15 MAJOR Risk Factors of Hypertension and 12 Tips To Avoid It
Heart disease, hypertension and cardiovascular diseases are the leading causes of death in the United States, claiming more than 1 million lives each year.
It is no wonder that we have been hearing more and more about high blood pressure, or hypertension, and the effects on the body over the last few years. All of us in the health field and most laymen now realize that high blood pressure is almost always a precursor to stroke and heart attack. In fact, hypertension (HTN) is the number one reason adults visit their physicians and treatment of hypertension (HTN) is the single highest use of prescription drugs. Patient awareness of HTN is on the rise with 85% of the adult population in the US having their blood pressure taken on a regular basis. In this report I am going to hopefully unlock the mystery of hypertension and explain in detail what HTN is and what to do about it. I am sure that for many of you this information could save your own life or the life of someone you love.
Blood pressure is the pressure your arteries place on the blood flowing through your venous system. Your heart has to overcome this resistance as it pushes blood through your arteries. It can be related to a water hose. If the hose is larger than the amount of water flowing through it, there is no problem and no backup. But if the hose is small, the water cannot move through as freely and there is a back pressure of water going in a reverse direction to the faucet. In the case of your heart, when the vascular resistance increases, the heart must beat harder to overcome this resistance, and there can be a backup of blood, which is the beginning of hypertension. Over the years, there has been much argument as to exactly how high does blood pressure have to be to be considered high. After years of research directed to find at what pressure the body begins to exhibit adverse effects associated with HTN, the 1988 Report of the Joint National Committee on Detection, Evaluation and Treatment of High Blood Pressure reported that blood pressure above or equal to 140/90 would be considered high .Now this does not mean that if your BP is 139/89 you are in the clear. Arbitrary cut offs are necessary because scientists generally have an internal drive to classify things.
So, what does 140/90 mean? What is it actually measuring? Let s start with examining the beating cycle of the heart in brief. The heart has two basic phases, systole and diastole. Diastole is when the heart relaxes and fills with blood. This corresponds to the number on the bottom, or in this case, 90. Systole is when the heart squeezes and pumps the blood into the arteries. This corresponds to the number on the top, or 140. So, when the blood is being forced through the venous system, the measurement is 140. Between beats the pressure is 90. The numbers refer to how much pressure is required to move water up a standardized glass tube, which is why you may see BP measures as 140/90 mm H2O.
There are several factors, which are associated with HTN and the common sequel, or after effects of the disorder. These are listed in Table 1. Standard medical texts divide hypertension into two major categories: 1) Primary of Essential hypertension and 2) Secondary Hypertension. Up to 94% of all hypertension is considered essential, or have an unknown etiology or cause. Most likely, essential hypertension arises from a so-called genetic predisposition combined with environmental factors such as stress, diet, sedentary lifestyle and pollution. Secondary hypertension is high blood pressure arising as a symptom from a distinct disease process somewhere else in the body. The major causes of secondary hypertension are renal (kidney) disease, endocrine (steroid hormones produced by the body), and oral contraceptives.One of the most important aspects of essential hypertension that medical texts do not teach is that HTN is one of many diseases that is associated with the western diet. People who live in the remote areas of Asia, the Pacific Islands, Central and South America as well as Africa do not suffer from HTN. Nor do they experience a rise in blood pressure that is associated with advancing age in the US.The evidence that diet is actually a more important factor than genetics is demonstrated by the fact that racially identical members of these societies who seem exempt from HTN have a significant increase in the incidence of HTN when they move to a western culture and adopt the western diet. It is astounding to realize that in the US approximately 60 million people suffer from HTN. That is 40% of the adult population!!!
The good news is that most of these risk factors can be mitigated with simple changes in diet and lifestyle. It has been my experience that the most common denominator of all hypertensive patients I come into contact with is their being overweight. This goes back to the western diet, high in rich foods and low in fresh fruits and vegetables and our sedate lifestyle. This is not to say that all people with high blood pressure are overweight, but in my experience the majority are. One group of scientists has been studying the effects of hypertension at Harvard for over 30 years. The product, called the Framingham Study, clearly demonstrated a direct link between obesity and blood pressure. In subsequent studies of the children of those in the original research, the Framingham offspring study, up to 78% of HTN in men and 64% of HTN in women were directly attributable to obesity. Studies indicate that the distribution of body fat is also an important variable because blood pressure and tryglycerides (blood fats) as well as plasma glucose (blood sugar) levels are highest in patients with trunk obesity, or obesity with the weight carried around the chest and abdomen. Adults who were obese as children are at particular risk to the ravages of hypertension. This is particularly concerning because of the dramatic rise in childhood obesity. If you ever wonder if American children eat too much, just visit your local mall and look around. It is intuitively obvious that we are setting our children up for a lifetime of health problems. In school, one of my professors expressed to our class that if his hypertensive patients would maintain just 120% of their ideal body weight, he believed that 70% could come off of their hypertensive medications. Using the 1983 Metropolitan Height and Weight table, this means that a medium framed 5 10 male whose ideal body weight is 151-163 lbs could weigh from 181-196 lbs. and still have only minimal increases in blood pressure due to his obesity.
The average 5' 6" woman, whose ideal body weight is 130-144 lbs. could weigh from 156-173 lbs. The problem is that in the US, people do not stop at 120% of their ideal body weight. Many keep going and going and going. So the first line of defense in one s personal war against hypertension is weight reduction and institution of a fitness program specifically designed to meet the individual s needs. This is one of the reasons I developed my EAT, DRINK AND BE HEALTHY Exercise Workout. I cannot stress to you enough the importance of exercise. In our sedentary western culture, it is no longer an option. The videos we developed are designed to give you personal instruction in the privacy of your own home. My second undergraduate degree from Florida State University is in Exercise Physiology and Psychology. I have over 25 years experience in this field and was a competitive athlete throughout my undergraduate and graduate years. In these tapes, I will teach you how to have maximum results in the shortest period of time possible and how to balance your program with eating and proper lifestyle. For information on this tape series, call my office at (800) 726-1834. Many of you just do not know where to begin your personal weight reduction and weight maintenance lifestyle. Remember, DIETS DON'T WORK, but EAT, DRINK AND BE HEALTHY is a lifestyle you can live with!
Obesity is but one of the many dietary and environmental factors leading to hypertension. Other factors that correlate with high blood pressure include the ratio of sodium to potassium in the diet, percentage of polyunsaturated fats as well as total fats and cholesterol, how much fiber is on one s diet and the amount of simple carbohydrates and sugars.
The role of sodium in the pathogenesis of high blood pressure has been studied extensively and the results are decisive. There is a pressure inside the cell, which maintains the liquid inside and outside the cell in a state of equilibrium. This pressure is maintained by sodium in the cell, and potassium outside of the cell. (The actual mechanism is simplified here. A complete discussion of cellular physiology will be available in a later report.) The excessive consumption of sodium in our western diet produces an influx of water into the cells of the body causing swelling. This in turn produces an increased pressure around the walls of the arteries.
RISK FACTORS FOR HYPERTENSION
1. Male sex (until women reach menopause)
2. Black race
6. Diabetes Mellitus
7. Family history of HTM
8. Physical inactivity*
10. Type A personality*
11. Caffeine abuse*
13. Hyper lipidemia*++
14. Hyper triglyceridemia*++
15. Alcohol consumption*
*These risk factors can actually be reduced or eliminated completely with little sequel. ++These items collectively are referred to as Hyper lipo proteinemia, or elevation of bad lipids and cholesterol with decreases in good lipids. These are also amenable to change through modification of lifestyle the blood vessels, leading to increased blood pressure in individuals who are susceptible. Potassium works outside the cell to offset the effects of the sodium on the inside. The fact that we do not consume sufficient potassium is compounded by the fact that the body does not conserve potassium as it does sodium. Though the body excretes sodium, it maintains more sodium that it does potassium, perhaps because of the levels of sodium we consume. So, if we just cut down on our sodium will that help reduce our blood pressure? No, unfortunately it is not that easy. You see, it is not the absolute sodium content that is the problem, but it is the ratio of sodium to potassium. When sodium is far in excess of potassium, susceptible individuals may become hypertensive.Therefore, sodium restriction alone may not reduce blood pressure, but it should be accompanied with potassium supplementation. Three separate studies confirm the benefits of increasing potassium in the diet. In one study, 10,000 adults had their dietary intake of 17 nutrients monitored. The results demonstrate an inverse relationship between the amount of potassium consumed and the mean systolic blood pressure. The American Journal of Clinical Nutrition reported a comparison of 98 vegetarians and a matched group of non-vegetarians. The average blood pressure for the vegetarians was 126/77 and 147/88 for the non-vegetarians. Both groups had similar sodium intake and excretion, however, the vegetarian group had significantly higher levels of potassium. The famous medical journal, Lancet, reported in 1982 that during a trial with potassium supplementation, subjects who received potassium supplementation had, on the average, significantly lower blood pressures.
If you or someone you know is on anti-hypertensive medications, there is one thing of which you and your doctor should be aware. Many of the diuretics used to combat high blood pressure can rapidly deplete the body s stores of potassium. With the information we have seen above, it is not hard to extrapolate the fact that the anti-hypertensive medications can actually exacerbate hypertension in the long term. If this applies to you,
DO NOT STOP TAKING YOUR MEDICINE WITHOUT FIRST DISCUSSING IT WITH YOUR PHYSICIAN!!! Bring this article into your physician s office and discuss it with him or her. You may actually enhance your physician s knowledge and understanding and get better health care. A word of personal advice: If your physician does not want to discuss your current treatment, and treatment options, I would shop around and find a physician who is more open minded and oriented to natural treatments.
The US recommended daily allowance of fiber is 30 grams a day. If you think you get even half of that, calculate how much you actually consume and you will most likely be shocked. The western diet is woefully deficient in fiber. Yet experimental studies show that people who increase their dietary fiber show a decrease in blood pressure. One study took 300 health food store customers, people who are already at least health conscious by virtue of where they were found, and increased their dietary fiber 100 grams per week. The results showed a decrease in blood pressure of 4mm Hg systolic and 3mm diastolic. Individuals suffering from diabetes often have hypertension (classified as secondary hypertension). In a research program, 12 diabetic men were placed on a special diet for two weeks. The diet contained 3 times their normal dietary intake of fiber and 50% increase in potassium. In just two weeks, subjects average blood pressure dropped 10%. Raw fruits and especially vegetables contain an abundance of fiber, but also have numerous other benefits. Researchers took 32 subjects and changed their diet so that 62% of their caloric intake came from raw foods. In 6.7 months, the average diastolic blood pressure of the group dropped 17.8mm Hg. The participants also dropped an average of 8.5 lbs. The weight loss could conceivably be responsible for the drop in blood pressure. Regardless, both, are a significant drop. It is also noteworthy that 80% of those who smoked or consumed alcohol spontaneously ceased that activity.
ESSENTIAL FATTY ACIDS
Saturated fat---unsaturated fat---polyunsaturated fat---what does all this stuff mean? Let s reduce the complexity of this topic. Fat is a long chain of molecules, which can be thought of as like a train with lots of cars. If all the cars are full, then it is saturated. If one of the cars is empty, then it is unsaturated. If two or more of the cars are empty, then it is polyunsaturated. Pretty easy isn't it? Well, now that we know the difference, what does it mean to me? When the body breaks down fat into its smaller parts, the saturated fat makes more LDL, or Low Density Lipoprotein. These are the fats that clog arteries. Saturated fats are found primarily in red meat, dairy products and some vegetable oils such as cottonseed and coconut seed. Polyunsaturated fats make more HDL, or High Density Lipoprotein. These are what are often referred to as good cholesterol. These bring the fats that can clog arteries back to the liver to be processed for other uses. Polyunsaturated fats are most of the vegetable oils and fish oils. These are often referred to as Omega 3 (from fish, see part 2 of this newsletter and read about the best cod liver oil I have ever found) and Omega 6 (from sources such as evening primrose or flaxseed oil) fatty acids. Polyunsaturated fats may actually lower blood pressure, for one reason, because they are metabolized into prostaglandin. One of the actions of prostaglandin is to dilate the blood vessels, which will reduce pressure. Prostaglandin also enhances sodium and water excretion. However, this effect is inhibited when aspirin, or other non-steroid anti-inflammatory medications are taken, because these medicines block the enzymatic activity which leads to the production of prostaglandin. Interestingly the standard medical procedure is to promote the use of aspirin to reduce the risk of heart disease.
Finland has done considerable research on the beneficial effects of increasing polyunsaturated fat while decreasing saturated fats. They have consistently found that the higher the ratio of saturated fats to polyunsaturated, the higher the individual s blood pressure, and conversely. One study which fed subjects a diet low in fats, but higher in polyunsaturated saw a blood pressure drop from an average of 139/89 to 129/81. This is significant for two reasons. First, it dropped the relative category of the patient from hypertensive to normotensive. Second, it only took 6 weeks. Other studies examined previously demonstrated similar benefits in such a short time frame.
NUTRIENTS, SUPPLEMENTS AND THERAPEUTIC CONSIDERATIONS
Studies have shown that hypertensive patients have lower levels of intake of vitamin A, C and potassium. Supplementation with vitamin B complex, including 50 mg thiamine, 40 mg riboflavin, 200 mg pantothenate, cod liver oil, 200 mg nicotinic acid and 50 mg lipoic acid have shown to lower blood levels of saturated fatty acids, while increasing polyunsaturated fatty acids in just 10 days.
Several studies indicate that alterations in calcium metabolism have been implicated as a primary factor in the development of hypertension. Some have plainly demonstrated an inverse relationship between dietary calcium and blood calcium levels and blood pressure. It also seems that hypertensive persons actually secrete more calcium in their urine, thus increasing their dietary need.
Magnesium is a very potent vasodilator, and hypertension is a symptom of its deficiency. Magnesium helps to regulate contractility of smooth muscle, like those surrounding arteries, at the cellular level. Studies have found consistently low levels of Mg in hypertensive patients,43 and the greater the level of hypo magnesemia the higher doses of antihypertensive medications patients tend to be taking.The British Medical Journal reported a study which gave 20 hypertensive patients magnesium supplementation for 6 months. The average blood pressure of the group dropped 12/8 mm Hg.
Coenzyme Q10, also known as ubiquinol, is a little known nutrient. It is an essential component of the mitochondria, or the organelle, which produces cellular energy. CoQ10 can be synthesized in the body, but deficiencies have been reported. Cardiovascular disorders, such as hypertension, are body states which require increased tissue levels of CoQ10, and heart tissue biopsies of patients with various heart diseases at death demonstrated deficiency in up to 75% of cases.In patients with documented hypertension, administration of 100 mg of CoQ10 daily for 8 weeks was found to significantly reduce blood pressure, with 54% of the participants achieving greater than a 10% drop in their blood pressure
THINGS TO AVOID
1. No caffeine.
2. No margarine or hydrogenated oils. Read product labels carefully. Hydrogenated oils are hidden in many products people use every day.
3. Keep your fat intake to 10-15% of daily calorie intake. You can measure this by taking your total calorie intake, say 1800 calories, and divide by 10, which gives 180. Each gram of fat contains 9 calories, which means that on the 1800-calorie diet, a person could consume 180 calories, or 20 grams of fat.
4. No pork or shellfish.
5. No luncheon meat. These typically contain sodium nitrate, a known cause of colon cancer.
6. No dairy products, except skim or fat free products.
7. No alcohol. Alcohol decreases the body s ability to burn fat by almost 35%.
8. Cut bread consumption to one slice per day. (use only whole grain bread)
9. Use olive, grape seed, Coconut, or macadamia nut for your oil needs. However, use these products sparingly because they are 100% fat.
10. No aspartame, ( NutraSweet ),or Sucralose (Splenda) which interferes with the blood sugar regulation in your body. Researchers also theorize that use of aspartame can cause people to actually gain weight. Plus, aspartame is extremely toxic. Watch for an upcoming issue of the EAT, DRINK AND BE HEALTHY newsletter on NutraSweet!
11. No mayonnaise, which is usually 100% fat.
12. No mono-sodium-glutamate, or MSG. Besides being loaded with excess sodium, MSG damages brain cells along with its cousin NutraSweet (both are called excito toxins in neurochemistry).
PLEASE BE ADVISED:
Not all supplements are the same. Just because a vitamin says it has a nutrient such as calcium in the product, does not mean that the calcium is biochemically available for your body to utilize.
For example, we all need oxygen to breathe. Yet water has oxygen and we cannot breathe it. The point is that the oxygen in water is not biochemically available. Some vitamins are even synthetically produced in a laboratory with no natural ingredients. We have several manufacturers of vitamins, which offer high bio availability and therapeutic effect. Please call or write our office for additional information, 1-800-726-1834 or visit our web site, www.healthmasters.com
Let me tell you the story of several of my patients which will hopefully motivate and encourage you. Matt came to see me several years ago. He was 33 years old, 10 pounds overweight with a blood pressure of 180/120. Matt s mother had informed him that his father had been receiving treatment for hypertension since he was 40 years old, which was 15 years earlier. She then told Matt that his father had been impotent for the past 15 years as well due to the blood pressure medication. Obviously, Matt was extremely motivated. Within one month following my EAT, DRINK AND BE HEALTHY program and suggested supplements, his blood pressure dropped to 120/70 with NO DRUGS!! Sheldon came into my office with a blood cholesterol level of 300. Within 30 days, his cholesterol had dropped to 177!!!
Let me ask you a question: If high blood pressure can be lowered by changing your diet, doesn't it make sense that if you had been eating correctly to begin with, you never would have developed HTN?
Dr Ted Broer