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Old 08-20-18, 10:14 PM
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canklecat
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The body doesn't always respond as expected to diet, exercise and lifestyle. Other complications can determine heart rate, BP and other issues, despite diet and exercise.

I'm 60 in reasonably good health despite some challenges (wonky thyroid, being checked this week for cancer). My blood work lab tests are fine. No problems with cholesterol. I eat whatever I like, but always within moderation. I exercise as vigorously and often as I can, mostly cycling (less often the past few months since I was hit by a car and the thyroid problems worsened). I take no prescription meds routinely. Occasionally I take metoprolol, a beta blocker, to relieve migraines/cluster headaches. It's an old trick dating back decades and helps some folks who suffer migraines and/or cluster headaches. The beta blockers make me a bit tired and dizzy for a day or so but it's a fair tradeoff for the pain relief. It does lower my BP and HR a bit.

My resting heart rate is seldom below 70, even when I was younger and fitter. Usually it's closer to 80. My BP is pretty normal but varies significantly. I often check my BP and HR during indoor training sessions, particularly high intensity intervals, and sprint/hill climb simulations. During maximum effort my HR peaks around 160-170, BP up to 160/90. That's not unusual for many folks. After awhile my BP settles to around 130/80 during the workout. Immediately after a workout it's not unusual for my BP to drop to 80/50 for about 15 minutes. Because HIIT can cause dizziness and even a bit of nausea I limit my sessions to once a week and only indoors now. I use that level of exertion only to improve my overall fitness so I can handle real hills and headwinds with more comfort. I don't race. I just want to be able to keep up with friends in group rides without being the anchor slowing everyone else down, or younger friends asking me if I'm okay.

It's possible my erratic BP and HR are influenced by my wonky thyroid. I'll find out more after a biopsy and other tests this week. I suspect it's due in part to an autoimmune disorder I was diagnosed with 15 or so years ago, but never really followed up on (Hashimoto's).

But, frankly, my BP and HR have never been typical for athletes. Even in my teens and 20s my HR and BP tended to run higher than average in competition. When I was an amateur boxer a ringside medic nearly freaked out when my BP was 140/90 before a fight. I told him "Have you looked at my opponent? I'm 5'11" and 154 lbs. He's well over 6 feet tall and at least a super middleweight, possibly a light heavyweight. Of course I'm anxious!" The doc let me go ahead with the bout. I outpointed the guy, but it was my toughest match.

Just before his first title bout against Sonny Liston, Muhammad Ali (then Cassius Clay) had a BP of something like 200/100. The doctor threatened to cancel the fight, but Ali and his handlers said he was fine, he just pretended to get excited and acted crazy to intimidate Liston. Years later, Ali admitted he was terrified of Liston and until he actually got in the ring wasn't sure he could beat Liston. The peak Sonny Liston was actually very good, a smaller version of a style similar to George Foreman. Just a bad stylistic matchup against Ali. Not that Liston and Foreman were overrated -- they were both fearsome fighters. But they played right into Ali's strengths, while Joe Frazier and Ken Norton exploited Ali's weaknesses and flaws.

Nowadays even when my systolic pressure is over 130, my diastolic usually is around 70 or lower. The current conventional wisdom says that's not too bad, since the resting or diastolic pressure is considered to be more significant in terms of overall heart health.

I may eventually take BP meds full time. I can cope with the minor loss of energy issues. But I doubt I'll take cholesterol meds until the old medical studies have been repeated to correct some admitted errors.

There's no consensus or definitive connection between diet and cholesterol and whether serum cholesterol has anything to do with plaque inside blood vessels. Most of the current practice is based on educated guesswork at doing the least harm -- the notion that it's safer to take the anti-cholesterol medication, even if it doesn't actually help prevent atherosclerosis.

One of my uncles did everything right -- diet, medications, etc -- and still had serious atherosclerosis, multiple procedures to unclog arteries, multiple strokes from TIAs to full blown strokes. Nothing seemed to make any difference. He ended up with Parkinson's and dementia in his 80s.

My mom wasn't as careful about her diet until I took over managing her health care over the past decade. Her cholesterol issue wasn't quite as serious and she took her meds. She still had multiple transient ischemic accidents (mini-strokes), gradually worsening dementia for which none of her neurologists could pinpoint any cause, and ended up in a nursing home a few months ago with severe osteoporosis despite careful management of her diet and medications.
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