Archive for hypertension
CRH Stimulation Test in White Coat Hypertension
Recall that the adrenal axis is the route by which the body responds to stress. Epinephrine can raise blood pressure. Here we see that white coat hypertension may be due to hypersensitivity of this system. Overreaction can be modified in several ways, including exercise, adaptogenic herbs such as ginseng and B vitamin support (primarily B5). Unfortunately, this approach is usually outside of the “box” for many doctors encountering white coat hypertension.
JCEM — Abstracts: Tabeta et al. 87 (8): 3672
Ambulatory blood pressure and brain atrophy in the healthy elderly
I have many elderly patients coming into my office on antihypertensive drugs. It is not unusual to find many with “controlled” BP over 150 systolic. Their doctors seem okay with this number and yet it has always worried me. Now my worries appear to have been vindicated. In this study we see shrinking of the brain in patients with even high-normal blood pressures. Searching my website will demonstrate many natural methods of lowering blood pressure safely. None of these methods provide substantial results (with the exception of water-only fasting, the results of which are just short of incredible); however, when combined can have a additive effect. Principle among the approaches is control of hyperinsulinemia. Elevated insulin appears to reduce the elasticity of the vessel walls leading the hypertension.
Neurology — Abstracts: Goldstein et al. 59 (5): 713
NSAIDs and Persistent Pulmonary Hypertension of the Newborn
This article points out yet another side effect of NSAIDs; potentially damaging effects on the fetus. It never ceases to amaze me that so many patients consider chiropractic dangerous and yet can not put NSAID use into perspective. This effect on the fetus is new to me, but does not surprise me. Add it to the list of kidney, liver, articular and GI damage.
Pediatrics — Abstracts: Alano et al. 107 (3): 519
Bone mineral density in women with essential hypertension
This is an interesting insight on the authors’ part. Article looks at the relationship of calcium balance in the body (as measured by bone density) to high blood pressure and found that women with high blood pressure had lower bone density. Knowing that increasing evidence supports the role of hyperinsulinemia in “essentil” hypertension, it may be that the mechanism that is responsible for decreased bone density is also the altered insulin sensitivity.
Fermented milk high in bioactive peptides has BP lowering effect in hypertension
This article evaluated milk fermented with Lactobacillus and found that it lowered blood pressure in 21 weeks. Now, I’m not convinced that it was bioactive compounds in the milk that produced the results–supplementation of probiotics can lead to many positive health effects that could very well lead to mild lowering of BP.
AJCN — Abstracts: Seppo et al. 77 (2): 326 -
Frequency of Analgesic Use & Risk of Hypertension in Younger Women
There are two things that strike me about this study. First, of the 80,000 or so women in this study, use of aspirin 1 day/month was 51%, NSAIDs was 77% and acetaminophen was 72%. My gosh!! Are we that addicted to OTC pain relief? No wonder this class of drugs (NSAIDs) are responsible for 16,000+ deaths per year. We are taking them like candy, never considering the litany of adverse reactions and long term damage these things can cause. Secondly, in this study NSAID users (22 days/month) had 1.86 times the risk and acetaminophen had twice the risk of high blood pressure. While this use (as 22 days/month) seems incredibly excessive to me, it is a well known fact that these drugs damage the kidneys and this may be one of the mechanisms by which hypertension in affected.
Age-specific relevance of usual blood pressure to vascular mortality
An article like this can be a major eye-opener for many clinicians. I see many patients with “treated” hypertension in the area of 150 systolic. This has always bothered me, but pharmaceutical intervention does have its limits.
This study finds that BP above 115 have a positive correlation with CVD and all cause mortality. This would suggest that much more effective approaches to HTN are needed and I would think this opens up the realm for alternative approaches, top of which is water only fasting (search previous updates), followed by exercise, dietary modification, magnesium, etc…
Just when you think we understand everything there is to know about human physiology, we get a subtle reminder that we are not even close.
First, a quick lesson on blood vessel health. There is a compound called nitric oxide that helps our blood vessels to relax and open up. This is generally a good thing. Nitric oxide has an arch enemy called ADMA that keeps it from being able to relax your blood vessels. Being prediabetic ups your levels of ADMA and is one of the principle reasons why the vast majority of blood pressure problems are actually prediabetes in disguise.
So where does the nitric oxide come from in the first place? Here’s where the story gets a little circular.
Nitrates that are naturally present in foods (vegetables, in general, are very high in nitrates) are converted by bacteria in our mouth to nitrite. (We have seen studies where antiseptic mouthwash actually stops this process and studies that suggest that stomach acid and nitrite protect the stomach lining)
The nitrite is then acted on by stomach acid to produce nitric oxide, which is a molecule well known to help lower blood pressure.
Based on all this, what do you think might happen to blood pressure if you used an antiseptic mouthwash? That is exactly what researchers set out to determine in this particular study.
In this small study, 19 participants were given a chlorhexidine-based antiseptic mouthwash for 7 days. Here’s what they found:
- The production of oral nitrite production dropped by 90%.
- Nitrite levels in the blood dropped by 25%.
- Systolic and diastolic blood pressure increased by 2–3 .5 mm Hg, increases correlated to a decrease in circulating nitrite concentrations (r2 = 0.56, p = 0.002).
- The blood pressure effect appeared within 1 day of disruption of the oral microflora and was sustained during the 7-day mouthwash.
While this small amount of increased blood pressure is not likely to send anyone off into stroke range, it is still important when added to other health-destroying habits.
Overall, this demonstrates just how important it is to have the right blend of bacteria in our bodies and to do everything possible to avoiding destroying our normal bacterial flora that is so common in our sterilized lifestyle.
Insulin Causes Endothelial Dysfunction in Humans
Mark this one down…this is another article in the developing saga of the relationship between hyperinsulinemia and hypertension. Many doctors focus on salt reduction in hypertensive patients, and yet education about whole grains vs refined carbs may be time better spent…
Circulation — Abstracts: Arcaro et al. 105 (5): 576
Childhood obesity statistics remain a concern even at the Presidential level. We know the answers, but we have to be willing to make the needed changes to our lives.
I have made it very clear where I stand on the childhood obesity epidemic. The vast majority of the fault lies not with the schools, not with the TV advertisers and not even with McDonald’s. Rather, it lies squarely in the laps of the parents. Let me relay a very sad story to illustrate the point.
My son, Keegan, is a 7 year old first grader. A few weeks ago, before I packed his lunch for the next day, we had an updated discussion about what I was putting into his lunch. We do this from time to time to make sure he’s eating enough and that he likes what I’m giving him. I asked him if he would eat some purple cauliflower if I put a few small pieces in his lunch. He noted concern that the other kids would make fun of him because he would be the only kid at the table eating cauliflower. With some negotiations he agreed to eat the cauliflower I put in his lunch (I pointed out that none of the other kids would have a square of dark chocolate in his or her lunch either, so he conceded my win).
A few days later I asked him if he ate the cauliflower. He said that he did, but he held it under the table so the other kids wouldn’t see him eating it. My heart broke. The idea that he should be ashamed to eat cauliflower in front of his friends both hurt me and angered me. What does this say about our collective child health rearing skills that a solitary child eating cauliflower should feel the need to eat this food out of sight? Shouldn’t the kids eating Doritos for lunch be the ones hiding in the corner in shame because, at some level, that child’s parents are completely oblivious about how much these foods destroy the future health of that child?
Do you think I’m being overly dramatic? If so, it’s because you haven’t yet read this particular article.
There has always been concern with rapid weight gain in a child leading to the rise in childhood obesity statistics. This concern extends to the weight gain in the womb due to gestational diabetes, as an infant when the child is on formula instead of breastmilk, as a toddler as they explore new foods or beyond. In this study, researchers looked broke weight gain into age categories to determine at what ages the rapid growth was the most associated with future health challenges (in this case, high blood pressure).
The age groups were broken down as follows: 3 to 9 months, 9 to 36 months, 3 to 7 years, and 7 to 11 years. The children’s blood pressure at age 11 was then determined. Here’s what they found:
- Faster childhood linear growth between 7 and 11 years of age (getting taller) in girls led to a 27% higher risk of higher blood pressures.
- In boys, this risk was over double the risk – 211%.
- At age 11, both boys and girls with the highest BMI had 272% higher risk of having higher blood pressure (Tweet this).
Based on this study, the time bomb of health is ticking at my son’s school. The fact that Keegan’s friends would make fun of him for eating cauliflower (I have heard him say the same of hummus) speaks volumes as to the foods these kids are exposed to at home.
In your child’s lunchroom, would your child be in Keegan’s shoes, or would your child sneer at the idea of eating foods like cauliflower or hummus?