Hypertension (High Blood Pressure)
Where High Blood Pressure is not caused by other illness (renal disease, adrenal tumours etc), it is called Essential Hypertension. In fact Essential Hypertension represents the vast majority of cases (95%) and, although common, is multi-factorial in origin and often complicated to manage.
Changes in heart function, blood volume, viscosity (thickness) and vascular vessel tissue function can all affect blood pressure, yet so may psychological stress as it steps down via hormonal regulation to affect the physiology of the body. For this reason, an integrated approach to medical management is suggested to address Essential Hypertension according to Your individual requirements.
What is normal Blood Pressure?
Blood Pressure is measured in two values, its high point, known as Systolic, that occurs during a heart beat, and its low point, known as Diastolic, that occurs between beats. The diastolic BP is a measure of arterial resistance. A normal measure is generally considered to be 120/80mmHg.
When do you have High Blood Pressure?
Rising blood pressure occurs when these measures elevate, however the historic aim of blood pressure management has attempted to keep blood pressure below 140/85.
When may a Doctor medicate?
When you receive your first medication will now depend upon your doctor’s interpretation on when to intervene, with some guidelines suggesting treatment should begin as low as 130mmHg (in some circles now called Pre-Hypertension). Unfortunately, this new category has encouraged earlier prescription practices particularly in the United States, when rather it should be seen as a sensible warning sign to encourage a healthier lifestyle.
But before you worry about it, make sure it’s real!
It is important to properly evaluate if a high BP reading is actually true. Blood pressure fluctuates throughout the day, so a high point up to 15mmHg beyond normal can be reached due to biological rhythms (unfortunately this takes you already into Pre-Hypertension range). Furthermore, ‘White Collar Syndrome’ (fear of your doctor) may also influence your reading elevating blood pressure by 10mmHg or more (add the two together and you suddenly have High Blood Pressure; wrong time and wrong Doctor!).
Therefore, it is recommended that after your first diagnosis of High Blood Pressure, this should be repeated at other times in the day and perhaps at other locations (eg. pharmacies) before medication is initiated. If there is any doubt, the gold standard teat is a 24 hour BP monitor. There are times, however, when medication should be commenced immediately such as with symptomatic high BP (headaches) or if BP is too high, for example 200/100.
Lifestyle Modification; the place to begin
If you are diagnosed with high Blood Pressure, the first place to start is an evaluation of your lifestyle. Your Doctor is likely to review your Cardiac Risk and this is therefore a time in which you should follow guidelines for the management of Cardiovascular Disease. You should also rule out Insulin Resistance and Diabetes that are often associated through the common syndrome classification known as Metabolic Syndrome or Syndrome X.
Additionally you should assess whether or not psychological issues such as Stress, Life Balance or Emotional and Relationship crises may be driving your High Blood Pressure through the physiological stress response. This is particularly pertinent where there is no indication of Cardiac Disease or Insulin Resistance/Diabetes.
Which Healthy Eating Plan should I choose?
This depends upon your associated risk factors and Medical Conditions.
First and foremost, do you need to address Insulin Resistance or Diabetes? If you answer yes to either of these choose an Insulin Resistance or Diabetes Healthy Eating Plan as appropriate.
Do you have Cardiac concerns? Consider the Superfoods that apply in the Cardiovascular Disease section. A quick summary would include plenty of fish, fruit and vegetables, legumes, nuts and seeds.
A second option is to choose a Vegetarian Eating Plan as advocated in the Ornish approach.
If you have High Blood Pressure and are otherwise well, decide whether or not you are currently stressed or anxious. In this case consider a Low Stimulant Healthy Eating Plan in particular, otherwise an Optimal Healthy Eating Plan will suffice.
Don’t be too concerned here by the variety of options. All of these approaches are generally healthy compared to most current diets. Commit to what appears most appropriate and trial it over 3 months.
The key, however, is to reduce the obvious eating mistakes that lead to high blood pressure; excesses in any of the macronutrients (animal proteins, fats or carbohydrates) and an excess of processed foods (high in phosphates and salts).
Should I Lose Weight?
As obesity is a risk factor to high blood pressure , losing weight is important. First, try one of the Eating Plans as suggested by your Medical Condition. Alternatively, find a formularised weight loss programme (diet/ exercise) you are comfortable with, preferably supported by peers.
If neither are effective, consider discussing weight loss with a Doctor who may examine some of the hidden causes of unsuccessful weight loss that may include Thyroid Disease, Adrenal Exhaustion, Hormone Imbalances (Oestrogen Dominance), undiagnosed Diabetes or Insulin Resistance and so forth, with associated nutrient insufficiencies that lead to resistance against weight loss.
Also consider whether Emotional or Compulsive Eating are preventing your compliance with weight loss programmes. These may also be linked to Neurotransmitter imbalances that will need to be corrected if you are to be successful.
What about Fats in particular?
If you follow any of the Eating Plans you will minimise your intake of unhealthy fats, either through limiting saturated fat or trans-fats intake that are produced from high heat cooking. The more fresh or lightly cooked foods (salads, soups, steamed, stir fry, grilled), the better.
As for butter versus margarine, limiting your use of foods that require either is the best place to begin, for most people will also add a sugar laden spread to whatever they have ‘buttered’.
As for dairy, the volume argument holds true here, too. If you are only consuming one serve of dairy in a day do not be overly concerned to go no or low fat as there are valuable fat soluble vitamins in dairy. Howeve,r if you are consuming more than this then consider low fat varieties on most occasions (information regarding the Dairy Dilemma is available at the Osteoporosis Healthy Eating Plan page).
What about Salt?
About 30% of people with Essential Hypertension will be salt responders and should limit their salt intake to below 3 mg per day. If you do not eat processed foods, this will mean a small pinch at every meal. If you do eat processed meals...we advise you should reduce your intake as it is hard to keep counting salt measures and difficult to stay below 3 mg. For the other 70% of people with high blood pressure salt will not be an issue, yet the same rules should generally apply.
What effect will Food Intolerances have?
For some people Food Intolerances can have a short term effect on Blood Pressure due to stimulating a physiological stress response. Therefore identifying foods you are intolerant to can be helpful in assessing whether they influence your blood pressure.
What other Nutrients/Herbs might a Practitioner recommend?
The following nutrients are recommended particular with regards to high blood pressure. Again, where high blood pressure exists with other Medical Conditions such as Diabetes or Cardiovascular Disease, you may need to focus on these issues first or simultaneously. Always ensure, by discussing with your practitioner, whether there are any drug-nutrient-herb reactions you need to be aware of.
Recent evidence suggests that Bonito Peptides, an extracted fish protein, may be an effective anti-hypertensive.
CoQ10 may assist with blood pressure through modifying heart muscle contractility and improving overall cardiac function.
Fish Oils (EPA/DHA) can be helpful in reducing high blood pressure due to wide spread effects on blood vessel membrane qualities, lipid oxidation, blood viscosity and biochemistry etc.
The amino acid, Arginine, may be helpful where high blood pressure is linked to abnormal and excessive smooth muscle contraction in blood vessels. Caution with cocurrent herpes infections.
Magnesium is also helpful in inducing smooth muscle relaxation, particularly when supported by Taurine and the B Group Vitamins
Celery is, perhaps, the most commonly used anti-hypertensive herb in its role as a diuretic. Other herbs used for this purpose include Dandelion and Golden rod, yet evidence of effectiveness is limited.
When is Exercise a risk?
As with almost all Medical Conditions, exercise is important for blood pressure management. Aim for at least 30 minutes of exercise per day.
However, you should be cleared by a Doctor before beginning any intensive exercise programme.
Smoking? The answer's Obvious
This is probably the most significant change you can make in your life if you are a smoker. If you cannot quit without assistance, this being the majority of smokers, it may be sensible to join a multidisciplinary programme. Peer support is often essential to the success of any quit smoking plan.
Remember, although pharmaceutical approaches that replace nicotine via chewing gum, patch or otherwise are often helpful, eventually they must be weaned otherwise you may simply be trading the risk of lung cancer for other diseases.
Stress, Life Balance, Emotional Intelligence, Spirituality
As Depression is now indicated as a potential risk factor for Cardiac Disease, anything that deals with your mental health may be an advantage, as will specific treatments focused on Depression.
Such interventions may include:
Relaxation and Meditation independent or as part of a Yoga programme
Other Effects Based Stress Managements techniques
Cause Based Stress Management Techniques
Achieving Work Life Balance
Learning to effectively manage Emotions
Prioritising Family and other Relationships (including healing old wounds)
Becoming connected with your community, environment and, if you are spiritual, the concept of God/Universe that matters to you.
Should you learn a Relaxation Technique?
When your high blood pressure is linked to stress, Relaxation techniques can be very effective, along with Meditation and, if available, Biofeedback.
Mind-body exercises that include relaxation and breathing techniques as a component of the class such as Yoga and Tai Chi are particularly helpful.
Managing high blood pressure is often complicated due the numerous factors that may contribute to it. However, instituting positive lifestyle change is always a good place to start, after which a carefully selected programme of nutrients/herbs may potentially minimise your need for prescription medication. Always remember, your Doctor needs to know what programme you are following in order to review the risk of drug-nutrient-herb interactions.