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Hypertension

“normal” blood pressure [Hypertension]was accepted as whatever your age was plus 100. So a twenty-year old was expected to have a BP no higher than 120/80. A forty-year old, 140/90. And if you were 60, a top number of 160 was considered perfectly acceptable. But medicine changes its mind more often than most of us change our socks.

If your blood pressure is high and you are on medications, I recommend the following:
1. Measure your blood pressure twice a week after taking deep belly breath and record the value in a book.
2. Follow the wellness IQ on this website to improve your eating and drinking habits.
3. Increase your exercise to improve your cardiovascular function by brisk walking daily.
4. If your blood pressure reading is high during your doctor visit, this is due to white coat syndrome.
5. Stay taking your medications until your blood pressure becomes stable then you can gradually reduce your medications by working with your health care provider. Taking medications indefinitely is not recommended.

According to the Centers for Disease Control and Prevention (CDC), 1 in 3 American adults (about 70 million people) have high blood pressure. About half have uncontrolled high blood pressure, which increases your risk for a number of serious health problems, including:

Heart disease
Stroke
Kidney disease
Cognitive decline, dementia and Alzheimer’s disease
Globally, more than 1 billion people struggle with high blood pressure, and prevalence has nearly doubled in the past four decades.

Overall, men tend to have higher blood pressure than women, and while high-income nations have seen a significant decline in hypertension, prevalence in low- and middle-income countries, such as South Asia and Africa, is spiking. According to researchers, prevalence is “completely inverse” to national income.

Worldwide, high blood pressure is thought to cause nearly 13 percent of all deaths, or about 7.5 million deaths annually.

What Causes High Blood Pressure?

According to medical physiology textbooks, as much as 95 percent of hypertension is called essential hypertension, meaning the underlying cause is unknown. From my perspective, this simply isn’t true. A number of factors have been identified as contributing to high blood pressure, including but not limited to:

Insulin and leptin resistance. As your insulin and leptin levels rise, it causes your blood pressure to increase

Elevated uric acid levels are also significantly associated with hypertension, so any program adopted to address high blood pressure needs to normalize your uric acid level as well

Poor nutrition in childhood has been shown to raise the risk of high blood pressure in adulthood

Lead exposure

Pollution. As your insulin and leptin levels rise, it causes your blood pressure to increase

Insulin and leptin resistance. Air pollution affects blood pressure by causing inflammation while noise pollution asserts an effect via your nervous and hormonal systems.

Air pollution has been shown to increase your risk of high blood pressure to the same degree as having a body mass index (BMI) of 25 to 30.

Living in an area plagued by constant noise pollution (busy city streets with night time traffic) has been shown to increase the risk of hypertension by 6 percent, compared to living in an area where noise levels are at least 20 percent lower

The Importance of Diet and Insulin Sensitivity

As noted by the lead author Majid Ezzati, Ph.D., a professor of global environmental health at Imperial College London.

“The perception is that people are not getting enough calories, but the reality is, they’re not getting healthy calories. Making fresh, healthy food affordable and accessible for everybody should be a priority.”

One of the most important dietary changes needed to improve high blood pressure is to eliminate or dramatically reduce sugar and processed fructose from your diet. The easiest way to do that is to replace processed foods with real, whole foods. This will address not only insulin and leptin resistance but also elevated uric acid levels.

One 2010 study discovered that those who consumed 74 grams or more per day of fructose (the equivalent of about 2.5 sugary drinks) had a 77 percent greater risk of having blood pressure levels of 160/100 mmHg (stage 2 hypertension).

Consuming 74 grams or more of fructose per day also increased the risk of a 135/85 blood pressure reading by 26 percent, and a reading of 140/90 by 30 percent. To learn more about healthy eating, please see my optimal nutrition plan, which will guide you through the necessary changes step-by-step.

To ascertain whether insulin/leptin resistance is at play, be sure to check your fasting insulin level. If your hypertension is the result of elevated insulin levels, dietary intervention will be key.

Aim for a fasting insulin level of 2 to 3 microU per mL (mcU/mL). If it’s 5 mcU/mL or above, you definitely need to lower your insulin level to reduce your risk of high blood pressure and other cardiovascular health problems.

Keep in mind that the so-called “normal” fasting insulin level is anywhere from 5 to 25 mcU/mL, but please do not make the mistake of thinking that this “normal” insulin range equates to optimal.

The American Heart Association (AHA), the American College of Cardiology (ACC, and the Centers for Disease Control and Prevention (CDC) recommend lifestyle modification as the first-line treatment. If that doesnt work, patients may be prescribed a thiazide diuretic (commonly known as a water pill) before getting even more meds until their blood pressure is forced down. Commonly, people will end up on three drugs, though researchers are experimenting with four at a time. Some patients even end up on five different meds.

Whats wrong with skipping the lifestyle modification step and jumping straight to the drugs? Because drugs dont treat the underlying cause of high blood pressure yet can cause side effects. Less than half of patients stick with even the first-line drugs, perhaps due to such adverse effects as erectile dysfunction, fatigue, and muscle cramps.

What are the recommended lifestyle changes? The AHA, ACC, and CDC recommend controlling ones weight, salt, and alcohol intake, engaging in regular exercise, and adopting a DASH eating plan.

The DASH diet has been described as a lactovegetarian diet, but its not. It emphasizes fruits, vegetables, and low-fat dairy, but only a reduction in meat consumption. Why not even more plant-based? Weve known for decades that animal products are significantly associated with blood pressure. In fact, if we take vegetarians and give them meat (and pay them enough to eat it!), we can watch their blood pressures go right up.

Ive talked about the benefits to getting blood pressure down as low as 110 over 70. But who can get that low? Populations centering their diets around whole plant foods. Rural Chinese have been recorded with blood pressures averaging around 110 over 70 their whole lives. They eat plant-based day-to-day, with meat only eaten on special occasions.

How do we know its the plant-based nature of their diets that was so protective, though?

Because in the Western world, as the American Heart Association has pointed out, the only folks getting down that low on average were those eating strictly plant-based diets, coming in at about 110 over 65.

So were the creators of the DASH diet just not aware of this landmark research done by Harvards Frank Sacks? No, they were aware. The Chair of the Design Committee that came up with the DASH diet was Dr. Sacks himself. In fact, the DASH diet was explicitly designed with the number-one goal of capturing the blood pressure-lowering benefits of a vegetarian diet, yet including enough animal products to make it palatable to the general public.

You can see what they were thinking. Just like drugs never workunless you actually take them. Diets never workunless you actually eat them. So whats the point of telling people to eat strictly plant-based if few people will do it? So by soft-peddling the truth and coming up with some kind of compromise diet, the on a population scale maybe youd do more. Ok, but tell that to the thousand U.S. families a day that lose a loved one to high blood pressure. Maybe its time to start telling the American public the truth.

Sacks himself found that the more dairy the lactovegetarians ate, the higher their blood pressures. But they had to make the diet acceptable. Research has since shown that its the added plant foodsnot the changes in oil, sweets, or dairythat appears to the critical component of the DASH diet. So why not eat a diet composed entirely of plant foods?

A recent meta-analysis showed vegetarian diets are good, but strictly plant-based diets may be better. In general, vegetarian diets provide protection against cardiovascular diseases, some cancers, and even death. But completely plant-based diets seem to offer additional protection against obesity, hypertension, type-2 diabetes, and heart disease mortality. Based on a study of more than 89,000 people, those eating meat-free diets appear to cut their risk of high blood pressure in half. But those eating meat-free, egg-free, and dairy-free may have 75% lower risk.

What if were already eating a whole food, plant-based diet, no processed foods, no table salt, yet still not hitting 110 over 70? Here are some foods recently found to offer additional protection: Just a few tablespoons of ground flaxseeds a day was 2 to 3 times more potent than instituting an aerobic endurance exercise program and induced one of the most powerful, antihypertensive effects ever achieved by a diet-related intervention. Watermelon also appears to be extraordinary, but youd have to eat around 2 pounds a day. Sounds like my kind of medicine, but its hard to get year-round (at least in my neck of the woods). Red wine may help, but only if the alcohol has been taken out. Raw vegetables or cooked? The answer is both, though raw may work better. Beans, split peas, chickpeas, and lentils may also help a bit.

Kiwifruits dont seem to work at all, even though the study was funded by a kiwifruit company. Maybe they should have taken direction from the California Raisin Marketing Board, which came out with a study showing raisins can reduce blood pressure, but only, apparently, compared to fudge cookies, Cheez-Its, and Chips Ahoy.

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