As Dr. Frita Fisher explains, these are actually the top 10 known causes of high blood pressure. Number zero on the list would be “primary hypertension”, which means high blood pressure with no clear underlying cause.

Superficially, this feels a little like the sometime practice of writing the catch-all “heart failure” as the cause of death on a death certificate, because yes, that heart sure did stop beating. But in reality, primary hypertension is most likely often caused by such things as unmanaged chronic stress—something that doesn’t show up on most health screenings.

Dr. Fisher’s Top 10

• Thyroid disease: both hyperthyroidism and hypothyroidism can cause high blood pressure.
• Obstructive sleep apnea: characterized by snoring, daytime sleepiness, and headaches, this condition can lead to hypertension.
• Chronic kidney disease: diseases ranging from diabetic nephropathy to renal vascular disease can cause high blood pressure.
• Elevated cortisol levels: conditions like Cushing’s syndrome or disease, which involve high cortisol levels, can lead to hypertension—as can a lifestyle with a lot of chronic stress, but that’s less readily diagnosed as such than something one can tell from a blood test.
• Elevated aldosterone levels: excess aldosterone from the adrenal glands causes the body to retain salt and water, increasing blood pressure, because more stuff = more pressure.
• Brain tumor: tumors that increase intracranial pressure can cause a rise in blood pressure to ensure adequate brain perfusion. In these cases, the hypertension is keeping you alive—unless it kills you first. If this seems like a strange bodily response, remember that our bodily response to an infection is often fever, to kill off the infection which can’t survive at such high temperatures (but neither can we, so it becomes a game of chicken with our life on the line), so sometimes our body does kill us with one thing while trying to save us from another.
• Coarctation of the aorta: this congenital heart defect results in narrowing of the aorta, leading to hypertension, especially in the upper body.
• Pregnancy: pregnancy can either induce or worsen existing hypertension.
• Obesity: excess weight increases blood flow and pressure on arteries, raising the risk of hypertension and associated conditions, e.g. diabetes etc.
• Drugs: certain medications and recreational drugs (including, counterintuitively, alcohol!) can elevate blood pressure.

For more information on each of these, enjoy:

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Want to learn more?

You might also like to read:

Hypertension: Factors Far More Relevant Than Salt

Take care!

Dr. Michael Bruce, the Sleep Doctor, addresses a common concern: waking up in the middle of the night and struggling to fall back asleep.

Understanding the Wake-Up

Firstly, why are we waking up during the night?

Waking up between 2 AM and 3 AM is said to be normal, and linked to your core body temperature. As your body core temperature drops, to trigger melatonin release, and then rises again, you get into a lighter stage of sleep. This lighter stage of sleep makes you more prone to waking up.

Note, there are also some medical conditions (such as sleep apnea) that can cause you to wake up during the night.

But, what can we do about it? Aside from constantly shifting sleeping position (Should I be sleeping on my back? On my left? Right?)

Avoid the Clock

The first step is to resist the urge to check the time. It’s easy to be tempted to have a look at the clock, however, doing so can increase anxiety, making it harder to fall back asleep. As Dr. Bruce says, sleep is like love—the less you chase it, the more it comes.

It may be useful to point your alarm clock (if you still have one of those) the opposite direction to your bed.

Embracing Non-Sleep Deep Rest (NSDR)

Whilst this may not help you fall back asleep, it’s worth pointing out that just lying quietly in the dark without moving still offers rejuvenation. This revujenating stage is called Non-Sleep Deep Rest (otherwise known as NSDR)

If you’re not familiar with NSDR, check out our overview of Andrew Huberman’s opinions on NSDR here.

So, you can reassure yourself that whilst you may not be asleep, you are still resting.

Keep Your Heart Rate Down

To fall back asleep, it’s best if your heart rate is below 60 bpm. So, Dr. Bruce advises avoiding void getting up unnecessarily, as moving around can elevate your heart rate.

On a similar vain, he introduces the 4-7-8 breathing technique, which is designed to lower your heart rate. The technique is simple:

• Breathe in for 4 seconds.
• Hold for 7 seconds.
• Exhale for 8 seconds.

Repeat this cycle gently to calm your body and mind.

As per any of our Video Breakdowns, we only try to capture the most important pieces of information in text; the rest can be garnered from the video itself:

Wishing you a thorough night’s rest!

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