Hypertension and our diet

By: Mir Neelofer Nazir

 Despite its prevalence, high blood pressure (also known as hypertension, or HTN) is a somewhat mystifying condition. It’s a serious symptom of cardiovascular dysfunction and can be the smoking gun behind strokes, heart attacks, kidney damage, vision loss, and more. However, in many cases, doctors and researchers find it difficult to isolate one culprit.

Age, stress, gender, weight, cholesterol, inactivity, and smoking can all contribute to blood pressure alterations. Inflammation is also considered a risk factor, particularly because chronic inflammation can drive development of fibrosis (excessive scar tissue) in the cardiovascular system and other areas, leading to hardening of arteries.

Because of the multitude of potential factors behind hypertension, many practitioners recommend an assortment of lifestyle interventions to help balance blood pressure and improve cardiovascular health. One lifestyle change might only make an incremental difference, so a number of concurrent changes are usually required for a positive impact.

Early Intervention can Control Hypertension

One of the biggest reasons hypertension can be so dangerous is it’s considered a silent disease. In fact, it’s one of the most under diagnosed conditions across gender, age, and race. The first and most crucial piece of advice is to get your blood pressure checked on a regular basis. Early detection and subsequent lifestyle interventions can prevent permanent damage caused by chronic HTN.

Blood pressure refers to the force of blood on our vascular system. It’s regulated by a complex web of interrelated hormonal and neurological feedback loops which influence blood vessel diameter, heart rate and contractility, blood volume, and other functions. Systolic pressure, the first (or top) number in the standard reading, describes blood pressure when the heart is beating. Diastolic pressure reads pressure between beats. A good reading is 120/80—any higher than that, and potentially dangerous pre-hypertension may have begun. High blood pressure starts around 140/90.

Vicious Cycles

Like so many other imbalances in the body, HTN is both a cause and an effect. Over time, higher blood pressure reduces blood vessel elasticity, which forces the heart to work harder. This added pumping action can lead to even higher blood pressure and less elasticity. If blood vessels incur too much damage, blood pressure can become difficult to control.

As is common in our culture, many people respond by taking prescription medications—most of which come with significant side effects. For some, these medications are a necessity. However, many people find they can reduce the problem with healthy lifestyle interventions including smoking cessation, weight loss, healthy diet, stress reduction, and exercise. In fact, there are quite a few alternative approaches that can help people lower their blood pressure and support their overall health in the process.

Food and Hypertension

There’s no question that food can both contribute to HTN and serve as the basis for a solution. Weight control is a big factor, as hypertension can be aggravated by carrying a large load. But it’s not only how much we eat. The types of foods on the menu can make a big difference—particularly those that relate to inflammation.

Clinicians have developed specific food guidelines to better control high blood pressure called the “dietary approaches to stop HTN” (DASH) diet. To follow the DASH diet, it is recommended that patients eat lots of fruits and vegetables, whole grains, lean proteins, nuts, and beans. There’s nothing revolutionary about this approach, and it could be recommended to most people regardless of their health status. Magnesium is often one of the leading minerals our bodies need to perform.  In addition, keep in mind that potassium is shown to help reduce blood pressure, and can be found in green leafy vegetables such as spinach and kale, as well as bananas, avocados, and other fresh foods.

The DASH diet is part addition and part subtraction. While we add healthy, nutrient-dense foods, we need to reduce the amount of sodium we eat. That’s not an easy road in this country. Most restaurant and processed foods are very high in sodium. If you’re eating something out of a can or a package, chances are you’re not doing anything to help your blood pressure. Avoid adding salt to your food, especially when dining out. Potassium salt alternatives are available and can help substitute for regular table salt. Inflammation is one of the underlying contributors to hypertension, so steer clear of pro-inflammatory foods like sugar and trans fats as well.

Sitting is one of the worst things we do to our bodies. Some have even called it “the new smoking.” A growing body of research shows that sitting for long periods increases risk for obesity and metabolic syndrome, a condition associated with HTN, elevated blood sugar, increased abdominal fat, and elevated cholesterol. One study found that adults who logged more than 4 hours per day in front of a screen as compared with less than 2 hours, had an almost 50 percent increase in death from all causes, and 125 percent increase in cardiovascular events such as heart attack. These are sobering statistics. We need to think creatively about designing our sedentary work and play to be healthier. We know that an active lifestyle is a great way to improve blood pressure. Thirty minutes of moderate activity can make a world of difference for your cardiovascular health.

Stress can also be a major contributor which can be relieved by physically active meditations such as yoga, Tai Chi, and Qi Gong. These ancient exercises calm the mind and are proven to reduce the neural and chemical stress signals that contribute to high blood pressure.

 New Research Identifies a Potential Treatment

Weight and inactivity may be visible causes of HTN, but there’s more happening on the molecular level. New research is providing better insights into how inflammation and other detrimental factors affect our blood vessels and increase our risk for high blood pressure.

A major culprit may be galectin-3, an inflammatory protein associated with heart disease, organ fibrosis, cancer, and a variety of other conditions. Elevated galectin-3 in the circulatory system is recognized as a contributing factor in vascular fibrosis (hardening of blood vessels), which leads to HTN. In 2011, the FDA approved a galectin-3 blood test to monitor cardiovascular disease.

Two recent studies illuminate how elevated levels of galectin-3 influence HTN. Published in the journal Hypertension, these studies add to the fast-growing body of research showing that high galectin-3 contributes to inflammation, vascular fibrosis, and heart damage.

This research also explores the benefits of a natural treatment for blocking the pro-inflammatory effects of galectin-3: modified citrus pectin (MCP). Developed from citrus peels and modified for enhanced absorption and bioactivity, MCP has a natural affinity for galectin-3, binding to the protein and inactivating it. In both studies, MCP reduced cardiac inflammation and fibrosis associated with galectin-3.

MCP has no known side effects. But perhaps its biggest asset is that it goes after some of HTN’s root causes, rather than simply ameliorating symptoms.

HTN is a serious and potentially fatal condition, and there is no magic bullet to fix it. The best approach is to monitor blood pressure levels on a regular basis and intervene early on in the process. Be sure to consult with your primary care doctor, who can help support your efforts to control HTN with solutions that are right for you.

Aim for a healthy weight, supplement wisely, eliminate processed foods and other pro-inflammatory items from your diet, emphasize fresh fruits and vegetables, reduce stress, and move your body regularly. Keep in mind that each of these steps can work to support healthy blood pressure; together they can form a synergistic program to help optimize cardiovascular and overall health.

 (Author is  PG scholar Dietics, Tutor/Technologist Kidney Hospital Srinagar)

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