Transient elevations in systolic blood pressure occur as normal adaptations during fever, physical exertion, and emotional upset, such as during anger and fear. Persistent hypertension, or high blood pressure, is common in obese people because the total length of their blood vessels is relatively greater than that in thinner individuals.
Although hypertension is usually asymptomatic for the first 10 to 20 years, it slowly but surely strains the heart and damages the arteries. For this reason, hypertension is often called the "silent killer". Prolonged hypertension accelerates arteriosclerosis and is the major cause of heart failure, vascular disease, renal failure, and stroke. Because the heart is forced to pump against greater resistance, it must work harder, and in time the myocardium enlarges. When finally strained beyond its capacity to respond, the heart weakens and its walls become flabby. Advanced warning signs include headache, sweating, rapid pulse, shortness of breath, dizziness, and vision disturbances.
Hypertension also ravages blood vessels, causing small tears in the endothelium and increasing the demand for energy in countering the excessive mechanical load on the arterial vessels - this accelerates the progress of atherosclerosis. Furthermore, a stretched muscle cell accumulates more lipid than a relaxed muscle, further enhancing this metabolic and morphological change in cells and tissues. As the vessels become increasingly blocked, blood flow to the tissues becomes inadequate, and vascular complications begin to appear in vessels of the brain, heart, kidneys, and retinas of the eyes.
Systolic or pumping pressure, the higher of the two is normally around 120 in a healthy adult and the lower diastolic about 70, normally expressed as 120/70. 130/80 is average for a 40 yr old NZ male, 117/75 for a 40 yr old female. Hypertension is defined physiologically as a condition of sustained elevated arterial pressure of 140/90 or higher (which is dangerously high), and the higher the blood pressure, the greater the risk for serious cardiovascular problems. As a rule, elevated diastolic pressures are more significant medically, because they always indicate progressive occlusion and/or hardening of the arterial tree.
About 90% of hypertensive people have primary, or essential, hypertension, in which no underlying cause has been identified by their doctor. The following factors are believed to be involved:
1. Diet. Dietary factors that contribute to hypertension include excessive use of table salt, saturated fat, and cholesterol intake and deficiencies in certain metal ions (Potassium, Calcium and Magnesium).
3. Age. Clinical signs of the disease usually appear after age 40.
4. Race. More blacks than whites are hypertensive, and the course of the disease also varies in different population groups.
5. Heredity. Hypertension runs in families. Children of hypertensive parents are twice as likely to develop hypertension as are children of normotensive parents.
6. Stress. Particularly at risk are "hot reactors", people whose blood pressure zooms upward during every stressful event.
7. Smoking. Nicotine enhances the sympathetic nervous system's vasoconstrictor effects.
According to allopathy primary hypertension cannot be cured, but most cases can be controlled by restricting salt, fat, and cholesterol intake, losing weight, stopping smoking, managing stress, and taking antihypertensive drugs. Drugs commonly used are diuretics, beta blockers, calcium channel blockers, and ACE inhibitors (drugs that inhibit the renin-angiotensin mechanism by inhibiting angiotensin-converting enzyme).
Secondary hypertension, which accounts for 10% of cases, is due to identifiable disorders, such as excessive renin secretin by the kidneys, arteriosclerosis, and endocrine disorders such as hyperthyroidism and Cushing's disease. Treatment for secondary hypertension is directed toward correcting the causative problem.
20% of New Zealanders suffer from high blood pressure. Men over 35 and women over 45 should have their blood pressure checked every few years. Blood pressure results can be influenced up to 50% by temporary factors such as mood, and what one has eaten and drunk. For a correct reading take blood pressure 4-5 hours after food and never when stressed, upset or emotional. Apparently, a reading may also be altered when the kidneys are acting as the primary filtering system as opposed to the liver. If you have high blood pressure, regular monitoring is essential.
Contributing factors include high sodium intake, food sensitivities, stress, toxic chemical exposure, caffeine consumption, use of recreational drugs, cadmium and lead toxicity, smoking, and a low fibre intake.
Eliminate all junk food, alcohol, tea, coffee, sugar (can cause high blood pressure, especially if the person is lacking in Chromium), food coloring and preserved foods. MSG, baking soda, canned vegetables, commercially prepared foods, over-the-counter medications that contain ibuprofen, diet soft drinks, foods with mold inhibitors, preservatives and most sugar substitutes, meat tenderizers, softened water, and soy sauce need to be avoided. These products can cause the cells to swell and interfere with the effectiveness of diuretics in the treatment of hypertension. Increase the consumption of Potassium containing foods e.g. green vegetables, whole grains, dried fruit, bananas, grapes, peaches, plums, pumpkin, squash, potatoes, beets, brewer's yeast, zucchini, legumes, sprouts, seeds and vegetable juices.
Arginine is a powerful stimulator of nitric oxide (NO). NO is required for the smooth muscle of the blood vessels to relax. The stress release of adrenalin raises blood pressure. Tryptophan can modify this stress response. The amino acid Histidine can also blunt the effect of adrenalin on the vascular system.
Subnormal activity of the Sodium/Potassium pump appears to be a common feature of primary hypertension and is stimulated by insulin, thyroid hormone, Taurine and Potassium. Magnesium and Quercetin also help maintain cellular electrolyte imbalance.
Lowering blood pressure is important, however elevated insulin, glucose and lipid levels must also be addressed. Lecithin granules in the diet will assist with lipid management and Cholesterol Balance by Radiance is helpful in balancing cholesterol levels. Chromium will help moderate blood sugar levels. Taurine and Methionine levels are low in hypertensive patients. Taurine lowers BP in its own right through aldosterone regulation (suppresses renin-angiotensin feedback) and facilitates the metabolism of Calcium, Magnesium, Potassium and Selenium. It also lowers heavy metal concentration. Taurine (2 g/day) should be given.
Vitamin C and Bioflavonoids strengthens blood vessel walls at 1000mg 3 times daily. Also just 1000 mg a day lowers LDL's by 10% and blood lipids by 40%, lowering blood pressure. Niacin, Betaine hydrochloride, Vitamin E (200 IU) and Fish oils reduce blood viscosity and hence blood pressure. Taurine, Coenzyme Q10, and Lipoic acid supplementation results in a significant drop in blood pressure. Many studies have demonstrated the ability of Coenzyme Q10 to reduce blood pressure in hypertension patients. Coenzyme Q10 lowers blood pressure when taken over a long period of time. Therapeutic dosage is 60mg 3 times daily. Vitamin D supplementation in women significantly drops blood pressure. Copper supplementation may lower blood cholesterol. Increase Vitamin B6 intake. Vitamin B6 inhibits platelet aggregation and relieves edema. Too little Manganese, and Vitamin B3, has been linked to high blood pressure also.
Fish oils lower serum lipids. Therefore fish intake should be increased to at least 4 times a week. Otherwise a GLA/EFA should be used on salads etc. Fish oils depress the vascular response to agents that promote contraction. Increase calcium intake to 1000 mg/day (500mg twice daily). Calcium is a natural tranquilizer which may explain its role in lowering blood pressure. In one study of 4000 hypertensive patients, 85% dropped their blood pressure to safe levels by doubling their Calcium intake. Use calcium citrate, aspartate and orotate. Studies have shown Magnesium deficiency to be endemic to western society. Reversible hypertension is a clinical finding in hypomagnesemia and magnesium depletion; 50% of magnesium-depleted patients are hypertensive and their blood pressure returns to normal with supplementation. Magnesium regulates muscle tension through a combination of muscle physiology and neurophysiology, correcting excessive excitation, inflammation and energetic dysfunction due to insulin resistance. Magnesium lowers blood pressure, as it is a vasodilator - arterial vasospasm is a major contributor to hypertension and sudden heart attacks. It also acts as a calcium channel regulator. It normalizes heart rhythm, and reduces plasma triglycerides and lipid precipitation on blood vessel walls. Take 500 mg twice daily.
Use a high Potassium salt substitute or Celtic sea salt. A Californian biochemist, Dr Jacques de Langre, has spent 35 years researching the health benefits of sea salt. He claims that a low-salt diet for the treatment of high blood pressure is based on dogma, not evidence and a salt-restrictive diet can actually raise blood pressure. He believes refined table salt is a toxin to the body, yet unrefined Celtic sea salt is extremely healthy and may actually lower blood pressure. Potassium supplementation would be 300-600 mg daily. Excess salt itself does not normally raise blood pressure if Potassium and Calcium intake is increased also, or surprisingly, if non-chloride forms of Sodium are used. Excess Sodium is eventually expelled from our bodies, but can take valuable Potassium and Calcium along with it, often resulting in a Potassium or Calcium deficiency, both of which are major causes of high blood pressure. Potassium excretion is also increased by excess sugar, and tea, coffee and alcohol.
Insulin resistance is a major contributor to cardiovascular illness. Check for hypothyroidism. If present supplement with Selenium, Tyrosine, Iodine, Copper and Zinc.
The herb Cayenne along with Garlic will lower blood pressure. Garlic improves circulation as well as reducing cholesterol and fats in the blood. Take 4,000 mcg standardized allicin extract 3 times daily. You could use these herbs in cooking also. Hawthorn berries (1.8% vitexinn-4'rhamnoside) help to strengthen the heart muscle by increasing blood flow to the heart, thereby improving heart contractions, and reduces blood pressure by reducing resistance in the arteries. Take 250 mg 3 times daily. Combination Cayenne-Garlic-Hawthorn Formula by Nature's Way is blended specifically for high blood pressure.
Ginkgo (24% standardized extract) improves circulation throughout the cardiovascular system and has anti-platelet as well as antioxidant and anti-inflammatory properties. Dandelion leaf acts as a mild diuretic so that excess fluids are excreted. Take 1 125mg capsule or 30 drops 3 times daily. Other useful herbs that have a diuretic action include Uva Ursi, Juniper berry, Cranberry and Parsley. Motherwort, Lime Blossom, Valerian, Skullcap, Lemon Balm, Kava, and Chamomile are useful herbs to add to a hypertensive prescription as they work on the nervous system to calm and soothe. Suma herb tea, 3 cups daily, has been reported to be beneficial for high blood pressure.
Reishi increases coronary blood flow. Asian clinical studies have shown it to be effective as a calmative in anxiety and hypertension, and for reducing blood pressure. Dosage is 3000 mg 3 times daily. Du Zhong is a herb from Traditional Chinese Medicine used for dizziness and light-headedness due to hypertension from "rising liver yang".
A bowel cleanse or general detoxification program may help relieve some work from the body and may have a beneficial effect on high blood pressure. Papaya aids digestion. Alfalfa is an excellent herb to alkalinise the blood. Flaxseed oil contains essential fatty acids which help in lowering blood pressure. Take 2 tablespoons daily.
Heavy metals can cause cardiovascular problems. Increase excretion of Cadmium and Lead by supplementing with Zinc, Selenium, Calcium and Vitamin C. A hair analysis will show specifically any heavy metal toxicity and specific chelation therapy can then be used to eliminate them. Follow detoxification procedure if exposed to pesticides.
Stress management is an important part of dealing with high blood pressure. Studies on Transcendental Meditation (T.M.) at Harvard Medical School in the mid-seventies showed it to lower oxygen consumption, increase blood flow, and slow heart rate, leading to a deep relaxation. Researchers also found TM to lower levels of blood lactate, which is associated with anxiety, and to decrease blood pressure in people with hypertension. Some form of meditation, or other relaxation techniques i.e. massage, listening to relaxing music or gentle exercise, performed on a regular basis, will go a long way in assisting the reduction of blood pressure. Counselling, mental imagery, and biofeedback may also be useful. Other benefits will also be felt, like a general feeling of calm and an increased ability to deal with stressful situations.
In handling the stresses of life, people can usually be divided into two basic types - Confronters and Avoiders. Confronters face up to life's problems while Avoiders ignore them hoping they will go away. In an experiment on anxiety induced high blood pressure, a large group of volunteers were given periodic sharp electric shocks at timed intervals. The Confronters in the group watched the clock, braced for the shock, then relaxed again. The Avoiders did not watch the clock, not wanting to know when the shock was coming. As a result, due to their constant tension, the Avoider's blood pressure was continually an average of 30% higher than the Confronters, all of whose blood pressure remained normal.
Exercise is crucial in the treatment of hypertension. Aerobic exercise will benefit the cardiovascular system and it must be done on a regular basis. If you haven't exercised before, or are very much out of shape, it is advisable to see a qualified health practitioner who can devise a safe program for you to follow. You can overdo it so be careful! Ideally, you want to build up to doing 20-30 minutes, 3 times a week, as a minimum. You want to be exercising so that you maintain your heart rate at 60% of its maximum. To calculate your maximum heart rate, subtract your age from 220. This is your maximum heart rate. To get 60% of your maximum heart rate, multiply the number by 0.6. This is the heart rate you want to aim for and maintain while exercising aerobically.
The Bach Flower remedies may assist with mental and emotional imbalances. Impatiens is useful for those who are agitated, impatient or easily upset. It is said that astrological FIRE signs (Aries, Leo and Sagittarius) are more prone to heart and high blood pressure problems. Acupuncture, Pulsing and Reflexology may also be helpful for high blood pressure.
Side effects of drug treatment:
Diuretics - Increased risk of mortality due to myocardial infarction or sudden death. Diuretics deplete Potassium, Magnesium, Zinc, and B group vitamins. Some diuretics have an adverse effect on serum lipids, blood glucose and raise glyco-hemoglobin concentration.
Beta Blockers - Similar to diuretics, they cause changes in serum lipid fractions. At least 25% of patients treated with beta blockers will develop a need for antidepressants. They also increase the risk of heart failure, cause weight gain, decreases energy, and sexual dysfunction. Long term use of these drugs are contraindicated. Beta blockers may decrease Coenzyme Q10 levels thus reducing energetics of cardiac cells. Coenzyme Q10 levels also fall, therefore, supplementation is required.
Alpha blockers - Alpha blockers can cause hypertension, dry mouth, constipation, sedation, and dizziness. They are not effective for long term treatment of hypertension.
Methyl dopa, Captopril, Propanolol - Up to 50% of patients taking any of the above drugs experience fatigue or lethargy; 30% had some form of sexual disorder and over 10% had sleep disorders, nightmares, headaches, anxiety, irritability, palpitations, nausea, dry mouth and muscle cramps.
Angiotensin 2 inhibitors - These can affect trace element status in the body. Selenium and Zinc are decreased and Copper rises, with this medication.
Nutritional and Herbal support for High Blood Pressure includes:
Heartcare - Heartcare is a standardized (5:1) leaf and flower extract of hawthorn. Produced by Schwabe and Co of Germany backed with 50 years of research, and subject to 80 scientific clinical studies. Improves blood flow and nutrient supply to the heart.
Garlicin HC - Garlicin with Hawthorn, Cayenne, Rutin and Vitamin E. Supports healthy heart and circulation. Assists to normalize blood pressure and to reduce cholesterol.
Magnesium Complex - Necessary for contraction and relaxation of muscles, including the heart muscle. Magnesium is known as the anti-cramping mineral and is helpful for muscle twitches around the eyes, spasms in the muscles of the arms or legs and cramps in bed at night.
Omega 3 Fish Oils - Salmon oil is one of the best sources of omega 3 fatty acids. The 0mega 3 fatty acids, mainly found in certain seafood, have been clearly shown to offer some protection against heart disease. They help reduce abnormal blood clotting, high cholesterol and blood pressure - all factors which contribute to this condition.
Coenzyme Q10 - Improves the heart-muscle metabolism, enhances immunity, acts as an antioxidant. Taking this supplement may help prevent coronary inefficiency and heart failure.
Some interesting points on High Blood Pressure:
Caution: Any individual who has been treated for by-pass surgery or has coronary blockage should not allow the diastolic blood pressure to fall below 85 mm Hg, as it increases the risk of low perfusion injury, i.e., ischaemic damage to heart and brain tissue. Furthermore, medication for hypertension needs to be restricted at night as the average drop in B.P. with sleep is 30-40 mm Hg, which once again, can compromise perfusion pressure in the elderly.
Reduce weight. Decrease salt and sugar intake and increase intake of Potassium and Magnesium rich foods. High intakes of sugar can raise blood pressure and has an additive effect with high salt intakes. Avoid deep fried foods and food additives. Reduce stress, through yoga. Stress can also produce a craving for salt. Avoid smoking. If cheese is eaten, fresh cheese is preferable to aged cheeses. Reduce or avoid all tea, coffee and alcohol. Avoid use of oral contraceptive. It increases the need for Vitamin B6 and increases the risk of stroke. Avoid the herb licorice (in excess of 3g/day of active form) as it can raise blood pressure.
Treat infections such as Chlamydia. Chronic hypertension can be caused by an infection such as Chlamydia pneumonia. Chlamydia is known to cause inflammation in blood vessels which causes high blood pressure and encourages the formation of plaque. Approximately 1/3 of patients with hypertension have antibodies to this bacterium.
Increase the consumption of oats, as they are rich in Silicon and mucopolysaccharides. Garlic, onions and ginger in cooking should be used often. Eaten on a regular basis, celery is helpful as it promotes the excretion of excess fluids and decreases blood pressure. Potassium-rich foods or supplements should be increased to reduce risk of a stroke i.e. vegetables and fruit. Increase fibre consumption in the form of apples, oat bran, broccoli, cabbage, carrots, whole grains, psyllium husks and green leafy vegetables. Fibre helps bind excess cholesterol which in turn reduces blood viscosity and thus blood pressure. Increase aerobic exercise, swimming, walking, cycling. Do not lift heavy weights. Maintain a high fluid intake - drink at least 6-8 glasses of purified water daily. Identify and eliminate food allergies and sensitivities as they can aggravate hypertension.
For purposes of measuring longevity, the lower diastolic or resting pressure is the most important figure. Listed below are the average number of years lost from a man's life by disorders brought on by high diastolic blood pressure at age 45.
Diastolic Pressure Average years lost at age 45
90 3 years
95 6 years
If you are taking MAO inhibitors, which are drugs that are used to counter depression, lower blood pressure, and treat infections and cancer, avoid Tyramine. Combining MAO inhibitors with Tyramine causes the blood pressure to soar and could cause a stroke. Avoid the amino acid Tyrosine also.
People who snore heavily are much more likely to have high blood pressure or angina than silent sleepers. Researchers suggest that snorers may suffer from a slight malfunctioning of the part of the brain responsible for fluent breathing; this can put an unnatural strain on the heart and lungs due to oxygen shortage.
Patients with hypertension often suffer apnea, in which they stop breathing. Apnea, which occurs while sleeping, is associated with loud snoring and restless sleep. It is not unusual for the apnoeic patient to feel excessively sleepy during the day. Evaluation and treatment of apnea can help reduce high blood pressure in these patients.
We would like to acknowledge the contribution made by Amie Skilton in compiling this information.