Happy New Year, my friends!

While the rest of the world calls January "New Year, New You," in the physical therapy world, my colleagues and I have a different, darker name for it.

We call it "Heart Attack and Stroke Season."

It sounds dramatic, but the pattern is undeniable. We see a surge of referrals in January for stroke and cardiac rehabilitation. Why? Because the holidays are a "perfect storm" for your cardiovascular system: high stress, travel, salty foods, alcohol, disrupted sleep, and cold weather constricting blood vessels.

For people with underlying—often undiagnosed—issues, the holiday load is the final straw.

But the scariest part isn't the older patients we see in rehab. It’s the young professionals I see in the clinic who have no idea they are walking time bombs.

For the past two years, I’ve specialized in treating workers' compensation patients—often active people in their 20s and 30s coming in for shoulder pain or back injuries. But before I can touch a patient, I have to check their vitals.

We have a strict safety threshold: If your systolic blood pressure is higher than 160 or your diastolic is higher than 90, physical therapy is canceled. It’s unsafe to exercise.

I can’t tell you how many times I’ve had to look a 32-year-old in the eye and say, "I can't treat your shoulder today. Your blood pressure is dangerous."

Their reaction is almost always the same.

It’s not fear. It’s annoyance.

"I feel fine," they say, frustrated that I’m blocking their progress. "I’m just stressed from work. Can’t we just do the exercises?"

There is a deep denial that comes with being young and high-achieving. We view our bodies as machines that should just work. When a "minor detail" like blood pressure gets in the way of our to-do list, we get irritated.

However, hypertension is the number one risk factor for heart disease. And heart disease is the number one killer in the world.

It doesn’t care if you "feel fine." That is exactly why they call hypertension the Silent Killer.

If you’re sitting there thinking, "Well, my parents have high blood pressure, so it’s just genetics," or "I’m getting older, this is normal," I need to challenge that.

Recent statistics reveal a terrifying reality: 20.4 million young adults (ages 18-39) currently have stage 1 or 2 hypertension. That is more than 1 in 5 of us.

But here is the truly dangerous part:

While older adults (40+) are generally tracking and managing their numbers, our generation is flying blind. We are significantly less likely to have it treated or controlled, partly because many young adults don't have a routine place for healthcare.

We are walking around with a ticking clock in our chest, completely unaware because we haven't checked.

You feel fine... until the day you don't.

To understand why "feeling fine" is irrelevant, I want you to visualize your blood vessels as the wings of an airplane.

An airplane wing is designed to flex. It can handle turbulence and stress, but it has a finite lifespan of "flexes" before the metal fatigues and snaps.

Your arteries are the same. They rely on a protein called elastin to stretch and snap back with every heartbeat. Unfortunately, your body shuts down the elastin factory right after puberty. The supply you have now is all you get.

When high blood pressure constantly hammers your vessel walls, that precious elastin breaks down. Since your body can’t make new elastin, it repairs the damage with collagen instead.

Think of collagen as "gristle." It’s stiff. It doesn't stretch.

When your vessels turn to gristle, your heart has to pump even harder to force blood through them, which raises your blood pressure even more. It’s a vicious cycle.

Every day you walk around with untreated high blood pressure, you are burning through your limited supply of "wing flexes."

You don't need to overhaul your entire life overnight (we know that leads to quitting by February). Instead, let's look at the fundamentals that give you the highest return on investment for your heart.

1. The Potassium-Sodium Seesaw

Most people focus on cutting salt (sodium), which is important. However, adding potassium is just as crucial. Potassium helps your kidneys flush out sodium and relaxes your blood vessel walls.

2. Flush the Pipes (Movement)

You don't need to become a "gym rat." You just need to mobilize your blood flow.

3. Manage the Metabolic Load

Carrying excess weight places a mechanical load on your heart, forcing it to work harder.

4. The "Dry" Flex

Alcohol raises blood pressure—full stop.

5. Don't Smoke

If you smoke or vape, quitting is the single most effective thing you can do. Nicotine constricts your blood vessels, effectively clamping down on the hose while the water is running.

6. Stress Systems

Stress isn't just in your head; it's inflammation in your arteries.

If you check your blood pressure and it’s high, don’t panic.

For young adults specifically, guidelines note that many people can achieve their goal blood pressure without medication through "vigorous implementation of lifestyle changes."

You have a window of opportunity right now where your habits can be your medicine.

However—and this is important—if your doctor deems that lifestyle isn’t enough, take the medication.

There is no shame in using science to save your kidneys, brain, and heart. The medication protects your "wings" from snapping while you work on the lifestyle habits. They work together, not against each other.

I know it’s annoying to think about this when you have family responsibilities to meet and a career to build.

But I want you to fast forward 20 years.

I want you to be the 50-year-old who has the energy to hike with their kids, the clarity to lead their company, and the freedom to travel without a suitcase full of medications.

I don’t want you to be the patient in my clinic recovering from a stroke because you "felt fine" until you didn’t.

Your health isn't built in perfect conditions. It's built in the messy reality of today. So go get that cuff, check your numbers, and let’s protect those wings.

To your health and freedom,

Grazelle 🌱

PS: My OBGYN has allowed me to get back to my “normal” activities. So I’m slowly building my body back up with flexibility and body weight exercises to start. Good call, cause my back is starting to ache adjusting to all these new mom duties.

Whenever you’re ready, here are some other (free) resources you can check out: