Read an Excerpt
The Complete Guide to Lowering High Blood Pressure Naturally
By Deborah Mitchell St. Martin's Press
Copyright © 2014 Lynn Sonberg
All rights reserved.
ISBN: 978-1-4668-6268-5
CHAPTER 1
High Blood Pressure Basics
You walk into your doctor's office and hop up on the examining table, and a nurse or physician's assistant comes in and takes your blood pressure. He or she than scribbles a few numbers on a sheet of paper (or enters them into a computer) and prepares to leave the room. Before the health-care individual leaves, you might inquire, "How's my blood pressure?" But what exactly do you know about blood pressure? Do you understand the significance of the figures your health-care professional tells you? What is considered to be a "healthy" blood pressure for someone of your age, health status, and weight? Do the figures really represent your blood pressure, or are there some factors that have influenced or distorted your pressure that day? How many times and how often should you have your blood pressure checked?
HIGH BLOOD PRESSURE: BY THE NUMBERS
More than 73 million men and women in the United States — about three times the number who have diabetes and about one-third of the adult population — have high blood pressure. Unfortunately, an estimated 20 to 30 percent of people are unaware their blood pressure is high. In addition, many people with hypertension do not fully appreciate the seriousness of high blood pressure. Ignorance, in this case, is not bliss.
One reason for this lackadaisical attitude is obvious ... or should I say not obvious, since high blood pressure is a silent, invisible disease. Everyone with high blood pressure would likely be better off if every time their pressure rose above a certain point their nose lit up or their ears started to flap. Then it might get their attention!
And there's more. An additional 25 percent of adults have prehypertension, which means they are at risk for developing high blood pressure. These figures do not take into consideration the growing number of children and adolescents who have hypertension as well. Along with the incredible challenge to personal health, hypertension also costs the United States more than $76 billion in health-care services, medications, and missed workdays per year.
While these numbers are frightening enough, there is more:
• In growing numbers, high blood pressure is being diagnosed in younger and younger folks, including elementary-school–aged children. The long-term implications and health consequences of developing high blood pressure at a young age are enormous, and it is one of the concerns covered in this chapter and this entire book.
• About 66 percent of people older than age 65 have high blood pressure. Since many people in this age group are already dealing with other health problems and likely taking at least one medication, hypertension is a serious consideration.
• Even people who don't have high blood pressure at age 55 have a 90 percent chance of developing it within their lifetime. Thus the bottom line is, nearly everyone can expect to have high blood pressure at some time during their lives.
• Since high blood pressure is invisible and without symptoms, people tend to adopt the old "out of sight, out of mind" approach, but unfortunately, hypertension is not out of body. In fact, the impact of high blood pressure on the entire body is so significant, I dedicate an entire chapter to it.
None of this means, however, that you can't take steps to reduce and, dare I say, even prevent high blood pressure. Healthy management of hypertension is entirely possible and you can conveniently make it a part of your lifestyle.
Awareness of and knowledge about high blood pressure is of paramount concern among adults, however, not only because more men and women have this silent disease but also because they are the ones responsible for helping prevent the disease in children and adolescents and ensuring treatment if it does occur. Yes, high blood pressure can be a family affair.
So if you or a loved one can make the statement, "I have high blood pressure," let's help you better understand what's behind those words before exploring the many ways you can manage the disease.
WHAT IS HIGH BLOOD PRESSURE?
High blood pressure, or hypertension, is a condition in which the force of the blood on the artery walls as it travels throughout the body is greater than values that have been determined to be healthful. Those values are known as systolic and diastolic blood pressure. When a doctor tells you your blood pressure is 130/80 mmHg, it means your systolic pressure is 130 and your diastolic pressure is 80 millimeters of mercury (more on measuring blood pressure in chapter 2). One or both values can be too high, normal, or too low.
• Normal blood pressure is defined as 120/80 mmHg or lower.
• Prehypertension is defined as readings of greater than 120/80 mmHg to 139/89 mmHg.
• Stage 1 blood pressure is defined as 140 to 150 mmHg systolic or 90 to 99 mmHg diastolic.
• High blood pressure is defined as 140/90 mmHg or higher. However, high blood pressure is subdivided into stages: 140 to 159 mmHg systolic or 90 to 99 diastolic is stage 1; 160 mmHg systolic or higher or 100 mmHg diastolic or higher is stage 2.
• Systolic pressure is the force of the blood on the artery walls when the heart contracts
• Diastolic pressure is the pressure on the artery walls when the heart is relaxing, between beats
Blood pressure is a very fluid phenomenon, because it changes to meet your body's needs. Thus your blood pressure while you are propped up on the couch and reading a novel on your tablet will be different from your blood pressure when you are preparing dinner or racing up the stairs because you are late for a meeting at work. All of these changes in blood pressure are normal.
However, if your blood pressure remains in a high or abnormal range even when you are relaxing and then goes even higher to meet other situations in your life, then you have high blood pressure. But not all high blood pressure is the same, so let's look at the different types before going any further.
Essential Hypertension
Two other terms with which you should become familiar are "essential" or "primary hypertension" and "secondary hypertension." Essential hypertension is by far the most common type of high blood pressure, accounting for about 90 percent of all cases. This type of hypertension is also referred to as idiopathic because its cause is unknown, although it is generally associated with lifestyle factors (e.g., diet, overweight, lack of exercise, stress) and genetics. If you are wondering why experts do not know exactly what causes a condition as common as high blood pressure, the best I can say is that they are zeroing in on understanding the cause. In the meantime, they are gaining a much better understanding of the contributing factors, which you can read about in this chapter under "Why People Get High Blood Pressure."
WHY PEOPLE GET HIGH BLOOD PRESSURE
I have already mentioned that experts do not know exactly what causes high blood pressure. However, that does not mean they have not come up with a list of potential and likely suspects that have been shown to contribute to or be associated with its development. The list consists of two major categories: things people cannot change and things they can change. Obviously you want to focus on the factors you can change, but it's also good to know that even though there are some things you can't change, you can still have an effect on them. For example, you can't change the fact that high blood pressure runs in your family, but you can take steps toward modifying or eliminating certain lifestyle risk factors and significantly improve your chances of resisting high blood pressure.
The following list is not complete — scientists are continuously researching the origins, prevention, and treatment of high blood pressure, so there may be more factors to come. However, it represents what researchers have discovered thus far about high blood pressure. Do any of the following risk factors for high blood pressure apply to you?
Factors You Can't Change — but Can Influence
• Ethnicity. High on the list of risk factors you cannot change is your ethnicity. In the United States, African Americans are twice as likely as whites to have high blood pressure. That percentage declines somewhat around age 44, but the risk among blacks still remains higher than among whites. Among older adults (older than 65), black women have the highest incidence of hypertension.
• Age. The older you get, the greater your risk of developing high blood pressure. That's because aging is associated with more wear and tear on your blood vessels, more opportunity for the negative effects of other risk factors (e.g., poor diet, smoking, alcohol, and so on) to do their damage, and the like. So, as you can see, while getting older is a risk factor, you can still influence the degree to which it has an impact. Unfortunately, there is another angle to age and hypertension. An increasing number of young people — children and adolescents — have high blood pressure.
According to a study in BMC Pediatrics, 21 percent of schoolchildren ages 8 to 13 had high blood pressure. The prevalence was especially high among overweight and obese children and Hispanic youngsters. Another unfortunate situation is that many of these cases are not diagnosed because people generally don't associate hypertension with children. The topic of high blood pressure in children is important especially for parents to understand, and it is addressed in more detail in chapter 2.
• Genetics. If your mom, dad, grandparents, and/or siblings have high blood pressure, your chances are increased. Research suggests that about 25 to 30 percent of cases of essential hypertension are associated with genetic factors. So far, however, experts have not identified which genes are responsible for high blood pressure.
• Gender. A greater percentage of men than women develop high blood pressure up to about age 45. Both women and men have similar chances of developing high blood pressure between the ages of 45 and 64, after which time a greater percentage of women develop hypertension.
Factors You Can Change
• Salt. A high-salt diet can cause the body to retain excess water, which in turn causes the blood volume to expand, which then causes blood pressure to rise. Although everyone is not equally sensitive to salt, most people who have high blood pressure have some sensitivity to the sodium in salt. The association between high salt intake and high blood pressure can be seen especially among a group of people who live on the northern islands of Japan. These individuals consume more salt than people anywhere else in the world, and they also have the highest incidence of essential hypertension in the world. Salt is discussed in chapter 3 on diet.
• Stress. Stress plays a complicated role in blood pressure and heart health. One way it has an impact is that it activates the sympathetic nervous system, which results in more rigid arteries and thus a rise in blood pressure. You can learn to manage stress ... before it manages you and your blood pressure.
• Alcohol. Experts say it doesn't take much alcohol to send your blood pressure higher, as well as increase your risk of irregular heartbeats, stroke, and heart failure. Intake in excess of one drink daily for women and two drinks for men can contribute to hypertension. Excess alcohol also can raise triglyceride levels.
• Overweight/obesity. Being overweight or obese is a significant risk factor for high blood pressure. If your body mass index (BMI) is between 25 and 30, you are considered overweight. A BMI greater than 30 is considered obesity. People who carry excess weight may have elevated production of insulin and higher blood volume, and the burden of extra pounds can make the heart work harder. Being overweight or obese also raises cholesterol and triglyceride levels while lowering levels of good cholesterol (HDL cholesterol) and raising the risk of developing diabetes.
• Diet low in calcium, magnesium, and potassium. These three minerals have an intimate relationship when it comes to blood pressure, and maintaining a healthy balance between them goes a long way toward avoiding high blood pressure. Thus it is critical to adopt eating habits that provide a balance of calcium, magnesium, and potassium.
• Lack of physical exercise. Engaging in regular physical activity promotes healthy blood circulation and heart muscle, both of which support a healthy blood pressure. Inactivity also contributes to obesity, another risk factor for hypertension.
• Insulin resistance/diabetes. Insulin resistance is when the body does not respond properly to insulin. Because the body cannot respond normally, the pancreas secretes more insulin, which results in high levels of insulin in the blood. Over time, people with insulin resistance can develop high levels of glucose (sugar) in the blood and thus diabetes. Insulin resistance can cause blood pressure to rise as a result of the inflammation associated with diabetes.
• Smoking. If you smoke, you not only temporarily raise your blood pressure every time you light up; you also damage your blood vessels. Even if you don't smoke, exposure to secondhand smoke can increase your risk of heart disease. It seems clear that smoking at any level is a health risk!
• Elevated C-reactive protein. You may be wondering how you can change a factor you know nothing about and perhaps never heard of until now. C-reactive protein is a substance in the blood that indicates the presence of inflammation, and inflammation is a predictor of the development of high blood pressure, as well as cardiovascular disease, in some people. Levels of C-reactive protein can be reduced by making dietary changes, and so it is a risk factor that you can influence.
• Obstructive sleep apnea. Do you snore, breathe with stops and starts, and wake up feeling like you didn't sleep well? You may have obstructive sleep apnea, a common condition in which people stop breathing for several seconds or longer while sleeping. It's estimated that nearly 20 percent of adults in the United States have some degree of sleep apnea, yet only about 10 percent have been diagnosed. In obstructive sleep apnea, the airways become blocked or narrowed and people do not get enough oxygen, which in turn causes damage to the blood vessel walls. This sleep disorder is a risk factor for both high blood pressure and heart disease. Sleep apnea also stimulates the nervous system to release chemicals that can cause blood pressure to rise.
And the Result Is ...
Most people who have essential hypertension have stiff or inelastic arterioles, which are the tiny peripheral arteries the farthest away from the heart. Arterioles may be small, but they play a critical role in your health and in blood pressure. Specifically, arterioles transport oxygen-rich blood and nutrients to all the tissues in the body via even smaller blood vessels called capillaries. Once the oxygen has been delivered, veins carry the oxygen-depleted blood to the lungs and heart.
This brings us back to the basic question as to what exactly causes high blood pressure. Although scientists know these peripheral arteries get stiff and thus cause blood pressure to rise, they don't know exactly what makes the arterioles become stiff. That's where the risk factors come into the picture, because people with essential hypertension tend to have several of these factors, including genetic influences.
ENERGY DRINKS AND HIGH BLOOD PRESSURE
Energy drinks such as Red Bull, Monster, and 5-Hour Energy, for example, may do more than give you a shot of energy: they also can cause your blood pressure to spike and have a negative effect on your heart's natural rhythm. Research presented at the American Heart Association's Epidemiology and Prevention/Nutrition, Physical Activity, and Metabolism 2013 Scientific Sessions revealed that among 132 healthy adults tested, those who drank one to three energy drinks experienced an average rise in systolic blood pressure of 3.5 points. In a subgroup of 93 individuals, the QT interval was 10 milliseconds longer. The "QT interval" refers to a portion of the heart's rhythm on an electrocardiogram. When it is prolonged, it can cause sudden cardiac death or serious irregular heartbeats. While this study was done in healthy adults, the impact on people who already have high blood pressure and/or a heart condition could be more pronounced and hazardous.
OTHER TYPES OF HYPERTENSION
Since essential hypertension makes up the majority of cases of high blood pressure, it is the focus of this book. However, there are several other types of high blood pressure that, although much less common, are still important. In fact, these lesser-known types of high blood pressure can develop as complications of essential high blood pressure, so it is helpful for patients and physicians to be aware of their existence and how to recognize them. With that in mind, let's take a brief look at these "other" types of high blood pressure.
(Continues...)
Excerpted from The Complete Guide to Lowering High Blood Pressure Naturally by Deborah Mitchell. Copyright © 2014 Lynn Sonberg. Excerpted by permission of St. Martin's Press.
All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.
Excerpts are provided by Dial-A-Book Inc. solely for the personal use of visitors to this web site.
