Contact us: 098-482-2495
Advertising: jonathan@cuencahighlife.com | Editorial: david@cuencahighlife.com

Wonder why you have high blood pressure? The reason may surprise you!

No doubt you know that high blood pressure is creating a global health crisis. But, until relatively recently, infectious diseases were a bigger annual killer.

Today, ‘non-communicable diseases’ have become more deadly, and most are associated with ‘modifiable causes’, including being overweight and obesity.  Processed foods and a boatload of sugar in everything, fried foods and huge portions are overwhelming our ability to fight disease.

These ‘non-communicable diseases’ include cardiovascular disease, cancer, diabetes and chronic lung diseases. Speaking for the World Health Organization, Director-General Dr. Margaret Chan says, “One of the key risk factors for cardiovascular disease is hypertension — or raised blood pressure.  Hypertension already affects one billion people worldwide, leading to heart attacks and strokes.  Researchers have estimated that raised blood pressure currently kills nine million people every year.”

The WHO report notes that hypertension is more prevalent in low-and-middle-income countries, and often remains undiagnosed and untreated. But hypertension rates continue to grow unabated in North America, Australia, and other ‘rich’ countries of Europe. It is especially worrisome in formerly ‘poor nations’ China, India, and South Asia. Middle Eastern countries Qatar, the UAE, and Egypt suffer from exploding rates of obesity, diabetes, hypertension and heart disease. The irony does not go unnoted when it comes to our increase in technology, seen around the world. With a decrease in hunger comes a increase in inactivity, a contributing cause for obesity, cardiovascular disease, and hypertension.

The U.S. Centers for Disease Control reports:

  • Having high blood pressure puts you at risk for heart disease and stroke, the leading causes of death in the United States.
  • One in three adults, about 75 million American adults (32%), have high blood pressure.
  • About 1 in 3 American adults has pre-hypertension — blood pressure numbers that are higher than normal — but not yet in the high blood pressure range.
  • Only about half (54%)of people with high blood pressure have their condition under control.
  • High blood pressure was a primary or contributing cause of death for more than 410,000 Americans in 2014 — more than 1,100 deaths each day.
  • High blood pressure costs the U.S. $48.6 billion each year. This total includes the cost of health care services, medications to treat high blood pressure, and missed days of work.

 

What happens if your blood pressure is out of control?

Heart: Uncontrolled hypertension damages and narrows arteries, potentially leading to a stroke. Coronary artery disease, enlarged left heart, and heart failure. Stroke, transient ischemic attack (TIA), and cognitive impairment leading to dementia.

Kidney scarring leads to inability to filter waste properly and kidney failure, leading to dialysis and/or transplant; scarring can lead to an aneurysm (a bulge in the wall of a blood vessel) which can rupture and cause internal bleeding.

Eyes: Hypertension damages the eye’s blood vessels (retinopathy), leads to fluid build-up, and nerve damage.

Sexual dysfunction is linked to hypertension: decreased blood flow means difficulty achieving and maintaining an erection; vaginal dryness means sexual displeasure in women.

Major Causes:

Primary hypertension is linked to genetics, poor diet, inactivity, smoking tobacco, and obesity. Other reasons include family history and age. Diet details? Too much salt and alcohol, and too little potassium in your diet (found mostly in fresh fruits and vegetables.) Some medications and long-term stress contributes to hypertension. Some may not take their medications properly, or they may be taking other medications and supplements that render their medications less effective. Some may not be taking their medications at all.

Secondary hypertension can result from other medical conditions that affect your kidneys, arteries, heart or endocrine system, and can also occur during pregnancy.

Maybe there are other reasons for high blood pressure that have not been addressed?

If you’ve been trying to control your blood pressure but you’ve been unsuccessful, consider these suspects:

  • Sleep apnea: also associated with obesity: studies show that sleep apnea may be the culprit that prevents improvement even when treated with three or four medications. Obesity is strongly correlated with sleep apnea. Better sleep is associated with weight loss and regular activity.  Learn more here.
  • Low vitamin D levels: although research isn’t conclusive, preliminary studies show an association between vitamin D deficiency and high blood pressure. But a large study showed that supplementing with vitamin D compared to placebo did not have a significant effect on high blood pressure — it is not recommended to take vitamin D in place of your treatment medications if you have high blood pressure.

 

Recommended dosage by Dr. Andrew Weil: Adults under 50 200 IU daily; over 50-70 400 IU, and over 70 600 IU daily: take D3 (cholecalciferol) instead of D2 (ergocalciferol). Sunlight causes our body to manufacture vitamin D in our skin, about 10 minutes sunlight exposure, two to three times weekly.  Dietary sources include fortified foods, eggs, salmon, tuna, mackerel and sardines. Read more here.

  • Thyroid issues. Hypertension may be a missed complication of hyper or hypo (high or low) thyroid. Testing is recommended. Read more here.
  • ‘White Coat Syndrome’: One thing that can definitely raise your blood pressure is YOU! Are you one of the 20% or more of patients who have “white coat syndrome” where your blood pressure surges when measured in a clinical setting like the doctor’s office? Read more here.

 

Throughout Latin America, despite an “upward trend” in general medical care and health, the rate of hypertension is noted along with growing rates of heart disease and diabetes.

In our adopted home of Cuenca, many expats have arrived bearing the burden of chronic hypertension. A CDC study found that about 70% of adults in the U.S. who are at least 65 years old suffer from high blood pressure but almost half of these do not have their condition under control. And of course, in the U.S., more than 70% of adults are overweight or obese.

But many are taking control! And that is a great thing, and it should be noted that with weight loss and activity you can lower your blood pressure naturally.

Eat right…on your way to a healthy weight. Enjoy a variety of vegetables and fruits, without added sodium. A deficiency of potassium is linked to hypertension — and Ecuador is just so rich in potassium-rich fresh greens and all kinds of produce, fruits, delicious fish, whole grains, nuts and seeds.  These foods are the keys to a healthy life,. Learn more here.

If you’d like some helpful guidance, the DASH eating plan (Dietary Approaches to Stop Hypertension) is a proven plan that can lower blood pressure, reduce cholesterol, and improve insulin sensitivity. It’s a guide to healthy eating, not a “diet” (although many experts will refer to it as the “DASH Diet”).   No matter, learn more about the plan here, and enjoy some delicious recipes here.

Besides weight, if you currently smoke, quit. Go easy on alcohol.  Breathe … reduce stress with yoga and regular activity that you enjoy, even if it’s just walking.  You can control some ‘modifiable risk factors’ and reduce your risk for hypertension naturally.

By the way, two numbers represent blood pressure. The higher (systolic) number shows the pressure while the heart is beating. The lower (diastolic) numbers shows the pressure when the heart is resting between beats.

According to Blood Pressure UK, ideally, we should all have a blood pressure below 120 over 80 (120/80). At this level, we have a much lower risk of heart disease or stroke. Read my previous column about what is considered “normal” blood pressure here.

Sources:

American Heart Association.  Sleep Apnea and Heart Disease, Stroke. http://www.heart.org/HEARTORG/Conditions/More/MyHeartandStrokeNews/Sleep-Apnea-and-Heart-Disease-Stroke_UCM_441857_Article.jsp#.WKIPnRIrJyo

Andrew Weil, MD. Vitamin D. https://www.drweil.com/vitamins-supplements-herbs/vitamins/vitamin-d/

Centers for Disease Control and Prevention. Division for Heart Disease and Stroke Prevention. High Blood Pressure Fact Sheet. https://www.cdc.gov/dhdsp/data_statistics/fact_sheets/fs_bloodpressure.htm

CDC.gov. Blood Pressure Control. Helping patients take their medicine. https://www.cdc.gov/vitalsigns/blood-pressure/

Circulation. The epidemiology of blood pressure and its worldwide management. http://circres.ahajournals.org/content/116/6/925

Cleveland Heart Lab. 4 Surprising Causes of High Blood Pressure. http://www.clevelandheartlab.com/blog/horizons-4-surprising-causes-of-high-blood-pressure/

Cuenca Highlife. What’s Normal? Blood pressure, blood glucose, body temperature. https://www.cuencahighlife.com/whats-normal-blood-pressure-blood-glucose-body-temperature/

Defeat Diabetes Foundation. Rising Hypertension, Cardiovascular Disease, in Latin America.  http://www.defeatdiabetes.org/rising-hypertension-cardiovascular-disease-latin-america/

Gazette Review. Top 10 fattest countries in the world — 2017 list. http://gazettereview.com/2016/06/top-10-fattest-countries-in-world/

Journal Hypertension.  Obesity the most influencing and modifiable risk factors in Latin America. https://www.ncbi.nlm.nih.gov/pubmed/27753811

Mayo Clinic. High blood pressure dangers: Hypertension’s effects on your body. http://www.mayoclinic.org/diseases-conditions/high-blood-pressure/in-depth/high-blood-pressure/art-20045868

University Health News. Unexpected symptoms of thyroid issues include high blood pressure. http://universityhealthnews.com/daily/heart-health/unexpected-symptoms-of-thyroid-issues-include-high-blood-pressure/

U.S. Department of Health & Human Services. Your Guide to lowering Blood Pressure. https://www.nhlbi.nih.gov/files/docs/public/heart/hbp_low.pdf

World Health Organization. A global brief on HYPERTENSION. Silent killer, global public health crisis. http://apps.who.int/iris/bitstream/10665/79059/1/WHO_DCO_WHD_2013.2_eng.pdf?ua=1

World’s Healthiest Foods. Potassium. http://www.whfoods.com/genpage.php?dbid=90&tname=nutrient

_________________

About the Author

Susan Burke March

Susan Burke March, a Cuenca expat, is a Registered and Licensed Dietitian, a Certified Diabetes Educator who specializes in smart solutions for weight loss and diabetes-related weight management. She is the author of Making Weight Control Second Nature: Living Thin Naturally — a fun and informative book intended to liberate serial dieters and make healthy living and weight control both possible and instinctual over the long term. Contact her at SusantheDietitian@gmail.com

  • Hi Ja,
    Certainly diet and exercise are part of the natural prescription recommended by all health experts to stay healthy! As far as “highly mineralized ancient salt”, I’m unfamiliar with this, but excess sodium contributes to high blood pressure, and reducing it by eliminating processed foods (typically higher in sodium) and including lots of potassium – rich vegetables and fruits will certainly help control high blood pressure. Thanks for writing. Susan

  • Thanks, Ken. Great question! I do not know where to purchase a monitor or the price but I imagine a farmacia or medical supply house in town have monitors for sale. Let’s see if any readers weigh in on this. Susan

    • StillWatching

      They’re ubiquitous. Virtually any pharmacy will carry them, but the least expensive source I have found is Coral. You can purchase a simple to use, digital cuff that has a memory of your last 10 readings, for about $20. These units are quite accurate and all you have to do to use them is press a single button and remain still while the reading is rendered in ~60 seconds or less. Follow the simple instructions that come with the device and be consistent in the way you use it as well as the time(s) of day you take readings.

      Keep in mind that they are no different than a scale that measures your body weight in that the most important element isn’t the absolute accuracy of the device, but the relative changes it may indicate as time goes on. e.g., if your bathroom scale says you weigh 150 pounds and you really weigh 140 pounds, that isn’t nearly as useful information as would be, a change in weight on THAT SCALE that says your weight has gone from 150 to 160. Same principle with the blood pressure cuff.

  • Know better

    The thumbnail description for this article is extremely misleading. High blood pressure is not even in the top ten causes of death, according to the CDC’s own website: http://www.who.int/mediacentre/factsheets/fs310/en/
    Infectious diseases cause less than 5% of deaths. It’s not a serious cause of death any more and can only be mentioned as a cheap, but pretty much non-existent, threat.
    Tell me why a *dietician* is an expert on medical issues–NOT.

    • Hypertension and cardiovascular disease have a causal relationship. Read more from the World Heart Federation. As a Registered Dietitian and Certified Diabetes Educator, my expertise is in epidemiological research and prevention. I’m curious about your criticism, and not certain about your goals in parsing my language about risk for serious consequences when high blood pressure is untreated. If you would share your credentials?

      http://www.world-heart-federation.org/cardiovascular-health/cardiovascular-disease-risk-factors/hypertension/

      There are at least 970 million people worldwide who have elevated blood pressure (hypertension).

      In the developed world, about 330 million people have hypertension, as do around 640 million in the developing world. The World Health Organization rates hypertension as one of the most important causes of premature death worldwide and the problem is growing.81 In 2025 it is estimated there will be 1.56 billion adults living with high blood pressure.

      What counts as hypertension?
      High blood pressure is defined as a systolic blood pressure at or above 140 mmHg and/or a diastolic blood pressure at or above 90 mmHg. Systolic blood pressure is the maximum pressure in the arteries when the heart contracts. Diastolic blood pressure is the minimum pressure in the arteries between the heart’s contractions.

      How hypertension impacts on your heart and blood vessels
      Hypertension is a risk factor for coronary heart disease and the single most important risk factor for stroke. It causes about 50% of ischaemic strokes and increases the risk of hemorrhagic stroke.

      Hypertension stresses your body’s blood vessels, causing them to clog or weaken. Hypertension can lead to atherosclerosis and narrowing of the blood vessels making them more likely to block from blood clots or bits of fatty material breaking off from the lining of the blood vessel wall. Damage to the arteries can also create weak places that rupture easily or thin spots that balloon out the artery wall resulting in an aneuvrism.

      Elevated blood pressure in people less than 50 years old is associated with an increased cardiovascular risk. As you get older, your systolic blood pressure becomes a more important predictor of the risk of cardiovascular disease.

      Although increasing blood pressure is part of aging, a healthy low salt diet, physical activity and maintaining a healthy weight can reduce the risk of this happening.

      Dietary salt is a significant factor in raising blood pressure in people with hypertension and in some people with normal blood pressure. If you are already overweight then a high intake of salt increases your risk of cardiovascular disease.

      Types of hypertension
      The amount of blood pumped by the heart and the size and condition of the arteries determines your blood pressure. However, many other factors can affect blood pressure including the condition of your kidneys and levels of various hormones in the body.

      Some people experience essential hypertension, which has no identifiable cause. If you are diagnosed with this its origins may be genetic, or due to your lifestyle including diet, weight and physical inactivity. Secondary hypertension is caused by another condition such as problems with your kidneys, certain medicines and some other medical problems.

    • Ken

      “Know Better” – Tell us who you are and more about your medical credentials.

      • StillWatching

        Personally, I care far more about the accuracy of the information “Know Better” presents than his medical credentials. The instant issue isn’t one that requires great training to opine on, but it does require command of the pertinent facts, combined with logic and common sense. In that regard, Know Better’s comments are sorely lacking.

        As Susan has aptly pointed out, there is a causal relationship between hypertension (high blood pressure, in laymans terms) and Ischaemic heart disease and stroke and those two conditions rank number one and two on the list of the top 10 causes of death world wide that “Know Better” has provided in his link to the WHO site.

        Of course any trained medical professional would know this, so it is obvious that with or without formal credentials, Know Better is ignorant of the pertinent facts or lacks the common sense and intelligence to apply them correctly.

  • Hi there, Ms. Moon,
    A previous comment is invaluable regarding measuring your BP: I’ll post it again, since it is well said:
    regarding blood pressure monitors: “They’re ubiquitous. Virtually any pharmacy will carry them, but the least expensive source I have found is Coral. You can purchase a simple to use, digital cuff that has a memory of your last 10 readings, for about $20. These units are quite accurate and all you have to do to use them is press a single button and remain still while the reading is rendered in ~60 seconds or less. Follow the simple instructions that come with the device and be consistent in the way you use it as well as the time(s) of day you take readings.

    Keep in mind that they are no different than a scale that measures your body weight in that the most important element isn’t the absolute accuracy of the device, but the relative changes it may indicate as time goes on. e.g., if your bathroom scale says you weigh 150 pounds and you really weigh 140 pounds, that isn’t nearly as useful information as would be, a change in weight on THAT SCALE that says your weight has gone from 150 to 160. Same principle with the blood pressure cuff.”