A Client's Easy Solution to High Blood Pressure - Health Coaching Behind the Scenes

In this episode, I examine a client's unexpected high blood pressure journey and the lifestyle factors at play. Despite a history of good health, the 40-year-old tech nomad faced spikes due to increased alcohol intake and richer meals. A move to a new country led to significant health improvements, highlighting the impact of environmental changes on wellness. This case reinforces the idea that while medications can help, addressing root causes through simple lifestyle adjustments is essential for sustained health.

 

Website and Health Coaching: 
https://www.drashori.com

Subscribe to my free Healthy Aging newsletter:
https://newsletter.drashori.com/ 

Follow me on Instagram:
https://www.instagram.com/DrAshoriMD

Join me on Facebook:
https://www.facebook.com/DrAshoriMD

---------------------------

If you are looking for a guide to help you navigate your health, book a 1-hour paid session with me. If you're not quite ready and want to get to know me better, book a free 15-minute introduction session. 

Thank you for listening to this week's episode of Doctor Turned Health Coach by Mohammad Ashori MD. I would love your support by subscribing to this podcast, sharing it with someone you love, and leaving me a review on your favorite podcast app. 

-Dr. Ashori MD

 

Episode Transcript

(00:00):
Welcome to the doctor-turned-health-coach podcast.
My name is Dr. Ashori. I'm a board-certified family medicine physician with
my online health coaching practice and my private primary care practice here
in California. Everything's online.
And today I wanted to bring you guys, kind of take you behind the scenes of

(00:25):
a health coaching client.
There are many success stories, there are many stories that are still in the
making with my health coaching clients, but this one stood out to me.
And it's come up a couple of times in other versions, so I thought I would share this with you.
I'm going to change things around just a little bit so that I don't divulge
any private information.

(00:48):
So this gentleman came to me, very active, quite busy, online digital nomad like myself.
He's a traveler, goes all over the world, and his practice is online.
His business is online in the technology space. So he has tons of meetings,
tons of consultations, tons of different things that he has to do on a regular basis.

(01:13):
So there's a bit of stress, but never has he dealt with blood pressure,
with major blood pressure issues in the past.
So, at 40, oftentimes in Western medicine, we say, okay, well,
if you develop blood pressure problems, it's probably a little bit of what we
call essential hypertension.
And this is a condition where your blood pressure just naturally goes up as

(01:37):
the vessels stiffen, or at least that's the theory.
Of course, the way we treat this is with blood pressure medications so that
we can lower your risk of major cardiovascular events like atrial fibrillation,
heart attack, stroke, heart failure, kidney disease, you name it.
All of these things are affected by high blood pressure.

(02:00):
Of course, the definition of high blood pressure now is becoming a bit contentious.
The most recent JNC-8 has recommended that it should be in the 120 over 80 range or lower.
And some people, some health gurus will say, no, it should be 90 over 60 and
lower. Okay, well, we'll leave that aside for now.

(02:21):
But this gentleman suddenly started seeing blood pressures in the 170-some, over 111.
So, during this time, he was staying with some friends in another state,
and he was about to actually leave for another country.
He was going to be there for a few months before leaving for another country.

(02:42):
Now, during his stay with his friends, I asked him, you know,
what things were different, and we tried to identify a few things.
Nothing really stood out. He was always pretty active. He cooked a lot of his
own meals, but he ate out as well. But he would make good choices.
Never had any weight issues. His weight didn't change. His exercise regimen didn't change.
His stress level didn't change. He would still work during the day while his friends were out.

(03:05):
But when his friends came back, they would get together. They would have some
meals. They would have some chips.
They would have some alcohol, have some wine together.
And some things kind of stood out. we slowly kind of discovered that,
uh-oh, maybe he's having a little bit more wine and a little bit later at night.
Not a lot more, but a little bit more. Maybe it was the chips.

(03:27):
Maybe the food he was eating up was a little bit more rich.
So with that information, of course, you know, we did a bunch of other blood
tests to make sure nothing else was going on, but his blood pressure was persistent.
170 over 110.
183 over 115. He felt okay.

(03:47):
He even was open to try some blood pressure medications, but fortunately this
wasn't a long duration of blood pressure problem, so we tried a few other things.
Right before we were about to try one thing, he actually decided to go to this
new country sooner, because the job opportunity was there.
He wanted to get there, so he moved he moved to

(04:08):
this new country in europe for the next few months and
guess what as soon as he got there i had him buy a blood pressure cuff he was
using a blood pressure cuff by the way that was in his in this friend's house
that's why he even checked his blood pressure in the first place and the blood
pressure suddenly was 92 over 62 93 over 65.

(04:32):
90 over 53. He felt great. No problems, no issues. So what changed?
Was it jet lag? Was it that he was suddenly living a very different lifestyle
here in this new country? Well, as a matter of fact, it was.
It turned out that he would still have his glass of wine.

(04:53):
He sent me photos of the glass of wine. It was much smaller than the glasses
of wine he was consuming with his friends. And in fact, that's exactly what we were about to trial.
We were about to have him just cut back on the alcohol 50% and consume it a
little bit earlier in the day.
As soon as the friends come home from work, have your glass of wine,
chill, do the other stuff, continue, still have your chips, still have your

(05:16):
other food. Let's see what the blood pressure shows.
Long story short, it turned out that he was having just enough alcohol,
a little bit more than what his body mass index, his muscle mass, his liver could handle,
and so that alcohol wasn't cleared by the time he would go to bed,
and he was having it late enough that it was disrupting his sleep.

(05:39):
Both REM and deep sleep are affected by alcohol, caffeine, stress,
a lot of different things.
And in this situation, he wasn't getting the right amount of sleep.
Now, this is, he's not very much open to using sleep trackers and other devices.
And in my practice, I use them when they're absolutely necessary.

(06:01):
But as you can imagine, there's a lot of great tests that can do even better.
So we don't always use technology when it's not really going to give us more information.
But one of the best tests that we
could do is we move them out of that environment into a new environment.
He had rented an Airbnb or something.
I don't remember whether it was a hotel or Airbnb, but he was able to cook in

(06:25):
that space, so he was making his own meals, and he was having his glass of wine,
usually around 5 p.m. or 4 p.m.
And his blood pressure was fantastic. Now, he was just as active as before.
Of course, he was less car dependent because he was outside of the U.S.,
so he was biking everywhere in this new city. He was renting a bike or something like that.

(06:47):
And that's all it took. All it took for his blood pressure to change was the
decrease in alcohol intake.
Yes, I'm certain that the environment changed, the dietary change,
the activity level with the biking, that all contributed, but not going from 170 to 90. Unlikely.

(07:08):
And it goes to show you that sometimes when you start on a medication,
on a blood pressure medication, you do get a good result.
He would have had his blood pressure get much lower.
We were, in fact, talking about a thiazide diuretic, a common blood pressure
you guys might know, called hydrochlorothiazide.
And his blood pressure would have been better, but we would have never solved his actual problem.

(07:30):
And chances are his disrupted sleep would have but eventually caught up with
him while the blood pressure was being masked with a blood pressure medicine.
So I hope this is of value to you guys. Now, of course, the details of our coaching
and back and forth is more complicated. We had one hour sessions every week.
That's the way my coaching works. But we were exchanging a lot of text messages,

(07:51):
a lot of voice messages, photos he would send me, things I would send him,
articles I would send him, articles he would send me.
But in the end we figured it out and now
he's somebody who comes into my practice and goes he's
not always part of my practice he'll stay part of my practice for
a few months and then he's off in the wilderness and
then he comes back in but it's been a fantastic education point for me and for

(08:16):
him if you find this content useful please share it with somebody who might
benefit from this maybe you or a loved one are dealing with blood pressure issues
share this podcast episode with them,
go to my website, drashori.com.
The information is in the show descriptions, and thank you for listening.