The first number is called systolic pressure and the second, diastolic. Each time the heart beats, there is an increase in pressure. This high point is called systolic pressure. In between beats is the low point called diastolic pressure. Diastolic pressure is given the most attention because if it is too high, the arteries are under excessive pressure even when the heart is relaxed. In the nonstressed adult, the diastolic pressure should be well under 90. In well-conditioned athletes, it's not unusual to find diastolics in the low 60s.

 

"While some people need drugs to lower their blood pressure, millions can do it through diet," says Norman Kaplan, M.D., the nationally known blood pressure expert, in Nutrition Action Newsletter. Add to that stopping smoking, keeping alcohol intake at a minimum (or not at all, depending on blood pressure levels), learning relaxation techniques, exercising regularly, and taking nutrient supplements to combat toxins, complete any dietary inadequacies, and bring optimal support to physical health and the recipe for the recovery and conservation of good health is complete. Eating an ideal diet will not only lower blood pressure but restore health to damaged blood vessels, kidneys, hearts, and brains. Whole fresh, lively foods; lots of fresh fruits and vegetables, especially leafy greens; grains and legumes; nuts and seeds; only low fat or no fat dairy foods; lighten up on meat and put deep water fish on the menu at least once a week. This diet ensures high fiber intake, increased unsaturated fat and decreased saturated fat intake, a beneficial mineral balance, and, weight loss, if required. A natural diet also implies greater fiber intake and the use of vegetable-based (rather than animal-based) oil sources. Both high fiber levels and low fat intake, emphasizing unsaturated fats, have been shown to have benefits in lowering blood pressure. As naturopathic physician Michael Murray has stated, "The lack of dietary fiber is a common underlying factor in many diseases of western 'civilization.'" High fiber diets have been shown to be effective in preventing and treating many forms of cardiovascular problems, including hypertension. In addition, the presence of soluble fibers in the body clears the blood of toxins like lead and cadmium, both of which have been found in higher than normal levels in persons with high blood pressure.

Concerning fat intake, in cultures where the diet is high in poly- or mono-unsaturated fatty acids, blood pressure levels are more healthy. This is because the body uses vegetable fatty acids to make those little cellular hormones called prostaglandins. Some of these, the "E" series, regulate blood pressure and are known to be decreased in hypertensive people. In addition, a wholesome diet is low in sodium, provides sufficient potassium, magnesium, and calcium (necessary to healthy blood pressure, see section "Magic Minerals"), and is free of denatured foods like salt, sugar, hydrogenated fats, caffeine, and white flour. Denatured foods activate the stress response, using up nutrients and weakening the body's ability to recover from emotional stressors. (And, yes, people who have high stress jobs do tend to have higher average blood pressure than others, a phenomenon which has only recently been verified in the laboratory.)  Last, even moderate amounts of alcohol can produce acute hypertension in some people. The problem is labeled acute because researchers at Northwestern University have found that blood pressure goes down when drinking ceases and gradually returns to unsafe levels when drinking resumes. In their article, these researchers emphasize the responsibility physicians have in learning about the alcohol use of their patients. Chronic drinkers, given the same treatment as nondrinkers, do not achieve the same degree of blood pressure control. And, of course, smoking is out. Not only is it a major heart disease risk factor, nicotine actually constricts the small blood vessels, directly affecting blood pressure levels. 

Blood pressure rises in two ways: 1) the arteries constrict, creating a greater resistance to blood flow; 2) fluid in the cardiovascular system is increased. Sodium can be at the base of both of these phenomena. Although sodium occurs naturally in food, it accounts for only about 10 percent of total sodium intake. It is sodium chloride, salt, which is the culprit. In cultures where salt is used, people tend to have higher blood pressure than those from cultures where salt is not used. Further, in salt-using cultures, blood pressure levels escalate with age. Although only 200-1000 mg of sodium a day are essential for health, the average American consumes 10-50 times that amount. Some folks are salt resistant and can eat these amounts all their lives without deleterious effect. However, as many as 40 percent of people with high blood pressure are "salt sensitive." Their blood pressure falls with a low salt diet. This sensitivity to salt is higher among African-Americans, the elderly (the kidneys slow down with age and so don't excrete excess sodium as easily), people who are overweight, and those who have a family history of high blood pressure.

Since there is no simple test or diagnosis for salt sensitivity, the general advice to people with high blood pressure is to assume that you are sensitive and reduce your intake. The British Medical Journal reported that a modest reduction of sodium (from 8 grams down to 5 grams per day) will reduce the risk of stroke by 22 percent and heart disease by 16 percent. Even if you are not at risk, if you are a woman, you may want to cut back on your salt intake. The higher your salt intake, the more water retention and weight gain you may experience premenstrually. If you are using The Pill or estrogen therapy, salt will cause additional bloating. Further, salt may increase the risk of premature osteoporosis. The more salt in your diet, the more calcium will be excreted from your body.  Moderate salt intake is considered to be no more than 4-6 grams per day. It is important to remember that 75 percent of the salt in the average diet comes from processed foods. We add only 15 percent to food at the table. 

"...a clear understanding of the relationships between sodium, potassium, and magnesium would, in my opinion, eliminate the need for blood pressure medication for roughly half of those currently taking it." This statement was made by Julian Whitaker, M.D., in his newsletter Health & Healing. As you will read in the section "To Salt or Not to Salt," there is nearly universal agreement on the importance of limiting sodium intake, especially for people with hypertension. However, Dr. Whitaker states unequivocally that it is as important to increase your intake of both magnesium and potassium as it is to reduce your intake of salt. Potassium works with sodium to help regulate fluids in the cells, and to equalize the acid-alkaline balance in the blood. To function correctly, these minerals need to be present in the body in a ratio of 5:1, potassium to sodium. Health Counselor editor Karolyn Gazella reports that the typical American diet includes twice as much sodium as potassium. This results in water retention and the loss of potassium through the urine. In fact, Researchers from the University of Mississippi report that too little potassium combined with too much sodium may be a major contributing factor in the development of hypertension.

 To study the effects of potassium on blood pressure, researchers at Duke University ran double-blind studies using potassium supplements. Participants receiving the supplements experienced a significant reduction in blood pressure. African-Americans showed the biggest drop. Their blood pressure went down almost 20 points, causing the speculation that this sub-group might be particularly sensitive to the blood pressure lowering effects of potassium. Further, animal studies have shown potassium to be protective against both kidney damage and strokes, two of the major health problems which can occur as a result of ongoing high blood pressure. When high blood pressure occurs, patients are given diuretics to stimulate the excretion of excess fluids. Since this process robs the body of potassium, potassium supplements are often prescribed. However, magnesium, which has been called "one of the most promising and least-used minerals" for blood pressure control, is also lost. It is not replaced. Unfortunately, the body cannot store potassium without magnesium. In the presence of adequate amounts of both potassium and magnesium, the potassium itself increases the excretion of sodium and excess fluids.

 Dietary sources of potassium include apple juice, apricots, avocado, bananas, legumes, beets, cantaloupe, carrots, oranges, pears, white and sweet potatoes, raisins, salmon, sardines, watermelon, and winter squash. Amounts of 4-6 grams per day are recommended. Magnesium is highest in whole grains and leafy greens, but also occurs in many fruits and vegetables. The recommended intake ranges from 300-500 mg. Dr. Kaplan reports a "major controversy" surrounding the usefulness of calcium in lowering blood pressure. However, he did indicate that up to 30 percent of people with high blood pressure also excrete calcium in their urine and that in those cases additional calcium might be useful. Writing for the Journal of Hypertension, Lawrence Resnick, M.D. reported the effectiveness of calcium, two grams per day, in lowering blood pressure in people who are salt sensitive. The authors of a 1985 study appearing in JAMA report finding that African-American men have lower calcium levels partly as a result of lactase deficiency, indicating another use for calcium supplementation. Calcium is found in yogurt and other milk products, soybeans, sardines, salmon, peanuts, sunflower seeds, and leafy greens. 

Stroke is the third leading cause of death in the U.S. High blood pressure is the most common known risk factor. (It is also a risk factor for heart attack.) Evidence exists showing that adequate levels of magnesium, potassium, and calcium to be linked with lower blood pressure. The importance of magnesium in blood pressure control is demonstrated by a recent study conducted by Honolulu Heart Program researchers. When 61 different dietary factors were examined, magnesium showed the strongest link between high intake and low blood pressure. Men getting 330-1,429 mg a day had the lowest blood pressure. A Georgetown University study showed that persons with high blood pressure had an 11 percent drop following magnesium therapy. Giving extra potassium to people with mildly elevated blood pressure can also result in decreases. A Duke University study showed that after two months of potassium supplementation, hypertensives experienced as much as a 20 point drop in blood pressure. In a 12 year study reported by the New England Journal of Medicine, there were 24 deaths associated with stroke among the 859 subjects. Adjusting for calorie intake, the authors found that dietary potassium intake was significantly lower in those dying of stroke. One-third to one-half of all people with high blood pressure, and especially African Americans and older people, are salt sensitive. Lawrence Resnick, M.D., of the Cardiovascular Center at New York Hospital-Cornell Medical Center, has found that adding 2,000 mg of calcium a day blunts salt's blood pressure raising effects. He commented, "... the more salt elevates blood pressure, the more calcium lowers it."    

 The following supplements are recommended to people with high blood pressure by Murray and Pizzorno in The Encyclopedia of Natural Medicine. These supplements are to be taken in addition to a general multiple vitamin-mineral supplement.

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