High Blood Pressure VS. Hypertension: Is there a difference?
In this educational video Dr. John Osborne, Chief Medical and Scientific Officer at Clear Cardio, provides a comprehensive deep‑dive into blood pressure and hypertension. He begins by emphasizing that high blood pressure is a silent, asymptomatic condition that affects half of U.S. adults and is a major risk factor for stroke, heart attack, heart failure, kidney damage, blindness, and dementia. He defines normal blood pressure as <120/80 mmHg and high blood pressure as >130/80 mmHg (with 120/80 mmHg being ideal), explaining the physiological basis of systolic and diastolic pressures. Osborne outlines the body’s redundant regulatory systems—brain, heart, kidneys, hormonal axes, and the autonomic nervous system—that together maintain pressure. He reviews major risk factors, both non‑modifiable (age, genetics) and modifiable (excess sodium, obesity, sedentary lifestyle, smoking, certain medications). Non‑pharmacologic interventions are highlighted, especially the DASH (Dietary Approaches to Stop Hypertension) diet, low‑sodium intake, potassium chloride substitution, and the blood‑pressure‑lowering benefits of non‑fat dairy. He advises on accurate home monitoring, recommending an upper‑arm digital cuff (specifically the Omron Evolv) over wrist devices, and suggests taking frequent readings to assess trends, aiming for a consistent systolic <130 mmHg and diastolic <80 mmHg. While preferring lifestyle changes, he acknowledges the rapid, reliable effect of antihypertensive medications for those who need them, including patients with resistant hypertension. Finally, Osborne promotes Clear Cardio’s services—patient assessment calls, the PULSE program, and a combined medical‑functional approach—to help individuals achieve optimal blood pressure control and reduce cardiovascular and cognitive risk.
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There's a good reason why we call blood pressure the silent killer, because usually you may have no symptoms whatsoever. It's good for your blood vessels, it's good for your brain, it's good to prevent dementia, by the way, it's good to prevent plaque progression, it's good to help prevent heart attacks, and good to prevent blindness, by the way. So high blood pressure can even blind you. Hello everybody, this is Dr. John Osborne, the Chief Medical and Scientific Officer at Clear Cardio. So today we're going to do a deep dive into blood pressure— what it is, why we worry about it, why we follow it, why we track it. We'll give you some tips on how to track your blood pressure at home, easy simple things, and then we'll talk about how we can help you at Clear Cardio with your blood pressure. So, a couple big pictures. High blood pressure is epidemic. Half of U.S. adults, anyone over 18, has high blood pressure. In the U.S., by the way, the lifetime risk of developing high blood pressure is 90% from the age of 40. So, it is incredibly common, incredibly epidemic, and there's a good reason why we call it the silent killer, because usually you have no symptoms. It could be great and normal, it could be elevated, it could be severely elevated, and you may have no symptoms whatsoever. So, I will say, many people tell me, I kind of know when my blood pressure is high. Honestly, use a number, use a monitor. We'll talk about some of the tricks there in a minute, but If you worry, wonder about if you have high blood pressure or not, just check it. You know, I wouldn't say, you don't look anemic, or you do look anemic, just by looking at you, I couldn't tell. I couldn't tell what your, you know, your calcium levels are, or your sodium levels are, or your cholesterol levels are by looking at you. So if you really want to know, is your blood pressure high, is it borderline, is it normal, whatever, you just got to measure it. And it's really super simple. We'll talk about some of the details here in a minute. So a very, very simple question that, again, I hear all the time, what is high blood pressure? Very simply, We're talking about a tube, a blood vessel, and high blood pressure is literally how much pressure is exerted by the blood in that tube, the blood vessel, on the wall of the vessel. That's what it is. Our body is really designed to work in optimal levels of blood pressure, which we're going to say normal is actually below 120 on the top, that's the systolic number, and 80 on the bottom, which is the diastolic number. We're going to call that normal. Now, interestingly, there are studies, epidemiologics data, that suggest normal blood pressure could even be lower, maybe even 90 to 100. We're going to say where the data are for the moment is normal blood pressure is below 120/80. It's good for your blood vessels, it's good for your brain, it's good to prevent dementia, by the way, it's good to prevent plaque progression, it's good to help prevent heart attacks, it's good to prevent blindness, by the way— so high blood pressure can even blind you— and strokes as well. In fact, high blood pressure and strokes are really, really tightly related. Lots of things can contribute to strokes and plaque, etc., but high blood pressure and strokes are really tightly related. If you don't want a stroke, check out your blood pressure, please. At a minimum. So blood pressure, our body has many, many different redundant and duplicative mechanisms and tools to modulate your blood pressure. So blood pressure is very, very important in your body. It is controlled by your brain and your heart and your kidneys. So blood pressure is controlled by a variety of interacting systems. We have hormonal systems that can affect blood pressure, hormones made by our adrenal glands and other glands as well that can affect your blood pressure. The kidneys play a very, very large role in regulating blood pressure. So if you have kidney problems, one of the common consequences of that is blood pressure is high. Not the only cause, but certainly kidneys play a very large role in helping to modulate your blood pressure. The heart plays a role. Obviously, it's going to pump blood into the blood vessels, so it plays a role. And then we have a whole variety of not just hormonal aspects of blood pressure regulation, but also the nervous system, and particularly the sympathetic and the parasympathetic nervous system. The sympathetic nervous system is that fight-or-flight aspect of the sympathetic nervous system. The sympathetic nervous system is your kind of very basic control of how your body works, which regulates blood pressure and a variety of other things as well, the things that just go on without our having to think of them. In the autonomic system, system, we have the sympathetic, which generally drives blood pressure and heart rate higher, and then the parasympathetic, which slows heart rate and can lower blood pressure. So we have nervous system inputs, central nervous system inputs, we have hormonal inputs, we have the regulation of the kidney as well. All of these factors, all of them work together to very, very tightly control your blood pressure. So it is critical that it is controlled. High blood pressure, leading cause of blindness, strokes, heart failure, kidney damage. And in the most recent guidelines on blood pressure that just came out this last August of '25, not only did they mention all of those usual, what we call target organs, that is organs that blood pressure affects in a bad way— brain, eyes, heart, kidneys— but also very importantly, very much related to cognitive issues and dementia. So anybody that does not want to become demented, have cognitive issues as we get older, make sure that blood pressure is perfect. In fact, recent study just came out in the last few days shows that if you look at cardiovascular risk factors, so blood pressure, diabetes, and cholesterol, which obviously we talk about all the time, it's absolutely critical for what we talk about in cardiology, but those factors, and if we control those factors, A good blood pressure should be below 130/80 at a minimum. 120/80 is even better. Controlling cholesterol, controlling, reversing, treating diabetes— those 3 cardiovascular risk factors can have very large effects in helping to stave off and prevent dementia and cognitive issues as well. So how high blood pressure develops? A lot of factors. Again, there are genetic factors. Age, alas, is another big risk factor. Salt intake plays a big role— salt or sodium. I will say, we, as I like to say, live in brine, particularly if it's processed food. If it comes out of a can, if it comes out of a bag, if we eat at a restaurant, pretty much guaranteed it's going to be quite, quite high in salt. So that plays a big role. Also too, our society is becoming both grayer, older, which also contributes to high blood pressure, and also fluffier. So as we gain weight, we have a real epidemic of obesity and overweight in the US. 70% of us fall into either the overweight or obese category. About 40% of us are obese, the remainder are overweight, and only a minority of us actually have normal body weight from the CDC criteria. Want clarity on your arterial risk? Click now the link in the description to schedule your Clear Cardio patient assessment call. We'll review your risk factors, see if our advanced program fits you, or point you in the right direction. So weight plays a big role, sodium, sedentary activities, certain medications can elevate blood pressure. Of course, smoking elevates blood pressure. We talked about genetic factors, birthdays. So the big modifiable risk factors for high blood pressure, lose weight, watch your salt, exercise, don't smoke. I think those are kind of the big, big major factors that modify high blood pressure. I'll also talk about that for high blood pressure, the DASH diet's phenomenal. It's basically the Mediterranean diet but low in sodium and high in nonfat dairy. Dairy actually lowers blood pressure, by the way. And in fact, that DASH diet— D-A-S-H for Dietary Approaches to Stop Hypertension— actually is on all the guidelines. I always like to say the DASH diet is the first pill, if you will. I jokingly say that I want to use for high blood pressure. So there's a lot of stuff we can do non-pharmacologically for blood pressure. I always like to say dairy is helpful. We could even replace some of the sodium chloride and table salt with potassium chloride. It's called low salt, which you can buy at your grocery stores or on Amazon, etc. Also shown to lower blood pressure and translate to less strokes and also less mortality as well. So lots of non-pharmacologic things we could do. Another question for blood pressure— hypertension is just another word for high blood pressure. So if you hear those 2 terms, we're really talking about the same thing. And by the way, blood pressure has to be certainly in limits. If it's too high, we have problems— strokes, heart attacks, heart failure, kidney damage, dementia. And it can be too low, and then we get into issues of fainting, dizziness, passing out, getting up out of a chair, out of bed. Feeling that swooning feeling. So we do have guardrails on high blood pressure. We don't want it too high. We also want to make sure it's not too low as well. Low blood pressure can be an issue, not as nearly as big an issue as high blood pressure or hypertension. So this pressure in the blood vessels affects the heart. It makes the heart work harder. By the way, the work that the heart does is mostly blood pressure work. As the blood pressure goes up, your heart has to work hard enough. The heart can thicken up just like any muscle. The harder you work it, it thickens up. The heart does that too in the setting of high blood pressure, and that can cause something called left ventricular hypertrophy. Literally, the heart muscle is thicker. This is reversible. If we And take care of the blood pressure, by the way. So it very much directly affects the heart and can cause heart failure, either by overloading the heart and the heart becomes just unable to beat anymore, becomes a kind of a big floppy bag and doesn't pump well. But also, even before that occurs, is that thick muscle— the heart, in order to pump blood, has to do 2 things. It has to pump the blood, so it has to squeeze. But importantly, and we tend to forget about this, it also has to relax to allow blood to come into the chamber before it beats again. So in people with high blood pressure and thickening of the heart muscle— and other things can do this as well, diabetes is very commonly related to this too, and a bunch of other more obscure diseases. But if your heart is thickened because of high blood pressure or diabetes or other similar things, the heart may squeeze okay, but it doesn't relax okay. So again, we're back to causing heart failure, not because the heart doesn't squeeze well, but because it doesn't relax well. So that's how it can impact the heart, causing heart failure. And at the blood vessel level, as the blood pressure goes up, it tends to convert the lining of the vessel, which is called the endothelium, it's that Teflon-like slip and slide, if you will, Teflon-like lining of the blood vessel, In the setting of high blood pressure or smoking or diabetes and many other inflammatory conditions, but certainly high blood pressure, it'll convert that lining of the vessel that normally should be like Teflon, or as I call it, a slip and slide, it'll convert it to Velcro. And I assure you, we do not want sticky vessels. Okay, so that's how high blood pressure can affect the heart. And of course, it can affect the kidneys, causing kidney damage, leaking protein in the urine, which is one of the things we look for all the time as an early indicator of the kidneys being under stress. But also, again, high blood pressure can cause strokes, can cause blindness. And we also mentioned It's now very much related to dementia and cognitive issues as well. So this is why we want to identify it, treat it, and control it. I will say, for medications, the advantages are they work very quickly, very reliably, very promptly. But I will say we can use to lower blood pressure, and we do a lot of that work at Clear Cardio with our functional people and part of our PULSE program too. So best way to check your blood pressure, uh, at home with a digital cuff monitor— that is an upper arm digital cuff monitor. Do not use the wrist monitors. They are random number generators. It They're just not accurate, okay? People like them, they're smaller, a little bit easier to use perhaps. They're just not accurate. So check your blood pressure at home with a digital cuff monitor. My favorite monitors are made by Omron. There's a bunch of companies out there, but Omron makes a very reliable certified monitor. They make a bunch of different monitors. My specific favorite monitor that I recommend to people at home is called the Evolv. It's the Omron, O-M-R-O-N, Evolv, E-V-O-L-V, Evolv. Small, portable, it's got a display right here. You hit the button, it'll automatically generate the numbers. You can also have it Bluetooth all that data to your phone. It'll keep track of all the numbers, it'll sort them out, you can graph the blood pressure over time, you can also look at your heart rate as well with that same device and the same technology. And you can get it on Amazon for about $70 to $80, so pretty cost-effective as well. So best way, check your blood pressure. Do it initially, if you haven't checked it, every day for a couple weeks would be great. I want more numbers, I want to look to see where the trends are. There can be a lot of noise in blood pressure depending upon what's going on, what you ate, exercise, salt, all of those variables. So we want to get a lot of numbers so we can really see what the trend and the average is. When I look at blood pressure numbers, patients bring them and show them to me, I'll kind of in my mind sort of throw out the top couple ones, God knows what's happened, but lower ones, I'm really looking for the trend or the average, and we want that blood pressure, the systolic, the top number, consistently below 130 and the bottom number below 80. Above 130 on the top or 80 on the bottom consistently is how we define high blood pressure, but I'll also say that normal blood pressure is below 120 on the top, the systolic number, and below 80, the diastolic number. So hopefully this is helpful to understand what is high blood pressure, what it means. High blood pressure is hypertension. How it impacts not just the heart, but the kidneys, the brain, and also cognition, and an important contributor to dementia too. We have lots of different ways of treating it. Non-pharmacologic is always what our preference is, but if that does not work, we have lots and lots of different tools that are very effective and proven to lower blood pressure and prevent the strokes, the heart attacks, even blindness, heart failure, kidney damage, and also, again, dementia and cognitive issues as well, if we need medications. All of this we help you work through. And lastly, if we're worried about high blood pressure, or if we have it, or just not sure, let us know. At Clear Cardio, we are here to help. And no matter— in our patients that have normal blood pressure, want to keep it, we're going to work with you to maintain that normal blood pressure, and that's the best scenario. But if we're not sure, or unsure, or maybe borderline, Clear Cardio is for you. And certainly if it's high, we of course see lots of people with what we call resistant hypertension. Blood pressure is super high, been on all kinds of medications, no one can control it. Well, as it turns out, you know, in the world of preventive cardiology, high blood pressure is really, really critical. One of the things I did a number of years ago is you can get boarded in hypertension, you can become a clinical specialist in hypertension. No one does it because no one pays you to do it, if you will, but I did it because I really, really understand blood pressure identification, control, treatment. Absolutely critical for us to prevent lots and lots of avoidable problems, from heart attacks, heart failure, kidney damage, blindness, and dementia as well. So we are here to help. If you're not sure, give us a call. If you have high blood pressure, give us a call, and we have lots of ways of helping you, working with you on the medical side and on the functional side, and our PULSE program to really get those numbers optimal and keep you healthy. And as I love to say, medically boring. So thanks for joining us again on this deep dive into high blood pressure, what it is, how to treat it, what are the different impacts high blood pressure has. So if you are interested, please click below, please subscribe, and we'll keep you informed on all of the important data and factors and risk factors and all the different treatments for heart disease, all cutting edge here at Clear Cardio. So thank you again. This is Dr. John Osborne from Clear Cardio, and please reach out to us if we can help. Don't miss this other episode right here on the screen where we will reveal the missing answers you need to know about true cardiovascular prevention. And if you're ready for absolute clarity on your arterial risk, click the link in the description to schedule your Clear Cardio patient assessment. We'll look at your specific risk factors and see if our advanced program can help you.
