Ep. 14 - Hypertension: Selecting the Initial Medication

Running is widely considered one of the best forms of exercise for improving cardiovascular health and longevity. But is there a point where too much running can actually do more harm than good? In this episode of Beyond Conventional Medical Thinking, Dr. Sam Mann examines the research surrounding the benefits and potential risks of long-distance running. From weight management and joint health to cardiovascular disease, Dr. Mann explores what studies reveal about how running affects the body over time. He discusses whether running increases the risk of arthritis, how high-mileage training may affect the heart, and why exercise intensity matters just as much as distance. You'll also discover why moderate running may offer many of the same health benefits as endurance training, without some of the associated risks. Beyond Conventional Medical Thinking is a groundbreaking medical podcast hosted by Dr. Samuel Mann, renowned physician, researcher, and author. Drawing on decades of patient care and research at NewYork-Presbyterian Hospital – Weill Cornell Medical College, Dr. Mann shares clinical insights and treatment approaches that work in practice yet are often absent from medical literature. His latest book, Hidden Within Us offers a pioneering new understanding of the relationship between emotions and health, one rarely considered by physicians, patients, and research psychologists. Get your copy here.: https://www.amazon.com/Hidden-Within-Understanding-Mind-Body-Connection/dp/B09XSX849K

When treating high blood pressure, how low should you aim? Is a systolic blood pressure below 120 really better than 130, especially as you get older?   In Episode 21 of Beyond Conventional Medical Thinking, Dr. Samuel Mann examines current hypertension treatment guidelines and the research behind recommended blood pressure targets. While guidelines often encourage aggressive blood pressure control, Dr. Mann questions whether the modest benefits of lower targets outweigh the potential risks of additional medication.   Drawing on major clinical trials, including the SPRINT and ACCORD studies, Dr. Mann discusses how age, medication side effects, and differences in blood pressure measurement can influence treatment decisions. He also explains why blood pressure readings taken at home may provide a more accurate picture than those taken during a doctor's appointment.   For more information about Dr. Samuel Mann and his approach to hypertension treatment, visit drsamuelmann.com, or purchase his latest book, Hidden Within Us, available on Amazon.

Statins lower cholesterol, help prevent cardiovascular events, and save lives. But for some people, they may also cause muscle pain that can be easy to dismiss or blame on something else. In this episode of Beyond Conventional Medical Thinking, Dr. Samuel Mann takes a closer look and examines statin-associated muscle symptoms, including what the pain can feel like, where it commonly occurs, and who may be at greater risk. He also shares his own experience with persistent pain while taking a statin. If you take a statin and have unexplained or persistent muscle pain, Dr. Mann explains why it’s worth discussing with your doctor rather than simply assuming it’s age, exercise, or a muscle strain. Listen to Episode 20 of Beyond Conventional Medical Thinking with Dr. Samuel Mann.

In this episode, Dr. Samuel Mann examines what research suggests about coffee, caffeine, and long-term health, including their effects on blood pressure, cardiovascular health, inflammation, cognitive decline, Parkinson’s disease, diabetes, sleep, and anxiety. He explains why caffeinated and decaf coffee may offer different benefits, how much coffee appears to provide the greatest benefit, and when it may pose greater risks. Dr. Mann also shares a simple at-home blood pressure experiment to help you determine how caffeine affects you personally. Welcome to Beyond Conventional Medical Thinking, a podcast with Dr. Samuel Mann, physician, researcher, and author of Hidden Within Us.

Hypertension during pregnancy requires careful monitoring and treatment to protect both mother and baby. In this episode, Dr. Samuel Mann is joined by Dr. Line Malha, Attending Physician at Weill Cornell Medicine and a nephrologist and hypertension specialist. They discuss how the CHAP Trial changed treatment guidelines, how to get accurate blood pressure readings, and what clinicians and patients should know about preeclampsia, gestational hypertension, and medication options during pregnancy. Dr. Malha also shares what women should know before pregnancy, including steps that may help reduce the risk of hypertension and the importance of identifying blood pressure changes early. Welcome to Beyond Conventional Medical Thinking, a podcast with Dr. Samuel Mann, a physician, researcher, and author. His latest book, Hidden Within Us offers a pioneering new understanding of the relationship between emotions and health, one rarely considered by physicians, patients, and research psychologists. Get your copy here.: https://www.amazon.com/Hidden-Within-Understanding-Mind-Body-Connection/dp/B09XSX849K

We’re constantly being reminded to drink more water, but could following that advice sometimes do more harm than good? In this episode, Dr. Samuel Mann examines the relationship between water intake, diuretics, sleep, and blood sodium levels. He explains why diuretic medications may contribute to frequent nighttime urination and why anyone taking one should have their sodium levels monitored by a physician. Welcome to Beyond Conventional Medical Thinking, a podcast with Dr. Samuel Mann, a physician, researcher, and author. His latest book, Hidden Within Us offers a pioneering new understanding of the relationship between emotions and health, one rarely considered by physicians, patients, and research psychologists. Get your copy here.: https://www.amazon.com/Hidden-Within-Understanding-Mind-Body-Connection/dp/B09XSX849K *This episode is for educational purposes only. Never change your medication or fluid intake without consulting your physician.

Anxiety isn't just a psychological condition, it also has physical effects throughout the body. Although Dr. Samuel Mann is a hypertension specialist rather than a psychiatrist, decades of treating patients with high blood pressure have shown him that anxiety, depression, ADHD, and other conditions frequently overlap with cardiovascular health. Welcome to Beyond Conventional Medical Thinking, a podcast with Dr. Samuel Mann, a physician, researcher, and author. His latest book, Hidden Within Us offers a pioneering new understanding of the relationship between emotions and health, one rarely considered by physicians, patients, and research psychologists. Get your copy here.: https://www.amazon.com/Hidden-Within-Understanding-Mind-Body-Connection/dp/B09XSX849K In this episode, Dr. Mann explains why he sometimes recommends an unexpected treatment that isn't commonly discussed in standard anxiety guidelines. He discusses the science behind adrenaline, why certain beta blockers may help reduce physical symptoms of anxiety, which ones he prefers (and avoids), and why this approach can produce results much sooner than many traditional anxiety medications. If you've struggled with chronic anxiety despite conventional treatment, this episode offers a perspective you may not have heard before.

Continuing the conversation from episode 14, today we're going to talk about resistant hypertension. This is the type of hypertension with a Blood Pressure above 140/90, that doesn't respond to the usual medication. So, what do you do next? Plus, I'll share a treatment recommendation that isn't mentioned in the 2025 Hypertension Guidelines. Welcome to Beyond Conventional Medical Thinking, a podcast with Dr. Samuel Mann, a physician, researcher, and author. His latest book, Hidden Within Us offers a pioneering new understanding of the relationship between emotions and health, one rarely considered by physicians, patients, and research psychologists. Get your copy here: https://www.amazon.com/Hidden-Within-Understanding-Mind-Body-Connection/dp/B09XSX849K

Welcome to Beyond Conventional Medical Thinking, a podcast with Dr. Samuel Mann, a physician, researcher, and author. His latest book, Hidden Within Us offers a pioneering new understanding of the relationship between emotions and health, one rarely considered by physicians, patients, and research psychologists. Get your copy here: https://www.amazon.com/Hidden-Within-Understanding-Mind-Body-Connection/dp/B09XSX849K In this episode you will hear: Why I don't agree with the guidelines for selecting the initial hypertension medication and what I do instead Why it's important to measure plasma renin levels. So why don't physicians measure the plasma renin activity? It's of huge value in selecting a drug, especially in young populations Side effects of the most commonly prescribed diuretic Potassium sparing diuretics The issues with spironolactone and its alternatives Three loop diuretics that are alternatives to the usual thiazides Second category of calcium channel blockers What the guidelines tell us if your blood pressure is above 140

In this episode, I discuss the FDA (Food and Drug Administration)'s process for approving and reviewing new medications and new treatments. While it's a necessary procedure, there are good and bad things about it. From the perspective of a clinician, here are some of the major drawbacks. Tune in to hear some lessons from my clinical experience plus my perspective of the big drawbacks on this process. Welcome to Beyond Conventional Medical Thinking, a podcast with Dr. Samuel Mann, a physician, researcher, and author. His latest book, Hidden Within Us offers a pioneering new understanding of the relationship between emotions and health, one rarely considered by physicians, patients, and research psychologists. Get your copy here: https://www.amazon.com/Hidden-Within-Understanding-Mind-Body-Connection/dp/B09XSX849K