Ideal Blood Pressure Numbers Explained
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It’s Q&A Day at 10almonds!
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In cases where we’ve already covered something, we might link to what we wrote before, but will always be happy to revisit any of our topics again in the future too—there’s always more to say!
As ever: if the question/request can be answered briefly, we’ll do it here in our Q&A Thursday edition. If not, we’ll make a main feature of it shortly afterwards!
So, no question/request too big or small
❝Maybe I missed it but the study on blood pressure did it say what the 2 numbers should read ideally?❞
We linked it at the top of the article rather than including it inline, as we were short on space (and there was a chart rather than a “these two numbers” quick answer), but we have a little more space today, so:
Category | Systolic (mm Hg) | Diastolic (mm Hg) | |
Normal | < 120 | AND | < 80 |
Elevated | 120 – 129 | AND | < 80 |
Stage 1 – High Blood Pressure | 130 – 139 | OR | 80 – 89 |
Stage 2 – High Blood Pressure | 140 or higher | OR | 90 or higher |
Hypertensive Crisis | Above 180 | AND/OR | Above 120 |
To oversimplify for a “these two numbers” answer, under 120/80 is generally considered good, unless it is under 90/60, in which case that becomes hypotension.
Hypotension, the blood pressure being too low, means your organs may not get enough oxygen and if they don’t, they will start shutting down.
To give you an idea how serious this, this is the closed-circuit equivalent of the hypovolemic shock that occurs when someone is bleeding out onto the floor. Technically, bleeding to death also results in low blood pressure, of course, hence the similarity.
So: just a little under 120/80 is great.
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Shoe Wear Patterns: What They Mean, Why It Matters, & How To Fix It
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If you look under your shoes, do you notice how the tread is worn more in some places than others? Specific patterns of shoe wear correspond to how our body applies force, weight, and rotational movement. This reveals how we move, and uneven wear can indicate problematic movement dynamics.
The clues in your shoes
Common shoe wear patterns include:
- Diagonal wear on the outside of the heel: caused by foot angle, leg position, and instability, leading to joint stress.
- Rotational wear at specific points: due to internal or external rotation, often originating from the hip, pelvis, or torso.
- Wear above the big toe: caused by excessive toe lifting, often associated with a “lighter” or kicking leg.
Fixing movement issues to prevent wear involves correcting posture, improving balance, and adjusting how the legs land during walking/running.
Key fixes include:
- Aligning the center of gravity properly to prevent leg overcompensation.
- Ensuring feet land under the hips and not far in front.
- Stabilizing the torso to avoid unnecessary rotation.
- Engaging the glutes effectively to reduce hip flexor dominance and improve leg mechanics.
- Maintaining even weight distribution on both legs to prevent excessive lifting or twisting.
Posture and walking mechanics are vital to reducing uneven wear, but meaningful, lasting change takes time and focused effort, to build new habits.
For more on all this plus visual demonstrations, enjoy:
Click Here If The Embedded Video Doesn’t Load Automatically!
Want to learn more?
You might also like to read:
Steps For Keeping Your Feet A Healthy Foundation
Take care!
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The Snooze-Button Controversy
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To Snooze Or Not To Snooze? (Science Has Answers)
This is Dr. Jennifer Kanaan. She’s a medical doctor with a focus on pulmonary critical care, sleep disorders, and sleep medicine.
What does she want to tell us?
She wants us to be wary of the many news articles that have jumped on a certain recent sleep study, such as:
- Is hitting the snooze button really a bad idea? Study sheds light on the impact of morning alarms on sleep and cognition
- Hitting Snooze May Help You Feel Less Sleepy and More Alert, Research Says
- Is it okay to press the snooze button?
- Hitting Snooze May Help You Feel Less Sleepy and More Alert, Research Says
- Hitting the snooze button on your alarm doesn’t make you more tired
For the curious, here is the paper itself, by Dr. Tina Sundelin et al. It’s actually two studies, by the way, but one paper:
The authors of this study concluded:
❝There were no clear effects of snoozing on the cortisol awakening response, morning sleepiness, mood, or overnight sleep architecture.
A brief snooze period may thus help alleviate sleep inertia, without substantially disturbing sleep, for late chronotypes and those with morning drowsiness.❞
Notably, people tend to snooze because an alarm clock will, if not “smart” about it, wake us up mid sleep-cycle more often than not, and that will produce a short “sleep hangover”. By snoozing, we are basically re-rolling the dice on being woken up between sleep cycles, and thus feeling more refreshed.
What’s Dr. Kanaan’s counterpoint?
Dr. Kanaan says:
❝If you’re coming in and out of sleep for 30 minutes, after the alarm goes off the first time, you’re costing yourself 30 minutes of uninterrupted, quality, restorative sleep. This study doesn’t change that fact.❞
She advises that rather than snoozing, we should prioritize getting good sleep in the first place, and once we do wake up, mid sleep-cycle or not, get sunlight. That way, our brain will start promptly scrubbing melatonin and producing the appropriate wakefulness hormones instead. That means serotonin, and also a spike of cortisol.
Remember: cortisol is only bad when it’s chronically elevated. It’s fine, and even beneficial, to have a short spike of cortisol. We make it for a reason!
If you’d like to hear more from Dr. Kanaan, you might like this interview with her at the University of Connecticut:
Want the best of both worlds?
A great option to avoid getting woken in the middle of a sleep cycle, and also not needing to hit snooze, is a sunrise alarm clock. Specifics of these devices vary, but for example, the kind this writer has starts gently glowing an hour before the set alarm time,and gradually gets brighter and lighter over the course of the hour.
We don’t sell them, but here’s an example sunrise alarm clock on Amazon, for your convenience
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You Are Not a Before Picture – by Alex Light
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It’s that time of year, and many of us are looking at what we’ll do in the coming days, weeks, and months to level-up our health. So… Is this a demotivational book?
Quite the opposite! It’s rather a case of an often much-needed reminder to ensure that our plans are really our own, and really are what’s best for us. Why wouldn’t they be, you ask?
Much of diet culture (ubiquitous! From magazine covers to movie stars to the models advertising anything from health insurance to water filters) has us reaching for “body goals” that are not possible without a different skeleton and genes and compromises and post-production edits.
Alex Light—herself having moved from the fashion and beauty industry into health education—sets out in a clear, easy-reading manner, how we can look after ourselves, not be neglectful of our bodies, and/but also not get distracted into unhelpful, impossible, castles-in-the-air.
Bottom line: you cannot self-hate your way into good health, and good health will always be much more attainable than a body that’s just not yours. This book can help you sort out which is which.
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What’s the difference between a heart attack and cardiac arrest? One’s about plumbing, the other wiring
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In July 2023, rising US basketball star Bronny James collapsed on the court during practice and was sent to hospital. The 18-year-old athlete, son of famous LA Lakers’ veteran LeBron James, had experienced a cardiac arrest.
Many media outlets incorrectly referred to the event as a “heart attack” or used the terms interchangeably.
A cardiac arrest and a heart attack are distinct yet overlapping concepts associated with the heart.
With some background in how the heart works, we can see how they differ and how they’re related.
Understanding the heart
The heart is a muscle that contracts to work as a pump. When it contracts it pushes blood – containing oxygen and nutrients – to all the tissues of our body.
For the heart muscle to work effectively as a pump, it needs to be fed its own blood supply, delivered by the coronary arteries. If these arteries are blocked, the heart muscle doesn’t get the blood it needs.
This can cause the heart muscle to become injured or die, and results in the heart not pumping properly.
Heart attack or cardiac arrest?
Simply put, a heart attack, technically known as a myocardial infarction, describes injury to, or death of, the heart muscle.
A cardiac arrest, sometimes called a sudden cardiac arrest, is when the heart stops beating, or put another way, stops working as an effective pump.
In other words, both relate to the heart not working as it should, but for different reasons. As we’ll see later, one can lead to the other.
Why do they happen? Who’s at risk?
Heart attacks typically result from blockages in the coronary arteries. Sometimes this is called coronary artery disease, but in Australia, we tend to refer to it as ischaemic heart disease.
The underlying cause in about 75% of people is a process called atherosclerosis. This is where fatty and fibrous tissue build up in the walls of the coronary arteries, forming a plaque. The plaque can block the blood vessel or, in some instances, lead to the formation of a blood clot.
Atherosclerosis is a long-term, stealthy process, with a number of risk factors that can sneak up on anyone. High blood pressure, high cholesterol, diet, diabetes, stress, and your genes have all been implicated in this plaque-building process.
Other causes of heart attacks include spasms of the coronary arteries (causing them to constrict), chest trauma, or anything else that reduces blood flow to the heart muscle.
Regardless of the cause, blocking or reducing the flow of blood through these pipes can result in the heart muscle not receiving enough oxygen and nutrients. So cells in the heart muscle can be injured or die.
But a cardiac arrest is the result of heartbeat irregularities, making it harder for the heart to pump blood effectively around the body. These heartbeat irregularities are generally due to electrical malfunctions in the heart. There are four distinct types:
- ventricular tachycardia: a rapid and abnormal heart rhythm in which the heartbeat is more than 100 beats per minute (normal adult, resting heart rate is generally 60-90 beats per minute). This fast heart rate prevents the heart from filling with blood and thus pumping adequately
- ventricular fibrillation: instead of regular beats, the heart quivers or “fibrillates”, resembling a bag of worms, resulting in an irregular heartbeat greater than 300 beats per minute
- pulseless electrical activity: arises when the heart muscle fails to generate sufficient pumping force after electrical stimulation, resulting in no pulse
- asystole: the classic flat-line heart rhythm you see in movies, indicating no electrical activity in the heart.
Cardiac arrest can arise from numerous underlying conditions, both heart-related and not, such as drowning, trauma, asphyxia, electrical shock and drug overdose. James’ cardiac arrest was attributed to a congenital heart defect, a heart condition he was born with.
But among the many causes of a cardiac arrest, ischaemic heart disease, such as a heart attack, stands out as the most common cause, accounting for 70% of all cases.
So how can a heart attack cause a cardiac arrest? You’ll remember that during a heart attack, heart muscle can be damaged or parts of it may die. This damaged or dead tissue can disrupt the heart’s ability to conduct electrical signals, increasing the risk of developing arrhythmias, possibly causing a cardiac arrest.
So while a heart attack is a common cause of cardiac arrest, a cardiac arrest generally does not cause a heart attack.
What do they look like?
Because a cardiac arrest results in the sudden loss of effective heart pumping, the most common signs and symptoms are a sudden loss of consciousness, absence of pulse or heartbeat, stopping of breathing, and pale or blue-tinged skin.
But the common signs and symptoms of a heart attack include chest pain or discomfort, which can show up in other regions of the body such as the arms, back, neck, jaw, or stomach. Also frequent are shortness of breath, nausea, light-headedness, looking pale, and sweating.
What’s the take-home message?
While both heart attack and cardiac arrest are disorders related to the heart, they differ in their mechanisms and outcomes.
A heart attack is like a blockage in the plumbing supplying water to a house. But a cardiac arrest is like an electrical malfunction in the house’s wiring.
Despite their different nature both conditions can have severe consequences and require immediate medical attention.
Michael Todorovic, Associate Professor of Medicine, Bond University and Matthew Barton, Senior lecturer, School of Nursing and Midwifery, Griffith University
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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What you need to know about PCOS
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In 2008, microbiologist Sasha Ottey saw her OB-GYN because she had missed some periods. The doctor ran blood tests and gave her an ultrasound, diagnosing her with polycystic ovary syndrome (PCOS). She also told her not to worry, referred her to an endocrinologist (a doctor who specializes in hormones), and told her to come back when she wanted to get pregnant.
“I found [that] quite dismissive because that was my reason for presenting to her,” Ottey tells PGN. “I felt that she was missing an opportunity to educate me on PCOS, and that was just not an accurate message: Missing periods can lead to other serious, life-threatening health conditions.”
During the consultation with the endocrinologist, Ottey was told to lose weight and come back in six months. “Again, I felt dismissed and left up to my own devices to understand this condition and how to manage it,” she says.
Following that experience, Ottey began researching and found that thousands of people around the world had similar experiences with their PCOS diagnoses, which led her to start and lead the advocacy and support organization PCOS Challenge.
PCOS is the most common hormonal condition affecting people with ovaries of reproductive age. In the United States, one in 10 women of childbearing age have the condition, which affects the endocrine and reproductive systems and is a common cause of infertility. Yet, the condition is significantly underdiagnosed—especially among people of color—and under-researched.
Read on to find out more about PCOS, what symptoms to look out for, what treatments are available, and useful resources.
What is PCOS, and what are its most common symptoms?
PCOS is a chronic hormonal condition that affects how the ovaries work. A hormonal imbalance causes people with PCOS to have too much testosterone, the male sex hormone, which can make their periods irregular and cause hirsutism (extra hair), explains Dr. Melanie Cree, associate professor at the University of Colorado School of Medicine and director of the Multi-Disciplinary PCOS clinic at Children’s Hospital Colorado.
This means that people can have excess facial or body hair or experience hair loss.
PCOS also impacts the relationship between insulin—the hormone released when we eat—and testosterone.
“In women with PCOS, it seems like their ovaries are sensitive to insulin, and so when their ovaries see insulin, [they] make extra testosterone,” Cree adds. “So things that affect insulin levels [like sugary drinks] can affect testosterone levels.”
Other common symptoms associated with PCOS include:
- Acne
- Thinning hair
- Skin tags or excess skin in the armpits or neck
- Ovaries with many cysts
- Infertility
- Anxiety, depression, and other mental health conditions
- Sleep apnea, a condition where breathing stops and restarts while sleeping
What causes PCOS?
The cause is still unknown, but researchers have found that the condition is genetic and can be inherited. Experts have found that exposure to harmful chemicals like PFAs, which can be present in drinking water, and BPA, commonly used in plastics, can also increase the risk for PCOS.
Studies have shown that “BPA can change how the endocrine system develops in a developing fetus … and that women with PCOS tend to also have more BPA in their bodies,” adds Dr. Felice Gersh, an OB-GYN and founder and director of the Integrative Medical Group of Irvine, which treats patients with PCOS.
How is PCOS diagnosed?
PCOS is diagnosed through a physical exam; a conversation with your health care provider about your symptoms and medical history; a blood test to measure your hormone levels; and, in some cases, an ultrasound to see your ovaries.
PCOS is what’s known as a “diagnosis of exclusion,” Ottey says, meaning that the provider must rule out other conditions, such as thyroid disease, before diagnosing it.
Why isn’t more known about PCOS?
Research on PCOS has been scarce, underfunded, and narrowly focused. Research on the condition has largely focused on the reproductive system, Ottey says, even though it also affects many aspects of a person’s life, including their mental health, appearance, metabolism, and weight.
“There is the point of getting pregnant, and the struggle to get pregnant for so many people,” Ottey adds. “[And] once that happens, [the condition] also impacts your ability to carry a healthy pregnancy, to have healthy babies. But outside of that, your metabolic health is at risk from having PCOS, your mental health is at risk, [and] overall health and quality of life, they’re all impacted by PCOS.”
People with PCOS are more likely to develop other serious health issues, like high blood pressure, heart problems, high cholesterol, uterine cancer, and diabetes. Cree says that teenagers with PCOS and obesity have “an 18-fold higher risk of type 2 diabetes” in their teens and that teenagers who get type 2 diabetes are starting to die in their late 20s and early 30s.
What are some treatments for PCOS?
There is still no single medication approved by the Food and Drug Administration specifically for PCOS, though advocacy groups like PCOS Challenge are working with the agency to incorporate patient experiences and testimonials into a possible future treatment. Treatment depends on what symptoms you experience and what your main concerns are.
For now, treatment options include the following:
- Birth control: Your provider may prescribe birth control pills to lower testosterone levels and regulate your menstrual cycle.
- Lifestyle changes: Because testosterone can affect insulin levels, Cree explains that regardless of a patient’s weight, a diet with lower simple carbohydrates (such as candy, sugar, sweets, juices, sodas, and coffee drinks) is recommended.
“When you have a large amount of sugar like that, especially as a liquid, it gets into your bloodstream very quickly,” adds Cree. “And so you then release a ton of insulin that goes to the ovary, and you make a bunch of testosterone.”
More exercise is also recommended for both weight loss and weight maintenance, Cree says: “Food changes and better activity work directly to lower insulin, to lower testosterone.”
- Metformin: Even though it’s a medication for type 2 diabetes, it’s used in patients with PCOS because it can reduce insulin levels, and as a result, lower testosterone levels.
What should I keep in mind if I have (or think I may have) PCOS?
If your periods are irregular or you have acne, facial hair, or hair loss, tell your provider—it could be a sign that you have PCOS or another condition. And ask questions.
“I call periods a vital sign for women, if you’re not taking hormones,” Cree says. “Our bodies are really smart: Periods are to get pregnant, and if our body senses that we’re not healthy enough to get pregnant, then we don’t have periods. That means we’ve got to figure out why.”
Once you’re diagnosed, Ottey recommends that you “don’t go through extremes, yo-yo dieting, or trying to achieve massive weight loss—it only rebounds.”
She adds that “when you get this diagnosis, [there’s] a lot that might feel like it’s being taken away from you: ‘Don’t do this. Don’t eat this. Don’t do that.’ But what I want everyone to think of is what brings you joy, and do more of that and incorporate a lot of healthy activities into your life.”
Resources for PCOS patients:
- AskPCOS: A guide designed by experts on the condition that helps answer all your questions about it and how to manage it.
- PCOS Challenge: An advocacy and support organization for people with PCOS.
- PCOS Patient Communication Guide: A tool for better communication with your health care providers.
- Polycystic Ovary Syndrome Question Prompt List: Questions you can ask your provider about PCOS.
For more information, talk to your health care provider.
This article first appeared on Public Good News and is republished here under a Creative Commons license.
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Cupping: How It Works (And How It Doesn’t)
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Good Health By The Cup?
In Tuesday’s newsletter, we asked you for your opinion of cupping (the medical practice), and got the above-depicted, below-described, set of responses:
- About 40% said “It may help by improving circulation and stimulating the immune system”
- About 26% said “I have never heard of the medical practice of cupping before this”
- About 19% said “It is pseudoscience and/or placebo at best, but probably not harmful
- About 9% said “It is a good, evidence-based practice that removes toxins and stimulates health”
- About 6% said “It is a dangerous practice that often causes harm to people who need medical help”
So what does the science say?
First, a quick note for those unfamiliar with cupping: it is the practice of placing a warmed cup on the skin (open side of the cup against the skin). As the warm air inside cools, it reduces the interior air pressure, which means the cup is now (quite literally) a suction cup. This pulls the skin up into the cup a little. The end result is visually, and physiologically, the same process as what happens if someone places the nozzle of a vacuum cleaner against their skin. For that matter, there are alternative versions that simply use a pump-based suction system, instead of heated cups—but the heated cups are most traditional and seem to be most popular. See also:
National Center for Complementary and Integrative Health | Cupping
It is a dangerous practice that often causes harm to people who need medical help: True or False?
False, for any practical purposes.
- Directly, it can (and usually does) cause minor superficial harm, much like many medical treatments, wherein the benefits are considered to outweigh the harm, justifying the treatment. In the case of cupping, the minor harm is usually a little bruising, but there are other risks; see the link we gave just above.
- Indirectly, it could cause harm by emboldening a person to neglect a more impactful treatment for their ailment.
But, there’s nothing for cupping akin to the “the most common cause of death is when someone gets a vertebral artery fatally severed” of chiropractic, for example.
It is a good, evidence-based practice that removes toxins and stimulates health: True or False?
True and False in different parts. This one’s on us; we included four claims in one short line. But let’s look at them individually:
- Is it good? Well, those who like it, like it. It legitimately has some mild health benefits, and its potential for harm is quite small. We’d call this a modest good, but good nonetheless.
- Is it evidence-based? Somewhat, albeit weakly; there are some papers supporting its modest health claims, although the research is mostly only published in journals of alternative medicine, and any we found were in journals that have been described by scientists as pseudoscientific.
- Does it remove toxins? Not directly, at least. There is also a version that involves making a small hole in the skin before applying the cup, the better to draw out the toxins (called “wet cupping”). This might seem a little medieval, but this is because it is from early medieval times (wet cupping’s first recorded use being in the early 7th century). However, the body’s response to being poked, pierced, sucked, etc is to produce antibodies, and they will do their best to remove toxins. So, indirectly, there’s an argument.
- Does it stimulate health? Yes! We’ll come to that shortly. But first…
It is pseudoscience and/or placebo at best, but probably not harmful: True or False?
True in that its traditionally-proposed mechanism of action is a pseudoscience and placebo almost certainly plays a strong part, and also in that it’s generally not harmful.
On it being a pseudoscience: we’ve talked about this before, but it bears repeating; just because something’s proposed mechanism of action is pseudoscience, doesn’t necessarily mean it doesn’t work by some other mechanism of action. If you tell a small child that “eating the rainbow” will improve their health, and they believe this is some sort of magical rainbow power imbuing them with health, then the mechanism of action that they believe in is a pseudoscience, but eating a variety of colorful fruit and vegetables will still be healthy.
In the case of cupping, its proposed mechanism of action has to do withbalancing qi, yin and yang, etc (for which scientific evidence does not exist), in combination with acupuncture lore (for which some limited weak scientific evidence exists). On balancing qi, yin and yang etc, this is a lot like Europe’s historically popular humorism, which was based on the idea of balancing the four humors (blood, yellow bile, black bile, phlegm). Needless to say, humorism was not only a pseudoscience, but also eventually actively disproved with the advent of germ theory and modern medicine. Cupping therapy is not more scientifically based than humorism.
On the placebo side of things, there probably is a little more to it than that; much like with acupuncture, a lot of it may be a combination of placebo and using counter-irritation, a nerve-tricking method to use pain to reduce pain (much like pressing with one’s nail next to an insect bite).
Here’s one of the few studies we found that’s in what looks, at a glance, to be a reputable journal:
Cupping therapy and chronic back pain: systematic review and meta-analysis
It may help by improving circulation and stimulating the immune system: True or False?
True! It will improve local circulation by forcing blood into the area, and stimulate the immune system by giving it a perceived threat to fight.
Again, this can be achieved by many other means; acupuncture (or just “dry needling”, which is similar but without the traditional lore), a cold shower, and/or exercise (and for that matter, sex—which combines exercise, physiological arousal, and usually also foreign bodies to respond to) are all options that can improve circulation and stimulate the immune system.
You can read more about using some of these sorts of tricks for improving health in very well-evidenced, robustly scientific ways here:
The Stress Prescription (Against Aging!)
Take care!
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