Best Bets Healthy for Blood Pressure

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High blood pressure (hypertension) is known as “the silent killer.” It causes no symptoms, but it’s a major risk factor for stroke, heart disease, con-gestive heart failure, kidney damage, glaucoma and Alzheimer’s disease. Blood pressure-related diseases account for 39 percent of U.S. deaths. Hypertension also is a rising national epidemic. In 1990, 25 percent of American adults had it. By 2000, the figure was 29 percent. Doctors are quick to treat hypertension with drugs, but natural approaches often are just as effective.

How High Is High?

Imagine for a moment that blood is water, the heart is a pump and blood vessels are a system of garden hoses. Just as water presses against the inside of a hose, blood pushes on your blood vessels, exerting blood pressure. When the heart beats, pressure increases. That’s “systolic” pressure, the first number in a blood pressure reading. Between heartbeats, pressure drops to “diastolic” pressure, the second number in a blood pressure reading.

“Normal” blood pressure is 120/80 (millimeters of mercury). But that number can be misleading, as blood pressure varies throughout the day. When you wake, it’s usually low. It rises during the day. And when you run to catch a bus, it spikes sharply, then returns to normal. A classification of high blood pressure means persistently elevated readings.

Until recently, physicians diagnosed blood pressure as “high” if, over a month, it was consistently above 140/90. But recently, researchers have discovered that even what was once considered “high-normal,” from 130/85 to 139/89, increases the risk of blood pressure-related health conditions. If you want to live to a ripe old age, keep your blood pressure as close to 120/80 as possible. The suggestions in this article will show you how.

First Things First

• Don’t smoke. If you smoke, there are many excellent reasons to quit. Blood pressure control is one of them. Smoking constricts the blood vessels, which increases blood pressure.

• Limit alcohol. A little alcohol — up to two drinks a day for men and one for women — reduces heart attack risk by raising HDL, also known as “good” cholesterol. But if you drink more, you risk developing high blood pressure.

Herbs Help

Substitute culinary herbs for salt. Salt is sodium chloride. As salt consumption increases, the body retains more water. Some of it winds up in the blood, which raises blood pressure. Researchers at the National Institutes of Health analyzed 32 studies of salt restriction on blood pressure. Their conclusion: If Americans consumed less salt, deaths from heart disease and stroke would fall substantially. But the salt habit is hard to break. This is where culinary herbs can come to the rescue — their flavor can substitute for salt’s. Try any culinary herbs and spices, but for rich, complex aroma and taste, try Indian curry blends — either prepared curries or homemade blends from recipes in Indian cookbooks.

Go for garlic. Speaking of culinary herbs, garlic (Allium sativum) is better known for cutting cholesterol, but it also lowers blood pressure. Australian research-ers analyzed eight studies of garlic (Kwai brand supplements, 600 to 900 mg daily) as a treatment for high blood pressure. The herb reduced blood pressure significantly. Noted herbalist James Duke, Ph.D., recommends chewing one raw clove a day. If that puts you off or upsets your stomach, try taking its powdered equivalent in capsules. Deodorized brands work well. Garlic’s close botanical relatives (onion, scallions, leeks, chives and shallots) also help control blood pressure. They don’t pack garlic’s punch, but they do help.

Heart-friendly hawthorn (Crataegus spp.) has been used as a heart tonic for centuries. It’s especially effective in treating congestive heart failure. One reason it works is that it reduces blood pressure. Iranian researchers gave 92 people with mild hypertension either a placebo or hawthorn. Twelve weeks later, in the herb group, blood pressure had dropped significantly. Recommended dose depends on the preparation. When using tincture, take 5 to 10 drops three times a day. Or take 1/2 teaspoon of solid extract a day.

Asian ginseng (Panax ginseng) has stimulant properties, so some physicians tell people with hypertension to avoid it. But Korean red ginseng, a steamed form of P. ginseng, shows promise in reducing blood pressure. At Seoul National University, researchers gave people with hypertension Korean red ginseng (4.5 grams a day). After eight weeks, their blood pressure was lower. To find Korean red ginseng, ask a naturopath or a practitioner of Chinese medicine.

If you take blood pressure medication, try reishi mushrooms (Ganoderma lucidum). These medicinal mushrooms may not reduce blood pressure by themselves, but they boost the effectiveness of blood pressure medication. Asian researchers gave people taking blood pressure medication either a placebo or reishi (55 mg of extract daily, equal to 4 grams of raw mushrooms). After two weeks, the placebo group showed no change, but in the mushroom group, blood pressure declined significantly. Two to three tablespoons of reishi mushrooms weigh about 4 grams.

Rauwolfia (Rauvolfia serpentina), also known as Indian snakeroot, is a classic Ayurvedic herb. It contains the compound reserpine, which became a standard blood pressure medication in the 1960s. Then concerns about side effects led to its replacement by other (more expensive) drugs. Eric Yarnell, N.D., president of the Botanical Medicine Academy in Vashon, Washington, says that whole rauwolfia root does not cause the side effects of isolated reserpine, and that the herb is still a good choice for blood pressure control. To treat mild hypertension, he recommends a standardized tincture: 4 drops twice a day for a week, then 4 drops once a day.

Eat Your Way to Lower Blood Pressure

During the 1970s and 1980s, the medical literature hinted that a low-fat, near-vegetarian diet reduces blood pressure. During the 1990s, Harvard and Johns Hopkins researchers launched the Dietary Approaches to Stop Hypertension (DASH) study. They fed 459 people with mild hypertension one of three diets. The first group received a typical American diet, with lots of meat and high-fat items and with few whole grains, fruits and vegetables. The second group consumed a high-fat diet with more plant foods. The third group ate a low-fat, near-vegetarian diet containing four to five daily servings each of fruits and vegetables (twice what the typical American eats), along with whole grains, fish and some chicken. Neither high-fat diet reduced blood pressure. But in just eight weeks, the low-fat, near-vegetarian diet reduced blood pressure significantly — about as much as some blood pressure medications.

You can consume the DASH diet’s five servings of vegetables a day by including a salad at lunch and dinner, one vegetable at lunch and two at dinner or a veggie snack (a carrot, celery stalk or a handful of green beans). It’s also not much trouble to eat the DASH diet’s five daily servings of fruit. Have some at breakfast, lunch and dinner, and replace all junk food snacks with fruit. The DASH diet also was designed to be palatable to the average American. Just about every participant assigned to the near-vegetarian diet (96 percent) stuck with it for the entire eight weeks. One dinner featured New Orleans-style jambalaya, usually a sausage-filled, high-fat disaster. But DASH jambalaya was mostly vegetables with a little chicken and New Orleans spices.

As discussed above, reducing salt lowers blood pressure. But you don’t have to sacrifice salty taste. Just switch from sodium chloride to potassium chloride (brand name: No Salt). Potassium chloride tastes just like salt, but without sodium-related blood pressure elevation. Beyond reducing sodium in the diet, potassium actually reduces blood pressure on its own. Fruits and vegetables are high in potassium. That’s one reason why a near-vegetarian diet helps control blood pressure.

A low-fat, near-vegetarian diet can reduce blood pressure significantly.

Rx: Weight Loss and Exercise

Want lower blood pressure? Lose 10 pounds. In a recent analysis of 18 studies, University of Texas researchers concluded that losing 5 percent of body weight — 10 pounds for a person who weighs 200 pounds — reduces blood pressure significantly. Many other studies agree.

It makes perfect sense that weight loss should reduce blood pressure. Recall the garden hoses. Carrying extra weight is like placing bricks on a hose. The bricks squeeze the hose, which increases the water pressure inside it. Remove the bricks — that is, lose weight — and blood pressure falls.

So how do you lose those 10 pounds? The low-fat, near-vegetarian DASH diet is a good place to start. In addition, get regular, moderate exercise and don’t “diet,” in the traditional sense of the word. This advice comes from James Hill, Ph.D., director of the Center for Human Nutrition at the University of Colorado Health Sciences Center in Denver and cofounder of the National Weight Control Registry (NWCR), a unique database of people who have lost at least 30 pounds and kept it off for at least a year. Since 1993, the NWCR has collected more than 4,500 weight-loss success stories. The average registrant has lost a whopping 60 pounds and kept if off for five years.

Hill’s advice to stop dieting may seem crazy. It isn’t; most diets don’t produce permanent weight loss. “Dieting,” he explains, “involves major eating changes in the short term that are virtually impossible to maintain long term. My mantra is ‘Small Changes for Life.’ People who lose weight permanently figure out what diet modifications they can live with over the long haul — and stick with them for good. Small changes are manageable. You don’t feel deprived.

“Many people in the NWCR switch from whole milk or 2 percent to 1 percent or skim,” Hill says. “Or they take the bacon and cheese off their burgers and go with plain hamburgers topped with lots of lettuce, tomato and pickles. The beauty of making small changes is that they’re no big deal. But over time — a year or two — small dietary changes can add up to significant weight loss.”

Many studies show that exercise helps lower blood pressure. Exercise helps because it contributes to weight loss. Tulane University researchers enrolled 90 people with hypertension in an exercise program. Seven years later, 41 percent of the sedentary controls still had high blood pressure. But in the exercise group, the figure was just 19 percent. The Tulane researchers then analyzed 54 studies of exercise as a treatment for hypertension. Exercising con- sistently and significantly reduced blood pressure.

Any regular moderate exercise reduces blood pressure. You don’t have to sweat buckets. Regular, brisk walking is enough. Walking also helps keep weight off, Hill says. “Walking is the No. 1 physical activity reported by people in the NWCR,” he says. “They incorporate more walking into their lives. They take the stairs instead of the elevator. Instead of coffee dates with friends, they make walking dates.”

Manage Your Stress Mindfully

Stress constricts blood vessels and makes the heart beat harder. The result is higher blood pressure. Relaxation opens blood vessels, calms the heart and decreases blood pressure. Beyond weight control, another reason exercise helps control blood pressure is that it reduces stress. Exercise releases natural tranquilizers (endorphins). That’s why exercise feels calming. Other calming therapies also reduce blood pressure, notably yoga, tai chi, transcendental meditation (TM) and pet ownership.

The ancient Indian stretching art of yoga combines exercise with meditative stress reduction. No wonder many studies show that it reduces blood pressure. Indian researchers measured the blood pressure of 24 diabetics, then enrolled them in a 30-minute daily yoga class. After 40 days, their blood pressure was significantly lower.

Tai chi involves slow, dance-like movements with deep breathing and meditative focus. British researchers taught a basic tai chi routine to 17 women who practiced it three times a week. After 12 weeks, their blood pressure was significantly lower.

At Maharishi University in Fairfield, Iowa, researchers taught TM to 127 African-Americans with hypertension. After three months, controls who did not meditate showed no change in blood pressure. But the daily meditators’ blood pressure declined significantly.

Several studies have shown that human-pet interactions — playing with a dog, having a cat purr in your lap or gazing at a fish tank — can be profoundly relaxing. As a result, pets help control blood pressure. At the State University of New York at Buffalo, researchers investigated the blood pressures of 240 married couples, with and without pets. Pet owners had significantly lower blood pressure.

Supplements May Help

Blood pressure-lowering fruits and vegetables are high in potassium. Supplemen- tation with the mineral also reduces blood pressure. That’s what Johns Hopkins researchers found in an analysis of 33 studies of potassium and blood pressure. Clinical nutritionist Shari Lieberman, Ph.D., author of The Real Vitamin and Mineral Book (Avery, 2003), recommends 100 to 300 mg daily.

Another reason plant foods reduce blood pressure is their vitamin C content. Several studies show that vitamin C supple- mentation helps reduce blood pressure. University of South Carolina researchers gave vitamin C to 31 people with hypertension. After eight months, their blood pressure had declined significantly. Most studies show that 500 mg a day is enough to reduce blood pressure.

Coenzyme Q10 improves heart function and the health of the circulatory system, including blood pressure. Idaho researchers gave either a placebo or coenzyme Q10 (60 mg a day) to 83 people with hypertension. Twelve weeks later, the supplement group had significantly lower blood pressure. Take 60 mg a day.

Take the Pressure Off

If your blood pressure is normal, these approaches will help it stay that way. If it’s high, they just might bring it down to a healthy level without drugs. But if these suggestions don’t bring your pressure down to normal, it’s prudent to take medication because hypertension is a risk factor for so many serious conditions. If you take medication, continue to use natural and herbal approaches (under your health practitioner’s guidance). They usually help keep medication dosage — and any side effects — to a minimum.

San Francisco health writer Michael Castleman is the author of 12 consumer health books, including Blended Medicine (Rodale, 2000). Visit his website at


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