A World Under Pressure

Culture and language may divide us, but one thing that people share no matter where
they are on the globe is a propensity for developing dangerously high blood pressure.
But just because pressure is rising the world over doesn’t mean you have to jump on
this particular trend. There are natural ways to help you and your arteries keep their cool.

By Claire Sykes

February 2008


Industrialized countries are continuing to see their sedentary, fast-food-consuming populations bloat with obesity, and developing nations are picking up the bad health habits of the west. The sum of those disturbing pieces of news is a problem of global proportions.

From the Americas to Africa, the number of people with chronically high blood pressure (also known as hypertension) is growing, threatening a global epidemic of cardiovascular disease. “Until recently, we thought that hypertension was a problem predominantly in North America, Western Europe and Japan. But it’s prevalent in many countries, especially those in Africa, including South Africa, and in Eastern Europe and Latin America,” says Michael Weber, MD, professor of medicine at State University of New York Downstate Medical Center in Brooklyn. He also co-authored High Blood Pressure and Health Policy: Where We Are and Where We Need to Go Next, an international report released in May 2007 at the National Press Club in Washington, DC.

About 1 billion people in the world have high blood pressure, with 60% more expected by 2025, the report states. Just over half of the 72 million Americans with hypertension are women, who are also three times more likely to develop type 2 diabetes. This disorder hits African Americans earlier and more seriously than any other ethnic group. Also sobering is the fact that blood pressure is excessive among 19% of kids who are, on average, 13 1/2 years old.

“We’re talking about populations around the world that have become more sedentary in their lifestyles and are consuming significantly more calories than they did a few decades ago,” says Weber. “Countries like India, Malaysia and Vietnam have become industrialized, transitioning from a fairly simple lifestyle to a highly urbanized one. As people have migrated from rural areas into cities, they eat more fast food and walk less, and their blood pressure goes up dramatically.

“Most of the measures that health experts in many countries have taken to address high blood pressure at the patient level—primarily issuing guidelines for how far blood pressure should be reduced in hypertensive patients and also recommending drugs that can help achieve these goals—haven’t been as successful as they should’ve been,” Weber continues. “The problem has been that the guidelines have often been ignored for a variety of reasons, including limited patient access to medical care, cost, indifference on the part of both patients and doctors, and the use of inexpensive older drugs that often cause side effects. It’s a serious issue that governments and policy makers have to get involved with, now.”

The Numbers Game
     While public health authorities are busy drafting initiatives and bills, you could help yourself if you’d stick out your arm and get a hug from the cuff. Unless you get checked, you may never know you have high blood pressure—dubbed “the silent killer” because of its typical lack of symptoms.
 

Blood pressure is expressed as two numbers measured in millimeters of mercury (mmHg). The numbers indicate how hard the blood is pushing against the inner walls of the arteries with each heartbeat. The top number is the systolic pressure, when the heart muscle contracts and pumps blood from its chambers into the arteries. The bottom number is the diastolic pressure, when the heart is resting between beats as the chambers fill with blood. Normal blood pressure is less than 120/80, prehypertension is 120-139/80-89 and hypertension is 140/90 on up.

When your arteries are too narrow or constricted, blood rushes through them with a greater-than-normal force. If it doesn’t let up, you’re in trouble.

Maureen Williams, ND, a naturopathic physician who practices in Hartland, Vermont, explains: “If the heart keeps beating blood through tight and resistant passageways, it compensates by building more muscle. As the heart muscle gets bigger, its chambers get smaller and the heart becomes less able to move enough blood—even though it’s working really hard. Pressure builds in the respiratory vessels when the heart can’t keep up, and eventually the pressure becomes so great that fluid leaves circulation and collects within the lungs. This is called congestive heart failure and can eventually lead to death. High blood pressure also increases your risk of stroke, heart attack, kidney disease and eye damage.”

The list of woes caused by high blood pressure only continues to grow. Research published in the Archives of Neurology (12/07) has linked hypertension with mild cognitive deficits.
Anything that contributes to constricted arteries, including genetics, is guilty of having a hand in high blood pressure. Obesity is the biggest culprit by far, forcing the heart to work hard pushing blood through the excess weight. Then there’s lack of exercise, stress, nutritional deficiencies, smoking, certain medications, kidney disease and, yes, aging. “In the US, by the time you reach 60, there’s a [more than 50%] chance you’ll have high blood pressure, and if you’re in your 80s, it’s close to 100%,” says Weber.

Back in February 1997, Frank Merewether’s doctor told him his blood pressure was 104/64. A month later, it jumped to 144/94. Over the years, the numbers have fluctuated, depending on his medication and his efforts to treat his blood pressure. “I try to be religious about taking medicines and supplements, but other than that, I don’t worry. I’ve been pretty cavalier about it,” admits the 67-year-old from West Fairlee, Vermont.

He’s not alone. “Only about 50% to 60% percent of people diagnosed with high blood pressure are trying to get it under control. Even those taking medication and changing their lifestyle reduce their blood pressure to acceptable levels just over half the time,” says Weber.

Arterial Relaxation
There’s no mystery to controlling blood pressure. “If you can get the muscles of the arterial walls to relax, the blood pressure will, too,” says Williams. “That’s what antihypertensive drugs do.” While they reduce high blood pressure quickly, they also can cause dizziness and dry mouth, headaches and constipation. Because of these side effects, Merewether started seeing Williams, who says, “I have other patients who are using these drugs, but often they can eventually cut them down, or even out entirely, as they work with me on changes in diet and lifestyle.”

Williams says a vegetarian diet is most helpful in lowering blood pressure, in particular the DASH diet (Dietary Approaches to Stop Hypertension). It’s high in fruits, vegetables, whole grains and proteins, and low in dairy, saturated fats and cholesterol. Williams also emphasizes garlic, ginger and onions, which help reduce plaques in the arteries. So does the lycopene in tomatoes. Wild, cold-water fish, like salmon and mackerel, contain healthful fats, as do nuts and seeds, also great sources of fiber. But let up on the salt, too much of which causes high blood pressure. For dessert?

Have some dark chocolate. Enjoyed in moderation, its flavonoids not only act as an anti-oxidant and anti-inflammatory, but also open the blood vessels.

Regarding supplements, Williams recommends 300 mg twice per day of magnesium, a natural calcium channel blocker (a class of drugs that prevents calcium from getting into the muscle cells of the heart and arteries, which constricts them). Merewether takes a daily 450 mg dose of hawthorn extract, and twice a day he takes three drops of another herb called rauvolfia, both of which dilate blood vessels. A teaspoon of cod liver oil (just like Grandma took) and 60 mg of the antioxidant compound CoQ10, taken daily, can also help lower blood pressure. And the amino acid L-arginine, at a dosage of 1,500 mg twice a day, “contributes to the production of nitrous oxide, which is involved in vessel dilation and flexibility,” notes Williams. Researchers at the University of Utah found that quercetin, a phytonutrient found in onions and apples, lowered pressure among people with hypertension in a double blind, placebo-controlled study published in the November 2007 issue of the Journal of Nutrition.

Since obesity plays a huge role in high blood pressure, strive for an ideal body weight by losing fat and gaining lean muscle mass. Along with filling your fork with healthful foods, that means getting your body in motion. “With exercise, a lot of oxygen and blood flow through the body, and to allow for that, the blood vessels have to maintain a higher pressure. Because they work so hard to do that, when you stop exercising your blood vessels relax even more,” says Williams, who advises a daily 45-minute walk (although a little less will do the job).

And then know when to stop moving so much. Yoga and tai chi both help relax blood vessels. So does meditation. In an analysis of 107 studies, one form called Transcendental Meditation reduced systolic pressure by an average of 5.0 points and diastolic by 2.8.

Acupuncture helps, too. “We have lots of evidence that acupuncture excites brain cells to release endorphins, which in turn quiets down the neural outflow from the brain and reduces the constriction of blood vessels,” says John Longhurst, MD, professor of medicine and director of the Susan Samueli Center for Integrative Medicine in Irvine, California. “This action slows down the heart and its need for oxygen, thereby lowering blood pressure, but only when it’s elevated. Over two months, 30 minutes per week of electroacupuncture (weak electrical stimulation of the acupuncture needles) can lower blood pressure as much as 10 to 20 mmHg. But unless you continue with treatments, within two months your blood pressure most likely will shoot back up.”

To know if all your efforts are paying off, get your blood pressure checked regularly—several times over three days to verify consistency—and write the numbers down. Consider a home blood pressure monitoring device, but be sure to test it for accuracy against the professional one at your practitioner’s office.

“If your blood pressure remains too high,” says Williams, “you need to get it down fast, so see your medical doctor.” Then look to a long-term program that includes a healthy choice of foods and supplements, along with an exercise regime and stress-reduction program.
It may not require as much as you think to push your blood pressure down to a healthier level. Just replacing that steak with a plate of vegetables or taking the stairs instead of the elevator can make a difference—and make the world a much healthier place.

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