How to Avoid High Blood Pressure

PART # A High blood pressure is one of the most preventable conditions. But it plays a contributing role in more than 15% of deaths in the United States, according to a new Harvard study. Although it causes no symptoms, HBP boosts the risks of leading killers such as heart attack and stroke, as well as aneurysms, cognitive decline, and kidney failure. 28% of Americans have high blood pressure and don't know it, according to the American Heart Association. If you haven't had yours checked in 2 years, see a doctor. While medication can bring down blood pressure, it may cause side effects such as leg cramps, dizziness, and insomnia. Fortunately, most people can reduce their blood pressure without medication. First get to a healthy weight. Then add these strategies. Learn other ways to use food to reverse disease, look younger, and live longer. 1. Go for power walks Hypertensive patients who went for fitness walks at a brisk pace lowered pressure by almost 8 mmhg over 6 mmhg. Exercise helps the heart use oxygen more efficiently, so it doesn't work as hard to pump blood. Get a vigorous cardio workout of at least 30 minutes on most days of the week. Try increasing speed or distance so you keep challenging your ticker. 2. Breathe deeply Slow breathing and meditative practices such as qigong, yoga, andtai chi decrease stress hormones, which elevate renin, a kidney enzyme that raises blood pressure. Try 5 minutes in the morning and at night. Inhale deeply and expand your belly. Exhale and release all of your tension. 3. Pick potassium-rich produce Loading up on potassium-rich fruits and vegetables is an important part of any blood pressurelowering program, says Linda Van Horn, PhD, RD, professor of preventive medicine at Northwestern University Feinberg School of Medical. Aim for potassium levels of 2,000 to 4,000 mg a day, she says. Top sources of potassium-rich produce include sweet potatoes, tomatoes, orange juice, potatoes, bananas, kidney beans, peas, cantaloupe, honeydew melon, and dried fruits such as prunes and raisins.

4. Read food labels for sodium Certain groups of peoplethe elderly, African Americans, and those with a family history of high blood pressureare more likely than others to have blood pressure that's particularly salt (or sodium) sensitive. But because there's no way to tell whether any one individual is sodium sensitive, everyone should lower his sodium intake, says Eva Obarzanek, PhD, a research nutritionist at the National Heart, Lung, and Blood Institute. How far? To 1,500 mg daily, about half the average American intake, she says. (Half a teaspoon of salt contains about 1,200 mg of sodium.) Cutting sodium means more than going easy on the saltshaker, which contributes just 15% of the sodium in the typical American diet. Watch for sodium in processed foods, Obarzanek warns. Thats where most of the sodium in your diet comes from, she says. Season foods with spices, herbs, lemon, and salt-free seasoning blends. 5. Indulge in dark chocolate Dark chocolate varieties contain flavanols that make blood vessels more elastic. In one study, 18% of patients who ate it every day saw blood pressure decrease. Have 1/2 ounce daily (make sure it contains at least 70% cocoa) 6. Take a supplement In a review of 12 studies, researchers found that coenzyme Q10 reduced blood pressure by up to 17 mmhg over 10 mmhg. The antioxidant, required for energy production, dilates blood vessels. Ask your doctor about taking a 60 to 100 mg supplement up to 3 times a day. 7. Drink alcohol--but not too much According to a review of 15 studies, the less you drink, the lower your blood pressure will dropto a point. A study of women at Boston's Brigham and Women's Hospital, for example, found that light drinking (defined as one-quarter to one-half a drink per day for a woman) may actually reduce blood pressure more than no drinks per day. One "drink" is 12 ounces of beer, 5 ounces of wine, or 1.5 ounces of spirits. Other studies have also found that moderate drinkingup to one drink a day for a woman, two for a mancan lower risks of heart disease. "High levels of alcohol are clearly detrimental," says Obarzanek. "But moderate alcohol is protective of the heart. If you are going to drink, drink moderately." 8. Switch to decaf coffee Scientists have long debated the effects of caffeine on blood pressure. Some studies have shown no effect, but one from Duke University Medical Center found that caffeine

consumption of 500 mgroughly three 8-ounce cups of coffeeincreased blood pressure by 4 mmhg, and that effect lasted until bedtime. For reference, 8 ounces of drip coffee contain 100 to 125 mg; the same amount of tea, 50 mg; an equal quantity of cola, about 40 mg. Caffeine can raise blood pressure by tightening blood vessels and by magnifying the effects of stress, says Jim Lane, PhD, associate research professor at Duke and the lead author of the study. "When you're under stress, your heart starts pumping a lot more blood, boosting blood pressure," he says. "And caffeine exaggerates that effect." If you drink a lot of joe, pour more decaf to protect your ticker. 9. Take up tea Lowering high blood pressure is as easy as one, two, tea: Study participants who sipped 3 cups of a hibiscus tea daily lowered systolic blood pressure by 7 points in 6 weeks on average, say researchers from Tufts Universityresults on par with many prescription medications. Those who received a placebo drink improved their reading by only 1 point. The phytochemicals in hibiscus are probably responsible for the large reduction in high blood pressure, say the study authors. Many herbal teas contain hibiscus; look for blends that list it near the top of the chart of ingredientsthis often indicates a higher concentration per serving. 10. Work (a little) less Putting in more than 41 hours per week at the office raises your risk of hypertension by 15%, according to a University of California, Irvine, study of 24,205 California residents. Overtime makes it hard to exercise and eat healthy, says Haiou Yang, PhD, the lead researcher. It may be difficult to clock out super early in todays tough economic times, but try to leave at a decent hourso you can go to the gym or cook a healthy mealas often as possible. Set an end-of-day message on your computer as a reminder to turn it off and go home. 11. Relax with music Need to bring down your blood pressure a bit more than medication or lifestyle changes can do alone? The right tunes can help, according to researchers at the University of Florence in Italy. They asked 28 adults who were already taking hypertension pills to listen to soothing classical, Celtic, or Indian music for 30 minutes daily while breathing slowly. After a week, the listeners had lowered their average systolic reading by 3.2 points; a month later, readings were down 4.4 points.

12. Seek help for snoring It's time to heed your partner's complaints and get that snoring checked out. Loud, incessant snores are one of the main symptoms of obstructive sleep apnea (OSA). University of Alabama researchers found that many sleep apnea sufferers also had high levels of aldosterone, a hormone that can boost blood pressure. In fact, it's estimated that half of all people with sleep apnea have high blood pressure. If you have sleep apnea, you may experience many brief yet potentially life-threatening interruptions in your breathing while you sleep. In addition to loud snoring, excessive daytime tiredness and early morning headaches are also good clues. If you have high blood pressure, ask your doctor if OSA could be behind it; treating sleep apnea may lower aldosterone levels and improve BP.

13. Jump for soy A study from Circulation: Journal of the American Heart Associationfound for the first time that replacing some of the refined carbohydrates in your diet with foods high in soy or milk protein, such as low-fat dairy, can bring down systolic blood pressure if you have hypertension or prehypertension.

PART # B

1. Limit refined carbs A steady intake of white starches and sugary foods can cause salt retention and elevate blood pressure. Switch to 100-per-cent whole-grain foods such as whole-grain whole wheat bread and crackers, brown rice, whole-grain pasta, large flake or steel-cut oats, quinoa and unhulled barley. Avoid sugary drinks; limit dessert to once or twice per week. Get used to adding less sugar or honey to coffee and tea and breakfast cereal. 2. Add milk or soy protein. The DASH diet includes two to three low-fat dairy servings per day. One serving includes 1 cup skim or 1 per cent milk, 1 cup of 0.1 to 1 per cent milk-fat (MF) yogurt and 1.5 ounces of 7 per cent MF cheese. To increase your intake of soy protein, use unflavoured or unsweetened soy beverages in place of, or in addition to, milk. Add firm tofu to stir-fries, toss soy beans into salads and snack on roasted soy nuts or edamame. 3. Increase fruit and vegetables The DASH diet is also plentiful in fruit and vegetables: seven to 12 servings each day. These foods are excellent sources of potassium, a mineral that helps blood vessels relax and causes the kidneys to excrete more sodium. In fact, studies show that people with a low daily intake of the mineral are more likely to develop high blood pressure and suffer a stroke. Adults need 4,700 milligrams of potassium each day. Excellent sources include bananas (1 medium = 422 milligrams), apricots (4 = 362 mg), prune juice ( cup = 373 mg), cantaloupe (1 cup = 440 mg), spinach ( cup cooked = 443 mg), Swiss chard ( cup cooked = 508 mg) and sweet potato (1 small = 285 mg). 4. Eat legumes and nuts Include beans and/or nuts in your diet four times per week. These foods are a good source of vegetable protein and theyre rich in magnesium, a mineral that promotes normal blood pressure. Add chickpeas, kidney beans, black beans and lentils to salads, soups, pasta sauces, tacos and chilies. Snack on a small handful of unsalted, raw or dry roasted nuts. 5. Watch sodium Excess sodium has been linked with elevated blood pressure in many studies. Canadians, aged nine to 50, require 1,500 milligrams of sodium each day. With age, our body becomes more sensitive to the blood pressure-rising effect of sodium and daily requirements drop to 1,300 milligrams for adults aged 50 to 70 and 1,200 milligrams for people over 70.

For most adults, the daily upper sodium limit is 2,300 milligrams. If youre over 50 or have high blood pressure you should consume less. 6. Limit or avoid alcohol If you drink, limit yourself to one to two drinks per day or a weekly maximum of 7 for women and 9 for men. Drinking more than two drinks per day increases blood pressure and escalates the long-term risk of developing hypertension. 7. Lose excess weight. If youre overweight and have hypertension, losing five kilograms will lower your blood pressure. In some cases, weight loss can reduce or eliminate the need for blood pressure medication. If you need to cut calories, replace refined grains and sweets with more fruit and vegetables. Leslie Beck, a Toronto-based dietitian at the Medcan Clinic, is on CTVs Canada AM every Wednesday. Her website is lesliebeck.com.

PART # C: Remedies using herbal and organic products Causes of High Blood Pressure In most cases of high blood pressure, the American Heart Association says there is no one identifiable cause. This kind of high blood pressure is called primary hypertension oressential hypertension. It is usually a combination of factors, such as: Weight. The greater your body mass, the more pressure there is on your artery walls. That's because more blood is produced to supply oxygen and nutrients to tissues in your body. Activity level. Lack of physical activity tends to increase heart rate, which forces your heart to work harder with each contraction. Tobacco use. Chemicals in cigarettes and tobacco can damage artery walls. Sodium intake. Excessive sodium in the diet can result in fluid retention and high blood pressure, especially in people sensitive to sodium. Potassium intake. Low potassium can result in elevated sodium in cells, because the two balance one another. Stress. Stress can raise blood pressure. Alcohol consumption. Excessive alcohol intake can, over time, increase the risk of heart disease. Age. The risk of high blood pressure increases as you get older. Family history. High blood pressure often runs in families. High blood pressure can also be caused by an underlying condition, such as kidney disease, hormonal disorders, thyroid disease, adrenal gland disease, and the use of certain drugs, such as oral contraceptives, or herbs such as licorice. This type of high blood pressure is called secondary hypertension. Natural Remedies for High Blood Pressure Lifestyle changes and natural remedies may help to control high blood pressure, but your doctor may also recommend medication to lower high blood pressure. It is important to work with your doctor, because untreated high blood pressure may damage organs in the body and increase the risk of heart attack, stroke, brain hemorrhage, kidney disease, andvision loss. See a drawing of a hypertensive heart. Coenzyme Q10 (CoQ10) There is some evidence that the supplement CoQ10 may help to reduce high blood pressure. A 12 week double-blind, placebo-controlled trial of 83 people with systolic hypertension examined the effect of CoQ10 supplements (60 mg twice daily). After the 12 weeks, there was a mean reduction in systolic blood pressure of 17.8 mm Hg in the Coq10-treated group. Another study conducted at the University of Western Australia looked at the effect of CoQ10 on blood pressure and glycemic control in 74 people with type 2 diabetes. Participants were randomly assigned to receive either 100mg CoQ10 twice daily, 200mg of the drug fenfibrate, both, or neither for 12 weeks.

CoQ10 significantly reduced systolic and diastolic blood pressure(mean reduction 6.1 mm Hg and 2.9 mm Hg respectively). There was also a reduction in HbA1C, a marker for long-term glycemic control. To learn more about CoQ10, read the Coenzyme Q10 (CoQ10) fact sheet. Garlic In a meta-analysis of seven randomized controlled trials of garlic supplements, three trials showed a significant reduction in systolic blood pressure and four in diastolic blood pressure. Researchers concluded that garlic powder supplement may be of clinical use in patients with mild high blood pressure. Garlic supplements should only be used under the supervision of a qualified health practitioner. Garlic can thin the blood (reduce the ability of blood to clot) similar to aspirin. Garlic may interact with many drugs and supplements such as the prescription drugs such as Coumadin (warfarin) or Trental (pentoxifylline), aspirin, vitamin E, gingko. It is usually recommended that people taking garlic stop in the weeks before and after any type of surgery. To learn more about garlic, go to the articles about garlic. Hawthorn The herb hawthorn is often used by traditional herbal practitioners for high blood pressure. In a randomized controlled trial conducted by researchers in Reading, UK, 79 patients with type 2 diabetes were randomized to receive either 1200 mg of hawthorn extract a day or placebo for 16 weeks. Medication for high blood pressure was used by 71 percent of the patients. At the end of the 16 weeks, patients taking the hawthorn supplement had a significant reduction in mean diastolic blood pressure (2.6 mm Hg). No herb-drug interactions were reported. Fish oil Preliminary studies suggest that fish oil may have a modest effect on high blood pressure. Although fish oil supplements often contain both DHA (docohexaenoic acid) and EPA (eicosapentaenoic acid), there is some evidence that DHA is the ingredient that lowers high blood pressure. Learn more about fish oil. Folic acid Folate is a B vitamin necessary for formation of red blood cells. It may help to lower high blood pressure in some people, possibly by reducing elevated homocysteine levels.

One small study of 24 cigarette smokers found that four weeks of folic acid supplementation significantly lowered blood pressure. Learn more about folic acid. Diet Changing your diet is an important part of lowering high blood pressure. The DASH (Dietary Approaches to Stop Hypertension) diet is promoted by the National Heart, Lung, and Blood Institute of the National Insitutes of Health (NIH). The DASH diet includes fruits and vegetables, low-fat dairy foods, beans and nuts. Sodium is limited to 2,400 mg per day. Studies have found that the DASH diet can reduce high blood pressure within two weeks. These are the daily guidelines of the DASH diet:

7 to 8 servings of grains 4 to 5 servings of vegetables 4 to 5 servings of fruit 2 to 3 servings of low-fat or non-fat dairy 2 or less servings of meat, fish, or poultry 2 to 3 servings of fats and oils 4 to 5 servings per week of nuts, seeds, and dry beans Less than 5 servings a week of sweets

Serving Sizes 1/2 cup cooked rice or pasta 1 slice bread 1 cup raw vegetables or fruit 1/2 cup cooked vegetables or fruit 8 oz. of milk 1 teaspoon olive oil 3 ounces cooked meat 3 ounces tofu A related diet called the DASH-Sodium reduces sodium to 1,500 mg a day, which is approximately equal to 2/3 teaspoon from all sources (processed and canned foods contain hidden salt). Patients following the DASH-Sodium diet had a significant reduction in high blood pressure. More: The Salt Wars: Is Salt Restriction Necessary?

Part # D: How Vitamins and Minerals can help? Calcium, Magnesium, and Potassium Calcium. Calcium supplementation appears to have a modest but statistically significiant reduction in systolic blood pressure (mean difference of 2.5 mm Hg), however better quality studies are needed. Learn more about getting enough calcium in your diet. Potassium. A meta-analysis of five trials indicated that potassium supplementation compared to a control resulted in a large but statistically non-significant reduction in systolic blood pressure (mean difference 11.2 mm Hg) and diastolic blood pressure (5.0 mm hg). Learn about potassium in the diet and find out which foods have potassium. Magnesium. In 12 randomized controlled trials, participants receiving magnesium supplements did not have a significantly reduction in systolic blood pressure, but they did have a statistically signicantly reduction in diastolic blood pressure (mean difference 2.2 mm Hg). Read more about magnesium in the diet. Mind-Body Interventions Mind-body interventions, particularly autogenic training, biofeedback, and yoga, have been found to modestly reduce high blood pressure compared with placebo. Autogenic Training Autogenic training is a technique used for stress reduction and relaxation. It involves a series of sessions in which people learn how to control breathing, blood pressure, heart rate, and body temperature. People learn six exercises that each involve a certain posture (e.g reclining in a chair), concentration without a goal, imagination, and verbal cues. Each exercise is learned by watching a teacher demonstrate it or by reading a description. It requires regular practice. Biofeedback Biofeedback is a technique in which people learn how to gain control over internal body processes that normally occur involuntarily, such as blood pressure, heart rate, muscle tension, and skin temperature. Biofeedback is primarily used for high blood pressure, migraine, tension headache, chronic pain, and urinary incontinence. Of the different types of biofeedback, thermal feedback (which measures skin temperature) and electrodermal activity feedback (which uses a probe that responds to sweat) may be more effective than direct blood pressure feedback or electromyography (EMG), which measures muscle tension. Learn more about biofeedback. Yoga Preliminary studies have found that yoga may lower blood pressure. Go to the yoga resources page.

Aerobic Exercise Aerobic exercise is an important part of the natural approach to lower high blood pressure. A meta-analysis of 105 trials involving a total of 6805 participants found that aerobic exercise was associated with a mean reduction in systolic blood pressure of 4.6 mm Hg, with corresponding reductions in diastolic blood pressure. People with high blood pressure should speak with their doctor first before embarking on a new exercise program. Learn about the effect of exercise on blood pressure and the heart. Ayurvedic Medicine In Ayurveda, the traditional medicine of India, high blood pressure is treated according to each persons dosha, or constitutional type. The pitta type may have a flushed face, red eyes, headaches, light sensitivity, irritability, and nosebleeds. The kapha type may have excess weight, water retention, high cholesterol, sluggishness. The vata type may feel cold, have gas, bloating, or constipation, insomnia, or nervousness, worry, or anxiety.

Traditional Chinese Medicine In traditional Chinese medicine, high blood pressure is often attributed to a problem with the circulation of vital energy (qi) in the body. Chinese medicine practitioners believe that depression, anger, obesity, and high intake of fatty foods are some of the causative factors. A combination of acupuncture and herbs is often recommended. Foods thought to have medicinal properties that may help high blood pressure include water chestnut, turnip, honey, Chinese celery, hawthorn berries, and mung beans. Emotions also play a role in our health. Learn about emotions in traditional Chinese medicine.

Do Vitamin Mineral Supplements such as Potassium, Calcium or Magnesium Help Lower Blood Pressure? So far, research has shown that potassium does lower blood pressure. Studies have not indicated that calcium and magnesium supplements prevent high blood pressure. Here's the latest:

Potassium helps to prevent and control high blood pressure. Be sure to get enough potassium in the foods you eat. Some good sources are various fruits, vegetables, dairy foods, and fish. Foods High in Potassium Food Apricots, dried Avocados, raw Bananas, raw Beets, cooked Brussel sprouts, cooked Cantaloupe Dates, dry Figs, dry Kiwi fruit, raw Lima beans Melons, honeydew Milk, fat free or skim Nectarines Orange juice Oranges Pears (fresh) Peanuts dry roasted, without salt Potatoes, baked, flesh and skin Prune juice Prunes, dried Serving Size 10 halves 1 ounce 1 cup 1 cup 1 cup 1 cup 5 dates 2 figs 1 medium 1 cup 1 cup 1 cup 1 nectarine 1 cup 1 orange 1 pear 1 ounce 1 potato 1 cup 1 cup Potassium (mg) 407 180 594 519 504 494 271 271 252 955 461 407 288 496 237 208 187 1081 707 828

Raisins Spinach, cooked Tomato products, canned, sauce Winter squash Yogurt plain, skim milk

1 cup 1 cup 1 cup 1 cup 8 ounces

1089 839 909 896 579

Values were obtained from the USDA Nutrient Database for Standard References, Release 15 for Potassium, K (mg) content of selected foods per common measure. http://www.nal.usda.gov/fnic/foodcomp/Data/SR15/wtrank/wt_rank.html

Calcium and Magnesium. These nutrients have not been consistently shown to prevent high blood pressure, but are important nutrients for overall good health. Good sources of calcium are dairy foods such as milk, yogurt, and cheese. Be sure to choose skim or lowfat varieties. Lowfat and nonfat dairy products have more calcium than the high fat versions. Foods High in Calcium Food Broccoli, raw Cheese, cheddar Milk, fat free or skim Perch Salmon Sardine Spinach, cooked Turnip greens, cooked Tofu, soft Yogurt plain, skim milk Serving Size 1 cup 1 oz 1 cup 3 oz 3 oz 3 oz 1 cup 1 cup 1 piece 8 oz container Calcium (mg) 42 204 301 116 181 325 245 197 133 452

Values were obtained from the USDA Nutrient Database for Standard References, Release 15 for Calcium, Ca (mg) content of selected foods per common measure. http://www.nal.usda.gov/fnic/foodcomp/Data/SR15/wtrank/wt_rank.html

You should get enough magnesium if you follow a healthy diet. Magnesium is found in whole grains, green leafy vegetables, nuts, and dry peas and beans Foods High in Magnesium Food Beans, black Broccoli, raw Halibut Nuts, peanuts Okra, frozen Oysters Plantain, raw Rockfish Scallop Seeds, pumpkin and squash Soy milk Spinach, cooked Tofu Whole grain cereal, ready-to-eat Whole grain cereal, cooked Whole wheat bread Serving Size 1 cup 1 cup fillet 1 oz 1 cup 3 oz 1 medium 1 fillet 6 large 1 oz (142 seeds) 1 cup 1 cup block cup 1 cup 1 slice Magnesium (mg) 120 22 170 64 94 49 66 51 55 151 47 157 37 24 56 24

Values were obtained from the USDA Nutrient Database for Standard References, Release 15 for Magnesium, Mg (mg) content of selected foods per common measure. http://www.nal.usda.gov/fnic/foodcomp/Data/SR15/wtrank/wt_rank.html

PART # E: How much minerals or vitamins you need everyday?

Recommended Daily Allowances for Adults (19 Years and Up) NUTRIENT Male 19-50 Yrs Male >50 Yrs Female 19-50 Yrs Female >50 Yrs

RDA Vitamins (Per Day) vitamin A - retinol 900 g 900 g 700 g 700 g vitamin C - ascorbic acid 90 mg 90 mg 75 mg 75 mg vitamin D #1 #5 5* g 10* g 5* g 10* g vitamin E 15 mg 15 mg 15 mg 15 mg vitamin K 120* g 120* g 90* g 90* g vitamin B1 - thiamin 1.2 mg 1.2 mg 1.1 mg 1.1 mg vitamin B2 - riboflavin 1.3 mg 1.3 mg 1.1 mg 1.1 mg vitamin B3 - niacin 16 mg 16 mg 14 mg 14 mg vitamin B5 - pantothenic acid 5* mg 5* mg 5* mg 5* mg vitamin B6 - pyridoxine 1.3 mg 1.7 mg 1.3 mg 1.5 mg vitamin B12 #2 2.4 g 2.4 g 2.4 g 2.4 g biotin 30* g 30* g 30* g 30* g choline 550* mg 550* mg 425* mg 425* mg folate - folic acid #3 400 g 400 g 400 g 400 g Recommended Daily Allowances for Minerals calcium 1000* mg 1200* mg 1000* mg 1200* mg chromium 35* g 30* g 25* g 20* g copper 900 g 900 g 900 g 900 g fluoride 4* mg 4* mg 3* mg 3* mg iodine 150 g 150 g 150 g 150 g iron 8 mg 8 mg 18 mg 8 mg magnesium #4 400/420 mg 420 mg 310/320 mg 320 mg manganese 2.3* mg 2.3* mg 1.8* mg 1.8* mg molybdenum 45 g 45 g 45 g 45 g phosphorus 700 mg 700 mg 700 mg 700 mg selenium 55 g 55 g 55 g 55 g zinc 11 mg 11 mg 8 mg 8 mg potassium 4.7* g 4.7* g 4.7* g 4.7* g sodium #5 1.5* g 1.3* g 1.5* g 1.3* g chloride #5 2.3* g 2.0* g 2.3* g 2.0* g

Legend 1 g = 1 mcg = 1 microgram = 1/1,000,000 of a gram 1 mg = 1 milligram = 1/1,000 of a gram 1 g = 1 gram #1 As cholecalciferol. 1 g cholecalciferol = 40 IU vitamin D.