After Reading: What Your Doctor May Not Tell You About Hypertension: The Revolutionary Nutrition and Lifestyle Program to Fight High Blood Pressure By Mark Houston, M.D., Barry Fox, Ph.D., Nadine Taylor, M.S., R.D.
Hypertension is as common as salting the fries and its existence is directly proportional to the amount of salt being used—we use salt in heaping loads not in pinches. “Of the more than 50 million hypertensive Americans, fewer than 14 million have it under control,” and it exists as a “silent killer” for the 1/3 who are unaware.
Much of the blame must be shouldered by the doctors who are not offering enough advice about nutrition, exercise, and other lifestyle factors but rather relying on conventional medicine. It is this lack of advice that provides this silent killer the opportunity to exhibit “…no obvious symptoms until the blood pressure is very high.”
Doctor…Doctor…how could you do this to me? His or her reply would note that it was essentially you that caused your hypertension and that you were likely not taking your meds or following the medically prescribed diet appropriately. Are you to blame? Is it you that must shoulder the weight? Let’s find out…
WHAT IS HYPERTENSION
“But since you can’t feel, hear, taste, or see the signs of hypertension, you can easily ignore it.”
Medically speaking, it is a numbers game. Common-sense speaking, it is not a numbers game. Do not misread me and believe that these numbers are unimportant. These numbers are like calories, grams of fat, and etc…—they are misleading. A stage two hypertension level is not misleading in that it does not necessitate treatment, it is misleading in the way we are nudged into treating it.
“I must emphasize that there are no magic pills or instant cures for high blood pressure”—”lifelong battle.”
After scanning those numbers I provided above and now reading that 32% of deaths resulting from hypertension-related heart disease occur with a systolic pressure less than 140 mmHg, would you go back up to those numbers to verify that ’140′ is in the stage 2 zone? Scroll up. Whole body shiver. Scroll down. More bad news: stage one has a greater risk of (compared to normal/high normal):
- Heart attack: 31%
- Stroke: 2x
- Death rate: 43%
It is these itsy-bitsy misconceptions that should provide enough of a nudge into the awareness that stage 1 is not necessarily better than stage 2. It may be the better of the two evils, but then again there are no good evils—and then again, again, being below these levels does not technically clear you of all risks.
Hypertension is simply excess pressure, pressure that results in endothelial damage. It is this endothelial lining of cells that:
- Secretes hormones & substances that regulate blood pressure.
- Regulates the stickiness of the blood.
- Regulates the growth of the blood vessel wall.
“The endothelium is, in fact, an endocrine organ which means that it manufactures and secretes hormones locally and directly into the bloodstream.”
- Contraction & Dilation via hormones
- Nitric oxide if blood pressure is too high—dilates.
- Function of Platelets
- Thickness/Thinness of blood
- How white blood cells stick to the arterial walls
- Inflammatory Process
- Growth, Thickness, & Stiffness of vascular muscle
- Helps control oxidative stress
- “akin to biochemical thievery”
- Unbalanced molecules snatching electrons from other substances.
- Antioxidants: Body manufactures them and we can get them from food.
HYPERTENSION & THE ENDOTHELIUM
Along with its buddies—high cholesterol, diabetes, aging, and genetic hypertension—hypertension is not a dormant out-of-sight-out-of-mind feature because you cannot feel, hear, see, or taste it—it betrays your body by continually damaging it. As pressure rises, smalls cracks and lesions will form and endothelial dysfunction will be the end result after an often flawed immune response appears on the scene to begin the repair process. This crime scene is perfect for the development of plaque, a sticky combo of cholesterol, fat, calcium, and cellular debris. The immune cells burrow in and “set up camp”, and…
ARTERIO- VS ATHERO-
Atherosclerosis is when arterial walls become thick, fibrous, and calcified because of the build up of plaque. When plaque builds up it reduces the diameter of the artery and thus builds pressure (hypertension).
Arteriosclerosis acts similarly to thicken, stiffen, and calcify the walls of arteries, but it is due to a decreased blood supply.
Arterio- & Athero- obviously beget one another. If there is plaque and the diameter is reduced, then the blood supply is reduced too. If blood supply is reduced, damage is a given, and although blood supply is not rampant, immune mediators will work their way to the scene.
BP = CO X SVR
Blood Pressure equals Cardiac Output times Systemic Vascular Resistance. More simply put, blood pressure equals force times resistance. Just as in an air-filled balloon or a packed-by-mom school lunch in a brown paper bag or a crowded auditorium, force and resistance each play an integral part. An overly filled balloon may pop; a too-many-snacked brown paper bag may rip; and a crowded auditorium may turn riotous—these contribute to force, but blood pressure is force multiplied by resistance. That balloon is tied; that brown-bagged lunch will likely have to be ripped open to unearth its goodies; and you want space to move, you best book it for the exits and leave the auditorium.
Those examples mentioned above offer an analogical insight into blood pressure, but they are too easily controlled. Our arteries cannot be untied, ripped apart, and easily exited . Our arteries—Mark provides this analogy—are more like a garden hose. With a firm grip and a great sense of humor, one can thumb-tip the nozzle of a garden hose and spray some innocent bystanders. It is that decreased diameter resistance that yields a much more powerful rush of water.
It won’t last forever:
- Maybe you get tired and your finger gets dislodged.
- Translation: plaque can become dislodged too → embolus → clog somewhere else.
- Maybe the resistance from behind the finger has begun to wear down the hose or even spring a leak.
- Translation: arteriosclerosis & atherosclerosis
- Maybe both will happen…
FACTORS THAT SEND THE HEART INTO OVERDRIVE
- Narrowed Arteries
- Being Overweight
- Fat = tissue = needs blood supply too.
- “…a pound of fat contains about a mile of capillaries.”
- Emotional Stress
- Fight or Flight = Increased: Heart Rate, Blood Sugar, Cholesterol, and Blood Pressure
- Psychological Factors
- Personality: Aggressiveness, etc…
- Physical Stress
- “Yet too much of a good thing can be a bad thing.”
- Lack of Sleep
- When done appropriately, the heart pumps more efficiently:
- Decreased atherosclerosis
- Decreased blood fats
- Decreased vascular resistance
- “Yet too much of a good thing can be a bad thing.”
- Increases arterial wall tension and speeds rate of muscular contraction.
- Crowds oxygen with carbon monoxide → less oxygen per unit of blood.
- Need more blood to satisfy oxygen requirements → hypertension
- Hormonal Regulators
- High Sodium Diet
- Draws water back into the body—more water equals more volume and an increased vascular pressure.
- Can have as much as 50% more blood during the later stages.
HYPERTENSION & YOUR BODY
BRAIN & ALZHEIMER’S
“…number one cause of dementia in the U.S. may actually be hypertension, which causes a condition called vascular disease.” We fall victim to the belief that we can outsmart the degeneration of the brain in a way that only skirts around the obvious. It is a “white matter disease” and I urge you to recognize the significance of this. Simply put, if you don’t use it, you will likely lose it, but if you abuse it, you will surely lose it. Read more about it: Link, Link.
Capillaries are networks of the smallest blood vessels in the body. Now imagine that garden hose from before again. Could you exert that same thumb to nozzle technique on a hose with the dimensions of a strand of your hair? Probably not, and this is where you now imagine plaque or any form of bodily debris clogging these small vessels—your eyes have small arteries too!
A high blood pressure will certainly weaken your vasculature, but what about your heart? It is a pump, a pump that can potentially be surgically replaced in the future. It is not a fresh roll of toilet paper, just hung after reaching the brown cylinder of its ancestor. It becomes bigger, stronger, and eventually weaker. Hypertension is like your body going to the gym constantly. Professionals refer to it as cardiomegaly. In layman’s terms, a hypertensive heart is like Arnold Schwarzenegger after too many years of heavy lifting and…, weak, flabby, and ready to surrender.
80% of patients also have coronary artery disease. Low HDL levels, high LDL levels, and high triglycerides is the perfect construction plan for new plaque settlements along the walls of your arteries. Your heart needs a blood supply to nourish, oxygenate, and essentially power it to pump. When blood levels are tinkering on disastrous and your heart, the ultimate blood machine, is crying because it itself is not getting enough blood, that is called a heart attack.
Hypertension overwhelms the kidneys with its force and the toxins rushing its way via the blood. It ends with your body drowning “in its own waste” and begins with the kidneys being unable to filter these toxins—uremia. Another factor is the enzyme renin which is released by the kidneys in an effort to help regulate blood pressure. As the system progressively fails, so does its ability to regulate.
WHAT CAN YOU DO?
FACTORS YOU CANNOT CHANGE
- 1/3 of African-Americans have hypertension, compared to 1/4 of Caucasians.*
- Females: less hypertension before age 60 and more after age 60.*
*I am nowhere near convinced that race and sex make you more likely to suffer from hypertension. I feel that there are too many controllable factors not being taken into account by the vast majority of suffers to jump to such conclusions.
FACTORS YOU CAN CHANGE
- Alcohol Abuse
- Poor Diet
- Lack of Exercise
- Emotional Stress
VITAMINS & MINERALS
- Potassium & Sodium Balance
- High potassium & low sodium = hypotension
- Low potassium & high sodium = hypertension
- Average American Intake: 1:2 (Potassium:Sodium)
- Ancestors Intake: 5:1 (Potassium:Sodium)
- Adequate intake can lower hypertension.
- Vitamin D
- Low levels linked to:
- Elevated VLDL
- Body’s ability to clear fat slows
- Aids in calcium absorption
- Low levels linked to:
- Vitamin E, B6, & Zinc
- Lower in hypertension
- Inversely proportional to blood pressure: High Magnesium Diet = Low Blood Pressure
Some population studies show that a higher protein diet can lower blood pressure, but “…animal protein is less effective than non-animal protein.” Mark recommends 1.0-1.2g/kg of body weight.
OMEGA FATTY ACIDS
Mark offers eight reasons why omega-3s are the best:
- “…spur the body to increase production of substances that encourage the blood vessels to relax.”
- Improve insulin sensitivity
- Quell inflammation
- Reduce stickiness tendency
- Reduce fibrinogen—a clotting factor
- Reduce irregular heart beat
- Reduce blood fat
- Reduce coronary problems and diseases
- Protect against saturated fats.
- Enhance production of artery relaxing substances.
- Block stress induced hypertension.
FISH OIL STUDY
- Group 1: Made no changes
- Systolic & Diastolic, no notable changes.
- Group 2: 1 meal of fish
- Systolic: ↓6.0
- Diastolic: ↓3.0
- Group 3: Lost weight
- Systolic: ↓5.5
- Diastolic: ↓2.2
- Group 4: 1 meal of fish and lost weight
- Systolic: ↓13.0
- Diastolic: ↓9.3
The results are blatantly obvious. There are no pills that can save you and only a modified lifestyle can protect you and fend off hypertension. Mark also uses a few pages to mention some olive oil studies and I recommend you refer to my article on heart disease to see whether an oily diet is right for you or not.
The NHANES-II Study has been following 14 thousand Americans since 1975 and has recognized vitamin C, which can relax arteries and aid in reversing endothelial dysfunction, as another piece to the hypertensive enigma. Some studies have shown that vitamin C has a bigger effect on those with hypertension—the NHANES-II Study found that low plasma levels of vitamin C were found in 20% of white men and 30% of black men.
I quote myself from earlier: “1/3 of African-Americans have hypertension, compared to 1/4 of Caucasians.” These numbers are more than vaguely similar in nature and this may help explain the gap between races.
OTHER NUTRITIONAL FACTORS
- Coenzyme Q10
- Not essential—we manufacture it in our bodies.
- Mark writes that levels do decrease with age, hypertension, atherosclerosis, and diabetes mellitus.
- I find this misleading though. Age is not a predetermined set of years, it is a result of how you proceed throughout life. A unhealthy lifestyle begets some nasty results while a health-focused lifestyle begets more life.
- “Back in the 19th century, celery was considered a delicacy.”
- Antihypertensive & Diuretic
- Natural ACE inhibitor
- Works “…as well as captopril…”
- Natural ACE inhibitor
- Reduces endothelial dysfunction
- Reduces cholesterol
- Helps make nitric acid
The implementors behind DASH—Dietary Approaches to Stop Hypertension—are no different than the typical whimsical mind of an American dieter. They too sought miracle ingredients, but, again like us, they found none. Instead of retreating and accepting hypertension as just another part of life, they pushed forward and sought to see how these touted foods worked together in synergy.
“They also seem to avoid developing the steep rise in systolic blood pressure that we see so often in the rest of the population.”
“And the stricter the vegetarian diet, the lower the blood pressure levels.”
Eight weeks, 459 adults, 27% of which had hypertension, the results were:
- GROUP 1*
- Standard American Diet: No change
- Group 2*
- Similar Diet, but with more fruits and vegetables: Blood pressure dropped
- Group 3*
- DASH-1 Diet: Blood pressure dropped faster and more
- High in fruits and vegetables
- Low fat dairy
- Low: cholesterol, saturated fat, and total fat
- DASH-1 Diet: Blood pressure dropped faster and more
*Each diet contained about 3000 mg of sodium. With all three being asterisked, I feel it is safe to assume that there is not one single factor that predisposed one to hypertension. Likewise, treatment and or prevention work best as a synergy.
- 429 Subjects
- Blood Pressures: 129-59/80-95 mmHg
- 57% African-American
- 57% Women
- 41% Hypertensive
- Group 1: Standard American Diet
- Group 2: DASH-II Diet
Each subject consumed a specific level of sodium for one month at a time:
- 4.300 mg
- 2,400 mg
- 1,500 mg
Cutting back the salt intake reduced the blood pressures in both groups.
Group 1 utilized both salt restriction and hypertensive medications and their average reductions were:
- Systolic: 11.5 mmHg
- Diastolic: 6.8 mmHg
Group 2 showed greater reductions, compared to group 1, with each sodium reduction.
THE MESSAGE: “You can lower your blood pressure significantly by following the DASH-II diet and restricting your sodium intake to 1,500 mg/day, or less. And you can expect to see results that are equal to those achieved throughout monodrug therapy for mild hypertension. These results are immediate, sustainable, and inexpensive.”
AUTHOR’S MODIFIED DASH DIET
His advice is a little confusing at first—recommends decreasing fruits—but then slightly clears it up—most people will be doubling their fruits and vegetables. It is important to note that he is an advocate for raw fruits and vegetables.
- Saturated Fats: Avoid
- Potential Sources: Snacks, Canned Foods, MSG, Baking Soda/Powder, and Meds
- Protein: 1.0-1.2 g/kg of body weight per day
- Fat: 25-35% of total calories
- Omega-3s: 10%
- Omega-6s: 10%
- Omega-9s: 50%
- Saturated Fats: ≤30%
- This is a point of disconnect for me. He clearly writes off saturated fats—high in LDLs and trigylcerides—and he clearly contradicts himself with his ‘modified’ diet.
- Carbohydrates: Avoid Simple Carbs—spike your blood sugar levels.
- Simple: Processed, canned, and baked foods, white rice, sodas, table sugar, etc…
- Complex: Fruits and vegetables
- Water: Eight 8 ounce glasses each day
- Fiber: Get naturally…
- Too much, especially the handcrafted form, can disrupt the absorption of vitamins and other vital components.
- Excess tissue necessitates a greater blood supply—”…a pound of fat contains about a mile of capillaries.”
Honestly, think about that for a moment. You may not realize it, but for every pound you gain and every hinderance that opposes your body, it must be met with an equally impressive opposition in order to maintain a balance. Blood, being the carrier of the hammers and nails to life, must work to reach every spec of your body. When it fails to do so, you fail too, spec by spec. Obesity is a window pleading with a help wanted sign for a business that will never succeed. Workers will come and workers will go, their work having never amounted to much more than an effortful failure.
- Insulin resistance and blockade.
As the pancreas juices up its engines to pump out more insulin—can be helpful as it is a natural response—sodium retention can be elevated. It is too much insulin in the circulation that precedes this and only acts to increase blood volume. Just as in that balloon, brown bag, and auditorium, a greater volume always results in greater pressure, and in this case, a higher incidence of atherosclerosis too. Read more about the effects of blood sugar and diabetes.
- Lose ten pounds—shown to help decrease blood pressure.
Only a healthy weight is a healthy weight and there are no in betweens. Our lickety-split temptation to shed it quickly or even gain it quickly—bodybuilders and their gaining seasons—is a burden to the body and can, potentially, be dangerous. An understanding of kidney stones will help clarify this.
Caffeine, a stimulant that meets resistance and subsides after 30-60 minutes and sometimes days, often provides more than that morning or mid-afternoon jolt—”A single cup of coffee drives up your blood pressure and heart rate and makes your arteries stiffer almost immediately, although these effects tend to be short-lived (mentioned just above).”
Other than the satisfaction this jolt provides to many as they splurgingly throw handfuls of money its way, the idea of caffeine is conflicting, especially in how we seize the cup quite a few times each and every day. A short little rant, followed by two studies, is undeniably necessary—for heaven’s sake people, it may save your life (not the coffee).
Stimulation acts to discourage the depressing calm (antonyms) and mediate a balance. As a coffee drinking society, we are no longer on the brink of being stimulated, we are drowning it. We are not splashing around in its joyous waters of ecstasy, we are self-submerged beneath reality and blockaded from practicality. Our body can naturally make itself aware, a form a stimulation, but we choose a different path, a path of infinite resistance.
Staying up too late, working too hard, masticating the unimaginable, and etc…—then we seek to be stimulated because we are in a depressed state. It is an unrestricted up and down fueled by our desire to avoid reality and exceed the limits. It all averages out though…Rant complete.
In the first of two studies, two cups of coffee were provided to a 150 pound individual.
- Systolic: ↑ 5-9 mmHg*
- Diastolic: ↑ 3-8 mmHg*
*If caffeine free for 12 hours or more, these blood pressure changes rectified themselves. If caffeine free for 12 hours or more… who the hot-place, opposite of in-the-sky-above-the-clouds heaven, can’t remember its name, beneath our feet about a million miles, do these scientists think they are talking too! Seriously, does anyone know a one-cupper of coffee. I know some no-cuppers, me and not many others, but even a two-cupper is a rarity. Whether it is an energy drink or Folgers in your cup, this is not a society where 12 hours or more can lapse without another rant.
Two-hundred and fifty milligrams of caffeine (2 1/2 cups of drip coffee) was the protocol for the second study. Three times each day for seven days, participants indulged and had significant increases in their diastolic blood pressures 24 hours after the first cup. It’s okay though, it subsided within a few days…
Alcohol is a vasodilator—evidenced by bloodshot eyes and the ruddy complexion of the joyous fellow—and causes the body to react with vasoconstriction. Studies show that 1 1/2 to 2 drinks increases both the risk and severity of hypertension. Some other reasons to avoid:
- Empty calories → gain weight.
- Interferes with nutrition and dulls appetite
- Blocks absorption (vitamins, etc…)
- Release of cortisol
- Promotes sodium retention and potassium loss → increases blood pressure
- Decreases Blood Pressure, LDLs, Triglycerides, and Blood Sugar
- Increases HDLs
- Improves endothelial function & Increases nitric oxide
- Reduces formation of blood clots
- Burns Calories & Reduces total body fat
- Improves blood flow
- Helps manage stress
- Burns off stress hormones, releases tension, and eases anxiety and depression
“…Avoid bulking up and overdoing it. And if you feel that you’re straining, ease off.” I completely agree with this, yet he offers a conflicting Harvard Alumni Health Study in which he forgets to take a stand. Burning calories, 2,100/week, decreased the participants risk of coronary artery disease by 10%. Continued improvement with a 19% reduction was achieved by setting fire to 4,200 calories, but reductions only plateaued after this level.
I can put gas into a car to get me from point ‘a’ to point ‘b’, and for argument’s sake, let us imagine that my journey in miles is my life in years. I also know how much gasoline it will take me to get from sperm to eternal rest. If I for some reason choose to over-fill it for the journey, would my car become obese? No. A puddle would splash into existence beneath my feet and only my receipt would print out a heftier number. I find this Harvard Study misleading based on this reasoning.
It is misleading because, do we need to burn more calories than we need to burn? Obviously we do not, but unlike an automobile, our bodies can unwillingly be forced to adapt, saving the ground beneath our feet from a puddle of fries…and I wish I could say the same for that receipt. This redundancy is both idiotic and extremely taxing on your only automobile through life, your body.
Mark also writes that anything that can make you strain, including heavy weight lifting, isometric exercises, rope climbing, sit-ups, and push-ups, should be attempted in a safe and aware manner—”…certain resistance exercises that drive your blood pressure up…”
How shall we proceed then? Mark tells us that sedentary people have a “20 to 50 percent increased risk of developing hypertension” compared to fit and active people. He also recommends reaching an intensity or a higher heart beat, and maintaining it. Forty-five minutes of aerobic exercise and fifteen minutes of resistance exercise each day, coupled with the loss of 4,200 calories per week, is also on his regimen.
I feel a structured plan will work because I know from personal experience. I feel a calorie counting plan will inevitably fail though, as the majority of you already know. Knowing that a brisk walk can be enough though, should be intriguing enough to engage you more fully. He writes that systolic blood pressure elevates during a walk and tends to drop afterward. In a study with mildly hypertensive men, the drop lasted 8-12 hours after the exercise. So, minus the calorie counting, relaxed aerobic exercise coupled with some manageable resistance exercise may be your best bet.
The fight or flight response, a sympathetic response, leads to:
- Increased heart rate
- Vascular resistance
- Thickening of blood
- Platelet Stickiness
- Stress hormones
- Adrenaline, Cortisol, and Norepinephrine
…all factors that contribute to hypertension. Some studies lead one to believe that mental stress is the boulder that breaks the back, when compared to physical stress. Chronic stress injures the endothelium and subdues blood vessels and may eventually overburden them into an inability to correct themselves after stress. And this is why chronic stress can lead to atherosclerosis and hypertension.
According to the authors, this is what works:
- Progressive Relaxation
- Especially Transcendental
- Example: concentrate on one word (love).
- Associated with ↓ atherosclerosis, ↓ cholesterol, and ↓ rates of hospitalization.
- Especially Transcendental
- Deep Breathing, Yoga, T’ai Chi, etc…
I hope after reading this that you come to the same conclusion I do. I hope you see that hypertension cannot be treated mono-therapeutically. You cannot just lose ten pounds or decrease your salt intake by a couple of table spoons and expect it to just go poof. Your vessels may relent and blow a gasket eventually, but that is a different poof and likely your last.
Maybe it’s unfair for me to impose such restrictive advice upon you because you cannot possibly imagine all this complex mumbo-jumbo going on within you or maybe you need to realize that your actions culminate and essentially provide the answer at the other end of the equals sign in your existence equation. Spoiler Alert: hypertension is presenting at epidemic levels, and you are to blame.
Do you have hypertension?
What causes it?
What lifestyle modifications have helped you?