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I feel like it's worth pointing out that high blood pressure is itself, like weight, a surrogate endpoint. Unless extreme (so extreme you would physically be aware of it), high blood pressure itself is not a problem. We use it as a proxy marker for things that are a problem, like heart diease. And while blood pressure is correlated with various diseases and shorter lifespan, lowering blood pressure by itself does not necessarily seem to do much of anything. There have been several drugs that lower blood pressure very well but do not lead to lower incidences of other diseases or all-cause mortality.

I'm not sure of the research around lifestyle changes to affect blood pressure and whether that changes anything compared to a drug, but I'm in the midst of a book about medical research that's exploring why targeting surrogate endpoints doesn't always lead to the success we assume it will.

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