By Dr. Mercola
According to the Centers for Disease Control and Prevention (CDC), 1 in 3 American adults (about 70 million people) have high blood pressure.1 About half have uncontrolled high blood pressure, which increases your risk for a number of serious health problems, including:
Overall, men tend to have higher blood pressure than women, and while high-income nations have seen a significant decline in hypertension, prevalence in low- and middle-income countries, such as South Asia and Africa, is spiking. According to researchers, prevalence is "completely inverse" to national income.
Worldwide, high blood pressure is thought to cause nearly 13 percent of all deaths, or about 7.5 million deaths annually.
What Causes High Blood Pressure?
According to medical physiology textbooks, as much as 95 percent of hypertension is called essential hypertension, meaning the underlying cause is unknown. From my perspective, this simply isn't true. A number of factors have been identified as contributing to high blood pressure, including but not limited to:
• Elevated uric acid levels are also significantly associated with hypertension, so any program adopted to address high blood pressure needs to normalize your uric acid level as well
• Poor nutrition in childhood has been shown to raise the risk of high blood pressure in adulthood9
• Lead exposure
• Air pollution. Air pollution affects blood pressure by causing inflammation while noise pollution asserts an effect via your nervous and hormonal systems.
Air pollution has been shown to increase your risk of high blood pressure to the same degree as having a body mass index (BMI) of 25 to 30.
Living in an area plagued by constant noise pollution (busy city streets with night time traffic) has been shown to increase the risk of hypertension by 6 percent, compared to living in an area where noise levels are at least 20 percent lower10
The Importance of Diet and Insulin Sensitivity
As noted by the lead author Majid Ezzati, Ph.D., a professor of global environmental health at Imperial College London:11
"The perception is that people are not getting enough calories, but the reality is, they're not getting healthy calories. Making fresh, healthy food affordable and accessible for everybody should be a priority."
One of the most important dietary changes needed to improve high blood pressure is to eliminate or dramatically reduce sugar and processed fructose from your diet. The easiest way to do that is to replace processed foods with real, whole foods. This will address not only insulin and leptin resistance but also elevated uric acid levels.
One 2010 study12 discovered that 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 (stage 2 hypertension).
Consuming 74 grams or more of fructose per day also increased the risk of a 135/85 blood pressure reading by 26 percent, and a reading of 140/90 by 30 percent. To learn more about healthy eating, please see my optimal nutrition plan, which will guide you through the necessary changes step-by-step.
To ascertain whether insulin/leptin resistance is at play, be sure to check your fasting insulin level. If your hypertension is the result of elevated insulin levels, dietary intervention will be key.
Aim for a fasting insulin level of 2 to 3 microU per mL (mcU/mL). If it's 5 mcU/mL or above, you definitely need to lower your insulin level to reduce your risk of high blood pressure and other cardiovascular health problems.
Keep in mind that the so-called "normal" fasting insulin level is anywhere from 5 to 25 mcU/mL, but please do not make the mistake of thinking that this "normal" insulin range equates to optimal.
Do You Have High Blood Pressure?
A blood pressure reading gives you two numbers. The upper or first number is your systolic blood pressure reading. The lower or second number is your diastolic pressure. For example, a blood pressure reading of 120 over 80 (120/80) means you have a systolic arterial pressure of 120 and a diastolic arterial pressure of 80.
Your systolic pressure is the highest pressure in your arteries. It 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. Ideally, your blood pressure should be about 120/80 without medication.
If you're over the age of 60, your systolic pressure is the most important cardiovascular risk factor. If you're under 60 and have no other major risk factors for cardiovascular disease, your diastolic pressure is believed to be a more important risk factor.13
According to guidelines14,15,16 issued by the Joint National Committee (JNC) on Prevention, Detection, Evaluation and Treatment of High Blood Pressure in 2014, the following blood pressure classifications are used to determine whether you might suffer from hypertension:17
|Blood Pressure Classification||Systolic Pressure (mmHg)||Diastolic Pressure (mmHg)|
Systolic Pressure (mmHg): <120
Diastolic Pressure (mmHg): <80
Systolic Pressure (mmHg): 120-139
Diastolic Pressure (mmHg): 80-89
✓ Stage 1 Hypertension
Systolic Pressure (mmHg): 140-159
Diastolic Pressure (mmHg): 90-99
✓ Stage 2 Hypertension
Systolic Pressure (mmHg): ≥160
Diastolic Pressure (mmHg): ≥100
How to Avoid a False Hypertension Diagnosis
To avoid a false hypertension diagnosis, keep in mind that your blood pressure reading can vary significantly from day to day, and even from one hour to the next, so don't overreact if you get one high reading here or there. It's when your blood pressure remains consistently or chronically elevated that significant health problems can occur. The following variables can also affect the validity of your blood pressure reading:
• Incorrect blood pressure cuff size: If you're overweight, taking your reading with a size "average" blood pressure cuff can lead to a falsely elevated blood pressure reading, so make sure your doctor or health care professional is using the right size cuff for your arm.
• Incorrect 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.
• Nervousness: "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. If this applies to you, stress reduction is key.
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.
Measuring Pressure on Both Arms May Provide Valuable Health Info
More recently, researchers are urging healthcare providers to measure blood pressure twice, once on each arm. A number of studies have revealed that a significant difference between your right and left arm pressure may indicate circulatory problems that raise your risk for stroke, peripheral artery disease or other cardiovascular problems.18
Slight variations in blood pressure between left and right is normal, but when the difference is five points or greater, it could signal trouble. A British study found that people with a five-point or more difference between arms had nearly double the risk of dying from heart disease in the next eight years.19
Another analysis of 20 studies found that those with a right-to-left arm difference in blood pressure of 15 points or more were twice as likely to have peripheral artery disease in the arms and/or legs. As noted by Harvard Health Publications:20
"In younger people, side-to-side differences in blood pressure can occur when a muscle or something else compresses an artery supplying the arm, or by a structural problem that prevents smooth blood flow through an artery. In older people, it's usually due to a blockage arising from atherosclerosis, the artery-clogging disease process at the root of most heart attacks, strokes, peripheral artery disease and other cardiovascular conditions.
A less common cause of a between-arm difference in blood pressure is an aortic dissection. This is a tear inside the wall of the aorta, the main pipeline of oxygenated blood from the heart to the body. At your next doctor's visit, ask to have your blood pressure checked in both arms. If there's a difference greater than 10 point, another test called the ankle-brachial index might be in order to check for peripheral artery disease."
If you're between the ages of 18 and 59 without major health conditions, or if you're 60 or older with diabetes and/or chronic kidney disease, conventional medicine recommends drug treatment if your blood pressure is at or above 140/90. In those over 60 who do not have diabetes or chronic kidney disease, the panel suggests delaying drug treatment until you're above 150/90. According to the JNC panel members:21
"For all persons with hypertension, the potential benefits of a healthy diet, weight control and regular exercise cannot be overemphasized. These lifestyle treatments have the potential to improve BP control and even reduce medication needs. Although the authors of this hypertension guideline did not conduct an evidence review of lifestyle treatments in patients taking and not taking antihypertensive medication, we support the recommendations of the 2013 Lifestyle Work Group."22
While recommending diet and exercise is a step in the right direction, the panel didn't take it all the way. In my experience, even stage 1 and 2 hypertension can be successfully addressed with lifestyle interventions, to where drugs become unnecessary.
The key is to be sufficiently aggressive in your diet and lifestyle modifications. There are plenty of clinical success stories that vouch for this stance.23 That said, if you have seriously elevated blood pressure, it would be wise to be on medication to prevent a stroke while you implement these lifestyle changes.
Omega-3 Is Vital for Healthy Blood Pressure
Recent research highlights the importance of animal-based omega-3 fats for healthy blood pressure — especially in young adults. More than 2,000 healthy men and women between the ages of 25 and 41 participated in the study. Diabetics and those with a BMI over 35, which is considered obese, were excluded.
The findings showed that those with the highest serum levels of omega-3 also had the lowest blood pressure readings. On average, their systolic pressure was 4 millimeters of mercury (mm Hg) lower and their diastolic pressure was 2 mm Hg lower compared to those with the lowest omega-3 blood levels. As reported by WebMD:24
"'This suggests that promoting diets rich in omega-3 foods could be a strategy to prevent high blood pressure,' [Dr. Mark] Filipovic said … Even a small reduction in pressure, as little as about 5 mm Hg, could prevent a great number of strokes and heart events in the general population …
Another recent study found that doses of omega-3 fatty acids as low as less than a gram a day could help those who already have high blood pressure reduce their numbers … The fish oil may work by improving blood vessel function and reducing inflammation, among other things,' Filipovic said."