probably changed some things. I’ve been fasting off and on since I was in my 20s and I’m in my 40s. Sometimes it’s the only thing that will bring pain levels down enough. Sometimes I can’t get my gut back in balance without it. I finally figured out what the carbohydrates are doing… they’re putting some distance between the fast and the first time the body has to produce a lot of bile.

        The origins of vegan and fasting at least in the modern day, can be traced to Natural Hygeine (a 1930s theory of medicine), but in the 1970s there was a revival of some of those ideas with the popularization of carrot juice as a health food, and into the 80s and 90s with juice bars.

        The most virulent form was the “raw food” movement that said people are being starved of enzymes found in uncooked food. Some Paleos accept that idea also and the more radical forums on Paleo involve people who eat raw meat. Bleh, I say, but they probably feel the same about my food, so, to each their own.

        Many of the older techniques for fasting or ‘cleansing’ or ‘detox’ involve taking actions that would either calm the gallbladder or cause it to release a lot of bile (the olive oil with a drop of lemon trick, the warm castor oil moist heat pack, the separation of protein and carbohydrate foods in ‘food combining’…) Since at that time, removing the gallbladder wasn’t a possibility, people suffered with it a lot.

        Unfortunately, now we’ve gone the other way, the fact we can remove it means no effort is put into preserving it or curing what ails it.

        So my guess is, the reason they tell a person to eat fruit when they get off of a fast, is, they’re unconsciously repeating advice designed for a world in which a bilious attack could lead to disability.

        I’m not an expert on this, but I got interested when my mom went to a raw foodist retreat and I thought it was such a complex theory that I did my best to trace its origins. I was thinking, this can’t be just some scammer coming up with a way to fleece the rich. They were very sincere about it. Since then though, the retreat really did turn into a scam. The true believers are long gone.

  43. Lorna Sewell

    A very helpful Catch 22 overview which stitches bits of information together coherently and constructively for the lay-person. Particularly valued the advice in the conclusion. Thank you.

  44. David Bailey


    You vanished recently for something like two weeks! I suspect that raised a lot of people’s stress hormones, worrying that you might have been finally stopped from telling us the truth!

    If you made a comment in the comments, telling us you would be away for a while, I think that would be of actual therapeutic value

    1. Göran Sjöberg

      David, I think you are making a good point.

      Today one tends to get used to meet friends and get informed regularly on blogs like Malcolm’s. When that habit gets broken for whatever reason worry is natural.

      1. JanB

        Glad I’m not the only one. I everso slightly went into headless chicken mode when deprived of my wonderful daily ‘Kendrick Fix.’
        I really should get out more.

      2. AhNotepad

        It’s not so much deprivation as having time to look at other things. There’s so much to look at. Suzanne Humphries, Barbara O’Neill, Tom Levy (make sure you see his video on Liposomal Science, and the interview with Desiree Rover. Not to mention plenty of others. The FDA have told one maker of injectable ascorbate to cease manufacture and sales of the product. This is possibly to either reduce supply and push the price up, or a precursor to making vitamins prescribable drugs, either way, if you have time because the blog master is on hols for a few days, make a lot of noise so the FDA know they can’t get away with it.

    1. AhNotepad

      Randall, natural substance or not, why would you want to lower cholesterol? Bad cholesterol and good cholesterol are unnecessary and misleading labels. You might as well say the plumber who comes to fix the leaks is the bad guy, and the cleaner who comes in to deal with the water damage is the good guy.

  45. Angelica

    Thank you for another good insight. I never heard of that lung-blood-clot removing technique, wow! I had multiple PE and what they did for me was put me on warfarin for 6 months. Actually it was a big argument because I was upset that they stopped after 6 months. I had had three infarcts, and the largest one hadn’t yet healed. Ever since, I’ve been taking larger doses of Vitamin E than recommended, fish oil and a 325mg pill of aspirin each day. I considered natto and such, but that didn’t last. These three seem to do the trick.

    And also, the vitamin E particularly is helpful to my PCOS, my painful periods have calmed down to tolerably annoying, but to get that effect I have to take 2000 IU Vitamin E for about 3 days of my period. I thought I was imagining it, but I’m not. Within an hour of taking that high dose, the heavy, excruciatingly painful, clotty periods I’ve suffered since puberty are transformed into heavy but ok periods.

    Also, ever since, that infarct area still hurts (12 years now!). They condemned me to a life of chronic pain. That’s the kind of thing I have a strong urge to sue about.

    But, moving on, I can tell if my bp is up. My migraines tell me right away. I found a list of blood pressure meds that also work for migraines, but I’ve lost it now. I’ve never been able to get off of beta blockers no matter how hard I try, because all it takes is to accidentally be glutened (something claims gluten free but isn’t), and it triggers a migraine with the whole cavalcade of nausea, sound and light sensitivity, weird light effects on the corner of my vision.. etc. When I read up on bp meds (also my mother in law had falls due to THREE being prescribed to her!), I got to wondering about the ACE inhibitors also. My instinct said those were not as evil as the rest.

    Do you know of an ACE inhibitor that can be used in migraine prevention? I wonder if I can switch to it safely from the beta blocker. The beta blocker is playing hell with my adrenals. I feel like I”m adrenaline deficient, but I’m not. I feel out of breath, but my blood % is always perfect, hardly ever 97% or below.

    1. Göran Sjöberg

      Angelica, interesting!

      I have heard that it is very difficult to stop the beta-blockers if you have been on them for a while. I have got a close friend who has made the same experience as you trying to get off the hook. So I am happy myself that I rather immediately (after half a year) dropped them after my serious MI 20 years ago and the beta-blocker was dropped together with all the other medications they pushed on me. It was the same feeling of having been turned into a zombie” since the “adrenals” had been turned off, that made me drop the beta-blocker.

      As you I am today on high levels on natural vitamin E (2 400 IU/day) which seems to work well keeping my unstable angina at bay. I am a strong believer of vitamin supplements! Vitamin C and D the base! All kinds of physical exercise seem to be a boost to keep “the blood running”. And of course all stress reducing activities should be encouraged.

      I guess that everyone has to make decisions for himself after having done his proper “homework”. My gut feeling is that most of us CVD-victims would be much better off by also being off all Big Pharma medications and instead treating our condition through nutritious food low in carbohydrates and optimally on a ketogenic diet. Anyway it couldn’t hurt trying to find new ways as you do

      1. AhNotepad

        Not always difficult. I was on beta blockers for a couple of years. Stopped beta blockers and coincedentally changed to low carb diet. No need for beta blockers since I found nothing much happened when I stopped them. PITA having to take pills every day. Now I just take vit C, KCl, Mag L-Theonate, Vit D, B1, B3, E…..Doh!!

      2. shirley3349

        In my personal experience, different beta-blockers have very different effects. I was like a zombie on Atenolol but feel more or less normal on Bisoprolol. I cannot contemplate ever coming off them, as 15 years ago my un-medicated BP was 215/140, with a water-hammer effect inside my skull. It took three months to get it properly under control with various drugs. Now, as my weight continues to come down slowly on a very low carb diet, I may be able to reduce my medication one day, but only very, very gradually.
        I nave never, touch wood, had a heart attack. I may have had very mild angina in the past but it always stopped if I sat down and took a few deep breaths and I have not had it recently. I do have atrial fibrillation and the bisoprolol also keeps the rate down. My pulse is now steady but whether or not I am back in sinus rhythm I cannot tell.
        I often wish I did not have to take so many pills but the alternative seems to be worse. I’m hoping that when I see the cardiologist before Xmas, my rhythm will be well controlled and I can come off anticoagulants, though to be fair, they are problem free to date.

      1. Peggy Sue

        Not sure about an ACE inhibitor for migraines but I know that candesartan (ARB) has definitely been used. No idea of the details but it cropped up when I was looking into dosage a year or so ago.

        Do you follow a low carb diet for the PCOS? My niece is a fellow sufferer and it has definitely helped.

    2. Angelica

      Thank you for the replies, they really help! Yes the pulse rate issue is a problem. I switched to weight training exercise because my pulse refused to go above 100 ever, even during jogging! It was scary. Although I can’t exercise much lately (I’m recovering from a mold issue in my house, which is cleaned up, but there are some lasting effects on me), I can’t ever not exercise. I’m terrified of when I get old enough to not be able to move much. I have the worst leg pains if I don’t exercise daily.

      Interestingly, weight training has helped much more than I expected. My back doesn’t hurt nearly as much, and I call push ups “shoulder fixers” because they tend to make my shoulders crack and stop hurting afterward. Deadlifts took a while because they spike your bp, but once you get used to it, it seems to overall lower bp. I still get a brisk walk, but the pulse limit is too much for running anymore.

      1. Göran Sjöberg

        Interesting again!

        Basically the years take their toll and especially if you have had any MI I guess. So while having been able to still run rather fast on my bike those twenty years ago (I then decided to go by bike to my work (12 km) every day the year around) I am much slower today. Finally I had to walk my bike uphills where my wife had to wait for me.

        So I decided to get an electric bike a few month ago. What a treat! – and I can now go as before and today we are actually taking our bikes for lunch in town.

        Preserving or even healing your health seem to be a constant battle and my guess it is possible to improve if you get all your vitamins and minerals at proper levels and especially avoid any “poisonous” foods like the GMO we are surrounded by.

      2. Gary Ogden

        Angelica: Very interesting! I can still run, but at a slow pace. But it is the (body)weight training that has been a great help for me. Pushups and pull-ups (these really get the pulse up) and squats.

  46. Vaguely

    I’ve only just discovered Dr Kendrick’s site and am glad to have done so.
    I’m 69. I have had high blood pressure (untreated it’s over 160 – treated it’s 130/140) for years with high cholesterol. I developed, probably unrelated, but you never know, a variety of lower body pains, which have been variously interpreted and treated to no avail.
    I gave up the statins which helped alleviate some of the pains. I’ve recently given up Amlodipine, which I’ve only just found can also be a cause of pain.
    I’ve been a vegetarian since my 20s and in the last few years have been (as far as is practical) eating a high fat/low carb veggie diet. This diet has had no beneficial effects on my BP or cholesterol levels. For the last two or three months I’ve turned to a vegan diet; this has reduced my cholesterol levels. I’m not too sure about my blood pressure. I can’t say that my cholesterol levels bother me and I’ve argued with my GP about this. My BP does concern me though. I’m going to get a watch to monitor the daily fluctuations and if the BP is over 160 on average consider getting a different BP medication. I shall ask about Conn’s syndrome.
    Any thoughts on which medication? And any specific watch?

    1. David Bailey

      You should certainly monitor your BP at home, and take the readings with you when you visit your GP (BTW I’m not sure a BP of 130/140 is possible, so I think that was a typo).

      As I know from experience, you can get into a vicious circle – you go to the clinic to have your BP measured, so you are aroused as that is done, so you become more worried, the next time you go…….

      My experience was that a cuff monitor is probably more reliable than one that fits on the wrist- others will probably comment.

      Coincidentally, you are the same age as I am. I feel I have nearly reached three score years and ten, so although I hope to live a lot longer, I’m not going to stuff myself with drugs that might just give me slightly longer! Above all I don’t want to spoil my remaining years with leg pain and other unpleasant symptoms. As you can guess, I came to that conclusion after a very unpleasant brush with statins.

      Now you are free from a lot of your pain, I’d definitely try to exercise if you aren’t already. Cycling is great – providing you can find some car free tracks/paths.

      1. Vaguely

        David: Thanks for your helpful comments. I can’t cycle as I have high hamstring tendinopathy, achilles and other leg problems-none of which respond to the inept treatments that physios and snake oil therapists employ (another forum needed for that..). I doubt that I can blame these pains on statins (although I’d like to). I’m able to walk the dogs though, so not too bad.

      2. Mr Chris

        I had your problems when cycling, and because of them, and what I read on this blog, I gave up statins, and since have never looked back, hardly ever go to the doctor, and the people in the chemist no longer recognise me.
        What more could you want?

    2. Gary Ogden

      Vaguely: Have they checked your mineral status? Very important. For some, such as Cu, plasma levels don’t give the information you need. Read the two link chris c has posted about Cu. Mineral deficiencies are more common than ever due to their reduced levels in foods resulting from modern agricultural practices which resemble soil mining.

      1. chris c

        There was a woman who used to post interesting stuff on minerals, but unfortunately she was rather monomaniac and tended to take over every blog she posted on.

        Lots of things are required in tiny doses, and may be surprisingly toxic in overdose – copper, zinc, magnesium, manganese, selenium, iodine etc.. Without them a lot of enzyme systems collapse.

        Her cure-all for minerals was grains. Er, I don’t think so! Not that long ago, farmers could only dream of wheat yields of 10 tonnes/ha. Now that is commonplace and I think the world record is north of 18 tonnes/ha. Assume in the last half century average yields have doubled: yet the annual plants only have around the same quantity of roots. That means the minerals are diluted into twice as many grains. And as AH Notepad pointed out above, the soil gets depleted from the constant cropping so even less is available.

        On the other hand permanent pastures, including perennial herbs and wildflowers, have root systems that grow larger and especially deeper, and grazing animals concentrate the minerals especially into their livers (yum!) Real Meat may be a better source of many of them. Add some greens and eggs and you might be golden. It might be a plan to supplement occasionally – belt and braces – but probably all the time would be a waste of money (expensive urine as with water-soluble vitamins)

      2. Gary Ogden

        chris c: Right you are. And as we age, we don’t absorb them as well. I figure eating reasonable amounts of a variety of nutrient-dense foods will supply most of my nutrient needs, and don’t take a multi-vitamin. I’m not against them, but I think we can supply most of our needs from food. I do wear both belt and braces (but only on my hikes), build the health of my garden soil, and grow and purchase ingredients of the highest quality to prepare nearly all the food I consume. Nothing from agriculture; either pastured, organic, or garden, most of it local. Tasty it is, too!

    3. Helen

      Although I’m younger than you (mid-fifties) I have moderate hypertension. It rises very rapidly in stressful circumstances – which includes contact with health professionals! it can reach 160/110. I’m not too concerned about it though, since I test at home with a digital monitor that has an arm cuff. The longer I relax, the lower my BP falls, to around 118/65.

      For years, I had improperly treated severe hypothyroidism, which kept my blood pressure low, but the pulse pressure (the difference between the systolic and diastolic readings) was abnormally wide. I was perpetually cycling between tachycardia and bradycardia. Others with hypo end up with abnormally high BP, along with tachycardia. If you haven’t had a thorough thyroid health screen recently, one that includes TSH, FT4, FT3 (the most important), plus TPO and TG antibodies, now might be the time.

      1. Helen

        I would add that poorly controlled hypothyroidism can be the unsuspected cause of muscle and joint pain and stiffness.

      1. chris c

        Obviously not coconut oil or she would be dead (joke). I favour EVOO, and coconut oil, and avoid seed oils like the plague they are, not that you’d get anyone from Harvard admitting to that any time soon. I suppose as a vegetarian rather than vegan you can use butter and cheese (I am currently enjoying Vacherin Mont D’or which is seasonal) and some vegetarians also eat fish.

        Can’t be easy though, Carrie Diulus


        is Type 1 diabetic, keto and vegan, might be worth exploring while I go eat some beef . . .

      2. Gary Ogden

        chris c: I have not yet had a chance to thank you for the two links to copper. Sometimes comments appear in a strange form, with no reply button. Very important information. I did a back-of-the-envelope calculation of my Cu intake, and came up with 1 mg from chocolate alone (32g), and probably that much from nuts. My weekly liver gives about 15 mg. Clinical trials have used up to 6 mg/day for weeks, and that the upper tolerable limit is 10 mg/day, but that the RDA, at 0.9 mg/day, is too low. Cu deficiency is associated with CVD, NAFLD and metabolic syndrome, and that upwards of 60% of the population is Cu deficient because foods don’t have as much as they used to.

    1. Marie - Sweden

      My mother

      Thanks for telling us about this article. It`s the same story here in Sweden. I try to protect my mother. She was prescribed Zocor (=simvastatin) when she had a minor heart attack when she was around 80. After a year or so, she suffered from muscle weakness, aches and cramps in her legs and insomnia. Thanks to the Internet I found critical voices, for instance, http://www.thincs.org, and ordered Uffe Ravnskov`s first book – The Cholesterol Myth. I also translated patient stories from http://www.askapatient.com and after a while she stopped. Her doctor disagreed. She recovered (some don´t) and was without statins for at least 12 yars. This spring she turned 98 and sadly, I discovered that last year she had been put on another statin – atorvastatin (=Lipitor)! I became very angry – not at my mother – but at this doctor and the system. I asked her what the doctor had said. He had told her that she had to take the medication!.

      The same thing with her eye drops – she had to take them.
      Unfortunately, I was not present when the statins were prescribed but had a discussion with the doctor about her eye drops. Didn´t make any difference although I tried my best to tell the doctor that my mother already had a betablocker for her blood pressure and maybe this combination eye drop (betablocker/ prostaglandin) could make her pressure too low (falls)

      I think it`s a good idea to write down what you want and don´t want when it comes to medications but, so far, it has not been possible to get this included in the computerised medical journals here in Sweden. It has just begun.

      I think as many as possible shouid read critical books. I like:
      Doctoring Data (Malcolm Kendrick)
      Selling Sickness (Alan Cassels, Ray Moynihan)
      Seeking Sickness (Alan Cassels, about screening)
      Books by Uffe Ravnskov and Duane Graveline
      Death by Prescription (Terence H. Young)
      The Truth about Statins (Barbara H. Roberts)
      Statins Toxic Side Effects (David Evans)
      The Patient Paradox (Margaret McCartney)
      Too Many Pills (James Le Fanu)
      Books by Gilbert Welch and Nortin M. Hadler for instance Rethinking Aging
      Overdosed America (John Abramson)
      The Truth About The Drug Companies (Marcia Angell)

      Please google the titles and writers and you will find out more.


      1. Mr Chris

        Marie Sweden
        I think you should add “How statin drugs really lower cholesterol and kill you one cell at a time by James and Hannah Yoseph to your list.
        this book is really scary and certainly underlines how Merck are duplicitous

      2. Bill In Oz

        I gather that the elderly in aged care homes in Australia are often put on statins by doctors working at them, as a ‘matter of course’. Theu must be named for what they are “Poison pills.”.

  47. Randall

    The BMJ: leading general medical journal (For GPs, hospital doctors, educators) – Subclinical magnesium deficiency: a principal driver of cardiovascular disease and a public health crisis because of chronic diseases, medications, decreases in food crop magnesium contents… modern societies are at risk for magnesium deficiency magnesium deficiency increases the risk of numerous types of cardiovascular disease https://openheart.bmj.com/content/5/1/e000668

  48. Lance

    Doc, wouldn’t this theory only apply to stenosis of the aorta, not the coronary arteries? Stenosis of the aorta would greatly increase blood pressure at the heart and would cause supply stress to other organs. The higher BP upstream of the aorta may also increase BP and stream power (hydraulic engineering term that implicitly includes pressure, shear stress and turbulence) within the coronary arteries leading to potential damage to their endothelium. But would having only stenosis of the coronary arteries have the same impact on other organs and also have any significant effect of increasing BP within the heart and aorta?

    1. Dr. Malcolm Kendrick Post author

      I am not sure on this. Quite how various organs communicate ‘distress’ is not clear. There are baroreceptors in the neck, the kidney is very sensitive to decreased blood flow. Does the liver have a way of saying ‘more blood flow please?’ Not sure. I do not know if the heart itself can signal to itself to pump harder.

      1. Lance

        Sorry I wasn’t clear with my point. You say in your blog post above that:

        “Looking at this from the other direction, could it be that cardiovascular disease causes high blood pressure. Well, this would still explain why the two things are clearly associated, although the causal pathway may not be a → b. It could well be b → a. I must admit that I like this idea better, because it makes some sense. If we think of cardiovascular disease as the development of atherosclerotic plaques, leading to thickening and narrowing of the arteries then we can see CVD is going to reduce blood flow to vital organs, such as the brain, the kidneys, the liver, the heart itself. These organs would then protest, leading to the heart pumping harder to increase the blood flow and keep the oxygen supply up. The only way to increase blood flow through a narrower pipe, is to increase the pressure. Which is what then happens.”

        My point is that stenosis of the cardiac arteries would not cause elevated BP because the stenosis would not obstruct the ejection fraction from the left ventricle. Only stenosis of the aorta would cause the obstruction. Do you think this is a fair consideration or are there other factors related to stenosis of cardiac arteries that can lead to higher BP?

    2. Martin Back

      Interesting point. But if the aorta was stenosed leading to increased blood flow in the coronary arteries, their endothelium would soon become damaged and they in turn would become stenosed, thus balancing out the blood flow. Maybe.

    1. chris c

      Try giving up wheat and see what happens?

      In retrospect my symptoms going back to early childhood just happened to be symptoms of diabetes and conditions that are “common in diabetics” but were mostly written off as “psychosomatic”. Strangely going low carb and nailing my blood glucose and insulin caused most of them to improve or reverse completely, and cutting out wheat and omega 6 seed oils did for the rest.

      Of course that only “proves” that I made the symptoms up and have now stopped “pretending to be ill for sympathy”.

      Likewise my father was a textbook case of hypothyroid – entirely unsurprising as he was hypERthyroid when young and the treatment was to remove most of the gland. Yet he was diagnosed with “treatment-resistant depression” because not unsurprisingly antidepressants failed to work. And as for the colleagues who were similarly diagnosed with psychosomatic disease or hypochondria, and by the time the cancer or heart disease was actually identified it was too late . . . makes me want to shout WAKE UP AT THE BACK THERE!

  49. Stu

    Great Piece of writing….as somebody who has suffered in the past from episodes of malignant hypertension, I’ve followed this series from article 1, waiting for this one.

    In the article, you say that you don’t treat hypertension until way above current guidelines….what values do you use for guidance? I’ve never trusted any of the docs who aim for 120/80.

    Many Thanks

  50. Soul

    Not much to add other than to mention I’m feeling pretty darn good, with my out of convention NO raising methods. I can get used to feeling better.

    In neighborhood American medical news learned a 92 year old neighbor has been told it is vitally important that he have a heart valve changed. An operation date has been set. 92 year old is excited, oddly to me, and talking about mid-life crisis and buying an Alfa Romeo afterwards. Being a bit cynical it has me thinking his cardiologist is thinking similar with it being vitally important that he have a new Alpha Romeo also. Hoping I’m wrong and the operation goes well for the old guy.

    And was stopped this morning on my walk by a cardiologist wife. She told me I looked as if I had been adopted by a trash man. Hahahahah, she added, Chinese joke. I’m not sure what this joke means. I decided to not ask for clarification. My guess, her husband is a cardiologist that tells others that exercise, such as walking, does not help the heart. I was a bit tired from the walk by that point maybe looking a bit trashy? Don’t know. This one has me stumped.

    1. David Bailey

      I really feel doctors should devise some sort of policy about tailing off treatment for all kinds of disease as people reach old age. I know it is difficult, because I know a man who has had 2 (different) cancers operated on in his 70’s, and is still going strong doing rock climbing and other forms of exercise. However, maybe if at least elderly patients were always given a reasonable chance to back out of ‘heroic’ medical efforts to extend their life, it would help them AND save the health service a lot of money..

      1. Soul

        I agree. It would be ideal if such a system were created. It is not likely to happen in America but one can dream as I believe it could save money but also less suffering in some instances.

        What I wish would happen is for more effective treatments to be used, in cardiology as this blog focuses on, with cancer, etc.

        I can think of another neighbor as an example of this. The neighbor is in his later 60s. He had a heart attack a year ago. Everyone lately has been talking about him as his health appears to be becoming worse. He appears to labor while walking. He attended a neighborhood party last week and was in bad shape. I can’t say what his problem is entirely but as a key board doctor will guess. I don’t know his mediations except for one. The one medication I’m familiar with is a PPI. He has been taking the PPI for over a decade. As doctor Kendrick has written about PPI’s have been found to raise the risk of a heart attack since they lower NO levels. So my guess is no one has told him taking the PPI is risk for his heart. (I passed the information onto others about the PPI to give to him but doubt it was passed on.) I’m predicting this neighbor will be on the typical American revolving hospital door, in and out for various expensive treatments. Sadly with his stressful job it would not surprise me if he wasn’t with us much longer.

  51. Steve R

    Bloody hell, Malcolm! Love the post, but you don’t half have a knack of making me feel like I’ve completely wasted the last 25 years of my life as a peddler of statins and calcium channel blockers.

      1. Bill In Oz

        Ummmmm ? Malcolm, I thought we in this blessed company were being guided by skeptical science, common sense and clear thinking, rather than authority figures such as in a church…But all ‘converts’ are certainly very welcome.. 🙂

      2. Gary Ogden

        Bill in Oz: I’m going to speculate that he means “church” in the broadest sense. I wouldn’t be caught dead in a religious church, but, as Dr. Kendrick says, church-goers have a lower rate of CVD, so the woods is my church, and I attend weekly, just like religious folks theirs.

      3. Steve R

        I believe, brother. Hallelujah, I BELIEVE!! The problem is presenting the creed of the holy skeptic church to a general public who, after years of deception by Big Pharma, regard us as the lunatic fringe. I was heartened to see a feature in the G2 supplement of the Guardian newspaper last week which addressed the diet/cholesterol/CHD argument – until I read it! It was a horribly biased piece which came down heavily on the side of ‘conventional wisdom’. It rubbished Uffe Ravnskov, and had far too many quotes from Rory Collins for my liking! It did raise one or two interesting points, such as why are drug companies not obliged to publish all their study results. Still, at least the debate is becoming increasingly mainstream.

        I’m not entirely sure it’s quite the right time to question Joe Public’s use of anti-hypertensives, however. Might push his blood pressure up.

      4. Bill In Oz

        Yes gary, time is the ‘bush’ is how we put it here…For some reason we have no ‘woods’ but lots of bush..Always good. 🙂

      5. Bill In Oz

        Steve R. I think you need to face the simple fact that the Guardian, like most other mainstream media outlets, does not have the capacity to be skeptical and to think clearly about ‘science’. It is rare that i read the Guardian and mostly I do so only to find out what the naively un-skeptical are thinking..

    1. David Bailey

      Steve R,

      It is great to hear you have changed your mind about these drugs!

      While prescribing statins, I wonder how aware you were of these drugs’ side effects, or did you dismiss them using concept that these effects are nocebo effects generated by people’s mistrust of statins!

      Did you ever consider the question of the NNT of statins?

      1. Steve R

        Hi David,
        Thank you for your delight at my enlightenment. It’s a shame it came so late in my career!
        I have to say that (and I realise this may not be popular) my experience as a prescriber of statins was that they were reasonably well tolerated. Certainly some people experienced muscle pain and a small number could not tolerate them. I had no experience of anything serious, but then again I was not around long enough to encounter any of the potential long-term side -effects.
        I love the NNT statistic. I find it really easy to understand, much more so than absolute and relative risk, and it underpins all evidence-based medicine. Unfortunately, I don’t remember it being mentioned once when I was being sold statins.The whole thing was presented with a smokescreen of risk and risk reduction. It was when I was told every man over the age of 63 should be on a statin that I realised I was being sold a pup!

      2. AhNotepad

        Steve R, Thanks for the information in your post. As a non-medical I have noticed that almost all the people I talk to, who are on statins, don’t report any adverse effects. I still bang the drum and suggest they read Malcolm’s book, as not taking medicine when not needed must always be better than taking it. To suggest every man over 63 should be taking statins smacks of “at that age any adverse effects can easily be blamed on something else, so we’re off the hook”.

      3. David Bailey

        Steve R,

        After my rather unpleasant brush with statins – see https://drmalcolmkendrick.org/2014/10/11/silence-was-the-stern-reply-2/

        I used to chat to people of about my age that I met on walks about my experience, and I collected an amazing number of negative responses. I had even been warned by a friend that my problems might be caused by statins, but I ignored her because she wasn’t a doctor!

        Those ‘muscle pains’ included intense cramps in my case.

        I wonder if doctors get feedback if a patient stops using his prescriptions, because I got the impression most of them just gave up in disgust, (and a few reported no side effects). I think some people are embarrassed to tell their doctor they are stopping statins.

      4. Dr. John H

        I think there are a couple of reasons why it would appear that statins are “reasonably well tolerated”. One, is that patients tend to know that doctors don’t want to hear about side effects, so they keep quiet. The other is that adverse effects of statins mimic old age, so both patients and doctors are fooled into thinking the patient is just getting old (which of course requires more drugs). A while ago I read an article from the Weston A. Price Foundation (great resource, by the way) about a doctor who took over at a large nursing home and didn’t believe in statins, so he took everyone off of them. The result was astounding, there was a great awakening – residents started recognizing their children when they couldn’t before. People threw their canes away, and more.

        The “Statin Nation” movie (which Malcolm is in) has some interviews with people getting sick on statins, which is quite good and worth watching. I tell everyone who is still in the dark about statins to watch “Statin Nation”.

      5. LA_Bob

        Steve R,

        Thanks for your perspectives. It’s always useful to hear from a “recent convert” what made them change their minds.

      6. David Bailey

        Clearly there is an interesting discrepancy here regarding how frequently statins cause muscle pains. I have read suggestions that:

        1) Simvastatin may be the worst for doing this.

        2) People who take exercise are more at risk of statin side effects.

        Certainly most of the people I encountered were at least hill walkers or cyclists – as I am myself.

      7. David Bailey

        Dr. John H,

        Do you have a link to the article from the Weston A. Price Foundation, that described the effects of withdrawing statins from people in a nursing home.

        I dare say a lot of doctors read this blog, and some might try the same experiment.

      8. Dr. John H

        I found the article: https://www.westonaprice.org/health-topics/health-issues/a-dietitians-experience-in-the-nursing-home-part-2/

        “I once worked at a facility that employed a new physician who had studied medicine outside of the pharmaceutical model. He did not believe in the use of statin drugs, and they were discontinued on eighty-two residents. We observed residents “waking up,” recognizing family members, no longer requiring assistance with meals, and walking for the first time in many years. The transformation in these residents was stunning. The facility staff was startled.”

  52. Göran Sjöberg

    Yesterday on my bike to town I happened to pass my old (82 years) friends house but was stopped in my track by him hollering from his porch and to invite me to a cup of coffee. It was so nice to find him so alert despite all the health problems and medications he had endured during most parts of his life. This certainly brings hope.

    Ten years ago I had him get off his statins – I actually “stole” his bottle. Before that he had attended several of my public lectures on the cholesterol issue so he was not ignorant of the risks involved. However, the pressure mounted from his GP’s (who he had always trusted) and his family actually forbid him to talk with me about his medications. So he went back into the statin trap and his health obviously deteriorated with severe balance, muscle pains and short time memory problems in front of my sad eyes. Talking medication was though a taboo subject when we met.

    But suddenly I noted a strong general improvement of his health and finally he told me that he had met a new GP who told him that after 70 statins are of no use and that you should instead guard your cholesterol. For obvious reasons he still feels a little bit ashamed about this subject when we meet.

    BTW, he joined me to town on his own standard bike and was running faster than me so I had to turn on my electric motor and then he didn’t have a chance 🙂

    1. mand Season

      He needs to have a local journalist do a piece about him. Do you know any local journalists? 😉 How are “the masses” (who trust their doctors – who have been trustworthy and always mean well) – to know the truth about statins?

  53. JDPatten

    A fascinating article on how lowering blood pressure reduces dementia risk . . . maybe.
    But there’s important stuff in the comments, particularly Dr J David Spence’s.
    Blood pressure is not necessarily . . . uh . . . blood pressure. It’s complicated.
    (Everybody here should get access to medscape. It’s easy to sign up. Some items are on the money; some not. You should know where the Establishment stands in any case, and fire comments at them when appropriate.)

    1. Andy S

      JDPatten, re. blood pressure and dementia.

      Blood pressure is affected by clogged arteries which are affected by high triglycerides. Easier to control TG than BP. I will pass on the BP medications.

      Conclusions Increased levels of triglycerides at midlife predict brain Aβ and tau pathology 20 years later in cognitively healthy individuals. Certain lipoprotein subfractions may also be risk factors for Aβ pathology. These findings further support an involvement of lipids in the very early stages of AD development.

      1. Gary Ogden

        Andy S: My triglycerides have been in the mid-40’s when I’ve had them checked. Does that mean I won’t be losing my mind any time soon (some might suggest I already have!)?

      2. Andy S

        Gary, re losing mind with high TG.
        Some elderly appear to lose their minds by being outspoken, challenging authority, or adopting cult diets. This is a different subset from those that loose grey/white matter from high TG.

      3. chris c

        Well I’m doomed then, I spent most of my life with ridiculously high trigs (and ridiculously low HDL). A previous GP remarked upon my “weird lipids” without putting two and two together, of course he prescribed statins.

        I hope the last 14 years with trigs 1/10 of what they were and double the HDL might help but I’m not holding my breath.

        Of course I wonder if the high trigs are actually causal or just an indicator of IR/hyperinsulinemia.

  54. David Bailey

    This is slightly off-topic, but very relevant to the issue of poor medical science.

    The excellent book covers a whole variety of ways in which medical science (particularly academic) can fail.

    There is a particularly detailed account of the cell-lines scandal in which many cell-lines that are used in research, are actually contaminated with faster growing cells, which replace the desired cells completely in a few generations!

    I found this book on a blog related to problems in high energy physics. The blog author (and physicist), Sabine Hossenfelder, introduced this book because it illustrates that science can go off the rails in all areas!

  55. Bill In Oz

    Meanwhile ( again ) there is a very interesting article in the Journal of Applied Physiology as regards the potential for MitoQ supplement fo reversing hardening of the arteries in the elderly.

    Here is a paragraph : “We show that 4 wk of treatment with the mitochondria-specific antioxidant MitoQ in mice completely reverses the age-associated elevation in aortic stiffness, assessed as aortic pulse-wave velocity. The destiffening effects of MitoQ treatment may be at least partially mediated by attenuation of age-related aortic elastin degradation. Our results suggest that mitochondria-targeted therapeutic strategies may hold promise for decreasing arterial stiffening with aging in humans, possibly decreasing the risk of many chronic age-related clinical disorders.”

    Given that mice are mammals, like we humans, with very similar physiological processes in our bodies, I think this would be a useful idea. MitoQ is an over the counter supplement readily available from such places as Iherb. In fact it was recommended to me back in 2013, as an anti-aging supplement..This research tells us why.

    1. Bill In Oz

      And of course hardening of the arteries leads to higher blood pressure, which is the topic of this post by you Malcolm.

      1. Gary Ogden

        Bill in Oz: Thanks for that link. Is MitoQ available as a supplement? We are not mice, of course, but I can see no reason it wouldn’t have a similar effect in humans.

    2. JDPatten

      I tried MitoQ a few years ago, took it for a month, but it hurt my wallet so much at two American dollars a day that I didn’t keep with it. (U.S. iherb doesn’t carry it. Yeah, in OZ? You take it??)

      It seems a good idea, but how can one discern if one is getting the full mousey benefit? I didn’t notice any difference after a month. Maybe it’s not noticeable?

      1. Bill In Oz

        JDP, that’s very odd. I took it for about 2 years 2013-2014. I did not get it from IHerb. I got it from a pharmacy in Melbourne at the recommendation of the anti-aging specialist I was then seeing in Melbourne. And it was roughly A$40.00 a container of 50 tablets…Perhaps a low dose though ?

    3. Martin Back

      I was initially sceptical about these results, figuring that for such a small creature the pulse-wave velocity would be difficult to measure accurately and the differences in velocity would be small.

      It turns out that there is quite a literature on measuring PWV in mice using ultrasound or magnetic resonance, and it varies quite a bit.

      The calculated PWV in mice ranged from 220 to 850 cm/s with vasodilating anesthetics producing the low values and vasoconstricting agents producing the higher values. Thus PWV can be determined noninvasively in mice, is similar to that in other mammals, and responds as expected to vasoactive agents.Noninvasive determination of pulse-wave velocity in mice

      (The suspicious me wonders whether they are measuring a temporary vasodilating effect or a permanent age-related stiffening reversal due to MitoQ. How would you distinguish between the two using PWV? Surely you need to autopsy the aortas?)

    4. Göran Sjöberg

      Well, CoQ10 seems strongly related to the MitoQ or rather vice versa but can of course not be patented. The CoQ10 is also an “expensive” supplement but I guess at a much lower price level if I am not wrong.

      Anyway CoQ10 is in my daily supplement box for me to be “on the safe side”.

    5. LA_Bob

      Hi, Bill

      I found this study. It focuses on the effect of mitochondrial anti-oxidants on kidneys rather than arteries, but the broader point of the paper is “proceed with caution”.

      “…since MitoQ accumulates into mitochondria at very high concentrations, the possibility remains that it could have effects on mitochondrial function other than on ROS levels, not all of which might be beneficial. For example, a recent study has reported that MitoQ can actually increase ROS production in some cancer cells…”

      Heck, maybe increasing ROS production in cancer cells is a good thing, but still…

      “Whilst it seems clear that experimentally all of these agents can lower ROS levels in mitochondria and prevent oxidative stress, rather less attention has been paid to potential off‐target effects, which might be unique to each compound.”

      Remind anyone of statins? The wonderful drugs to lower your cholesterol? Oh, they have side effects? Hmmmmmm…

      I don’t think I would take MitoQ at this point. Not enough known about the overall effects.

    1. Gary Ogden

      Eric: Thank you for that link. The Guardian is still capable of good journalism. Now, if they would only do vaccines, statins, dietary advice, the massive spying on everyone, and about a hundred other things! What this piece shows is the iron grip industry has on the practice of medicine. Disgusting.

    2. Göran Sjöberg

      Eric, thank you for this link!

      This article is really a great one an and of a kind we want to see more of.

      Dr. Mercola often touches down on this opioid epidemic being “pushed under the carpet”.

      What a disgusting medical world/society we are living in!

      “Keep away at all cost!” seems to be a good attitude in order to “survive”.

      BTW My brother was given this type of very strong pain killer after having had kidney surgery. Having turned suspicious at that time (my influence I guess) he asked what they were offering him and when they told him the pills were “just in case” he refused since he didn’t have any pain.

  56. Antonetta R.

    Just thank you for another enlightening column. After 19 years of lowest dose statin use and nevertheless developing a 90% blocked artery when on it, i took it upon myself to unsubscribe myself. My bp is fine when not stressed or around white coats, so i always refuse when doctors offer medication upon measuring and instead present an excel sheet of the values i measure at home and discussion is closed. It helps that I am not a docile woman. So presently, i ( 66 and overweight by about 13 kg) am feeling very fine without any prescription medication. Did have an echo of heart and no LVH or RVH. Nothing wrong with the heart. So clearly, although overweight, my heart is not suffering damage from it. It helps that I don’t like sweets so my carb intake was sooner fruit and veg and bread. Have now started on the low carb, high fat diet about ten days ago. Amazing how good one feels without much carbs and how less hungry one is.
    So here is a toast (I do continue my glass of wine) to you Dr. Kendrick. Bless the inquisitive and non-confined minds!!

    1. JDPatten

      I thought that if I stayed away from white coats, that I would be fine also. Consider, though, that there are all sorts of other daily circumstances that you might react the same way to. Consider also that ventricular hypertrophy is not the only possible result of hypertension. The left atrium can become dilated such that it becomes susceptible to atrial fibrillation. That’s me. I was 68. That’s not everyone. But who knows what you might be susceptible to. BP is a complex thing.
      Just sayin’.

  57. smartersig

    Increase NO producing foods the obvious being Beets but the kick ass NO producing food by all accounts is Rocket (Aragula)

    1. Frederica Huxley

      Hmmm, I wonder if I could supercharge my beet kvass by fermenting it with a handful of rocket? If not, we always have rocket in our daily salad!

  58. BobM

    Here’s an interesting presentation by Ivor Cummins:


    He discusses a study with the glycocalyx and what happens when it is subjected to high blood sugar. Basically, the glycocalyx is decimated.

    The main thrust of the presentation is about LDL-p, the current darling of cardiologist and considered to be EVIL if it’s “high”, but this paper segues into Dr. Kendrick’s theories, too.

    1. Göran Sjöberg


      What a great link.

      Ivor Cumming is a long time favorite of mine. And his great talk (with an engineers approach to my taste) at the Low Carb 2018 conference in Huston was accompanied by the talk of my absolute favorite Gary Taubes who set me of on my “sceptic” journey.

      Makes me fell optimistic in a pessimistic world!

      Perhaps I will try to join in on the next Low Carb conference.

      1. BobM

        I saw Ivor speak at Ketofest in Connecticut two years ago (couldn’t make this year’s), and thought he was great. Like him, I’m an engineer, so he and I tend to think alike. (Which I’m not sure is good or bad ;-).

        I’d have loved to see Taubes. I think he’s great.

  59. Charles Gale

    CoQ10 thread continued…

    …yep, it is expensive and like Goran it’s in my supplement box too – an essential one for me.

    Here’s a link to the CoQ10 website and the manufacturers with whom they are in partnership: PharmaNord and Kaneka:


    It’s worth a few minutes to click on the “go to company” links where there are buyers guides, buyer’s guide Q and As and in the case of Kaneka plenty of brand recommendations using Kaneka.

    I’m not sure it’s the type of supplement/substance where you might expect to feel different (not in my case) but I know that some commenters here have mentioned, for example, increased energy.

  60. Soul

    I’ve been reading of late about hair growth. I’ve unfortunately inherited my father’s side of the family for thinning hair. Of late I’ve been doing my best to learn how to keep what remaining I have on top.

    Something I’ve run across in my reading is that many blood pressure medications lead to hair loss. That came as a surprise to learn since Minoxidil helps some with maintaining hair and lowers blood pressure. Apparently other BP medications are not helpful and can be harmful with hair growth. Couple that with BP medications not being helpful with preventing cardiac events for most, possibly causing some cancers, it sounded like a raw cruel deal.

    1. Göran Sjöberg

      Soul, don’t apologize but be proud of your male status instead. My own experience is that women are fully ware of the “hormonal base” behind this problem and I have myself, when I lost most of my turf in my early twentieth , never encountered any problems in connections with the opposite sex.

      My advice is to cut i very short instead of fighting against your “nature”.

      1. Soul

        Thanks Goran for the advice. I like that. Like you, I am able to have my hair cut short and it looks nice. The advice I receive from others is split. Some tell me to cut or shave it short. Others advise to have a hair transplant done, the Elton John look I suppose. If I go that route, spend the big money, I want to be healthy which may or may not ever happen.

        Of late I have been able to stop my hair from thinning further it appears. I’m different from others due to having a stomach condition that did not respond to medications. With it I need to work on my diet, figuring out food(s) that cause me problems. The current diet I’m on has me loosing very little hair. At least the shower drain is no longer showing hair in it.

      2. JDPatten

        Göran, Göran, Göran. You call “it” a problem, then you call attention to it by cutting it short.
        My wife is my barber. Whatever pleases her pleases me. 🙂

      3. Gary Ogden

        JDPatten: About three years ago I fired my barber and quit shaving because it hurts like the dickens. I can play Santa Claus any day of the year, yet I’m as bald as Göran on top.

      4. JanB

        Gentlemen, gentlemen, gentlemen – your balding pates are your testosterone badges of honour. Wear them with pride.

      5. JDPatten

        In exchange for my quarterly trim (Sides & back, well polished on top.) my wife asks that I keep my “Santa Claus” neatly trimmed. So I do. Fair’s fair.
        I left behind shaving after the Navy: Had done it twice a day – against the grain. That was 1970.

    2. chris c

      Theoretically since both sides of my family have early male pattern baldness, this should by now have happened to me. When my cousin visits and we go out for a meal I introduce him by saying

      “He got all the brains but I got all the hair!”

      I go through something of a seasonal shed in late winter/early spring but so far it mostly grows back again, at 65 I am just starting to thin a bit on top.

      When I was young women were supposed to like long hair on guys but this has evidently changed a lot in the meantime. Low testosterone means I don’t have to waste money on hats and scarves.

  61. jane

    It’s interesting that you write of a ‘battle’ between kidneys and heart in the in the treatment of hypertension. As I understand it, the function of the kidney collecting tubules is to collect urine produced in the kidney parenchyma and funnel it to the renal pelvis. Since one cause of hypertension is water retention I suppose it follows that there is a link. Couldn’t the problem of high blood pressure be a kidney malfunction rather than anything to do with the heart’s performance ?
    Whilst you write that high blood pressure can cause atherosclerosis, a study on elderly Masai found that whilst they experienced just as much atherosclerosis as in the US, they experienced no corresponding heart disease.

  62. Randall

    A new study on vit D and fish oil. After more than five years, researchers were unable to find any overall benefit. BUT – A secondary analysis showed taking fish oil lowered the risk of heart attack by about 28 percent, which is a “statistically significant” finding, says Dr. JoAnn Manson. Again small doses and bad math tried to win the day. Please read the comments here to see what’s wrong with most supplement studies and this one. https://www.reddit.com/r/Supplements/comments/9vxsgn/vitamin_d_and_fish_oil_supplements_disappoint_in/ Study – https://www.npr.org/sections/health-shots/2018/11/10/666545527/vitamin-d-and-fish-oil-supplements-disappoint-in-long-awaited-study-results?utm_source=twitter.com&utm_medium=social&utm_campaign=npr&utm_term=nprnews&utm_content=2039

    1. AhNotepad

      Randall, that 28% is a very high figure, so it must be a relatuive risk. Relative risk figures are misleading without the absolute risk figure to put them into perspective. I think we should found a new society, TARRS, (The Anti Relative Risk Society).

    2. Bill In Oz

      Randal I saw that study ( It got publicised here in Oz on the ABC’s Health Report with Scottish doctor Norman Swann)..
      The people in this study were on 2000 IU of Vitamin D3 and 1000 mlg of fish oil per day….
      Yawn, yawn mate !
      I take 20,000 IU of Vitamin D3 each day and at times it’s been more And 3000 mlg of fish oil…
      Funny how these studies almost always are using low doses and then reporting that it doesn’t work…

      1. Gary Ogden

        Bill in Oz: Vital Choice Wild Seafoods (where I get mine) has a good analysis of these fish oil “studies.” There can be no question that dietary EPA and DHA are crucial for health. I simply eat a small amount of fish each day, and forego fish oil. Vitamin D in winter, though I haven’t started yet.

      2. chris c

        Plus my suspicion with the anti-fish-oil studies is that it probably doesn’t work if you are eating the massive overdose of omega 6 that most people do. Drop the “heart healthy vegetable oils” and probably whole fish will suffice. I shall devour a herring shortly.

  63. Charles Gale

    Another non BP thread…

    …I’ve just visited Dr Levy’s website (the “vitamin C guy”) and found 2 new vitamin C interviews dated 23 July 2018 and 14 August 2018. Here are the links:




    A few takeaways…

    1st interview has a recap/update since the 2006 interview on the importance of vitamin C to the arterial wall and heart disease. Also, it stresses it is important to get vitamin C into the cells and not just high plasma levels.

    2nd interview has the following Q and A:

    Dr Passwater: What about your personal vitamin C program?
    Dr Levy: I usually take two packets of Livon liposome C and a large teaspoon of a vitamin C powder called Cardio-C (Vitamin C Foundation) that also contains lysine and proline for a good anti-atherosclerotic effect on a daily basis.

    Both Dr Levy and Dr Suzanne Humphries recommend liposome C but it is expensive. I’ve started taking it but it works out (in England) about £1.00 a sachet or £1.00 a gram. Not for mega dosing but it’s now part of my multi C protocol (in moderation!)

    So, doctors Levy, Humphries and Rath (and also here) in accordance concerning the role of vitamin C and arterial health.

    1. AhNotepad

      Charles Gale, thanks for the links. I buy the Live-On liposomal C, 12 boxes at a time, that saves a lot of money, but it is expensive. I reason that depending on circumstances, if I can avoid having to be off work for a day, then it is worth high doses if needed. Even a box full at £30 is worth it, and the bonus is not feeling I’ll. Powder will do it, but the dosing is not so convenient when out and about.

    2. Göran Sjöberg


      With my present Linus Pauling’s dosage of 15 g/day I am using pure ascorbic acid dissolved in water and sipped during the day. Buying it bulk by the kg that ends up at 5 Swedish krona or roughly about half a £ per day which I think is manageable.

      Today I had a 7 km walk with my wife in our nearby, rather hilly forest and didn’t experience any signs of angina. Before entering on my vitamin supplement “protocol” (C and E are here being the main pillars) about five years ago I struggled with unstable angina and typically couldn’t make more than a few hundred meters before having to stop in my track to recovery from angina

      So, I am as much a believer in vitamin supplements as I am a disbeliever in what the NHS is “offering me” for my severe CVD.

    3. Dr. John H

      It appears that Linus Pauling and Mathias Rath figured out 25 years ago that heart disease is chronic scurvy – a deficiency of vitamin C. Tens of thousands of people have reversed their heart disease with Pauling Therapy with a very high success rate.

      1. Dr. John H

        From a Pauling perspective, chronic scurvy is the root cause. Anything that causes inflammation in the arteries is also a contributor, and high blood sugar is a big one. Medical researchers won’t look at the chronic scurvy though, but will finger diabetes for the simple reason that treating diabetes = big profit, and treating chronic scurvy = no profit.

      2. AhNotepad

        Dr John H, it seems according to Tom Levy that root canal fillings have a major association with heart disease, and may be more significant than other single causes. I accept I could be wrong in this, but I also accept (or maybe it’s just a belief) that sugar = negative and ascorbate = positive influences on the outcome. You are right in saying that treating scurvy is low profit. If however, the NHS would use such low cost, safe, and effective treatment, their money worries would go away, and fewer people would be sick.

      3. Andy S

        Dr. John H,
        Another way to look at the problem. High levels of C may not be required if hyperglycaemia is controlled. Solution is to reduce carb intake, increase fat intake and provide adequate protein.
        Result would be low insulin, high glucagon, reduced mTOR stimulation, induce autophagy and make stored fat available for energy production via mitochondria.

        To test this hypothesis I am on day six of a mostly meat diet. Dropped weight by 7 lb, blood pressure lower, hunger disappeared, more energy. Two meals per day is about right. Keeping a food diary and BP score to see what correlates.

    1. Göran Sjöberg

      For “whatever reason” MSM is touting this widely 🙂 .

      It was “head line news” today in Sweden and I guess it is also “world wide” news. Someone else has noted the same?

      1. Göran Sjöberg

        I should add that I am on 10 000 IU/day of this “dangerous” drug! And 2 400IU on natural vitamin E – a “true” killer! 🙂

    1. Dr. John H

      I took a look at the study. Yikes! What a mess! Here is the source of the food that they used:

      It’s a bunch of junk food and the “fats” are mostly industrially processed seed oils. A better title for the article would be:

      “Industrially processed seed oils make mice fat”

      Do they make people fat? Who knows! But, I won’t be lining up to volunteer.

  64. Bill In Oz

    High BO and dementia may be connected according to a study just published in the UK. Strong pulses of blood are thought to damage the micro arteries in the brain of older folk thus setting for later loss of brain power = dementia

    My ( unresearched ) thoughts on this : maintaining the flexibility of the micro arteries is important just as it is for the coronary arteries..So Chondroitin sulfate seems to be the go – yet again !

  65. HenryL

    A little late to the party here, but just to express appreciation for a return to the subject of Blood Pressure, in an enjoyable and calmly balanced, pleasantly rounded, blog post! Gave a nice sane- sounding regrounding perspective. I felt BP was looking slightly messy (just my internal state no doubt) after branding as a surrogate end point in one neck of the woods, consideration of its potential role as a factor in mechanical damage to arteries in other places etc. Hopefully to become a mini-series.

    On another note, I just happened to hear the (UK) BBC Radio 4 ‘Analysis’ program “The Replication Crisis” this evening (12th Nov) which had a couple of bursts of John Ioannidis on the state of medical research. It was primarily focused on psychology research but/and I think many followers of this blog will probably enjoy it… A couple of rather wince-inducing moments towards the end (if I heard them right over the clatter of washing up) where sCiEnTiSts declaimed that of course there may be a couple of rotten apples in the barrel but that the overwhelming majority of scientists are ABSOLUTELY NOT doing anything deliberately or even subconsciously that might tend to make the results of their research look more exciting than they really are. Now how would they know that with such certainty?

  66. Jimmy Christian

    I can’t help thinking that the barrage of drugs offered up by cardiologists designed to reduce risk factors (hypertension, “cholesterol” etc.) in combinations, along with others that are constantly being pushed (diabetes drugs, antidepressants etc.) contribute en masse not only to CVD but a whole host of other maladies. There is a wealth of data comparing drug drug interactions with two drugs, but the moment three or four enter the mix, then that data becomes more sparse (and importantly, the effects become very hard to test in randomized controlled trials). In particular, there are many drugs whose effects are magnified or reduced by dietary components — the grapefruit juice 3A4 inhibition issue being a more famous one. Imagine the number of foods one is not permitted to eat for fear that they will interfere with one’s daily polypharmacy!

    Instead, doctors should be concerned about the number of drugs that they are prescribing that interfere with a perfectly reasonable diet. One cannot live on chemicals alone. Iatrogenicity is a serious problem, and it often masquerades in the shape of far too many prescription drugs.

    But back to the main topic. BP measurements fluctuate substantially throughout the day, and can often be higher in medical situations (doctor’s offices, other stressful locales where the patient — or well person about to be turned into a patient thanks to shifting diagnostic goalposts — receives the test, often conducted in an imprecise or improper manner). Result — PILLS. Not to mention panic. I will admit to being one of those who freaks out a little when a BP cuff approaches — I cannot stand the compression. Classic white coat HT. There is a recent BMJ study that shows that those who suffer white-coat HT are no worse off than those normal BP and certainly don’t need treating. Yet the medical profession wants to shove more pills down healthy people’s throats — follow the money and you will see that the only way Large Pharma can make more money and satisfy their shareholders is to sell more drugs — and that sometimes requires the creation of more patients. It’s the same as with statins.

    People should all remember that they have the right to use four little words whenever their GP or any other medical professional approaches them with a “test” — aside from requiring said medic to cite all benefit and risk (relative and absolute) values associated with any treatment that could emerge from the result (why do the test if it won’t provide any useful benefit). Those words are: “I Do Not Consent.” If you don’t want your “cholesterol” tested or any other test, use these words. You do not have to explain why. Any violation of this amounts to assault, or possibly battery.

    Of course, if you’re okay with the test, go for it. But be aware that it can lead one down the wrong path.

    1. Marie - Sweden

      Thank you
      Jimmy Christian
      November 13, 2018 at 6:37 am

      I totally agree with you.
      I was going to have one of my knees X-rayed some yeas ago. I wasn´t too keen on it but my sister persuaded me. I had to visit the health clinic to get a referral. Sure enough, the doctor said – I would like to make some tests.
      I said – I am am not interested in my blood pressure, nor in my cholesterol levels. I may be an unusual “patient” but I have come to this conclusion after having read one book after the other. After that, I showed her a book that I had in my handbag. It was Alan Cassel`s – Seeking Sickness – about different types of screening.
      She seemed rather pleased to meet such a “patient”.

      1. Göran Sjöberg


        It is good to see that there are also Swedes on top when it comes to expose medical scams.

        Alan Cassel`s “Seeking Sickness” is certainly exposing what it is all about. My own basic approach is to keep as far away from all NHS as possible and to seek less dangerous alternatives for remedy and prevention.

        The Hippocratic “Food as medicine” is the alternative baseline – and if you are “hit” by some “serious” ailment (e.g. T2D) the LCHF ketogenic approach seems worthwhile to try out to start with.

    2. Jeffrey Dun

      You are right of course, our BP does fluctuate (significantly) over the course of the day.

      I have often wondered how to get a reliable reading of our true underlying BP. To this end, I stumbled across a Youtube demonstration by a Dr Adam Story called “How to lower your BP in minutes naturally without pills”.

      His method is to breath very deeply for 5 minutes prior to taking your BP. In accordance with his instructions I took my BP first – it read 130/70. I then breathed very deeply for 5 minutes and took my BP again – it read 95/65.

      I tried again the next day and recorded 98/69.

      I have never personally recorded a systolic reading below 100 before, although I did have a 24 hour BP monitor 10 years ago and my systolic reading fell into the 90s when I was asleep.

      So is this approach cheating ? Or, is it giving us a good idea of our BP when we are in a relaxed state ? I think it is probably the latter.

      1. Andy S

        Hi Jeffrey,
        Re blood pressure and breathing. Looks like that oxygen demand is linked to arterial pressure. BP medications are not the answer.
        Probably other factors affect BP: stress, high glucose, insulin, etc..

      2. Gary Ogden

        Jeffrey Dun: Very interesting! I think you’re on to something here. During the summer of my marathon training at age 55 (25-35 miles/week) I often had systolic BP below 100.

    3. Göran Sjöberg


      I guess you must be well aware of the great book “Overdiagnosed” by Gilbert Welch et al.

      From a nationally recognized expert, an exposé of the worst excesses of our zeal for medical testing.

      1. Jimmy Christian

        Hi Goran, yes indeed I am familiar with this book — it’s an excellent read. Recommended to all!

        Have you also seen Nortin Hadler, MD’s work, including the book Worried Sick? A little more technical but an additional, supportive perspective on many of the topics covered by Gilbert Welch and indeed Malcolm Kendrick, though without direct references to either.

  67. Charles Gale

    AH Notepad and Goran…Vit C thread

    Both Dr Suzanne Humphries and Dr Levy recommend the Livon labs liposomal Vit C. As you say, very portable and I stick a sachet in with my lunch box for work.

    Goran – I’m impressed with your dosage of 15g a day of ascorbic acid (AA). Strong stuff and I alternate between AA and sodium ascorbate due to the C-flush inducing qualities of the AA.

    AA – strong stuff? Not sure if anyone uses it topically for skin conditions but it if you rub it in with your fingertips it will leave you with brown finger tips (like a smoker’s nicotine stained fingers) and, possibly, slight burning of the skin.

    And, also, nagging away is the possibility of the enamel stripping of teeth in drinking too much AA. Some say use a straw.

    MITOQ and pulse wave velocity (PWV) testing in mice thread…

    …like Martin (Back), I would have thought PWV testing in mice was not really possible.

    Surely, for example, apes would be more congruent with humans for any sort of testing, especially in matters of CVD.

    But how does animal testing work nowadays? I’m sure many of us have seen (back in the day 1970s and 1980s) pictures of rabbit and monkeys in horrific lab conditions with e.g. electrodes implanted in their skulls.

    I’ve no idea what animals are available. It seems, time and time again nowadays, to be either rats or mice but are we comparing apple and pears in comparing mice with humans?

    1. Göran Sjöberg


      Well – I don’t know. I don’t have any problems with my 15g/day but I am sipping that during the day dissolved in water. Ascorbate is the obvious alternative if you have a problem. (My wife is adding sodium bicarbonate to neutralize the acid.)

      Though when I have severely increased this intake to counter a suspected infection I am passing over the “bathroom” limit 🙂

  68. TS

    Perhaps we should listen to Stephen Hawking’s solutions!
    Excerpts from his
    “Brief Answers to the Big Questions” The final book by Stephen Hawking:

    “One way or another, I regard it as almost inevitable that either a nuclear confrontation or environmental catastrophe will cripple the Earth at some point in the next 1000 years….I am convinced that humans need to leave Earth. If we stay, we risk being annihilated….What about boldly going beyond the solar system?….There are around a thousand stars within thirty light years of Earth. If 1 per cent of these have Earth-sized planets in the Goldilocks zone, we have ten candidate New Worlds.” (Then Stephen Hawking explains how we do it!)

    And he warns,

    “Why are we so worried about artificial intelligence? Surely humans are always able to pull the plug?
    People asked a computer, ‘Is there a God?’ And the computer said, ‘There is now’, and fused the plug.”

  69. JanB

    Hello? Anybody out there? It’s gone awfully quiet. Of course, it may be that nobody is posting, or I’ve lost my link or, um, I’ve died but no one has told me. Please, Gary, Jennifer, Bill, ANYBODY! Please reassure me that I’m still alive and kicking. 👋

      1. Bill In Oz

        Glad you are back,,This blog was missed. I was wondering if you Malcolm had hit a health block..Now that would have been a cause for deep regret…

      2. chris c

        Kaspersky. Been using it for years and never been invaded yet or had other problems. From what I know about Eugene Kaspersky, rumours that it lets Putin invade your computer are false news. Only downside I’ve found is that scans use one hell of a lot of processor.

      3. LA_Bob

        I’ve always thought that when this happens you’ve taken a few days off, something to which you’re entirely entitled.

    1. AnnaM

      The question, I think, is why does blood pressure rise in the other tribe. I wish there were more information about their diet, exactly what types of industrialized food they are eating and how much.

  70. Errett


    In the U.S. and most other countries, blood pressure rises with age, beginning early in life. Results of this study support the idea that the tendency in Westernized societies for blood pressure to rise with age is not a natural part of aging but could result from a cumulative effect of exposure to Western diet and lifestyle.

    The findings appear November 14 in the journal JAMA Cardiology.

    “The idea that rising blood pressure is a result of aging is a widely held belief in cardiology, but our findings add to evidence that rising blood pressure may be an avoidable consequence of Western diet and lifestyle rather than aging itself,” says Noel Mueller, PhD, MPH, assistant professor of epidemiology at the Bloomberg School and member of the Welch Center for Prevention, Epidemiology and Clinical Research.

    For their study, the researchers took blood pressure measurements from 72 Yanomami aged one to 60, and found no trend towards higher or lower readings as the participants aged. The researchers also measured blood pressure in 83 members of the nearby Yekwana tribe, which is more exposed to Western influences including dietary — and here they found a clear trend towards higher pressure with advancing age.

    The Yanomami live as hunter-gatherers and gardeners in a remote rainforest region of northern Brazil and southern Venezuela. Their diet is low in fat and salt and high in fruits and fiber. Studies of adult Yanomami since the 1980s have shown that atherosclerosis and obesity are virtually unknown among them, and that they have extraordinarily low blood pressure on average, with no apparent increase as they age.

    The new study reveals that this age-stability of blood pressure among the Yanomami starts in early childhood. It is the first to compare the Yanomami to a geographically co-located population — the Yekwana — that has had a different exposure to Western diet and other Western lifestyle influences.

    The researchers, examining members of Yanomami villages in southern Venezuela, found that their blood pressure measurements averaged 95 (mm Hg) systolic over 63 diastolic. (In U.S. adults, the average systolic is 122 and diastolic 71.) This low figure among the Yanomami is consistent with prior studies in Yanomami adults, but the researchers measured roughly the same blood pressure among Yanomami children as well. In fact, the data suggest that blood pressure in this population remains close to the same low level from age one at least through age 60, with no trend towards an increase or decrease.

    In contrast to the Yanomami, the Yekwana have been exposed to some aspects of Western lifestyle and diet, including processed foods, through interaction and trade with the industrialized world. While blood pressure readings at the youngest ages were virtually the same as those for their Yanomami peers, there was a statistically clear trend towards rising levels with advancing age — roughly 0.25 mm Hg per year — such that the Yekwana had levels averaging 5.8 mm Hg higher by age 10, and 15.9 mm Hg higher by age 50.

    “This age-related rise in blood pressure begins in early childhood — which suggests that early childhood may be a ‘window of opportunity’ for lifestyle interventions to prevent later rises in blood pressure,” Mueller says.

    To put these findings in context, in the U.S. systolic blood pressure rises by about 1.5 mm Hg and 1.9 mm Hg per year among boys and girls, respectively, and 0.6 mm Hg per year among adults.

    Mueller and his colleagues plan to follow up with a study of the gut bacteria of the Yanomami and Yekwana to determine if the gut microbiome account for the two tribes’ differences in blood pressure with advancing age.

    Funding was provided by the National Heart, Lung and Blood Institute (K01HL141589), the Alfred P. Sloan Foundation, the C&D Fund and the Emch Fund for Microbial Diversity.

    Story Source:

    Materials provided by Johns Hopkins University Bloomberg School of Public Health. Note: Content may be edited for style and length.

    1. Gary Ogden

      Erret: On the other hand, the Yanomami don’t live very long, which may have something to do with sodium deficiency.

      1. Bill In Oz

        Gary ..Very Off Topic..I am enjoying reading WUWT and Jo Nova as well as Judith Curry. The habitual skepticism learned & I have been trained in here on CVD, is a great tool for examining the Climate warming doomsday forecasts.

  71. David Morris

    Hi Dr Kendrick,
    A good read, difficult subject incredibly well explained, thank you.
    In my business we undertake lots and lots of ambulatory blood pressure monitoring. I will give a copy of this article to my cardiographers, it will help them understand, which always makes a job more interesting.
    Best wishes,
    David Morris

  72. Charles Gale

    Deep breathing to lower BP

    Here’s a handy dandy link to Dr Adam Story’s 5 mins deep breathing (DB) to lower blood pressure, as mentioned in Jeffrey Dun’s comment:

    A few takeaways:

    – he’d been sitting for 15 minutes B4 taking 1st blood pressure/pulse readings
    – B4 DB the readings were: blood pressure 145/69 and pulse was 64
    – after 5 mins of DB the readings were: blood pressure 115/77 and pulse was 62
    – garlic and bananas are good foods for lowering blood pressure

      1. mand Season

        The habit can be acquired with practice. 🙂 By doing a few minutes every day, gets easier and easier for breathing deeply to become the individual’s default.

      2. Gary Ogden

        biddy99: Just do what feels right; not too fast, not too slow. Breathe with the diaphragm; I learned this decades ago playing the trumpet. The whole area above and below the navel should swell up when you inhale. If you feel comfortable and are getting enough air, you’re doing it right.

      3. JanB

        Singing is good. I joined a choir some months ago and my breathing, even with some asthma, is much improved. We are obliged to concentrate on expanding the whole chest area. It’s good in so many other ways too.

      4. mand Season

        Playing any musical instrument, and acting classes teach breathing as well. Yoga etc, of course. I took the Alexander technique route which is similar but isn’t associated with any belief system.

        Oh, also laughter yoga – which really is NOT anything like yoga (it shares the approach to breath, that’s all) – the benefits are manifold but include plenty of oxygen getting into the bloodstream and everywhere it’s needed, with accompanying wonderful side effects. Energy levels, immune system, mood, you name it. It’s socially bonding too and club members usually become friends, which is an added plus for those isolated by illness. (I am actually qualified to lead a LY club but not well enough to run one for now!)

        @Gary Ogden – me too, except I find the sheep distract me.

      5. Jean Humphreys

        Singing – how I wish. Whie taking a statin, for those two years, I lost control of my vocal cords. I am ok in normal speech, but raising my voice causes my voice to break, and trying to sing makes my larynx ache, and produces random croaks. Although pretty much all of the other effects have resolved, it is now eighteen years since the statin years, so I don’t suppose it is going to recover now

      6. JanB

        Ah, Jean – I feel for you. I have had the same problem after ten years of statins. My voice, once rather good, was reduced to croak and squeak but after 6 months in the choir I’ve seen a definite improvement. It’ll never be the same again, I know, but it’s lovely to sing again and always gives me a ‘lift.’
        I never made a connection. Silly old me. It’s been 5 years since I dumped them and never regretted it for a moment.
        You can always sing in the car. I did and do. 🎶🎶🎶🎶🎶🎶

      7. Jean Humphreys

        I do still try to sing from time to time, but it is no good – it hurts. When I was in my teens I was in every choir available – including the school madrigal group, which was invitation only.. In the spring and summer just before I married, I joined a local choir preparing for the Leith Hill Music Festival.That was a fantastic exerience, and I can say that I have sung for Ralph Vaughan Williams’ widow. (The narrator for the piece that had one was Richard Baker.) Days that cannot come agiain. I still wish I could do something – I would love to really belt out something rude!

      8. mand Season

        Oh, that is sad. Your singing history is very like mine! I can’t cope with the commitment of a choir these days, simply too many outings in a month and it’s pretty strenuous, but I do still bellow the Hallelujahs with the car radio. I have to agree that I had too little breath for it for a lot of years but that is less now, hm (need to work out what it correlates with!)

        Here’s hoping the pain is a symptom that you find a way to reverse some day.

      9. Gary Ogden

        mand Season: It does indeed become habitual. This is my normal way of breathing, though I sometimes have to think about it. While lying down counting sheep, I practice breathing this way and am rewarded with a rapid, glorious, restful slumber!

    1. Göran Sjöberg

      These are my readings today!!! And without deep breathing – just relaxing in bed at night for half an hour or so.

      I used the deep breathing technique to reduce stress at work. Worked fine when I actually went walking from one stressful meeting to the next. I guess stress and high BP is strongly connected 🙂

    2. jane

      All well and good but surely this would only work if the underlying reason for the hypertension was anxiety or a difficulty in relaxing. Most hypertension is suffered for unknown reasons.

      1. Jeffrey Dun

        I think you are missing the point of why I raised this technique in the first place (see my post of 13 November).

        I was replying to Jimmy Christian who spoke about how substantially BP can fluctuate over the course of a day and how this results in making judgments about whether a person is truly hypertensive more problematic: moreover, this judgement is exacerbated even further by white coat hypertension.

        I suggested that this technique may give us a good indication of our BP when we are in a relaxed state. That’s all.

        It wasn’t putting it forward as a “cure” for hypertension, nor did I suggest it as a means of cheating the BP test, or of fooling your doctor.

  73. Randall

    Statins in Familial Hypercholesterolemia 20 year study: Statin users (n = 1,041) experienced 89 CAD events and 17 deaths during 11,674 person-years of follow-up versus statin never-users (n = 518), who had 22 CAD events and 9 deaths during 4,892 person-years. (1 person saved by treating for 3,300 person-years on a statin.) I my opinion using this study, statins are useless, were as statins should have been a life saver in patients with very high cholesterol. https://www.ncbi.nlm.nih.gov/pubmed/27417002

    1. Dr. John H

      Will you describe how you came to your conclusion vs. theirs “moderate- to high-intensity statin therapy lowered the risk for CAD and mortality by 44%.”


  74. Bill In Oz

    Slightly off topic ..It seems guaranteed more deaths among the poor & elderly this Winter in the UK, because of the cold and much high power prices.. Many more people die in cold weather than hot. So staying warm at home is crucial to preventing a higher death rate and even a higher rate of CVD.
    And why is this happening ? Ahh it’s all being done at the direction of the European Court of “Justice” !

    A very weird kind of “justice”… in fact not justice at all…But an inevitable cost of being in the EU..I’m sure many more Britains are looking forward to giving Europe the flick after this little stuff up.

    1. AhNotepad

      Bill In Oz, The question I ask is, is the cold the thing that’s killing people, or is it poor nutrition? I would think the latter, since there are populations that exist in far colder places than do most of the EU population. They wear appropriate clothes, and they have a reasonable diet.

    2. Anthony Poole

      “Slightly” off topic! Indeed, and what has being in the EU got to do with anything? We unfortunate Britons (not Britains) are about to suffer the greatest blow to our standing in the world if the wretched Brexit goes through, together with a predictable drop in our standard of living – and of course the poor and disadvantaged will suffer the most together with our NHS.

      1. AhNotepad

        Anthony Poole, there are different opinions of course shared by many people. This may be a suitable topic for this blog as it could demonstrate to people how it is possible to raise blood pressure.

    1. Gary Ogden

      Dr. John H: Indeed. Reading that utterly demolished my trust in Medicine, while strengthening my trust in doctors, that is, real doctors, those who, like me, have a healthy skepticism about what they’ve been taught. I believe my journey began with Uffe Ravnskov’s “Ignore the Awkward,” purchased from the Price-Pottenger Nutrition Foundation, which led me to SpaceDoc, which led me here, to this big, happy family.

  75. AhNotepad

    My blood pressure has just risen! The BBC Food Programme http://www.bbc.co.uk/programmes/m000198h has a Henry Dimbleby co author of The Schools Food Plan giving some information. He mentioned schools are offering skimmed milk, not whole milk. PHE argue only skimmed milk is acceptable, since if we let people eat whole milk they will think sat fat is ok, so they will go out and eat lots of sat fat.

    So would those that say sat fat is not good, please explain why. I think they will discover they have no idea, or else poorly supported reasons.

  76. Charles Gale

    “Leave a reply problems”

    I’ve tried twice to post a comment and link on magnesium and they appear to have vanished (i.e. they are not awaiting moderation), and my one word “Testing” comment to did get through to “awaiting moderation” status.

  77. Errett


    Some patients with coronary artery disease have inadequate blood flow to the heart muscle during periods of mental/emotional stress. This condition — called “mental stress-induced myocardial ischemia” (MSIMI) — is related to the severity of plaque buildup in the coronary arteries in men but not women, reports a study in Psychosomatic Medicine: Journal of Biobehavioral Medicine, the official journal of the American Psychosomatic Society. The journal is published in the Lippincott Portfolio by Wolters Kluwer.

  78. Errett

    When is high blood pressure dangerous? Medical associations offer widely differing answers. In the USA, for example, patients are seen as hypertensive much sooner than in Germany. A team working with Prof. Karl-Heinz Ladwig of the Technical University of Munich and the Helmholtz Zentrum München has concluded that treating patients sooner does not reduce the risk of deadly heart disease. It could even negatively affect their mental health.


    1. Dr. John H

      Odd that they report people with high blood pressure are less depressed, then get depressed on BP drugs. They attribute that depression to mental stress, and not to the drugs!

  79. smartersig

    One angle which I do not think has been discussed on here but appears in the Times today is SCAD, a condition which is not prompted by the usual suspects but by a tear due to pressure on the vessel. Extreme aerobic (runners) can often get it and have a heart attack despite being very fit. This interests me because I had a HA on returning from a run and the symptoms were the same as cited by young women in the Times ie central chest pain but not in the arms. SCAD never seems to get discussed however and the post HA care seems to be one size fits all ie your arteries must be blocked due to high cholesterol…DOH!

    Would welcomee Dr Kendricks thoughts on SCAD


  80. Lucie

    In my opinion, the most negative effect of the narrowing of an artery is not the increase in global blood pressure but the local increase in speed at the point of narrowing with onset (1) of turbulence and (2) of a local depression (Venturi effect, the pressure can even become locally negative), both of which may well contribute to damaging the endothelium.

  81. Patricia C. Tice

    What about enzymes to clear arteries?? I had read that Woebenzyme could clear atherosclerosis in about 2 years if taken consistently and correctly. Along the same lines, we know that the MTHFR mutations (which are far more common than expected) can lead to atherosclerosis. That may mean keeping a watch on Homocysteine levels consistently to keep the arteries clear.

  82. TucsonTom

    So why does my BP always respond in the OPPOSITE direction from expected? Baseline (medicated) systolic 143 (diastolic always 180?

    1. Gary Ogden

      Paige: Anyone who is concerned about their blood pressure should read Port, et al., from the European Heart Journal, 1 October 2000
      click PDF and you will have the entire paper. Worth printing if you have a printer.


Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out /  Change )

Google photo

You are commenting using your Google account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s