Hypertension (high blood pressure)

The presence of pressure in the circulatory system is essential. Blood must be kept moving, and blood pressure provides this force for blood to flow throughout the body.

Measuring blood pressure

Blood pressure in our arteries (carrying oxygen rich blood away from the heart) is measured in two ways giving two readings – systolic pressure and lower diastolic pressure. The systolic blood pressure is the pressure in the blood vessels at the height of the contraction of the left ventricle of the heart (the pump which creates the pressure). This is, of course, always higher than the diastolic pressure which is the pressure in the arteries when the heart relaxes and represents the residual ‘background pressure’. These two readings are measured using the units known as millimetres mercury (mmHg). Why, you may ask? Well, traditionally the sphygmomanometer was the device used to measure blood pressure and it contained a tube marked in millimetres and filled with mercury. The higher the blood pressure, the higher the mercury level would rise in the tube scoring a greater height in millimetres.

Blood pressure is easy to measure either traditionally using a sphygmomanometer (blood pressure cuff) and stethoscope or using a modern electronic blood pressure device. It should be measured at rest ideally, and if moderately raised, the test should be repeated on multiple occasions. If consistently high, a diagnosis of high blood pressure could be made. Remember that our blood pressure changes constantly throughout the day depending on physical activity or stress levels. If after multiple tests it is still not clear you may need to wear a special device which monitors you over 24 hours to accurately determine how your body controls blood pressure throughout the day.

Blood pressure levels

Although there is a fair amount of variation from person to person depending on their age, gender and body weight, this chart will give you a reasonable idea of the various categories of blood pressure:

Why the term ‘hypertension’?

Note that the medical word ‘hypotension’ means low blood pressure and the word ‘hypertension’ means high blood pressure. There is often confusion around the word ‘hypertension’ with some interpreting its meaning being very tense/stressed. Of course tension and stress could certainly be the underlying cause of high blood pressure, but they are just some of the factors linked to this condition and are not necessarily always present. The term ‘hypertension’ may also have its root in physics and describe the state of the artery walls. This is because the muscles in artery walls can contract, making the vessel narrower, or relax, making the vessel wider. This is one of the ways in which our body regulates blood pressure and blood flow. Back to the plumbing analogy… when pumping water through pipes, the narrower the pipe, the higher pressure the water in the pipe will exert on the pipe walls. If you suddenly widen the pipe, the pressure will drop considerably. Our arteries are the same.

Types of blood pressure and their causes

Blood pressure is categorised into two groups: primary hypertension is high blood pressure without an obvious cause i.e. most likely due to lifestyle, environmental and genetic causes, and secondary hypertension is when high blood pressure occurs secondary to some other known disease, condition or medication.

Causes of primary hypertension (+-90% of cases):

• Lifestyle e.g. sedentary and not enough exercise
• Obesity
• Diet e.g. high sodium intake, caffeine
• Environmental causes
• Stress
• Smoking
• Age e.g. > 50 years
• Familial causes (it runs in the family).

Causes of secondary hypertension (+-10% of cases):

• Heart conditions
• Diseases of the blood vessels e.g. arteriosclerosis
• Kidney problems
• Hormonal problems e.g. thyroid, or adrenal glands
• Certain medicines e.g. birth control pills.

Symptoms?

Unfortunately, in many cases high blood pressure can present with no symptoms at all, thus making regular monitoring important especially if you are considered high risk. Warning signs and symptoms do occur in some patients and may be suggestive of possible high blood pressure, these typically include:

• Headaches – pulsating typically
• Nose bleeds
• Shortness of breath
• Irregular heartbeat or palpitations
• Chest pains
• Fatigue or confusion.

Consequences of uncontrolled hypertension:

Although a hypertension crisis (more than 180/120 mmHg) poses an immediate risk of serious consequences such as a stroke or heart attack, long term, moderate high blood pressure may also lead to damage of the retinas of the eye affecting vision (known as hypertensive retinopathy) or damage the tiny blood vessels in the kidneys, leading to chronic kidney disease (CKD) – read the article here or listen to the podcast here.

What to do?

If you meet one or more of the causes mentioned above, you should have your blood pressure checked regularly. If you have been diagnosed with hypertension, you need to be treated and monitored by a healthcare professional as if not carefully controlled and monitored especially over time, you can develop serious consequences, and if very high i.e. a high blood pressure crisis, it’s considered a medical emergency.

If you are at risk of high blood pressure based on the known causes thereof, but your blood pressure is still normal or perhaps you fall in the category of ‘prehypertension’ i.e. its borderline high or if you are being treated for hypertension but want to include further supportive treatments, consider the following:

• Exercise moderately (3-4 times weekly for 30-45 minutes).
• If you’re overweight, see a dietitian for a healthy sustainable weight loss programme and low sodium diet – refer to the DASH diet (Dietary Approaches to Stop Hypertension).
• Formally put measures in place to destress e.g., meditation, breathing exercises.
• Quit smoking.
• Drink at least 2 litres of filtered water daily.
• Shift to a more plant-based diet by reducing meat intake to 1-2 times weekly.
• Eat 5-6 servings of fresh fruit and vegetables daily including leafy greens and brightly coloured vegetables.
• Reduce your sodium intake by limiting canned foods and salty snacks.

Try to specifically include these cardiovascular protective foods in your diet on a regular basis:

• Garlic (in food, not as a supplement) 1-2 cloves per day. Eating 10-15 minutes after crushing or chopping results in the most medicinal benefit.
• Cocoa (dark chocolate in moderation).
• Olive oil.
• Onions.
• Celery.
• Soy protein.
• Green tea.
• Pomegranate and blueberries.
• Cold water fish (salmon, sardines, herring, albacore tuna).
• Nuts and beans.

Consider supplementing with the following – (discuss these with your doctor if you are hypertensive and on medication first):

• Co-enzyme Q10 – 60 -120mg daily
• Fish oils (EPA & DHA) – 1 gram daily
• Vitamin D3 – 1000iu daily
• Magnesium – 500 – 750mg daily
• Potassium (eat potassium rich foods bananas, grapefruit, broccoli, pumpkins, squash, dried beans and peas)
• Calcium – 1200mg daily

Additional supportive interventions:

1. A.Vogel Multiforce Alkaline Powder – 1 teaspoon daily in a glass of water at bedtime – a source of calcium, magnesium and potassium.
2. A.Vogel VegOmega-3 – a vegan source of omega-3 essential fatty acids (DHA, ALA and EPA).
3. A.Vogel Crataegus Oxy – A Western Herbal medicine which acts as a cardiac tonic that assists with promoting the function of the heart by providing a broad acting cardiac supportive action.
4. A.Vogel Nephrosolid – A Western Herbal medicine which acts as a tonic to support the function of the kidneys.

  Listen to the podcast here: Hypertension