Cardiorespiratory &Fitness
Blood pressure is the force exerted by circulating blood against the walls of your arteries, measured in millimeters of mercury (mmHg) and expressed as two numbers:systolic pressure (the higher number, when the heart contracts) over diastolic pressure (the lower number, when the heart relaxes between beats). A reading of 120/80 mmHg is read as "120 over 80."Blood pressure is arguably the single most important modifiable cardiovascular risk factor, as elevated blood pressure silently damages blood vessels, heart, brain, kidneys, and eyes over years and decades.
Your blood pressure fluctuates throughout the day in response to physical activity, stress, sleep, meals, and circadian rhythms. It is typically lowest during sleep and highest in the morning. Sustained elevation of blood pressure—hypertension—forces the heart to work harder and damages arterial walls, creating a cascade of cardiovascular complications. Even mildly elevated blood pressure (130-139/80-89 mmHg, Stage 1 hypertension) significantly increases risk of heart attack, stroke, kidney disease, and dementia.
The insidious nature of hypertension is its lack of symptoms until severe damage has occurred, earning it the moniker "the silent killer."Nearly half of American adults have hypertension, yet only about half are aware of it. The good news:blood pressure is highly responsive to lifestyle modifications including diet (particularly sodium reduction and DASH diet), weight loss, exercise, stress management, and adequate sleep. Many cases of hypertension can be prevented or reversed through lifestyle intervention alone.
Bottom line: TSH and Free T4 alone miss people with conversion problems. Free T3 is the only way to know if you have enough active thyroid hormone at the tissue level.
| Range Type | Level | Clinical Significance |
|---|---|---|
| Predicts stroke, heart attack, kidney disease, and dementia | Often asymptomatic until severe damage occurs | Highly responsive to lifestyle and pharmacological intervention |
| Optimal Blood Pressure Ranges | Normal:<120/80 mmHg | Optimal:<110/70 mmHg (lowest risk) |
| Stage 1 HTN:130-139/80-89;Stage 2 HTN:≥140/90 mmHg | Elevated:120-129/<80 mmHg (pre-hypertension). Hypertensive crisis:>180/120 mmHg (medical emergency). For adults over 60, target <140/90 often used, though lower may be beneficial. Home BP monitoring recommended—"white coat hypertension"can cause falsely elevated readings in clinic. Average of multiple readings most accurate. | DASH Diet and Sodium Restriction |
| Adopt DASH (Dietary Approaches to Stop Hypertension) diet emphasizing fruits, vegetables, whole grains, lean protein, low-fat dairy. Reduce sodium to <2,300 mg daily (ideal <1,500 mg for hypertension). DASH diet can lower BP by 8-14 mmHg. Increase potassium through diet (bananas, leafy greens, potatoes). | Regular Aerobic Exercise | Engage in 150+ minutes weekly of moderate aerobic exercise (brisk walking, cycling, swimming) or 75 minutes vigorous exercise. Aerobic exercise lowers systolic BP by 5-8 mmHg and diastolic by 3-5 mmHg. Even without weight loss, exercise provides BP benefits through improved vascular function. |
Standard lab range:Optimal:<120/80, Elevated:120-129/<80, Stage 1 HTN:130-139/80-89, Stage 2 HTN:≥140/90 mmHg
Achieve and maintain healthy body weight. Each kilogram (2.2 lbs) of weight loss reduces BP by ~1 mmHg. Losing 5-10% of body weight can lower BP by 5-20 mmHg. Reduce visceral (belly) fat specifically, as it is metabolically active and drives hypertension.
Practice stress-reduction techniques:meditation, yoga, deep breathing, progressive muscle relaxation. Chronic stress elevates BP through sympathetic activation. Ensure 7-9 hours quality sleep—sleep deprivation and sleep apnea significantly raise BP. Treat sleep apnea if present.
Limit alcohol to ≤2 drinks/day for men, ≤1 drink/day for women. Excessive alcohol raises BP by 2-4 mmHg. Quit smoking—nicotine acutely spikes BP and damages arteries. Consider medications (ACE inhibitors, ARBs, diuretics, calcium channel blockers) if lifestyle changes insufficient.
Hypotension (<90/60):dizziness, fainting, fatigue, blurred vision, nausea, cold clammy skin. Low BP typically less concerning unless symptomatic or acute.
Dehydration, blood loss, severe infection, heart problems, endocrine disorders, medications (diuretics, beta-blockers), prolonged bed rest, nutritional deficiencies (B12, folate)
Note: Blood Pressure and Cardiovascular Risk
Note: Lewington et al., "Age-specific Relevance of Usual Blood Pressure to Vascular Mortality,"Lancet, 2002
Landmark trial showing that intensive blood pressure control (target <120 mmHg systolic) reduces cardiovascular events by 25% and mortality by 27% compared to standard control (<140 mmHg), though with increased side effects.
Source:SPRINT Research Group, "Intensive vs Standard Blood Pressure Control,"New England Journal of Medicine, 2015
Meta-analysis of exercise intervention trials demonstrating that regular aerobic exercise reduces systolic BP by average 5-8 mmHg and diastolic by 3-5 mmHg, with greater reductions in hypertensive individuals.
Source:Cornelissen &Smart, "Exercise Training for Blood Pressure,"Journal of the American Heart Association, 2013
Original DASH trial showing that diet rich in fruits, vegetables, low-fat dairy, and reduced sodium lowers blood pressure by 11/6 mmHg in hypertensive individuals within 2 weeks, without medication or weight loss.
Source:Appel et al., "A Clinical Trial of the DASH Diet,"New England Journal of Medicine, 1997
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| Provider | Includes Test | Annual Cost | Total Biomarkers |
|---|---|---|---|
 Superpower | — | $199 | 100+ |
 WHOOP Advanced Labs | — | $349 | 65 |
 Labcorp OnDemand | — | $398 | 30+ |
| — | $486 | 40+ | |
| — | $468 | 83 | |
| — | $798 | 100+ | |
 InsideTracker | — | $680 | 48 |
 Function Health | — | $499 | 100+ |
| — | $900 | 70+ | |
| — | $1150 | 110 | |
| — | $Varies | 75+ |
This information is for educational purposes only and is not medical advice. Always consult with a qualified healthcare provider about your specific health needs and before making decisions about blood testing.
