High blood pressure (hypertension) is so common in the US that many people don’t take it as seriously as they should.
One out of every three American adults has hypertension, but only about half of them are being treated — and a far smaller percentage is being treated successfully.
Frightening statistic: About 58 million Americans are living with uncontrolled hypertension — a condition that dramatically increases their risk for heart attack, stroke, dementia, heart failure and kidney failure.
So why aren’t we doing a better job of keeping our blood pressure under control?
Even though regular exercise and a low-fat and low-sodium diet can help reduce blood pressure in many people, the overwhelming majority of doctors end up treating hypertension with medication. In some cases, medication is required to control blood pressure, but its use can have drawbacks.
Blood pressure drugs are notorious for causing side effects, including headache and dizziness… and many hypertension medications (especially the newer ones) can be costly. Not surprisingly, studies show that only about 20% of patients over age 65 take their hypertension medication as prescribed. Caution: Do not stop taking any blood pressure medication — or reduce your dosage — without first consulting your doctor.
Solutions that get overlooked: There are a number of natural approaches that can reduce your blood pressure or even eliminate your need for blood pressure medication. Unfortunately, most doctors have not been trained in these therapies, and there is rarely enough time during rushed office visits to discuss them.
My favorite nondrug approaches to help control blood pressure…
1.Get more potassium. Muscles in the heart and blood vessels require this mineral to contract normally and maintain a healthy blood pressure. We should consume five times more potassium than sodium, yet most of us get eight to 10 times more sodium than potassium.
If we increased our potassium intakes to the recommended amount of 4,700 mg daily and restricted our sodium intakes to recommended levels of 2,300 mg or less daily, studies show that we could see a 10% drop in hypertension rates.
My advice: Avoid processed foods (typically salt-saturated) and eat eight to 10 daily servings of vegetables and fruits, which are naturally high in potassium and low in sodium.
Good potassium sources: Sweet potatoes, bananas, green beans, cantaloupe, orange juice, tomatoes (fresh or cooked) and prunes. Caution: Never use potassium supplements unless prescribed by your doctor — they can be dangerous if you take certain medications or have kidney disease.
2. Add nuts to your diet. In a Pennsylvania State University study, men who consumed 1.5 ounces of pistachios (about 60 nuts) daily for four weeks averaged a 4.8 mm Hg drop in systolic (top number) blood pressure.
The benefits likely stem from pistachios’ healthful fats — one ounce has fewer than 2 g of potentially harmful saturated fat and nearly 11 g of healthful mono and polyunsaturated fats, which help lower blood pressure by reducing arterial inflammation and improving blood vessel dilation. Reductions in blood pressure also have been found with a similar daily intake of almonds and walnuts.
My advice: Get 30% of your calories from mono- and polyunsaturated fats (unsalted nuts are a good source)… restrict saturated fat to no more than 10% of total daily fat intake. Eliminate all trans fats from your diet. Good sources of mono- and polyunsaturated fats: In addition to nuts — salmon, ground flaxseed, olive oil and canola oil.
3. Get enough protein. Hypertension rates are lower in populations that consume high amounts of protein — possibly due to natural compounds in protein that inhibit the production of a chemical that constricts blood vessels.
The milk proteins casein and whey are especially abundant sources of amino acids that may also lower blood pressure. In a recent six-week trial, people with prehypertension or mild-to-moderate hypertension who consumed 20 g daily of whey protein saw their systolic pressure drop by an average of 8 mm Hg and their diastolic (bottom number) pressure fall by an average of 5.5 mm Hg.
My advice: Consume approximately 1.5 g of protein daily for every 2.2 pounds of body weight. (For example, if you weigh 160 pounds, aim for 109 g of protein daily.) Include 30 g of whey protein (available at health-food stores in drink powders and shake mixes), with the balance coming from high-protein foods such as fish, poultry, grass-fed beef (grass contains healthful omega-3 fatty acids), low-fat dairy products and beans.
4. Boost your vitamin-D levels. The lower your vitamin D levels, the higher your risk for hypertension, diabetes and certain cancers, according to recent studies. Our bodies produce vitamin D when sunlight hits our skin, but few Americans get enough sun to manufacture sufficient levels of the vitamin. Even in Nashville, where I practice, 90% of my patients are vitamin D deficient.
My advice: Because sun exposure increases skin cancer risk (and sunscreen blocks the production of vitamin D), take daily supplements totaling 2,000 international units (IU) to 4,000 IU of vitamin D3 (the most active form). That’s higher than the federally recommended 400 IU to 600 IU daily, but most researchers now agree that more is needed to safeguard health. Do not exceed 10,000 IU daily — high doses can cause adverse effects, such as nausea and headache.
5. Consult a chiropractor. For a recent study at the University of Chicago Medical Center, 25 patients with stage 1 hypertension underwent a treatment known as the National Upper Cervical Chiropractic Association (NUCCA) technique, which involves realignment of the topmost vertebra. Another 25 patients received a placebo treatment. Eight weeks later, doctors found that those who had had the real chiropractic adjustment averaged a 14 mm Hg greater drop in systolic pressure and an 8 mm Hg greater drop in diastolic pressure than those in the other group. Researchers theorize that misaligned vertebra may pinch arteries and nerves affecting blood flow.
My advice: While more studies are needed, it may be worth consulting a chiropractor, particularly if you suffer from both neck pain and hypertension. Important: Only licensed chiropractors certified in NUCCA techniques are qualified to perform this procedure. To find a qualified chiropractor, consult the National Upper Cervical Chiropractic Association (800-541-5799, www.nucca.org).
6. Try audio relaxation programs. Researchers at Seattle University College of Nursing found that when older adults listened for 12 minutes three times weekly to an audio relaxation program, their systolic blood pressure dropped by an average of 9 mm Hg.
The audio program consisted of a soothing voice guiding the listener through a progressive muscle relaxation sequence with the sound of ocean waves in the background. Progressive relaxation calms the parasympathetic nervous system, which controls blood vessel function.
My advice: Buy audio relaxation CDs on-line or look for such programs at your local library.
7. Consider taking certain supplements. Several nutritional supplements are advertised as having blood pressure–lowering effects. But the strongest evidence supports the use of… *
My advice: Ask your doctor about trying 200 mg of CoQ10 daily.
My advice: Try 100 mg of R-lipoic acid (the natural form of alpha-lipoic acid) twice daily… and 500 mg twice daily of acetyl-L-carnitine.
If you have high blood pressure (hypertension), home monitoring tells you if your efforts to control your condition are working.
What to do: In addition to doctor screenings every three months, take your pressure twice daily — morning and night. Avoid caffeine, tobacco and exercise for 30 minutes beforehand and sit quietly for five to 10 minutes before taking the reading. During the test, rest your arm comfortably on a table, level with your heart. Take at least two consecutive readings at each monitoring and record the results.
Automatic home blood pressure monitors — which allow you to take your blood pressure with an arm cuff — are available at drugstores for under $75. (Omron and Microlife make good products.) Do not use wrist or finger monitors — they are not as accurate as arm monitors.
*All of these supplements can be used in combination — with or without blood pressure medication. Consult your doctor.
