High Blood Pressure (Hypertension)

Hypertension is a condition of which greater than 90% of cases are "essential" or "idiopathic" in nature, which means no cause for the blood pressure elevation is known to exist, but it is nonetheless treatable.

Elevated blood pressure is a serious problem and must be treated aggressively! Left untreated it causes kidney, blood vessel, and heart damage, and is the major cause of strokes! Worse, it is a silent killer - people with dangerously elevated blood pressure may feel fine for a long time while major damage is done to vital body organ systems!

With the obesity epidemic we are facing in this country, undiagnosed and hence untreated hypertension is silently disabling and killing millions of Americans! Get your pressure checked today and on a regular basis!!

Helpful Dietary Changes

One hears a great deal about salt intake and blood pressure - however essential hypertension is related to salt intake only in some individuals.1 Eliminating salt from the diet lowers blood pressure in this select group of people, but in general decreasing dietary salt intake by itself is often much less successful in treating high blood pressure than previously thought.2 With the ever growing prevalence of processed and restaurant food, eliminating salt becomes even more difficult.

Vegetarian diets lower blood pressure.3 This occurs partly because fruits and vegetables contain potassium—a blood pressure lowering mineral.4 The high fiber provided by vegetarian diets and/or supplements also helps reduce high blood pressure.5

Coffee, stress,7 alcohol,8 and even sugar,6 may increase blood pressure, and I have witnessed many patient's blood pressures turn to lower numbers just by eliminating these factors in their diets and lives. Meditation, biofeedback, and self hypnosis have all been shown to lower blood pressure - by eliminating stress and anxiety!

Some studies have shown that food allergy can contribute to high blood pressure,10 and exposure to lead and other heavy metals has been linked to high blood pressure as well.11 Those suspecting a food allergy or heavy metal exposure should check with a nutritionally oriented doctor.

Lifestyle Changes

Smoking is particularly bad for people with high blood pressure12 - if you smoke you must stop! This is the single biggest thing you can do to improve your health and blood pressure!

Many people with high blood pressure are overweight. Weight loss significantly lowers blood pressure in most people, and just 10% of body weight lost initially will help a great deal.14

Regular exercise is vital to help reduce blood pressure, and it can have marked results! 3-5 times weekly for 20-30 minutes per session is the ideal, but any regular activity is better than none!! if you are over forty years of age please consult your doctor before starting a rigorous exercise regime.

Nutritional Supplements

Soy has a wonderful blood pressure lowering effect! Soy also has a wonderful anti - inflammatory effect because soy "fat" is about 50 percent linoleic acid, an Essential Fatty Acid. EFA's seem to have their effect mostly through their anti-inflammatory properties - they enter the same anti-inflammation pathway as the arthritis medications. They benefit not only high blood pressure, but also, dry skin conditions, and arthritis. A great supplement! - you need 30-50 mg of soy per day in your diet.

Many studies have found that calcium supplements—typically 800 -1,500 mg per day lower blood pressure. This effect is most beneficial with "isolated systolic hypertension", where the first (systolic) blood pressure number is high and the second (diastolic) number is normal.15 Constipation, bloating, and gas are sometimes reported with the use of calcium supplements. Individuals with a history of kidney stones should consult a nutritionally oriented doctor before taking calcium supplements.

Some,16 but not all,17 studies show that magnesium supplements - often called nature's "Calcium Channel Blocker" are ideal to help with elevated blood pressure, coronary artery disease causing angina (chest pain), and irregular heart rhythms by dilating blood vessels and calming the heart muscle. Typically 350–500 mg per day—lower blood pressure. The results are particularly effective in people who are taking a form of medication called "depleting diuretics".18

Potassium, mentioned above, is a wonderful supplement for some, especially African Americans bothered by high blood pressure! Vitamin C has been reported to lower blood pressure.19 Many people take 1–2 grams per day to help support healthy blood pressure levels. Some individuals develop diarrhea after as little as a few thousand milligrams of vitamin C per day, while others are not bothered by ten times this amount, and high levels of vitamin C can deplete the body of copper,24 an essential nutrient.   Vitamin E has shown a beneficial effect in lowering the risk of coronary heart disease, especially in men.

Coenzyme Q10 is frequently deficient in people with high blood pressure. When these people take supplements of coenzyme Q10—typically 50 mg twice per day—blood pressure goes down significantly.20

Omega-3 fatty acids, such as EPA and DHA in fish oil, may lower blood pressure.21 Most studies use at least 3 grams per day of EPA and DHA combined. The best way to get these is to eat fatty fresh fish like salmon and mackerel regularly, but most of us are unable to do so, so supplementation comes into play. Most fish oil supplements contain 30% EPA plus DHA, requiring 10 grams of fish oil to deliver 3 grams of EPA plus DHA. Those with heart disease and diabetes often benefit from fish oil (fish oil consistently lowers triglycerides), yet individuals should check with their nutritionally oriented doctor before taking more than 3 or 4 grams of fish oil for several months. Elevations in blood sugar have sometimes been reported.

Taurine, an amino acid, has been used to lower blood pressure in animals22 and people (at 6 grams per day),23 probably by reducing levels of the hormone epinephrine (adrenaline).

Herbs:

Herbs should not be considered the primary tool in reducing high blood pressure, but herbal supplements can be used to support healthy heart function and circulation.

Garlic has a mild blood pressure lowering effect.9,29 Garlic’s positive effect on the heart includes reduction of platelet stickiness and lowering of cholesterol and triglyceride levels. Garlic works best when fresh product is added to food. Use of garlic supplements is less reliably helpful, and in some studies did nothing - use the fresh stuff!

Blood pressure is lower in individuals who regularly drink green tea, suggesting that the herbs in it help lower high blood pressure. Remember though that green tea still contains caffeine and high intake may be counterproductive!

Western Medical Treatment

Diet, weight loss, and regular exercise are the mainstay of treating hypertension, and while these natural measures are great to treat mild hypertension or may be helpful in reducing the amount of blood pressure medicine used to control more serious hypertension. Traditional medication must be used aggressively to prevent long term damage to the body by uncontrolled hypertension. This includes stroke, heart attack, kidney damage leading to failure and life-time dialysis, loss of vision, and many others!! Medications are especially important if you are unable, or unwilling to change lifestyle issues like smoking, being over-weight, drinking alcohol, and not exercising regularly!

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References:

1. Stamler J, et al. Findings of the international cooperative INTERSALT study. Hypertension 1991;17(Suppl I):I-9–15.
2. MacGregor GA, et al. Double-blind study of three sodium intakes and long-term effects of sodium restriction in essential hypertension. Lancet 1989;ii:1244–7.
3. Margetts BM, et al. Vegetarian diet in mild hypertension: a randomised controlled trial. BMJ 1986;293:1468–1471.
4. Cappuccio FP, MacGregor GA. Does potassium supplementation lower blood pressure? a meta-analysis of published trials. J Hypertens 1991;9:465–73.
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6. Rebello T, Hodges RE, Smith JL. Short-term effects of various sugars on antinatriuresis and blood pressure changes in normotensive young men. Am J Clin Nutr 1983;38(1):84–94.
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8. Potter JF, Beevers DG. Pressor effect of alcohol in hypertension. Lancet 1984;i:119–22.
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14. Alderman MH. Nonpharmacologic approaches to the treatment of hypertension. Lancet 1994;334:307–11 [review].
15. Bucher HC, Cook RJ, Guyatt GH, et al. Effects of dietary calcium supplementation on blood pressureCa meta-analysis of randomized controlled trials. JAMA 1996;275:1016–22.
16. Motoyama T, Sano H, Fukuzaki H, et al. Oral magnesium supplementation in patients with essential hypertension. Hypertension 1989;13:227–32.
17. Patki PS, Singh J, Gokhale SV, et al. Efficacy of potassium and magnesium in essential hypertension: a double-blind, placebo controlled, crossover study. BMJ 1990;301:521–3.
18. Dyckner T, Wester PO. Effect of magnesium on blood pressure. BMJ 1983;286:1847–9.
19. Trout DL. Vitamin C and cardiovascular risk factors. Am J Clin Nutr 1991;53(suppl):322S–5S.
20. Digiesi V, Cantini F, Bisi G, et al. Mechanism of action of coenzyme q10 in essential hypertension. Curr Ther Res 1992;51:668–72.
21. Morris MC, Sacks F, Rosner B. Does fish oil lower blood pressure? A meta-analysis of controlled trials. Circulation 1993;88:523–33.
22. Abe M, Shibata K, Matsuda T, Furukawa T. Inhibition of hypertension and salt intake by oral taurine treatment in hypertensive rats. Hypertension 1987;10:383–9.
23. Fujita T, Ando K, Noda H, et al. Effects of increased adrenomedullary activity and taurine in young patients with borderline hypertension. Circulation 1987;75:525–32.
24. Finley EB, Cerklewski FL. Influence of ascorbic acid supplementation on copper status in young adult men. Am J Clin Nutr 1983;37:553–56.
25. Larsson O. Effects of isoprenoids on growth of normal human mammary epithelial cells and breast cancer cells in vitro. Anticancer Res 1994;114:123–28.
26. Lockwood K, Moesgaard S, Folkers K. Partial and complete regression of breast cancer in patients in relation to dosage of coenzyme Q10. Biochem Biophys Res Comm 1994;199:1504–48.
27. Lockwood K, Moesgaard S, Yamamoto T, Folkers K. Progress on therapy of breast cancer with vitamin Q10 and the regression of metastases. Biochem Biophys Res Comm 1995;212:172–77.
28. Judy WV. Nutritional intervention in cancer prevention and treatment. American College for Advancement in Medicine Spring Conference, Ft. Lauderdale, FL. May 3, 1998.
29. Silagy C, Neil AW. A meta-analysis of the effect of garlic on blood pressure. J Hypertension 1994; 12:463–8.

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Last revised: June 07, 2004

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