Hypertension Part I -
Are Your Hypertension
Medications Killing You?
Saturday, March 10, 2007 - By: Raymond Hinish, Pharm.D., CN, C.P.T.
Hypertension is defined as a persistent elevation in blood pressure. Over a number of years, hypertension can damage arteries and significantly increase the risk of cardiovascular disease, resulting in an increased risk of heart attack and stroke. There are four main causes of hypertension:
1. Constricted arteries
2. The Heart is pumping too hard
3. The kidneys are not kicking enough fluid
4. Arteries are calcified
Conventional medicine believes that these phenomena occur as part of the normal process of aging and, therefore, the only treatment is medication. Medications can work to remedy each of these issues. Some medications, called diuretics, cause the body to force out excess fluid, overworking the kidneys to process and remove the fluid. Some medications, such as beta blockers, prevent the brain from signaling the heart to beat faster or constrict arteries. This medication also decreases the force of the heartbeat so that each beat creates less pressure in the blood vessels. Calcium channel blockers decrease the flow of calcium into the nerves and muscles, thus preventing the arteries from constricting. ACE inhibitors, such as lisinopril, block the production of angiotensin II and thereby results in dilation of the blood vessels.
As you can see, none of these approaches answer the very important question, “Why has the body decided to constrict the arteries, retain fluid and get the heart beating with more force?” There is no doubt that the medications lower blood pressure but, the question remains, “Do these medications work to improve health?” In the interest of brevity, I will list some of the more popular studies and provide brief descriptions of their findings:
1. MRFIT Study (Multiple Risk Factor Investigation Trial)
A 1982 study of 12,866 men ages 35 to 57 who had an increased risk of heart disease. The subjects were split into two groups, one received a diuretic along with counseling on lifestyle while the control group received counseling alone. At the end of the study, the group who received the medication had a higher risk of death than those in the control group. This risk did not reach statistical significance, but showed a trend toward increased risk of death and, at least, showed no benefit. (JAMA 248 (12):1465-77; 1982)
2. Oslo Study
Study performed in 800 mildly hypertensive, asymptomatic men, 40-49 years of age. Half the group received drug treatment and half did not. The drugs did result in significantly lower blood pressure. Cerebrovascular events, such as stroke, only occurred in the group who did not receive the drugs. This seems like a positive finding about the use of medications, that is, until you find out that the heart disease incidence, including sudden cardiac death, was 50% higher in the group who received the medications. If you look at funeral rates for hypertensives, you see five times as many people die of heart attack than stroke. I think I will take my chances with lifestyle.
3. Australian Study
This study found twice as many deaths in people who took diuretics to treat hypertension compared to hypertensive individuals receiving no treatment at all. (Med J Aust.2:27-32 (1980))
4. MIDAS - Multicenter Isradipine Diuretic Atherosclerosis Study
Calcium channel blockers were compared to the cheaper diuretic called hydrochlorothiazide (HCTZ). Calcium channel blockers were found to increase the incidence “major vascular events,” including stroke and angina. The cheap diuretic was found to be as effective at treating the atherosclerosis. The fascinating part of the story is that by the end of the three year study, a number of the main researchers of the study had quit because the manufacturer of the calcium channel blocker had tried to control how the results were presented. There have been other studies that have linked calcium channel blockers to higher incidences of death.
As you can see, perhaps medications are not the solution to hypertension. Elevated blood pressure is an appropriate response to your body’s needs. When you exercise, your blood pressure increases in order to feed the tissues with enough oxygen to fuel the activity. There is a definite reason that the blood pressure increases during exercise. Likewise, when blood pressure increases chronically, as in hypertension, there is a definite reason why the body has done this. Correct the reason for the disease, and you will correct the disease itself. To my knowledge, every study to date that has evaluated lifestyle management of hypertension has found improvements in longevity. This is clearly not the case with medications.
In today’s newsletter, I am going to provide two very important factors that you can change today to improve your blood pressure. I will then tell you of one very big myth that most doctors repeat as if it were true. The first factor is chronic, low-grade dehydration. When mammals made the great move from ocean dwelling life to land life, evolution had to find a way to carry the ocean with the body. Thus, we became living, breathing, walking sacks of water. The biggest threat to our survival was not starvation and the claws of another animal, it was dehydration. So, the body built many mechanisms to control dehydration, including chemicals that cause the blood vessels to constrict and the kidneys to decrease water loss through urination. In addition, when the body becomes dehydrated the heart has to pump harder and faster in order to keep the blood pressure high enough to send blood to the vital organs. This is one of the very common reasons for many people’s hypertension, NOT ENOUGH WATER INTAKE. The body would rather that you die of heart attack or stroke 20 years from now than dehydration tomorrow. So, is it really that easy? Just drink more water and you’re cured? For a lot of people the answer is yes, that is all they need to do. For some, there may be other things that play a role in their hypertension. I would venture to say that low-grade dehydration is an issue for most people even though it may not be the only issue. Remember that water is the key, not tea, soda, coffee, juice…just good old, pure, clean water!
The second factor is stress. When you are under stress your body kicks out cortisol, a stress hormone, to help your body cope with the challenge. The unfortunate problem with cortisol is its effect on sodium retention and, therefore, water retention. In addition, adrenaline which is secreted when someone is under stress is also increased, leading to vessel constriction and an increase in heart rate and force. Control the stress or how stress impacts your body and you will commonly see improvements in blood pressure. Yoga, meditation and stress management are all beneficial for helping to normalize stress-induced hypertension. I also suggest that people who have a tendency toward being high-strung use an herbal adaptogen called Vital Adapt. We get more positive feedback about this product than any other product we carry for stress management. We suggest 2 full droppers twice daily.
The final note has to do with a common myth, sodium restriction for hypertension. The truth is, if we took one hundred people with hypertension and put them on an aggressive low salt diet, only five of those hundred people would notice significant improvements in their blood pressure. That means ninety-five people would get no benefit. In fact, if you take healthy people and put them on a sodium restriction diet, you may see a thirty-seven percent increase in cardiovascular related death rates. (Am J Med 06;119(3):275) We should control salt intake not restrict it, we want to naturally balance our intake of sodium with potassium so as to mimic what we would get if we ate as our Paleolithic relatives. Try to eat your food as unrefined as possible, after all, 77% of your sodium intake comes from such foods. And, make sure that you get plenty of potassium from fruit and vegetables in order to balance out your sodium intake. Otherwise, forget about salt!
Conventional medicine has thrown in the towel when it comes to trusting in the body’s natural intelligence. It exists under the premise that without some sort of synthetic chemical to balance the biochemistry, we will not survive. Their intentions are often positive and their methods have some sort of logic to them, however, they never seem to go deep enough. When we were kids we would “why” our parents into submission asking a seemingly endless series of “whys” to get to that final answer that allowed us to ultimately understand at the most fundamental level. This was an intuitive way to get to the core understanding of a question or problem. Kids get it, how is it that medical researchers do not? The majority of our learning and innovations come from the last few successive “whys” that we ask. The problem is with the belief that we only need to ask “why” once to get to the ultimate answer. With hypertension, the superficiality of medicine’s inquiry has catastrophic result…people die before their time not in spite of the treatment but possibly because of the treatment.
In the next column, I will talk about our supplement protocol for helping to normalize blood pressure. Until that time, put some of these suggestions into use right away and keep an eye on your pressure. I think you will be pleasantly surprised.