Reducing High Blood Pressure
Since the start of the 20th century, CVD or CardioVascular Disease, has been the number one killer in North America. Almost 60% of all deaths each year are a result of CVD. CVD results in 33.3 percent of all hospitalization expenditures. In the United States alone this translates into a death every 33 seconds and results in a cost of more than $326.6 billion each year to the health care system.
Medications and emergency rooms can and do save the lives of numerous patients, but the operating room will never bring this monstrous condition under control. By following the correct lifestyle and dietary advise we can prevent a large percentage of CVDs from ever occurring. Even after a major episode of CVD there is good evidence that, with the correct advice and follow-through procedures, we can reverse much of the damage.
The following are some of the factors that lead to coronary heart disease including stroke, atherosclerosis, congestive heart failure and high blood pressure. These conditions makes up 78% of all CVD’s and are the areas where we, can have the greatest influence. There are numerous factors that we can address to prevent CVD’s from occurring.
Hypertension, or high blood pressure, occurs when the body’s smaller blood vessels (known as the arterioles) narrow causing the blood to exert excessive pressure against the vessel. The heart must work harder to maintain this higher pressure resulting in damage to the heart, kidneys, brain, and eyes.
Between 50-60 million Americans ranging in age from 6 and older, have high blood pressure. High blood pressure causes arteries to become scarred, hardened, and less elastic. If hypertension is not treated it can lead to heart disease, stroke, kidney disease, and eye disorders. Only 18% of people with hypertension return to normal blood pressure levels while on medication.
In fact, it has been shown that the very medications patients take to reduce hypertension may indirectly act to increase blood pressure. This is due to the effect that hypertensive medications have on insulin sensitivity. Many of these medications cause a decrease in a cell’s sensitivity to insulin, which in turn results in endothelial cell dysfunction. Endothelial cell dysfunction is related to increases in blood pressure. This is why it is so difficult to get a patient off hypertensive medications once they have started using them.
Blood pressure readings should be taken in both arms. Usually there is a difference of 5-10 mm Hg between the left and right sides. Pressure differences of more than 10-15 mm Hg suggests arterial compression or obstruction on the side with the lower pressure. A fall in systolic pressure of 20 mm Hg or more, may be indicative of orthostatic hypotension caused by one or more of: adrenal stress, medications, decreased blood volume, or a disease of the peripheral autonomic nervous system.
Hypertension is typically defined as an a systolic pressure of 140 mg Hg or greater and a diastolic pressure of 90 mg Hg or greater.
- Normal – Systolic Pressure 90-119 mmHg – Diastolic Pressure 60-79 mmHg
- Prehypertension – Systolic Pressure 120-139 mmHg – Diastolic Pressure 80-89 mmHg
- Hypertension Stage 1 – Systolic Pressure 140-159 mmHg – Diastolic Pressure 90-99
- Hypertension Stage 2 – Systolic Pressure 160 mmHg – Diastolic Pressure 100 mmHg
Warning: Persons with blood pressures greater than 160/115 should immediately consult a physician. Short-term medications may be necessary, but you can also implement the following suggestions until your blood pressure has decreased.
1. Increase physical activity
When compared with their more active and fit peers, sedentary individuals with normal blood pressure have a 20 to 50 percent increased risk of developing hypertension. Activities could include anything from swimming and running, to the lifting of light weights, yoga, Tai Chi, or many of the other alternatives available to us.
2. Manage insulin levels
Insulin promotes glucose utilization, protein synthesis, and the formation and storage of neutral lipids through the regulation of sugar metabolism.
Problems with blood pressure occur when individuals develop insulin resistance, due to a defect in insulin receptor-site or insulin receptor-directed metabolism. This leads to high levels of insulin in the blood stream. High insulin levels are associated with endothelial wall dysfunction and increased blood pressure.
Pharmaceuticals used for the treatment of hypertension can also result in endothelial cell dysfunction.
To resolve and control this problem, you must reduce the glycemic load by increasing protein intake, reducing saturated fats, and avoiding refined carbohydrates.
3. Decrease your weight
Many CVD patients suffer from weight gain, often due to a decrease in insulin sensitivity and poor diet. Increased weight results in greater stress upon the heart and circulatory system. Weight gain is also linked to insulin resistance and often leads to obesity and cardiovascular disease.
Weight gain must be controlled and managed by reducing the glycemic load upon the body, increasing protein intake, reducing saturated fats, avoiding refined carbohydrates, and increasing physical activity.
4. Weight Training is essential
There is a basic equation you can’t get around when it comes to weight loss. The more muscle you have the more calories you will burn and the more fat you will lose. Research has shown that weight training with dietary modifications is almost 45% more effective than just diet alone (Miriam Nelson, Tufts University).
5. Make dietary changes
The majority of CVD patients consume a diet rich in saturated fats and refined carbohydrates. This typically results in an imbalance of the sodium/potassium levels, an increase in cholesterol levels, increased insulin levels, and increased water retention. These factors combine to increase blood pressure.
Dietary changes should include the consumption of greater quantities of fresh fruit and vegetables to assist in the balancing of sodium/potassium levels.
Avoid all canned fruit and vegetables due to their high sodium content. Studies have shown that an average decrease of 95 mmol per day of sodium can result in a decrease in blood pressure by 6.3/2.2 mm Hg.
Dietary potassium can also be increased by eating foods high in fiber and by avoiding all refined carbohydrates.
6. Stop smoking
Blood pressures rises significantly with the smoking of only one cigarette.
7. Decrease coffee and alcohol consumption
Caffeine-sensitive individuals are susceptible to increased blood pressure caused by coffee. One cup of coffee at 8:00 in the morning has been shown to cause a measurable increase in blood pressure at 10:00 that evening.
Alcohol can be a factor in hypertensive in individuals who consume more than two drinks per day. Low alcohol consumption (1 drink per day) has been associated with an overall decrease in blood pressure (especially in women). There are also indications that light to moderate drinking can have some protective effects in coronary heart disease, but the research is not conclusive in this matter. My advise is moderation, one or two drinks per day (one most days) especially with food to slow absorption will probably be beneficial for most people. For those individuals who are alcohol sensitive and suffer from hypertension, alcohol abstinence may be necessary.
8. Avoid birth control pills
Studies have shown that women using birth control pills have 2-3 times the rate of hypertension. The combination of birth control pills and cigarettes can be lethal.
9. Decrease stress
Increased stress results in the production of higher levels of cortisol which has been associated with hypertension. Chronic high stress can lead to high blood glucose levels, weight gain, and increases in LDL and cholesterol levels.
Implement stress reducing life-style changes. This could include the incorporation of regular exercise, meditation, and personal time off into their daily schedules.
10. Take nutritional supplements
Often dietary and lifestyle changes alone are often not enough to adequately reduce CVD risks. Today’s foods are sadly deficient in many essential nutrients and minerals. Supplementation for hypertension should include:
- Multivitamin and mineral tablets to support liver function in the removal of waste products, and to prevent the production of free radicals.
- Vitamin C at 500-1000 mg per day since Vitamin C acts as an anti-oxidant and prevents the harmful breakdown of LDL particles.
- Vitamin E at 400-800 iu. per day since Vitamin E acts as an anti-oxidant and prevents the harmful breakdown of LDL particles.
- Magnesium at 400 – 800 mg per day can help to reduce angina, blood pressure, and heart palpitations.(38)
- Co enzyme Q10 – 50 mg 3 times per day. “Findings indicate that treatment with coenzyme Q10 decreases blood pressure possibly by decreasing oxidative stress and insulin response in patients with known hypertension receiving conventional antihypertensive drugs.”
- Vascupress – This is a great supplement from AOR, that we commonly prescribe to our patients with hypertension. This supplement is high in antioxidants and nitrates.
Additional information from AOR on Vascupress: “Clinical trials have shown that diets high in fruits and vegetables can reduce blood pressure and the incidence of harmful cardiovascular events. The cardioprotective effects of a high fruit and vegetable diet were thought to be related to the high antioxidant content found in those foods, yet clinical trials remain inconclusive as to the exact mechanism of action behind protective effect. The highest protection has been found to come from dark leafy vegetables, like beetroot, spinach and lettuce, which are high in nitrate content. Vegetarians consume up to 10 times more nitrate from vegetable/fruit sources than non-vegetarians, which has been hypothesized to be the key reason for lower rates of hypertension and myocardial infarctions in vegetarians.”
11. Invest in Massage Therapy
Research has shown that massage therapy can have a significant affect on hypertension. Massage can decrease both systolic and diastolic pressure, decrease cortisol levels, decrease cardiac output, even decrease feelings of anxiety and depression.