The highest BP will be during or right after vigorous sex, but I don’t think those extreme measurements are considered indicative of high blood pressure. Nevertheless folks (particularly men) over 65 do tend to get mini-strokes disproportionately during sexual activity, though I suspect arterial stiffness plays a role. Measuring arterial stiffness or taking Cialis as a prophylactic against extreme blood pressure spikes may be a good precaution for anyone over 65.
As for time of day, it depends : My doctor had me on Losartan taken once a day at bedtime (the normal recommendation, since most deaths due to high BP occur during your sleep since you won’t be able to call 911!). Since Losartan has a half-life of 10 hours, my highest blood pressure was right before dinner when the drug had mostly worn off. I now split my dose and take half after breakfast and half after dinner.
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There was a large study that found that reducing salt in your diet is typically an excercise in futility since the body’s craving for salt/sodium is so strong that you end up eating more salt than you realize. According to the study those on a low sodium diet ended up ingesting just as much sodium as controls. The only exceptions were people whose starting sodium blood levels were actually high. Trying to control blood pressure by lowering salt intake, when sodium levels (as measured by blood tests) are within normal range, is an exercise in futility.
In addition those with higher sodium levels (within normal range) in the blood actually have lower total mortality rates than those with lower (within normal range) sodium levels : While lower sodium levels reduces Cardio mortality rates it raises mortality rates from slip-and-fall accidents, caused by impaired responsiveness of the central nervous system.
Raising potassium levels may be more useful, particularly since they are often low to start with.
Since the salt craving of the body is really a craving for sodium, and blood pressure rise only happens if you raise both sodium and chloride levels, I wonder if you can trick the body by ingesting baking soda along with your low salt diet : this should help reduce blood pressure (since chloride levels will drop) but still provide enough sodium for the central nervous system. One problem is that blood tests may not reveal any effect from ingesting baking soda since blood levels of bicarbonate is under tight control (since it affects alkalinity of blood), and any sodium + potassium in the blood must be balanced by chloride + bicarbonate levels. However tissue levels of chloride vs bicarbonate levels may shift towards higher bicarbonate levels, which might help with blood pressure. There is also a belief that raising alkalinity of tissues (other than blood) is protective against cancer.
Neo
#84
Sorry not trying to upset anyone. I was sharing info on the device because it felt like interesting technological piece of progress that could help the many data driven, experimenters here.
I was trying to just share a relatively low cost way that those of us here who are interested could learn more about ourselves - at the deeper level that many of us here are interested in.
Fyi worth Dr. Eric Topol was the main source, not Dr Attia - he is a member of the National Academy of Medicine, and is one of the top 10 most-cited researchers in medicine!!! For decades an international leader in (1) cardiology, (2) precision medicine, and (3) digital health). Did you feel that any of his perspectives on the power of accurate wristband BP sensors was off? If so what specifically? I thought basically each point about the types of value that he made was spot on.
Re Peter Attia, I’d take his more aggressive approach to the value of data vs more conversional medicine anytime.
For instance I’ve always had amazing Hb1Ac and fasting glucose measurements from blood tests and when asked my doctors if anything I could do to improve further they have just been, no those are great numbers. But the amount of learnings from now and then wearing a continuous glucose monitor have been truly amazing to me (the way certain foods nevertheless can spike me, but others don’t, how different type of post meal activity blunts the spikes to different degrees, and a whole range of minor things I can do to minimize my variability and spikes (which might be a big part of why Cana, Acarbose and Metformin each has been seen as synergistic with rapa for rodent life extension)).
The amount of quick feedback loops and micro experiments I (and others here) would be able to get and do if relatively low cost wearables can give accurate BP is quite powerful.
And given that cardiovascular disease is the biggest killer, seems like an area that might be worth optimizing.
Also having a benchmark sense for how ones blood pressure is during the night can be very valuable in order to be able to pick up night blood pressure changed in the future that traditional ways of measuring blood pressure would never pick up. And for me building a time series like that over the coming years will be valuable and something to also correlate towards my other sleep metrics.
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Neo
#85
Cool, yes, exciting stuff!
I totally agree that technology advancing is amazing stuff (and can’t wait when my AppleWatch will be able to measure also my BP and glucose levels 
) but I was just referring than in normal healthy individuals you can get away with occasional/intermittent/sporadic measurements as fluctuations are normal and might produce unnecessary anxiety… e.g. if I am stressed for a week/month and my BP goes higher does not mean that I have high BP and that I necessarily need to be aggressive with medications or lifestyle changes, but if I see an upward trend in a year/two then I would think, can I do something about it. I am just saying to spot a trend you don’t need to be that obsessive. I even listened to Peter Attia The Drive #247 you shared and it is full of useful information. I was just saying that something actions of people like Peter Attia are motivated by personal anxiety, which PA clearly states in latest podcasts often… he is talking about fear of ASCVD and dying young, about anger and drive against it… so if you shave off that layer and understand his personal fears it is easier to understand what is rational metrics and what is irrational (but still useful in some cases).
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A cardiologist’s view of the latest BP trials
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Below 110, I start to feel a little dizzy. I feel best between 115 and 130. Maybe that’s just because I am old.
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LaraPo
#90
I feel the best between 120 and 130. 110 feels too low for me. Under 110 makes me dizzy.
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blsm
#91
I had multiple people telling me my 90/60 BP was great but it sure didn’t feel like it to me! I feel much better when my systolic is at least 100 personally.
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jakexb
#92
Anyone looking for a good BP monitor, Qardio automatic monitors are on sale for the next few days and have been clinically validated. I have one and it’s very accurate.
zazim
#93
I am always in the market for another blood pressure monitor. The recent reviews on Amazon are so horrible, it gave me second thoughts. I’m glad you have had a good experience. Someday I’m going to try the stethoscope route.
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tananth
#94
Most continuous BP monitors in watches don’t actually measure BP directly (using a compression cuff), they measure pulse wave velocity. I was skeptical how that could ever work, since pulse wave velocity depends on both arterial stiffness (the primary reason to measure pulse wave velocity) AND BP. Also measuring pulse wave velocity across a 1 inch distance sounds like it would not be very accurate. However most watch based BP monitors (eg by fitvii) require that you measure your blood pressure a few times with an actual BP cuff so the watch can estimate your arterial stiffness (from pulse wave velocity + true cuff based BP), then assume that your arterial stiffness won’t change over the short term and any changes in pulse wave velocity are indicative of changes in BP. They claim that the accuracy of this relative BP measurement is very good, as long as you repeat the baseline BP normalization every few months (to account for long term changes in your arterial stiffness). It also has the advantage of using very little power, so the new fitvii G5 series does continuous measurements every 5 minutes and can do so for many days on a single charge. I ordered a G5 model fitvii from Hong Kong (only the previous generation, that does not include continuous BP measurement, is sold in USA), $80 including shipping, and will report back on how accurate it actually is.
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Neo
#95
Yes, please do report back!
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zazim
#96
This is a long program, but it gives a very interesting perspective on the role of nitric oxide in blood pressure, vascular health, glycemic control, etc. I believe it was 1999 that the three people involved with nitric oxide won the Nobel prize in medicine. It’s fascinating how little understood it was and is. The video presents a theory why blood pressure medications do not work on some people and why Viagra does not work on some patients. At a very minimum, you will not use mouthwash or antacids again if you watch the video. Most supplements in this space, including beet root capsules, are useless.
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Neo
#97
Another study (out of Switzerland 
) showing success of cuff-less:
https://www.nature.com/articles/s41598-023-33205-z
“These results encouragingly suggest
that cuff-less 24-hour ambulatory blood pressure monitoring may soon become a clinical possibility.”
“the differences between both devices remained within the limits recommended by the ISO 81060-2 international standard when comparing a device to gold-standard references17, with biases within ± 5 mmHg and SD values ≤ 8 mmHg“
Apparently best results for the smaller subsets that had the sensor on the arm instead of on the wrist (but good on wrist too).
“For the 19 patients for whom it was placed at the upper arm, where PPG was hypothesized to be less sensitive to arm motion artefacts”
And seems comfortable:
” the results of the device acceptance questionnaire revealed that a watch-like device worn at the wrist or upper arm was found to be more comfortable, highly compatible with daily activities and was overwhelmingly preferred to its cuff-based alternative by the participants”
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约瑟夫
#98
As I have posted before, in my view the E500 watch is a “no brainier” to have and use.
Once you calibrate the watchs software{H Band] to a reference BP monitor the data provided is more the accurate for this use.
Attach are screen shots for the last 24 hours{04/22/2023 through 04/23/2023] of my BP using an E500, the software{H Band] calibrate to a BP monitor. A measurement every 5 minutes.
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More news on blood pressure:
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Neo
#100
Looks like one perhaps can exercise lungs for a few min to improve BP:
”High-resistance inspiratory muscle strength training (IMST) is an emerging, time-efficient (5 min/day) lifestyle intervention. Early research suggests high-resistance IMST may promote adherence, lower blood pressure and potentially improve vascular endothelial function”
Mike Lustgarden did a short experiment with this (seems to be $60 and have an app):
Has anyone tried it or something similar? The literature seems to support it (and potentially Mike S’ N=1 study depending on you agree or disagree how quickly things should revert after stopping the training).
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Neo
#101
They claim it’s also improves HRV, V02 max and other things:
Neo
#102
Does seem to have quite ok reviews (for their prior generation, and $10 cheaper version) on Amazon
www.amazon.com/BREATHER-Breathing-Exerciser-Drug-Free-Respiratory/dp/B00FE8N7Y4/
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