Hypertension, The Silent Epidemic

Rates of hypertension are increasing… do you know your numbers?

It’s called the “silent killer” because it has no symptoms, which leaves many people unaware they have it. Hypertension, i.e., high blood pressure, is a serious and common condition, with the most recent data reporting that nearly half of U.S. adults have it.1 Hypertension is also becoming increasingly common among young adults and can predict a major cardiovascular event later in life.2 3 Hypertension is a major risk factor for stroke and heart disease, including heart failure and heart attack. Left untreated, it can also damage delicate blood vessels throughout the body, leading to kidney disease, dementia, vision loss, and sexual dysfunction.4 While the overall death rate from heart disease has declined over time and deaths from stroke and diabetes have leveled off, deaths from high blood pressure have increased.5

The good news is that high blood pressure is "modifiable"—it can be controlled—and death from the condition is preventable. The key is knowing your numbers (normal blood pressure is below 120/80 mm Hg) and staying proactive to keep your numbers in check.

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What Exactly Is High Blood Pressure and Who Is at Risk?

When you get a blood pressure reading, what do those numbers even mean? The first number is your systolic pressure, or the pressure that occurs as blood pumps out of the heart and into your blood vessels. The second, or diastolic pressure, is when your heart rests between beats. High blood pressure is when the force of your blood pushing against the walls of your blood vessels is consistently too high. Elevated blood pressure (prehypertensive) is 120- 129/80 mm Hg, while high blood pressure is 130-139/80-89 mm Hg.6

 

Some of the common risk factors for developing hypertension include excess weight, lack of physical activity, a diet heavy in processed foods and sugar (especially fructose), excessive alcohol consumption, and smoking. Those with insulin resistance and type-2 diabetes are also at a higher risk of high blood pressure. African Americans are also at a higher risk. According to the American Heart Association, the prevalence of high blood pressure in African Americans is among the highest in the world and develops earlier in life.7 One observational study found that by the age of 25, hypertension among African Americans was nearly twice that of their white counterparts.8 And recent research from Northwestern University found that in 2017 African American men had a 43 percent higher rate of death from heart failure, while African American women had a 54 percent higher death rate from heart failure compared to other racial groups.9 “This heart failure trend is another manifestation of the undertreatment of hypertension,” senior study author and cardiologist Sadiya Khan, MD said. “Know your blood pressure and make sure it’s being well managed and well-treated.”

 

Make Managing Your Blood Pressure A Priority

Managing high blood pressure is possible—and you can do it with lifestyle interventions. Reduce your intake of processed foods and sugar, especially high-fructose corn syrup, which has been independently associated with higher blood pressure, even in adults with no previous history of hypertension.10 Eat an abundance of potassium-rich vegetables and fruit to maintain a healthy sodium-potassium balance. Move your body regularly. This doesn’t have to mean rigorous workouts at the gym; something as simple as a daily walk goes a long way. If you are a heavy drinker, work to cut back your alcohol intake. Adopt small healthy habits and they will coalesce into big changes to your health! In addition to healthy lifestyle habits, certain vitamins and nutrients are proven to support healthy blood pressure.

Beetroot Juice 

Nitric oxide (NO) is a molecule that is naturally produced by the body, but diminished production is associated with hypertension and other cardiovascular dysfunction.11 NO has a number of important functions, including promoting blood vessel flexibility and vasodilation, both of which help maintain normal blood pressure. Beetroot is rich in dietary nitrate, which the body readily converts to NO. One recent review investigated 11 studies to examine the relationship between beetroot juice and blood pressure and concluded, “This easily found and cheap dietary intervention could significantly decrease the risk of suffering cardiovascular events and, in doing so, would help to diminish the mortality rate associated to this pathology. Hence, beetroot juice supplementation should be promoted as a key component of a healthy lifestyle to control blood pressure in healthy and hypertensive individuals.” Recent research suggests that another way beetroot juice supports cardiovascular health is by reducing over-stimulation of the sympathetic nervous system (SNS); activation of the SNS increases heart rate, blood pressure, and blood vessel constriction. Studies have shown that doses between 250 mL and 500 mL daily are effective in reducing blood pressure.12 13 14 15 16

Vitamin D 

Studies have consistently shown that low blood levels of vitamin D are linked to hypertension. One study found that men and women with vitamin D levels of 15 ng/mL or less had a three to six times increased risk of developing hypertension over a four-year period compared to those with levels of 30 ng/mL or higher.17 Other research has found that increasing vitamin D levels with supplementation lowers blood pressure.18 A study investigating the effects of vitamin D supplementation on 250 African American men and women found that for each 1 ng/mL increase in blood levels of vitamin D, there was a drop in systolic blood pressure. Doses were given at 1,000, 2,000, or 4,000 IUs daily for three months, with the most significant decreases found in those taking 4,000 IUs.19 It is worth noting that African Americans are particularly at risk of developing a vitamin D deficiency because darker skin reduces natural vitamin D production.20 It’s important to have your levels checked and aim to maintain levels between 40-80 ng/ mL.21

Celery Seed Extract

Celery seeds contain a unique compound known as “L-3-n-butylphthalide” or 3nB, that has a relaxing effect on blood vessels, effectively lowering blood pressure (it is also what gives celery its unique taste and smell). Celery seed extract appears to work in the same way as calcium channel blockers, which are often prescribed as antihypertensive drugs, by blocking the flow of calcium into cells that line the blood vessel walls, helping them to relax.22 One trial of 30 mild to moderate hypertensive patients found that a standardized extract of celery seed extract at 75 mg twice daily lowered both systolic and diastolic blood pressure at three and six weeks of follow up. And while calcium channel blockers can reduce blood flow to the brain, in animal studies, celery seed extract has been shown to improve blood flow, prevent stroke, and enhance energy production in the brain.23

Hibiscus Tea 

Drinking three cups of hibiscus tea every day can be an enjoyable and easy way to reduce blood pressure. A study including 65 pre- and mild hypertensive adults had the participants drink three eight-ounce servings of hibiscus tea or a placebo daily for six weeks. At the end of the study, there was an improvement in both systolic and diastolic pressure in those drinking the tea, compared to the placebo group. The most improvement was seen in systolic pressure and in those participants who had higher blood pressure to begin with.24 A recent analysis of five studies investigating the effect of hibiscus tea on blood pressure confirmed that the tea had a significant effect on lowering systolic and diastolic blood pressure.25