So, and I think that's really important to know because even if someone doesn't have frank hypertension after that 120 or 80 cut off point, you, like you said, you start getting that incremental risk. Now is there some low number that you find can be potentially deleterious? Is it kind of like the three bears in the oatmeal where, you know, too high is bad, but too low is bad. And what does that cut off for you? Yeah, the opposite is if you get too low of blood pressure, you will under-perfuse your organs.

So if it's your brain, you can pass out all these consciousness. Give it your heart. You can actually end up with a heart attack, kidneys, you get kidney problems. So the

lower limit generally

about 110 over 70. Now occasionally you can drop a little lower short term, but if you're symptomatic, certainly you need to reduce the medications. And most people, for example, they stand up too quick to get dizzy, the light headed, they exercise or blood pressure falls. And you just have to teach them how to check their pressure at home with a blood pressure cuff and then adjust the medicines accordingly.

Got it. And what are some common contributing medical conditions to hypertension or to high blood pressure?

There's a whole list of secondary causes, but honestly about 90% high blood pressure is actually genetic. The other 10% are called secondary. So there's different types of adrenal problems, field chromisetoma, which makes too much adrenaline. Another one makes too much cortisol. Another one makes too much alistairana. All these are hormones that cause blood pressure to go up due to constriction of the arteries or increase in salt and water absorption. And then there's a lot of drugs on the market that are over the counter, but also prescription that can elevate blood pressure. So you always look for the dietary things, like too much sodium, not enough potassium, obesity, for example. And there's a lot of other causes, but those are the main ones that people should be aware of.

Now, is it the case that 90% of people with quote unquote essential hypertension are more genetics that is it the case that the genes load the gun, but the environment pulls the trigger or is it sort of like people are going to get hypertension as kind of the vascular endothelial dysfunction progresses over time? What's your thought on the interaction of lifestyle and vascular disease? Yeah. So there's clearly two pieces to

that equation, the genetics and then the genetic expression. And we'll get to the basics of why you have high blood pressure, but when you have a hypertension gene and there's a bunch of these and we measure those, the expression of those genes is three basic responses. So there's inflammation, oxidative stress and vascular immune dysfunction. And so what happens early on is you get arterial disease, like endothelial dysfunction. The arteries will get stiff, they constrict so that the precursor for hypertension actually is vascular biology problems, vascular disease. And then the blood pressure goes up as a end result of the vascular problem. And that gene can penetrate early as a teenager or a can penetrate later usually in their thirties or forties. But you can modify the gene expression by doing certain environmental things. And we talk about dietary things like sodium, magnesium, potassium, exercise, weight reduction, you know, a lot of different techniques.

So let's take a deep dive into that because your book, which is controlling high blood pressure through nutrition supplements, lifestyle and drugs. So nutrition is that first piece there that you mentioned. And we know that food is medicine, we know that food can change genetic expression, food is information. So when you talk about nutrition, what nutrition recommendations do you recommend for say a patient with high blood pressure?

The best study is called a dash to diet that stands for dietary approaches to stop hypertension. It was published in the New England Journal. And it's basically a low sodium, high potassium, high magnesium, high fiber, plenty of protein, low fat, particularly saturated fats, no trans fats, but then increasing good fats like omega threes, monounsaturated like olive oil. And the Mediterranean diet and the dash to diet are actually very similar because they're more of a plant based diet with the right types of minerals and electrolytes in them. And in the book that that I just published, we go through all the different types of high blood pressure diets available. But we really give the hypertension institute diet. It's called hip, hypertension

institute. Well, we're going to be hip. So yes, the

hip program. And so if you want to be hip, there's a lot of information in the book, particularly two chapters that I wrote with my nutritionist, Lee Bell, on what you do to manage blood pressure with the nutrition and good dietary means.