Point taken about variability among organizations. I am not advocating using medicines to push BPs down to super low levels. For me, diet can play a role (appreciate you video link), but I think we have to add physical activity into the mix, something the Youtuber doesn't mention.

In addition, association is not causality. You will note that I made no call for using medicines to drive BP down. I simply reported new findings of an association between BP and cardiovascular risk. This is not high-level evidence, but hypothesis generating.

I think the AAFP has newer guidelines, with a slight tweak re: home monitoring.

https://www.aafp.org/afp/2021/0615/p763.html

Even the AHA (I don't know their biases, but take your point) puts hypertension as beginning at Systolic between 130-139 or diastolic between 80-89.

Oh, I got my BP down to systolic 90 with diet exercise, and a slight drop in weight. For many (admittedly, not for all), physical activity can be a remarkable drug-free approach to optimizing BP. I genuinely hope you are wrong that I am in danger!

On the diet score, there is a gene that may makes African-Americans such as me much more salt sensitive. In those with the gene, gene, as little as one extra gram (half a teaspoon) of salt could raise blood pressure as much as 5 mm Hg.

I am interested in hearing more evidence-based info on the connection of the AHA and drug industry (not doubting you, but want to learn more).

I'll end with this: We agree that lifestyle can go a long way re BP and more. I have no interest in promoting medicines, except for the minority for whom they can be life-saving.

Thanks for sharing your thoughts.

Best,

Michael