By Dr. Mercola
The number of deaths due to hypertension, or high blood pressure, increased nearly 62 percent from 2000 to 2013, according to a new report from the US Centers for Disease Control and Prevention (CDC).1
Currently, about 70 million US adults struggle with the condition, which amounts to one in every three adults. Only 52 percent of those who have been diagnosed have their blood pressure levels under control, and another one in three US adults has pre-hypertension, which means blood pressure is elevated and at risk of progressing to full-blown hypertension.2
If your blood pressure is elevated, it means the force of blood pushing against the walls of your arteries is too high, which can cause damage over time. Many are familiar with the related heart risks this can cause. For instance, high blood pressure increases your risk of heart disease, heart failure and stroke.
Less well-known, but equally important, is the fact that high blood pressure can contribute to kidney failure, by weakening and narrowing blood vessels in your kidneys, and problems with memory and understanding.
High blood pressure has even been linked to an increased risk of developing, and dying from, cancer,3 and is known to trigger and worsen complications of diabetes, including diabetic eye disease and kidney disease.
Even Slight Weight Gain Increases Your Blood Pressure Levels
If you're overweight or obese, you have a greater risk of developing high blood pressure. However, research presented last year at the American Heart Association's High Blood Pressure Research Scientific Sessions in San Francisco, California found that even a slight increase in weight may drive your levels up.
In a small study of 16 people, participants were asked to eat an extra 400 to 1,000 calories a day for eight weeks, in order to add about 5 percent to their body weight (about 10 excess pounds for a 200-pound person).4
At the end of the study, those who put on weight had their systolic blood pressure rise by an average of 4 mm Hg, from 114 to 118 mm Hg. This is still considered to be in the healthy range if the lower number (diastolic measure) is also healthy.
However, greater increases in blood pressure were seen in those who put on weight in their abdomen. This makes sense since research suggests your waist size may be an effective measure for assessing obesity-related hypertension risk.5
If you have a high waist-to-hip ratio, i.e. you carry more fat around your waist than on your hips, you may be at an increased risk for obesity-related hypertension.
To calculate your waist-to-hip ratio, measure the circumference of your hips at the widest part, across your buttocks, and your waist at the smallest circumference of your natural waist, just above your belly button.
Then divide your waist measurement by your hip measurement to get the ratio. (The University of Maryland offers an online waist-to-hip ratio calculator you can use.6) The Mayo Clinic uses the following waist-to-hip ratio designations to evaluate your health risk:
Dietary Sugar Raises Your Blood Pressure
One of the primary underlying causes of high blood pressure is related to your body producing too much insulin and leptin in response to a high-carbohydrate (i.e. high sugar) and processed food diet.
You've probably heard of the DASH diet, which is claimed to be among the most effective for controlling hypertension. It consists largely of fresh vegetables, fruits, lean protein, whole grains, low-fat dairy, and very low sodium content.
But it's ALSO low in sugar/fructose. So, while people on DASH diets do tend to show reduced hypertension, the reason for this may not be solely the reduction in salt, but the reduction in sugar. The same holds true for reducing your intake of processed foods, which are top sources of both heavily processed salt and sugar/fructose.
Research shows that dietary sugars influence blood pressure and serum lipids independent of the effects of sugars on body weight.7 In a review in the journal Open Heart, the authors also argue that the high consumption of added sugars in the US diet may be more strongly and directly associated with high blood pressure than the consumption of sodium.8 They write:9
"Evidence from epidemiological studies and experimental trials in animals and humans suggests that added sugars, particularly fructose, may increase blood pressure and blood pressure variability, increase heart rate and myocardial oxygen demand, and contribute to inflammation, insulin resistance and broader metabolic dysfunction.
Thus, while there is no argument that recommendations to reduce consumption of processed foods are highly appropriate and advisable, the arguments in this review are that the benefits of such recommendations might have less to do with sodium—minimally related to blood pressure and perhaps even inversely related to cardiovascular risk—and more to do with highly-refined carbohydrates."
How Does Sugar Affect Your Blood Pressure?
One 2010 study showed that consuming a high-fructose diet lead to an increase in blood pressure of about 7mmHg/5mmHg, which is greater than what is typically seen with sodium (4mmHg/2mmHg).10
Research also shows that drinking a single 24-ounce fructose-sweetened beverage leads to greater increases in blood pressure over 24 hours than drinking a sucrose-sweetened beverage,11 which again points to the detrimental effects of fructose on your health. Why is it so bad for your blood pressure levels?
In order to effectively treat and recover from high blood pressure, it's important to understand its underlying cause, which is often related to your body producing too much insulin and leptin in response to a high-carbohydrate and processed food diet. As your insulin and leptin levels rise, it causes your blood pressure to increase. Eventually, you may become insulin or leptin resistant.
As explained by Dr. Rosedale, insulin stores magnesium, but if your insulin receptors are blunted and your cells grow resistant to insulin, you can't store magnesium so it passes out of your body through urination. Magnesium stored in your cells relaxes muscles.
If your magnesium level is too low, your blood vessels will be unable to fully relax, and this constriction raises your blood pressure. Fructose also elevates uric acid, which drives up your blood pressure by inhibiting the nitric oxide in your blood vessels. (Uric acid is a byproduct of fructose metabolism. In fact, fructose typically generates uric acid within minutes of ingestion.)
Nitric oxide helps your vessels maintain their elasticity, so nitric oxide suppression leads to increases in blood pressure. So any program adapted to address high blood pressure needs to help normalize both your insulin/leptin sensitivity and uric acid level.
Eliminating Excess Sugar Knocks Out Three Issues at Once
As it turns out, by eliminating excess sugar/fructose from your diet, you can address all three issues (insulin, leptin, and uric acid) in one fell swoop. As a standard recommendation, I recommend keeping your total fructose consumption below 25 grams per day.
If you're insulin resistant (about 80 percent of Americans are), have high blood pressure, diabetes, heart disease, or other chronic disease, you'd be wise to limit your fructose to 15 grams or less per day, until your condition has normalized.
In his book The Sugar Fix, Dr. Richard Johnson includes detailed tables showing the content of fructose in different foods. Keep in mind that for most Americans, in order to lower your fructose/sugar consumption you'll also need to eliminate sugar-sweetened beverages and processed foods.
Staying Fit Can Keep Your Blood Pressure Healthier, Longer
It's not only your diet that matters for healthy blood pressure… a comprehensive fitness program is another strategy that can improve your blood pressure and heart health on multiple levels (such as improving your insulin sensitivity). For example, research shows that men who are fit can stave off increases in blood pressure that tend to occur with age. In men with strong heart fitness, blood pressure levels didn't start increasing until their mid-50s. However, in sedentary men, signs of high blood pressure appeared in their mid-40s.12
Study co-author Dr. Xuemei Sui, an assistant professor in the department of exercise science at the University of South Carolina's Arnold School of Public Health, told Medicine Net:13 "A higher level of fitness can significantly delay this natural increase of blood pressure with age… For those with a high level of fitness, it will take almost [an additional] decade" to develop early signs of high blood pressure."
To reap the greatest rewards, I strongly suggest including high-intensity interval exercises in your routine. You'll also want to include weight training. When you work individual muscle groups you increase blood flow to those muscles, and good blood flow will increase your insulin sensitivity. If you want to kill several birds with one stone, exercise barefoot outdoors on sunny days. Not only will you get much-needed sunshine to promote production of heart-healthy vitamin D, but bright daylight sun exposure will also help maintain a healthy circadian clock, which will help you sleep better.
Poor sleep is yet another oft-ignored factor that can cause resistant hypertension. Going barefoot, meanwhile, will help you ground to the earth. Experiments show that walking barefoot outside—also referred to as Earthing or grounding—improves blood viscosity and blood flow, which help regulate blood pressure. Keep in mind that, in most cases, high blood pressure is a condition that can be managed and oftentimes reversed with natural lifestyle changes.
Grape Seed Extract and Bilberry Extract for Heart Health
Grape seed and bilberry extract are two more natural tools that may help support healthy blood pressure levels. Rich in antioxidants including flavonoids, linoleic acid and phenolic procyanidins, grape seed extract has previously been shown to help dilate blood vessels and was shown to lower blood pressure in people with metabolic syndrome (most of whom also had prehypertension). After taking grape seed extract for four weeks, systolic blood pressure (the top number) dropped 12 points on average while diastolic blood pressure (the bottom number) dropped an average of 8 points.14
The European blueberry, bilberry, which is also rich in antioxidants, is most well known for prevent and even reversing eye conditions like macular degeneration. However, research shows it also has cardioprotective effects. Bilberries are a good source of flavonoids, especially anthocyanins, which have powerful antioxidant activity. Research found that it offers numerous cardioprotective effects, including anti-ischemic and anti-arrhythmic activity.15
Be Aware of White Coat Hypertension
"White coat hypertension" is a term used for when a high blood pressure reading is caused by the stress or fear associated with a doctor or hospital visit. This can be a transient yet serious concern, and it's estimated that up to 20 percent of people diagnosed with hypertension actually only have white coat hypertension, which means their blood pressure was only elevated because they were nervous.16 If this applies to you, try testing your blood pressure levels at home instead. Stress reduction is also key. Below, I will address stress reduction, and provide a technique that can help you control stress that may be contributing to high blood pressure.
Also, to decrease your risk of being falsely diagnosed with hypertension in this situation, take a moment to calm down (be sure to arrive for your appointment ahead of time so you can unwind), then breathe deeply and relax when you're getting your blood pressure taken. Some doctors may actually recommend antidepressants as a solution to help their patients "relax," but be aware that this will likely cause far more harm than good.
My Top-Recommended Strategies to Prevent Hypertension
If you are diagnosed with high blood pressure, dietary strategies will be crucial to controlling your levels. Avoiding processed foods (due to their being high in sugar/fructose, grains, trans fat and other damaged fats and processed salt) is my number one recommendation if you have high blood pressure. Instead, make whole, ideally organic, foods the focus of your diet. As you reduce processed foods, and other sources of non-vegetable carbs, from your diet, you'll want to replace them with healthy fat. Sources of healthy fats to add to your diet include:
Butter made from raw, grass-fed organic milk
Organic pastured egg yolks
Coconuts and coconut oil (coconut oil actually shows promise as an effective Alzheimer's treatment in and of itself)
Unheated organic nut oils
Raw nuts, such as pecans and macadamia, which are low in protein and high in healthy fats
Grass-fed meats or pasture raised poultry
I encourage you to read through my full list of strategies to prevent hypertension, however, below you'll find some additional highlights.
- Skip breakfast: Research shows that intermittent fasting helps fight obesity and type 2 diabetes, both of which are risk factors for high blood pressure. Your body is most sensitive to insulin and leptin after a period of fasting. While there are many types of fasting regimens, one of the easiest to comply with is an eating schedule where you limit your eating to a specific, narrow window of time each day. I typically recommend starting out by skipping breakfast, and making lunch your first meal of the day.
- Optimize your vitamin D levels: Arterial stiffness (atherosclerosis) is a driving factor for high blood pressure. As your blood travels from your heart, cells in the wall of your aorta, called baroreceptors, sense the pressure load, and signal your nervous system to either raise or lower the pressure. However, the stiffer your arteries are, the more insensitive your baroreceptors become, and the less efficient they become at sending the appropriate signals. Vitamin D deficiency is, in turn, linked to stiff arteries, which is why optimizing your levels is so important.
- Address your stress: The link between stress and hypertension is well documented. Suppressed negative emotions such as fear, anger, and sadness can severely limit your ability to cope with the unavoidable every day stresses of life. It's not the stressful events themselves that are harmful, but your lack of ability to cope. I recommend the Emotional Freedom Technique (EFT) to transform your suppressed, negative emotions and relieve stress.
- Normalize your omega 6:3 ratio: Most Americans get too much omega-6 in their diet and far too little omega-3. Consuming omega-3 fats will help 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.
- Optimize your gut flora: Compared to a placebo, people with high blood pressure who consumed probiotics lowered systolic blood pressure (the top number) by 3.56 mm Hg and diastolic blood pressure (the bottom number) by 2.38 mm Hg.17 The best way to optimize your gut flora is by including naturally fermented foods in your diet, which may contain about 100 times the amount of bacteria in a bottle of high-potency probiotics.
- Maintain an optimal sodium-potassium ratio: An imbalanced ratio may lead to hypertension. To ensure yours is optimal, ditch all processed foods, which are very high in processed salt and low in potassium and other essential nutrients. Instead, eat a diet of whole, unprocessed foods, ideally organically and locally-grown to ensure optimal nutrient content. This type of diet will naturally provide much larger amounts of potassium in relation to sodium.
- Eliminate caffeine: The connection between coffee consumption 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 may exacerbate your condition.
- Vitamins C and E: Studies indicate that vitamins C and E may be helpful in lowering blood pressure. If you're eating a whole food diet, you should be getting sufficient amounts of 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.
- 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 blood pressure in people with borderline hypertension. If you want to incorporate olive leaves as a natural adjunct to a nutritionally sound diet, 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.
- 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.