Defending yourself against the silent killer

Under new blood pressure guidelines, half the US population is now at risk for hypertension. Luckily there are numerous ways to treat and prevent this “silent killer.”  

I don’t know about you, but I’m much more of a salty-snack, “chips” kind of a guy now than the sweet-toothed, sugar monster I was as a child.  It’s common knowledge that high-sodium diets can lead to high blood pressure, but newer research suggests that added sugars are equally pernicious: so both us savory snackers and you cookie monsters should get our blood pressures checked regularly.

High blood pressure (hypertension) is called a “silent killer” because it has no obvious symptoms to indicate that something is wrong, despite being a major risk factor for heart disease.  Approximately half of all strokes and heart attacks are attributed to hypertension, which also increases the risk for vision loss, kidney disease, dementia, and sexual dysfunction.

High blood pressure should now be treated at 130/80 according to new recommendations by the American College of Cardiology and ten other health organizations (previous guideline was 140/90).  As a result of the new guidelines, doctors are now discussing hypertension with an additional 30 million adults. Hopefully they’re using words like vegetables, fruit and home-cooking, because diet should always be the first line of treatment for mild and moderate hypertension.

Defend with a Dashing diet

Both your doctor and your search engine will tell you that the best diet to treat high blood pressure is the DASH diet (Dietary Approaches to Stop Hypertension) emphasizing fruits, vegetables, whole grains, beans, nuts, low-fat dairy, seafood and poultry.  This dietary pattern probably sounds pretty familiar, as this diet also reduces the risk for diabetes, osteoporosis, kidney stones, cancer, and heart failure, and is endorsed by the Dietary Guidelines for Americans as an example of a healthy eating pattern for all.   The DASH diet was developed by the National Institute of Health, and first presented to the public in 1998.  It has remained one of the most popular diets, earning “best overall eating plan” 8 years in a row by US News & World Report.

The DASH diet is low in sodium and emphasizes foods rich in potassium, magnesium, and calcium – electrolyte minerals that regulate blood pressure.  Potassium and sodium work together in our bodies to regulate fluid balance, and the ratio of potassium to sodium in the diet is a strong indicator of risk for heart disease.  Eating more potassium rich fruits and vegetables is one of the most effective dietary strategies to improving your blood pressure, and most Americans consume less than half of the recommended 4,700 mg day, so there is a lot of room for improvement.

If you eat a lot of packaged foods, your sodium intake can become quite high, because salt is used as both a preservative and flavor enhancer.  Most salt in the US diet (75%) comes from packaged foods, not the salt shaker.  Here is a useful tip when reading food labels: look for foods with a 1:1 ratio of sodium to calories.  Most Americans consume approximately 2,000 calories/day, and our sodium recommendation is less than 2,300 mg/day – so looking for packaged foods with an equal ratio of sodium to calories prevents overconsumption of sodium throughout the day.

Some research suggests that limiting added sugar is as important, or potentially more important, than sodium in influencing blood pressure.  For example, a single serving of soda can raise blood pressure 15 points, and according to the British Medical Journal “added sugars probably matter more than dietary sodium for hypertension.”  The DASH diet recommends moderate alcohol consumption; but warns that excessive drinking can raise blood pressure.

The DASH diet was an early example of the benefits of a whole foods, plant-based diet in supporting healthy blood pressure, and researchers are now exploring additional benefits of adding specific foods into the diet, with encouraging results for beets, olive oil, and other mighty plant foods. (see the “Mighty Foods to Lower Blood Pressure” list below)

Alternative Approaches

In addition to diet, there are a variety of other approaches to help manage blood pressure.  Regular exercise can reduce blood pressure up to 9 points.  Exercise strengthens the heart, so that it pumps blood more efficiently, resulting in less “pressure” on the arteries from each pump.   As your body weight increases, so does your blood pressure, therefore weight loss can also lead to a significant reduction in blood pressure (up to 10 points).  Even small amounts of weight loss can reduce your blood pressure significantly.

Researchers are currently exploring the potential for acupuncture and mindfulness meditation in treating hypertension.  Peer-reviewed, randomized, placebo-controlled trials find that the benefits of acupuncture can be as effective as prescription drugs – lowering both systolic and diastolic blood pressure 4-8 points.  And of course the benefits are even more pronounced when these therapies are combined with other dietary and lifestyle approaches.

The research on acupuncture and hypertension is growing, and there appears to be point specificity, meaning that the acupuncture needs to include specific acupuncture points.  Clinical research conducted at the University of California-Irvine in both humans and animals, finds that approximately 70% of those with mild to moderate hypertension respond to treatment, after about 8 weeks.  Using an animal model, researchers have even shown how acupuncture works: by influencing the autonomic nervous system, and areas of the brain responsible for regulating blood pressure.

World renowned integrative medicine pioneer Dr. Andrew Weil advocates the 4/7/8 breathing technique, practiced twice a day, and reports that after 2-3 months, this “relaxing breath” can lower heart rate and blood pressure, as well as helping to manage stress and anxiety.  The 4/7/8 relaxing breath “is utterly simple, takes almost no time, requires no equipment and can be done anywhere” according to Dr Weil.  Simply pay attention to your breathing and count to 4 while inhaling, hold your breath for a count of 7, and then exhale through your mouth for a count to 8.  Repeat this cycle for a total of 4 breaths.

Taking Charge of your Health

A 2017 NPR report described how most medical providers are so rushed to get through appointments, that they don’t always take blood pressure measurements correctly.  Rather than relying on stressed-out doctors, many people use a home blood pressure monitor.  It’s best to check your blood pressure at different times of the day, and to keep a log to share with your doctor.  To get the most accurate measurements, you should sit still (and relaxed) for at least 5 minutes prior to each measurement.  Sit with your back straight and your feet flat on the floor, legs uncrossed, and avoid eating, caffeine, or exercise for at least 30 minutes prior to measuring.

The “silent killer” sounds pretty scary, but luckily we have many weapons to defend ourselves!  I can dip my salty chips into an olive oil-rich hummus, and you cookie monsters can brew up a pot of hibiscus tea.  We can all make progress on getting more veggies and fruits into our diet, because our health is priceless.


Mighty foods to lower blood pressure:

I’ll be diving even more into the value of heart-healthy foods in my free Heart to Heart Talk, and Taste tours this month. Come and learn more!


This article was written for the Sound Consumer

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