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How to lower blood pressure?

According the National Health and Medical Research Counsel “More than six out of ten people who are taking anti-hypertensives have blood pressure readings above the normal range. And more than half of those who are not currently taking anti-hypertensives could reduce their absolute risk of cardiovascular disease by doing so.”

What is High Blood Pressure or Hypertension?

High blood pressure is often treated as a disease, however it is actually your body’s response to blood vessels affected by metabolic stresses, inflammation, and insulin resistance. Persistent high blood pressure is a consequence of structural changes and stiffening of the blood vessels from prolonged vascular inflammation.

Checking blood pressure

Over time vascular changes can thicken and narrow blood vessels and this prevents them from being able to dilate and contract correctly. Blood pressure is the pressure that blood exerts on the walls of the arteries as it is pumped by the heart around the body. Normal blood pressure is usually written systolic over diastolic pressure for example, 120/80 mmHg.

High blood pressure is the diagnosis of pressure greater than, or equal to, systolic 140 mmHg and/or the diastolic pressure is greater than, or equal to, 90 mmHg for adults to 65 years. Other treatments targets are used for other age groups, and with the presence of other diseases and conditions.

Symptoms of High Blood Pressure

Often there are no obvious signs or symptoms of high blood pressure, even when blood pressure is very high. Signs to look out for that may indicate your blood pressure is high are: increased perspiration, headaches, dizziness, nosebleeds, tinnitus, confusion, tiredness, anxiety, and florid skin complexion.

Working out what you can do to lower blood pressure can be confusing. This next section will outline some of the different treatment strategies you can use to lower your blood pressure.

Hypertension symptoms

Strategies have been grouped into the following categories: diet, lifestyle, nutrition therapy, and medications. Diet and lifestyle work by addressing the drivers or causes of high blood pressure. Nutrition therapies and medication help to control or lower blood pressure but do not work directly on the underlying causes.

Why is high blood pressure bad?

  • High blood pressure increases your risks for serious disease.
  • Ischaemic heart disease is related to high blood pressure. It is estimated that 66% of strokes and 50% of heart attacks are related to high blood pressure.
  • Impaired renal health: Over time hypertension can narrow and thicken the blood vessels of the kidneys causing reduced filtration and a build-up of metabolic wastes in the blood.
  • Kidney failure may also occur. Impaired vision: uncontrolled high blood pressure can cause blood vessels in the eyes to burst or bleed causing blurred or impaired vision and/or blindness.

Dietry components to help you lower blood pressure

  • The DASH diet (Dietary Approach to Stop Hypertension) has shown help lower blood pressure. The DASH diet is rich in vegetables, fruits, low fat dairy products with reduced amounts of meats, saturated fats and sodium. The benefits of the DASH diet are related to the increase in total nutrition, particularly the antioxidant, vitamins and minerals

DASH Diet

Other dietary components that can help to lower blood pressure:

Assorted nuts

  • Tree nuts: Have been shown to improvebloodpressure control particularly when nuts are consumed regularly for extended time. The benefits of nuts can be attributed to effects of reducing inflammation, antioxidant activity,and improving the elasticity and reducing stiffness of the blood vessel walls, and improvements of glucose use.
  • Fibre: higher intakes of total fibre and insoluble fibre are associated with lower blood pressure. The blood pressure lowering effects of fibre have been attributed to a variety of factors, including improved vasodilation (increased nitric oxide release), and improvement in blood vessel elasticity; inhibiting sodium absorption, and improved insulinsensitivity and blood sugar control.

Foods with fibre

Vegetables with nitrates

  • Dietary nitrate from vegetables, an increase of just two serving per day of vegetables high in nitrates vegetables such as green leafy vegetable or beetroot can reduce systolic blood pressure.
  • Some vitamins and minerals can have positive actions on blood pressure regulation that are not understood based on their conventionally recognized ‘vitamin function’. Of importance to lowering blood pressure are vitamin D metabolites, calcium, magnesium, vitamin B6, vitamin C and vitamin E, and beta-carotene. The DASH diet is very high in these vitamins and minerals.

Vitamins and minerals

  • Improving the ratio of n6:n3 fatty acids in the diet has been shown to lower blood pressure by reducing the release of inflammatory molecules.

Fish oil

Salt

  • Salt intakes (in salt sensitive people) can increase blood pressure. High sodium from salt seems to reduce the amount of the molecules (nitric oxide) released in the blood vessels walls which are essential for blood vessels elasticity. Reductions in elasticity increases pressure on the blood vessels walls.

Abdominal obesity

  • Obesity increases the risk of hypertension as angiotensinogen (the precursor to Angiotensin II) is over expressed, especially in internal fat. Obesity may also contribute to hypertension via other mechanisms, related to proinflammatory molecules (IKK-B and NF-KB) secreted from fat cells. This inflammatory effect contributes to disturbances in the blood vessel wall and hypertension. As this is such a critical factor for hypertension, achieving a healthy weight is essential to reducing or resolving hypertension

Smoking cessation

  • Is essential to managing hypertension, and for overall cardiovascular health. Smoking is associated with increasing viscosity of blood making it stickier which can increase blood pressure.

Stress

  • Stressful lifestyles or events that cause you to be anxious, depressed, angry and hostile can increase blood pressure as it causes your sympathetic nervous system to release an array of hormones and chemical messengers. These chemicals can cause constriction of blood vessels and increase platelet stickiness resulting in increased blood pressure.

Medications

There are a number of medications for hypertension. Following is a list of common medications that are used and their associated side effects.

  • Thiazide diuretics: used to reduce blood pressure via reducing blood volume; side effects include decreased level of potassium and increased cholesterol and glucose levels; may not be suited to people with gout and diabetes.
  • Loop diuretics: used to reduce blood volume and thus reduce blood pressure; may deplete potassium
  • Potassium-sparing diuretics: prescribed to reduce blood volume and thus reduce blood pressure; side effects include hyperkalaemia.
  • Beta-blockers: these beta-adrenergic antagonists stop the vaso-constrictive and hypertensive effects of catecholamine in the body: side effects include congestive heart failure, bronchospasm, masking of hypoglycaemia induced by insulin, depression, insomnia, fatigue. Relative and absolute contraindications in heart failure, airway disease, heart block, diabetes, and peripheral vascular disease
  • Angiotensin-converting enzyme (ACE) inhibitors: these drugs inhibit ACE – the rate-limiting enzyme involved in Angiotensin II production. Side effects include cough, rash, loss of taste; use with caution in patients with renovascular disease
  • Calcium-channel blockers: by inhibiting calcium channels, these drugs reduce vasoconstriction. Side effects include constipation, nausea, headache, conduction defects: use with caution in heart failure or block.
  • Angiotensin II Receptor Blockers (ARBs): these drugs act as Angiotensin II antagonists, reducing the receptor-site binding of this potent vasoconstrictor. Side effects include upper respiratory infection, dizziness, diarrhoea, back pain, cough, dizziness, drowsiness, ataxia, anaemia, fatigue. Knowing what to do about your blood pressure can be confusing, and can present some lifestyle challenges. If you would like a personalised dietary and lifestyle plan or more information about lowering your blood pressure, please don’t hesitate to call. We are here to help

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