Looks can be deceiving. After all, as I've mentioned before on Twitter, I've lost around 50 lbs over the last two years with diet and exercise, ride my bike 50+ miles a week, and as a result have greatly decreased my doses of antihypertensives. https://twitter.com/CherTobs/status/1316389279350878208

Three years ago, this anonymous Twitter troll might have had a little bit of a point. I wasn't that healthy. I was overweight and on fairly high doses of antihypertensives as I entered my late 50s. No more.

Unfortunately, family history being family history, it's become clear, that I can't get completely off BP meds. After my last dose titration downward, my BP is a little higher than guidelines say it should be, which means my doctor will probably up the dose back to where it was.

Of course, what this demonstrates is that science-based medicine does NOT reject diet and exercise. Science-based diet and exercise are part of SBM, but are often not enough by themselves. Often drugs are *still* required. SBM should and usually does embrace all modalities.

I mean, I'm about as thin as I was when I was a resident 25 years ago, but even as thin as I've become again family history still dictates that I still need at least one antihypertensive to keep my blood pressure in the optimal range.