BY DR LYDIA THURTON
High blood pressure frustrates many of my patients. Changes in diet and exercise help but many are told they need medication. Virtually every patient with hypertension dreams of one day being able to come off of their medication. Here are five things to know if you’re struggling with hypertension.
High blood pressure can be caused by medication side-effects. Drugs include commonly used pain medications like NSAIDS (Ibuprofen, Advil, Aleve) and coxibs (Celebrex). Skin conditions like psoriasis and eczema can include prescription for corticosteroids or protopic, these can also raise blood pressure. Nasal decongestants and birth control pills can contribute to resistant hypertension as well.
High blood pressure by itself isn’t a problem. The concern is heart attack and stroke, together known as cardiovascular disease. Rather than ask your doctor “will this drug lower my blood pressure?” what needs to be asked is “how much will this lower my risk of cardiovascular disease?” Your doctor can use the Framingham calculator to estimate your actual risk of having a cardiovascular event. This can help you decide if you want drugs based on logic rather than emotion. The Cocharane database, one of the biggest research facilities in the world, found that people with mild hypertension (140-149 mmHg/ 90-99 mmHg) that are taking medication have not been shown to reduce deaths from heart attacks and strokes.
Once medication begins, most patients assume that they will have to continue for the rest of their life. If you’ve had two consecutive visits with your health care provider where your blood pressure has been normalized, you can initiate “step down therapy.” Which is essentially reducing your medication dose to the lowest possible amount to control your pressure. Some patients may not need to be medicated at all. Do not lower your dose without a health care provider monitoring your progress. Usually step down therapy involves cutting your dose in ½ and monitoring for two weeks, then by another 50%, recheck in two weeks.
Sugar restriction can be more important than salt restriction. Salt restriction generally reduces blood pressure by 4-2 points. Eating a diet high in processed sugars can raise blood pressure by as much as 7 points. The DASH diet, the low sodium nutrition plan used for hypertension coincidentally is also low in sugar. Whether the effect on blood pressure lowering is due to sugar or salt remains to be seen. Increasing evidence is pointing to dietary high fructose corn syrup, which has risen in processed foods alongside the blood pressures of Canadians.
Get your vitamin D tested. Talking to another naturopathic doctor yesterday, she mentioned to me how many of her patients are deficient, despite supplementing with vitamin D. This blood test needs to be purchased through your MD or naturopath. Why our government health care system doesn’t check for this vital nutrient, implicated in many chronic diseases, is beyond my understanding. Vitamin D prevents your arteries from becoming stiff, the root cause of high pressure. Less flexible arteries makes your heart work harder to pump. Imagine using your lungs to blow up a balloon, versus a tire. Stiff walls are not good. Use vitamin D and antioxidants to help. Vitamin D blood levels should be above 75 nmol/L.