How I went from a hypertensive stressed out exec to Ironman finisher and you may consider this route to fixing high blood pressure
October 2015. It’s me and two thousand others in wetsuits on the cold sand. Cold, because the warming sun has only started to rise over the Mediterranean Sea. A lady in her 60s is confidently adjusting her swim goggles next to me. I’m shaking. We’re high on adrenaline. The crowd is shouting 5, 4, 3... and Boom! Suddenly all of my anxiety disappears. I’m in the zone. Whether I cross the finish line or not, preparing for this challenge alone helped me fix my high blood pressure.
This is the story of my 2 year journey from a stressed out high-tech exec diagnosed with anxiety and high blood pressure to an Ironman race finisher free of these chronic conditions. If you experience cardiovascular issues, type 2 diabetes, anxiety or depression, I hope to point you to a new way of treating them. I’m not a medical doctor, so I can’t give medical advice. But this is what I learned from my personal experience. I’ll share with you the 4 main steps, as well as key lessons and practical tools, that helped me.
1. Make a first step to break unhealthy routine.
Not long before my 49th birthday I decided to visit a doctor. I was irritated at work and home. Headaches. Insomnia. Chronic tiredness. Etcetera, etcetera. The classic story of work stress leading to anxiety and hypertension.
The doctor gave me two options. Either he can prescribe me a quick fix, a medicine which will take the symptoms away but will not actually cure my health issues. The problem that in the next 6 months would snowball into an emergency room visit. Heart attack or stroke. Alternatively, I could change my lifestyle. Don’t think about work the second you step out of the office and start running every day.
So I decided to start from running. Seemed easier. I put on my tennis shoes and ran to the nearby park. Prior to meeting with the doctor my only physical activity was one game of tennis a week. I tried running in the past but the habit just didn’t stick. To summarise: I was not in great shape.
That day I didn’t think about how great it would be if I ran a marathon. I was profusely sweating and wishing for a hot shower. I was just running. And the next day. And the day after. I started with just 15 minute runs. It took 10 days to see a difference, my evening blood pressure was lower and I felt calmer. My sleep improved. I knew that I broke the circle. I can't stop now. I have to run every day.
It was much later that I came across an explanation of these improvements. Psychology professor Lisa Feldman Barrett from Northeastern University (Boston, Massachusetts) has a great analogy. She suggests thinking of the brain as an accountant, constantly trying to balance a “body budget”. Too much physical or emotional stress, bad nutrition, insufficient rest lead to low body budget. Less available energy to spend. Barrett believes that anxiety, depression, heart disease, type 2 diabetes and Alzheimer’s are illnesses that result from stretched body budgets. Working too much, not exercising or sleeping enough and eating unhealthy results in a chronic deficit. Which eventually leads to illness.
"Too much physical or emotional stress, bad nutrition, insufficient rest lead to low body budget. Less available energy to spend. Barrett believes that anxiety, depression, heart disease, type 2 diabetes and Alzheimer’s are illnesses that result from stretched body budgets".
How do we increase the body budget? Identify the main source of your “deficit”. Then cover the deficit with health ‘payments’, such as regular exercise, meditation, controlled breathing, balanced nutrition and healthy relationships.
This was my approach. And even though I was feeling better, my motivation started to dwindle. I started to miss daily runs. This is where the second element of my plan came in.
2. Surprise your brain and commit to a major challenge.
Just as I started to miss my daily runs, a 5K charity run at my daughter’s school came up. This gave me an idea. I should commit to a longer, more serious marathon run. The purpose of which is to let Facebook and your friends know about your commitment. Here’s your motivation. There’s no turning back now, you’re running that marathon. People will be asking you. You can’t just say you changed your mind.
Fast forward 9 months to the marathon I told Facebook about. I finished in 4 hours and 15min. This isn’t a terrific result. Even for a 50 year old. It was never about the result however. It was about health. Preparing for the marathon resulted in:
- My blood pressure normalised.
- My anxiety significantly decreased. I became calmer both at work and at home.
- I launched a positive feedback loop. I started to eat healthier food, sleep more hours and watch less TV.
- I became more confident. At work and in everyday life.
And also the feeling of crossing the finish line is pretty nice.
I kept asking myself, what would happen if I exercised more? Would I feel even better mentally and physically? Where do I get additional motivation from? How do I trick my brain?
3. Hack your brain by raising the bar.
How have I raised the bar? I decided to sign up for an Ironman triathlon race. Full Ironman triathlon distance consists of 2.4-mile (4km) swim, 112-mile (180km) bike ride and 26-mile (42km) run. All done within the 16-17 hour limit. So, in short: it’s a high bar. In October 2014, a few months after completing my first marathon, I booked an Ironman race in Barcelona for October 2015. On that same day I booked my hotel. Purchased my flights. Announced my race participation on Facebook. It was a point of no return.
It was much later that I read a book called “Buddha’s Brain” by a neurophysiologist Dr Rick Hansen. He explains why this approach works. Our brain is always looking for stimulation. From scanning Facebook posts, to exploring beautiful landscapes, to having an engaging discussion with friends. Our brain rewards us with dopamine spikes for taking on new challenges. The bigger the challenge, the more attention it gets from the brain.
"Our brain rewards us with dopamine spikes for taking on new challenges. The bigger the challenge, the more attention it gets from the brain. "
To prepare for a marathon, you need to train three hours per week for three months. To prepare for an Ironman race, you need to train for six months and increase your weekly training hours from three to at least eight.
Here is what happened to me while preparing for Ironman:
- I have become more efficient at work. As one of the guys from the management team put it: “Keep doing your training thing. Things are easier now because you do not have time to micromanage us’.
- I stopped watching TV altogether and cut the time on social media. I attended less parties and focused on a narrower circle of friends.
- I slept more hours. Ate healthy. Cut alcohol to almost zero. Deviation from these rules meant a ruined workout the next day which I could not afford.
I completed my first Ironman in 13 hours and 18 minutes. Not exactly an amazing result. Quite acceptable given my age and health history. It was VERY hard. Several times I just wanted to stop and lay flat on the ground. The crowds of spectators were super supportive. “Go Dmitri, Go!” I crossed the finish line with a big smile on my face. And the loud announcement: “Dmitri, you are an Ironman!” I will never forget this moment.
Here are the main tips to get ready for an endurance race:
- Get support from your family early in the process. Healthy relationships = larger health budget
- Get a solid training plan. The best I’ve come across is a classic book by Joe Friel “The Triathlete’s Training Bible”. The TrainingPeaks app incorporates the approach described in Friel’s book and it is widely popular among endurance athletes.
- Discuss with your doctor boundary conditions of your plan.
- Get yourself some decent gear. Buy running shoes from a specialist shop. For a bit of extra money you will set yourself for a joyful gliding experience vs a torture. Buy a second hand bike to start with. It takes time and practice to select a bike which ideally fits you.
- Get yourself a sports watch with a chest strap heart rate monitor. Running within appropriate heart rate zones is VERY important. Not only to train better. Also to protect you from overtraining. Especially if you have a history of cardiovascular irregularities. Sports watches with wrist based heart rate sensors do not provide sufficient accuracy during running.
- Develop a solid rest and recovery strategy. It is not only about nutrition and sleep. It is also about learning when to pause training to avoid a burn out. Our recovery time increases with age.
Since 2015 I completed two more full Ironman and 10 half Ironman races. I booked one and sometimes two future events soon after completing every race.
Two main points to remember:
- To stay healthy, both physically and mentally - you need to exercise.
- To stay motivated you need to have a goal - your next race.
Now for the final element of the plan. The lesson I wish someone had told me earlier.
4. Master breathing and meditation to complement physical exercise
I admit. I paid zero attention to these items in my early training days. I often worked out with brutal force, ignoring the signals which my tired body and mind were sending. The older I got, the more time my body required to recover. I suddenly became more sensitive towards these signals.
I used to be quite sceptical about mindfulness exercises. Up until I read “Buddha’s Brain” by Dr Rick Hansen. This book cites and explains research linking meditation as a useful tool in treating certain medical conditions. As well as strengthening the immune system.
I also read fascinating stories by famous athletes. Like the NBA basketball legend LeBron James who incorporates mindfulness exercises in his daily training.
Professor Barrett’s theory also points to a huge positive impact of meditation and breathing on our ‘body budget’.
I learned a lot about focused breathing exercises from Patrik McKeown’s book “The Oxygen Advantage”. Meditation and focussed breathing are a part of my daily routine these days. They help me to keep going during long endurance runs and bike rides. They increase my breathing capacity. They improve sleep and recovery. They help me to be calmer and more satisfied with my life.
I have become a deep believer that a combination of physical and mindfulness exercise possesses powerful healing properties. My YouTube channel includes short instructional videos with follow along exercises with a primary purpose to lower anxiety and high blood pressure: breathing, acupressure, meditation, yoga, walking, Qigong, nitric oxide dump etc. It also includes videos with relaxing music. Most videos are 5 to 10 min long so they can be easily integrated into everyone's busy schedules.
UPDATE January 2023. Based on my experience with fixing high blood pressure with breathing exercises and exercise, me and my friends developed a blood pressure app BreathNow. It includes many follow along video guides with calming exercises like breathing and meditation which help to lower blood pressure short term.
