Hypertension

30 Jul

Donald Drake, an avid exerciser with weight loss resistance, came to me with hopes of finding some new strategies for fat reduction.  During the intake process we discovered that his blood pressure was 160 / 100 (one sixty over one-hundred).

The first number represents the systolic blood pressure, the assessed pressure placed upon the walls of the arteries when the heart contracts.  The second number represents the diastolic pressure, the pressure between “beats.”

120/80 is considered ideal, but there’s lots of room for what might be referred to as “normal.”

When Do Things Get Risky?

When the systolic number exceeds 150 and the diastolic is higher than 90 we’re looking at risk.  Donald’s intake reading was a red flag.

Hypertension is a primary risk factor of heart attack
Hypertension is a primary risk factor of heart attack, and with the right approach, is often completely reversible

High blood pressure, also referred to as hypertension, exists in epidemic proportions in adult populations in 21st century America.  Near 35% of our adult population has been identified as being hypertensive, and it’s suspected that 30% of those who have blood pressure don’t know it yet.

The mindset among many at the point of diagnosis is “there’s a pill for that” . . . . and there very well may be, but in my experience, few people on blood pressure meds have a true understanding of the condition they’re being medicated for.

Donald Drake was offended when I told him I wasn’t going to take him through any exercise protocol until his blood pressure was at a safer level, or, until we had medical clearance from his physician.  If we explored the reason for his upset, it would boil down to failure to understand the indications of a common but life-threatening condition.  It’s that same that misunderstanding that prevents many from finding the steps that might “undo” the condition too-often-thought-of as a treatable but unfixable disease.

In this article, I’ll share a few insights and perspectives allowing us to take better aim at reversal of high blood pressure conditions.

Donald Drake went to his primary care physician shortly after our intake session.  The doctor diagnosed him with primary hypertension, wrote him a prescription for Lisinopril, and handed him a “low-salt guidelines” diet sheet.

The doctor’s advice was “eat better and start exercising.”  Donald again became upset (not good for his blood pressure).

“Doc, I already workout and I eat clean.  You’re not telling me anything I don’t know.”

Although I understand why DD got offended, his doctor wasn’t “wrong.”  He was operating under today’s conventional medical paradigm, offering commonly dispersed advice, and he was clearly well-intentioned.

It isn’t the doctor who’s at fault, but rather the paradigm itself.

The medical field doles out “eat better and exercise” advice based on a long history of evidence documenting an active lifestyle as a predecessor of long term health.

In today’s information-flooded world, the simplicity and generality of “eat right and exercise” advice makes it impotent.

Sure, we all know health improvement can come from shifts in diet and movement, but there are far too many variables for ‘eat right and exercise” to provide any real direction.

Donald, thankfully, learned the underpinnings of the Six Point Secret, went through the 10-week A.L.I.V.E. protocol, and discovered why his previous attempts at exercise and nutrition were leaving him in a compromised state of health.  Per his most recent check-in, he’s going for regular checkups, his blood pressure rarely exceeds 120/80, and he’s medication free.

If more people were able to cut through the confusion and find sound strategies for betterment, we’d have a population with a far greater sense of control and a medical field more able to empower patients to restore health.

Let’s see if in a brief article (OK, maybe not so brief but reasonable in length) we can get some real direction.  Donald’s doc handed him a low-salt plan, so let’s start there.  Let’s discuss the efficacy of “reduce sodium” as a prescriptive measure in treating hypertension.

SALT

Sodium and salt are synonymous.  Sort of.  OK, not really.  OK, not at all.

Let’s take a closer look.

If you poke around through conventional information channels, it’s easy to point a finger at salt and accuse it of being the hypertensive villain, and if you want some salt to point a finger at, you don’t have to look very hard or very far.  Salt finds its way onto every restaurant table in America and into virtually every snack food from cookies to chips.

Sodium has many roles in human metabolism and due to its propensity for water, high sodium intake may increase water both intracellularly and in the interstitial space between cells.  The increased fluid retention can lead to the heart working harder to move more fluid through a reduced arterial space.  The likely outcome of more water inside and around the arteries would be greater pressure inside.

If we had only that information to go on, we could draw the following conclusion

EXCESS SALT = EXCESS WATER

EXCESS WATER = EXTRA PRESSURE

so . . . .

EXCESS SALT = HIGH BLOOD PRESSURE

This conclusion seems to make sense, and years ago, scientific evidence seemed to support the idea that an over-consumption of sodium was a primary contributor to problematic hypertension.  Interestingly, much of that referenced evidence stems from Walter Kempner’s 1930’s work on treating obesity and hypertension with a diet that became known as The Duke University Rice Diet.

Over the decades that followed, medical institutions recommended reductions in sodium, down to as low as 1500 mg per day, finding that these reductions often correlated with drops of 5 mm Hg in systolic blood pressure and 1-3 mm Hg in diastolic pressure.  Not a “fix” but perhaps a piece of the puzzle.

Research published in the 1970’s concluded that Kempner’s low-sodium low-animal-based-food diet resulted in significant reductions in blood pressure.

In reviewing those studies, it became clear that many variables resulted in multiple outcomes, so it’s a leap to extrapolate that blood pressure reductions were due to low sodium.  Perhaps the noted pressure reductions were simply due to reduced body mass.  When a body drops 50 or 60 pounds, there’s clearly less of a burden on the heart.

Thankfully research continued, and wow did things get confusing.  In their attachment to what came to be known as the salt hypothesis (high sodium intake = high blood pressure), researchers conducted the INTERSALT study reaching into 52 nations to draw conclusions as to the contribution of salt intake to hypertension incidence.

The initial conclusions verified the salt hypothesis, and researchers nodded their heads agreeing salt is in fact the culprit.  It didn’t stop there.  Through peer review, this study was scrutinized, the researchers were criticized, and suffice it to say, the back and forth debate opened up a salty can of worms that drew more researchers into the pool.

A growing body of evidence soon punched so many holes in the salt hypothesis, in the large scheme of evidence, it had little to stand on.

Some studies actually showed a reduction in blood pressure among those who consumed more than modest amounts of sodium, others showed reductions in blood pressure when sodium was increased but balanced with potassium and magnesium, and still others demonstrated how populations with higher sodium intake had lower incidence of hypertension.

The important distinction that needed to be made clear was the now obvious distinction that was being ignored.  Someone had to separate common table salt from natural sources of sodium.

NATURAL SALT ISN’T USUALLY ON THE TABLE

Table salt, sodium chloride, the salt we sprinkle on french fries and into Blood Mary cocktails is synthetically derived, processed and bleached until it’s an unnatural compound void of any other valuable minerals in any significant levels, at least related to health.  To equate table salt with “the salt of the earth” is to equate a synthetic unnatural compound with a natural source of electrolytes and vital minerals.

Cutting out table salt goes along with cutting out bleached and processed flours and sugars.  The synthesized foodstuffs are unnatural and may contribute, not only to water retention, but to inflammation, both culprits in blood pressure escalation.

Let’s be careful here.  Cutting out table salt doesn’t mean trading it for crackers and snack foods that come in boxes with labels that say “low sodium.”   When sodium is omitted from a tasty cracker or snack, consumers often compare the revised taste to cardboard or styrofoam, neither of those high on the “Great Taste List.”

When you remove a prime taste factor from a beloved food, sales of that food plummet.  In preservation of their revenues, food manufacturers have learned to replace the table salt with something else, and they often add compounds that are equally unnatural and potentially harmful (such as MSG and other chemical flavor enhancers).

With this new information, we can now conclude table salt may be problematic, but let’s be careful not to throw the sodium out with the table salt.

Real salt, as in natural unprocessed salt, has many health benefits.  It is charged with negative ions and unlike processed table salt, works to support fluid balance.

It’s also important to note that an absence of sodium or a sodium deficiency can lead to a myriad of health problems affecting everything from heart rhythm to adrenal function, so . . . treating hypertension by reducing table salt is only a tiny piece of a strategy that requires more of an overhaul, and it’s best accompanied by a number of other nutritional shifts which we’ll address shortly.

I suggest we get salt out of the line of fire, recognize that table salt and chemical additives are just not going to be healthy for anyone, and focus more on what we can change . . . holistically . . . . to restore blood pressure to safer levels.  This has to focus, not only on what we avoid, but more importantly, on what we opt to eat and what we opt to do!

INFLAMMATION

The forefront of science illuminates the links between inflammation and chronic disease, and hypertension is a chronic disease that has direct links to the inflammatory process.

A combination of poor dietary choices, toxic stress, emotional stress, and poor lifestyle choices lead to a maladaptive reprogramming of the immune system.  In its attempt to protect the body, the immune system has its innate intelligence corrupted and it begins to drive systemic inflammation.  When that inflammatory mechanism it turned toward the circulatory system, the arterial walls thicken.

As inflammatory cytokines, the cellular drivers in inflammation, swell the walls of the arterial system, the passageway for blood movement narrows increasing the pressure within the entire arterial network.  The heart has to move the same volume of blood through a smaller space (much like water being forced through a narrowing hose) and the entire system is forced to work harder.

Anything that drives systemic inflammation of the circulatory system increases risk of heart incident.

WHEN THE WALLS ARE ALTERED . . . 

Atherogenesis is the formation of fatty clusters (atheromas) that move through the circulatory system carried along by the blood. While they’re typically too small to form a blockage in the vessels of a healthy circulatory system, when the arterial walls swell, the narrowing of the space may lock an atheroma in place causing a sudden interruption of blood flow.

According to recent studies, 70% of heart attacks are preceded, not by blockages that can be identified by angiogram, but rather by sudden blockages caused by atheromas.

If we understand that the inflammatory process can create a hypertensive condition, the converse is also true.  A reversal of the inflammatory process opens up the arteries, reduces the risk of sudden blockage, and works to restore health.

Strategic exercise combined with supportive eating can work to reverse the inflammatory process and reduce blood pressure, often to safe levels within the ranges of what might be considered normal.

Let’s take a glimpse at some of the commonly prescribed meds and their mechanisms of action, and then I’ll direct you to some of those exercise and eating strategies I’ve referred to.

MEDICATION

Pharmaceutical products aimed at reducing blood pressure are often referred to as anti-hypertensives, but there are a number of classes of drugs, each with its own approach toward reducing dangerously elevated arterial pressure.

Three of the most commonly prescribed are diuretics, beta-blockers, and ACE inhibitors. I’ll briefly address each one.

Diuretics

Diuretics help the body excrete sodium and reduce water retention.  The supposed links between sodium and hypertension have led to long term use of this class of medication to manage a chronic condition.

Commonly prescribed diuretics include furosemide (Brand Name: Lasix) and chlorothiazide (Brand Name: Diuril).  These diuretics have many potential risks, many resulting from a loss of potassium, so they are often prescribed with potassium-sparing agents.

If water retention is a factor in an individual’s hypertensive state, diuretics can coax the body to excrete sodium and reduce water.  This is often accompanied by cramping and fatigue.  Prolonged use of diuretics has been linked with elevations in blood sugar.  Although these drugs may work to keep elevated blood pressure in check, they do nothing to cure or reverse the condition.

ACE inhibitors

Angiotensin is a naturally occurring chemical compound that constricts vessels including the smooth muscle that makes up the walls of blood vessels.  ACE is an acronym for Angiotensin-Converting Enzyme.  As the name suggests, ACE inhibitors reduce the angiotensin levels in the body resulting in a relaxing of smooth muscle in arteries.

Commonly prescribed ACE inhibitors include lisinopril (Brand Name: Zestril) and enalipril (Brand Name: Vasotec).

As with all drugs, there is the potential for side effects but the safety record of ACE inhibitors prescribed to the right population doesn’t merit concern.  Note, however, that ACE inhibitors, while they may control pressure, and prevent an impending incidence due to excessive pressure, do not “cure” the condition.

Beta blockers

Beta blocking agents interrupt the beta signal that prompts the heart to speed up.  They limit heart rate elevations and in that limit the heart-induced pressure within the arterial system.  They are prescribed for safety and to prevent an unnecessary cardiac incident, but they do nothing too remedy or “cure” the condition.

Commonly prescribed beta blockers include metoprolol (Brand Name: Lopressor) and propanolol (Brand Name: Inderal), and atenolol (Brand Name: Tenormin)

Side effects may include fatigue, slow heart beat, cold hands and feet, insomnia, and impotence.

While there are other categories of medications, you no doubt picked up a common theme.  None of the medications are curative.

That doesn’t mean the chronic hypertensive condition isn’t reversible.

Even though he used what might be considered extreme dietary measures, Walter Kempner, with his Rice Diet, was able to reduce pressure without pharmacology.  That shows it’s possible.  The trick lies in achieving that end without extremely restrictive dieting or any extreme measures . . . and in the great majority of cases I’ve seen, this is not only possible, it’s relatively simple!

REVISITING “REVERSAL”

If the condition is prompted by a chronic inflammatory reaction, implementing a strategy aimed at reversing inflammation will work to reverse the condition.

If the condition is amplified by poor dietary choices, then dietary corrections should further aid in restoration of health.

If circulation is optimized through a strategic exercise protocol, the circulatory system, in its harmonious interplay with the other systems of the body, can find restoration of optimal function.

Following you’ll find some of the exercise and dietary strategies that are integrated into the A.L.I.V.E. protocol to maximize the power of the Six Point Secret in reversing negative movement along the disease continuum including specific nutritional supplements that can aid in reversing high blood pressure.

STRATEGIC EXERCISE

While it’s said that exercise “works” to reduce blood pressure, “any old exercise” just won’t do the trick.

It is a strategic approach incorporating a multi-faceted stress and recovery cycle that can work to reverse the inflammatory state that prompts many if not most of the high blood pressure conditions that plague individuals from all walks of life.

Intense weight training may be risky for individuals with high blood pressure.

Random aerobic protocols do little to produce lasting change.  Sporadic or excessive heart rate elevations may lead to cardiac incident for those at risk (it’s important to state that anyone with any incidence of high blood pressure should see a physician, get medical clearance, and obtain a suitable exercise protocol from a competent exercise specialist).

Exercise will “work” as a vehicle for reducing inflammation and optimizing blood flow if it involves a safe progressive aerobic challenge, and if it works to develop “parasympathetic recovery.”

The nervous system works to “speed things up” when exercise or stress dictate a greater need for oxygen and available nutrients.  The stress conditions that lead to inflammatory disease are aggravated by chronic stimulation (anxiety, emotional stress).

A focus on “more, faster, more, faster” without a focus on recovery can only add to stress load.

The exercise protocol aimed at reversing inflammation should involve modest stimulation using resistance and rhythmic movement.

The Functional 6 routine (a component of the A.L.I.V.E. protocol) followed by a brief aerobic session with variations in intensity allows for a progressive and appropriate challenge, but also allows for a “teaching” of the parasympathetic nervous system, the cooling down mechanism, to restore a physical “calm.”

A greater willingness of the body to recover quickly with that element of “calm” has proven to correlate with reduction in inflammation and alleviation of the symptoms and conditions that are driven by inflammatory stress.

Blood carries oxygen through the circulatory vessels, so a greater utilization of oxygen combined with a reduction of intracellular toxins also serves to optimize blood flow and circulatory function.

Rather than relying on strenuous resistance exercise where the body is fixed in place, the individual seeking restoration of health will benefit from exercises that move the body through space, challenging resistance, not in a linear path, but through all three planes of motion.

All of these strategies are built into the A.L.I.V.E. protocol.

SUPPORTIVE EATING STRATEGIES

When it comes to the nutrition piece, let’s start out with the macro.  Rather than starting with what to avoid, it’s best to begin with a sense of what you should eat.

You’ll want to make the most natural food choices possible.  I wish I could tell you that part is easy . . . but in today’s world, it is not.  Still, nobody said ease was a guarantee.  If you’re working to reverse a chronic condition, the additional effort and expense will pay off.

For proteins, lean cuts of grass fed meat, USDA certified organic free-range chicken and poultry, cage-free eggs, and wild caught cold-water fish are going to provide quality amino acids without the destructive drugs, toxins, and alien compounds that invade our bodies through commercially raised livestock.   Dairy products should also be organic obtained from grass-fed cows raised without hormones or antibiotics.

I know for many there will be an immediate knee jerk reaction . . . “animal meats?!?!  They’re high in cholesterol and fat?!!?”

I’ll address cholesterol in another article, but for now, there’s more to understand than the common beliefs regarding cholesterol and heart disease.  As far as fat, the correlation between dietary fat and hypertension is similar to the correlation between sodium and hypertension.  There’s far more to the picture than a simple hypothesis.

The fats we obtain from grass fat naturally raised sources are very very different than the fats we obtain from animals raised in confinement raised on pellets and drugs.  The fats we want to avoid, especially in cases of high blood pressure, are synthesized fats (hydrogenated and trans-fats) and those that are prone to oxidation.  Heating polyunsaturated oils, previously considered “good fats,” such as corn and safflower oils, creates a molecular alteration which may turn cholesterol in the bloodstream into the oxidized sticky stuff that does become plaque and clog arteries.

Now . . . for those who opt not to consume animal products, you’ll be thrilled to know, raw nuts (they have to be raw as cooked nuts contain hydrogenated oils . . . a definite no-no) have been shown to have blood-pressure-lowering effects when consumed as a part of an overall supportive meal plan.  Consider raw almonds, pecans, walnuts, hazelnuts, Brazil nuts, and even raw pistachios.  Add in seeds such as pumpkin seeds and sunflower seeds, and chia seeds and you’re eating your way toward healthier blood pressure.

Other sources of protein that can fit into any lifestyle include beans, chickpeas, edamame, hemp, green peas, quinoa, and leafy greens.

Beyond the proteins, you’ll want to consume what we call “protein sparing nutrients,” those nutrients that will provide you metabolic fuel.  As carbohydrate choices include naturally grown organic fruits and vegetables in a variety of colors.

Some additional foods, beyond the generality of “fruits and vegetables” that have been isolated in research as having benefit in reducing blood pressure are dark colored berries (blueberries, cranberries, elderberries, blackberries), dark cherries, and sources of healthy oils (avocado, coconut, flaxseed).

Oh, and before we conclude this now-somewhat-lengthy piece on hypertension, there was that issue with salt.  Let’s get that wrapped up neatly.

Consider using Celtic sea salt and other natural salts to flavor foods, not as a magic remedy, but as an element of supportive eating.

Now we have one thing left to do.  Address what we want to avoid.

We’ve already established we want to stay away from synthesized salts and fats.  We want to minimize or eliminate the intake of simple sugar.  And . . . if we really want to optimize the diet to reduce chronic blood pressure elevation, we have to recognize that wheat is not the same wheat your grandparents ate.  Stay away from wheat products and snack foods in general (even gluten free) and base your nutrition on the basics I’ve outlined and you can’t go wrong.

AND THEN . . . THE “EXTRA”

I’ll finish off by spotlighting a few supplements that have a solid body of research evidencing their value in reducing chronic blood pressure elevation, but rather than expanding on each one, I’ll provide a simple short list and leave it to you to explore their value.

Know that supplements are “the extra,” and the keys to taking control of a chronic condition and moving toward its full reversal are going to lie within the lifestyle strategies we’ve already discussed.  With that said, here’s the short list:

SUPPLEMENTS THAT CAN PLAY A ROLE

This is by no means a complete list, but the supplements listed have been well researched and evidence indicating their value in supporting restoration of healthy blood pressure is significant.

  • CoQ10
  • Hawthorne Berry (English Hawthorne)
  • Omega 3’s
  • Acetyl L-Carnitine
  • Magnesium Gluconate

Perhaps, if there is substantial demand, I’ll provide a more thorough and comprehensive list of the supplements that show promise in reversing hypertension and include a summation of the research.


The Six Point Secret to Perfect Health is the foundation of the A.L.I.V.E. protocol.  A.L.I.V.E. is delivered in a variety of forums, all combing exercise, nutrition, empowerment, and simple, lasting lifestyle shifts.  Find more information on A.L.I.V.E. at http:/yourhealthbeginsnow.com and more about the Six Point Secret by exploring additional articles at http://sixpointsecret.com

 

REFERENCES

Kempner W, Newborg BC , Peschel RL, Skyler JS. Treatment of massive obesity with rice/reduction diet program. An analysis of 106 patients with at least a 45-kg weight loss. Arch Intern Med. 1975 Dec;135(12):1575-84.

Kempner W. Treatment of hypertensive vascular disease with rice diet. Arch Intern Med. 1974 May;133(5):758-90.

Carvalho JJ, Baruzzi RG, Howard PF, et al. Blood pressure in four remote populations in the INTERSALT Study. Hypertension. 1989 Sep;14(3):238-46.

Freedman, D, Petitti, D., Salt and blood pressure: conventional wisdom reconsidered.  Technical Report No. 573, Department of Statistics, U.C. Berkeley, CA 94720

Montecucco F, Pende A, Quercioli A, Mach F.  Inflammation in the pathopsychology of essential hypertension. J Nephrol 2011 Jan-Feb; 24 (1) 23-24

Stefanadi E, Tousoulis C, Androulakis ES, Papageorgio N, Charakida M,  Siasos G, Tsiofis C, Stefanadis C.  Inflammatory markers in essential hypertension: potential clinical implications.  Curr Vasc Pharmacol 2010 Jul;8(4):509-16

Zillich AJ, Garg J, Basu S, et al. Thiazide diuretics, potassium, and the development of diabetes: a quantitative review. Hypertension. 2006 Aug;48(2):219-24.

Soriquer F, Rojo-Martínez G, Dobarganes MC, et al. Hypertension is related to the degradation of dietary frying oils. Am J Clin Nutr. 2003 Dec;78(6):1092-97.

Rosenfeldt FL, Haas SJ, Krum H, et al. Coenzyme Q10 in the treatment of hypertension: a meta-analysis of the clinical trials. J Hum Hypertens. 2007 Apr;21(4):297-306.

Erlund I Koli R, Alfthan G, et al. Favorable effects of berry consumption on platelet function, blood pressure, and HDL cholesterol. Am J Clin Nutr. 2008;87:323-31.

INFLAMMATION

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