If you had high blood pressure, what would you prefer?

[TheImpOfThePerverse2026]

To be told by your doctor you need to lose weight and sort your life out.

OR:

If it gets any higher you'll need to be put on tablets?

What is the normal response from a UK GP?

I think that’s pretty unfair. Fat shaming is a big reason people don’t go to GPs and to be honest weight isn’t always the problem it’s usually diet and fitness. You knew you were overweight and you could have chosen to do something about it. Don’t put this on a GP.

This is absolutely the opposite of what berry is saying

Fat shaming could have changed my life. A year later I was diagnosed with BC; I have no doubt in my mind that my unhealthy weight contributed.

Why would you need to be fat shamed. Did you not realise you were overweight?

Your GP would have bollocked you to high heaven because your blood pressure was mildly raised?

Did you need a bollocking? Was it a surprise to you that being overweight increased your blood pressure? Because it sounds like you sorted it on your own

What on earth is BC?

Fat shaming is increasingly frowned upon and disliked by many people.

How is the GP supposed to read your mind and know you are one of the ones happy to be “fat-shamed” ?

fat shaming can also make some people’s eating habits worse and leads to them gaining weight

Tablets

i was 37 when I was diagnosed with high blood pressure. It was dangerously high.

I did at the time attempt to lose weight and I did very successfully but due to horrible events in the past 5 years have put it all back on again

mines heriditary. And I also have a congenital heart condition

But you did lose weight, without being fat shamed, you didn’t need it

so the purpose of the fat shaming would have been… what? That you deserved to be shamed for being fat?

This just sounds like the zeal of a convert tbh

What is BC

Also if you’d had to be put on tablets the doctor/nurse does a whole thing with you and would likely have discussed weight loss.

Some many variables. If you’re middle aged or older a GP may want your BP lowered asap. You may still have a high BP with weight loss. You may have other health conditions that suggests BP medication.

Without GLPs/weight loss surgery, I recall reading 95% of people put weight back on. I’d say a good GP should recommend both lifestyle changes and meds.

Being on daily medication is really not a big deal once you get used to it.

Some BP meds are actually cardio and renal protective.

I'm not on any meds - I'm fit and healthy.

But I'm on a significant dose of HRT for other meno symptoms. HRT is licensed to treat osteoporosis and is obviously preventative for this too, as well as dementia, heart disease, diabetes, autoimmune diseases and cancers.

Oestrodiol is anti-inflammatory. Oestrone (which our bodies try to produce in meno) is inflammatory.

I listen to every evidence & research-based podcast from Louise Newson - with all the world-leading experts - it's scary and brilliant (and in hindsight obvious) what continuing with transdermal HRT does for women, the preventative benefits.

It does sometimes feel like there is a bigger reason why Big Pharma doesn't want the simple / cheap HRT to be the solution. Plus GPs etc are still insufficiently educated and still hung on on the incorrect (and apologised for) Women's Health Initiative study.

Studies have shown that men taking Testosterone does generally improve their wellbeing etc. There are several really good Newson podcasts on Testosterone - by both a world leading male expert doctor and others, all about men as much as women.

Bollocking your patients is a good way for them not to come back when they have problems. Yes lifestyle is important but again doctor's are reluctant to comment on weight (unless you are really obese), when I was being examined and the doctor nearly said something about weight the nurse quickly shushed him. We all know we should try to keep our weight down. For blood pressure also reduce salt intake and caffeine particularly. I have now lost a bit of weight anyway and BMI is normal.

I also have white coat syndrome if they take my blood pressure at the surgery it is way high, at home not quite perfect but too close to medicate.

I assume he didn't 'put you on tablets'.

I’d never choose tablets. Cut the carbs and it’ll drop. Mine did

I think a GP will explain both ways to treat a high BP. This is very normal I think.

Yes! I recently had to do a home blood pressure test, and it happened to coincide with me being in the first few days of the 'keto' variant of the Fast 800 diet (which was both very low carb and very low calorie). It failed ultimately for me because I only stuck to it for about 10 days, but all of my BP readings were SO much lower that I thought the machine had broken. Something like 20 or 30 points lower.

There was no point in even submitting the readings unless I flt confident I was going to sustain that way of eating. Yor post has inspired me to try and get back on track with very low carb.

Likely this GP would have had the “loose weight & lifestyle change” conversation a thousand times over and would have it a thousand times more with people coming through the door.
Probably to no avail, so apathy and the only other thing to offer is of course medication.

Had the GP told you to get your shit together, there would be complaints.. so rock/hard place.

There is an ocean of information, guidance, education on healthy lifestyles out there, there is some personal responsibility in taking in some information about the consequences of high blood pressure.
In answer to your original question, both.

My GP was super sweet many years ago. I told him I was worried about conceiving due to some gynae issues in my 20s. He gently told me that whilst he knew there was a lot of pressure on women, he felt (having weighed me) that I might be very successful conceiving at a lower BMI.

He was so lovely and landed the message so well. I went home and joined WW online (this was 2004) and lost 20lbs in ten weeks and never put it back on apart from pregnancy.

So I would always want a GP to be upfront about lifestyle way before any discussion about medication.

With the exception of menopause. Because lifting weights and eating chia seeds DOES NOT help night sweats and lack of sleep!

It isn't always lifestyle etc. that affects BP. I was healthy, exercised regularly, eat healthily, cooked from scratch most days, not much in the way of processed food.
I had to have a minor medical procedure, they took my BP, and it was high. They said although it might be slightly raised because I was nervous about the procedure, they felt it was too high. I had the procedure and it was still high; they suggested when I want to get my stitches out, it should be taken again.
Before that, I had an accident, in the hospital my BP was 212/120, basically they were not going to let me out until they got it down; cue medication.
I have gone from 2 to 1 type of medication now, and have now started taking aged garlic, to see it that can make a difference.
I have done a lot of reading, and spoken to an alternative therapist, she told me some of her clients have had cardio vascular problems after contracting COVID; which I was very ill with 3 times.
I can't state categorically that COVID caused my problem, but prior to that, whenever I had my BP taken it was always very healthy.

You should be given both options and be allowed to choose. However if your BP is dangerously high they would be sensible to push medication while you make lifestyle changes (if you choose to do that)
High BP is the biggest cause of stroke in the UK.

But you seem intelligent so you didn't need your doctor to tell you to do those things, did you?

Also, I had high blood pressure at a normal weight.

For me, I'd rather try the self support option before going on tablets, so I'd have been looking at the first option. GP doesn't need to fat shame you, but just point out factors you should try yourself before tablets. Surely this should be the case for most things that need treating.