The Power of Two: Why Patient Validation is Crucial for Blood Pressure Control

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Are there any questions?

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So what you're saying is, you know, Dr.

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Choctaw you're talking
about high blood pressure.

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What about low blood pressure?

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Okay.

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Normally the belief is that the normal
for the bottom number of diastolic is 80.

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As long as it's above 60, and I'm
speaking generally now, everybody's

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a little different, it's not, it
should not be a major problem.

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If it goes below that, then
certainly you want to, um, um, you

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know, go to the emergency room or
call 9 1 1 or something like that.

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But normally it should not, it should
not be, but that's a good question.

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Thank you for reminding me.

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Yes, sir.

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Which one?

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more riskier to have the diastolic
or the, uh, the top or the bottom?

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Uh, I mean,

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no, that, that, that's
an excellent question.

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And I'll tell you why.

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Years ago, four to 50 years ago, we used
to only concentrate on the diastolic.

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You know, the doctors said,
well, you know, that top number

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you have, but that's okay.

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It's that, it's that lower number
that we're concerned about.

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Now that's changed.

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And so both are considered dangerous.

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Um, but, and that's contributed to some
of the confusion because 30 or 40 years

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ago, doctors would say, yeah, your, your
systolic is 150, but your diastolic is 92.

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So we're okay.

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You don't need to be on medication.

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Now that's completely flipped.

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Now, now we treat both equally, that we
don't want either one to be elevated.

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Now, I, I should parenthetically add,
every doctor doesn't agree with it.

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There's still some doctors
that say, no, I don't think

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you need to chase both of both.

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But most of the literature suggests
that to decrease stroke, heart attack,

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that you want to treat both numbers.

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One more question.

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What's the relationship between the
blood high blood pressure and plaque

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and plaque?

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Oh, excellent.

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Excellent.

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Thank you.

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Um, the damage that blood pressure does
is that when that blood comes out of

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the heart systole or pushes it out.

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It comes out through the aorta and
it hits all those different arteries.

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As it comes out at a high pressure, it
damages the internal wall of the artery.

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And so the wall, the wall ends
up getting more and more narrow.

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You know, there are plaques
that are laid there.

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This has to do with the
cholesterol that adds into that,

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so it gets more and more narrow.

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And as that wall of the blood pressure
gets more and more narrow, that

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puts more pressure on the heart.

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The heart has to work harder now to get
the same amount of blood pressure to you,

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so it does damage to the blood vessels.

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And a good way is to look at the blood
vessels as canals that carry the blood.

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But if it comes out very
hot, it's hitting that wall.

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And, and this is every second, you
know, your heart is beating 24 7.

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So just think about that, if
you're 50 years old, think about

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how often that's happening.

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And pretty soon that, that wall begins
to show, show the effects of that damage.

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So you want to lower that blood
pressure, plus you don't want that

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heart to work any more than it has to.

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It might be great up to 50
years, but what about 60 years?

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What about 70 years?

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The average life expectancy is about, I
think in this country, is about, for men

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it's probably about 71 years, for women
it's higher, probably because they go

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and have their blood pressure checked
at the doctor's office more often than

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we men do, uh, but that's why it damages
the wall, that's what the pressure is.

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And one last question, uh, you were
mentioning about resting, you know, put

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in that mode, non husband wife mode,

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in resting position before taking in,
measuring your, your, your pressure.

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Yes, yes, yes.

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Um, but if I do that, I mean, am I,
wouldn't be able to also to, if it's

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high, not high, but let's say if I'm 125.

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Okay.

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My rest.

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You want to bring it
down, because I'm resting.

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I'm very, uh.

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Yes, and that's what we have.

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It will come down some.

80
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It varies how much it comes down.

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But usually it will be a
little lower, most of the time.

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But is that realistic?

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Is that, I mean, is that the real issue?

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Accurate?

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Yes, it is.

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Yes.

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No, I understand your question.

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Yeah.

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It's just as accurate as it was
before you wrestled because, and

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that's, that's the whole point.

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If you're in control, you can make that
a certain way as often as you like.

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Right?

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So, so part of it is sort of
training yourself to get it at

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that lower level, but first you
gotta know what that level is.

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You see what I'm saying?

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So let's say you're
sitting, it's 130 over 80.

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You stand, it's 125 over 80.

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You say, okay, all right.

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So now I want to get that
125 when I'm sitting.

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So it's, it's things for you to work on
and it may vary the different time of day.

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So you might want to take the
blood pressure in the morning.

102
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You might want to take it in the
evening, record it because that's all

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the way, that's all the way you can
know, what it is at different times.

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And that's a good thing to know.

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Maybe, let's say you take your blood
pressure every single day, twice a

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day, and you notice a pattern after a
couple weeks, you notice on Wednesday,

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in the evening, your blood pressure is
always high, always high, consistently.

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And so you say, well, why is that?

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What, what am I doing on
Wednesday in the evening?

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And you may be able to track
back to an event that occurs.

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Maybe, maybe somebody comes to visit you.

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I don't know.

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But, but, so then you can, you
can control your environment and

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say, okay, I'm not going to do X.

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on Wednesday, whatever.

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So that's the other reason for
doing it at different times.

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Definitely.

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Mm hmm.

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To be rushing and get there late.

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Yes.

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Because when you get there
later than as soon as you sit,

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then get a nurse call you in.

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Exactly right.

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The first thing they're gonna do is have
you wait and then do the blood test.

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And your blood pressure will be high.

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Right.

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So we should try to make sure
we come in plenty of time.

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Yeah.

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And, and, but we, we are gonna be late.

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I, I hate being late,
but I am late sometimes.

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I, I, I am, um, I always try to
be early so that I'm never late.

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And most times that work,
but it doesn't always work.

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But, but you can say to the, to
the nurse, I, this is what I do.

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Well, you know, I, I was rushing.

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I couldn't find a parking spot and, and
that was a long line and this and that.

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I don't know whether that
works, but I, I do it anyway.

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Uh, but, but just work on that, you
know, and, and now that you know

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that that's an issue, then look at
ways that you can mitigate that.

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Um, if they give me a one o'clock
appointment, I try to be there at 1230.

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Just me because I know something's going
to happen that I can't control because

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I don't know what it is yet And more
likely than not that'll get me there

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one o'clock on time Not always but it
increases my yield so I was sort of do

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that because that I can control I can't
control all this other Stuff that might

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happen, you know, somebody cuts me off
on the freeway or whatever, whatever,

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whatever But I try to manage those things,
but those are realities Absolutely.

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But when people get their arteries
fogged up, like my brother in law.

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Okay.

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He had three of his
arteries was fogged up.

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He had to have a discovery.

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I don't know if that
had anything to do with

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it.

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Absolutely.

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Absolutely.

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And what, what you, what
she's talking about is, is a

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heart attack to some extent.

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Because as I'm talking about those blood
vessels, It's where the heart is pushing

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and it's going out throughout the body.

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The heart also has blood vessels on it.

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As it pushes the blood out, it's
supplying itself, heart's just a

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muscle with, with blood vessels.

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You know, the, uh, LAD, you know,
the right, the right vessels,

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the right vessels, et cetera.

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And they are, those
are tiny blood vessels.

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If they get clogged or whatever, then
you have a heart attack because if

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the heart can't get muscle, can't
get blood to its own muscle, it dies.

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It weakens.

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It's not as efficient.

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Some call that heart failure.

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Heart failure is where the heart
is pumping, but it's not getting

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the blood out as well as it should.

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And usually we have medication many
times to try to help the heart with it.

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So no, that's extremely important
because it's just, that's

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probably even more serious.

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Because those blood vessels are
so small, the margin for error

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is very, very, is very, very low.

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Yes, sir?

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Computers.

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How much faith do you put in
computer answered questions of

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your feelings or medical care?

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That is an excellent question,
because it's right in keeping

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with 2024, uh, AI, whatever.

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And I, you know, I'm 76 years old, all
right, so I can tell you, I've come from

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the black and white TV and the rotary
phones and all that sort of stuff.

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My approach is I don't
pretty much trust anything.

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100%.

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But I believe that the
computer is not going anywhere.

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Um, and, um, this phone really does help
me, you know, to do what I need to do.

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So I take it, I use it, but I
take it with a grain of salt.

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To put it another way, uh, Ronald
Reagan once said, trust but verify.

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So I, I'll look it up on the computer,
but I'll use a different source.

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You know, I may ask, Uh, a professional
and say, you know, doctor, so and so,

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what, what do you think I looked it up
on, on, um, the Mayo Clinic website?

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What, what, what's been your experience?

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I, I verify, you know, so I still
do it, but I, but I verify, but

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I think it's reasonably accurate.

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It's not perfect.

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It's not perfect.

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So the other thing I do is I'll look it
up under more than one source, you know,

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so I may look up two different sources.

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And if two or three sources tell
me the same thing, then, then

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I'm more likely to, to trust it.

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But I think healthy skepticism is good.

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I think it's good to always be a
little skeptical, uh, because people

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will try to tell you anything, and
you don't want to believe them.

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Say, the Mayo Clinic.

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Yes, yes, yes.

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So you kind of feel more confident
in them than, say, you just go

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online and anybody checks it.

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Yes.

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And,

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and that, that's another great part.

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Uh, that, that's why I, I gave
you names to look up, because

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those are names that I use.

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Okay.

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So I've already done some of that better.

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So I'm comfortable if I look at Yale
Health or Kaiser Permanente or Mayo

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Clinic or Harvard Health, um, because
I've, I've been doing that for years.

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Every, when I do these presentations,
every day I get literature

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from all of them, you know,
magazines usually for physicians.

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And so I, I read that every single
day and then I come up with what

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topic I'm going to talk about.

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So I, I use them as a resource.

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That's about it.

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But yeah.

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No, I definitely would suggest it.

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Do we have any questions online?

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Oh!

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Hello, welcome.

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Hello.

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Hello.

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I just got here.

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Were you guys talking about the anxiety
today or the high blood pressure today?

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We were talking about high blood pressure.

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Anxiety is next month, but watch the
church website because some podcasts

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are coming out on anxiety even
before the masterclass next week.

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Okay, so I do have a question.

237
00:11:51,294 --> 00:11:51,854
Um, yeah.

238
00:11:52,864 --> 00:11:57,914
I've been taking high blood pressure
medicine for about six years, and

239
00:11:57,914 --> 00:12:02,255
then my husband went to the doctor a
couple weeks ago, and they're like,

240
00:12:02,334 --> 00:12:08,444
oh, your home machine is like reading
20 points higher than it should be.

241
00:12:09,144 --> 00:12:14,425
So I was wondering, should I approach
my doctor and see if I still need

242
00:12:14,425 --> 00:12:17,155
to be on this medication or not?

243
00:12:18,305 --> 00:12:19,464
Well, let me ask you a question.

244
00:12:19,704 --> 00:12:20,944
How old is your machine?

245
00:12:20,954 --> 00:12:22,724
Is it, is it accurate up to date?

246
00:12:23,369 --> 00:12:23,890
Well, he got

247
00:12:23,890 --> 00:12:24,749
a new one now.

248
00:12:24,749 --> 00:12:29,099
So the, the other one, I'm not sure how
old it was, but when he took it into

249
00:12:29,499 --> 00:12:33,999
Kaiser and they compared it to what they
had, they said that it's reading wrong.

250
00:12:35,459 --> 00:12:35,829
Okay.

251
00:12:35,829 --> 00:12:38,600
So they, they said that, that
your machine was reading wrong.

252
00:12:38,920 --> 00:12:39,380
Yes.

253
00:12:40,060 --> 00:12:40,390
Okay.

254
00:12:40,429 --> 00:12:41,419
Actually, that's a good thing.

255
00:12:41,500 --> 00:12:42,160
That's a good thing.

256
00:12:42,160 --> 00:12:43,520
So, cause you can get rid of the machine.

257
00:12:43,970 --> 00:12:44,670
Uh, good.

258
00:12:45,120 --> 00:12:47,550
Uh, so what, what I would
recommend, check the blood

259
00:12:47,550 --> 00:12:49,270
pressure to different times of day.

260
00:12:49,819 --> 00:12:54,169
You know, uh, and, and, and record
it because what you want to know

261
00:12:54,199 --> 00:12:55,979
is, is there a certain pattern?

262
00:12:56,529 --> 00:13:00,660
Um, and that's how you validate
the accuracy of the blood pressure.

263
00:13:00,670 --> 00:13:04,029
When you check it at home, check
at different times of day and

264
00:13:04,029 --> 00:13:05,239
different days of the week.

265
00:13:05,929 --> 00:13:06,169
Okay.

266
00:13:07,574 --> 00:13:11,494
And the other thing is, uh, yeah, as,
when, when you go back and see your

267
00:13:11,494 --> 00:13:15,874
doctor, take your blood pressure cuff with
you when they check your blood pressure,

268
00:13:16,094 --> 00:13:20,664
have them to check your blood pressure
with your cuff to make sure it's the same

269
00:13:21,314 --> 00:13:23,064
as the reading that you get when you go.

270
00:13:24,104 --> 00:13:24,424
Okay.

271
00:13:24,794 --> 00:13:25,274
Thank you.

272
00:13:25,734 --> 00:13:26,124
Okay.

273
00:13:26,154 --> 00:13:26,904
You're very welcome.

274
00:13:28,564 --> 00:13:29,674
Any other questions?

275
00:13:32,254 --> 00:13:32,854
Okay.

276
00:13:33,354 --> 00:13:34,435
It is.

277
00:13:34,614 --> 00:13:37,405
Oh, I don't know.

278
00:13:37,405 --> 00:13:41,035
Uh, thank you all very much.

279
00:13:41,225 --> 00:13:44,125
Uh, Pastor Rivas, would you close
us with a word of prayer, please?

280
00:13:44,504 --> 00:13:48,065
Father, thank you for this day
you've given us, O Lord God.

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00:13:48,335 --> 00:13:52,564
This is the day that you have made and
we shall rejoice and be glad in it.

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00:13:53,334 --> 00:13:57,765
Thank you for the information, for
the knowledge that you have given

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00:13:57,765 --> 00:13:59,674
us, O Lord God, through you, Dr.

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00:13:59,674 --> 00:14:00,374
Chactau.

285
00:14:00,734 --> 00:14:06,165
I just Ask the Lord God to keep him
and his family safe wherever he is,

286
00:14:06,165 --> 00:14:12,214
wherever he goes, that, uh, his exit
and his entering of Father be a bless,

287
00:14:13,124 --> 00:14:16,254
uh, to himself and to the family and
to all the people who are around him.

288
00:14:16,614 --> 00:14:21,074
As a matter of fact, also bless
every family that he's represented,

289
00:14:21,354 --> 00:14:24,794
uh, essentially, oh Lord God,
and those who are virtually.

290
00:14:25,014 --> 00:14:27,614
In Jesus name, we thank
you and we praise you.

291
00:14:27,684 --> 00:14:28,194
Amen.

292
00:14:28,254 --> 00:14:28,724
And amen.

293
00:14:29,784 --> 00:14:30,244
Thank you.

294
00:14:30,294 --> 00:14:31,094
Have a great day.