Ken Babal, C.N.

High Blood Pressure

Hypertension (high blood pressure) is an intermittent or sustained elevation of blood pressure. In a healthy person, physical activity or emotional tension will cause a temporary rise in pressure that returns to normal after a period of relaxation. It is abnormal when the pressure remains high. High blood pressure without any apparent cause, such as kidney trouble, obstruction of an artery or an adrenal gland disorder, is called essential or primary hypertension. It is estimated that 15-20 percent of all adults have high blood pressure.

Elevated blood pressure increases the work load on the heart because it is forced to pump against a greater resistance. A constant strain is also placed on the vasculature. In the tiny capillaries of the kidney where pressure is normally high there is also a risk of damage. For this reason, high blood pressure, if untreated, can cause heart and kidney disease or stroke.

Dietary factors associated with hypertension are saturated fat, cholesterol and sodium. Other factors are stress, smoking, sedentary lifestyle and obesity. It is estimated that each 10 percent reduction in weight reduces the risk of heart disease by 20 percent due in part to blood pressure normalization.

Hypertensives are often salt-sensitive and may need to restrict it in the diet. Too much salt (sodium) causes the body to retain water and tissues to swell, putting pressure on arteries. Most people get more than enough sodium just from the foods they eat, without reaching for the salt shaker. It is estimated that 70 percent of the sodium in the American diet comes from processed/packaged foods, to which salt is added to compensate for the lack of natural flavor. Canned vegetables and soups, pickles and snack foods are usually very high in sodium. Fast foods are notoriously high as are cured meats such as sausage, salami, ham, bacon, hot dogs and corned beef. Some fish products such as smoked salmon and anchovies contain more salt than the seawater they came from. Cheese, milk and condiments are also often high in sodium.

Increasing potassium (vegetables and fruits) in the diet has been found to be as effective as lowering sodium in hypertensive individuals. This is because potassium and sodium exist in a see-saw balance in the body where an abundance of one causes the other to be excreted in the urine. (“Light salt” is a mixture of sodium chloride and potassium chloride in a balanced ratio.) Some of the best sources of potassium are tomato or vegetable juice (preferably low-sodium), orange juice, raisins, banana and avocado. Think vegetables and fruits at every meal and you’ll be sure to obtain your quota of potassium.

Studies show that calcium and magnesium play critical roles in preventing high blood pressure. In addition to its role as a bone builder, calcium is involved in nerve transmission and muscle contraction and helps regulate the heartbeat. Muscle or leg cramps at night, particularly when high blood pressure is present, may indicate a calcium deficiency. Best sources of calcium are low-fat dairy products, sardines, broccoli, kale, watercress, sesame and almonds.

Calcium and magnesium work together to maintain the regular pattern of contraction and relaxation in muscles, including the muscles that surround blood vessels. Calcium cannot be properly utilized without magnesium, and deficiencies appear to be just as common. It has been known for decades that low levels of magnesium cause progressive vascular constriction while large doses cause low blood pressure. Studies show that magnesium deficiency is strongly related to sudden death in persons with ischemic heart disease (lack of blood in an area of the body) and hypertension. Ironically, some of the adverse reactions of hypotensive drugs may actually be a magnesium deficiency created by the drug. Magnesium is found chiefly in fresh green vegetables, avocado, soyfoods, whole grains, corn, apples, banana, seafood and nuts (particularly almonds).

Many people with hypertension have benefited from following a DASH diet. DASH stands for Dietary Approaches to Stop Hypertension. It consists of a diet rich in vegetables, fruits, low-fat dairy products, whole grains, poultry, fish and nuts and is low in saturated fat, red meat, sweets and beverages containing sugar. The eating plan has been proven to lower blood pressure in just 14 days. A clinical study showed that reductions in blood pressure were about as large as what drug therapy can do for mild high blood pressure.

Specific foods that are helpful for lowering blood pressure are fish, garlic, onions, celery, mung bean, bladderwrack (a seaweed), maitake mushroom and pomegranate. In a clinical study, two ounces of pomegranate juice concentrate (equivalent to approximately 8 ounces juice) everyday for two weeks reduced high blood pressure in hypertensive patients. The effect was attributed to a reduction in angiotensin converting enzyme by 36 percent. It is this enzyme that is targeted by blood pressure medications known as ACE-inhibitors.

In Japan, garlic research has been so extensive and supportive of its therapeutic value that doctors commonly prescribe it. Hundreds of studies have documented its ability to lower blood pressure, total cholesterol, LDL cholesterol and triglycerides and reduce blood platelet stickiness.

Ten Commandments

High Blood Pressure

1. Avoid high-sodium. Main sources are canned soups and vegetables, pickles, condiments, snack foods, fast foods (burgers, fries), cured meats (sausage, salami, ham, bacon, hot dogs, corned beef) and smoked salmon. Use a salt substitute or light salt such as Heart Salt from Solgar Vitamin Company.

2. Reduce saturated fat and sugar. Main sources of saturated fat are meats, butter and whole milk products. Avoid cookies, pies, pastries, cakes, candy, soda pop and sugary breakfast cereals.

3. Increase potassium by eating fruits and/or vegetables with each meal. Eat 4-5 servings of fruit and 5-7 vegetable servings everyday. Serving sizes are a ½ cup cooked, 1 cup leafy-raw, 6 ounces juice (unsalted/unsweetened) and 1 whole fruit.

4. Reduce or eliminate coffee. The combination of caffeine, stress and a tendency to hypertension can cause dangerously high blood pressure.

5. Include other healthful foods and herbs. Some specific foods and herbs that help lower blood pressure are fish, garlic and onions, celery, mung bean, bladderwrack (seaweed), maitake mushroom, pomegranate, hawthorn, hibiscus, coleus forskohlii, stevia and olive leaf.

6. Take nutritional supplements. In addition to a multiple vitamin-mineral supplement, consider calcium, magnesium, coenzyme Q-10 and omega 3 fatty acids (flax or fish oils), arginine and anti-ACE peptides.

7. Maintain a healthy weight.

8. Don’t smoke cigarettes.

9. Practice stress management techniques. Learn how to use exercise, meditation or prayer to lower blood pressure.

10. Purchase a blood pressure cuff. Monitoring you blood pressure is a form of biofeedback that can help you learn how to control it.

Selected references: Appel, L.J., et al. A Clinical Trial of the Effects of Dietary Patterns on Blood Pressure. New Eng J of Med 336 (1997): 1117-24; Aviram, M. & Dornfeld, L. Pomegranate juice consumption inhibits serum angiotensin converting enzyme activity and reduces systolic blood pressure. Athero 158 (2001): 195-8.