Get full access to Outside Learn, our online education hub featuring in-depth nutrition, fitness and adventure courses, and more than 2,000 instructional videos when you sign up for Outside+..
—Pat S., Tampa Bay, Fla
Understanding High Blood Pressure
A: The first thing to know about high blood pressure is that it has no symptoms. The second thing to know about it is that it’s really serious.
Less than half of the estimated 68 million Americans who have high blood pressure have their condition under control, and 1 in 5 adults in the United States have no idea that they have it in the first place. And why does this matter? Because high blood pressure is a major risk factor for both heart attacks and strokes. It’s a leading cause of unexplained death. And for many people, sadly, the first symptom is frequently a heart attack.
“Hypertension is often called the silent killer because it usually exhibits no obvious symptoms until the blood pressure is very high,” says Mark Houston, MD, MS, author of What Your Doctor May Not Tell You About Hypertension. Houston warns that most people who have it won’t feel anything out of the ordinary and have no idea that something is amiss until plenty of damage has been done.
To make matters worse, in as many as 95% of high blood pressure cases, we have no idea what the underlying cause is. This kind of high blood pressure is referred to as “essential hypertension,” and though it remains a bit of a mystery, we do know that certain risk factors play a part.
Age, race, and family clearly play a part. Hypertension tends to run in families, is more likely to affect men than women, and—in the United States, at least—blacks are twice as likely as whites to have it (though the racial gap tends to narrow around the mid-40s). After the age of 65, African-American women have the highest incidence of hypertension.
And while we don’t know the exact causes of high blood pressure, there are several factors known to play a role. Top of the list: smoking, being overweight or obese, and living a sedentary life. Too much salt in the diet is thought to be a factor, but this remains controversial (more on this in a moment).
So how does high blood pressure hurt you?
Think of the blood coursing against the blood vessel walls like the waves in the Pacific Ocean pounding against the rocks. When those waves are violent and powerful, repeated “hits” produce little erosions in the rocks, little pimple-like “injuries” or indentations. The same thing happens in your arteries, except those little “injuries” then become inflamed and attract metabolic debris (e.g., bacteria, oxidized LDL-cholesterol, and calcium), eventually leading to plaque buildup.
When we’re talking about the artery walls, we’re really talking about something called the endothelium, a thin layer of cells that lines artery walls. When the endothelium isn’t working well, it’s called endothelial dysfunction, which is a huge risk factor for just about everything, from heart disease to diabetes. It’s even related to erectile dysfunction.
The endothelium releases a number of vital compounds, including the all-important nitric oxide, which opens artery walls, thereby lowering blood pressure and improving circulation. “A healthy endothelium promotes optimal blood flow, and prevents blood clots, plaque buildup, and inflammation,” explains Steve Parcell, ND. “Conversely, a dysfunctional endothelium is associated with constriction of arteries leading to hypertension, inflammation, and clot formation.” In short, high blood pressure ultimately increases the risk for heart disease, stroke, and diabetes.
4 Natural Solutions for High Blood Pressure
Both diet and lifestyle have a huge—repeat, huge—impact on blood pressure, and any natural treatment for hypertension should begin there. A few suggestions:
1. Cut out sugar.
Fructose in the diet—from high-fructose corn syrup to the plain old white stuff—massively increases hypertension risk. A normal blood pressure reading is 120/80—or below—these two numbers. Research shows that an intake of 74 grams per day of fructose (the amount in 2½ sugary soft drinks or sweetened juices) increases the risk of having a blood pressure reading of 135/85 by 26%; a reading of 140/90 by 30%; and a reading of 160/100 by a whopping 77%.
2. Be aware of insulin resistance and metabolic syndrome.
Insulin resistance and hypertension are both key features of something called metabolic syndrome, which significantly increases heart disease risk. Research going back to 1987 suggests that high blood pressure is an “insulin resistant state,” and the two have been linked in dozens of studies since then. When you have insulin resistance, both blood sugar and insulin are elevated. And since insulin sends a message to the kidneys to hold on to sodium, your body retains more water, which drives blood pressure up even more.
3. Reduce carbohydrates, boost magnesium.
If you are eating the standard American diet high in carbs, you are more likely to develop insulin resistance. (Sugars and carbs, especially refined ones, raise insulin levels.) What you might not know, however, is that insulin resistance affects both fat and magnesium storage. Why does this matter?
It’s simple: when insulin can’t do it’s job very well, your body can’t store magnesium effectively. Magnesium plays a critical role in relaxing muscles as well as blood vessels. And if blood vessels don’t relax and dilate, they constrict and increase blood pressure. Surveys show that 75% of Americans don’t get enough magnesium, and insulin resistance adds to the problem. Good food sources of magnesium include pumpkin seeds, spinach, Swiss chard, soy beans, black beans, quinoa, cashews, and sunflower seeds.
4. Delve into DASH.
The dietary program for lowering blood pressure that’s gotten the most attention is the DASH (Dietary Approaches to Stop Hypertension) diet. It focuses on lots of fruits and vegetables, as well as whole grains, poultry, fish, meat, nuts and beans. The DASH-2 diet added sodium reduction to the mix. Visit dashdiet.org to learn more.
Focus on potassium. “People concentrate on sodium restriction,” explains Houston, “but it’s equally important to look at the ratio of sodium to potassium in the diet.” These two minerals have a symbiotic relationship, and the balance of the two is critical to good health. The Institute of Medicine now recommends that adults consume at least 4,700 mg of potassium a day to lower blood pressure and blunt the effects of salt. Swiss chard, yams, spinach, lentils, and avocados are good food sources of potassium.
Supplements for high blood pressure
A few standouts that have been shown to help lower blood pressure:
Omega-3s: Dozens of studies have demonstrated the ability of EPA and DHA (omega-3s found in fish oil) to lower blood pressure. ALA, an omega-3 found in plant foods, has also been found useful. “Omega-3s increase nitric oxide—a substance that opens up blood vessels and improves elasticity of the arteries,” says Houston.
CoQ10 is widely given in Europe and Japan to millions of people suffering from cardiovascular disease. People with hypertension are more likely to have a CoQ10 deficiency than those without hypertension. The Ubiquinol form of CoQ10 has been shown to be better absorbed by the body, particularly in people over age 40.
Magnesium relaxes blood vessels. Large population studies have shown that the more magnesium people take in, the lower their blood pressures.
Whey protein is a natural ACE inhibitor. ACE inhibitors help reduce blood pressure by interfering with an enzyme that causes the muscles
surrounding the arteries to constrict.
Vitamin D affects a hormone called renin that controls blood pressure. “If vitamin D is low, renin is increased, and this causes the arteries to constrict,” says Houston.
Resveratrol: “Resveratrol increases nitric oxide, lowers arterial stiffness, and slows vascular aging,” says Houston.