Q: I try to follow the medical news. Guidelines around blood pressure have been bouncing around the past few years. What’s going on?
—Bill Q., Polson, Mont.
What do the numbers in your blood pressure reading mean?
A: For a long time the numbers 120/80 signified “perfect” blood pressure, although somewhat lower is rarely a problem. The upper number, called systolic, basically measures the resistance, or the “pressure” of the blood volume pushing against your veins and arteries. This peripheral resistance is quite volatile: it can bounce around a bit because it is susceptible to adrenaline, the major stress hormone. Adrenaline is a short-acting, strong vasoconstrictor, meaning it dramatically increases the pressure in your vascular system, and thus this upper number can jump up significantly during a stressful event—including going to the doctor’s office.
The lower number, called diastolic, measures the ability of your heart to pump blood between its chambers, which infuses the blood with oxygen from the lungs. An elevated diastolic above 90 mm/Hg (millimeters of mercury being pushed up a tube, though this method is no longer used) can signify the beginning of an enlarged, boggy, less efficient heart muscle.
How high is too high for blood pressure?
Guidelines from the American College of Cardiology and the American Heart Association recently lowered the “cut-off” for hypertension (high blood pressure) from 140/90 to 130/80. This instantly made millions of Americans “eligible” for drug therapy. The evidence upon which the recommendation for a lower cut-off for “high” blood pressure is murky, because no statistically significant benefit was found for all-cause mortality, cardiovascular disease, or heart or kidney disease when treating blood pressure more aggressively. The rationale of the heart associations is “preventive,” but cardiac medications themselves are not benign—up to 40 percent of patients on cardiac medication suffer side effects including fainting or falling, electrolyte abnormalities, fatigue, weight gain, muscle aches, kidney damage, and even acute kidney failure.
Blood pressure is a dynamic measurement (it changes depending on circumstances), so a single reading shouldn’t be the basis for making a diagnosis of hypertension. It’s imperative to sit quietly for at least 2 minutes before taking your blood pressure. It’s much better to monitor your blood pressure at home, because even a visit to the doctor can be stressful enough to raise it. I have a loaner cuff in my office for this purpose. When a patient’s pressure is high in the office, I send them home with a cuff and ask them to take 10 readings in 5–7 days at different times of day, and then report their results back to me. This is a much more accurate way to gauge overall blood pressure.
What causes high blood pressure?
Hypertension isn’t really a disease; it’s a symptom of suboptimal health. Check out environmental causes first: caffeine, alcohol, and food allergens can all raise blood pressure. Other causes of high blood pressure that need to be assessed include kidney disease, narrowing of major blood vessels around the heart, excessive secretion of adrenaline, mineral imbalances in the blood, sleep apnea, and thyroid hyperfunction (Graves disease).
What are natural ways to treat high blood pressure?
Hypertension can almost always be managed, or at least improved, with lifestyle considerations.
- First off, if you smoke, stop. Period.
- Next, exercise daily. It’s far better to walk briskly for a half-hour each day than to be a weekend warrior. Find some kind of movement that you enjoy and can work into a daily routine. Activity lowers stress hormones, releases body tension, and reduces sodium levels through sweat.
- It also helps reduce and maintain weight—even a few extra pounds can have a profound effect on blood pressure. So find a food plan that keeps you satisfied, yet moving toward an optimal weight.
- Many (but not all) folks with hypertension get relief with a low-salt diet. Canned soups and processed meats are the biggest culprits for “hidden” sodium. If you have high blood pressure, figure out if salt is a problem for you.
- One of my favorite naturopathic lifestyle habits is contrast hydrotherapy. Alternating hot and cold, always ending on cold, is incredibly healing for many human ailments. Take a hot shower until you’re heated through and almost limp, then quickly change the temperature to as cool as you can stand. Try to do this every time you bathe. You will grow to love the invigorating cold rush, which stimulates circulation so that the blood is moving, not congested. This will help create an optimal blood pressure.
3 supplements to help support healthy blood pressure
- Vitamin K (500 mcg daily) is a potent anti-hypertensive and cardiac protectant. Foods high in vitamin K include turnip greens, broccoli, cabbage, spinach, watercress, and asparagus, as well as dairy products from grass-fed animals. The chlorophyll in grass converts to vitamin K in the belly of the happy beasts. This doesn’t happen with factory-farmed, corn-fed cows.
- Some studies have shown that Coenzyme Q10 (100–300 mg daily) markedly decreases blood pressure, especially with elevated systolic numbers. It can take 1–4 months of regular use to produce results.
- The most potent and reliable herbal medicine to reduce high blood pressure is Indian snakeroot (Rauvolfia serpentina). Work with a qualified naturopathic physician or well-trained herbalist before trying this Ayurvedic intervention, as high doses can cause depression, among other side effects. But when used properly, this ancient remedy has been shown to be highly effective in managing blood pressure.
Role of black-owned barber shops in reducing hypertension in African-American men
Some fascinating literature has emerged around the barber-shop approach to managing hypertension. African-American men comprise the highest risk group for premature cardiovascular death in the U.S. Black-owned barber shops play a central role in African-American public life, because the intimacy and easy conversation encourages both confidentiality and companionship.
Black barbers became engaged in reducing the risk of death related to hypertension several decades ago by discussing the issue with their customers, and it’s paying off. This offers a contrast to the clinical setting of a medical office, the mere thought of which can cause a blood pressure spike.