Your risk of hypertension – high blood pressure – increases as you get older. Everybody’s does.
For one in three people in the UK and USA, that risk turns into actual hypertension and another 25% have pre-hypertension or borderline high blood pressure. So it’s a threat that over half of people need to act on as they get older.
Indeed by age 60 almost 2 out of 3 people have some form of elevated blood pressure.
The problem is that there very rarely any symptoms of high blood pressure; consequently many sufferers are unaware of the threat.
So for too many people the first sign that something is wrong, and they have untreated hypertension, is a heart attack or stroke! In fact high blood pressure is the main risk factor for stroke, which is not only a top 5 killer but a major cause of disability.
Unfortunately that’s not all. Because, in addition to the risk of stroke and heart disease, chronic hypertension increases the risk, in both sexes, of dementia, sexual dysfunction, kidney disease and impaired vision.
The good news, however, is that hypertension is both easy to diagnose and treat, which must always be done under a physician’s guidance. So the advice here is complementary to working with your doctor.
There are drugs that can lower blood pressure, but this article concentrates on simple, natural lifestyle modifications that include diet and nutrition. The added benefit of these actions is that they will also improve your overall health.
How high blood pressure threatens your health
Some 66% of stroke victims have blood pressure readings in excess of 160/95 mm Hg. It happens in two ways.
Firstly, hypertension can weaken the walls of the artery and cause the wall to bulge out – an aneurysm. If this aneurysm ruptures in a brain artery, the result can be bleeding in the brain, causing pressure and damage to the brain. Alternatively, the aneurysm can cut off the supply of blood, and therefore oxygen, to the brain.
Secondly, hypertension also accelerates the build-up of sludgy plaque within the walls of the arteries – atherosclerosis. This narrows the artery and blood clots are more likely to form on the uneven surface of the artery wall, blocking the blood flow to the brain.
Either way there is serious and potentially fatal brain damage.
Multiple mini-strokes leading to dementia
Unfortunately, there is an even more insidious way the brain can be damaged by chronic hypertension. Unchecked, the lack of oxygen caused by blockages can lead to a series of small, sometimes even unnoticed strokes.
But these mini-strokes – called infarcts – cause damage to brain tissue and the accumulation of this damage is called multi-infarct dementia. That shows up as confusion and short-term memory loss.
Continuous (known as “chronic”) high blood pressure damages the capillaries that carry blood to the retina. The capillaries thicken, become narrower, and can eventually leak or become blocked, leading to visual impairment or even blindness.
We’ve seen that hypertension damages blood vessels. In the case of the kidneys, this can lead to your kidneys being unable to remove wastes and fluids from your body. In a vicious circle, the fluid retention then raises blood pressure even further – with a possible end result of kidney failure.
Just as narrowing of the arteries or a blockage leading to the brain can cause a stroke, so the same chain of events in the arteries leading to the heart can cause coronary heart disease and potentially a heart attack, which is often but not always preceded by chest pain.
If the brain is receiving less blood – and therefore less oxygen – the result, as we have seen, can be diminished cognitive function.
But brain cells are also covered by a fatty coating called a myelin sheath. If the brain is receiving fewer nutrients because of hypertension, and particularly less anti-oxidants, the myelin sheath can become vulnerable to oxidation – free radical damage.
Furthermore, if the brain is not receiving enough anti-inflammatory nutrients, it can become inflamed.
Current research shows that both free radical damage and chronic inflammation are key drivers of dementia.
Hypertension leads to reduced arterial elasticity and impaired blood flow and this reduced blood flow in turn can, and often does, lead to erectile dysfunction in men and reduced arousal in women.
The Good News! High blood pressure can be reduced
Fortunately all these risks and threats can be very significantly reduced in quite simple ways. But to understand how – let’s look at what causes hypertension and how you measure it.
The causes of high blood pressure
Blood pressure is the amount of force that the heart exerts to pump your blood through many miles of your circulatory system. (If you laid all your arteries, veins and capillaries end to end they would stretch for almost 100,000 kilometres!) That pressure is needed to deliver the oxygen and nutrients to body cells necessary for metabolism and to remove waste products.
As your heart contracts, it pumps blood into the arteries and blood pressure increases. That peak pressure is assessed by the systolic measurement. As it relaxes, the blood flows back from the veins into the heart and blood pressure drops – the lower value is the diastolic measurement.
This pattern happens about 100,000 times a day, almost 40 million times a year. So by the time you are 50, your heart has beaten almost 2 trillion times. And a bit of TLC is in order!
Everyday factors that determine temporary changes in blood pressure include exercise and stress. The body needs more oxygen and glucose for your muscles during exercise and in response your heart rate increases to deliver them, resulting in a temporary increase in blood pressure. There is a similar sequence when you are stressed.
In addition, your kidneys can affect the amount of blood in circulation by increasing or reducing the rate at which sodium is removed from the body. The more blood in circulation, the higher your blood pressure.
For this and everyday variations to happen over decades without damage, your small arteries need to be flexible enough to widen to accommodate the extra flow. So the elasticity of your arteries is a key element in ensuring a normal blood pressure.
LIFESTYLE FACTORS CONTRIBUTING TO BLOOD PRESSURE
Factor 1: Overweight
Being overweight forces the heart to pump harder and therefore increases blood pressure. Being overweight can also disrupt your breathing while you are asleep, which again increases blood pressure. A male waist measurement of 102cm/40″ or over and a female waist over 86cm/34″ is a risk factor.
Factor 2: Too much salt (sodium)
Excess intake of sodium – salt – causes arteries to constrict, therefore narrowing vascular channels and increasing blood pressure. It also encourages the body to retain fluid and the extra volume of blood further increases blood pressure. As so many processed foods have high levels of salt, this is a significant risk factor.
Factor 3: Too little potassium
Potassium helps counterbalance the effect of sodium. For sources of potassium see later.
Factor 4: Alcohol
The indications are that over two glasses of wine a day – or alcohol equivalents – increase hypertension risk. One glass, however, as a relaxant, seems to have the opposite effect. Older people metabolise alcohol less well and should reduce this guideline amount.
Factor 5: Lack of physical activity
Inactivity results in lower levels of nitrous oxide in the blood, which would otherwise help the arteries to dilate. Low activity levels also reduce the elasticity of blood vessels.
FACTORS TO BE AWARE OF OUTSIDE YOUR CONTROL
Factor 6: Age
As we have seen, the risk of high blood pressure rises with age until almost 60% of people over 60 have hypertension.
Factor 7: Gender
Women are more prone to pre-hypertension than men.
Men are at a 25% higher risk of having a stroke and at a younger age compared to women. However, as women live longer, there are more total incidences of stroke in women.
Factor 8: Genetics, including Race
There is a tendency for high blood pressure to run in families. An African or Caribbean origin predicts a higher risk of cardiovascular disease. Black people are twice as likely to have a stroke and at a younger age than white people.
Factor 9: Medications and Medical Conditions
There are several medications that raise blood pressure, including corticosteroids, lithium, some immune-suppressors, Cox-2 inhibitors (pain relievers like ibuprofen), antacids and certain anti-depressants.
Diabetes and high cholesterol are linked to hypertension.
What about caffeine in coffee or other drinks? Although caffeine does cause a short term rise in blood pressure, the results of a 12-year study on over 100,000 women found no apparent link to long term hypertension. However, it would be wise to limit coffee intake to 4 cups a day, especially as you get older.
And the pill? The oral contraceptive pill does raise the risk of hypertension slightly, but low dose oestrogen pills raise it less.
What is normal blood pressure?
The latest medical research makes the important point that pre-hypertension also carries high risk. People with pre-hypertension have double the risk of developing full hypertension, and a 2010 review in the Journal of the American College of Cardiology calculated that some 30 million people had died prematurely while suffering pre-hypertension in the decade 2000 to 2010.
There is debate about when normal turns to pre-hypertension and then to full high blood pressure.
A reading of up to 120/80 (spoken as “120 over 80”) is generally viewed as reasonable, but this chart represents the latest science. It is the guideline issued by US The National Heart, Lung and Blood Institute following the Framingham long term study where one quarter of over-65-year-old people in the range of 120 -130 systolic and 80-84 diastolic went on to develop full hypertension with all the attendant risks.
|Systolic mm Hg||Diastolic mm Hg|
|Normal BP range||Under 120||Under 80|
|Pre-Hypertension||120 – 139||80 – 89|
|Stage 1 Hypertension||140 – 159||90 – 99|
|Stage 2 Hypertension||160 +||100 +|
You may find you have a condition known as Isolated Systolic Hypertension where systolic BP is above 140 but diastolic is less than 90. In fact this is very common in people over 60. This is associated with reduced elasticity of arteries. But is still a health threat, as it can still lead to the same dangers as full hypertension.
For younger people – 50 and below – the more common condition is Isolated Diastolic Hypertension. This is when the diastolic reading is above 90 mm Hg. It elevates the risk of heart attack, stroke and kidney failure.
Although the first check should be done at the doctor’s, the new digital blood pressure monitors are a good way to keep a check on your own situation. But don’t be obsessive and always take two measurements about 2 minutes apart and average them, as BP can vary quickly. If your doctor is concerned she may advise an ambulatory test, where you are loaned and wear a BP monitor for a whole day.
How to lower blood pressure naturally
The following actions are listed in order of their impact on reducing blood pressure short and long term. The top two are linked because the eating plan will lead to a healthy weight loss.
Lose weight if needed. Research shows that every 10kg weight reduction can lead to a reduction in systolic BP of approximately 10mm Hg.
Eat a Mediterranean/anti-inflammatory diet. This will not only help you to reduce blood pressure and increase the elasticity of arterial walls, but will reduce inflammation – which is the underlying cause of most serious age-related diseases.There is a simple but effective plan at http://www.nutrishield.com/the-science/anti-inflammatory/ This plan is very similar to the American DASH (Dietary Approaches to Stop Hypertension) diet developed by the National Institutes of Health. Studies show that this plan, on average, dropped BP levels by 11/6 mm Hg. It’s a tasty diet rich in fruit and vegetables, fish, nuts, whole grains, olive oil and lean meat.
Increase activity to the equivalent of at least 5 x 30 minutes of brisk walking a week. Exercise has multiple benefits that include increasing the level of nitric oxide in the blood, which in turn causes the artery walls to relax, which then leads to a lower blood pressure. Supplements such as Co-Enzyme Q10 and the procyanidins in eg. grapeseed extract can also help increase nitric oxide levels.
Reduce salt by an average of half a teaspoon a day. In practice this means being very sparing with the salt shaker and cutting back on processed foods which are high in salt content – because convenience food manufacturers have no responsibility to look after your health.Soy sauce, pasta sauces, anchovies, ham, bacon, French fries, peanuts and pizza are all high salt/sodium foods. Flavourings like garlic, black pepper, celery seed, ginger, thyme, allspice and turmeric bring out the flavour of food and not only reduce the need for salt, but all have positive health effects of their own.
Increase potassium intake. There are low-sodium salt substitutes with more potassium than sodium. This not only reduces sodium intake, it increases your potassium intake and increased potassium intake correlates with a 24% lower stroke risk. Potassium-rich foods include mushrooms, citrus foods, salmon, spinach, avocado, bananas and raisins.Note, however, that people with kidney problems, or who are taking ACE inhibitors or NSAID drugs should not increase their potassium intake without consulting their doctors.
Increase magnesium intake. As we get older, the body absorbs dietary magnesium less efficiently, as it does most nutrients. Magnesium-rich foods include nuts, seeds, fish, green vegetables and whole grains.
Increase polyphenols. A study in the Journal of the Academy of Nutrition and Dietetics showed that increasing polyphenols – in this case using a cup a day of blueberries – reduced blood pressure by an average of 7/5 mm Hg. A further study in the America Society for Nutritional Sciences showed that green tea polyphenols also reduce blood pressure.Polyphenols along with Omega 3 help improve the elasticity of arteries. The polyphenols in dark chocolate do the same.
Increase Omega 3. Not only does an increased Omega 3 intake reduce damaging internal inflammation, but it helps to reduce BP levels.
Take a comprehensive nutritional supplement. Finally the proposed anti-inflammatory diet at http://www.nutrishield.com/the-science/anti-inflammatory/ does also suggest a comprehensive nutritional supplement.This will ensure you have optimum daily levels of Omega 3, grapeseed, green tea and bilberry polyphenols, CoQ10, curcumin, carotenoids like beta carotene, lutein and lycopene, and a full range of vitamins and minerals that includes vitamin D3 and K2 and magnesium.
The combination has been designed to provide a protective and significant daily level of anti- inflammatory and anti-oxidants nutrients and to help improve the elasticity of vascular walls.
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