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The Devastating Effects of Hypertension (High Blood Pressure) – Part I

Introduction

Hypertension (HTN) is a medical term used to describe high blood pressure (BP), and BP is technically a measurement of the force of blood against your arterial walls from the contraction (Systolic, the top number) and relaxation (Diastolic, the bottom number) of your heart. A blood pressure of 120/80 mmHg is read as 120 mmHg Systolic and 80 mmHg Diastolic. Your heart, over the course of a single day and average lifespan beats about 100,000 times and over 2.5 billion times, respectively. This constant repetitive pressure exerted on your arterial walls can have devastating health consequences if too high, and this is true if only slightly high for prolonged periods of time.

Chronically high BP is the number one cause of cardiovascular disease including stroke, atherosclerosis, heart attack, and heart failure. It is the most important preventable risk factor for premature death. Unfortunately, for most people with HTN, they do not experience any symptoms. Furthermore, the damaging effects of chronically high blood pressure are relentlessly insidious, and may not be known until significant organ damage has already been done. It is the major preventable cause of blindness, kidney failure, and congestive heart failure.

Epidemiology

Approximately 95% of people suffering from high BP are classified as primary hypertensives, meaning that there is no known obvious cause. On the other hand, people classified as secondary hypertensives have an identifiable cause, such as endocrine disorders, kidney disease, complications from diabetes, etc. For most primary hypertensives, making appropriate lifestyle choices can have a significant impact on lowering Bp. People with HTN that make healthy lifestyle habits, and on medication, can at the very least reduce the dosages, or at best come off of the medications all together. This is especially true of people with primary HTN, which as stateed above, is the vast majority.

Based on the above information, it is probably no surprise to know that 1 in 3 US adults are estimated to have high BP; that is HTN greater than or equal to 140/90 mmHg. It fact, the older we get the more likely we will have HTN. Current estimates state that over 55% of women and 50% men over 70 yoa have HTN. It is fair to say, that very few people are immune to the negative effects of high BP, especially when you consider that the threshold for detrimental effects of chronically high BP is only 115/ 75 mmHg. In other words, if your BP is equal to or less than 115/75 mmHg your risk for cardiovascular disease or other BP related illnesses is close to zero. Knowing this, estimates of the negative health consequences of chronically high BP, when using 115/75 as your threshold, are probably closer to 95%.

See the table below for the different classifications of hypertension.

HTN Stages.001

Other epidemiology data are telling in terms of how lifestyle plays a role in this epidemic. Within the US, HTN rates are much higher in the Southeastern US than other parts of the country. These high rates are closely to the higher obesity and diabetes rates in the Southeast; which, are directly related to more sedentary lifestyles and poorer nutrition. Smokers and others that over consume alcohol also tend to have higher rates of HTN.

Unfortunately, 1 in 5 U.S. adults do not know they have high BP; and, the vast majority of the ones that do are not getting appropriate treatment in the conventional sense of BP treatment (controlling BP only with prescription medications). When considering that the best way to manage BP is through appropriate lifestyle change with or without medications, than it is fair to say that almost no one gets optimal treatment.

Lifestyle and Nutraceutical Interventions

Most cases of primary HTN, that is ≤ 140/90 mmHg, can be managed with lifestyle changes alone. People with Stage I hypertension should be put on prescription medications, but can likely come off of those medications with appropriate lifestyle interventions in the near future. Stage II and above definitely require aggressive pharmaceutical invention; however, once again, positive lifestyle change can at the very least reduce medication dosing.

Lifestyle interventions should begin with eliminating or reducing any habits that may be exacerbating the issue. Aggravating factors include: smoking, being sedentary, high salt intake, low vegetable and fruit intake, high fructose consumption, lack of sleep, high caffeine intake, excessive alcohol intake, chronic dehydration, and of course perceived high stress.

Healthy lifestyle habits that have consistently shown to lower and optimize BP, and should be the foundation of any BP lowering treatment, are eating plenty of vegetables and low glycemic index fruits, and getting consistent exercise. Another lifestyle habit that should be cultivating and practiced even if for only 5 minutes a day is meditation. Meditation has been shown to have numerous benefits for the body including lowering BP; and, the most difficult thing about it is just doing it.

Having a basic understanding of how Rx BP medications work can give one an idea of how nutraceuticals may help. For example, most BP medications lower BP either directly or indirectly by reducing the force of heart contractions and/or relaxing the smooth muscle in your arteries. Reducing the force of heart contractions reduces the pressure exerted on the arterial walls. And, when the arteries are relaxed your vessels widen and BP decreases. These medications include ACE (Angiotensin Converting Enzyme) inhibitors, Calcium Channel Blockers, and ARBS (Angiotensin II Receptors), and even Beta-Blockers.

The other class of medications used to lower BP are called diuretics (aka water pills). These medications work by telling the kidneys to get rid of excess of water and sodium in the blood. As the name implies, the medications can initially have someone running to the bathroom frequently to urinate.

Nutraceuticals that have research showing they lower BP work basically the same way as Rx meds, with the beneficial exception of also having plenty of antioxidants. These include, but are not limited to, the following:

Natural Muscle Relaxers

Magnesium 1
Potassium 2
CoQ10 3
Cocoa 4
L-Arginine 5
Hawthorn (Crateagus) 6
Olive Leaf 7

Natural Diuretics

Dandelion (Taraxacum officinalis) 8
Green and Black Tea (Camellia sinensis) 9
Horse Tail (Equisetum arvense) 10
Parsley (Petroselinum crispum) 11
Corn Silk (Zea mays ) 12
Hibiscus sabdariffa (Hibicus) 13
Coriander (Coriandrum sativum) 14
Celery seed (Apium graveolens) 15

In my opinion, thus far, the above nutraceuticals have the most research on them, and are also considered very safe. The one caveat to this is potassium. One needs to be cautious when taking potassium supplements along with ACE inhibitors and some Beta-blocker medications. Although rare, there is a potential to cause hyperkalemia with taking potassium with these medications.

Conclusions

Anyone, interested in adding years to their life or just improving their quality of life should regularly check their BP. HTN is significantly correlated with morbidity and mortality, even more so than smoking, lack of exercise, poor nutrition, and chronic insomnia. And, it is one of the few objective measures of health that can be done from the comfort of your own home. All one needs to do is get a BP cuff at a local drug store or just order one online. Most are cheap and usually accurate. However, check the reviews to make sure you are getting a good one.

The most effective way to lower BP is with healthy lifestyle, such as, good nutrition and consistent exercise, as opposed to just pharmaceuticals or for that matter nutraceuticals. In other words, a pill cannot substitute for all the advantageous effects healthy habits impart on your cardiovascular system. Both supplements and drugs are necessary for many with HTN; especially, if your BP cannot be lowered with lifestyle interventions alone. Nutraceuticals can often help people with high BP by either allowing them to forego Rx drug treatment, or allowing them to reduce medication dose.

Most of the nutraceuticals listed above can be taken while on BP medications, with the possible exception of potassium. However, to be very safe one should always talk to their doctor when taking supplements with Rx medications. And to be safer yet, it is best to take your supplements away, at least an hour, from your Rx medications.

The best way to lower BP depends on how high it is. It also depends on if you have primary HTN (which most people do) or secondary HTN. If you have primary HTN, and your home BP cuff consistently reads 140/90 mmHG & above it is imperative that you lower it. Furthermore, if your BP tends to be 150/90 mmHg or higher, Rx medications will probably be necessary until you can control it with healthy lifestyle changes and/or nutraceuticals.

References/Resources
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8. J Altern Complement Med. 2009 Aug; 15(8): 929–934.
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11. J Ethnopharmacol. 2002 Mar;79(3):353-7.
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14. J Ethnopharmacol. 2009 Feb 25;122(1):123-30.
15. J Med Food. 2013 Jun;16(6):558-63.

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