Pressure up?

By Barbara Jarmoska

Think about water running through a garden hose. When the pressure in the hose goes up, one of two things has happened. Either the volume of the water has increased or the hose diameter has decreased. The same thing occurs in your body as blood flows through arteries. When arteries are constricted, or when blood thickness or volume is higher than it should be, high blood pressure results.

Blood pressure is measured by two numbers: systolic and diastolic. Systolic (the top number) represents the peak pumping pressure when your heart is fully contracted during a heartbeat. Diastolic (the bottom number) is the pressure when the heart is at rest between heartbeats. You can be diagnosed with hypertension if your systolic pressure is 140 or higher, and your diastolic is 90 or higher.

Normal blood pressure is defined as a systolic less than 120 and a diastolic less than 80. The table below lists the stages or classifications of hypertension.

Over time, hypertension damages both the heart and blood vessels. The higher the blood pressure, the more likely the risk of a heart attack, stroke, heart failure or kidney disease.

The most common type of high blood pressure is known as essential hypertension, sometimes called primary hypertension. Ninety-five percent of all patients have this type. Although researchers have been unable to pinpoint its specific causes, several risk factors definitely increase an individual's chance of developing essential hypertension. Some of these risk factors are controllable. They include obesity, high salt intake, smoking, lack of exercise and stress.

According to estimates based on U.S. Census information, one-fourth of the general adult population in America has some degree of high blood pressure—a total of about 50 million people. Approximately 1 billion people worldwide have hypertension. It is estimated that in the older population (greater than 60 years of age), the prevalence of hypertension is 60 percent. As the population continues to age, these numbers will continue to increase.

High blood pressure usually has no symptoms. That is why it is termed "the silent killer." However, it can be accompanied by headaches, confusion, numbness/tingling or shortness of breath, especially if blood pressure gets very high.

Many pharmaceutical drugs are used to lower blood pressure. Classifications of these drugs include: Angiotensin converting enzyme (ACE) Inhibitors, Alpha Blockers, Angiotensin II Receptor Blockers (ARBs), Beta Blockers, Calcium Channel Blockers, and diuretics. Many people are given multiple drugs from several classes. For a complete description of the way these various classifications of drugs work as well as a list of which drugs fall into the various categories, please request a free handout from any of the Freshlife Wellness Coaches or email barb@freshlife.com.

All synthetic drugs carry a risk of side effects. Each type of hypertensive medication comes with its own list of potential side effects. Since many people are on multiple medications, they can often suffer from multiple side effects. These include: dizziness, flushing, weakness, headaches, dry cough, elevated blood sugar, fatigue, elevated triglycerides and cholesterol, depression, decreased capacity for exercise, insulin resistance, peripheral edema (swelling of hands and feet), erectile dysfunction and constipation.

In addition to being aware of possible side effects, caution is advised when it comes to combining blood pressure drugs with other prescription medications as well as certain supplements, herbs, foods, over-the-counter (OTC) remedies and pain relievers. Check with your physician or health care practitioner before combining high blood pressure drugs with any other prescription drugs or remedies. For example, antacids are sometimes contraindicated with calcium channel blockers. Beware of eating grapefruit and drinking grapefruit juice and of using high potassium salt substitutes. Avoid caffeine in all forms if you are on blood pressure meds. You are advised to use caution or avoid the following supplements and herbs if you are taking hypertensive medications: ginseng, gingko biloba, hawthorn berry, lithium, guarana, kola nut, ma huang (ephedra), melatonin, St. John's wort and yohimbe.

Is it possible to treat hypertension by natural means? In many cases, absolutely! As with any naturopathic approach, diet and lifestyle changes are the first line of defense. When radical changes are made, radical results can occur. First and foremost is weight loss. Anyone with hypertension should strive to maintain a muscle-to-fat ratio (known as body mass index or BMI) of no more than 25 percent body fat for women and 20 percent for men. Well over half of all adults in America exceed these norms. Little wonder that hypertension is epidemic. It is impossible for a smoker to maintain cardiovascular health. Hypertension means, “Quit!” Exercise is essential. A minimum of 45 minutes, 4 – 5 times weekly is required. Initially, the exercise need not be strenuous. Walking is acceptable, but should be done continuously as an exercise regime. To say “I’m sure I’ve walked a total of 45 minutes by the end of the day” doesn’t count.

Anyone with hypertension should understand the importance of the relationship between sodium and potassium. These two minerals are responsible for regulating fluid balance in the body. It is interesting to note that whole, natural foods in all categories (grains, nuts, fruits, eggs, vegetables, legumes, etc.) have at least a 1:7 Na (sodium) to K (potassium) ratio. Many fruits and vegetables have a 1:400 Na/K ratio! The standard American diet has, at best, a 7:1 Na/K ratio, exactly the opposite of what nature intended. Many people are baffled because they don’t salt their food at the table. However, unless processed and restaurant foods are eliminated, the ratio can never be optimal. This takes effort, but the payoff is tremendous. Read labels, always check the Na/K ratio, and be sure to consume at least twice as much potassium as sodium at every meal. (Note: taking high doses of potassium in pill form can be dangerous and is not advised.)

Stress elevates blood pressure. As cortisol (adrenalin—the flight or fight hormone) rises, so does the arterial pressure. Folks with hypertension should spend a minimum of 20 minutes daily using meditation and/or guided imagery to reduce blood pressure. As brain waves alter, blood pressure follows.

Consider massage and aromatherapy. A stress-relieving massage using a combination of lavender, marjoram and ylang-ylang oils is especially beneficial.

When it comes to using dietary supplements to control blood pressure, there is one shining star—a time-released form of the naturally occurring amino acid, L-arginine.

Many physicians who are looking for a more natural way to treat hypertension endorse time-released L-arginine. One such health expert is Cathleen London, M.D., a member of the clinical faculty of Boston University and Tufts University School of Medicine. Dr. London states, “Prescription medications often have numerous side effects. Supplementing with L-arginine—something that the body makes naturally—has no side effects. This can mean fewer blood draws, and less need for the other medical monitoring you need to do with patients taking prescription drugs.”

The reason L-arginine is so effective at reducing blood pressure has to do with the role of the layer of cells lining the artery walls, known as the endothelium.

“The healthy function of vascular endothelial cells is crucial to cardiovascular health,” said Alan L. Miller, N.D., writing in the journal Alternative Medicine Review. Miller, an expert in sustained-release L-arginine, explained, “It was previously thought this single layer of cells that lines the lumen of blood vessels was merely a physical barrier between blood and the underlying tissue. However, about 20 years ago researchers began to understand that the vascular endothelium acts not only as a barrier, but also as vital regulator of blood vessel activity, with far reaching implications. A number of substances are produced and secreted by vascular endothelial cells, the most important of which is nitric oxide, a potent regulator of vascular function. Nitric oxide diffuses from endothelial cells into underlying smooth muscle, causing relaxation, which results in vasodilation. Since L-arginine is the body’s only substrate for nitric oxide synthesis, adequate L-arginine must be present for proper nitric oxide production.”

At first, researchers were not sure what this endothelium-derived substance was. It was fleeting and ethereal and it could, remarkably, stimulate the underlying smooth muscle to relax, thus causing vasodilation. Initially it was known as endothelium-derived relaxing factor (EDRF). By 1998, the winners of the Nobel Prize in Physiology of Medicine, Drs. R. Furchgott, L. Ignarro and F. Murad, determined the identity of EDRF as nitric oxide. Since then, thousands of scientific and medical papers have been published on the role of nitric oxide in blood flow and vascular endothelial health.
When clinically appropriate, Dr. London advocates enhancing nitric oxide levels with the use of sustained-release L-arginine. According to Dr. London, when you have enough L-arginine in your cells, sufficient nitric oxide is produced and several positive things happen:

• Arteries relax, causing greater blood flow.
• Blood platelets become less “sticky,” allowing them to perform their normal clotting functions.
• Artery walls remain more supple and flexible.
• In men, erections improve in the normal course of intimacy.

“In the past, the problem with supplementation has been that L-arginine doesn’t stick around very long in the body,” states Dr. London. “It is absorbed quickly, but then it disappears from the bloodstream in just a few hours, making it necessary to take large doses frequently throughout the day and night for it to be effective. Who wants to wake up several times every night to take a supplement? Plus, the frequent dosing made it expensive.” Dr. London recommends the sustained-release L-arginine from Sound Nutrition known as Polifusia, the only sustained-release formulation of the amino acid L-arginine available over the counter. Says Dr. London, “When researchers started studying the effects of patented, sustained-release L-arginine on patients with heart disease, it was exciting that PET scans indicated very dramatic results. There is also some indication that sustained-release L-arginine may help lower triglyceride levels. Polifusia is slowly released into the bloodstream over a 12-hour period, so you only need to take it twice daily for a 24-hour benefit.”

If you are on any other medications or have an underlying condition, you should consult your physician or qualified health professional before making changes to your health program. However, with cooperation from your physician, determination to make positive lifestyle and diet changes as well as compliance with a full-dose supplement program, you may be able to avoid, reduce, or eliminate your need for prescription drugs and maintain blood pressure within normal limits.