High Blood Pressure

High blood pressure (HBP) is the term used to describe a situation where the blood in the arteries is exerting undue stress on blood vessel walls: this is undesirable because the extra stress affects other organs as well, and can lead to serious health problems, such as stroke, kidney failure or heart attack.

Obviously, there are degrees of seriousness with this problem, some people have borderline HBP, others mild, some moderate, and others are in the high range. I have no hesitation in saying that if I were in one of the first three groups (and 80% of HBP patients are) my initial approach to the problem would be dietary intervention, and a close look at some of the natural therapies available. I have been reading some reports recently that tend to suggest very little benefit and some undesirable side effects from the medications prescribed for this condition. Equally, there are many experts who state unequivocally that high blood pressure can be successfully lowered & controlled by non chemical means.

One of my favourite stories from my youth was the Doctor who saw me for persistent headaches. I must have been about 14 at the time. After examining me carefully, he wrote out a prescription and gave it to me saying gravely "Now remember, this is to be taken half an hour before you get a headache". "Yes, Doctor", I said, respectfully, and left ... a few moments later, it struck me .....

What has this to do with the price of onions? Our medical professionals have come with an entirely new disease for you: PRE hyper-tension. Yup, being about to have high blood pressure is now a treatable condition. This new category was added in 2003. Along with many other health professionals, I am suspicious of the motives behind this diagnosis. You can read some comments about this questionable new diagnosis in RESOURCES.

I strongly recommend being absolutely sure that you were as relaxed as possible when the testing was done, since worry and tension can cause a temporary rise in blood pressure. I try to relax, and imagine myself sitting by a lovely pond, with the sound of water running, birds singing, and the smell of flowers. This is an interesting article on the possibility of a false diagnosis. http://news.bbc.co.uk/2/hi/health/3629921.stm

It is a sad commentary on our culture that younger and younger people are having problems with blood pressure, but for many of them there may be a simple solution, particularly for young women, though there is nothing in the study to suggest that this may also be true of young men!

Vitamin C is inversely related to Blood Pressure in young adults In cross-sectional analysis, after adjustment for race, BMI, education, and dietary intake of fat and sodium, plasma ascorbic acid at year 10 was inversely associated with systolic and diastolic BP. Those in the highest quartile of plasma vitamin C had 4.66-mm-Hg lower systolic BP and 6.04-mm-Hg lower diastolic BP (p=0.0002) than those in the lowest quartile.

The cause of HBP is somewhat mysterious, but we can put our finger on some possible culprits, chief among them being stress, inflammation and obesity. Interestingly, children of parents with high blood pressure are found to have high levels of CRP, a marker of inflammation. The researchers concluded "The results of this study suggest that the offspring of parents with hypertension may be more likely to have elevated levels of CRP, and may therefore have an increased risk of cardiovascular disease." (Diaz JJ, Arguelles, et al, Arch Dis Child, 2007; 92(4): 304-8)

In many cases, simply reducing one's weight to normal range is all it takes to control the problem. Many people who are overweight cannot exercise, and since regular exercise is very important for heart health, reducing one's weight also makes exercise more possible.

A diet high in processed foods, consequently high in sodium and low in potassium, can also be to blame: replacing the processed foods with a more natural diet, which is inherently higher in potassium and lower in sodium, can make quite a difference. This change can also mean that more fiber is introduced into the diet, and fiber (I'm quoting Dr. Balch here) helps lower blood cholesterol levels, stabilizes blood sugars, helps prevent colon cancer, constipation, obesity and many other disorders.

Recent research ( J Fam Pract 2002;51:353-359,369. )showed that among the 45 subjects consuming oats daily, (an amount totaling 6 gms of fiber) 73% were able to reduce their blood pressure medication. After 12 weeks, mean total cholesterol dropped by 15% and LDL cholesterol by 16%, and blood glucose levels improved significantly.

In fact, a 1997 study reported in the Journal of the American Medical Association reports that for every 10 grams of dietary fiber you consume per day, you enjoy a 29% decrease in your risk for cardiovascular disease! The more fruits and vegetables the diet contains, the more likely it is that blood pressure will regulate itself, probably not only because they contain more fiber and have an ideal potassium/sodium ratio, but also because they displace less healthy foods..

"I am hearing bits and pieces of talk questioning the value of a low-fat diet in the prevention of atherosclerosis. Once again there are those who point out that many individuals on a low-fat diet gain weight (and become obese) by eating more carbohydrates.

Some scientists point out that atherosclerosis is less common in countries where people do not decrease their dietary fat -- but eat more vegetables -- than it is in countries where people have decreased the amount of fat in their diet but eat more carbohydrates and fewer vegetables.

Thus far, the question that has been raised is, How valuable is a low-fat diet for the reduction of atherosclerosis?

But perhaps the question should be posed another way: How harmful is it not to eat a large quantity of vegetables and fruit daily?"

Occasionally, when all other explanations have failed, a person with HBP will find there is an allergic factor. If you are doing everything right, and still not seeing your BP come down, it might be worth while either undergoing testing for food allergies, or going on an elimination/rotation diet, which might enable you to spot the culprit for yourself. In fact, if you are Blood Type O, simply eliminating wheat, corn and dairy can bring your blood pressure back to normal in a hurry, as well as normalizing your weight.

Dietary intervention is more effective than any medication in bringing about reductions in blood pressure, as the DASH diet trials discovered. Here is a critical analysis of the trial (http://www.ti.ubc.ca/pages/letter50.htm), and in the RESOURCES you will find a link to Government information about the diet.

Many nutrients have shown a positive application for blood pressure control, and among the most important are magnesium, potassium, and an amino acid called Taurine: the higher the levels of Taurine in the diet, the lower the BP. Moreover, in a placebo controlled study, when supplemented, it was shown to lower BP. (Circulation 75(3):525-32, 1987.) Many recent studies link certain essential fatty acids to blood pressure control: this is why many health professionals recommend eating fish 2 or 3 times a week, as an excellent source of Omega 3 fatty acids. I also recommend the use of Coenzyme Q 10, as little as 60 mg of this nutrient can bring about a significant reduction in mean BP.

I am very impressed with a new supplement from Bonito, a mixture of peptides (or proteins) which works by inhibiting angiotensin converting enzyme (ACE), reversing the enzymes constricting effect on blood vessels, and relaxing the arterial walls. There are many drugs currently being prescribed that are ACE inhibitors, Lotensin, Capoten, Accupril among others: and they do seem to reduce the risk of heart attacks, though not strokes. They have a number of unpleasant side effects: dry cough, headache and light-headedness among them. This new natural Anti-ACE Peptides does not have side effects, because its action is different: rather than indiscriminately blocking the action of the enzyme, Anti-ACE converts it to a harmless substance. You will find more about it in the RESOURCES.

To take the second point, magnesium plays a part in all the enzyme reactions in the body, and also is essential ( with the other important electrolyte, potassium) for the "firing" of nerves and muscles. This means that few of the body's vital processes take place efficiently in the presence of low levels of magnesium.

A meta-analysis (Am J Hypertens 2002;15:691-696.) of the association between magnesium intake and blood pressure provided further evidence that increased magnesium intake is associated with reductions in blood pressure. Dr. Edgar R. Miller III, from The Johns Hopkins Medical Institutions in Baltimore, and colleagues conducted a meta-analysis using data from 20 randomized trials that studied the effects of magnesium supplementation on blood pressure: of course, they are very cautious about their findings, but effectively they found that, while the overall reduction in blood pressure attributed to magnesium use was small, an apparent dose-dependent effect was observed. Within limits, this means that higher doses of magnesium produced more BP lowering effect.

If you are African American, you will be interested in another meta-analysis done by Dr. Chester Fox, associate Professor of clinical family medicine at Buffalo using more than 100 studies. He determined that diets lacking in magnesium among young black men and women contribute not only to high blood pressure, but to insulin resistance. He also pointed out that serum magnesium tests are not necessarily reliable as a guide to magnesium levels, since much may be circulating, but little may be stored. He suggests adding good sources of magnesium such as avocados, leafy green vegetables and fruits to the diet, but to be careful about supplementation if you have kidney problems.

Third and fourth points: among older people, deficiencies of magnesium are especially common because processed foods contain low levels of the mineral, though it is abundant in whole foods. Magnesium levels are also adversely affected by alcohol consumption, diuretics, antibiotics, diabetes, kidney problems, and HRT. (Among younger women, birth control has the same effect. Think cramps!) Then too, production of hydrochloric acid, necessary for absorption of magnesium, decreases with age. Often these deficiencies go unrecognized, because magnesium levels are inefficiently measured through blood tests: most magnesium is stored in the cells. Ironic, that diuretics, often prescribed for heart patients, deplete the body not only of potassium ( a fact which is often addressed) but also the heart-important magnesium .

One of my preferred reference books is Dr. Werbach's Nutritional Influences on Illness, and I looked in the index to refresh my memory on some of the uses of magnesium: it did not surprise me to find some 47 health conditions listed, with the relevant research. since some "radical" naturopathic health professionals consider asthma, heart problems, fibromyalgia, menopause, PMS and migraine all to be, to one degree or another, magnesium deficiency diseases. But I will limit myself to the heart, and give some examples of the excellent results magnesium supplementation can have.

The role of magnesium in cardiac arrythmias was first acknowledged as long ago as 1943, and in 1989, the American Journal of Cardiology (63(14):43G-46G) published a study by Dr. Roden saying "the association between hypo-magnesia (Lynn: hypo= low) and arrythmias ... has long been recognized. More recently, acute intervention with magnesium in patients who are not hypomagnesic has demonstrated arrhythmia suppression.." In cases of High Blood Pressure, a 1981 study found that 50% of patients with HBP had low magnesium levels ( Lynn: bear in mind this was almost certainly based on blood readings, so in my opinion the number would be much higher!) and their hypertension was reversed when their magnesium levels rose. It is also interesting that many women who develop HBP do so after menopause, which makes the magnesium connection particularly important for them, especially if they are on HRT. As a bonus, Dr. Alan Gaby (NSN Vol.5 #9 p.402) says adequate levels of magnesium in post-menopausal women increase bone density levels. Another really interesting study showed that when a patient is deficient in magnesium, normal levels of a medication which would usually take care of the problem are of no help - more is needed to get results, unless the mineral deficiency is addressed. To restate that in reverse; if an underlying magnesium deficiency is identified and addressed, you may need less of your medication to get results. If such a deficiency exists and is NOT addressed, you will need higher than normal levels of medication to get results.

In Dr. Ronald Hoffman's book, Intelligent Medicine, (Simon & Schuster 1997, p.318-319) he points out that the method of action of calcium channel blockers is to block the spasm-inducing effect of calcium, thus keeping blood vessels dilated. He points out that calcium and magnesium compete for the same receptor sites in the smooth muscle wall of the blood vessel: magnesium is the nutrient that relaxes spasms, so its presence in greater amounts than calcium will prevent spasms in the same way calcium channel blockers do. This is why, when my Doctor prescribed a calcium blocker, I went away and took lots of magnesium. Dr. H. says his protocol in patients with advanced heart conditions is to recommend magnesium in reverse ratio to calcium. i.e., twice as much magnesium as calcium. Buy his book, do: it is full of excellent information. I recommend magnesium bound to either aspartate or citrate as being the most effective for absorption, and also to avoid the possibility of diarrhea that sometimes accompanies high doses. I have had a hard time up until now finding a means to get extra magnesium in meaningful amounts at an affordable price, but there are now some powdered formulas on the market, and I can recommend Magna-Calm as an excellent strategy.

The following information may be of interest to you: Magnesium: Research Misconduct?

For the past 15 years evidence has stacked up showing patients with acute coronary thrombosis improve their survival chances by 50 - 82.5% when given intravenous magnesium of 32-66 mmol in the first 24 hours. The single negative study showing that magnesium had a worsening effect on survival employed a far higher dose of magnesium (80 mmol) than the other studies. (European Heart J, 1991;12:12158), and one other study showing no benefit with magnesium employed the low dose of 10 mmol in the first 24 hours.

Although it would appear clear to any first year medical student that magnesium worked well for coronary thrombosis within the optimal dosage level of 30 - 70 mmol; that 10 mmol was shown to be too little, and 80 mmol had been shown to be too much, in 1990/91, the Fourth International Study on Infarct Survival decided to do a major study which was to definitely determine whether magnesium was beneficial when used for this purpose. Although their own meta-analysis of all earlier studies showed that magnesium was beneficial, the ISIS4 investigators also decided to test magnesium against the drug Catopril and a coronary vasodilator.

Astonishingly, the ISIS investigators chose to use the 80 mmol dosage for their study, the one dosage that had been found to be harmful. It should be noted that the ISIS4 study was funded to the tune of almost $10 million by Bristol Myers Squibb, the manufacturers of Catopril. Not surprisingly, magnesium lagged behind the drugs.

As a result of this paper, many hospitals ceased using magnesium in their treatment of acute coronary thrombosis.

The scandalous decision to use an overdosage of magnesium in this study must have caused the loss of several thousand lives within the study and many other lives in other hospitals that have now stopped using magnesium. Both nutritional pioneer Dr. Stephen Davies and Dr. Damien Downing, editor of the Journal of Nutritional and Environmental Medicine, criticized the designers of the study for clearly selecting too large a dose of intravenous magnesium, and also for giving magnesium too late and then too quickly. Downing even titled his editorial "Is ISIS4 research misconduct?" (J Nutr Environ Med, 1999;9:513)

There are also many herbs that help high blood pressure. The granddaddy of them all is, of course, garlic. Some researchers, in fact, theorize that it is a large part of the protective factor in the so-called Mediterranean diet. However, olive oil is also part of that diet, and a study published in Arch.Intern.Med, 2000; 160: 837-42 came up with some very interesting data: 23 people with mild to moderate HBP were told to cook their food with either olive oil or sunflower oil, and after 6 months, everyone switched diets. (Participants limited other fats: fat calories were limited to 26% of the daily total, and saturated fats were limited to 6%). Resting blood pressure was significantly lower in the olive oil group, and blood pressure medication could be significantly reduced - in fact, 8 of the olive oil group stopped taking medications altogether. Many people prefer to ingest Garlic as a dietary supplement, perhaps not wishing to limit their social life, and there are many extremely effective preparations available which deliver all the nutritional punch without any of the odor. Look for a dosage which will give you 8mgs of allicin, or an allicin yield of 4,000 mcgs per day.

Garlic is closely followed by onions, which of course belong to the same family. There can be no doubt that including generous amounts of these substances in your food has many beneficial results , not limited to lowering blood pressure.

This is another age-old remedy whose efficacy is now being confirmed by scientific evidence.: I think it is one of the best, most harmless and most reliable remedies for many heart ailments, working as a vasodilator, and also as a mild diuretic. Experiments with animals have shown decreased arterial blood-flow as well as increased coronary artery and peripheral flow, decreased heart rate and improved contractility of the heart muscle (Werbach - Botanical Influences on Illness). Use this only with the advice of a health profession if you are on Lanoxin, or any other ACE inhibitor! (Mashour NH, et al. "Herbal medicine for the treatment of cardiovascular disease: clinical considerations." Arch Int Med. November9,1998;158:2225-2234. Graham JDP. "Crataegus oxycantha in hypertension." Br Med J. November11,1939;951.)

Another herb from Ayurvedic medicine which shows very promising results is Coleus Forskohlii: a substance it contains (called forskolin) causes relaxation in the arteries, and a resultant lowering of blood pressure. This interesting herb, which appears to relax smooth muscle generally, has also had some success in use for asthma attacks.

Another herb which you would expect to find in your food is Cayenne Pepper, also known as capsicum. A study in 1987 found that it has a very beneficial effect on blood fats, bringing about a significant reduction in blood triglycerides and LDLs, the "bad" cholesterol. Cayenne is also a catalyst for other herbs, increasing their bio-availability. It can have the same effect on medications, so be careful! There are brands on the market which bill themselves as "cool", meaning they will not harm your stomach if you have a tendency to be adversely affected by spicy foods.

While on the subject of food, there are some writers who advocate the use of parsley to help the heart, and since it is also a mild diuretic and high in bioflavonoids, this makes sense; so you can see your ideal meal taking shape here: onions, garlic, parsley and a little cayenne pepper, add a little olive oil and red wine, some tomatoes, put in your fish, simmer and enjoy! A potato with its skin on for fiber and a salad of dark green leafies, and you have a meal fit for the gods, who are immortal!

Last of my herbs is Ginseng - but with a caveat: different ginsengs do different things: Korean and Chinese are stimulating, and can actually increase blood pressure. Look for Siberian Ginseng, Eleutherococcus Senticosus, which, being more neutral in its effect, is an excellent adaptogenic, or body balancer, and therefore not only lowers high blood pressure, but also raises low blood pressure. Tienchi Ginseng (Panax Notoginseng) is also said to help cardiovascular problems and reduce blood pressure.

A Chinese herb which is quickly becoming valued for its effects on High Blood Pressure and cholesterol levels is Jagulana, or Jiaogulan. Jiaogulan has been widely reported to be effective in the treatment of hypertension. Although the exact mechanism is still being researched, studies have shown that Jiaogulan improves the metabolism of the heart directly as well as enhancing the release of nitric oxide in the body, which helps to relax the coronary blood vessels. (Tanner, M.A., et al. "The direct release of nitric oxide by gypenosides derived from the herb Gynostemma pentaphyllum." Vanderbilt University Medical Ctr., Nashville, Tenn. Nitric Oxide 1999 Oct; 3(5):359-65. )

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Job Stress and Heart Disease - http://www.workhealth.org/prevention/prjscvd.html

Magnesium and Hypertension - an Overview - http://www.mgwater.com/hyper.shtml

Notoginseng and High Blood Pressure - http://www.chinaphar.com/1671-4083/23/1157.pdf

Abstract of study connecting Omega 3 and coronary heart disease in Women - http://jama.ama-assn.org/cgi/content/abstract/287/14/1815

Stressful Youth equals HBP in later life A Study - http://www.pslgroup.com/dg/1082be.htm

The American Institute of Stress - http://www.stress.org/

Yoga at your desk - http://www.artofwellbeing.com/articles/office_yoga.php

Treatment of Mild to Moderate Hypertension with Shark Cartilage and Cordyceps Sinensis - http://www.vrp.com/index.aspx

The DASH Eating Plan for controlling HBP - http://www.nhlbi.nih.gov/health/public/heart/hbp/dash/new_dash.pdf

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