Hypertension

What Is High Blood Pressure?

High blood pressure (hypertension) is defined as a blood pressure that is consistently (more than 6 months) above 140/90. Systolic blood pressure is the top number. Diastolic blood pressure is the bottom number. Hypertension may have no known cause (essential or idiopathic hypertension) or be associated with other primary diseases (secondary hypertension). Approximately 90% of people with high blood pressure have “essential” or “idiopathic” hypertension, for which the cause is poorly understood . The terms “hypertension” and “high blood pressure” as used here refer only to this most common form and not to pregnancy-induced hypertension or hypertension clearly linked to a known cause, such as Cushing’s syndrome, pheochromocytoma, or kidney disease. Hypertension must always be evaluated by a healthcare professional. Conditional hypertension following stressful events, dehydration, drug interactions or food allergies are self limiting when the cause is removed and some time passes. Extremely high blood pressure (malignant hypertension) or rapidly worsening hypertension (accelerated hypertension) almost always requires treatment with conventional medicine. People with mild to moderate high blood pressure should work with an understanding doctor to see if lifestyle or other events, such as the “white coat syndrome” (blood pressure that is elevated in the doctor's office but normal outside of the doctor's office) are causing the elevation. A personal home blood pressure monitoring device used throughout the day for one week or more is a helpful way of determining what is causing the blood pressure elivation.

What are the signs and symptoms of high blood pressure?

Unfortunatally, essential hypertension is usually without symptoms until complications develop. For this reason one can see the importance of getting checked regularly by your doctor. The symptoms of complications depend on the organs involved. The dangers of untreated high blood pressure can cause damage to the:

• brain
• eyes
• kidneys
• heart

What steps can you take to reduce your blood pressure?

• Maintain a healthy weight. Lose excess weight and keep it off with a long-term program of exercise and healthier eating
• Side-step salt. Avoid using too much table salt, limit salty fast foods, and read labels to find low sodium foods in your grocery store.
• Watch what you eat. Choose a diet low in cholesterol and animal fat; high in fruits, vegetables, whole grains, legumes, and low-fat milk products; with some nuts and seeds.
• Try coenzyme Q10. Taking 100 mg a day may have a significant impact on your blood pressure.
• Take minerals. Supplements of calcium (800 to 1,500 mg a day) and magnesium (350 to 500 mg a day) may be helpful.
• Boost heart health with garlic A 600 to 900 mg a day standardized garlic supplement can improve heart and blood vessel health, and also has a mild blood pressure–lowering effect.

As with conventional drugs, the use of natural substances sometimes controls blood pressure if taken consistently but does not lead to a cure for high blood pressure. Thus, someone whose blood pressure is successfully reduced by weight loss, avoidance of salt, and increased intake of fruits and vegetables would need to maintain these changes permanently in order to retain control of blood pressure. Remember, left untreated, hypertension significantly increases the risk of stroke and heart disease.

What dietary changes may help lower blood pressure?

• Limit salt intake. Primitive societies exposed to very little salt suffer from little or no hypertension. Salt (sodium chloride) intake has also been definitively linked to hypertension in western societies. Reducing salt intake in the diet lowers blood pressure in most people. The more salt is restricted, the greater the blood pressure-lowering effect. Individual studies sometimes come to differing conclusions about the relationship between salt intake and blood pressure, in part because blood pressure-lowering effects of salt restriction vary from person to person, and small to moderate reductions in salt intake often have minimal effects on blood pressure - particularly in young people and in those who do not have hypertension. Nonetheless, dramatic reductions in salt intake are generally effective for many people with hypertension.
  With the prevalence of salted processed and restaurant food, simply avoiding the salt shaker no longer leads to large decreases in salt intake for most people. Totally eliminating salt is more effective, but is quite difficult to achieve. Moreover, while an overview of the research found “There is no evidence that sodium reduction presents any safety hazards,” reports of short-term paradoxical increases in blood pressure in response to salt restriction have occasionally appeared. Therefore, people wishing to use salt reduction to lower their blood pressure should consult with a doctor.
• Reduce meat intake. Vegetarians have lower blood pressure than do people who eat meat. This occurs partly because fruits and vegetables contain potassium—a known blood pressure-lowering mineral. The best way to supplement potassium is with fruit, which contains more of the mineral than do potassium supplements. However, fruit contains so much potassium that people taking "potassium-sparing” diuretics can consume too much potassium simply by eating several pieces of fruit per day. Therefore, people taking potassium-sparing diuretics should consult the prescribing doctor before increasing fruit intake. In the Dietary Approaches to Stop Hypertension (DASH) trial, increasing intake of fruits and vegetables (and therefore fiber) and reducing cholesterol and dairy fat led to large reductions in blood pressure (in medical terms, 11.4 systolic and 5.5 diastolic) in just eight weeks.9 Even though it did not employ a vegetarian diet itself, the outcome of the DASH trial supports the usefulness of vegetarian diets because diets employed by DASH researchers were related to what many vegetarians eat. The DASH trial also showed that blood pressure can be significantly reduced in hypertensive people (most dramatically in African Americans) with diet alone, without weight loss or even restriction of salt. Nonetheless, restricting salt while consuming the DASH diet has lowered blood pressure even more effectively than the use of the DASH diet alone.
• Reduce sugar intake. Sugar has been reported to increase blood pressure in animals and humans in short-term trials. Though the real importance of this experimental effect remains unclear, some doctors recommend that people with high blood pressure cut back on their intake of sugar.
• Limit caffeine itake. Right after consuming caffeine from coffee or tea, blood pressure increases briefly. In trials lasting almost two months on average, coffee drinking has led to small increases in blood pressure. The effects of long-term avoidance of caffeine (from coffee, tea, chocolate, cola drinks, and some medications) on blood pressure remain unclear. A few reports have even claimed that long-term coffee drinkers tend to have lower blood pressure than those who avoid coffee. Despite the lack of clarity in published research, many doctors tell people with high blood pressure to avoid consumption of caffeine.
• Increase your fiber intake.Several double-blind trials have shown that adding 5–7 grams of fiber per day to the diet for several months leads to reductions in blood pressure. However, other trials have not found fiber helpful in reducing blood pressure. The reasons for these discrepant findings is not clear.
• Consider being tested for food allergies. Food allergy was reported to contribute to high blood pressure in a study of people who had migraine headaches. In that report, all 15 people who also had high blood pressure experienced a significant drop in blood pressure when put on a hypoallergenic diet. People who suffer migraine headaches and have hypertension should discuss the issue of allergy diagnosis and elimination with a doctor.
• Do not reuse frying oils. Reusing vegetable oils for frying, especially oils with high concentrations of unsaturated fatty acids (such as sunflower or safflower oil) has been associated with an increased risk of high blood pressure. Presumably, this increased risk is due to some of the degradation products (such as lipid peroxides or polymers) that result from the excessive heating of these oils. Frying with more stable oils, such as olive oil, is not associated with an increased risk of high blood pressure.

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Lifestyle changes that may be helpful in lowering high blood pressure.

• Smoking is particularly injurious for people with hypertension. The combination of hypertension and smoking greatly increases the risk of heart disease-related sickness and death. All people with high blood pressure need to quit smoking.
• Consumption of more than about three alcoholic beverages per day appears to increase blood pressure. Whether one or two drinks per day meaningfully increases blood pressure remains unclear.
• Daily exercise can lower blood pressure significantly. A 12-week program of Chinese T’ai Chi was reported to be almost as effective as aerobic exercise in lowering blood pressure. Progressive resistance exercise (e.g., weight lifting) also appears to help reduce blood pressure. At the same time, blood pressure has been known to increase significantly during the act of lifting heavy weights; for this reason, people with sharply elevated blood pressure, especially those with cardiovascular disease, should approach heavy strenuous resistance exercise with caution. In general, people over 40 years of age should consult with their doctors before starting any exercise regimen.
• Most people with high blood pressure are overweight. Weight loss lowers blood pressure significantly in those who are both overweight and hypertensive. In fact, reducing body weight by as little as ten pounds can lead to a significant reduction in blood pressure. Weight loss appears to have a stronger blood pressure-lowering effect than dietary salt restriction.

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These statements have not been evaluated by the Food and Drug Administration. These products are not intended to diagnose, treat, cure, or prevent any disease.