2. Ayurveda Die: Improper diet also contributes towards the unhealthy condition of the body. Eat a balanced diet and avoid the consumption of salt and sugar, pickles, alcohol, caffeine, tomatoes, and fatty foods to regulate high BP. Include ginger, green leafy veggies, yogurt, berries, oatmeal, onion, amla, Omega-3 fatty acid, beetroot, Vitamin C rich fruits, herbs, garlic, seeds, cucumber, bananas, pomegranate, nuts, avocados and olive oil, in your meals.
The heartening news is that most people can effectively control their blood pressure without the need for medications by following a healthy lifestyle like the Pritikin Program.  “Those who still need medications usually require a lower dose and/or fewer drugs, thereby reducing their risk of suffering adverse side effects from the medications,” states Dr. Fruge.

2. Take an omega-3 oil. Omega 6:3 ratio is important. A lot of us get way too much omega-6 in our diets, which is what's caused the omega-3 craze. Refined vegetable oil is one of the main culprits, and found in almost all processed foods, and even some orange juices. Because we have way too much omega-6 in our systems, we need to compensate by taking some form of omega-3 oil. Decreasing your intake of processed foods will have a similar effect.

Kiwis are another fruit that positively impacts blood pressure. Some researchers studied how the fruit fares compared to apples. They found that eating three kiwis a day over eight weeks reduced blood pressure in people with slightly high blood pressure more so than eating one apple per day during the same time. A daily serving of kiwi was also found to reduce blood pressure in people with only mildly elevated levels. Kiwis are also an excellent source of vitamin C which can also also improve blood pressure. 


Taking a few moments to concentrate on breathing deeply can be a great help. Meditation and yoga are other great activities to reduce stress. We recommend Yoga Burn, by Zoe Bray Cotton for an amazing at-home yoga workout.  In the long term, creating a routine that including one or more of these stress reduction techniques will be important to keep your blood pressure down in normal levels. [2]
While most Americans with hypertension are treated primarily with drugs, “these drugs do not come close to eliminating all the cardiovascular ills associated with the typical American diet and sedentary lifestyle,” observes Danine Fruge, MD, Medical Director at the Pritikin Longevity Center in Miami. Over the last four decades, the Center has helped thousands worldwide lower blood pressure naturally and significantly reduce many cardiovascular risks.

1. Concentrate on foods that lower blood pressure. Sugary, processed foods contain salt, sugar, damaged fats, and food sensitivities like gluten that contribute to or exacerbate high blood pressure. Shifting to a whole, unprocessed foods diet can dramatically impact your blood pressure. Many whole, unprocessed foods are rich in potassium, a mineral that supports healthy blood pressure. Some research shows that too much sodium and low amounts of potassium – can contribute to high blood pressure. Research shows people with high blood pressure can benefit from increased potassium in foods including avocado, spinach, wild-caught salmon, and sweet potatoes.

i am currently 63 years old and was on a higher daily dose of zestoretic from about 1992-2010 for 140/90 BP and slowly reduced my need (lower mg) for zestoretic by paying more attention to my health (diet, weight, exercise, etc), eventually (about 2014) i got down to 10mg of lisinopril (no more hctz) about once per week or as needed since i was monitoring BP at home. in late 2016, a new doctor recommended that i stop taking 10mg lisinopril, and my blood pressure was usually low about 100/60 after breakfast or exercise and would go up to about 130/90 in the evening. in 2017, my BP was 150/90 the morning before hernia surgery. anyway, long story short my BP seems to fluctuate a lot during the day, low (100/60) after exercise, low after breakfast, high (130/90) before going to bed. the low BP periods get shorter and shorter so i went back to taking 10mg lisinopril as needed, about once every 2 or 3 weeks and the low BP periods get long again. also my pulse seems to get higher (80) when my BP gets lower 100/60 and my pulse gets lower (70) when my BP gets higher (130/90). anyway, i recently moved so probably need to see another new doctor, but thought i would just let you know what is going on.
“We have many people with hypertension who come to Pritikin,” says Pritikin’s Associate Medical Director Danine Fruge, MD, “and within three days, many have blood pressures that have dropped so low that we need to reduce their medications or take them off their pills altogether. Yes, just three days. That’s how quickly and powerfully our bodies respond to healthy food, exercise, and other lifestyle changes.”
Glad to be helpful. If the nephrologist says all the tests were negative, that sounds reassuring and might mean your doctors could try different types of BP medication with you. Generally, three types of medication are considered equally acceptable for first-line treatment of high blood pressure: thiazide-type diuretics, ACE inhibitors or angiotensin receptor blockers (these two are related), or calcium channel blockers such as amlodipine.
In addition to these methods being effective, other lifestyle changes and diet adjustments may also be useful in lower blood pressure. One study explains that losing weight can have a significant positive impact on patients that have been diagnosed with hypertension. Even small reductions in bodyweight amongst those individuals who are both obese and hypertensive can yield life-saving benefits. Dietary changes can also help. In particular, the patient should aim to lower their daily intake of sodium, which causes an elevation in blood pressure. The patient should also focus on obtaining more calcium, potassium and other minerals that are useful in balancing blood pressure levels. Fiber, fruits and a lot of vegetables should also be an essential part of the patient’s daily diet.
This technique is known to surprisingly few health professionals, though it has proved valuable in the treatment of a wide variety of health problems. Recently, this powerful technique has been shown to be an extremely effective method for allowing the body to rapidly normalize high blood pressure more effectively than any other treatment reported in the scientific literature.
The causes are most often some combination of clogged “pipes” and excessive salt in the diet. Lifestyle changes, such as appropriate diet and exercise, are among the most effective treatment strategies for high blood pressure. Relaxation, meditation, and otherwise “taking it easy” are not effective solutions, as valuable as such strategies may be for your psychological well-being.
4. Cut down on processed food. Just about all processed foods contain huge amounts of fructose, particularly fruit drinks or any fruit-flavored products. Fructose is hidden all over the supermarket, even in the most unlikely places: processed meats, breads, pasta sauces and dressings. Fast food chains love fructose. The only thing they love more is vegetable oil.
Common painkillers (so-called non-steroidal anti-inflammatory drugs, NSAID), can increase your blood pressure by inhibiting the production of salt in your kidneys. This includes over-the-counter pills such as Ipren, Ibumetin, Ibuprofen, Diklofenak and Naproxen as well as the prescription drug Celebra. Painkillers with the active substance paracetamol are better for your blood pressure.
“Beware of the American Heart Association’s (AHA) 'Salty Six' — six popular foods that can add high levels of sodium to your diet,” says Rachel Johnson, PhD, a professor of nutrition at the University of Vermont in Burlington and the former chair of the AHA’s nutrition committee. The Salty Six include breads and rolls, cold cuts and cured meats, sandwiches, pizza, soup, and chicken.
In today’s time, when stress walks along, practicing poor eating habits combined with a sedentary lifestyle only add to the wellness issues. We prioritize our work, responsibilities and daily chores, and these things gradually tyrannize our life. Amidst pressure and hectic schedule, our health is something that suffers a lot. Stress and tension pave way for many ailments and to start with, high BP is the most common by far.
The heartening news is that most people can effectively control their blood pressure without the need for medications by following a healthy lifestyle like the Pritikin Program.  “Those who still need medications usually require a lower dose and/or fewer drugs, thereby reducing their risk of suffering adverse side effects from the medications,” states Dr. Fruge.
And I am 67 and am on HCTZ25mg (I retain a lot of water) and Losartan 75mg which causes leg cramps but I think I am experiencing angina – not always; it goes away after the initial pain – now I’m worried – yes I could lose weight but do not smoke(17yrs ago) or drink(used to then stopped now for a number of years). What’s are next move. Iam adopted so I can’t look to my Mom for any genetics…Thank you, Laurie
For this reason, Dr. Alan Goldhamer and his colleagues at the Center for Conservative Therapy set out to carefully document the effectiveness of supervised water-only fasting and to report the results to the scientific community in a way that other doctors might find convincing. To assist him in this task, Dr. Goldhamer and his research staff at the Center sought the help of one of the world’s leading nutritional biochemists, Professor T. Colin Campbell of Cornell University.
A 2013 study published in “Hypertension” concluded that flaxseed lowers blood pressure in hypertensive patients. It is a great home remedy for high blood pressure. More than 100 patients diagnosed with peripheral artery disease, a condition associated with high blood pressure, were assigned to a flaxseed group or a placebo group. The former ate 30 grams of flaxseed every day for 6 months.
3. Quit smoking and alcohol: Because, neither of the two is of any benefit to your health. What's more is that smoking is listed as a causative factor for almost all diseases. You name a disease, and smoking will be a contributing factor to it. Alcohol, on the other hand, has direct links with increasing blood pressure. No amount of alcohol intake is safe or healthy for men or women.
The sweet serves up flavanols that help lower blood pressure by relaxing blood vessels and boosting blood flow. On average, regular dark chocolate consumption could help lower your systolic blood pressure (the top number) by 5 points and your diastolic blood pressure (the bottom number) by almost 3 points, suggests an Australian analysis. How dark are we talking? Experts haven't been able to determine an ideal percentage of cocoa, says Vivian Mo, MD, Clinical Associate Professor of Medicine at the Keck School of Medicine of the University of Southern California. But the higher you go, the more benefits you'll get. 

Stress hormones constrict your blood vessels and can lead to temporary spikes in blood pressure. In addition, over time, stress can trigger unhealthy habits that put your cardiovascular health at risk. These might include overeating, poor sleep, and misusing drugs and alcohol. For all these reasons, reducing stress should be a priority if you're looking to lower your blood pressure.

“Beware of the American Heart Association’s (AHA) 'Salty Six' — six popular foods that can add high levels of sodium to your diet,” says Rachel Johnson, PhD, a professor of nutrition at the University of Vermont in Burlington and the former chair of the AHA’s nutrition committee. The Salty Six include breads and rolls, cold cuts and cured meats, sandwiches, pizza, soup, and chicken.
10. Increase intake of potassium: Potassium is important to keep blood pressure under control as it helps the body to get rid of sodium. Including more fresh and whole foods in your diet can contribute to healthy levels of potassium in your body. Foods rich in potassium include bananas, beans, nuts and seeds, tuna, salmon, dairy products and green leafy veggies are rich sources of potassium.
Oatmeal is one of a few semi-processed foods that lower blood pressure. That’s because getting the right amounts of dietary fiber and whole grains is vital to maintaining normal blood pressure, and oatmeal is a tasty source of both. Classic studies have proven that eating oatmeal can lower systolic and diastolic blood pressure. Plus, the fiber can help you maintain a healthy body weight and prevent obesity, a risk factor for high blood pressure. These are the 10 silent signs you could have low blood pressure.
Stress hormones constrict your blood vessels and can lead to temporary spikes in blood pressure. In addition, over time, stress can trigger unhealthy habits that put your cardiovascular health at risk. These might include overeating, poor sleep, and misusing drugs and alcohol. For all these reasons, reducing stress should be a priority if you're looking to lower your blood pressure. 

The American Heart Association considers 120/80 to be a normal blood pressure reading. Unless you have been diagnosed with high blood pressure you may not realize anything is wrong so it is important to get tested each time you see your doctor, or more frequently if you have a family history of hypertension. Often, hypertension has no obvious symptoms, but it could be quietly causing damage and threatening your health. This condition overworks the heart and damages the walls of the blood vessels. If left untreated, it can lead to tears, ruptures, or increased plaque build-up in your heart, which increases your risk for heart failure, heart attack or stroke.
In addition to these methods being effective, other lifestyle changes and diet adjustments may also be useful in lower blood pressure. One study explains that losing weight can have a significant positive impact on patients that have been diagnosed with hypertension. Even small reductions in bodyweight amongst those individuals who are both obese and hypertensive can yield life-saving benefits. Dietary changes can also help. In particular, the patient should aim to lower their daily intake of sodium, which causes an elevation in blood pressure. The patient should also focus on obtaining more calcium, potassium and other minerals that are useful in balancing blood pressure levels. Fiber, fruits and a lot of vegetables should also be an essential part of the patient’s daily diet.
One of the most important lifestyle changes to adapt when hypertension affects a patient is a more active daily routine. Exercise is reported to be an exceptionally useful method for controlling blood pressure levels and for reducing blood pressure in patients diagnosed with hypertension. Additionally, patients who regularly participate in physical activities are also at a lower risk of developing a complication or complications due to high blood pressure.

And I am 67 and am on HCTZ25mg (I retain a lot of water) and Losartan 75mg which causes leg cramps but I think I am experiencing angina – not always; it goes away after the initial pain – now I’m worried – yes I could lose weight but do not smoke(17yrs ago) or drink(used to then stopped now for a number of years). What’s are next move. Iam adopted so I can’t look to my Mom for any genetics…Thank you, Laurie
Raw almonds: Consuming a handful of raw almonds can make a significant difference in your blood pressure. Almonds are considered a key component of the DASH diet—dietary approaches to stop hypertension diet—as they are rich in monounsaturated fats scientifically proven to lower cholesterol, reduce arterial inflammation, and lower blood pressure. It is important to note that almonds are high in fat and calories, but when eaten as part of a healthy lifestyle, they may actually promote weight loss and muscle growth.

Elevating your feet will not lower blood pressure and will actually increase the blood pressure reading when your feet are higher than your heart. On the other hand, if you are doing activities to relieve stress such as yoga (which often elevates your legs, such as legs-up-the-wall pose), then over the long run, these stress reducing activities may help to decrease your blood pressure (but it is not the act of elevating the legs that is lowering the blood pressure it is the stress relieving activity).

Lowering your blood pressure requires more than just cutting back on sodium, Prevention.com reports. You also need to eat foods high in at least two of these three minerals: calcium, magnesium, and potassium. With white beans, you get the jackpot for all three. Just one cup contains 13 percent of the calcium, 30 percent of the magnesium, and 24 percent of the potassium needed for your daily recommended servings. Here are 7 things your doctor isn’t telling you about your blood pressure.
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Having a bad day can impair our judgment and lead to most of us making not-so-wise lifestyle choices like binge eating, smoking, or drinking. These unhealthy habits done in excess can negatively affect our health, especially our blood pressure. As one in four Americans continue to suffer from the epidemic of high blood pressure, it is imperative for us to effectively avoid and reduce this highly preventable disease associated with heart attack and stroke, aneurysms, cognitive decline, and kidney failure. Fortunately, there are ways to bring down blood pressure without the use of medication.

Seek the sun: A natural source of energy and one that keeps you healthy. A recent study found that people exposed to UV rays for a short duration experienced a significant drop in blood pressure, even before their production for vitamin D activated. This is thought to be because of the sunlight converting nitrate stored in the skin to nitric oxide—a potent vasodilator.
If you want to know how to lower blood pressure fast and safely, look no further. The good news is that there are things you can do immediately to bring your blood pressure down and get it closer to normal levels. By doing this you will reduce your risk of further health complications. Here are the best tips for bringing down your blood pressure quickly.
The main thing that strikes me about your comment is that you are taking three different BP medications. This is necessary for some people, but in other cases, with a little tinkering we are able to provide adequate control with just two medications. The combination of an ACE inhibitor (such as lisinopril) and a calcium channel blocker (such as amlodipine) was shown to be particularly favorable in the ACCOMPLISH trial, so this combination is now recommended by many experts.
Start by eating nuts. Pistachio nuts, singled out among other nuts, seem to have the strongest effect on reducing blood pressure in adults. This is according to a recent review and scientific analysis of 21 clinical trials, all carried out between 1958 and 2013. The review appears online in The American Journal of Clinical Nutrition, a publication of the American Society for Nutrition.
One notable recommendation within the new guidelines is the focus on lifestyle changes first, and medication only if necessary. Like all meds, blood pressure medications come with their side effects, so it’s always worth it to work on diet, exercise and stress management first. Even if an individual receives only partial benefits from lifestyle changes, it may still mean reduced medication usage, or one with fewer side effects if necessary. Here are a few lifestyle changes that you start today to reduce your blood pressure naturally.
Lowering your blood pressure requires more than just cutting back on sodium, Prevention.com reports. You also need to eat foods high in at least two of these three minerals: calcium, magnesium, and potassium. With white beans, you get the jackpot for all three. Just one cup contains 13 percent of the calcium, 30 percent of the magnesium, and 24 percent of the potassium needed for your daily recommended servings. Here are 7 things your doctor isn’t telling you about your blood pressure.

Could it ever be appropriate for a physician to prescribe slightly higher-than-routine dosing of a well-tolerated blood pressure medication, when other types of BP meds are not tolerated or would be problematical because of interactions with all the other drugs one might be on? I would assume fall risk should be evaluated in conjunction with such a consideration, and that it also might depend on how the particular tolerated BP med actually works in the body.


High blood pressure, or hypertension, is the leading risk factor for heart disease and stroke. Damage to your blood vessels occurs every time your pressure is elevated, and the new guidelines are meant to help people become more aware earlier.  And through earlier awareness, it may help prevent the damage that would occur if you waited for a later diagnosis.
My mother had a massive cardiac event 19years ago. She is currently 79y and has 25% function of her heart. Up until 6 months ago was doing great. Then she started getting very tired and could hardly get out of bed.turns out her bp medication was making her hypotensive. The cardiologist put her on a new medication but took her off all bp mendications for 2 days. I had her take her bp twice a day for those two days and her bp was 111/62or less in am and evening. She also on day two felt great and was able to be back to normal ADL. She took the new medication in the evening before bedtime and woke up with a be of 83/54. Scared me to death. She felt terrible all day. I told her to not take it again. I have been since monitoring her bp twice daily and she is averaging 110/64. She had one morning at 154/83 when she was scared about some thing with a family member but later that evening it was again at 112/68. She has an apt. With cardiologist in 9 days. Should i have her cont. to stay off if we monitor daily and we do not see a spike in bp. I called her dr. After first week and the message from nurse, since doctor would not talk to me, was to take half of her enalipril. I said ok and still am afraid to let her take it. Am i wrong is there another reason for her to take this medication that causes the hyopensiveness?
But the dark chocolate should be 60 to 70 percent cacao. A review of studies on dark chocolate has found that eating one to two squares of dark chocolate per day may help lower the risk of heart disease by lowering blood pressure and inflammation. The benefits are thought to come from the flavonoids present in chocolate with more cocoa solids. The flavonoids help dilate, or widen, your blood vessels (25).
Sprinkling ground flaxseed over your meals can make a big impact on your blood pressure readings. In a 2013 study published in the journal Hypertension, participants with high blood pressure and peripheral artery disease ate 30 grams (about an ounce) of milled flaxseed daily. After six months, their systolic blood pressure (the top number) went down by 15 mm Hg, on average, and their diastolic blood pressure (the bottom number) dropped by 7 mm Hg.

If you want to know how to lower blood pressure fast and safely, look no further. The good news is that there are things you can do immediately to bring your blood pressure down and get it closer to normal levels. By doing this you will reduce your risk of further health complications. Here are the best tips for bringing down your blood pressure quickly.
We've got a bit of a different podcast today for you Guys & Gals, but it's still a goodie, and jam packed with exciting information. The Chief Scientist at the Institute of Noetic Sciences, Dr. Dean Radin, joins us to discuss his expertise on real magic and how can it optimize performance for everyone. Dr. Radin is the author of many books, but his newest, titled Real Magic, delves into the worlds of telepathy and psychokinesis; which he explains may not solely be powers of the imagination. Enjoy!
In addition to these methods being effective, other lifestyle changes and diet adjustments may also be useful in lower blood pressure. One study explains that losing weight can have a significant positive impact on patients that have been diagnosed with hypertension. Even small reductions in bodyweight amongst those individuals who are both obese and hypertensive can yield life-saving benefits. Dietary changes can also help. In particular, the patient should aim to lower their daily intake of sodium, which causes an elevation in blood pressure. The patient should also focus on obtaining more calcium, potassium and other minerals that are useful in balancing blood pressure levels. Fiber, fruits and a lot of vegetables should also be an essential part of the patient’s daily diet.
Español: bajar la presión arterial rápidamente, Italiano: Far Abbassare Velocemente la Pressione del Sangue, Português: Baixar a Pressão Rapidamente, 中文: 快速降血压, Français: faire baisser la tension artérielle rapidement, Русский: быстро понизить артериальное давление, Deutsch: Schnell den Blutdruck senken, Bahasa Indonesia: Cepat Menurunkan Tekanan Darah, Čeština: Jak rychle snížit krevní tlak, Nederlands: Snel je bloeddruk verlagen, 日本語: 速やかに血圧を下げる, हिन्दी: रक्तचाप कम करें, العربية: خفض ضغط الدم بسرعة, Tiếng Việt: Hạ Huyết áp Một cách Nhanh chóng, 한국어: 빠르게 혈압 내리는 법, ไทย: ลดความดันโลหิตแบบเร่งด่วน, Türkçe: Tansiyon Hızla Nasıl Düşürülür

Re BP: as noted in the article above, several expert groups recommend treating adults aged 60+ to a goal of SBP less than 150. So if you find that your SBP is often in the 150s or higher, then it would be reasonable to consider a medication to lower BP, especially since it sounds like you’ve been trying lifestyle treatments but your BP is still not low enough.
In addition to these methods being effective, other lifestyle changes and diet adjustments may also be useful in lower blood pressure. One study explains that losing weight can have a significant positive impact on patients that have been diagnosed with hypertension. Even small reductions in bodyweight amongst those individuals who are both obese and hypertensive can yield life-saving benefits. Dietary changes can also help. In particular, the patient should aim to lower their daily intake of sodium, which causes an elevation in blood pressure. The patient should also focus on obtaining more calcium, potassium and other minerals that are useful in balancing blood pressure levels. Fiber, fruits and a lot of vegetables should also be an essential part of the patient’s daily diet.
Bananas are one great source of potassium, but there are other tasty ways to get your fill. Potatoes actually pack more potassium than the yellow fruit (and you might be surprised to learn there are plenty of other health benefits of potatoes, too). Sweet potatoes, tomatoes, orange juice, kidney beans, peas, cantaloupe, honeydew, and dried fruits like prunes or raisins are other good sources. In all, you should aim to get 2,000 to 4,000 mg of potassium a day, Van Horn recommends.
Although medications can lower blood pressure, they may cause side effects such as leg cramps, dizziness, and insomnia. “The best habits to establish for reducing blood pressure are the same ones for a healthy life; follow an anti-inflammatory diet, do consistent low-level physical activity throughout the day, and the time plenty of time to reduce stress by learning how to smell the roses,” said Dr. Barry Sears, president of the Inflammation Research Foundation, to Medical Daily in an email. Lowering blood pressure can be attained without a prescription, not just by remaining alert on salty foods, but also with these five little-known everyday habits:
Dr. Palanismy notes that a particular form of stress reduction called Mindfulness-Based Stress Reduction has been proven in research studies to reduce blood pressure. This approach to stress reduction uses meditation, body awareness and movement such as yoga to help people better observe their experiences, instead of being completely immersed in them. This helps them take a step back in stressful situations.

5. Take apple cider vinegar. In addition to lowering blood pressure almost overnight, apple cider vinegar has a myriad of fringe benefits. Apple cider vinegar helps with indigestion, especially if you suffer from diarrhea. It also soothes sore throats, cures hiccups instantly, and lowers cholesterol. Most importantly, it helps with weight loss by improving metabolism and reducing water retention -- and a healthy weight is key to normalizing blood pressure. 

Providing at least 5 servings of vegetables and 4 servings of fruits daily, which help ensure that you eat plenty of foods that are full of stomach-filling volume yet are low in calories, enhancing weight-loss efforts. Losing excess weight is one of the most effective ways to lower blood pressure in the short term. Eating plenty of nutrient-rich fruits and vegetables also means you’ll be eating excellent sources of potassium, magnesium, and calcium. Many studies have found that foods rich in these minerals help blunt some of the toxic effects of sodium.
3. Implement strategies to lower inflammation. Several cross-sectional and longitudinal studies connect high blood pressure with chronic inflammation, a driving force for nearly every disease on the planet. Lowering inflammation starts with what you put on your fork. Focus on anti-inflammatory foods like wild-caught seafood (rich in omega-3 fatty acids), freshly ground flax and chia seeds, spices like turmeric, and plenty of colorful plant foods. Good sleep, stress management, exercise, and the right nutrients can also help lower inflammation.
5) Turmeric. Modern science is just barely hitting the tip of the iceberg concerning the superfood capacity of turmeric, also commonly known as curcumin. But one of the herb's already known benefits concerns its abilities to significantly decrease inflammation throughout the body, which is a primary cause of high cholesterol and even high blood pressure. By actively reducing inflammation, turmeric helps improve cardiovascular function and maintain healthy blood flow.

While you shouldn't shrug off the change, there's also no need to panic. "Obviously, nothing happened overnight inside a woman's body or to her health with the release of the guidelines," says Dr. Naomi Fisher, director of hypertension service and hypertension innovation at the Brigham and Women's Hospital Division of Endocrinology, Diabetes, and Hypertension, and associate professor of medicine at Harvard Medical School.
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