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Prevention of High Blood Pressure. Do Not Let This Happen to You. Actual Patient Cases of High Blood Pressure from the Hypertension Institute
Joe was a 43-year-old black male contractor who was diagnosed with hypertension at the age of 21. Joe was married and had two children in high school. He stopped taking all of his blood pressure medicines over 10 years ago due to side effects of fatigue, depression, and impotence. He loved his coffee and drank six large cups a day and then wound down after work with three to four ice cold beers. He went to work early one Monday morning, but about 2 hours later he started to have a severe headache followed by weakness in his right arm and leg and inability to speak. He was rushed to the hospital where he was diagnosed with severe hypertension and a stroke. Later that day, he went into a coma and died 24 hours later.
Maria is a 46-year-old married Hispanic female and a mother of four children. She has had hypertension for over 20 years. She has a lot of stress in her life taking her kids to school and various sporting activities. She says that she does not have any time for herself. She takes all three of her blood pressure medications almost every day but is overweight, does not exercise, and eats fast food with lots of sodium, high calories and she loves her sweets. She went to her doctor last week complaining of shortness of breath and some left-sided chest pain. He did an electrocardiogram and examined her and said everything looked good except her blood pressure was elevated. He added a fourth blood pressure medication and told her that she was just stressed. He then gave her another prescription for her stress and told her to get some rest and not to worry so much.
The next morning, she woke up with severe chest pain, shortness of breath, and heavy sweating. She called an ambulance. When the ambulance arrived at her home, she had a cardiac arrest and her heart stopped beating. She had CPR (cardiopulmonary resuscitation) by the ambulance team. At the hospital, she was revived and diagnosed with a massive heart attack.
Robert is a 62-year-old married white male who is relaxing in his big easy chair at the kidney dialysis unit. He has had kidney failure for 10 years due to uncontrolled hypertension and is on the dialysis machine 3–4 days a week. He had to go on disability and does not work now. He was the owner of a small grocery store. He can no longer play golf with his buddies which he loved so much. He misses most of his grandchildren's school and sporting events because he is too tired or has to be on the kidney dialysis machine.
Betty is a 58-year-old divorced white female who lives alone. She has one daughter who takes care of her. She has had hypertension since the age of 26 but refused to take her blood pressure medications because they made her “feel bad.” She stays at home most of the time since she was diagnosed with end-stage congestive heart failure. She cannot walk more than 5 minutes without getting very short of breath. Her legs are swollen. She is on oxygen 24 hours a day. Her doctor has her on six medications and a very strict low-sodium diet. At night she has to sleep in a recliner since she cannot lie flat in her own bed because she cannot breathe. She is on the heart transplant list.
Mike was a healthy 42-year-old white male attorney, married, and father of three children. His mother and father both had hypertension, and they died when he was very young. He played football and basketball in high school and college and had a very good law practice. He ran every day, was not overweight, and felt great. He has not been to a physician for a physical exam since he was 22. On Saturday, he went out for his daily run. He was found dead in the park. His autopsy showed that he died from a ruptured thoracic aneurysm (the large artery that comes out of the heart in his chest burst). The pathologist noted that all of his arteries were severely damaged from chronic uncontrolled severe hypertension.
All of these people had one thing in common – hypertension. None of them should have died or had any of the complications. Many patients have no idea that something is not right until the damage is done. Even small increases in blood pressure will increase your risk for a cardiovascular event. For every mm Hg increase in your blood pressure, your risk for a heart attack, a stroke, or kidney disease increases. Even a small increase in blood pressure to 140/90 mm Hg will decrease your life by 10 years! Joe should have avoided the stroke and death. Maria should not have had a heart attack, Robert could have saved his kidneys, Betty would not be on the cardiac transplant list, and Mike would not have died from an artery that burst in his chest. If each of them had gone to their doctor for regular blood pressure checks and started the program to lower their blood pressure that we will describe in this book, they would not have suffered these cardiovascular events or died.
There are many things that you can start doing immediately to prevent high blood pressure, delay its onset, or reduce its severity. These will be discussed in detail in this book, but here is the list:
Maintain an ideal body weight, body fat, and visceral or belly fat for your gender and age.
Exercise at least 4 days per week for 1 hour each day with both aerobic and resistance training.
Get at least 8 hours of restful sleep per night.
Reduce dietary sodium chloride (table salt or NaCl) to less than 2000 mg (2 g) per day.
Increase potassium in your diet to at least 5000 mg/day (5 g).
Increase magnesium in your diet to at least 1000 mg/day (1 g).
Consume at least six servings of vegetables and six servings of fruit per day.
Reduce stress, meditate, and lower anxiety and relax.
Stop all tobacco products.
Reduce or stop alcohol.
Stop all sources of caffeine if you metabolize it slowly.
Consume specific types of foods and nutritional supplements that can prevent high blood pressure.
In the next chapter, we will start your journey on how to control your blood pressure, reduce all of these cardiovascular and kidney diseases, improve your life, and how long you live. We will start with a summary of the Hypertension Institute program to lower your blood pressure.
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The Hypertension Institute Program to Lower Your Blood Pressure
Summary
Maintaining control of your blood pressure is a lifetime commitment. It requires that you follow all of the suggestions in this book to achieve the optimal goals for blood pressure levels and cardiovascular disease reduction. Some patients are tempted to only do part of the program or only do it for only a short period of time. You must make this commitment to keep yourself healthy and have a normal life expectancy. The goals are as follows: (1–5)
Lower the blood pressure to normal (120/80 mm Hg).
Improve both the function and structure of the arteries. This means improvement in endothelial function, increase in nitric oxide levels, increased elasticity of the arteries, dilation of the arteries, decrease thickness of the arteries and heart muscle, and reduction in inflammation, oxidative stress, and vascular immune dysfunction.
Reduce all cardiovascular events such as coronary heart disease, heart attack, heart failure, kidney disease, and large arterial disease.
It has been well established in numerous clinical blood pressure trials that certain blood pressure medications may lower the blood pressure, but they are not effective in improving the function and structure of the arteries or the heart, and they do not optimally reduce cardiovascular events compared to other blood pressure medications, especially coronary heart disease and heart attack. Specially, the diuretic, hydrochlorothiazide, and many older beta blockers such as atenolol are inferior to other drugs called angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, and calcium channel blockers. (1–4) We will discuss these concepts and the blood pressure medications later in the book.
2.1 HERE IS A SUMMARY OF THE HYPERTENSION INSTITUTE PROGRAM
Determine the blood pressure level and other important measurements using a 24-hour ambulatory blood pressure monitor (24-hour ABPM) in conjunction with regular office blood pressures and home blood pressure readings.
Measure your blood micronutrient and macronutrient status and optimally replace all of those deficiencies with proper nutrition and supplements, antioxidants, and minerals.
Measure blood tests that determine the type of hypertension that is present. The two forms are called high-renin hypertension and low-renin hypertension. The blood tests include a plasma renin activity or PRA (a hormone that controls blood pressure and aldosterone), a hormone that controls blood pressure and blood volume. This will be discussed in detail later in this book.
Measure the genetics that determine your blood pressure and risk for coronary heart disease, heart attack, blood pressure, diabetes mellitus, cholesterol, and other blood fats.
Assess the presence and severity of the artery damage, artery elasticity and stiffness, endothelial function, nitric oxide levels, heart function and stiffness, heart size (enlargement), risk for coronary heart disease, coronary artery calcification, rest and exercise blood pressure, heart rate and its variability, the function of your nervous system and how it relates to blood pressure, and your overall cardiovascular risk with various noninvasive cardiovascular testing.
Exclude all of the secondary causes of hypertension.
Assess all of the new and emerging blood and urine tests that are called cardiovascular risk factors in addition to the usual measured risk factors such as blood fats and cholesterol, blood sugar (diabetes mellitus), homocysteine, and inflammation markers.
Properly measure obesity, total and regional body fat with a special machine called body impedance analysis. Maintain your ide...
