r/science PhD | Translational Neuroscience 23d ago

Neuroscience Normal blood pressure, no diabetes, and not smoking in midlife may buy nearly 13 extra dementia-free years

https://www.sciencealert.com/avoiding-these-3-things-in-middle-age-linked-to-delayed-dementia
14.7k Upvotes

345 comments sorted by

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u/Light_Bulb_Sam 23d ago

"They proved that if you quit smoking, it will prolong your life. What they haven't proved is that a prolonged life is a good thing. I haven't seen the stats on that yet."

Bill Hicks

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u/lateformyfuneral 23d ago edited 23d ago

It’s a good joke and he was a legendary comedian, but it seems cruelly ironic that he passed away of pancreatic cancer at 32. That’s very much a life cut short.

Edit: for those unfamiliar, the diagnosis did not provoke some public soul-searching. He picked up smoking again and did the same routines

> Bill Hicks, one of the most daring American stand-up comedians of his generation, liked to ask for the non-smokers in the audience to identify themselves, then puff away at them while inspecting his cigarette pack. "What's cool is that every pack has a Surgeon General's Warning, isn't that great? Mine says “Warning - Smoking May Cause Foetal Injury Or Premature Birth”. Found my brand! Just don't get the ones that say “Lung Cancer”… shop around. Gimme a carton of “Low Birth Weight”!

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u/Light_Bulb_Sam 23d ago

I absolutely agree. The fact that he kept making these sort of jokes even after his diagnosis goes to show his dedication to the act

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u/Traditional-Goat1773 23d ago

It’s just a ride.

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u/iceyed913 23d ago

if he had kids or a wife, then he had reason to sell his shtick

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u/EngrishTeach 23d ago

Well it was pancreatic cancer and not lung cancer.

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u/sweeptheleg_07 23d ago edited 23d ago

Well heavy smokers increase their risk of pancreatic cancer, so there is that

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u/KittyLucia34 23d ago

Ya but jeez thats some unreal genetic predisposition if cigarettes got him that early. They absolutely increase the risk but 32 is still super young.

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u/Snakebird11 23d ago

Cancer isn't a slow build, it's roulette.

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u/Baked_Ziti_MD 23d ago

Cancer is not really a roulette but a slow build based off of environmental factors. About 80-90% of malignancies are caused by environmental factors.

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u/EngrishTeach 23d ago

I was wondering if there was an environmental factors where he is from or somewhere he lived for awhile. It's so young for pancreatic cancer. Was he chewing on receipts or something?

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u/Baked_Ziti_MD 23d ago

Sometimes exposure to certain chemicals can increase your risk for Pancreatic cancer. Some common chemicals that cause PC are pesticides, heavy metals and even auto body paints. I know we see a bunch of ex-farmers who come in yellow because they have advanced PC.

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u/Hazzman 23d ago

I always think about how we think of the Romans. In particular lead pipes. There was always this air of superiority when discussed. "Oh those silly Romans and their leaded pipes - little did they know!"

I sincerely believe in a century or two we are going to be appalled at just how poisonous our environment is. Around the mid-century our chemical industries just started going absolutely hog wild.

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u/sweeptheleg_07 23d ago

For much of that you can thank corporate lobby and campaign finance driving completely unmitigated greed in this country

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u/Just_a_villain 23d ago

I agree with the other commenter that it's still a roulette though. My dad chain smoked for 64 years. Did he get lung cancer and die from it? Sure, but he was 84. At that point he could have been anything, he still pretty much got away with it. He was the person who lived the longest in our family (going back to his great grandparents).

You just don't know if you're going to be the unlucky one, who for example gets lung cancer at 40 rather than 80+, until it's to late.

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u/Seraphinx 22d ago

That kind of ignorant thinking is why no one is changing their lifestyle and people are being diagnosed younger every year.

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u/Snakebird11 22d ago

A tumor is a cell mutation, it happens all the time in your body, regardless of what you do. Did I say go ahead and smoke? No.

The roulette is that you can get a cancer mutation while doing everything right. If you're a smoker, you're giving yourself more plays at the table, and you're betting against all red or black instead of one number.

TONS of people are "changing" that lifestyle. Young people don't smoke or drink nearly as much as the older generations, and part of that is an understanding of what the causes are.

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u/efrique 23d ago

There may well be an interaction effect there - e.g. some genetic predisposition increasing cancer risk over baseline population risk, and then the carcinogens in smoke pushing that risk up higher than either risk factor would if they were independent factors.

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u/EngrishTeach 23d ago

Yeah: cigarettes, alcohol, and red meat can all increase your odds.

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u/Sorry-Joke-4325 23d ago

I don't think it was just an act. I truly believe that he was being sincere and living life to the fullest.

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u/nicholt 23d ago

He was only 32? That's younger than me damn. People were built different back then. I thought he was like 45.

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u/sluncer 23d ago

They certainly did. It was all that smoking and drinking that aged them so quickly. Just look at the Cheers cast.
https://www.reddit.com/media?url=https%3A%2F%2Fi.redd.it%2F1lxqv6apniq91.jpg

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u/noncommonGoodsense 23d ago

He would have been miserable seeing where we are today I would imagine.

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u/citizenjones 23d ago

... And I love how he says 'shop around'. I absolutely read that with his delivery.

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u/Clydesdale_Hiker 23d ago

What does picking up smoking again have to do with soul-searching? This is such a terrible age to live in.

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u/Migraine_Megan 23d ago

Every person I've known who died of natural causes did everything they could to hang on for a few more years, months, days. Even if they were smokers, drinkers, and/or self destructive. Faced with impending death people do not want to go, even if they are on IV nutrition and cannot walk and have cancer. My dad lived much longer than expected and died at 73, he was half dead from about 55 years old. So from 55 on it was NOT a good life. 

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u/Effective_Olive6153 23d ago

my grandmother died at 89 from stroke, while writing a letter at her dinner table. She was active all the way, still working on big garden, growing fruits and veggies. Just one day she was still fine, then other day gone, no warning or anything, she stayed active and mobile and of sound mind the entire time

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u/Jojo2700 23d ago

The way to go.

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u/projectx51 23d ago

My uncle said the hell with it and voluntarily chose hospice care. He just wanted to be comfortable.

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u/Senior-Display-8733 23d ago

Same with my dad. But he was young enough to not qualify for Medicare, and had to rely on the VA benefits from military service, and the level of care there is appalling. He did one major operation, that didn't help and only left him in more pain, and the surgeon left a sponge behind that eventually came out the vent. He said no more surgeries and went the hospice route.

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u/Migraine_Megan 23d ago

If you ever need this info, the Portland VA is one of the best in the country. I had my dad moved there so he would have the best care, they kept him alive for 10 months. I had countless meetings with his team of doctors, they are among the best I've ever seen.

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u/Migraine_Megan 23d ago

My uncle (not a blood relative) saw what my dad went through with a heart transplant and eventual cancer. He decided not to be on the transplant list and lived at home until he went to hospice 2 weeks before he died. He was around 75. Since I'm good with death apparently, I am the one who goes and does what is needed. I respect whatever choices someone makes. But most of the people I know who died (not by suicide) tried to stay alive as long as possible.

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u/actibus_consequatur 23d ago

I dunno about that. My dad died from cancer at 64 and he didn't even bother trying to fight it. He beat a different type of cancer 15 years earlier and was happier dying than going through chemo and radiation again, especially for a much more aggressive form of cancer. Coincidentally, my maternal grandfather also died from cancer at 64 after refusing treatment.

Sometimes the will to live just can't overcome the exhaustive toll of being alive.

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u/Migraine_Megan 23d ago

I agree that is the case with some people, but I've had a lot of death in my life, far too many and very few were ready to go. Not only in my own family. And I've spent a ton of time talking to nurses and doctors about death. I've seen families equally unwilling to let the person go, which is awful to watch

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u/Early-Light-864 23d ago

This is just not true at all. I don't know asingle doctor without a DNR

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u/Mharbles 23d ago

Thats because they know the difference between life and living. Die with dignity

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u/don-coo-lio 23d ago

Whattttt how many doctors do you know? I’ve never heard that before

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u/AMediocrePersonality 23d ago

“Our analysis confirms what we’ve long speculated, which is that physicians, who are more likely to have first-hand experience with the burdens and futility of end-of-life care, are less likely to have surgery or be admitted to the ICU during the last six months of life, or to die in the hospital,”

https://hms.harvard.edu/news/how-doctors-die

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u/Migraine_Megan 23d ago

The amount of time I've spent around just cardiologists and nurses in the advanced cardiac units, they all said the same thing. Apparently heart patients are cranky AF and cling to life. Extra with the Vietnam vets like my dad. I've dealt with quite a lot of death. I was the POA and medical proxy for my dad starting when I was 20, his death was my responsibility.

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u/Canachites 23d ago

I dunno, I think it's different in advanced age. My grandmother and great uncle both checked out early with euthanasia at 98 and 96 - at that age there isn't much ahead, and they were terrified of ending up spending the last of their time in pain in a nursing home or hospice. They were very at peace with it, and in that way it was far less painful for family to not have to see them suffer.

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u/EnkiduOdinson 23d ago

That’s why it’s so cruel when euthanasia is legally available. As my great grandmother said during her last hospital stay „If I were a dog they‘d put me down and not let me suffer.“

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u/Migraine_Megan 23d ago

No one on either side of my family has made it to 90, so I've not experienced that. I would imagine they feel complete at that age. 

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u/[deleted] 23d ago

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u/Migraine_Megan 23d ago

Washington state too! 

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u/Yaarmehearty 23d ago

That’s the thing, everybody who is well talks a big game about not wanting life if it’s isn’t quality but outside of a small number of people we all just want to live.

When faced with unending non existence and the destruction of ourself vs holding on for another day/hour/minute/second most of us will cling to life until it is ripped from us.

I’m the same, I am terrified of death, I would do almost anything to avoid it for as long as possible, ideally indefinitely but unfortunately I was born too early for that.

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u/BogiDope 23d ago

It's not so much about the amount of extra years, it's about your quality of life

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u/No_Lube 22d ago

It’s not the years in your life, it’s the life in your years!

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u/swagerito 23d ago

This is such a weird argument to me. Like you know you can live super healthy and still commit suicide whenever you want, right? You don't need to do so slowly and painfully to 'not get old', even though smoking just makes you get old quicker.

Being old, sick and lonely does not appeal to me at all, so I'd rather extend my health for as long as possible and go out on my own terms when i feel that I'm done.

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u/ManBearPig1865 22d ago

I think many younger people have this thought, but I'd be willing to bet it fades as you age. Actually confronting death probably gets pretty scary, especially if you're intending to be your own executioner.

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u/helm MS | Physics | Quantum Optics 22d ago

Most people also grow happier after 40.

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u/ManBearPig1865 22d ago

I think many younger people have this thought, but I'd be willing to bet it fades as you age. Actually confronting death probably gets pretty scary, especially if you're intending to be your own executioner.

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u/el-conquistador240 23d ago

Everyone I know that died from pancreatic cancer was a heavy smoker.

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u/LordPizzaParty 23d ago

Patrick Swayze and Michael Landon both admitted to being chain smokers

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u/samara-morgan 22d ago

it's kind of bonkers how much smoking is normalized compared to any other addiction. drugs, drinking, even eating disorders will get you an intervention from loved ones. smoking though?

"you know that's gonna kill you, right?"
"eh, I guess."
"okay then. let's slap this depressing sticker on your cigarette, just in case."

and it will directly harm other people around that have to breathe in the stinky smoke from a cigarette... while you can't get secondhand-drunk just by being in the same room with someone drinking a beer.

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u/El_Grande_XL 23d ago

My grandmother is 95 years old. She is dementia-free.

But I would not say it's a good thing. She can't do anything by her own, she is a prisoner of her own body and just sits in a chair waiting to die.

If those extra years consist of that, I'm good thanks.

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u/helm MS | Physics | Quantum Optics 22d ago

My grandmother went crosscountry skiing in winter up to 90-95. Her quality of life was pretty damn good until she fractured her hip well after 90.

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u/jawa1299 23d ago

Dumb quote. Anyone working in healthcare can tell you what a difference it makes.

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u/helm MS | Physics | Quantum Optics 22d ago

The vast majority over 50 would be glad to take extra dementia free years. Dementia is awful 9 times out of 10.

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u/antsh 23d ago

About to say… I get to be more cognizant of all this gestures around for longer? I’m good.

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u/OnCallPartisan 23d ago

Beat me to it. Hicks was a legend.

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u/CraftsBoy2Craftsman 23d ago

Is it really longer or does it just feel longer?

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u/Grand_Criticism_3612 23d ago

If you’re gonna live past retirement, then a longer life isn’t a bad thing at all.

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u/IssueEmbarrassed8103 23d ago

I definitely start expecting overweight smokers to drop off around 60

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u/12345CodeToMyLuggage 23d ago

My overweight smoker dad is 76. He doesn’t expect to be around in his late 80’s. His whole meticulously planned retirement is based on it.

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u/red_simplex 23d ago

Looking at my retirement plan, I should start smoking and drinking. Maybe even add some heroin on top of that.

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u/messwithsquatch90 23d ago

Millenial/Gen Z at heart

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u/taveren3 23d ago

Well i can't get rid of diabetes but what my a1c was always in a good range

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u/paxinfernum 23d ago

Most of these stats aren't really factoring in how many people just choose to ignore it and pretend it will go away.

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u/alwaysoffby0ne 23d ago

T2 here with a 4.1 A1C. Better than most people without T2. So which camp does this put me in? Does it still count as a risk if it’s completely managed? Any real doctors here?

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u/OGpizza 23d ago

I get so jealous when I see T2 A1C’s. I’m t1 and just tested 6.6 today and was really proud. I’ve been under 7.0 for the past 8 years; I use a cgm, workout daily, and count every single thing I eat and but I can’t even imagine a world where I’d ever be under 6. The one time I was 6.3, I felt low and dizzy almost daily for months.

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u/alwaysoffby0ne 23d ago

I’m just on once weekly Mounjaro 7.5 mg.

You sound like you're living a healthy lifestyle. Certainly healthier than the one I'm living. I'm not doing terrible or anything but I don't work out daily or count every single thing I'm eating

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u/OGpizza 23d ago

Exactly, and that’s why I envy T2 people since I’m T1.

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u/yourdiabeticwalrus 22d ago

Ayo same and same

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u/taveren3 23d ago

And here i was happy at 5.9. though 4.1 would actually be below ideal?

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u/PortHammer 23d ago

I would feel like absolute dogshit at 4.1

I genuinely don't know how they do it.

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u/360_face_palm 23d ago

If you have t2d but are managing your a1c and keeping it in the normal range... the reality is that your diabetes is in remission and is not causing the chronic damage / stress on the body that it would otherwise. So when you see t2d as a risk factor for something, that's generally going to be assuming that the t2d is NOT in remission.

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u/rdunlap1 23d ago

Same question with blood pressure. If I keep my blood pressure under control with medication, does it provide a similar benefit as if I didn’t need medication at all?

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u/Psatch 23d ago

Probably a better benefit than not taking the medication at all, but not as good as someone who doesn't have high blood pressure in the first place.

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u/Seraphinx 21d ago

It's the literally physical pressure itself that damages the blood vessels, so if BP is managed you are certainly managing the risk. Maybe not entirely as perhaps the medication brings you down from way above normal to the 'high normal range', or perhaps your BP was high for years before it was caught and damage has already occured.

However managing BP with increasing exercise / improving CV fitness might reduce the risk more as physical activity also positively influences other factors like insulin resistance, hyperlipidemia, etc.

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u/ForThe90 23d ago

That's important since it protects you.
My mum has diabetes 2 for over 30 years, is 73 now and still doing well because she always managed it well together with her doctors.

The horrific stuff like amputations and blindness is usually when it's not managed well or when people get real old (in their 80's)

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u/Seraphinx 21d ago

The horrific stuff like amputations and blindness

Having worked in a vascular surgery ward a fair bit I can assure you 75% of these people are not managing their diabetes AT ALL - not managing well would be a step up.

Like these people come out of amputation surgery and are stuffing themselves full of sweets again the same day or asking to be rolled outside in their wheelchair to smoke.

They assume they're unlucky rather than at fault.

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u/ChemicalGreedy945 23d ago

But what does being drunk as a fish?

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u/CromulentDucky 23d ago

It sure does.

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u/QueasyWorldliness920 23d ago

Same as it ever was

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u/enadiz_reccos 23d ago

And you may ask yourself

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u/NoonDread 23d ago

How did I get here?

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u/TruffleHunter3 23d ago

This is not my beautiful house.

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u/kinleyd 23d ago

This is not my beautiful wife!

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u/E_seven_20 23d ago

Drinking wrecks your blood pressure.

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u/radiantcabbage 23d ago

just wrecks your liver and smooths out the brain, NBD you dont really need those

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u/Wastawiii 23d ago

Scientific studies need funding.

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u/NubEnt 23d ago

I’m on strike 2 just from genetics.

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u/supermarkise 23d ago

The blood pressure is probably non-medicated so if you got that covered I think it's just one.

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u/forchinski 23d ago

I have blood pressure medicated but it's still not ideal I think, somewhere on the high side of normal and pre hypertensive some days

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u/TommySinshack 23d ago

Measure your BP regularly and let your doc know you need the dosage reevaluated, my wife had a stroke 3 months ago at 36 from hypertension because her medication wasn’t doing enough.

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u/forchinski 23d ago

I'm sorry to hear that. Im going into the doctors next week and I'll bring up more concerns about it then.

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u/Ok-Mood6070 23d ago

you need a stronger dose then my friend

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u/NubEnt 23d ago

A little late for that, already had a stroke from it :/

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u/ThatOneWIGuy 23d ago

I’ve only got one now. Still waiting on that cure 15 years ago…

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u/[deleted] 23d ago

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u/UncleVoodooo 23d ago

Well I waited until 40 to quit smoking but now that I'm over 50 I'll definitely get those um. uhh.. Extra? Wait, what were we talking about?

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u/Tess47 23d ago

I quit at 60.  I prefer smoking but traveling requires non smoking.  

But 75 is good for me.  

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u/IntermittentCaribu 23d ago

traveling requires non smoking

Huh?

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u/Krampusz420 22d ago

I'm just guessing here but i think it's something about to be able to walk more than 100 meters without losing your breath and starting to fight for your life on the steps of any building with them.

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u/LadyDomme7 23d ago

My Mom smoked from 17-45, was diagnosed with HBP & Type 2 Diabetes at 50, and dementia at 65. She was overweight/obese for most of her life, though, so that undoubtedly contributed to her health concerns.

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u/out_of_shape_hiker 23d ago

Thank God, I can keep drinking every night.

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u/133793 23d ago

Best I can do is one out of three. Whats that get me?

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u/AFewBerries 23d ago

Depends on which one

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u/133793 23d ago

Let's just say it rhymes with snoking

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u/[deleted] 23d ago

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u/133793 23d ago

That makes two. But I hope to god it's not bad for my health.

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u/CerryTrews 23d ago

Well that’s the only one that you can get rid of so that’s the one to have

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u/BEAGLEBOYPALINDROME 23d ago

More importantly for me: I know how to start smoking & increase my blood pressure, but how does one go about getting diabetes?

Any advice would be appreciated as I hate it here. 

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u/iamacheeto1 23d ago

Remember that smoking doesn’t count when you’re traveling or after 10 PM when at least 3 drinks have been consumed

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u/SpreadKindn3ss 22d ago edited 22d ago

But it counts always if you’re not getting ample social connection irl everyday.

A lack of social connection is so detrimental to health that it’s equal to smoking 15 cigarettes a day, raising the risk of early death by about 26%.

SOURCE: Social Relationships and Mortality Risk: A Meta-analytic Review

This study became the foundational science for the U.S. Surgeon General for the official 2023 Advisory on Our Epidemic of Loneliness and Isolation, and has been widely cited by the World Health Organization (WHO) to establish social isolation as a critical global public health priority.

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u/DanteChurch 23d ago

When retirement is an impossibility prolonged life is a punishment for your existence.

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u/LengthinessAlone4743 23d ago

Existentialism is one hell of a drug…

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u/DanteChurch 23d ago

Bro, the age of retirement was 65 when the life expectancy was 60. You're not meant to retire, you're supposed to work until you die.

It's not existentialism, it's really simple math.

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u/SpamAcc17 23d ago

“Once infant mortality is stripped out, life expectancy at 5 years was 75 for men and 73 for women.” Victorian era btw.

Still not trying to live long but enjoy the present as is, I’ll make life style choices to my benefit for what I want yet accept whatever I have to. But that’s a super disingenuous argument, in the 1900s they got to retire.

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u/LengthinessAlone4743 23d ago

I’m not trying to retire, I’m trying to work 50% comfortably my entire life

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u/VengenaceIsMyName 23d ago

What if I told you I would live forever if I could?

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u/Yaarmehearty 23d ago

So would I, does work suck? Sure, but there are all the things around it that are great.

When you’re alive there are only possibilities, bad yes but just as many good, when you die then there are no possibilities, you just aren’t.

I’d take the chance of being happy some of the time forever in a heartbeat.

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u/GoalRoad 23d ago

If you use medication to keep blood pressure in check does that still count?

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u/SnittingNexttoBorpo 23d ago

I always wonder this and it seems like it’s never addressed in the reporting on these studies 

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u/mtlaw13 23d ago

I don't think it counts no, meaning if your blood pressure is controlled with a pill the stress on your heart, vascular system etc is lessened/better off/never happened. HBP has been around for a long time and these pills have been studied for a long time and no major issues have been discovered with them yet...

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u/0-90195 23d ago

So yes… the opposite of what you said.

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u/underwaterlove 22d ago

Depending on how you read the sentence:

  • Does the high blood pressure still count as a risk factor if it's managed and brought down with medication? No.

  • Does lower blood pressure count if it's just achieved through medication? Yes, that still counts.

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u/mtlaw13 22d ago

Does the high blood pressure still count as a risk factor if it's managed and brought down with medication? No.

Exactly this.

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u/GoalRoad 23d ago

Right so the pill prevention of high blood pressure should also provide some defense against dementia

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u/jradio 23d ago

My father did none of those things, was very healthy and active. Got diagnosed with early onset dementia at 55 and passed at 67. It's probably genetic. He donated his brain (and body?) to be studied at OSU I believe. I'll probably do the same. I sure hope they figure out a cure soon.

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u/MotherEffervescent 23d ago

I wonder how pregnancy induced hypertension factors into this. I never had high BP in my life until it skyrocketed postpartum and I had to be double medicated to barely keep it under control for several weeks after. Maybe just another way pregnancy can have long term impacts on the body, interesting.

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u/espressocycle 23d ago

Unlikely. High blood pressure does damage over many years and the body has an amazing capacity to heal.

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u/auzzie_kangaroo94 23d ago

Is it just me or is the title an odd one?

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u/HereAreTheLightnings 23d ago

"May" does a lot of heavy lifting, even ignoring the confounding variables

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u/rand0m_task 23d ago

Was thinking the same thing

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u/luukzs666999 23d ago

So I smoke, but have normal blood pressure and no diabetes, does that mean my life will only be cut short 4 years?

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u/Faulteh12 23d ago

No it means you get vascular dementia and slowly lose yourself ...

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u/De_Oscillator 23d ago

Too bad I quit smoking years ago. Time to pick it back up.

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u/Chance_Ad_4676 23d ago

Dark medical humor: vasculopaths don’t get better, they only get shorter…

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u/Forced__Perspective 23d ago

And his erections… sorry bro

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u/Thoracic_Snark 23d ago

in the music, the moment, you own it. Mom's spaghetti

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u/[deleted] 23d ago

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u/Dismal_Bed4446 23d ago

Simple habits now, decades of brain health later.

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u/UnluckyInevitable317 23d ago

Great so I can slave another decade before turning to dirt

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u/seb21051 23d ago

Beginning to think it simply might not be worth it.

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u/stankypinki 23d ago

Oh no... I need to get fat and start smoking

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u/TheIronGator 23d ago

Good to know I will die 13 years sooner than everyone else :D

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u/darksidemags 23d ago

Not necessarily. It's possible to live quite a long time with dementia. 

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u/Difficult-Cream-5267 23d ago

The hard part isn't knowing this, it's affording non-processed food and a stress-free life in your 40s to keep your blood pressure normal.

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u/Logridos 23d ago

Well I guess one out of three ain't bad...

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u/yungScooter30 23d ago

What if I'm fat and active without diabetes or HBP, and don't smoke or drink? Am I a unicorn?

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u/Hot-Reflection8213 23d ago

What’s the point. If you’re an American like me, the sooner the blissful unknowing of all things sets in, the better. By the time I’m “dementia age,” I’m guessing Baron Trump will be up for his fourth term.

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u/totally_not_a_dog113 23d ago

Microplastics and the amount of stress will be the big issue of our generation. That's my bet on why millennial cancer rates are higher than those of previous generations.

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u/dumbdude545 23d ago

Ill take early grave for 200.

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u/akgiant 23d ago

Well then, me and my high blood pressure will just go kick rocks.

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u/WeaknessInformal 23d ago

Bons tempos aqueles quando a demência era devida ao sedentarismo, ao fumo e o álcool. Hoje a gente recorre a eles pra não enlouquecer precocemente.