Looks can be deceiving. After all, as I& #39;ve mentioned before on Twitter, I& #39;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://abs.twimg.com/emoji/v2/... draggable="false" alt="😂" title="Gesicht mit Freudentränen" aria-label="Emoji: Gesicht mit Freudentränen"> https://twitter.com/CherTobs/status/1316389279350878208">https://twitter.com/CherTobs/...

Three years ago, this anonymous Twitter troll might have had a little bit of a point. I wasn& #39;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& #39;s become clear, that I can& #39;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& #39;m about as thin as I was when I was a resident 25 years ago, but even as thin as I& #39;ve become again family history still dictates that I still need at least one antihypertensive to keep my blood pressure in the optimal range.