Hypertension: Avoid High blood Pressure with proper diet

When Sylvia Crawford, a 48- year- old middle school teacher, sought treatment for a knee injury, she learned her blood pressure was extremely high. Although it had been 140/90 or 150/100 for some time, the unexpected skyrocketing reading told her "the party was over."

The "party" is the ongoing feast of high-fat, high- cholesterol, high- sodium food most Americans can be found consuming on any given day. Diseases of the heart and circulatory system are a direct result. Sixty million Americans have hypertension. According to John McDougall, MD, Medical Director of The McDougall Program at St. Helena Hospital and Health Center in Northern California, hypertension is the most common reason for visits to the doctor and the number one reason why medicine is prescribed. It is, he says, "a plague."

Blood pressure is created by the force of the heart pumping blood through the arteries, bringing oxygenated blood to the cells, tissues, and organs of the body. Blood pressure measurement is expressed as a fraction whose numerator, the systolic pressure, measures the force of the blood as it is actively pumped by the heart; the denominator is the diastolic pressure- a measure of the force of the blood flowing through the arteries when the heart relaxes between beats. Together these numbers tell a lot about the health of the circulatory system.

Blood pressure varies within an individual based on activity levels and circumstances. For some people, simply having their blood pressure measured can cause an elevated reading. Therefore, to be certain about your blood pressure, you may want to take readings at various times of the day, using a device at home. When do you need to pay attention to your reading? According to the American Heart Association, anyone whose blood pressure is greater than 140/90 for sustained periods has high blood pressure, or hypertension, and should take steps to lower it.

Untreated, hypertension causes the heart to work very hard and ultimately damages it. The American Medical Association warns that a mild case of untreated hypertension can double your chance of a heart attack, and a moderate case triples it. Strokes are caused when hardened material from the wall of a blood vessel blocks an artery, diminishing or cutting off the blood supply to the brain. Increased risk of stroke is also related to hypertension.

Medication for Hypertension

Drugs are the standard treatment for hypertension. Several categories of pharmaceutical agents have been developed with the goal of reducing the pressure within the arteries. The first group contains diuretics which work by reducing the total fluid level in the body and therefore in the blood. The second category of medicine is beta blockers which alter the chemistry of the body so that it ignores some of the hormonal output from the adrenal glands, thereby creating a false state of relaxation. The third type of drug is called a sympathetic nerve inhibitor which prevents the nerves from constricting blood vessels. Calcium channel blockers, which prevent the blood vessels from absorbing calcium and therefore constricting, are also in this group. The fourth group, vasodilators, cause the muscles in the walls of blood vessels to relax and dilate.

Each drug prescribed for hypertension has side effects, ranging from headache and nausea to much more serious symptoms. It is not unusual for patients to use more than one type of medication to control their blood pressure, thereby increasing the imbalance in the body. In fact, one of effects is heart disease itself. One study, published in the Journal of the American Medical Association, determined that the use of high doses of calcium channel blockers was associated with an increased risk of heart attack.

Dr. John McDougall, who has studied most of the published research on treatment of hypertension, declares that, "the current treatment for high blood pressure is largely a failure for the vast majority of patients."

The Lifestyle Approach

A lifestyle approach to the treatment of hypertension begins by looking at the root cause. If the heart pumps harder because the blood vessels are narrowed with fatty deposits (atherosclerosis) due to diet, can a healthier diet either prevent or reverse atherosclerosis? Research has demonstrated again and again that lifestyle modification can reverse heart and circulatory diseases in a majority of cases. This suggests that a combination of weight reduction, low fat diet, reduced sodium, and moderate, regular exercise can return the blood vessels to a healthy condition and eliminate hypertension.

Individuals can take control of their health and their lives at virtually any stage; no one is "too far gone." Persons with no disease can maintain their health through a preventive program, while those who are ill can take steps to reverse their disease. Dr. McDougall has developed what he calls "the fastest and most efficient program for combating heart disease." People who adopt it experience a dramatic improvement and they see it quickly. "They also have very little trouble following my advice because the program is clear and powerful. Big changes beget big results." In the case of his program, follow- up studies have shown that 80 percent of his clients remain healthy when they adhere to the dietary and exercise regimen of his program.

The McDougall Program

Making major lifestyle changes can be a daunting task. Add the concerns brought on by a diagnosis of hypertension, and one might easily feel overwhelmed and helpless. Experts now recognize that individuals benefit enormously when they receive support in changing lifelong habits and adopting new ones. Fortunately more and more sources of help are available.

Once you check into the McDougall Program at St. Helena's Hospital and Health Center in California's Napa Valley, you will learn to cook, eat, and exercise in a therapeutic regimen which you can adopt for the rest of your life. Sylvia Crawford completely changed her lifestyle in just 12 days in 'McDougall camp.' "I went from 20 cups of coffee a day to zero; from a meat diet to total vegetarianism. And I've stayed that way." Following the high blood pressure reading, her cardiologist immediately prescribed two types of medication, which she was still taking when she signed on for the McDougall Program in June of 1995. "I was afraid to discontinue my medication during the program, and Dr. McDougall was supportive of this choice. However, shortly afterward, I did discontinue it, with the blessing of my cardiologist- once he saw that I had lost weight and was exercising daily." Sylvia was encouraged by the results others had obtained from the program. One hundred pounds overweight at the outset, the diet combined with exercise, pared away 50 pounds. She is amazed at the changes in values which resulted from the experience. "I admit it, I snuck coffee into 'camp'," she says. But now, I am a confirmed McDougallite: I could never have done it on my own."

Adopting a Healthy Diet

What are the dietary changes required for a healthy circulatory system? Both Dr. McDougall and Dean Ornish, MD, agree on prescribing a very low- fat vegetarian diet. Each includes a slew of recipes in their books. Although the recommended diet is far from the all- American diet, it can be delicious and filling. (Ornish's research demonstrated conclusively that lifestyle modification reverses heart disease.) The basics of the McDougall diet are grains, legumes, and vegetables, including tubers and yams. These ingredients are transformed into tasty soups, stews, main dishes, and side dishes. Salt is nearly eliminated, but flavors are enhanced through a creative use of herbs. Salt is not a major factor in hypertension for all individuals. In fact, studies have shown that when normal amounts of sodium are included in a vegetarian diet, blood pressure is not elevated except in a small percentage of people who are sodium- sensitive.

The McDougall plan contains absolutely no animal or dairy products in its effort to lower cholesterol levels of individuals with heart disease. McDougall's objective is to reach a cholesterol level of 150. Serum cholesterol is the level of cholesterol circulating in the bloodstream. It is a key component of the plaque which forms on arterial walls. Individuals who eliminate animal fats and cholesterol from their diets can have dramatically reduced cholesterol levels in a matter of days. Many experts believe this factor alone to be the most accurate predictor of heart disease. Sugar also is restricted in order to reduce the triglyceride level. The goal for this is 150 as well.

Exercise Can Help

The goal of a lifelong, regular exercise program can be as modest as 20 minutes or more of brisk walking daily. Alternatives to walking include dancing, water aerobics, and machine workouts. Building an exercise program entails increased intensity rather than increased time. However, it is not advisable to begin such a program until dietary changes are established. A high- fat, high- cholesterol diet combined with vigorous exercise places your life in jeopardy, according to Dr. McDougall. Once dietary changes are begun it is advisable to begin slowly, with just three sessions a week if you are out of shape, have been diagnosed with heart disease, or have suffered a heart attack or stroke.

Managing Stress

Stress is never outside of ourselves. Events are outside, and stress occurs when we react to them with certain emotional and biological responses. This gives us a great deal of control over life. We can choose to respond to anything in a relaxed, even- handed way, or succumb to the fight- or- flight reactions which occur automatically when we feel threatened. Our fight- or- flight response was developed back in cave times, and is designed to protect us by activating certain physiologic processes. Typically, a situation which produces feelings of fear, anger, or anxiety causes the adrenal glands to produce adrenaline. This powerful hormone causes a rise in blood pressure and signals the liver to dump cholesterol into the blood stream. The blood produces additional clotting factors to protect in case injury occurs.

However, since most modern stress results from psychological pressure, there is no combat or physical struggle to dissipate the blood factors and clear the bloodstream. Instead, we literally internalize the reaction so that it writes on the permanent record of the blood vessels.

The goal of relaxation training is to minimize the harmful response to stressful triggers. Herbert Benson, MD, in his classic work, the Relaxation Response, suggests that people use any one of a variety of techniques such as yoga, meditation, hypnosis, or autogenic training twice each day for 10 to 20 minutes as a way to control the stress response. He conducted experiments with practitioners of Transcendental Meditation and found that those with borderline hypertension were able to lower it to normal as long as they continued a twice- daily practice. He suggests that employing these techniques are likely to be effective in preventing hypertension as well as controlling it.

It is far more beneficial to gain daily control over stress than to carry a load of pressure for a time and then go on vacation. The practice of meditation, yoga, or tai chi on a regular basis produces neuron pathways for relaxation rather than excitation. Although it may seem useless to meditate at six in the morning when the whole world is peaceful, that 15 minute session will bear fruit when the 11 o'clock deadline approaches and the photocopier breaks down.

Some people literally need to be trained to recognize when their body is tense and when it is relaxed. Once the tension becomes perceptible, the next step is to learn to produce a relaxed state. Bio- feedback uses electronic equipment to measure activities of the autonomic nervous system such as skin temperature, brain waves, and blood pressure, and feeds back this information to the subject. For example, if you were asked to lower your blood pressure, you might try a variety of strategies such as deep breathing, thinking pleasant thoughts, or 'telling' your arteries to relax. Biofeedback would provide instantaneous feedback about your success in achieving a relaxed state.

Although the connection between a stressful response and hypertension has not been directly proven, Dr. McDougall offers a powerful insight into how stress leads to poor health. He suggests that stress causes us to do all sorts of things that have been proven unhealthful such as poor eating, smoking, drinking alcohol, and driving unsafely. Therefore, stress reduction can lead to better overall health.

Prevention is Best

What is recommended for individuals with normal blood pressure and safe levels of cholesterol and triglycerides? Because of the prevalence of circulatory disorders, Dr. McDougall maintains that all Americans need to establish habits most likely to produce lifelong health. He suggests people eat a very low fat vegan diet most of the time, with feasting only at holidays and special occasions such as birthdays. Although the body can tolerate a lot of stress through occasional poor diet and exercise, it needs to be maintained on a diet of starches, vegetables, and fruit for optimal health.

HERBS & VITAMINSUPPLEMENTS

Many substances from nature can be taken as supplements to maintain the health of the circulatory system and prevent heart disease and hypertension. They may also be an adjunct to treatment for those with moderately elevated blood pressure readings. For anyone with elevated readings (near 140/90) these therapies should be undertaken in conjunction with lifestyle modification as outlined in this article and under the supervision of a health practitioner.

Garlic is well known for its ability to 'cure what ails you.' It is arguably the most accepted and used herbal therapeutic and preventive. To improve circulatory health one needs to consume either fresh garlic cloves or tablets made with carefully dried garlic powder. To lower cholesterol the equivalent of a clove each day is sufficient. However, to tap into garlic's blood pressure reducing effect, at least three, and some researchers say five to 20, cloves are needed. Pesto anyone?

Hawthorn (Crataegus) is a widely prescribed herb to control blood pressure as well as reduce cholesterol. It is known to dilate the blood vessels, thus reducing blood pressure. Hawthorn's action is slow and the toxicity is low. Therefore, it is a good heart tonic.

Vitamin E, at the dosage level of 400 IUs daily, has been demonstrated to reduce the risk of coronary disease by 40% compared to the risk in individuals whose supplement level was close to the RDA of 15 IUs. These results came from a study conducted by Boston's respected Brigham and Women's Hospital in conjunction with the Harvard School of Public Health.

Vitamin C is very effective at lowering cholesterol when consumed at the level of two grams per day. Some researchers think that vitamin C deficiency creates a scurvy- like condition in the blood vessels which results in bleeding of the arterial wall and the formation of blood clots. These in turn attract other substances in the blood and form plaque.

Ginkgo is an herb enjoying new levels of popularity in the West, although the Chinese have long known of its ability to increase cerebral blood flow through blood vessel dilation. Since it is also reduces the clotting time of blood, it should be used under medical supervision by persons on anticoagulants.

Gugulipid, an extract of the guggul plant from India, is an herb employed in the healing system known as Ayurveda. It has been shown to lower serum cholesterol when taken at the dosage of 500mg for 12 weeks.

Pycnogenol is the industry name of an extract of pine bark that may protect the body in many of the same ways as nutrients found in vegetables and fruits. It is reputed to improve peripheral circulation, strengthen weak blood vessels, and restore capillary action. More research is needed to verify these effects.