Blood Pressure



Chronic high blood pressure (hypertension) is defined as having an average systolic blood pressure of 140 or higher and/or an average diastolic blood pressure of 90 or higher. Chronic high blood pressure can have multiple causes, but the majority of causes are related to an unhealthy lifestyle directly or indirectly.

 
  • Overview
  • Action Plan
  • Ask The Doctor
  • Related Info
  • Success Stories

Overview


High blood pressure is one of the most common diseases affecting the world today. In the U.S., it is estimated that approximately one third of adults have hypertension1 and another one third who have pre-hypertension. In response to this, many are given medications to help control their blood pressure, which has led to approximately 70% of adults age 65 or older in the U.S. to be taking one or more of these medications.1

High blood pressure is a concern because it not only can be directly harmful on organs such as our heart and kidneys but also is often a sign of an underlying process affecting the arteries (atherosclerosis) and is associated with a higher risk of getting a heart attack or a stroke. Hypertension is often called “the silent killer” because, most typically, there are no symptoms noticed, but sometimes, very high blood pressure can cause dizziness or headaches.

Uncommon but significant causes of high blood pressure include problems such as kidney failure, heart failure, liver failure, sleep apnea, insomnia, and anemia. The most common category of high blood pressure, however, is called “essential hypertension,” which basically means that it is related to a high sodium/salt diet, being overweight, being sedentary, and having unhealthy arteries. Atherosclerosis, or hardening of the arteries, typically advances with aging, and high blood pressure may be the only sign that this is developing. This means that most persons who have high blood pressure will see dramatic improvements in their health if they diligently modify their lifestyle, particularly their diet, to improve and even resolve high blood pressure as well as reduce the burden of atherosclerosis to lower their risk of a heart attack, premature disability, and death without resorting to medications.

 
References
  1. (CDC) CfDCaP. Vital signs: prevalence, treatment, and control of hypertension--United States, 1999-2002 and 2005-2008. MMWR Morb Mortal Wkly Rep 2011, 60:103-108.

Action Plan


Diet

  • Reducing your sodium intake alone may lower your blood pressure.1 I recommend those with high blood pressure reduce their daily intake of sodium to a maximum of 400 mg of added sodium daily (in addition to what is found naturally in whole, natural foods).
  • Eat a Nutritarian diet style rich in a variety of micronutrient-dense vegetables, legumes, seeds, nuts, and fruits as this diet-style lowers inflammation, normalizes body weight, and lowers the burden of atherosclerosis besides merely lowering blood pressure. This is due to a number of factors related to the comprehensive array of micronutrients these foods provide, including potassium,2  antioxidants, and nitrates which increase artery-dilating nitric oxide in the blood vessels.3
  • If you have a chronic disease or if you are taking any medication, please talk to your doctor before and after changing your diet and lifestyle as medication and/or dietary modifications may be necessary.

Exercise

Daily activity and all forms of exercise, particularly aerobic interval exercising,4 pushes the blood pressure down effectively. The more frequently one exercises, the more effective it is.

Lose weight

If you are overweight, a Nutritarian diet-style will help you reach your ideal weight, and losing weight will also lower blood pressure. As you make efforts to reach the dietary and exercise goals, you will not only be lowering your blood pressure, but also reducing your risk of heart disease, stroke, dementia, and cancer simultaneously.

Avoid stimulants

Avoiding stimulants such as caffeine can help to lower blood pressure.

Avoiding alcohol

Regular intake of alcohol can lead to high blood pressure. We recommend no alcohol use as it provides no micronutrients and may also raise your cancer risk.

 
References
  1. He FJ, Li J, Macgregor GA. Effect of longer-term modest salt reduction on blood pressure. Cochrane Database Syst Rev 2013, 4:CD004937.
  2. Aburto NJ, Hanson S, Gutierrez H, et al. Effect of increased potassium intake on cardiovascular risk factors and disease: systematic review and meta-analyses. BMJ 2013, 346:f1378.
  3. Lidder S, Webb AJ. Vascular effects of dietary nitrate (as found in green leafy vegetables and beetroot) via the nitrate-nitrite-nitric oxide pathway. Br J Clin Pharmacol 2013, 75:677-696.
  4. Molmen-Hansen HE, Stolen T, Tjonna AE, et al. Aerobic interval training reduces blood pressure and improves myocardial function in hypertensive patients. Eur J Prev Cardiol 2012, 19:151-160.

Ask The Doctor


The following are sample questions from the Ask the Doctor Community Platinum and higher members can post their health questions directly to Dr. Fuhrman. (All members can browse questions and answers.)

Q.

I am 5’8", 180lbs and 59 years old. I started the program last August after seeing Dr. Benson. Within 2 weeks, my BP went down from 150/90 on Diovan 80 mg OD to 100/50. I was also feeling dizzy. I cut my Diovan in half and was doing well. I lost 20 pounds. Then, the holidays hit and my sugar binging started. I gained back the 20 pounds and went back on my full dose of Diovan. I am now in the Motivational Outreach Program. I have again lost 20 pounds, but my BP is all over the place! For the most part it runs 110/70 on the Diovan 80 mg. The other day, I felt dizzy, and my BP was 100/56. The next day, I figured it was time to start the weaning process, so I only took 1/2 of the Diovan (40mg). By mid-day, I had a pounding headache, and my BP was 150/96! Why is it taking so long for my BP to come down this time? I am watching my sodium intake; no more than 500mg daily. Thanks.

A.

The reason why it is taking longer to normalize now is that every time you lose weight and gain it back, allowing your weight to yo-yo, you increase the amount of saturated fat and visceral fat percentage, worsening the underlying pathology that then takes longer to resolve the next time.

It’s not uncommon for your blood pressure to fluctuate like this as you move toward your optimal weight. Don’t be discouraged, I am sure it will continue to improve. Be careful as you progress, and speak to your doctor about continuing to monitor and lower your blood pressure medication. If you continue to feel dizzy and have readings of 110/70 or less you could hurt yourself in a fall and also damage your kidneys. Reducing stress, exercising, and optimizing your vitamin D level can all help to normalize your blood pressure.

 
Q.

I am perplexed by the passage in "Super Immunity" (page 43) that states lower blood pressure in the elderly is below 140/70 and leads to increased mortality. I am 54 years old and have been eating a Nutritarian diet for almost two years. I’ve managed to wean myself off BP meds and have readings between 140/82 to 115/65 (130/75 average) depending on time of day and my stress levels. My goal has always been to get more consistent readings in the lower range but am now wondering if that is unhealthy. What is an ideal blood pressure reading for me?

A.

Lowering diastolic blood pressure below 70 with medications leads to increased mortality. If you are not on medications, a lower blood pressure is not a risk. When you get as healthy as possible, you should not require medication to lower blood pressure. The key parameter that assures your low cardiovascular risk is the maintenance of a normal blood pressure without medications.

 
Q.

I am 45 years old and 5’4". I weigh 122 lbs. I don’t take any meds (just Dr. Fuhrman’s Women’s Daily Vitamin and Immunotect). I just had blood work, and numbers are good (normal ranges). I exercise about 4-5 times per week, I am not a smoker. I have 4-5 alcoholic beverages per week, otherwise I drink water. Here’s my problem - hypertension!! I have been keeping track of my blood pressure, and the last 3 day's readings are 148/97, 158/88, 153/89. I follow Dr. Fuhrman’s eating plan most of the time – having 1-2 cheat meals per week. I don’t eat very much salt (under 1500mg/day) and only have processed food (potato chips/cookies) about 1-2 days per week with my cheat meals. Please help – I don’t want to have hypertension, I know it is very, very dangerous.

A.

These processed foods are inflaming your body and making your arterial walls less elastic. Spend some time reading here and listening to some of the teleconferences so that you more fully understand the impact of nutrient rich foods for cardiovascular health. You likely need to be more aggressive avoiding added salt. I think you should commit 100% to the Nutritarian diet and re-evaluate in 6-8 weeks. Alcoholic beverages consumed regularly are a major risk for breast cancer. I strongly suggest you re-consider that practice as well.

Interval training is the type of exercise that is most effective. It would be great if you can do 2-3, 3-5 minute intervals a day. Why don’t you do a scientific experiment, just for the next 15 days? You can do it for 15 days I am sure. That means no added salt to your diet at all, including no Swiss chard, NO alcohol, and no flour or bread products. In other words, 100 percent whole, natural foods and a large salad to start both lunch and dinner. You will drop some weight, have better exercise tolerance, and lower your blood pressure. You will be amazed what 15 days can do.

 
Q.

What does it mean if your blood pressure readings are at 140 over 70, where the top number is high and the bottom number is in the low range?

A.

It usually means the blood vessels are getting stiffer with aging and is not a favorable sign. It is important not to compromise with diet and exercise and do everything possible to bring the top number back toward normal, including interval training and a Nutritarian diet. The difference between both numbers is called pulse pressure, and generally a lower number is better. One problem with medications to lower blood pressure is that they lower the bottom number (diastolic) while lowering the top number (systolic), and a diastolic pressure that is too low can interfere with perfusion of the coronary arteries and increase risk of death. A Nutritarian diet is extremely effective at normalizing pulse pressure, something drugs cannot do.