I have the same question. The operational definition of "too low’ is generally based on a binary outcome: “I’m dizzy and might/did fall” or “I’m not dizzy and do not have an increased chance of falling.”
With the combination of 80 mg. telmisartan and aged black garlic (which added ~5 point drop), my lowest BP while awake is ~103/62. I do not feel dizzy at that BP, even if I stand quickly, so that is my personal benchmark and I have no interest in going lower. I know one person who doesn’t like to go lower than 110 SBP because he feels “woozy.”
On points like this, Attia’s admonitions come to mind when he notes that for older adults, the first goal is not to sustain an injury, especially a fall, because it can precipitate a downward spiral from which there is no recovery. I think about this a lot because I like to hike and I know that one serious fall could put a permanent end to my ability to exercise – at this level or perhaps any level. The same is true for certain weight bearing exercises. Attia, for example, said that he stopped doing full squats when he reached ~50 years of age. I have stopped doing them as well, along with most routines that involve hyper extension.
@CronosTempi I never knew this about dementia (Sophie’s choice!). Thanks for the numbers, that will help me track it.
@RobTuck I didn’t know this about black garlic… I”ll look that up for the husband.
I’ve recently started l’citrulline for us to help the cause. I have not checked to see if it has had any effect on my bp but I’m hoping it’s just generically good for the vascular system.
One more potential time saver is that you are looking for the exact specification you will see on the LE label. Most of the studies that show BP results are based on 1.25 mg S-Allyl-Cysteine. The LE formulation provides 2.5 mg.
There is no hard answer to that but generally you don’t want it so low as to start negatively influencing brain perfusion. This can start occurring at levels below 70 so as a rule of thumb it’s probably best if the diastolic doesn’t go much below 70. Height most likely matters a little bit here but short people should tolerate slightly lower blood pressure than tall people before it starts negatively impacting brain perfusion. The reason for that is simple physics, but the taller you are the higher the blood pressure needs to be when standing up right to pump blood all the way up to the brain. That’s why infants are fine with diastolic blood pressure far below 70.
It goes without saying that if you notice frequent dizziness upon standing up that isn’t explained by other things, then you may be running a blood pressure that is slightly too low. That said, lack of dizziness is not enough to be certain that perfusion is excellent. It’s most certianly possible to have suboptimal perfusion occasionally desepite noticing no symptoms.
The target in this instance is S-Allyl-Cysteine in the amount of 1.25 to 2.5 mg. Additionally, there is a difference between aged garlic and aged black garlic; the research sourced S-Allyl-Cysteine from aged black garlic so there is always the possibility of shadow contributions from naturally co-occurring ingredients. TBD, I suppose. Life Extension’s product, and a few others, contain a formula specifically optimizing that ingredient.
I like Kyolic products and took one of their garlic formulations for years but it had no impact that I could determine on my BP.
Important point @Olafurpall. Since brain perfusion is most closely tracked with mean arterial pressure, it is worth calculating that. One simple formula is:
MAP = Diastolic BP + 1/3 (Systolic BP – Diastolic BP)
or MAP = (2 × Diastolic BP + Systolic BP) / 3
From the formula, you can see that DSP accounts for more of the outcome. Consistent MAP below 60 is definitely concerning and a better target might be 65 or 70.
Using my typical afternoon BP as an example – 108/62 – one might be concerned about perfusion based on the low DBP. However, the MAP of this reading is 77.3 which is above the level of 70 generally thought to be the safety threshold for the average person.
At the low end (our discussion here) MAP generally accounts for most variance in health outcomes.
@RobTuck FYI Dr Luks, osteopath, is pitching agility excersize for safe aging. IE surprise movement one must stay a master of to catch a trip or fall. Makes sense. IE weight lifting not that useful besides retaining muscle but to prevent falling one needs agility training.
I’ve upped my telmisartan dose to 40mg this week. Hasn’t done much for my BP, but it’s already low. I want it for the ARB activity, even though it isn’t an inverse agonist.
Let us know what your blood pressure was before and is after on the 40 mg TM for a few weeks. I have friends who have mid range normal blood pressure who want to determine if they can safely take a lower dose TM.
I realize we are a different group, but just sharing HOW different we are…
We had people over last night.
The guy’s company sends him to Princeton Longevity (8k paid for by them) and he mentioned his bp is always high there, but they said it’s probably white coat and they are not worried (foreshadowing).
So, I whipped my CONNEQT and it showed he has stage 2 hypertension! (We had been sitting fairly still at the table for over an hour, so I feel it was a good read).
I’ll also note, while he is an active and fit man, I was blown over that he didn’t seem concerned one bit (I’m hoping this means the fancy $$ longevity clinic was not as blasé as he made it seem, otherwise…)
I could not get over the contrast between how proactive we are and how the rest of the world is… even including an exceptionally smart (much more so than I!) and ‘seemingly’ health minded educated person.
I agree. In my experience, these clinics – I am most familiar with Mayo – are best suited to serve reasonably affluent clients who have little interest or knowledge in geroprotection and want to be told what to do. The outcome is not good if someone like us goes through their program because they are not used to being challenged. In fairness, the clinics dispense “settled” longevity knowledge. In our group (as I am sure some tire of some of us pointing out) we can be certain of little (perhaps nothing) and reasonably certain of much less that one might infer from reading many of our posts. If you structure deep LLM research to elevate only interventions for which the evidence is sufficient to label “high probability” (perhaps 95%), you will see from zero to five geroprotectives listed. Rapamycin is typically not one of them. SGLT2i’s might be the common element for first or second place.
That’s a good BP so long as you feel alert, can perform your usual cognitively complex tasks, and to not get dizzy. Try a “safe test” of jumping up quickly while holding on to support or being near a chair or cushion. I feel great at that BP. Better than when it was typically 128/75.
yea, I will skip the jumping, but I did 8km on the elliptical this morning and spent all last week mudding drywall in my basement without any worries. I did remove citrulline from my stack before increasing my dosage.
One thing to watch out for. In my experience, TM quickly produces a drop in BP, followed by a smaller and more gradual decline that can play out for 30-45 days or more as you realize knock-on benefits from being less labile. Not everyone reports this. Either way, it is probably a good idea to take at least one reading a day for the first 30 days, generally late afternoon or early evening will be your lowest BP.
Thanks for mentioning this! I only recently started taking l citrulline for the non bp benefits… and with my good bp which is on the low end of normal, I should look at this more closely now that I’m starting 20mg TM.