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High blood pressure (HBP) is the
term used to describe a situation where the blood in the
arteries is exerting undue stress on blood vessel walls: this is
undesirable because the extra stress affects other organs as
well, and can lead to serious health problems, such as stroke,
kidney failure or heart attack.
Obviously, there are degrees of
seriousness with this problem, some people have borderline HBP,
others mild, some moderate, and others are in the high range. I
have no hesitation in saying that if I were in one of the first
three groups (and 80% of HBP patients are) my initial approach
to the problem would be dietary intervention, and a close look
at some of the natural therapies available. I have been reading
some reports recently that tend to suggest very little benefit
and some undesirable side effects from the medications
prescribed for this condition. Equally, there are many experts
who state unequivocally that high blood pressure can be
successfully lowered & controlled by non chemical means.
One of my
favourite stories from my youth was the
Doctor who saw me for persistent headaches.
I must have been about 14 at the time. After
examining me carefully, he wrote out a
prescription and gave it to me saying gravely "Now
remember, this is to be taken half an hour before
you get a headache". "Yes, Doctor", I said,
respectfully, and left ... a few
moments later, it struck me .....
What has this
to do with the price of onions? Our medical
professionals have come with an entirely new
disease for you: PRE hyper-tension. Yup,
being about to have high blood pressure is now a
treatable condition.
This new category was added in 2003. Along with
many other health
professionals, I am suspicious of the motives behind this
diagnosis. You can read some comments about this
questionable new diagnosis in RESOURCES
at right.
I strongly recommend being absolutely sure
that you were as relaxed as possible when the testing was done,
since worry and tension can cause a temporary rise in blood
pressure. I try to relax, and imagine myself sitting by a
lovely pond, with the sound of water running, birds singing, and
the smell of flowers.
This is
an interesting article on the possibility of a false diagnosis.
The cause of HBP is somewhat
mysterious, but we can put our finger on some possible culprits,
chief among them being
stress,
inflammation and
obesity.
Interestingly, children of parents with high blood pressure are
found to have high levels of CRP, a marker of inflammation.
The researchers concluded "The
results of this study suggest that the offspring of parents with
hypertension may be more likely to have elevated levels of CRP,
and may therefore have an increased risk of cardiovascular
disease." (Diaz
JJ, Arguelles, et al, Arch Dis Child, 2007; 92(4): 304-8)
In many cases, simply
reducing one's weight to normal range is all it takes to control
the problem. Many people who are overweight cannot exercise, and
since regular exercise is very important for heart health,
reducing one's weight also makes exercise more possible.
A diet high in processed foods,
consequently high in sodium and low in potassium, can also be to
blame: replacing the processed foods with a more natural diet,
which is inherently higher in potassium and lower in sodium, can
make quite a difference. This change can also mean that more
fiber is introduced into the diet, and fiber (I'm quoting Dr.
Balch here) helps lower blood cholesterol levels, stabilizes
blood sugars, helps prevent colon cancer, constipation, obesity
and many other disorders.
Recent research (
J Fam Pract
2002;51:353-359,369. )showed that among
the 45 subjects consuming oats daily, (an amount totaling 6 gms
of fiber) 73% were able to reduce their blood pressure
medication. After 12 weeks, mean total cholesterol dropped by
15% and LDL cholesterol by 16%, and blood glucose levels
improved significantly.
In fact, a 1997 study reported in
the Journal of the American Medical Association reports that for
every 10 grams of dietary fiber you consume per day, you enjoy a
29% decrease in your risk for cardiovascular disease! The more
fruits and vegetables the diet contains, the more likely it is
that blood pressure will regulate itself, probably not only
because they contain more fiber and have an ideal
potassium/sodium ratio, but also because they displace less
healthy foods..
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I append a thought-provoking
squib here, from J. Willis Hurst, MD [Medscape
Cardiology, 2001. © 2001 Medscape, Inc.]
"I am hearing bits and pieces
of talk questioning the value of a low-fat diet in the
prevention of atherosclerosis. Once again there are those who
point out that many individuals on a low-fat diet gain weight
(and become obese) by eating more carbohydrates.
Some scientists point out that atherosclerosis is less common
in countries where people do not decrease their dietary fat --
but eat more vegetables -- than it is in countries where
people have decreased the amount of fat in their diet but eat
more carbohydrates and fewer vegetables.
Thus far, the question that has been raised is, How valuable
is a low-fat diet for the reduction of atherosclerosis?
But
perhaps the question should be posed another way: How harmful
is it not to eat a large quantity of vegetables and fruit
daily?"
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Occasionally, when all other
explanations have failed, a person with HBP will find there is
an allergic factor. If you are doing everything right, and still
not seeing your BP come down, it might be worth while either
undergoing testing for food allergies, or going on an
elimination/rotation diet, which might enable you to spot the
culprit for yourself. In fact, if you are
Blood Type O, simply
eliminating wheat, corn and dairy can bring your blood pressure
back to normal in a hurry, as well as normalizing your weight.
Dietary intervention is more
effective than any medication in bringing about reductions in
blood pressure, as the DASH diet trials discovered.
Here is
a critical analysis of the trial, and in the
RESOURCES
at right you will find a link to Government information about
the diet.
Many nutrients have shown a
positive application for blood pressure control, and among the
most important are magnesium, potassium, and an amino acid
called Taurine: the higher the levels of Taurine in the
diet, the lower the BP. Moreover, in a placebo controlled study,
when supplemented, it was shown to lower BP. (Circulation
75(3):525-32, 1987.)
Many recent studies link certain
essential fatty acids to
blood pressure control: this is why many health professionals
recommend eating fish 2 or 3 times a week, as an excellent
source of Omega 3 fatty acids. I also recommend the use of
Coenzyme Q 10, as little as
60 mg of this nutrient can bring about a significant reduction
in mean BP.
I am very impressed with a new
supplement from Bonito, a mixture of peptides (or proteins)
which works by inhibiting angiotensin converting enzyme (ACE),
reversing the enzymes constricting effect on blood
vessels, and relaxing the arterial walls. There are many
drugs currently being prescribed that are ACE inhibitors,
Lotensin, Capoten, Accupril among others: and they do seem to
reduce the risk of heart attacks, though not strokes. They
have a number of unpleasant side effects: dry cough, headache
and light-headedness among them. This new natural
Anti-ACE Peptides does not have side effects, because its
action is different: rather than indiscriminately blocking
the action of the enzyme, Anti-ACE converts it to a
harmless substance. You will find more about it in the
RESOURCES at right.
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I am struck by the fact
that each time I address a substance I consider essential
for the heart I find myself saying to myself as I write "THIS
is the most important one!" Maybe this is why I had a lady
ask me the other day whether I take all the things I write
about - well, the answer to that, of course, is that I don't
suffer from all the things I write about! However, I do take
a considerable number of supplements, and magnesium is
high on my list of musts. One because I did at one
point have a mild arrhythmia, two because of its
extreme importance in our bodies and three because of
the high incidence of magnesium deficiency. I would also add
four many people lack the stomach acid to absorb
magnesium.
To take the second point,
magnesium plays a part in all the enzyme reactions in the body,
and also is essential
( with the other important electrolyte, potassium) for the
"firing" of nerves and muscles. This means that few of the
body's vital processes take place efficiently in the presence of
low levels of magnesium.
A meta-analysis (Am
J Hypertens 2002;15:691-696.)
of the association between magnesium intake and
blood pressure provided further evidence that increased
magnesium intake is associated with reductions in blood
pressure. Dr. Edgar R. Miller III, from The Johns Hopkins
Medical Institutions in Baltimore, and colleagues conducted a
meta-analysis using data from 20 randomized trials that studied
the effects of magnesium supplementation on blood pressure: of
course, they are very cautious about their findings, but
effectively they found that, while the overall reduction in
blood pressure attributed to magnesium use was small, an
apparent dose-dependent effect was observed. Within limits,
this means that higher doses of magnesium produced more BP
lowering effect.
If you are African American, you
will be interested in another meta-analysis done by Dr. Chester
Fox, associate Professor of clinical family medicine at Buffalo
using more than 100 studies. He determined that diets lacking
in magnesium among young black men and women contribute not only
to high blood pressure, but to insulin resistance. He also
pointed out that serum magnesium tests are not necessarily
reliable as a guide to magnesium levels, since much may be
circulating, but little may be stored. He suggests adding good
sources of magnesium such as avocados, leafy green vegetables
and fruits to the diet, but to be careful about supplementation
if you have kidney problems.
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Excellent food sources of
Magnesium are:
almonds, hazelnuts, cooked, fresh spinach, cooked fresh Swiss
chard, dried sunflower seeds, halibut, mackerel, tofu, wheat
bran, brown rice, avocado, cooked beans.
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Third and fourth points: among
older people, deficiencies of magnesium are especially common
because processed foods contain low levels of the mineral,
though it is abundant in whole foods. Magnesium levels are also
adversely affected by alcohol consumption, diuretics,
antibiotics, diabetes, kidney problems, and HRT. (Among younger
women, birth control has the same effect. Think cramps!) Then
too, production of hydrochloric acid, necessary for absorption
of magnesium, decreases with age. Often these deficiencies go
unrecognized, because magnesium levels are inefficiently
measured through blood tests: most magnesium is stored in the
cells. Ironic, that diuretics, often prescribed for heart
patients, deplete the body not only of potassium ( a fact which
is often addressed) but also the heart-important magnesium .
One of my preferred reference
books is Dr. Werbach's Nutritional Influences on Illness,
and I looked in the index to refresh my memory on some of the
uses of magnesium: it did not surprise me to find some 47
health conditions listed, with the relevant research. since some
"radical" naturopathic health professionals consider asthma,
heart problems, fibromyalgia, menopause, PMS and migraine
all to be, to one degree or another, magnesium deficiency
diseases. But I will limit myself to the heart, and give some
examples of the excellent results magnesium supplementation can
have.
The role of magnesium in cardiac
arrythmias was first acknowledged as long ago as 1943, and in
1989, the American Journal of Cardiology (63(14):43G-46G)
published a study by Dr. Roden saying "the association between
hypo-magnesia (Lynn: hypo= low) and arrythmias ... has long
been recognized. More recently, acute intervention with
magnesium in patients who are not hypomagnesic has demonstrated
arrhythmia suppression.." In cases of High Blood Pressure, a
1981 study found that 50% of patients with HBP had low magnesium
levels ( Lynn: bear in mind this was almost certainly based on
blood readings, so in my opinion the number would be much
higher!) and their hypertension was reversed when their
magnesium levels rose. It is also interesting that many women
who develop HBP do so after menopause, which makes the magnesium
connection particularly important for them, especially if they
are on HRT. As a bonus, Dr. Alan Gaby (NSN Vol.5 #9 p.402)
says adequate levels of magnesium in post-menopausal women
increase bone density levels. Another really interesting study
showed that when a patient is deficient in magnesium, normal
levels of a medication which would usually take care of the
problem are of no help - more is needed to get results, unless
the mineral deficiency is addressed. To restate that in
reverse; if an underlying magnesium deficiency is identified and
addressed, you may need less of your medication to get results.
If such a deficiency exists and is NOT addressed, you will need
higher than normal levels of medication to get results.
In Dr. Ronald Hoffman's book,
Intelligent Medicine, (Simon & Schuster 1997, p.318-319) he
points out that the method of action of calcium channel blockers
is to block the spasm-inducing effect of calcium, thus keeping
blood vessels dilated. He points out that calcium and magnesium
compete for the same receptor sites in the smooth muscle wall of
the blood vessel: magnesium is the nutrient that relaxes
spasms, so its presence in greater amounts than calcium will
prevent spasms in the same way calcium channel blockers do.
This is why, when my Doctor prescribed a calcium blocker, I went
away and took lots of magnesium. Dr. H. says his protocol in
patients with advanced heart conditions is to recommend
magnesium in reverse ratio to calcium. i.e., twice as much
magnesium as calcium. Buy his book, do: it is full of
excellent information. I recommend magnesium bound to either
aspartate or citrate as being the most effective for absorption,
and also to avoid the possibility of diarrhea that sometimes
accompanies high doses. I have had a hard time up until now
finding a means to get extra magnesium in meaningful amounts at
an affordable price, but there are now some powdered formulas on
the market, and I can recommend Magna-Calm as an
excellent strategy.
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The following information
may be of interest to you:
Magnesium: Research Misconduct?
For the past 15 years
evidence has stacked up showing patients with acute
coronary thrombosis improve their survival chances by 50 -
82.5% when given intravenous magnesium of 32-66 mmol in
the first 24 hours. The single negative study showing
that magnesium had a worsening effect on survival employed
a far higher dose of magnesium (80 mmol) than the other
studies. (European Heart J, 1991;12:12158), and one
other study showing no benefit with magnesium employed the
low dose of 10 mmol in the first 24 hours.
Although it would appear
clear to any first year medical student that magnesium
worked well for coronary thrombosis within the optimal
dosage level of 30 - 70 mmol; that 10 mmol was shown to be
too little, and 80 mmol had been shown to be too much, in
1990/91, the Fourth International Study on Infarct
Survival decided to do a major study which was to
definitely determine whether magnesium was beneficial when
used for this purpose. Although their own meta-analysis of
all earlier studies showed that magnesium was beneficial,
the ISIS4 investigators also decided to test magnesium
against the drug Catopril and a coronary vasodilator.
Astonishingly, the ISIS
investigators chose to use the 80 mmol dosage for their
study, the one dosage that had been found to be harmful.
It should be noted that the ISIS4 study was funded to the
tune of almost $10 million by Bristol Myers Squibb, the
manufacturers of Catopril. Not surprisingly, magnesium
lagged behind the drugs.
As a result of this paper,
many hospitals ceased using magnesium in their treatment
of acute coronary thrombosis.
The scandalous decision to
use an overdosage of magnesium in this study must have
caused the loss of several thousand lives within the study
and many other lives in other hospitals that have now
stopped using magnesium. Both nutritional pioneer Dr.
Stephen Davies and Dr. Damien Downing, editor of the
Journal of Nutritional and Environmental Medicine,
criticized the designers of the study for clearly
selecting too large a dose of intravenous magnesium, and
also for giving magnesium too late and then too quickly.
Downing even titled his editorial "Is ISIS4 research
misconduct?" (J Nutr Environ Med, 1999;9:513) |
There are also many herbs that
help high blood pressure. The granddaddy of them all is, of
course,
garlic. Some researchers,
in fact, theorize that it is a large part of the protective
factor in the so-called Mediterranean diet. However,
olive oil is also part of that diet,
and a study published in Arch.Intern.Med, 2000; 160:
837-42 came up with some very interesting data: 23 people with
mild to moderate HBP were told to cook their food with either
olive oil or sunflower oil, and after 6 months, everyone
switched diets. (Participants limited other fats: fat calories
were limited to 26% of the daily total, and saturated fats were
limited to 6%). Resting blood pressure was significantly lower
in the olive oil group, and blood pressure medication could be
significantly reduced - in fact, 8 of the olive oil group
stopped taking medications altogether. Many people prefer to
ingest Garlic as a dietary supplement, perhaps not wishing to
limit their social life, and there are many extremely effective
preparations available which deliver all the nutritional punch
without any of the odor. Look for a dosage which will give you
8mgs of allicin, or an allicin yield of 4,000 mcgs per day.
Garlic is closely
followed by onions, which of course belong to the same family.
There can be no doubt that including generous amounts of these
substances in your food has many beneficial results , not
limited to lowering blood pressure.
Next on my list comes Hawthorn
berry (Crataegus).
This is another age-old remedy
whose efficacy is now being confirmed by scientific evidence.: I
think it is one of the best, most harmless and most reliable
remedies for many heart ailments, working as a vasodilator, and
also as a mild diuretic. Experiments with animals have shown
decreased arterial blood-flow as well as increased coronary
artery and peripheral flow, decreased heart rate and improved
contractility of the heart muscle (Werbach - Botanical
Influences on Illness). Use this only with the advice of a
health profession if you are on Lanoxin, or any other ACE
inhibitor! (Mashour NH, et al.
"Herbal medicine for the treatment of cardiovascular disease:
clinical considerations." Arch Int Med.
November9,1998;158:2225-2234. Graham JDP. "Crataegus oxycantha
in hypertension." Br Med J. November11,1939;951.)
Another herb from Ayurvedic
medicine which shows very promising results is Coleus Forskohlii:
a substance it contains (called forskolin) causes relaxation in
the arteries, and a resultant lowering of blood pressure. This
interesting herb, which appears to relax smooth muscle
generally, has also had some success in use for asthma attacks.
Another herb which you would
expect to find in your food is Cayenne Pepper, also known
as capsicum. A study in 1987 found that it has a very beneficial
effect on blood fats, bringing about a significant reduction in
blood triglycerides and LDLs, the "bad" cholesterol. Cayenne is
also a catalyst for other herbs, increasing their
bio-availability. It can have the same effect on medications, so
be careful! There are brands on the market which bill themselves
as "cool", meaning they will not harm your stomach if you have a
tendency to be adversely affected by spicy foods.
While on the subject of food,
there are some writers who advocate the use of parsley to help
the heart, and since it is also a mild diuretic and high in
bioflavonoids, this makes sense; so you can see your ideal meal
taking shape here: onions, garlic, parsley and a little cayenne
pepper, add a little olive oil and red wine, some tomatoes, put
in your fish, simmer and enjoy! A potato with its skin on for
fiber and a salad of dark green leafies, and you have a meal fit
for the gods, who are immortal!
Last of my herbs is
Ginseng - but with a
caveat: different ginsengs do different things: Korean and
Chinese are stimulating, and can actually increase blood
pressure. Look for Siberian Ginseng, Eleutherococcus
Senticosus, which, being more neutral in its effect, is an
excellent adaptogenic, or body balancer, and therefore not only
lowers high blood pressure, but also raises low blood pressure.
Tienchi Ginseng (Panax Notoginseng) is also said to help
cardiovascular problems and reduce blood pressure.
A Chinese herb which
is quickly becoming valued for its effects on High Blood
Pressure and cholesterol levels is Jagulana, or Jiaogulan.
Jiaogulan
has been widely reported to be effective in the treatment of
hypertension. Although the exact mechanism is still being
researched, studies have shown that Jiaogulan improves the
metabolism of the heart directly as well as enhancing the
release of nitric oxide in the body, which helps to relax the
coronary blood vessels. (Tanner,
M.A., et al. "The direct release of nitric oxide by gypenosides
derived from the herb Gynostemma pentaphyllum." Vanderbilt
University Medical Ctr., Nashville, Tenn. Nitric Oxide 1999 Oct;
3(5):359-65. )
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