Hypertension and your risk

Hypertension can be either a slowly progressive disease or abruptly deadly or fatal. The majority of people with high blood pressure never know they have this important medical problem. Individuals may simply present to a doctor in kidney failure or after a stroke or indeed a TIA. Transient Ischaemic Attacks or TIAs are a short-lasting, ‘reversible stroke’ or ‘mini stroke’ that lasts less than minutes to hours without permanent damage to the brain. TIA’s herald the possibility of a full-blown stroke and should be treated seriously. If you have a blood pressure beyond 115/75, you risk kidney failure, damage and blockages to your heart and peripheral arteries, strokes and TIA’s.

At one point in medicine, we seemed to have a set the bar too high at 140/90 to label someone as hypertensive and to commence treatment. However, there is a range between normal and hypertensive and this is called ‘Prehypertension.’ If you are prehypertensive, you need to adopt an integrative approach of diet and exercise. A weight loss of 5% to 10% could result in a reversal of this blood pressure trend. Sure, you may have genetic factors working against you but a fatalistic approach should never be taken as the saying goes, ‘genes load the gun but it is the environment that pulls the trigger’. The environment in this instance being diet, lifestyle and body composition (overweight/obesity and abdominal adiposity).

Getting 24 hour blood pressure monitor readings is highly advisable. This will give you a daytime and nightime average and whether you are a ‘dipper’ or ‘non-dipper’. A dipper has blood pressure readings that fall below the daytime average and this is desirable. Those that are non-dippers have a higher risk of left heart enlargement (left ventricular hypertrophy) and increased cardiovascular risk and end-organ damage. This is all because the blood pressure never drops in non-dippers with the heart working hard 24/7 with no respite during sleep.

There is a circadian rhythm with regard to blood pressure with a surge in the early hours of the morning before awakening¹. This is a dangerous period for individuals with high blood pressure. Many people have a stroke or cardiovascular event in the early hours of the morning or indeed, never wake up!

The importance of pharmacological approaches to hypertension cannot be stressed enough. The benefits are undeniable! However, the importance of diet and exercise in the management of hypertension and cardiovascular outcomes likewise are undeniable and to favour one over the other to me is clinical neglect.

The way doctors are taught is a totally interventionist approach and no wonder they think that the only way to treat anything is through an artifical drug and that nutrients like magnesium or nitrates in food have no impact on cardiovascular health or outcomes. This assumes that dietary factors or exercise could not possibly have an effect on physiological functions like vascular tone. This is an amazingly outdated and anachronistic mindset and yet this is the model adopted in the treatment of chronic disease. In this day and age, this is unethical! Research on the effects of dietary management, weight loss and micronutrients on supporting blood pressure parameters would simply crush the unbeliever and medicolegally indefensible.

From your perspective, buying into the pharmacetical approach only method which involves the ‘script-solution’ with little guidance to dietary and exercise factors means that you are putting your whole cardiovascular system at risk as there are a large number of other factors that damage your blood vessels beyond hypertension.

It was interesting that a study done at Australia’s Swinburne University using a SphygmoCor Sphygmomanometer to measure central arterial pressure i.e. the blood pressure near the heart in the large blood vessel called the Aorta, that even 1 glass of orange juice daily could raise central arterial pressure³. This central pressure is far more reliable as a determinant than the blood pressure taken in the arm (peripheral blood pressure)

What people regard as a healthy thing to do, can be deadly in terms of the effect on central blood pressure and you are putting yourself at risk by consuming fruit juice regularly.

This is not to say that whole fruit is bad. In fact whole fruit can be beneficial and in particular eating seasonal fruits that provide a variety not just the same fruits day-in and day-out. Whole fruit will have far less fructose than juices that have a high concentration of fructose and fructose is highly glycating as well i.e. it damages proteins 7 times more than glucose so for prediabetics or diabetics, fruit juice could be even more deadly but once again, whole fruit can be beneficial up to 3 – 4 servings a day or 3 – 4 moderately sized fruit per day.