[sublinear]

> If you meet one of these people hours before their heart attack you often wouldn't describe them as 'on the cusp of death'.

I disagree. It's not that the symptoms aren't there, but that they have become normalized due to obesity, smoking, etc. being commonplace. Shortness of breath, sleep apnea, feeling weak, upper body tension/pain, etc. are usually present for quite a while in most people before it finally happens. People don't check their blood pressure often enough despite it being so cheap and easy to do.

[outworlder]

I see your point, although some of the symptoms are quite subtle. Most people with sleep apnea don't know they have it until they get tested. Same for other symptoms.

What's really normalized is metabolic syndrome. 88% of adult americans have some degree of metabolic dysfunction. High blood pressure, obesity and other ailments are very often a direct result of that. So much so, that the 'normal' range of indicators such as uric acid has been revised and adjusted over the years, because "normal" people had higher levels and still appeared to be fine. Thankfully, we are starting to question that (eg. https://pubmed.ncbi.nlm.nih.gov/24867507/)

First order of business for anyone watching their blood pressure creeping up over the years (even more so if A1C, triglycerides, liver enzymes and uric acid are rising too): cut sugar in all forms. Not just the sugar you personally add to food, not only what's specified as 'added sugar', but all food containing sugar - which is basically all ultra processed foods. It does include sliced bread which is easily broken down into sugar( and is often laced with additional sugar, check ingredients). Leave your sugar 'allowance' to be used by a reasonable amount of fruits.

That may not reverse the problem (although, in my case, it did) but should help tremendously.

[Dalewyn]

>First order of business for anyone watching their blood pressure creeping up over the years: cut sugar in all forms.

No, first order of business is consulting your doctor and/or a nutritionist and otherwise adhering to common sense of having a reasonably balanced nutritional diet.

If your first order of business is taking random advice from the intertubez, you have bigger problems than high blood pressure.

[unmole]

> a nutritionist

In most places, any bozo can claim to be a nutritionist. From what I can tell, a large proportion of them are deranged crackpots.

So, no. Absolutely do not consult a self-described nutritionist.

[dcow]

I mean I get what you're saying. But most doctors have normalized refined sugar intake. Cutting out refined sugar and simple carbs is not harmful at all and carries not risk whatsoever. So I don't see how listening to some modern wisdom in a HN comment is dangerous. Our understanding of nutrition in the western medical theatre is woefully incomplete and outdated.

[mr_toad]

What makes sugar different from other carbohydrates?

[Raidion]

It's really quick fuel that leads to an insulin spike that triggers more fat storage and eventually leads to insulin resistance.

[TurboHaskal]

Sugar is 50% fructose and 50% glucose. The user you mention advocates for a higher amount of fruit which has mostly fructose so my take on this is that he prefers his pancreas over his liver.

[incone123]

Eating whole fruit means you consume fiber at the same time as the sugar, so the latter is metabolized more safely.

[TurboHaskal]

Eating whole cake means you consume fat at the same time as the sugar, so the latter is metabolized more safely.

[incone123]

Could you liquidize the cake and still get that benefit?

[NovaDudely]

I have to agree, while there is a lot of people who say there were no symptoms - it generally was normalized over decades of decline.

It was once I lost 100lb that it became apparent just how bad condition I was in even though at the time I thought I felt fine. It doesn't help when you mention a lack of energy, or poor sleep to the doctor and they just say "Everyone is tired!".

[jahewson]

No this is completely wrong. Over the age of 40, a perfectly healthy, functioning and complaint-free individual can have alarmingly high blood pressure. Often it's hereditary. They can even have an obese sibling who's just fine.

[eek2121]

Unsure why folks are hating on you. I have had hereditary high BP since I was 13. I was underweight at that point. I was never overweight until COVID. COVID launched me from a normal weight into 'obese' territory pretty fast, but I am now a 'normal' BMI with 9.5% body fat.

[fantasticshower]

This is entirely unrelated to this article and discussion, but something I've been wondering: what makes you say folks are hating on them? Is there a mechanism for downvoting that I'm unaware of?

[2devnull]

You’re wrong. A young person with borderline hypertension (130/80) can present in perfect health. Blacks for instance have a genetic predisposition to hypertension, obesity and diet don’t have to be involved. Besides genetics, other health conditions like insomnia or other medications can cause hypertension. Some people are just salt sensitive.

[incone123]

Black African Americans seem to have that predisposition, but not all Black populations do. There is a theory that ability to retain salt improved your odds of surviving a slave ship journey.

[moneywoes]

What makers can I check?

[gtop3]

The #1 marker you should be checking is blood pressure.

Cholesterol, Fasting Insulin levels, and (if male) free Testosterone are other good ones. Cholesterol and Insulin should be checked by all adults annually, and BP should be checked at least annually. T isn't checked as routinely, but it's worth knowing where you fit and has an impact on your metabolics and the test isn't a big deal.

[mikenew]

Buying a cheap little glucose meter is really valuable IMO. You can get them for close to nothing, and you can use them to check your fasting glucose, or your glucose response after meals.

Also, resting heart rate is very easy to measure, especially if you have any kind of fitness/smart watch, and that's a good marker of health too.

I'm a fan of getting lab work done, but it's definitely more of a hassle.

[samstave]

I have high BP due to my insomnia coupled with sleep apnea.

I have insomnia ~5 nights a week. and for some reason I can no longer take naps in my older age. I used to be able to Nap-on-command when I was younger. It SUCKS

[avgcorrection]

Here’s a spectrum:

- “on the cusp of death already”

- Normalized ill-health

There are some things in between those two.