Reduce high blood pressure (hypertension) to reduce disease risk
New guidelines on systolic blood pressure targets have just (Jan 2017) been issued for people aged 60 years and older with hypertension.
The following 10 point plan will not only lower your blood pressure and help you meet the guidelines, but the exact same plan will reduce your cholesterol too.
The guidance, issued jointly by the American College of Physicians (ACP) and the American Academy of Family Physicians calls for doctors to start treatment for patients who have persistent systolic blood pressure only at or above 150 mm Hg (millimetres of mercury).
The aim is to achieve a target of less than 150 mm Hg in order to reduce risk for stroke, cardiac events and death. The recommendation was rated “strong, with high-quality evidence”.
What’s significant is that, until recently, the advice was to achieve a much lower systolic blood pressure level of 120 mm Hg. And that a systolic level of between 120 and 139 was pre-hypertensive. Indeed that is still the official advice in the UK.
However, the lead researcher, commenting on the meta-survey results which drew on over 20 randomised trials, said: “The evidence showed that any additional benefit from aggressive blood pressure control is small, with a lower magnitude of benefit and inconsistent results across outcomes.”
If, however, patients have a history of stroke or have high cardiovascular risk, the guidelines suggest that physicians should consider starting or increasing drug therapy to achieve systolic blood pressure of less than 140 mm Hg – in order to reduce risk for stroke and cardiac events. The authors note, however, that this recommendation was rated weak, with only moderate-quality evidence.
The guidelines define ‘high cardiovascular risk’ as including patients with diabetes, vascular disease, metabolic syndrome, or chronic kidney disease, as well as older adults. They also advise that doctors should discuss the potential benefits and harms of specific blood pressure drugs and targets with the patient.
Less evidence for need to reduce BP below 140
The reviewers noted that most of the evidence for treatments to get patients below a target of 140 mm Hg come from a single trial called SPRINT (Systolic Blood Pressure Intervention Trial). This trial had a target of less than 120 mm Hg and found substantial reductions in cardiac events and deaths.
However, another large trial called ACCORD (Action to Control Cardiovascular Risk in Diabetes) – which evaluated the same targets – did not show the same benefits.
When you remove SPRINT data from the 20-study analysis, the effects on mortality were reduced and the effects on cardiovascular events were no longer significant, noted Dr Weiss, a lead researcher.
For over 60s, reducing BP is important
There is no question that improving blood pressure control in older people (60+) can substantially reduce illness and mortality. Over 25% of adults in this age bracket have hypertension, and only about 15% of them are aware of their condition because it has no symptoms.
Indeed an editorial in the Lancet calculated the risk of becoming hypertensive is greater than 90 percent for individuals in developed countries!
A 10-point plan to reduce BP naturally
Following this 10 point plan will improve your health and normalise your blood pressure, without potentially dangerous drugs – whether you are aiming to reduce your Systolic Blood Pressure to below 140 or 120.
1. Eat a DASH diet (Dietary Approaches to Stop Hypertension)
The eating plan known as the Dietary Approaches to Stop Hypertension (DASH) is rich in whole grains, fruits, vegetables and low-fat dairy products. Research shows it can lower your blood pressure by up to 14 mm Hg.
The DASH diet is also an anti-inflammatory diet which will not only lower blood pressure but defend you against a range of illnesses. See this link: http://www.nutrishield.com/the-science/anti-inflammatory/.
Reducing inflammation reduces hypertension. Inflammation is linked to the build-up of cholesterol on arterial walls, which narrows and restricts the blood vessels, which means that the heart has to pump harder, which increases blood pressure.
2. Reduce sugar and other carbohydrates
Insulin plays an important role in high blood pressure, as many people with hypertension have insulin resistance.
Eating sugars and excess carbohydrates – including bread, pasta, potatoes, or rice which are metabolised as sugars – will cause your insulin levels to remain elevated, leading to increased insulin resistance. To compensate, your body generates yet more insulin. It’s a vicious circle.
Insulin encourages the uptake of magnesium, but if your body’s insulin receptors are compromised and your cells grow resistant to insulin, you will not store magnesium effectively. That’s a problem because magnesium relaxes muscles, especially those in your arterial network. If your magnesium level is too low, your blood vessels will tend to constrict rather than relax, which will raise your blood pressure.
Insulin further affects your blood pressure by encouraging your body to retain sodium. Sodium retention causes fluid retention – which in turn causes high blood pressure.
3. Increase your Omega 3 intake
We in the West are getting too much omega-6 in our diets and far too little omega-3. Omega 6 fatty acids – found in polyunsaturated plant oils like safflower, sunflower and corn oil – are used by the body to produce hormones that promote inflammation.
Omega 3 fatty acids (from oily fish) have the opposite effect – they are used to produce hormones that reduce inflammation – which as we’ve seen helps reduce blood pressure. Omega-3 fats have another benefit – they help to re-sensitize your insulin receptors if you suffer from insulin resistance.
Omega-3 fats are typically found in flaxseed oil, walnut oil and fish, with fish being easily the best source.
4. Lose excess pounds and watch waistline measurements
Weight loss is one of the most effective lifestyle changes for controlling blood pressure, because blood pressure often increases as weight increases. Losing just 10 pounds (4.5 kilograms) can help reduce your blood pressure by up to 5 points.
Belly fat is especially dangerous and in general:
- Men are at risk if their waist measurement is greater than 40 inches (102 cm).
- Women are at risk if their waist measurement is greater than 35 inches (89 cm)
5. Less sodium and more potassium
Even a small reduction in the sodium in your diet can reduce blood pressure by between 2 to 8 mm Hg. In fact only small amounts of sodium occur naturally in foods – most sodium is added during processing. So eat fewer processed foods.
In cooking, add less standard table salt; replace with low-sodium, high-potassium salts or other herbs and spices.
Add extra potassium to your diet which can lessen the effects of sodium on blood pressure. Good sources of potassium are bananas, avocadoes, spinach and sweet potatoes.
6. Reduce your stress
Chronic stress is an important contributor to high blood pressure. It’s not stressful events themselves that are harmful, but your feelings of inability to cope. Studies show that people with heart disease can lower their risk of subsequent cardiac problems by over 70 percent simply by learning to manage their stress.
So make time for this simple but effective de-stressing deep breathing exercise which can be done anywhere, and takes a short time but brings immediate results. Click to go to Instant Relaxation exercise.
You might also want to listen to some classical music. A study at the University of Florence showed that listening for 30 minutes a day for 30 days while breathing calmly, could ‘significantly’ reduce blood pressure.
7. Be physically active regularly
Regular physical activity — at least 30 minutes on most days of the week — can lower your blood pressure by an average of 7 mm Hg.
The best types of exercise for lowering blood pressure include walking, jogging, cycling, swimming or dancing. Strength training also can help reduce blood pressure as it helps to reduce insulin sensitivity.
You should try to exercise to an intense level. ‘Intense’ means exerting yourself sufficiently that you are out of breath and can’t comfortably talk to someone during your workout. Fast walking while swinging your arms is a simple way to ‘intensify’ your exercise.
8. Moderate alcohol
In small amounts, a drink can potentially lower your blood pressure by 2 to 4 mm Hg.
But that protective effect vanishes if you drink too much alcohol. The limit is generally one drink a day for women (and men over age 65), or two a day for men under 65. One drink equals 150ml (5 fl oz) of wine.
Drinking more than moderate amounts of alcohol can actually raise blood pressure by several points. It can also reduce the effectiveness of blood pressure medications.
Does coffee increase blood pressure? The evidence is that it may increase your BP levels short term, possibly by blocking a hormone that dilates your arteries. Drink more decaf and try hibiscus tea which has been shown to help lower BP.
9. Ensure an optimum level of vitamin D
Research shows that blood pressure is typically higher in winter months than during the summer!
That’s because sun exposure enable your body to produce vitamin D. Lack of sunlight reduces your vitamin D levels. Vitamin D deficiency has been linked to insulin resistance and Metabolic Syndrome, a constellation of health problems that include elevated cholesterol and triglyceride levels, obesity, and high blood pressure.
Unfortunately there is abundant evidence that almost all of us in the West are well below optimum vitamin D levels – and would benefit from a vitamin D supplement in the winter. See http://www.nutrishield.com/category/vitamins/vitamin-d/
10. Take a well-designed daily health supplement
No one vitamin or nutrient will make a lot of difference on its own. It is a combination that can make a real difference to blood pressure levels – and health generally.
Studies indicate that vitamins C and E can be helpful in lowering blood pressure, as can calcium and magnesium.
The optimum level of vitamin C is 500mg a day – at which level there are other benefits too – including a reduction in cataract risk. Vitamin C has been shown to increase the body’s production of nitric oxide which helps keep blood vessels dilated.
The optimum level for vitamin E is 70mg a day, ideally including all the tocopherols (d-alpha, d-beta, d-gamma and d-delta) – the “family” of vitamin E compounds that are more effective than simple d-alpha vitamin E.
Omega 3 fish oil should be included at a level of 1,000mg a day. To get that level you would need to eat oily fish 3 times a week, so a supplement is wise for most people.
To which nutrients add the powerful anti-oxidant CoQ10 which, along with vitamin B6, helps dilate blood vessels. The University of Maryland examined several studies and found that supplementing with CoQ10 over 4-12 weeks could deliver a remarkable 17 point drop in systolic levels and 10 points in diastolic.
Folic acid and the lesser known nutrient betaine are also important. They reduce the level of a blood protein called homocysteine. Homocysteine makes arteries less flexible and stiff – restricting blood flow and increasing blood pressure.
Finally polyphenols – the protective compounds in fruits and vegetables and in green tea – have a role to play in reducing inflammation and hence indirectly, blood pressure.
There is a supplement that includes all these nutrients and more. It was formulated by the former Chair of the Forum on Food and Health at the Royal Society of Medicine. It’s called NutriShield Premium – www.nutrishield.com.
When a natural approach to preventing disease is available, it is a better choice than drugs. In the case of high blood pressure, the above 10 point plan is such a choice.
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Ann Intern Med, Published online January 17, 2017. Guidelines.
A Randomized Trial of Intensive versus Standard Blood-Pressure Control N Engl J Med 2015; 373:2103-2116 November 26, 2015 DOI: 10.1056/NEJMoa1511939
Action to Control Cardiovascular Risk in Diabetes (ACCORD) Trial: Design and Methods John B. Buse, MD, PhD The American Journal of Cardiology Volume 99, Issue 12, Supplement, 18 June 2007, Pages S21–S3
Intracellular magnesium and insulin resistance. Takaya J1, Higashino H, Kobayashi Y. Magnes Res. 2004 Jun;17(2):126-36.