By Dr. Mercola
According to CDC director Thomas Frieden1, high blood pressure is public healthy enemy No. 2. The CDC says 36 million people in the U.S. have uncontrolled high blood pressure, and of that number, 14 million don't even know it.
Interestingly, 16 million Americans who are on blood pressure medication still don't have their blood pressure under control – a fact that emphasizes the need for basic lifestyle changes in order to truly resolve this problem.
To bring awareness to high blood pressure concerns, the CDC has launched the Million Hearts health education program2, which teams up pharmacists and pharmacies with patient care teams to educate patients on the need to control blood pressure.
It's important to understand that uncontrolled high blood pressure is a very serious health concern that can lead to heart disease, and it also increases your risk of having a stroke.
The good news though is that following a healthy nutrition plan, along with exercising and implementing effective stress reduction techniques will normalize blood pressure in most people. It's actually an easily treated condition, but one that can cause serious damage to your health if it's ignored.
What do the Numbers Mean?
If you've ever had your blood pressure taken, you know that there are two numbers given in a blood pressure reading. The upper or first number is your systolic blood pressure reading. The lower or second number is your diastolic pressure.
120 / 80 = 120 systolic arterial pressure and 80 diastolic arterial pressure
Systolic pressure is the highest pressure, in your arteries and occurs when your ventricles contract at the beginning of your cardiac cycle. Diastolic pressure refers to the lowest arterial pressure, and occurs during the resting phase of your cardiac cycle.
Both numbers in a blood pressure test are important, but if you're 50 or older, your systolic pressure gives the most accurate diagnosis of high blood pressure. According to the most recent report (issued 2003) by the Joint National Committee (JNC) on Prevention, Detection, Evaluation and Treatment of High Blood Pressure, the following guidelines apply for determining whether you might suffer from hypertension:
Blood Pressure Classification Systolic Diastolic Normal <120 and <80 Pre-hypertension 120-139 or 80-89 Stage 1 Hypertension 140-159 or 90-99 Stage 2 Hypertension ≥160 or ≥100
per JNC 7 Express, December 2003
Getting an Accurate Blood Pressure Reading
Your blood pressure readings can vary significantly from day to day – even from morning to evening, and often within the same hour. It is when your blood pressure remains consistently elevated that significant health problems can occur. However, it's important to remember that there are several variables that can affect the validity of your blood pressure reading. For example:
- If you're overweight, a size 'average' blood pressure cuff can lead to a falsely elevated blood pressure reading. Estimates indicate that eight to ten percent of overweight and obese patients are wrongly diagnosed as hypertensive due to ill-fitting blood pressure cuffs. Since two-thirds of Americans are overweight, this is a significant concern. You should make sure your doctor or health care professional is using the right size cuff for your size.
- Arm position. If your blood pressure is taken while your arm is parallel to your body, your reading can be up to 10 percent higher than it really is. Blood pressure readings should always be taken with your arm at a right angle to your body.
- White coat hypertension, which is an elevation in blood pressure caused by the stress or fear associated with visits to doctors and other medical personnel, can be a transient but serious concern. Stress reduction in this situation is key. To decrease your risk of being falsely diagnosed with hypertension in this situation, I'd encourage you to breathe deeply and relax when you're getting your blood pressure taken.
First, Evaluate Your Diet
Groundbreaking research published in 1998 in the journal Diabetes3 reported that nearly two-thirds of the test subjects who were insulin resistant also had high blood pressure, and insulin resistance is directly attributable to a high sugar, high grain diet along with insufficient amounts of exercise. So, chances are that if you have hypertension, you also have poorly controlled blood sugar levels, and most likely eat a diet high in grains and sugars, and low in healthful fats.
Why does insulin resistance promote hypertension?
As explained by Dr. Rosedale, insulin stores magnesium, which relaxes your muscles, but if your insulin receptors are blunted and your cells grow resistant to insulin, you can't store magnesium. It simply passes out of your body through urination. If your magnesium level is too low, your blood vessels will constrict, which will raise your blood pressure and decrease your energy level. I actually wrote my first medical review paper on this in 1985.4
Insulin also affects your blood pressure by causing your body to retain sodium. Sodium retention causes fluid retention. Fluid retention in turn causes high blood pressure. Another dietary mechanism responsible for driving up your blood pressure is directly and specifically related to your fructose consumption.
Fructose breaks down into a variety of waste products, one of which is uric acid. Uric acid drives up your blood pressure by inhibiting the nitric oxide in your blood vessels. Nitric oxide helps your vessels maintain their elasticity, so nitric oxide suppression leads to increases in blood pressure. In fact, 17 out of 17 studies demonstrate that elevated uric acid levels lead to hypertension.
According to the latest research in this area, the safest range of uric acid is between 3 and 5.5 milligrams per deciliter, and there appears to be a steady relationship between uric acid levels and blood pressure and cardiovascular risk, even down to the range of 3 to 4 mg/dl. The ideal uric acid level appears to be around 4 mg/dl for men and 3.5 mg/dl for women.
How to Take Control of Your Blood Pressure
If your hypertension is the direct result of an out-of-control blood sugar level, then normalizing your blood sugar levels will also bring your blood pressure readings into the healthy range. To accomplish that, the first thing you need to do is remove all grains and sugars, particularly fructose, from your diet until both your weight and your blood pressure have normalized.
Following my comprehensive nutrition plan (which has recently been revised and updated) can help you take control of your diet in an incremental manner. Following this plan will automatically help normalize your insulin levels. Not only will it help normalize your blood pressure but it will also radically reduce your risk of the two most common causes of death, heart disease and cancer, and also other major epidemics such as obesity, diabetes and Alzheimer's.
To emphasize how important this one action can be, consider the following: According to a 2010 study5, those who consumed 74 grams or more per day of fructose (the equivalent of about 2.5 sugary drinks) had a 77 percent greater risk of having blood pressure levels of 160/100 mmHg. Consuming 74 grams or more of fructose daily also increased the risk of a 135/85 blood pressure reading by 26 percent, and 140/90 by 30 percent.
This is significant because the average American now consumes about 70 grams of fructose EVERY day! Worse yet, about 25 percent of all Americans consume over 134 grams of fructose a day, according to research by Dr. Richard Johnson, chief of the division of kidney disease and hypertension at the University of Colorado, and author of two books on the dangers of fructose, The Sugar Fix, and The Fat Switch.
As a standard recommendation, I strongly advise keeping your TOTAL fructose consumption below 25 grams per day. However, for most people – especially if you struggle with high blood pressure and insulin resistance – it would be wise to limit your fruit fructose to 15 grams or less, as it is virtually guaranteed that you will consume "hidden" sources of fructose from most beverages and just about any processed food you might eat.
Three Additional Dietary Considerations
Besides dramatically reducing or eliminating fructose and other sugars, including grains, normalizing your omega 6:3 ratio is an important dietary factor if you're hypertensive. Consuming omega-3 fats, such as that from krill oil, is one of the best ways to re-sensitize your insulin receptors if you suffer from insulin resistance. Omega-6 fats are found in corn, soy, canola, safflower and sunflower oil. If you're consuming a lot of these oils, you'll want to avoid or limit them.
If you're struggling with high blood pressure, you'd also be wise to limit your coffee consumption. The connection between caffeine and high blood pressure is not well understood, but there is ample evidence to indicate that if you have hypertension, coffee and other caffeinated drinks and foods can exacerbate your condition. If you want to eliminate caffeine from your diet, try to do it gradually over a period of days or even weeks in order to avoid withdrawal symptoms like headaches.
Another common substance that also elevates uric acid levels – and hence your blood pressure – besides fructose, is beer. The yeast and everything that's used to make beer result in a powerful uric acid trigger, so decreasing or eliminating beer consumption is also something to consider when you're trying to normalize your blood pressure.
Exercise – Ideally Outdoors!
Another vital strategy to take control of your health is exercise. A regular, effective exercise program consisting of aerobics, Peak Fitness exercises, core building and strength training, can go a long way toward reducing your insulin levels and your blood pressure. The newest evidence strongly suggests that 20-minute sessions of high intensity exercises are FAR superior to lengthy cardio or aerobics sessions, and provide you with more benefits in a fraction of the time.
Nearly every program should incorporate anaerobic sprint or burst-type exercises one to three times a week, as these have been shown to be even more effective than aerobic exercises at reducing your risk of dying from a heart attack. And, if you're insulin resistant, you'll definitely want to include weight training in your program. When you work individual muscle groups, you increase blood flow to those muscles, and good blood flow helps increase your insulin sensitivity.
The vast majority of people can normalize their blood pressure by implementing these strategies, along with normalizing your vitamin D levels (ideally via appropriate sun exposure), and reducing your stress.
Yes, there's overwhelming evidence that vitamin D is essential for your heart and cardiovascular system, so it's not surprising that it would have a beneficial impact on blood pressure. In fact, research shows the farther you live from the equator, the higher your risk of developing high blood pressure6, and blood pressure is typically higher in winter months than during the summer. A study published last year7 also concluded that the disproportionately higher rate of hypertension among African Americans compared to Caucasians appears to be due to higher incidence of vitamin D deficiency.
There are a number of mechanisms that can explain the connection between vitamin D and blood pressure:
- Lack of sunlight reduces your vitamin D stores and increases parathyroid hormone production, which increases blood pressure.
- Vitamin D deficiency has been linked to insulin resistance (IR) and Syndrome X (also known as Metabolic Syndrome), a group of health problems that can include IR, elevated cholesterol and triglyceride levels, obesity, and high blood pressure.
- Vitamin D is a negative inhibitor of your body's renin-angiotensin system (RAS), which regulates blood pressure. If you're vitamin D deficient, it can cause inappropriate activation of your RAS, which may lead to hypertension.
- Exposure to UV rays is thought to cause the release of endorphins, chemicals in your brain that produce feelings of euphoria and relief from pain. Endorphins naturally relieve stress, and stress management is an important factor in resolving hypertension.
- According to research presented at the annual American College of Cardiology meeting in New Orleans last year, vitamin D deficiency is associated with stiff arteries, which can drive up your blood pressure.
- Vitamin D also increases your body's natural anti-inflammatory cytokines and suppresses vascular calcification.
Unfortunately, the vast majority of people are severely deficient in vitamin D, regardless of race or nationality. In the United States, the late winter average vitamin D is only about 15-18 ng/ml, which is considered a very serious deficiency state. Overall, it's estimated that 85 percent of the American public are deficient, and as much as 95 percent of U.S. senior citizens, so getting regular exercise outdoors in full sun could be like hitting two birds with one stone...
Stress, including unresolved emotional issues, can also contribute to hypertension in some people. Prayer, meditation, or the Emotional Freedom Technique (EFT) are all useful techniques to keep your stress levels under control. Daily sun exposure and exercise are also oft ignored but effective, all natural mood-boosters and stress-relievers.
Supplements and Other Alternatives
Although there are supplements that can be helpful, such as the ones I've listed here, it's important to understand that they should never be considered as an alternative to the primary recommendations above, which treat the real cause of the problem. Using the supplements below without incorporating the lifestyle recommendations discussed above is an allopathic approach not very different from using drugs. In most instances, it is not likely to be effective.
- Calcium and magnesium. Even though I wrote a review paper on this nearly 30 years ago that emphasized the importance of calcium, it is now very clear to me that magnesium is far more important to consider supplementing than calcium. Daily magnesium supplementation can be useful in lowering blood pressure, especially if yours is on the high end of high. However, if you avoid sugars and grains and especially if you eat for your Nutritional Type™, it's unlikely additional supplements will be necessary.
- Vitamins C and E. Studies indicate that these vitamins can be helpful in lowering blood pressure. If you're eating for your nutritional type, you should be getting the right amount of both these nutrients through your diet alone. If you decide you need a supplement, make sure to take a natural (not synthetic) form of vitamin E. You can tell what you're buying by carefully reading the label. Natural vitamin E is always listed as the 'd-' form (d-alpha-tocopherol, d-beta-tocopherol, etc.) Synthetic vitamin E is listed as 'dl-' forms. You also want to limit your dose to no more than 100 units a day and make sure you take one that has tocotrienols in it.
- Olive leaf extract. In one 2008 study, supplementing with 1,000 mg of olive leaf extract daily over eight weeks caused a significant dip in both blood pressure and LDL ('bad') cholesterol in people with borderline hypertension. If you want to incorporate olive leaves as a natural adjunct to a nutritionally sound diet, you should look for fresh leaf liquid extracts for maximum synergistic potency. You can also prepare your own olive leaf tea by placing a large teaspoon of dried olive leaves in a tea ball or herb sack. Place it in about two quarts of boiling water and let it steep for three to 10 minutes. The tea should be a medium amber color when done.
- Electrical acupuncture. Acupuncture combined with electrical stimulation has shown to temporarily lower elevations in blood pressure in animals by as much as 50 percent. It's currently undergoing testing in humans and could be a promising alternative treatment for controlling blood pressure.
- Breastfeeding. Studies have shown that babies who are breastfed for more than 12 months have a dramatically reduced risk of developing hypertension. Researchers believe long-chain polyunsaturated fatty acids (the same found in fatty fish) in breast milk provide a protective effect for newborns.
- Quick tricks. Increasing nitric oxide in your blood can open constricted blood vessels and lower your blood pressure. Methods for increasing the compound include taking a warm bath, breathing in and out through one nostril (close off the other nostril and your mouth), and eating bitter melon, rich in amino acids and vitamin C.
Like obesity, high blood pressure is an epidemic. And, like obesity, your best treatment is to evaluate your lifestyle and make the necessary adjustments. A natural approach to preventing disease and healing yourself when illness strikes is always the better choice. In the case of high blood pressure, lifestyle changes – with particular emphasis on normalizing your insulin levels – can put you on the road to a drug-free, all natural return to optimal health.
What About Blood Pressure Medications?
The strategies discussed here should help to resolve high blood pressure issues for the vast majority of people, however, it's VITAL that you do go on a medication to lower your blood pressure if your blood pressure is very high! Yes, this is one of the few instances where drugs are necessary, as without it you are putting yourself at serious risk of a stroke, and the brain damage that occurs during a stroke tends to be permanent and typically or frequently irreversible.
On the converse side, if you are currently taking high blood pressure medication you want to make sure you never go off of them without careful monitoring. Doing so will put you at high risk for a condition called rebound hypertension that could cause your blood pressure to skyrocket and cause a stroke. In my experience the vast majority of people taking medications for their blood pressure can safely come off of the medications as long as they are carefully supervised by someone familiar with the process.
Once the cause of your problem has been addressed using the lifestyle changes above, then you will be able to slowly wean off your medication.
However, do NOT take antidepressant drugs to treat hypertension!
In recent years, many doctors have started prescribing antidepressants along with blood pressure medication – the thought being that high blood pressure is the result of stress, which is oftentimes the case. But antidepressants have no benefit on this kind of stress and can only put your health at even greater risk... so please, AVOID making the mistake of taking an antidepressant for high blood pressure. If your doctor recommends or prescribes one for your high blood pressure and not your depression, REFUSE it, as there is simply no justification for ever using these dangerous drugs for this purpose.
Please remember to read my New Nutrition Plan as it is a powerful resource to help you not only normalize your blood pressure, but also take control of your Health.