Hypertension

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Before You Begin Information presented here is for general educational purposes only. Each one of us is biochemically and metabolically different. If you have a specific health concern and wish my personalized nutritional recommendation, write to me by clicking here.

Contents
Classification of Hypertension
When Should Drugs Be Used To Treat Hypertension?
Side Effects of Anti-Hypertensive Drugs
High Blood Pressure Protocol
1. Nutritional Supplementation
    A. Coenzyme Q10 (CoQ10), L-Carnitine, and Lipoic Acid
    B. Magnesium
    C. Garlic
    D. Hawthorn (Crataegus monogyma)
    E. Vitamin C
    F. Calcium
2. Modified Mediterranean Diet
    Anti-aging Food Pyramid
    Diet Tips for Reducing Blood Pressure
3. Exercise
4. Hydration
Diet Tips for Reducing Blood Pressure
Summary

Elevated blood pressure is a major risk factor for heart attack or stroke. It is also know as the "the silent killer" because people with elevated blood pressure do not "feel" like they have a health problem. This "silence" camouflages the danger of hypertension and the need to do anything about it.

Over sixty million Americans have high blood pressure (also known as hypertension), including more than half of white Americans from 65 to 74 years of age, and 71% of African-Americans in the same age group.

What are  the  alternative anti-aging options for normalizing borderline to moderate hypertension.


Classification of Hypertension

The ideal anti-aging blood pressure for an adult is 120 (systolic) / 80 (diastolic).

Hypertension is divided into the following levels:

1. Borderline: 120-160 / 90-94
   
2. Mild: 140-160 / 95-104
   
3. Moderate: 140-180 / 105-114
   
4. Severe: 160 + / 115 + 
   

High Blood Pressure Protocol
 

The following 4 step protocol should be followed concurrently for at least 60 days. In most cases, you will see lowering of blood pressure. Do not stop your medications if you are current them and and always consult your doctor prior to starting any naturally oriented program.

Attention Because of tremendous individual variation, the use of nutritionals should therefore be personalized for your body. One person’s nutrient can be another person’s toxin. If you have a specific health concern and wish my personalized nutritional recommendation, write to me by clicking here.

1. Nutritional Supplementation

A. Coenzyme Q10 (CoQ10), L-Carnitine, and Lipoic Acid

CoQ10, also known as ubiquinone, is a coenzyme essential for the proper functioning of the mitochondria. It acts as a "spark plug" during the production of ATP, the energy currency of all body processes. CoQ10 deficiency has been found in 39% of patients with high blood pressure. This finding suggests there is a need for CoQ10 supplementation. Meanwhile, various medications, such as a class of statin drugs commonly used to lower cholesterol, inhibit the production of CoQ10.

When 10 patients with high blood pressure were given 100 mg of CoQ10 daily for 10 weeks, systolic pressure dropped from 161 to 142 mm Hg and diastolic pressure dropped from 98 to 83 mm Hg. In other words, expect a 10% drop in systolic and diastolic blood pressure with CoQ10 supplementation. Cholesterol levels also dropped from 227 mg/dL to 204 mg/dL.

The exact mechanism of action for lowering blood pressure remains unknown. It may be due to CoQ10's ability to lower levels of the dangerous oxidized form of cholesterol and to stabilize the vascular system via its antioxidant properties.

It is well documented that CoQ10 increases the efficiency of the energy production mechanism within the mitochondria. Mitochondria are the energy factories of the cell. The energy currency they produce is ATP. An increased efficiency in energy production results in a stronger heart muscle. In countries like Japan, CoQ10 is used extensively as an alternative and natural treatment for angina and congestive heart failure.

The body's production of CoQ10 begins to decline after age 20 to just 50% by age 70. Numerous long-term studies have been conducted to ascertain the efficacy of CoQ10 supplementation. These studies indicate that in those patients with myocardial dysfunctions such as ischemic cardio-myopathy or congestive heart failure, CoQ10 supplementation results in statistically significant improvements in condition. In an 8-year study of 424 patients with cardiac dysfunction, 58% improved by one functional class, 28% by two classes, and 1.2% by three classes. Further, overall medication requirements dropped, with 43% of the patients discontinuing between one and three drugs. Only 6% were required to add one drug.

CoQ10 also plays a vital role as an antioxidant in cellular membranes and plasma lipoproteins. It is present in all plasma membranes and in LDL-cholesterols. Studies illustrate CoQ10's protective action against the oxidative modification that makes LDL-cholesterol atherogenic. In its reduced form, ubiquinol, CoQ10 also functions as a chain-breaking antioxidant and is believed to regenerate vitamin E. In a study on 40 patients undergoing elective coronary artery bypass surgery, pretreatment with CoQ10 at 150 mg/day for seven days served as protection against oxidative compounds.

You can get CoQ10 from your diet, although the amount is minute. For example, one pound of sardines or 2.5 pounds of peanuts provides just 30 mg of CoQ10.

Working synergistically with CoQ10 as anti-aging cardio-protective and vaso-protective agents are two endogenous antioxidants that also enhance mitochondrial function and reduce free radical damage - L-carnitine and lipoic acid.

The ability of the cell to utilize fatty acids as a source of fuel is essential for optimizing the production of ATP by mitochondria in cardiac cells to keep the heart properly functioning. L-carnitine assists in this transportation process by bringing fatty acids from the extracellular space into the mitochondria. In one double blind trial, 500 mg per day of a modified form of carnitine called propionyl-L-carnitine led to a 26% increase in exercise capacity after six months.

Lipoic acid is both a water- and fat-soluble antioxidant. It neutralizes free radicals in both the fatty and watery regions of cells, in contrast to Vitamin C, which is only water-soluble, and Vitamin E, which is only fat-soluble. Lipoic acid is therefore called the "universal antioxidant". As such, it has the ability to recycle both Vitamin C and E in our body. It also helps break down sugars so that energy can be produced from them through cellular respiration. In addition to serving as a thermometer of the body's antioxidant network, lipoic acid is the only antioxidant that can boost the level of intracellular glutathione, a cellular antioxidant of tremendous importance. Glutathione is a water-soluble antioxidant essential for the optimum functioning of the immune system.

A 12-week course of intake is needed before a decline in blood pressure is seen.

Daily Nutritional Supplement consideration:
Coenzyme Q10: 60 - 120 mg
L-Lipoic Acid: 70 - 300 mg
L-Carnitine: 300 - 1200 mg


B. Magnesium 

Only 25% of Americans meet the Recommended Dietary Allowance (RDA) of 300 - 400 mg per day for magnesium. Most American women get between 175 and 225 mg per day, and men, between 220 and 260 mg. For the diet alone to supply enough magnesium, you would need to eat about 2000 calories a day. Nuts, whole grains, and legumes are excellent dietary sources of magnesium.

Magnesium is a critical mineral and cofactor in over 300 enzymatic reactions in our body, including the production of energy. Many nutritional expert feels that the optimum intake of magnesium should be from 6 - 10 mg / 2.2 pounds of body weight (about 700 mg a day for the average American). Magnesium is easily absorbed and interacts synergistically with potassium in many body systems. In one double-blind study, 21 male patients with high blood pressure were given 600 mg of magnesium (as magnesium oxide) or a placebo. Mean blood pressure decreased 10%. Magnesium supplementation appears to work best in conjunction with a high potassium diet. Population studies indicate that those who drink "hard water" high in minerals like magnesium have lower incidences of hypertension. However, high doses of magnesium may cause diarrhea. 

Daily Nutritional Supplement Consideration:
Magnesium Oxide: 200 - 400 mg 3 times a day.


C. Garlic

Garlic has been used for thousands of years for its immune enhancing properties. Modern use of garlic also focuses on its ability to lower cholesterol and blood pressure. Fresh garlic contains 0.1 to 0.36% of a volatile oil composed of the sulfur-containing compounds: alliin, allicin and others. Allicin is the primary compound responsible for the pungent odor of garlic, as well as its pharmacology. Allicin is inactivated by heat, which explains why cooked garlic produces neither as strong an odor as the raw, nor nearly as powerful physiological effects.

Numerous double-blind placebo-controlled studies have been done with standardized commercial preparations that provided a daily dose of at least 10 mg alliin, or a total allicin potential of 4,000 mcg. This is equivalent to 4,000 mg of fresh garlic - roughly one to four cloves. This is the dosage recommended by the German Commission E which establishes dosage requirements to allow for therapeutic claims in Germany. Results show a reduction of 11 mg Hg for systolic and 5.0 mm Hg for diastolic can usually be achieved within a one- to three- month period. Results are significantly better when fresh garlic is used compared to aged garlic.

Daily Nutritional Supplement Consideration:
Standardized commercial preparations that provide a daily dose of at least 10 mg alliin, or a total allicin potential of 4,000 mcg, or 1-4 cloves of fresh garlic a day. In the USA, a standard 500 mg garlic pill of 8,000 ppm allicin potential yields 4,000 mcg of allicin, while a 500 mg garlic pill of 12,000 ppm allicin potential yields 6,000 mcg of allicin.


D. Hawthorn (Crataegus monogyma)

Extracts from hawthorn berries and from the flowering tops of hawthorn are widely used by physicians in Europe for their cardiovascular enhancing properties. As a botanical, hawthorn's cardiovascular effects are mild. It requires at least two to four weeks before any effect can be seen. The exact mechanism is not fully known, although it appears that hawthorn has vasodilating properties. 

Daily Nutritional Supplement Consideration:
Standardized Hawthorn Extract: 100 - 400 mg (2% flavonoids and 18.75% procyanidins).


E. Vitamin C

Clinical studies show that vitamin C intake has a modest effect (a drop of 5 mm Hg) on lowering blood pressure in people with mildly elevated of blood pressure. More importantly, vitamin C increases HDL cholesterol (the good cholesterol). Many clinical studies demonstrate that vitamin C can normalize blood cholesterol. Thus vitamin C decreases cholesterol in patients with high cholesterol and optimizes it in people who have low blood cholesterol values. It also helps shift the blood lipid levels toward a favorable HDL/LDL ratio by increasing HDL. Together with its fat soluble form, ascorbyl palmitate, and certain amino acids such as L-proline and L-lysine, the role of vitamin C in enhancing and maintaining healthy anti-aging blood vessel walls and decreasing other risk factors for heart disease is well-documented.

Daily Nutritional Supplement Consideration:
Vitamin C: 1,000 - 3,000 mg
Ascorbyl Palmitate: 200 - 500 mg
L-Proline: 200 mg
L-Lysine: 200 mg

Attention Because of tremendous individual variation, the use of nutritionals should therefore be personalized for your body. One person’s nutrient can be another person’s toxin. If you have a specific health concern and wish my personalized nutritional recommendation, write to me by clicking here.

Once the blood pressure has been normalized, calcium supplementation should be reduced to 300-500 mg a day in line with maintaining a calcium to magnesium ration of at least 1 to 1 and up to 1 to 2 for best anti-aging health. 

Daily Nutritional Supplement consideration: 1,000 - 1,500 mg

2. Modified Mediterranean Diet

People that lives the Mediterranean region of the world have comparatively lesser incidence high blood pressure than the rest of the world. The main reason is because of their diet.
 

Anti-aging Food Pyramid

The anti-aging pyramid is a simple graphic format based on the modified Mediterranean Diet. This food choice program consists of 50-55% complex carbohydrates of low glycemic index type food such as legumes, nuts, whole-wheat, and whole fruits, 20-25% protein (preferably from plant sources), 25-30% fat, and 5% sweets, candies and dessert. This is in sharp contrast to the typical American diet where 46% comes from simple carbohydrate such as white bread and pasta, and 43% of calories comes from fat (most saturated and trans-fat)

There are three major layers to the Anti-Aging Food Pyramid. They are divided into daily intake layers, 2-3 times a week layers, and once a week layers. Imagine a pyramid with three groups of layers, each layer getting much narrower as it gets closer to the tip.

The broad base layers of the pyramid starts with 10 glasses of pure filtered water a day and complex carbohydrates supplying up to 55% of the calories These carbohydrates are those of low glycemic index type - barley, cereal, legumes, and above ground green leafy vegetables.

A limited amount of nuts, which is a fatty food, is also included in this first base layer. Three servings of vegetables should be taken daily. High glycemic index complex carbohydrates such as wheat, rice, and corn should be restricted. Moderate amount is acceptable if they are mixed with fat and protein.

Egg forms also part of the base layers. It is a good protein source. One egg per day is acceptable (including those used in cooking and baking). Organic eggs are the best.

Olive oil and fats from fish; nuts are part of this daily layer. 25-30% of the calories in your comes from fats. The fats in the diet should come mainly from olive oil, which is high in monounsaturated fats and also a good source of antioxidant. Some comes from the fish, poultry and meat consumed.

The second group of layers is a much smaller layer contains protein food from fish and poultry. You should eat from this group 2-3 times a week. Fish should be those that live in deep and cold water, such as salmon and tuna. Poultry should preferably come from free-range chicken.

The third group of layers , which is very small, contains foods that one should eat 1 time a week. These include sweets, red meat (lean).

If you want a step by step dietary approach, My Detox Diet plan will help you to lower your cholesterol gradually. 

You can also pick up many tips on how to change to a healthier lifestyle  by reading my over 100 Anti-aging Strategies.

Diet Tips for Reducing Blood Pressure

Anti-aging diet and lifestyle changes are the first and foremost step in the treatment of borderline to mild hypertension. Consider the following anti-aging tips, which, if followed, are highly effective in normalizing hypertension.

1. Maintain an ideal body weight. For the medium framed female, the ideal body weight is equal to 100 pounds + 5 pounds for every inch of height above 5 feet. For males, the ideal body weight is 106 pounds + 6 pounds for every inch of height above 5 feet. Thus, a female 5 feet 6 inches tall should have an ideal body weight of 130 pounds while a male 5 feet 10 inches tall should have an ideal body weight of 166 pounds.

2. Follow the anti-aging diet that emphasizes plant foods. Vegetarians generally have lower blood pressure and lower incidences of hypertension than the general population. Their diet contains more potassium, complex carbohydrate, fiber, calcium, and vitamin C and less saturated fat and refined carbohydrates than the diets of non-vegetarians.

3. Two blood pressure lowering foods:

a. Celery is high in 3-n-butylphthalide. In animal studies, intake of the equivalent of 4 sticks of celery for humans was shown to lower the blood pressure by 12%.

b. Garlic has been documented to cause a modest reduction in blood pressure. Take at least 4 cloves a day of fresh garlic a day for a 10 mm Hg drop in systolic and 6 mm Hg in diastolic pressure.

4. Avoid stimulants such as coffee or stress because their adrenergic simulative effects constrict blood vessels which leads to hypertension.

5. Maintain a high potassium and low salt diet by decreasing salt intake and increasing intake of fruits, vegetables and legumes. The diets of most Americans have a sodium:potassium ratio of 2:1. For anti-aging purposes, maintaining a 1:5 ratio is recommended. Optimally, the ratio can be closer to 1:100 as most fruits and vegetables have a ratio of 1:50. While it is good to restrict sodium intake, many studies show that this alone does not improve blood pressure in most people. A high potassium intake is needed. Potassium supplements alone (2.5 - 5 gm/day) cause a drop in systolic pressure of 12 mm Hg and in diastolic pressure of 16 mm Hg. This is especially effective in those over age 65 who do not respond as fully to common anti-hypertensive drugs. Potassium supplementation sold over the counter is limited to 99 mg by the FDA because of problems associated with high doses of potassium salt. Fortunately, potassium is easy to come by from food sources (1 medium size banana contains 400 mg of potassium, a slice of watermelon, or a tomato contains 530 mg). Banana and watermelon as a source of potassium is generally not recommended due to its high sugar content and lack of fiber. The so-called salt substitutes such as NoSaltâ are, in actuality, potassium chloride at a dosage of 530 mg potassium per 1/6 teaspoon. 

3. Exercise

No diabetes program is complete with a well-balanced exercise program. While most people think of exercise as a way to reduce body weight , exercise does much more, including reducing insulin resistance and impotence.

A well-balanced exercise must include three components:

a. Flexibility training
b. Cardiovascular training.
c. Strength training.

Ideally, about 2000 calories should be burned per week. Working out with  30 minutes of aerobics exercise at moderate intensity 5 times a week plus 15-20  minutes of strength training 3 times a week will accomplish this goal.
 

4. Hydration.

It is often overlooked is that high blood pressure can be a state of adaptation of the body to generalized chronic long-term dehydration.  Most are dehydrated and not know it. If you take in less than 8 glasses of water a day in addition to your regular diet, you are in a state of sub-clinical dehydration and not knowing it. Dry mouth is a late sign of dehydration and should be avoided. 

In a bid to fill blood vessels with volume and normalize low pressure due to chronic dehydration, the body through the constriction of the vascular system, forces the water from the vessel into the cell in order to deliver vital nutrients and oxygen. Such effort by the body may lead to a high blood pressure reading which really points to dehydration as the root of the problem. One of the first  and most effective screening test and treatment for those who have hypertension that falls in the class of " borderline" hypertensive  is a trail course on hydration (together with regular salt intake) treatment for 3 months instead of the reverse. This is often accompanied by the return to ideal body weight in the case of those who are obese. 

Certain individuals may have an imbalanced or oversensitive autonomic nervous system. The body overreacts and there may be a over-constriction of the vascular system. Stress reduction and increase water intake  should be considered instead of the reverse in such cases. Those with a healthy heart should  least 12-1 5 glasses of pure filtered water is taken in each day . 

Summary


A comprehensive strategy to normalize borderline and mild hypertension and bring it to anti-aging levels must include lifestyle and dietary changes.

Non-drug forms of treating hypertension as outlined in the anti-aging program have been extensively studied in recent years. 

Studies show that Coenzyme Q10, L-proline, and L-lysine decrease blood pressure and enhance cardiac ejection fraction. Two botanicals - garlic and hawthorn, have also been shown to have mild anti-hypertensive effects, in their case by causing mild vasodilatation, which reduces peripheral resistance.

Besides minerals, essential fatty acids found in fish oil and flaxseed oil have mild vasolidation, anti-inflammation and platelet aggregation properties, also contributing to lowering blood pressure. Popularity of fish oil has waned because most studies show that a high intake of 3,000 mg to 10,000 mg a day is needed to produce its therapeutic effect and high doses often causes a harmless but unpleasant fishy "burp" and a fishy aftertaste.

Considerations of a natural anti-aging strategy to normalize hypertension include:

1. Daily Nutritional Supplementation with:
   
   1. High potency multiple daily vitamin (including Vitamin C 1,000 - 3,000 mg, Vitamin B6 50-100 mg) and mineral intake (Calcium 800 - 1,200 mg, Magnesium 400 - 1,000 mg)
      
   2. Coenzyme Q10 60 - 120 mg, L-Lipoic Acid 70 - 300 mg a day, L-Carnitine 300 - 1,200 mg a day
      
   3. Standardized Hawthorn Extract 100 - 400 mg
      
   4. Standardized commercial preparations of Garlic that provided a daily dose of at least 10 mg alliin, or a total allicin potential of 4,000 mcg per day (or 1-4 cloves of fresh garlic a day)
      

2.  Maintaining ideal body weight by following the anti-aging food pyramid.

3.  Make sure the body is well hydrated with 10-15 glasses of water a day. Also maintain a regular salt intake together with a high-potassium diet rich in fiber and complex carbohydrates (fruits and vegetables, especially celery and garlic).

4.   Maintain a regular anti-aging exercise program.

Message from Dr. Lam I hope you have enjoyed reading this article. If you have areas you don’t understand, comments (good or bad), or if you have a specific health concern, feel free to write to me by clicking here.

About The Author

Michael Lam, M.D., M.P.H., A.B.A.A.M. is a specialist in Preventive and Anti-Aging Medicine. He is currently the Director of Medical Education at the Academy of Anti-Aging Research, U.S.A. He received his Bachelor of Science degree from Oregon State University, and his Doctor of Medicine degree from  Loma Linda University School of Medicine, California. He also holds a Masters of Public Health degree and  is Board Certification in Anti-aging Medicine by the American Board of Anti-Aging Medicine. Dr. Lam pioneered the formulation of the three clinical phases of aging as well as the concept of diagnosis and treatment of sub-clinical age related degenerative diseases to deter the aging process. Dr. Lam has been published extensively in this field. He is the author of The Five Proven Secrets to Longevity (available on-line). He also serves as editor of the Journal of Anti-Aging Research.

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