host posted on July 31, 2009 15:05
by Luke Curtis M.D.
Hypertension, or high blood pressure, is a very common health problem. Blood pressures higher than 140 mm Hg systolic (pumping phase of heartbeat) and/or 90 mm Hg diastolic (relaxed phase of heartbeat) are considered to be hypertension. According to research published in the November 2008 Hypertension, about 29% of all US adults had high blood pressure in the period 1999-2004.
Hypertension puts people at increased risk for many serious health problems including heart disease, strokes, kidney problems and damage to vision. Chronic hypertension is also a major cause of headaches, nausea and mental disorientation.
The early signs of hypertension often give no warning and the hypertensive patient often feels fine. That is why it is important to get your blood pressure checked at least once a year. Many pharmacies and supermarkets have automatic blood pressure testing cuffs that will test your blood pressure for free.
Some forms of hypertension are caused by kidney problems or various cancers. However, about 95% of hypertension is called “essential” hypertension and has no obvious cause.
Many drugs are used to treat hypertension. These include diuretics, or water pills, such as Lasix; beta blockers, such as Lopressor; thiazides, such as hydrochlorothiazide; and Angiotensin Converting Enzyme (ACE) inhibitors, such as Lotensin, Vasotec and Univasc. While many of these drugs are useful in controlling high blood pressure, all of them have potentially serious side effects. Diet can play a major role in blood pressure control but is often overlooked in treating hypertensive patients.
Limiting intake of sodium or salt is often recommended for controlling blood pressure. The average Western Diet contains about 5,000 milligrams (5 grams) of sodium daily (amounting to almost a tablespoon of salt), while only about 1,500 milligrams daily is needed to maintain health. Major amounts of salt are added to many processed foods such as soups, meats, vegetables, and many snack foods. Various studies have reported that limiting sodium intake can significantly reduce blood pressure in about half of hypertensive patients.
Hypertensive people should consider buying lower-sodium prepared foods and add only small amounts of salt to the food they prepare. Most fresh fruits and vegetables are low in sodium and are ideal for low salt diets. Low sodium herbal seasonings can also be used to replace salt in prepared foods.
Consuming enough potassium is critical to maintaining a good blood pressure. The biggest source of potassium in the US diet comes from fruits and vegetables. Bananas and citrus fruit are especially high in potassium. On the other hand, most sugary foods like colas, lemonade and artificial fruit drinks, cookies, candy and cake have little potassium. Only about 23% of the US population consumes the recommended 5 or more servings per day of fruits and vegetables. Numerous studies have reported that consuming higher levels of fruits and vegetables are associated with a significantly lower risk of hypertension. Various studies in developed nations have estimated that, if the entire adult population consumed 5 or more servings a day of fruit and vegetables, hypertension rates would fall by about 50%, heart attack rates would fall by about 30% and stroke rates would fall by 10%. (For a good review of the beneficial health effects of 5 fruits and vegetables a day on health- please see Journal of Nutrition Education and Behavior, January 2009).
All adults should be eating at least 5 servings a day of a wide range of fruits and vegetables. Fruits and vegetables can be enjoyed in many forms, including eaten raw by the hand, eaten in salads and soups, eaten lightly cooked as a side dish or blended into smoothies. Several studies have reported that having a home or school vegetable garden greatly increases both interest in vegetables and vegetable consumption in children. Note, people on an anti-yeast diet would probably be best to consume larger quantities of vegetables than fruits, since many fruits are high in natural fruit sugars which can feed growth of Candida.
Obtaining enough calcium and magnesium are also critical in controlling blood pressure. Only about half the US population consumes recommended levels of calcium and magnesium in their diet. Many studies have reported that consuming low levels of calcium and magnesium are associated with an increased risk of hypertension. Several studies have reported that taking supplements containing 500 milligrams or more of calcium and 200 milligrams or more of magnesium a day are associated with a significant drop in blood pressure in hypertensive patients.
Other foods and supplements may have beneficial effects on blood pressure. Supplements of the amino acid l-arginine have been show to be associated with modest declines in blood pressure. Consumption of yogurt and other fermented milk products has been associated with drops in blood pressure. This may be due to small protein products produced by the Lactobacillus bacteria in the yogurt. Some studies have shown that consumption of onion, garlic and tea can modestly reduce blood pressure. Some, but not all, studies have found that consumption of soybean products can lower blood pressure. Eating Wakame (brown kelp seaweed), hawthorn, ginger and gingko leaves have been associated with reduced blood pressure. The use of fish oils (rich in omega 3 fatty acids) have been associated with drops in blood pressure when consumed in high amounts (10 grams a day or more- about 2 teaspoons daily) but not at lower levels. (For a good review of the effects of specific foods on hypertension- please see Chen et al in the June 2009 Journal of Agricultural and Food Chemistry).
The DASH (Dietary Approaches to Stop Hypertension) diet has been very effective in many studies for controlling blood pressure. The DASH diet limits sodium to 2,400 milligrams per day, includes 8 to 10 servings of fruits and vegetables daily, 2 servings of meat and fish, 6 to 8 servings of whole grains and 2 to 4 servings of low fat milk. About half of the formerly hypertensive patients have achieved normal blood pressure on the DASH diet. Many of these patients have also been able to reduce or eliminate their prescription blood pressure medications.
Many studies have reported that exercise plays a beneficial role in reducing blood pressure in hypertensive patients. Adults should pick exercise they enjoy such as walking, jogging, bicycling, swimming, golf, exercise class, dancing, weights, tennis, golf etc- and participate for at least 30 minutes at least 3 times per week. Other techniques such as massage, Yoga, relaxation techniques and prayer have shown some promise in controlling hypertension.
Luke Curtis, M.D., M.S., CIH