Doctor’s Tip: High blood pressure (hypertension) |

Doctor’s Tip: High blood pressure (hypertension)

Dr. Greg Feinsinger
Doctor’s Tip

Blood pressure consists of two numbers: The upper (systolic) number is the pressure in arteries when the heart contracts; the lower (diastolic) number is the pressure between beats, when the heart muscle is relaxed.

When either the systolic or diastolic pressure is elevated, arteries are damaged. This results in increased risk of heart attacks; heart failure; strokes; kidney disease; dementia including Alzheimer’s; and rupture of the aorta.

Based on studies of large populations, it’s clear that ideal BP is less than 115/75. Above that level, the risk of heart attacks and strokes starts to climb, especially at levels of 140/90 and above. In their book “Beat the Heart Attack Gene,” Brad Bale, M.D. and Amy Doneen, RN, PhD state that in order to prevent heart attacks, doctors should keep their patients’ blood pressures below 120/80. (A caveat is that some frail, elderly people feel light-headed at that level and do better with a somewhat higher BP).

Following are some of the factors that can cause hypertension: 1) obesity; 2) genetics; 3) the standard American diet — high in animal products, fat, sugar, salt and added oil; 4) sleep apnea; 5) thyroid disease; 6) chronic kidney disease; 7) prescription medications such as steroids, some anti-depressants and estrogen; 8) over-the-counter medications such as naproxen, ibuprofen and decongestants; 9) some herbs such as licorice; 10) illicit drugs such as cocaine and amphetamines; 11) alcohol; 12) caffeine in some people; and 13) adrenal gland abnormalities.

Most people with hypertension have no symptoms, and it is therefore known as “the silent killer.” The majority of Americans eventually develop hypertension, and many of those go undiagnosed. It’s therefore important to check your blood pressure periodically, either with your own automatic cuff (you can buy a decent cuff for under $40 — Omron is a good brand), or visiting a blood pressure-checking station, available at Walmart and many grocery stores and pharmacies.

Here’s what we know about lifestyle and hypertension: 1) Early in the 20th century, there were no medications for hypertension, and people — including F.D.R. — died from what was called “malignant hypertension” — blood pressures above 220/120 or so. In the 1940s Dr. Walter Kempner put these people on a strict rice and fruit, salt-free diet, which brought blood pressures down to normal. 2) In countries on a Western diet, blood pressures increase with age. However, in societies such as the Blue Zones, where people are on a lifelong plant-based, whole-food diet, blood pressures are the same at 90 as at 19. 3) When hypertensives are placed on such a diet, blood pressures tend to normalize. 4) Blood pressure goes up during exercise, but regular moderate daily exercise helps lower blood pressure.

In his book “How Not to Die,” Dr. Greger mentions the following foods as being particularly effective at lowering blood pressure if consumed every day: whole (unprocessed) grains; ground flaxseed; hibiscus tea; legumes; watermelon. Also helpful are foods that cause the endothelial organ system that lines our arteries to produce nitric oxide, which causes arteries to dilate, thereby lowering blood pressure: beets, greens, cilantro, basil and rhubarb.

Lifestyle changes are inexpensive and free of side effects. Unfortunately, not everyone is willing to make them. There are now multiple medications to treat hypertension, and many have only rare side effects. If your blood pressure is high, it’s important to get down to 120/80 or less, one way or the other. If you are young, or if your hypertension is difficult to control, your provider should look for aforementioned factors that could be contributing.

Greg Feinsinger, M.D., is a retired family physician with a special interest in heart disease and diabetes prevention and reversal, ideally through lifestyle changes. He’s available for free, one-hour consultations — call 970-379-5718.

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