Misrepresenting the Facts

   I have no fondness for the product 5 Hour Energy.  I don't like that it is a caffeine supplement, that it is marketed mercilessly, and that its ads are misleading and deceptive.
   To be clear and repetitive, I understand that there are benefits to caffeine intake and I regularly consume two or more cups of coffee a day.  The research that supports the benefits of caffeine do so with regard to coffee with a dose response and an upper limit.  There is no scientific evidence to support a health benefit of energy drinks or caffeine supplements.  There is concern over misuse of these 'supplements,' especially in our youth.  It is possible that they cause harm in excess and in combination with other substances and activities..
Now back to this specific product.
   There is a commercial currently airing that suggests an endorsement from a great number of doctors.  The spokesperson (in a white coat) is standing near a desk with a huge stack of papers.  She says and the on screen text emphasizes that they contacted 3000 physicians.  They say that doctors recommend their product.  Here is what the obtuse, fine print says... obtuse because it is not easy to understand.. maybe on purpose.  
   It appears that they sent a survey to some doctors and received 503 responses - but it is not clear if they only sent it to 503 or 503 out of XX number responded.  That is a very important missing piece of information (as is where the doctors are practicing medicine (i.e. in the world); if they are seeing patients, how long they have been doing so; what the average age of the doctor who responded,  etc).  The fine print also says that 2500 docs (or their offices) were approached by sales staff and asked to read some information.  The text implies that 2500 people responded to the request which would be a nearly unheard of 100% response rate.  Again, who WERE those people and WHERE are they located.  Maybe they are all in one small part of the world, for example - or one state in the US or one region.  The ad claims a total sample of 3000 - so lets go with that as the actual resonses.
    It then says (the fine print not the voice over), 73% of the doctors 'would recommend a low calorie energy supplement to healthy patients ALREADY taking an energy supplement.' Being gracious, that means 2190 docs said this.  Of those, 1200 would specifically recommend low calorie 5 Hour Energy to their patients who ALREADY take a supplement and are healthy.  All told, less than 50%  of the doctors would actually recommend the product.  
   OF course I emailed them and asked for information on their actual sample of doctors... we should not hold our breath on that one.  However, I reminded them that if they were going to present this as if it were a valid survey then it was customary to share these details.

Diastolic

   I had a doctors appointment this week and my blood pressure was assessed.  It was a very healthy, normal 105/70 but it got me to thinking.  I wondered how close my bottom number or 'diastolic pressure' was to normal or abnormal and if there was a specific treatment for changing one of the numbers as opposed to the other. 
   I know that my diastolic pressure has been in the 60s before and though I don't know if that is a good place for it to be, I wondered why it went up. 
   Turns out that the bottom number is considered healthy or normal as long as it is under 80 and above 60.  It is not until the bottom number goes over 90 that one has the diagnosis of hypertension or high blood pressure, but doctors will put a watch on you if your number is over 80.  It is likely that a doctor would advise a person who's bottom number was over 80 and under 90 to watch their weight, eat better and to exercise.  Of course, a drug company might want that doctor to just go ahead and give you a pill.
   The top number, or systolic pressure, is considered safe and normal if it is under 120 (but over 90).  
   The NHLBI (National Heart Lung Blood Institute) is the most credible source that I know of for information about diagnosis and treatment of heart and lung conditions.  On their webpage I found a chart that shows when one is hypertensive by either number.
   My goal today was to see if the treatment for diastolic hypertension differed from treatment for systolic hypertension.  I could find no evidence of this.  What I did learn was that if either number is abnormal, a person is said to have hypertension or high blood pressure and if both numbers are abnormal, the highest value is used to determine what stage of hypertension the patient has.  I imagine that the stage is used to inform how invasive and intense the treatment should be.  High blood pressure is a risk factor for stroke.
   The best way for me to explain about the stages is to show you the chart from the NHLBI.  If your number is 120/90 then you have stage one hypertension by the diastolic number.  If your number is 160/95 you have stage two based on your systolic.
 
    It is said that following a healthy lifestyle can reduce the chances of becoming hypertensive.  A healthy lifestyle, as you know by now, includes not smoking, being of a healthy weight (one in which you have normal blood tests and are not stressing your joints), eating a quality diet (plant based with limits on red and processed meats, add fish and alcohol when appropriate ) and exercising - daily.  If you click here, the NHLBI has some helpful information on preventing hypertension in more detail.

 [note:  people with established high blood pressure must be careful about alcohol use]