Have you seen this post about a new consumer device using some technology previously reserved for medical and research settings to measure other types of BP, is that better than brachial BP only?
I’ve heard of this before, but I don’t really know anything about it, sorry.
I checked out the official website, and it seems that it needs an app and there’s a subscription service to generate the full health reports etc. Very fancy, but also looks kind of gimmicky?
I love devices and measurement, but I need to ask myself: are the new metrics (central pressure etc) going to change what I’m doing? It seems to me that the “outcomes” would be: cardio and weight training, taking ARBs, lipid management etc. Those are things I already do. I suppose it’s possible that I could have a normal brachial BP, but a horrible central pressure, but I don’t know how likely that is.
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Thanks. Interesting about those 2 blood pressure ranges.
I did not realize blood pressure was such a massive driver of cardiovascular disease.
Thankfully I’ve usually had good readings between those 2 values you mentioned: 110-125/70-85.
I should probably home test it more often than 3x a year, be more precise.
Never been flagged for high blood pressure from the doctor, or prescribed anything for it.
Though I do use PDE5 often with amino acids and beet root, and have experimented with ARB, CCB, BB’s.
Ok, will try to get below 30mg/dl. It’s gonna be challenging. What do you recommend to use to get there?
20/40/80mg atorvastatin? Another statin? Something else?
I did talk to my GP about doing higher dose atorvastatin but they liked my bloodwork results with the 10mg and said since I have no side effects, we should stay with 10mg.
But perhaps I should say or show them something (test/studies etc) to get to 30mg level to help get on stronger dose? Or just ask for referral to a specialist if GP won’t change medications?
I’ve never had hsCRP tested before, so I’ll ask about getting it tested on my next test.
I’m in my 40’s. No, never had a calcium score or cardiac CT test.
Which test do you recommend?
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Some of the measurments are right on the device without an app. The health reports with the subscriptions don’t add anything necessary.
It’s basically measuring something more accurately and causal rather than proxy as brachial BP, I suppose.
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Hey,
- Yes, high blood pressure is a massive driver. It places a lot of stress onto the heart. And also, it increases the damage to artery walls, which is where those atherogenic lipoproteins (ApoB, Lp(a) etc) get in.
For blood pressure, a good practice is to measure it yourself, morning and night, every day for 2 weeks. That should give you a pretty reliable picture. Readings at doctors offices are often a bit higher than normal, and you haven’t had time to sit and rest etc. In your 40’s, if your average is higher than 115/75, you might want to consider medications to lower it.
- Medications for LDL-C lowering: I take 10mg Rosuvastatin, 10mg Ezetimibe every day. That combination got me from LDL-C of ~200mg/dl down to around 70mg/dl. Then I add 1x 140mg Repatha (PCSK9i, injection) once per month, which brings me to an average of around 30mg/dl (has a trough 1 week after the injection, which then gradually goes up as the injection wears off).
If you’re only on 10mg Atorvastatin, a very simple addition for you is 10mg Ezetimibe. By “GP” I assume you’re in the UK. Unfortunately, my experience of UK GPs has been that they are simply not interested in this stuff, and they’ll say you’re 40 and shouldn’t worry about heart attacks. However, I did manage to persuade my mother’s GP to prescribe her Ezetimibe on top of her statin. Personally I don’t think that escalating the statin dose is the most effective way - it’s diminishing returns above 10-20mg for most people. Hitting two independent pathways with two medications at lower doses is better than doubling the statin, and I think most cardiologists would agree with that statement.
Importantly, you can explain to the doctor about your high Lp(a) and that means you should be more aggressive with your LDL-C lowering.
This is an amazing study supporting aggressive lowering of LDL-C: https://www.sciencedirect.com/science/article/pii/S0735109721051159
Look at Figure 3, showing risk reductions all the way down to 50mg/dl.
Here is another fantastic article, arguing that you should intervene early (such as in your case, in your 40s, before your first event). Exposure is cumulative. The LDL cumulative exposure hypothesis: evidence and practical applications | Nature Reviews Cardiology
Regarding Lp(a), it is an independent risk factor, and yours is well into the “high risk” bracket of >50mg/dl:
This analysis shows that even with well-controlled LDL-C, Lp(a) still confers risk. (Obviously high LDL-C and high Lp(a) is worse still): https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.124.069556
Nice user-friendly summary here: https://www.acc.org/latest-in-cardiology/articles/2025/12/01/01/feature-lipoprotein-a
Taken together, knowing that we can’t yet lower Lp(a), that means you must treat other risk factors as aggressively as possible. You need to argue to your doctor that you are not a “typical” person where an LDL-C of ~70mg/dl would be acceptable. You are a high-risk patient with a genetic pre-disposition to cardiovascular disease that you can’t control.
- hsCRP is a nice biomarker. You can check the paper I shared in my previous reply. Basically, inflammation is another independent risk factor, so it’s something you should want to control. Lowering it is another thing altogether, and I’d argue it isn’t as actionable as the lipoproteins, but if it does turn out to be high, you might want to try and figure out why.
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Thanks for the great information. I will measure my blood pressure, morning and night, as you mentioned above for 2 weeks. Never done that before.
I’ll talk with my doctor and see what they say about all those products. Especially now I do have the Lp(a) tested and it’s high.
Will probably be a referral to a specialist, or there are private clinics/doctors that go on cost/$ bases (not covered by government) who might be fine with writing scripts for those various medications.
It will cost more, but I’ll calculate it out to see what I can afford.
As the Repatha is quite expensive, and might not be covered.
I like how you mention to be more aggressive with treating this, argue with the doctor about the situation as being a high-risk patient. All true. Especially since no medications are available right now for the condition.
I need to improve doing that sort of thing, as I usually am not like that when talking to them.
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No worries. I think you can first go through your GP, and talk about Ezetimibe. Adding 10mg Ezetimibe might get you from 70 down to 40mg/dl. You don’t need to go directly to PCSK9i medications.
And you don’t need to be confrontational with your GP. But you can explain to them that you are concerned about your Lp(a). You can show him/her that you are educated about your LDL-C, Lp(a) and other risk factors, and you can come with a couple of papers as evidence if they push back. The key (IMO) is the need for early intervention to reduce cumulative exposure.
I think it’s also worthwhile to explain that you are proactive and taking care of other things like exercise, nutrition etc. End of the day, Ezetimibe is dirt cheap, very effective, and really they shouldn’t be giving you any sort of argument against it.
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I highly recommend The Boston heart cholesterol balance test that Thomas Dayspring recommends. I ordered it through empowerdx. I had actually started with Ezetimibe before taking the test. It indicated that it would do nothing for me (it could’ve said the same for statin for another person). After three months on 10mg my cholesterol went from 109 to 107.
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