Optimizing my TRT, having some issues at the moment!

[Exhortae]

https://www.ahajournals.org/doi/10.1161/HYPERTENSIONAHA.123.21732

There’s your problem.

Looking at 130-139 mm Hg at low-CVR group

• Diabetes: 5.2%
• Hypercholesterolemia: 42.5%
• Smoking: 32.1%
• Obesity: 32.1%

1/3 are smoking, 1/3 are obese, nearly half have hypercholesterolemia.

I have yet to find a study with people who have a BP of 130 mmHg (not 136 or 139), healthy individual, with good diet, physical activity...

 

[Exhortae]

Yeah, he's like that.

I understand he is like that, but that does not mean he has the right to act like that. People should respect each others, that's the minimum expected where I live.

 

[egruberman]

I have yet to find a study with people who have a BP of 130 mmHg (not 136 or 139), healthy individual, with good diet, physical activity...

You won't find that study as it's probably not worth doing. Even still this study suggests that for the portion of individuals with no complicating conditions having an SBP 130-139 comes with an elevated hazard ratio vs. those with an SBP of 120-129. Unfortunately, it's not powered sufficiently to yield a statistically significant outcome.

Even still, I'm curious why you would advocate for a more conservative approach to blood pressure management on a forum almost entirely populated by AAS users for whom elevated blood pressure is a tremendous risk factor?

People should respect each others, that's the minimum expected where I live.

You'll get respect when you earn it and that remains to be seen.

 

[Exhortae]

You won't find that study as it's probably not worth doing. Even still this study suggests that for the portion of individuals with no complicating conditions having an SBP 130-139 comes with an elevated hazard ratio vs. those with an SBP of 120-129. Unfortunately, it's not powered sufficiently to yield a statistically significant outcome.

Even still, I'm curious why you would advocate for a more conservative approach to blood pressure management on a forum almost entirely populated by AAS users for whom elevated blood pressure is a tremendous risk factor?



You'll get respect when you earn it and that remains to be seen.

With a BP of 132/75 and on cycle, would you take a BP medication ? I won’t.
With the same BP on trt, I also won’t
With the same BP while natural, again I won’t

why take something that has side effects with little benefit ? This is how I think. Some are throwing all kind of meds. I prefer a more conservative approach with the minimum required meds.

 

[egruberman]

With a BP of 132/75 and on cycle, would you take a BP medication ? I won’t.
With the same BP on trt, I also won’t
With the same BP while natural, again I won’t

Yes in all cases. I aim to keep my BP as low as is reasonable a result of the fact that I'm likely to die from ASCVD.

why take something that has side effects with little benefit ?

Telmisartan, for example has the side effect of being a ppar-gamma agonist. It improves insulin sensitivity, has anti-inflammatory effects in adipose tissue and cardiovascular benefits beyond blood pressure mitigation. It is used as a PED by some endurance athletes.

I prefer a more conservative approach with the minimum required meds.

A reasonable stance in any other context other than a forum exclusively dedicated to discussing of the use of performance enhancing drugs.

 

[rxzed]

Some of the concerns I have with the study you posted :

1/ "our study included 42 clinical trials conducted for 144 220 patients with various comorbidities (including diabetes and stroke)"

These patients were likely already unwell, possibly with poor diets and sedentary lifestyles. For example, my grandfather suffered from severe hypertension, reaching 220 mm Hg, but his lifestyle (high salt intake, no exercise, anger) remained unchanged except for taking older medications.

They specifically account for their baseline risk.

"To account for trial heterogeneity in the intervention duration and baseline risk of CVD or mortality, we adjusted for trial length and event rate (or mortality) of the reference groups for each trial in the model."

2/ I am not able to find the precise baseline for these patients before treatment.

"The SPRINT trial randomly assigned 9361 persons 50 years of age or older with an SBP of 130 to 180 mm Hg who had an increased risk of CVD".

The baseline range is broad to draw any meaningful conclusions and I am not able to find anything on the distribution of values. Could be that most patients had 140 mm Hg of BP or even more. Nothing can be deducted about patients who started with 130 mmHg who ended with less 120 mmHg. and I am only talkin about patient who are healthy with no comorbidity.

"The group with an SPB of 130 to 134 mm Hg defined the center of the network, with 21 trials directly comparing a mean achieved SBP of 130 to 134 mm Hg with 7 other mean achieved SBP groups"

"The median of the posterior distribution was selected as the point estimate, bounded by the 2.5th and 97.5th percentiles to form a 95% CI."

I'm certainly no statistics major, and maybe someone a bit smarter can correct me, but such confounding factors are accounted for before deriving any conclusions.

You're asking for a RCT that only compares an extremely small subset of the gen pop as participants. That's just unrealistic. I'm sure there's one out there, but I really can't be bothered looking for it.

 

[Ghoul]

.

What systolic BP would you consider pharmaceutical intervention in reasonable? 132 isn't it, you've made that clear, so what's the number? 150? 165?

 

[AlexDavis43]

I understand he is like that, but that does not mean he has the right to act like that. People should respect each others, that's the minimum expected where I live.

welcome to the internet

 

[Nidus]

Yes in all cases. I aim to keep my BP as low as is reasonable a result of the fact that I'm likely to die from ASCVD.


Telmisartan, for example has the side effect of being a ppar-gamma agonist. It improves insulin sensitivity, has anti-inflammatory effects in adipose tissue and cardiovascular benefits beyond blood pressure mitigation. It is used as a PED by some endurance athletes.



A reasonable stance in any other context other than a forum exclusively dedicated to discussing of the use of performance enhancing drugs.

How effective are these side-effects though? I think these only start at really high doses of Telmi or, like at 80-100mg and higher?

 

[malfeasance]

How effective are these side-effects though? I think these only start at really high doses of Telmi or, like at 80-100mg and higher?

I take 80. What are the side effects supposed to be?

 

[Nidus]

I take 80. What are the side effects supposed to be?

Better Insulin sensitivity, endurance, better lipids. Telmi reacts on the same receptors as Cardarine but not so strong as such as far as i know.

Seen articles in which cycling athlete took a ton of it to improve endurance as it mimics cardarine.

I havent noticed any difference from 40-80mg myself, however i noticed a difference in lipids by 2-3 points when taking telmisartan compared to taking none

 

[egruberman]

How effective are these side-effects though? I think these only start at really high doses of Telmi or, like at 80-100mg and higher?

Typically, higher doses. The point being that the side effects aren't particularly onerous.

 

[buck]

As most all the reading i have done tends to point at the lower the BP "as long as there are no symptoms from the low pressure" the longer life expectancy seems to be with numbers in the 110/70- 115/75 being the demarcation point.
So i work at keeping my levels low and have no issues from that. Others should follow their own comfort zone as they will reap the results of that one way or the other.

https://www.amjmed.com/article/0002-9343(73)90130-7/abstract#:~:text=On%20the%20other%20hand%2C%20the,and%2070%20mm%20Hg%20diastolic.

https://www.lifeextension.com/magazine/2016/11/lower-blood-pressure-empowers-longer-life

 

[Ghoul]

As most all the reading i have done tends to point at the lower the BP "as long as there are no symptoms from the low pressure" the longer life expectancy seems to be with numbers in the 110/70- 115/75 being the demarcation point.
So i work at keeping my levels low and have no issues from that. Others should follow their own comfort zone as they will reap the results of that one way or the other.

https://www.amjmed.com/article/0002-9343(73)90130-7/abstract#:~:text=On%20the%20other%20hand%2C%20the,and%2070%20mm%20Hg%20diastolic.

https://www.lifeextension.com/magazine/2016/11/lower-blood-pressure-empowers-longer-life

In 1977 you didn't have high blood pressure until you hit 165/95! That must've cost countless lives.

The big medical organizations that set guidelines are very conservative, moving at a glacial pace and only in response to overwhelming evidence of benefits and safety,

So since then the definition of high BP has been drifting down to where we are today, that is, with. a few special exceptions, anything over 120/80.

You're right, those lower numbers have shown better long term health outcomes, but we're now so close to the bottom(where certain risks start to increase), I doubt we'll see future universal guidelines go below 120/80. As more studies are conducted though, I think they'll be able to specify individually personalized BP targets below 120.

I heard one top preventive cardiology researcher on a panel say in response to the question "what does the evidence show about how low the ideal BP is?", "As low as you can get it without falling over."

 

[buck]

In 1977 you didn't have high blood pressure until you hit 165/95! That must've cost countless lives.

The big medical organizations that set guidelines are very conservative, moving at a glacial pace and only in response to overwhelming evidence of benefits and safety,

So since then the definition of high BP has been drifting down to where we are today, that is, with. a few special exceptions, anything over 120/80.

You're right, those lower numbers have shown better long term health outcomes, but we're now so close to the bottom(where certain risks start to increase), I doubt we'll see future universal guidelines go below 120/80. As more studies are conducted though, I think they'll be able to specify individually personalized BP targets below 120.

I heard one top preventive cardiology researcher on a panel say in response to the question "what does the evidence show about how low the ideal BP is?", "As low as you can get it without falling over."

With medical/government they don't look for healthy. They look at what has been proven harmful which seems to be harder to do and takes longer and sets the bar higher.

BP numbers as well as glucose have been being lowered occasionally for decades and are itertwined it seems.

Without data tracking people for decades no real results can be known.
I have known no one in my 65 years that has said they had low BP all their life and then suddenly got symptoms late in life and ended up with a bad vascular system/heart. But i know of countless people that can say they had high BP and ended up with problems.

I go with lower myself. For BP and Glucose although they are not as low as i would like as i also consider side effects from meds as they all have them when making decisions.

 

[malfeasance]

As most all the reading i have done tends to point at the lower the BP "as long as there are no symptoms from the low pressure" the longer life expectancy seems to be with numbers in the 110/70- 115/75 being the demarcation point.
So i work at keeping my levels low and have no issues from that. Others should follow their own comfort zone as they will reap the results of that one way or the other.

https://www.amjmed.com/article/0002-9343(73)90130-7/abstract#:~:text=On%20the%20other%20hand%2C%20the,and%2070%20mm%20Hg%20diastolic.

https://www.lifeextension.com/magazine/2016/11/lower-blood-pressure-empowers-longer-life

I wonder if there is a BMI (inverse) correlation to this, rather than it all being the benefit of a number from an arm sleeve.

 

[Ghoul]

I wonder if there is a BMI (inverse) correlation to this, rather than it all being the benefit of a number from an arm sleeve.

It was accounted for in the multivariable model they used.

It really says something about the 2015 SPRINT study when the same data is still being rerun through new algorithms a decade later to extract more info regarding what factors change risk for those with high BP.

It's been said risk of heart attacks rises during periods of weight change, up or down, for a long time, and this is this best evidence of that we have to date:

Association between weight variability, weight change and clinical outcomes in hypertension - PMC

The effect of body weight variability (BWV) and body weight change (BWC) in high-risk individuals with hypertension, but without diabetes mellitus (DM) remains unclear. We examined the effect of BWV and BWC on the primary outcome [the composite of ...

pmc.ncbi.nlm.nih.gov

 

[buck]

I wonder if there is a BMI (inverse) correlation to this, rather than it all being the benefit of a number from an arm sleeve.

I am sure many will have negative issues from other sources as well. But i doubt there are a large percentage that have had healthy BP and glucose numbers later in life and are still over weight. The life style factors that effect BP and glucose are also the same factors that tend to make one over weight. And most all factors that cause stress on the body from weight, food, lack of anger management etc. can all lead to higher BP. They are not all independent from anything i have seen. But these posts have been about BP so that seems to be the topic. If we want to talk long term health and longevity then all the other things that people are told to do and don't would be in play. But on the average i would tend to think that over weight people including those that are overweight from muscle mass, that keep their BP lower will be healthier and live longer.

 

[AlexDavis43]

I wonder if there is a BMI (inverse) correlation to this, rather than it all being the benefit of a number from an arm sleeve.

Seems you've been trying to talk yourself into losing weight for a while. Any movement in that thought process?

 

[HUGE McBIGLARGE]

Wtf am I meant to do with a bp of 140/60?

If I take AHTs I lower my SBP and DBP.

I don’t want isolated systolic hypertension, but if I treat it I get isolated diastolic hypotension.