Under Pressure: Dr. Mistry and Dr. Kadir On The Risks of High Blood Pressure

Thanks for tuning in to the Armor Men’s Health Hour Podcast today, where we bring you the latest and greatest in urology care and the best urology humor out there.

In this segment, Dr. Mistry and Donna Lee are joined by primary care physician Dr. Lamia Kadir of Family Medicine Austin. Our topic today is blood pressure--what it is, when is it abnormal, and what to do when it's too high. High blood pressure affects many men and women and can cause serious health problems if not addressed. According to Dr. Kadir, 140/90 is the range beyond which blood pressure numbers become abnormal. It takes several blood pressure readings, ideally at different times throughout the day and with/without caffeine, to diagnose high blood pressure (also called hypertension). If you have a family history of high blood pressure, you are more likely to be diagnosed with it yourself. Hypertension also puts you at higher risk of stroke, heart attack, and erectile dysfunction. If you or someone you love is looking for a primary care physician or are concerned about your blood pressure, you can reach Dr. Kadir at familymedicineaustin.com or call (512) 872-6868.

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Dr. Mistry is a board-certified urologist and has been treating patients in the Austin and Greater Williamson County area since he started his private practice in 2007.

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Transcript

Speaker 1: 0:09

Welcome back to the Armor Men's Health Hour with Dr. Mistry and Donna Lee.

Dr. Mistry: 0:16

Hello and welcome to the Armor Men's Health Hour. I'm Dr. Mistry, your host, here as always with my incredibly helpful and helpful, healthy and healthy...

Donna Lee: 0:26

Does that work? I'm the epitome of health according to my PCP.

Dr. Mistry: 0:26

...co-host, Donna Lee.

Donna Lee: 0:30

Hello, everybody! Happy day. I found the candle that says,"Oh, happy day!"

Dr. Mistry: 0:34

This is a men's health show. I'm a board certified urologist. Dr. Mistry is my real name.

Donna Lee: 0:39

Is it?

Dr. Mistry: 0:40

Despite all those naysayers out there.

Donna Lee: 0:42

The guy who said that you were full of it and that's not your name?

Dr. Mistry: 0:45

No, he never said I was full of it. He just called me gimmicky.

Donna Lee: 0:48

Yeah, but I think other people might say you're full of it.

Dr. Mistry: 0:50

You know what...

Donna Lee: 0:50

M-I-S-T-R-Y. Google that.

Dr. Mistry: 0:52

This is a men's health show.

Donna Lee: 0:54

Google it.

Dr. Mistry: 0:54

It was brought, this show is brought to you by the urology practice that I started in 2007, but now we're big time.

Donna Lee: 1:01

Mhmm. See all that gray hair on your face.

Dr. Mistry: 1:02

That is a lot of gray hair. I tell you, after hiking a hundred miles in Philmont with my son.

Donna Lee: 1:08

Yes. Two weeks you were gone.

Dr. Mistry: 1:09

Yes. The beard that I had at the end of that...

Donna Lee: 1:12

Epic?

Dr. Mistry: 1:12

...it made me feel very, very, very old.

Donna Lee: 1:14

Mhmm. I bet. Because you came back looking a little tired after a two week hike.

Dr. Mistry: 1:19

One week, it took me to recover.

Donna Lee: 1:21

I heard your toes still hurt.

Dr. Mistry: 1:22

My, I cannot feel two of my toes. I might need to go see a doctor. We have clinic locations all over the Austin area. That's where we started. But we see patients from all over the country and even all over the world when it comes to specialized medical problems. We are here open and ready to see you and take care of your needs. Whether they be just men's health oriented or any urologic condition. Donna, how do people get ahold of us? And where are our offices?

Donna Lee: 1:47

That's right. We will recover you from the nipples to the knees.

Dr. Mistry: 1:51

Nipples to the knees.

Donna Lee: 1:51

Speaking of needs. We are in Round Rock, North Austin, South Austin, and Dripping Springs, Texas. Our number's( 512) 238-0762. Our website is armormenshealth.com. And our email address I like to sing is armormenshealth@gmail.com. Okay.

Dr. Mistry: 2:06

Very nice. Today we have a guest, and you know I love guests.

Donna Lee: 2:09

A friend of mine. Mhhm.

Dr. Mistry: 2:09

I love guests. As a specialist, our business, and most of our patients come from referrals from primary care medicine. And although I think a lot of our patients might think that we practice a majority of primary care medicine, in fact, we really rely on the frontline medical practitioner to help take care of the day-to-day issues that patients deal with and make sure that their medical home is well taken care of. So somebody that knows what specialists you're seeing and what medicines you're on and make sure that you're staying healthy. Both of you and your family. We have Dr. Lamia Kadir. She's with Family Medicine Austin. And I want to thank you so much for joining us today.

Dr. Kadir: 2:46

Hi, thank you for having me.

Dr. Mistry: 2:48

So we see patients that have high blood pressure all of the time. And the management of high blood pressure changes so much from doctor to doctor. When we measure their pressure here in the office, a lot of times it's high. And I think it's because I'm incredible and maybe they're just excited about seeing me.

Donna Lee: 3:04

You usually make people nervous.

Dr. Mistry: 3:05

Yeah, I do make people nervous, don't I?

Donna Lee: 3:07

Because you're so hot?

Dr. Mistry: 3:07

I'm probably going to have to stick things in different holes and stuff like that. They're very unhappy about that.

Donna Lee: 3:13

Whoa.

Dr. Mistry: 3:13

Like if you have a normal blood pressure and you're about to get a vasectomy, we should really worry about you.

Dr. Kadir: 3:16

Yeah, that's true. That is true.

Dr. Mistry: 3:19

So if you're out there and you think that you might have high blood pressure, or how do you determine whether a patient has high blood pressure? And then what are some of the initial things that you do that are non-medication based to try to get that person out of that?

Dr. Kadir: 3:32

That's a good question. So first of all, because that patient is probably not evaluating their blood pressure on a regular basis, if you get a high number, essentially, anything above a one 40 over 90 is abnormal at any point in time, however, you're absolutely correct. So I'll have patients come in, they're nervous. They maybe ran up the stairs cause they're late. That initial blood pressure should be verified, ideally manually.

Dr. Mistry: 3:57

Which means not that electronic thing, that means somebody...

Dr. Kadir: 4:00

Electronic blood pressure cuffs are fine. I mean the American Academy of Family Physicians definitely says accept these electronic monitors. But the bottom line is you can't diagnose blood pressure with just one number. So that that's a little bit of a load off of you. So if you get a high, and it's not an emergency--so 160 on the top...

Donna Lee: 4:19

What do, what do the numbers mean? My husband checks his blood pressure 10 times a day and I don't know if he knows...

Dr. Mistry: 4:24

And some people think it's the, the top number that matters, some people's the bottom numbers that matter. Settle it for us.

Dr. Kadir: 4:29

Yeah. So 140 over 90 is the magic number. If you can remember that, it'll make life easier for you. Anything that hits a 140 on the top or a 90 on the bottom is abnormal. If that happens on two occasions, there's a chance that you have hypertension, which is prevalent globally, it's probably the number one reason that patients see their regular doctors for chronic prescriptions. It's a big deal.

Dr. Mistry: 4:51

And having a high blood pressure can put you at risk for stroke, for heart attack...

Dr. Kadir: 4:56

Absolutely.

Dr. Mistry: 4:56

...and erectile dysfunction. Let's not talk about the most important thing. The whole purpose of the heart is really just to pump blood to the penis.

Dr. Kadir: 5:02

Wow. That's, that's definitely a different way of looking at it.

Dr. Mistry: 5:06

Really? They don't teach you that in medical school?

Dr. Kadir: 5:07

It is important.

Dr. Mistry: 5:10

Did you not go to Baylor?

Dr. Kadir: 5:10

It's probably number five. Number one is stroke. You know, think of it as, think of the heart as a pump. It's pumping against a system. That big fat artery called the aorta feeds the rest of the body. And blood pressure patients, which, classically, for all of you who don't know, runs in families. And so there's a genetic predisposition here for a lot of these people. Imagine that artery is narrower. It's just too narrow. When we give you medication, which is one of the treatments of blood pressure, and ultimately everyone's headed in that direction--and we'll get to that in a second--I'm trying to open up the flood pipe so that the rest of the body, including the penis, is getting blood supply.

Dr. Mistry: 5:46

Mainly the penis, as I mentioned.

Dr. Kadir: 5:46

Yeah, including the penis.

Dr. Mistry: 5:49

So, so when you have a patient that comes and they see us, what we usually require, what I, what I ask them to do is go and purchase a blood pressure cuff.

Dr. Kadir: 5:55

I think it's great advice.

Dr. Mistry: 5:55

And not the most expensive ones. I say,"Go buy a$50 blood pressure cuff and measure your blood pressure in the morning before coffee, like five or seven times, and then send me the number." You think that's solid advice for somebody to do?

Dr. Kadir: 6:07

I think that's great advice. You don't want to create a level of anxiety. So I tell them,"Take the cuff." In my case, if I'm worried, yes--more than more than seven times a week is a great idea. But I just tell them,"Take it once a week. Alter the times." So great advice. Your blood pressure classically is higher in the morning when you wake up. With and without caffeine is a great idea. But if you're like my patient, I have a 60 year old male patient whose blood pressure was crazy. He was on three medications. He, I couldn't get it down, and something was wrong. And I was like,"Listen, do you drink soda?" He's like,"I drink stuff." I'm like,"What do you drink?" He's like,"Mountain Dew." I'm like,"Oh, okay." I could have left it there and known that that was some decent caffeine intake daily. And like,"How much do you drink?" He's like,"A bottle." But I felt like something was missing. I'm like,"How much? How big is the bottle?" He's like,"A liter." I'm like,"I'm so sorry. Do you drink a liter a day?" He's like,"Yes." And so here you have his diet, his potential poor decisions that he'd been making for a long time, contributing to hypertension. Well, that's why we felt like we couldn't control it. So you said earlier, diet, exercise are important. Ultimately...

Donna Lee: 7:17

Medically, we call that a no-no.

Dr. Mistry: 7:19

No. I, I was hoping that you weren't going to chime in and talk about my previous Diet Coke intake.

Donna Lee: 7:25

You quit.

Dr. Kadir: 7:25

Caffeine's a drug. A cup of coffee is fine, but.

Dr. Mistry: 7:29

...what an amateur.

Dr. Kadir: 7:29

A liter of Mountain Dew? Come on, peoples. Like, let's take it easy.

Dr. Mistry: 7:33

So if somebody is approaching blood pressure, you know, in the literature that comes out from the American Heart Association, they talk a little bit about pre hypertension, pre-diabetes, you know, all these preconditions. And a lot of the patients that I see are in their thirties, so they're, they haven't really kind of entered medical care yet. They're looking to have a family or something of that nature or even a vasectomy. And so what I try to do is try to find preventative things for them to consider. So you mentioned one good ones, caffeine intake, limiting that. We would also probably include smoking cessation in that. Weight loss I always consider like a really big thing for high blood pressure. What do you think?

Dr. Kadir: 8:06

Oh, weight loss. Are you kidding? Obesity is an epidemic. At one time we thought 33%. I think we're hovering closer to almost 50% of Americans are overweight or obese. I'm one of them and I'm working really hard at that. Any amount of weight loss is going to help everything, whether it be decreasing your blood pressure, preventing diabetes, decreasing your cholesterol, taking it easy on your knees. And of course helping your penis.

Donna Lee: 8:30

Mhhm. There it is.

Dr. Mistry: 8:31

See, we already taught her.

Donna Lee: 8:31

So even just losing five pounds...

Dr. Mistry: 8:33

Even not going to Baylor College of Medicine. She's teachable.

Donna Lee: 8:34

That's right, she said penis one time.

Dr. Mistry: 8:35

She's teachable.

Donna Lee: 8:36

Good job.

Dr. Mistry: 8:37

So, the other thing that I, I think is important for people to remember is also this idea of stress management. When we were younger in educating, we always knew or thought that stress helped to contribute to disease. And then we went to medical school and they were like,"It's not stress it's bacteria." You know, like, like, like we completely gave up conventional wisdom when we were educating. And now that I'm getting older and doing more and more things, I'm realizing how much stress management plays a role in, in, in affecting us when it comes to blood pressure and stress response. Maybe you could talk to the advice that you give to people when it comes to techniques for stress management.

Dr. Kadir: 9:15

Techniques, for stress management--there are many.

Donna Lee: 9:17

Meditate.

Dr. Kadir: 9:18

I think the bottom line and the way I present it to patients is: stress is poison, and there's no other way to look at it. I think it comes in different forms for my younger patient population, demographics down in Central Austin. I find that their jobs are a huge cause of their stress. I actually...

Dr. Mistry: 9:34

Jobs and wives.

Dr. Kadir: 9:34

Jobs and wives, or in my case, husbands. Husbands, thank you, Donna. Stress management--first target what's giving you stress. So for me it was work. And so I decreased my hours and decreased my stress. That's important. Unfortunately, as a result of that stress over compounded over many years, I have gained a decent amount of weight. Did you know that stress responses increase cortisol production and cortisol is a fat building hormone?

Dr. Mistry: 9:59

We talk about it all the time.

Dr. Kadir: 10:00

Can you imagine? And so stress inherent, you know...

Dr. Mistry: 10:03

People know that causes people to, people to get bigger.

Dr. Kadir: 10:07

So increased blood pressure, increased diabetes, increased penis problems, you name it. So stress strategies basics: target what's causing you stress. I love therapy. I think everybody needs to be in therapy. We all have things to talk about and unload. And if you have access to it, if you can afford it, it's always a good idea to talk to someone.

Dr. Mistry: 10:22

Acupuncture meditation.

Dr. Kadir: 10:24

Believe it or not sex is a stress reliever.

Dr. Mistry: 10:29

Oh, we believe it.

Dr. Kadir: 10:29

Yes, I know. A therapist is actually told me that and, and, and a good, healthy relationship with your sexual partner is important. Exercise decreases stress. Meditation, something that I'm trying to focus on, and I'm having a hard time focusing. Lots of, and then of course I have plenty of patients with anxiety and depression.

Dr. Mistry: 10:46

So for our listeners out there, let's not forget 140 over 90 is your magic blood pressure number. Both numbers are important. And if you want to make an appointment with Dr. Kadir at, you can visit familymedicineaustin.com or call(512) 872-6868. Thank you so much for joining us today.

Donna Lee: 11:02

Thank you.

Dr. Kadir: 11:03

Thank you for having me.

Speaker 1: 11:04

The Armor men's health hour. We'll be right back. If you have questions for Dr. Mystery emailing at armor men's health, ed gmail.com.