The Cause Of Hypertension or High Blood Pressure Tutorial Discussion
The following program presents principles designed to promote good health and is not intended to take the place of personalized professional care.The opinions and ideas expressed are those of the speaker.Viewers are encouraged to draw their own conclusions about the information presented.Hello, i’m Emerson.I’m medical director at eden valley lifestyle center.And i wanted to talk to you today about hypertension.This is actually part of the insulin resistance syndrome.It’s part of a package that we’ve been exploring in the series.Like to talk to you about a patient.
We had guam.He was the president of the university of guam and i was called to the emergency room to see him.He was a vip and so i was little bit apprehensive about going up.But on the way up i reviewed his case as i was driving up to the .We’ve seen him a couple of weeks earlier in the urgent care in a and at that his blood pressure was over.I said to him you know, really with this blood pressure this high we usually like to admit you to and try.
To get it down with medications.And he said oh no, no don’t do that.Anything, can’t you do anything to keep it down here in the .Oh, we gave him a couple of medications.His blood pressure did come down.He did respond.We gave him prescriptions and some medications and told him to follow up with us, because we would need to adjust his medications.Well, he then asked, do i have to take this the rest of my life i said well that depends.Now if you don’t.
Make any changes probably so that would be advised.On the other hand, if you make some changes you maybe able to get off your medications.Well, one of his situations at that time he was overweight, had a stressful job, he had a high flesh food intake, he smoked, he drank caffeine, he drank alcohol and he got no exercise.And i said if you would want to get off your medicines, if you make some changes, you’ve a very good chance of getting off the medications.First thing to do would be to stop the flesh foods.
And get rid of the animal products.Go to a plant based product.This will lower you insulin resistance and start dropping your blood pressure.I told him to start walking.Walking program will be very helpful.Avoid the caffeine.Stop the alcohol.And if you do these things, you’ll find that your mind will start clear and you might have a better experience at work which would decrease your stress level at work.Well when i got up to the , i got to hear the rest of the story.He had again done something.
Little bit unusual.He had actually done everything i asked him to do.He is very typea personality, very motivated.So he actually took a week off the work to make all of these changes.He’d gone on complete vegan diet.He had stopped smoking.He stopped the alcohol.He stopped the caffeine.He started walking.And something he noticed was that when he returned to work about a week later, his mind was clear and he was actually on top of his job, instead of trying to catch up.Putting out fires, now he was.
Actually planning how to avoid fires in the future.His stress level was markedly decreased and he is feeling a lot better.Well we had told him to call us if he made any of these changes and he started feeling lightheaded.Well he told his wife at one point, he says you know, i was getting out a chair i felt lightheaded.She says well i’ll your .You know, i said to call me if he started feeling lightheaded.And he said well i’m going to seem him a couple days all.I’ll give him a call then.
Next day he was getting out of car, opening the trunk and he has told his wife, he said yeah you know i feel a little lightheaded again today.She says well, give your a call.I said give me a call if you feel lightheaded.And he said well.I’m going to see him tomorrow.I’ll talk to him about it tomorrow.Well that evening, a very special occasion at the university of guam, because he was a president there.It was graduation night and all the faculty was there.
And all the students were there and all the press were there.And he was handing out diplomas and he passed out.Well, when i examined him there i told him you know.I’ve some good news and some bad news.So the good news is, as that you’ve made all these changes your blood pressure has come down to normal and you don’t need your blood pressure medications anymore.The bad news is, is that you’re still taking your blood pressure medications when your blood pressure was now being controlled.
With your lifestyle and your blood pressure dropped too low and you passed out.And i’m sorry you had to pass out in front of all those people, and that’s the bad news.But the good news was as long he stayed on that program his blood pressure stayed normal and he didn’t need medications.If he strayed from programs right to getting back on american lifestyle which guam had adopted since world war ii, blood pressure started increasing and we needed to get him back on his medications.So, how big a problem is hypertension in america.
Well, it’s actually one of the second leading cause for office visits in united states, accounting for about nine percent of all office visits.And it’s also one of the most common class of drugs that are prescribed for hypertension medications.We find that in america blood pressure as people get older increases and the prevalence and incidence increases as we get older.Especially with men actually over age blood pressure is over over or common in fact more than half of men over age have blood pressures in that range.Women also have blood pressures increasing.
As time goes on as they get older.American blacks tend to get high blood pressure sooner and more frequently than the whites or even hispanics.Is this because they are more sick actually as we’re gonna find out later on high blood pressure is a response to a disease circulatory system.A system that is being blocked, blocked up and clogged up and narrowed.And hypertension is a response to this.Blocks being generally more muscular, more strong, react more violently to this diseases vascular problem with a higher blood pressure.Unfortunately it causes.
Complications, which we’re gonna talk about as well.Now we used to think high blood pressure was a part of aging.We used to have a formula of what a normal blood pressure was and it included your age in that formula.It determined what a normal or expected blood pressure was or would be for you.However in later years we found that in countries that are on vegan type diet or plant based diet, the third world countries blood pressure does not increase with age.So, what we find in american.
Is that blood pressure doesn’t necessarily increase with age, it increases with the length of time you’re on the american diet.That’s the problem with blood pressure.We find that in china.There are three aboriginal groups in china that basically subsist on cereals and vegetables blood pressure stays the same throughout the lifetime.In kenya nomads consisting mainly of milk, the blood pressure stays the same throughout their lifetime as well.In urban africa, we find that blood pressures are high and rise again significantly with age.But in the tribal african areas, blood pressure stays the same, no matter how.
Old they get.It stays constant.In fact urban africa weight is also a problem, but in the tribal communities its not.Now we had a problem at one point, a lady came to us in guam and she was complaining that her blood pressure was high and that she should be getting workmen’s compensation for it.Because it was her job that was stressing her out and causing her blood pressure to be too high.I was kind of thinking that if i give her workmen’s compensation then half of guam would be needing workmen’s compensation.
What we found in the literature actually was that with people with hypertension, stress does cause the blood pressure to go higher, but it’s related to their vascular problem which we gonna look at little bit later.And that a normal person under stress blood pressure will go up, but if they don’t have hypertension blood pressure doesn’t go up as high.So i shared with her that your stress can cause blood pressure to go up but if we get to the underline problem of why you have hypertension to begin.
With, stress will not cause it to go as high.I said you know in tribal africa, they’re under stress.When they’ve tribal wars, they’re afraid to go the bathroom behind a tree because they’re afraid their enemy is gonna come up and kill them.I said now that’s stress and they don’t have hypertension.And anyway i didn’t give her workmen’s compensation.Now among vegetarians here in united states, we find that blood pressure also does not rise with age, stays very constant.However on the american diet, blood pressure does rise.In third world communities where stroke and heart disease is fairly rare.
And they eat plant based diets, again their blood pressure stays fairly constant, strokes, heart attacks are virtually unknown.But in america blood pressure rises from the teens to the ‘s.So, another question we would like to ask is, is hypertension genetic is this one of the problems that we really can’t address because we don’t know how to change genetics again we look at the african cultures and the tribal africans blood pressures today are still in the normal healthy range but their ancestors who came over to america centuries ago, their blood pressures are very high.
Some are genetics different environment.And we find today that when blacks move from their tribal communities to urban areas in the cities, blood pressures go up, obesity becomes a problem, atherosclerosis becomes a problem and they develop our problems that we’ve in the western culture.Well, some may say you know, i feel okay, why should i try to bring my blood pressure down well hypertension does increase your risk of morbidity and mortality, morbidity meaning sickness, mortality of course meaning death.What they found is that if you have hypertension.
Your chance of dying of anything is usually twice as great.You’ve two times of chance of closure in left artery, artery narrowing in climbing off.You’ve three times of chance of dying of a heart attack.Four times of chance of dying of heart failure, where the heart can no longer pump effectively to do the job that it needs to do.Seven times a risk of a stroke.And these are all risks with hypertension and are usually a result of years of the effects of hypertension on the body.
It’s usually not considered an acute problem, because friends since weightlifters when they’re pressing their weights their blood pressures can get up to to systolic and they don’t have strokes or heart attacks because they got healthy arteries.But you combine the hypertension with unhealthy arteries then you have problems.Are there other risk factors for heart diseases, heart attacks and strokes yes.Hypertension is just one risk factor.And now risk factor is something that increases your risk of a certain disease.Other risk factors include being a male, male sex,.
Older age, race, smoking, high cholesterol levels, and diabetes is a very strong risk factor, obesity, stress, physical inactivity.These are all risk factors.Some of them are major risk factors.Last ones i mentioned are more minor risk factors, like physical inactivity and stress.How do these risk factors combine well, if you just have for instance high blood pressure, five, the ten year risk of heart attack, be lessen about five percent.However if you had other risk factors to hypertension such as high cholesterol or a low hdl, which is a good cholesterol.
Or diabetes, cigarette smoking, and then large heart, as you add each risk factor to the previous ones your risk, your ten year risk of heart attack increases dramatically, so that if you have all of those risk factors, your risk of heart attack or stroke in ten years about percent.So generally physicians will work with you to try to decrease those risk factors, decrease your chance of getting those complications.Well blood pressure what is it, and how low is safe well, blood pressure is the pressure in your.
Arterial walls that occurs after the heart contracts.When the heart contracts it shoots blood out of left ventricle into the aorta.The aorta, if its healthy will actually stretch and expand and when the heart then relaxes the aorta starts contracting and the aortic valve prevents blood from going back into the heart and helps keep the blood pressure up so it can profuse to rest of the body.The aorta will continue to contract until the heart relaxes and then expands and then gives another squeeze and pushes out another ejection of blood.
The peek is called your systolic blood pressure.The drop of the blood pressure between beats, the low part is called the diastolic blood pressure.What’s normal well high normal is considered over , but if you check the literature that is not optimal.Optimal is less than over.And how do you get optimal blood pressures well, there are lifestyle approaches which we’re going to talk about shortly, ways of getting your blood pressure down.Typically medications are given but again many cases these can be avoided or eliminated.
If we approach it from a lifestyle point of view.What’s a difference between optimal and normal or again high normal over , optimal over or less if a person has a diastolic of , they have what would be called an average risk of a stroke or heart attack.If they get that blood pressure from down to with lifestyle approach, their risk of heart attack and stroke is cut in half.So going from normal to optimal can cut your risk of heart attack or stroke in half.And there.
Are countries where this is normal, over , or even less is normal.As i was doing a medical, some medical training in one of our little adventist s down in mexico, took two weeks and went down there, i was helping the little country a physician down there and he had just delivered baby and i think he is trying to find something from me.He says why don’t you go and check her blood pressure.And i went and i checked her blood pressure.I came out and i was shocked.
I said her blood pressure is over.She must be hemorrhaging.And he looked over me and he smiles and says they are all over down here because they are all on plant based diet.They couldn’t afford meat products and that’s why their blood pressure ran.They’ve actually shown that the lower you get your blood pressure if it’s with lifestyle, the less your risk of heart attacks and strokes.High blood pressure can also cause problems such as kidney failure.The higher your blood pressures overtime, the higher your risk of kidney failure.
And this is a very real problem.We had a black woman coming to the emergency room.Young girl in her s blood pressure is very high.We started her on a couple medications and we’re trying to get her, we got her blood down in the .And i share with her.I said you’ve got very high blood pressure.We need you do workouts and we need to get you started on some medications and continue to follow you and make sure blood pressure is controlled.Well i think we saw her one time in the.
Office afterwards and she stopped coming.We then saw her about a year and half later.She is in emergency room and now she had again very high blood pressure but her kidneys were in failure.We got her blood pressure down but we were unable to get her kidney function, to be restored and she went on dialysis, young girl.It’s tragic, now on dialysis.So blood pressure is something to take seriously and to get it addressed if it is elevated.In guam, we had some wonderful toping nurses.
There but i was always kind a worried about how technical proficient they were coming from america of course as i had them.And one of the problems was they would get their blood pressure and whenever i would take the blood pressure in the room, blood pressure is always points higher and i thought can’t these nurses take the blood pressures.And then i read about the white coat syndrome.White coat syndrome is very well documented that when nurse takes a blood pressure for the first four visits, blood pressure generally to points higher.When the physician takes it,.
It runs anywhere as high as points higher.Now this effect will attenuate after about four minutes of the visit.We’ve also found that the effect of the white coat syndrome that will also usually go away after the fifth visit once the patient gets familiar with the physician and the nurse and then no longer seems to be a problem.Well the question then comes up what essentially causes hypertension or essential hypertension essential hypertension is a term used for the blood pressure elevation we see in percent of patients.There is a five percent of the people.
That have hypertension that’s caused by something else.Either hyperthyroidism or renal artery stenosis or an endocrine tumor or something of this nature can cause hypertension as well.But percent of patients is what they call essential hypertension and that is what responds most readily to a vegan type diet.So what causes hypertension anyway well we go back to the insulin resistance syndrome and we’ll be talking a little bit more about this in our next talk on hypertension.But in general, briefly the insulin, its job in is to get sugar from the.
Intestines into the cells to get burned.So part of what insulin does is a key and it opens a little door to the cell and opens a cell, allows sugar to leave the blood go into the cell and get burned and that brings your blood sugar down.The other thing that insulin does is it dilates arterioles to help the blood flow, get from the intestines to the kidney or wherever else it needs to get to.This is, has been demonstrated in many tests and they’ve actually found the mechanism by which.
Insulin dilates arterioles.It’s a same mechanism by which nitroglycerin under the tongue dilates arterioles.Insulin goes into the arterioles and there are little endothelial cells lining arterial walls insulin stimulate search those endothelial cells to release nitric oxide synthase which changes arginine into nitric oxide and that’s similar to the nitroglycerin that you put under your tongue, and that nitric oxide dilates the arterioles and gives you laser dilation.They have done tests where they have measured nitric oxide levels after infusions of insulin and found the nitric oxide levels.
Increase in a dosedependent way.This was true in both venous vessels and also arterial vessels.It was also shown to be true.In patients with type diabetes this relationship is disturbed.And even in non diabetics patients said are obese, have hypertension this insulin resistance prevents the insulin from dilating those arterioles.So, insulin stimulates nitric oxide release and causes laser dilation and this in turn helps blood flow.What can block this effect insulin resistance can block this effect.So that insulin no longer has that laser dilatory effect that it had before.And this can cause hypertension.
We’re going to look into this in more detail in our next talk on hypertension.But in brief the kidneys get blood flow from the heart and in fact these little organs get about percent of your total blood flow out of the heart.When there is no insulin system shows arterioles are nice and open and there is a good blood flow through the kidneys.When there is insulin resistance on the other hand, the kidneys say you know at a blood pressure over , i’m not getting the blood flow i need i’m going to turn the blood.
Pressure thermostat up.So hangs on the salt water, blood pressures rise, the perfusion through the kidney improves to some extent.And the kidney says well this is a better.I’m gonna leave this new blood pressure thermostat let’s say over a.And it maintains this as long as there is that, there is our construction from the insulin resistance.We find that patients who go on a plant based diet usually take a week or two the arterioles open up and you get better perfusion and the kidney says oh no the blood pressure of.
Over i’m getting too much flow i can go ahead and turn down the blood pressure thermostat.Gets rid of the extra salt and water, many times people with edema on the legs usually takes about a week and their edema can go away.That’s something we see commonly in people that make these lifestyle changes.And then the blood pressure drops and many times we can get them off the medications.This is something that can be done at home but again its good to be working with your physician.
So that he can adjust your medications if indeed your blood pressure starts to respond to this and help prevent you from passing out like our university president did at the beginning of our talk.Plant based foods tend to take anywhere from three, seven, fourteen days before we see this response but its good to get blood pressure cuff of your own.Monitor your blood pressures and as you see changes stay in touch with your physician and monitor that blood pressure and make the adjustments as needed.Next time we’re going to be talking more about the.
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