Everyone chooses their medicine not only according to the ailments they experience, but also in relation to their beliefs and their mode of reasoning. Such a curator will take the words of the academy for a definitive truth, such an adventurer will give himself up without precaution to shamans and gurus, such a mystic will offer himself to the scalpels where he will see the hand of God, such a geek will adopt an esoteric nutritional diet demonstrative, such a philosopher will avoid care that is too consensual.
Engineers are passionate about cardiology, probably because the cardiovascular system seems to them to come from a plumbing logic with its pump, its valves and its piping; the mechanical measurements of heart rate and blood pressure bordering on fascination.
One of my polytechnician patients was surprised to see his blood pressure rise at altitude, while the atmospheric pressure decreases. His reasoning was theoretically perfect. Blood pressure is the product of cardiac output (called preload by cardiologists) by peripheral resistance (afterload). The drop in atmospheric pressure decreasing afterload should also decrease blood pressure. CQFD.
I replied (too) quickly that the effort to climb in altitude had increased its preload; but he had anticipated this (stupid) remark by telling me that his blood pressure remained high, even at rest.
I explained to him that preload and afterload themselves depended on many other parameters (muscles and tissues of the arteries and the heart, kidney function, oxygen saturation, blood viscosity and composition, etc.), each of which was subject in turn to hormonal and nervous regulations. I would go so far as to put medicine at risk by saying that we only know a tiny fraction of the hundreds of blood pressure regulating factors.
He pointed out to me judiciously that between 0 and 5000 m of altitude, the atmospheric pressure was divided by two, passing from 750 to 375 mm of mercury. Considerable drop compared to 120 mm of our blood pressure.
I still had the environmental argument of the oxygen concentration in the ambient air, a factor that mobilizes even more parameters. Faced with his reluctance, I gave him the final blow: after a few months at altitude, the body ends up compensating for all the environmental factors and brings the blood pressure back to its usual level.
Not having verified this fact, he accepted it gracefully. He concludes that the work of the cardiologists was easier than that of the plumbers, because the cumulus clouds do not adapt to their environment, they have to be changed three times more often when the water is hard. And finally, our agreement was total on the cardiological benefit of walking in the mountains.
Long consultation financially less profitable than that of a mystic or a philosopher, but much richer.