Heart Health and High Blood Pressure

We had a couple of strokes this week one famous and one closer to home, with high blood pressure being a key factor in increased and rapid risk learn how you can moderate this easily without having to resort to medication.

Is salt really the bad boy? Or is it simply lack of potassium? Read on for for simple tips and tricks to stay healthy

The heart muscle pumps roughly 5 litres of blood around the body each minute. It’s health relies of the presence of many nutrients including Co Q 10, taurine and magnesium. How hard it has to work is highly dependent on the level of pressure in the cardiovascular system or blood pressure. Blood pressure is sometimes called the silent killer.

Blood Pressure – the silent killer

The cardiovascular system is the system of supplying blood to the body, brain and tissues. A network of veins, arteries, capillaries and blood vessels powered by the heart the hardest working organ in the human body. Obviously is a closed system, leaks through injury can lead to death through loss of blood. As any closed system it has to maintain a degree of pressure to function properly. The blood pressure is a measure of the combined pressure of all the bodies tissues against the cardiovascular system. Sodium intake is the most common nutrient associated with regulating blood pressure.

We all know salt is bad for you right? With salt reduction and labelling everywhere. However whether salt will trigger rises in blood pressure is a highly individual genetically based pattern with around 50% of people (depending on what you read) not being high responders to sodium intake. As is the way with these things you can either test your genes (recommended) or see how your blood pressure responds to a lower sodium intake over a 4 week period. Genetics of sodium intake and high blood pressure can be read about here, it’s simple enough though to order a genetic test through 23andme.com and then use an online engine to analyse this such as Promethease.

Find out if you are a high responder to excess sodium intake and adjust your intake as necessary. If you sweat a lot a moderate salt intake is required, both a very high and very low salt intake are associated with adverse health outcomes. There are plenty of other habits you can adopt to help with moderating blood pressure which have nothing at all to do with sodium intake. If you are a high responder then keeping your salt intake to a sensible level is a good idea. Around 3-6g of actual salt depending on exercise levels each day should suffice. Overall balancing potassium with sodium appears to be as important as total sodium intake.

If you have high blood pressure you can start by adopting some of these habits below. If you do not know what your blood pressure is it’s worth getting a monitor and checking this at home. Checking for a few days in the morning and a couple of times throughout the day gives a much more accurate picture than popping to the Dr’s as you can get a false high reading and ‘white coat’ syndrome which pushes up your blood pressure.

QUICK FIXES

• Increase all sources of potassium and nitrate rich foods = eat your veggies!
• Exercise
• Cut down on excess booze
• Stop smoking
• Stretch or do yoga or do both
• Eat more magnesium or supplement with magnesium
• Take No2 boosting supplements and foods including nitrates and citrulline / arginine
• Lower sugar intake and insulin production
• Practice fasting and increase AMPK (read more about this molecule in another article shortly)
• Lose weight if you are fat, over-weight or obese
• Chill out and meditate
• Sleep more
• Go in the sauna
• Take fish oils and eat more oily fish
• Lower inflammation
• Lower oxidative stress

If you take hardly any sodium at all – take a little bit, some cases of very low sodium intake actually increase blood pressure… and can be bad for you.

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All of these have been shown to directly or indirectly help with lowering blood pressure a moderate amount. Combining a few of these tips or all of them can have an additive effect.
 
WANT MORE DETAIL? WHAT IS BLOOD PRESSURE AND HOW DOES IT WORK?
 
So if you imagine your bodies like a house with a central heating system, but one which moves around like a mobile home! The boiler (heart) keeps the blood (water) pumping around the pipes, arteries and veins, and the radiators could be thought of as organs or vessels, fed through capillaries even, each needs to be filled up and kept warm (oxygenated) by the constant flow of water…. If the system is full of water the pressure can be maintained better.
 
Blood vessels can open up to allow more blood to flow this is called vasodilation. They can also close down which is called vasoconstriction. For lowering blood pressure we are obviously interested in vasodilation. Exercise is one of the easiest ways to cause vasodilation. The system needs to expand and contract depending on the amount of blood required to do its job of bringing oxygen to all the working tissues and removing waste products and carbon dioxide…..
 
The system needs pressure to function. Too little and you can’t get the blood around properly. Too much and the system breaks down faster with more likelihood of furring of the pipes (calcification) and things bursting (stroke).
 
The blood pressure is measured through 2 numbers. Systolic and diastolic. The 1^stnumber is when the heart pumps the blood around the body and the 2^ndnumber is when the heart is filling back up with blood. When you get your blood pressure measured it can often be raised through ‘white coat syndrome’ e.g. you get stressed about the test. Measuring frequently across a week at different times is certainly the best way to assess how your overall blood pressure health lies. In general a blood pressure between 90/60 and 120/80 is considered optimal. With a level between 120/80 and 140/90 considered borderline high blood pressure and above this as high blood pressure.
 

• The cardiovascular system comprises of a pump and network of veins, arteries, capillaries and vessels
• It’s a closed system and is regulated by the pump and pressure 
• Blood pressure is a combination of blood volume verses the combined resistance of all tissues in relation to blood flow and heart rate
• Fluid balance within the body and the blood influences blood pressure
• The resistance and stiffness of the tissues also influences blood pressure
• Blood stickiness and viscosity may influence blood pressure
• Stress temporarily increases blood pressure and restricts blood vessels
• When blood vessels open up this thereby reduces the pressure on the system – there’s more room for the blood
• A raised blood pressure maybe associated with increase all-cause mortality
• Relaxed and flexible body tissue including muscle will reduce blood pressure

 
Remembering it’s the combined pressure of all the tissues on this system and the stiffness of the system itself which can both lead to higher levels of blood pressure. So if you have a lot of body mass and that mass is stiff and rigid this may contribute to higher blood pressure. Tissue stiffness is associated with increased blood pressure with even simple shorter term stretching programmes showing a reduction in blood pressure in as little as 4 weeks.
 
Increased blood volume is one of the quickest ways to increase blood pressure. Although keeping well hydrated wouldn’t necessarily increase blood pressure. Hydration is necessary when we exercise. It also occurs with higher levels of nutrients being carried in the blood such as glucose and sodium with increased fluids. This will also occur in a sauna where the heat will increase blood volume. This may also help with overall performance a higher blood volume means the heart pumps less to deliver the same nutrients to the cells.
 
Remember that all increases in blood volume through exercise and heat ultimately help with lower blood pressure overall in the period of recovery between these stressors. Overall you are better off training and getting hot for good blood pressure control. Due to the lower levels of blood pressure following these types of activity. 
 
Whatever your mass making sure your mass surrounding your cardiovascular system is pliable and flexible is a good idea for performance and also for blood pressure management.
 
Because we are generally talking about the pressure from tissues on the system, fluid and electrolyte balance play a big part in the picture. For example blood volume will increase cardiac blood output and hence increased blood pressure. The fluid balance in the body is regulated by the kidneys which rely on electrolytes to help control this.
 
Specifically potassium is required to balance sodium levels. In general sodium increases fluid retention in the body and potassium helps fluid balance and removal of excess fluids from the blood into the bladder. This careful balance between potassium and sodium needs to be regulated also because is controls fluid balance inside and outside the cell and in turn regulates nerve impulses. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3362178/
 
An increase in fluid outside the cell may also increase blood pressure. Normally sodium increases extracellular fluids, fluid outside the cell and potassium increases intracellular fluid inside the cell.  This partly accounts for sodium consumptions margin role in increasing blood pressure. This also accounts for the remarkable effect potassium from vegetables and fruits has on normalising blood pressure.
 
Overall it appears on balance that simply increasing potassium rich vegetables has a better effect on regulating blood pressure than drastically cutting sodium levels. Indeed vegetable consumption around 7 servings day is one of the best predictors of lowering all cause mortality – perhaps in part due to its positive effect on normalising blood pressure.
 
As well as general tissue stiffness and pressure from fluid balance, the system itself can also increase pressure through arterial stiffness. We will discuss this more below.
 
Nitric Oxide is a gas produced by the body which tells the blood vessels to dilate. This in turn naturally lowers blood pressure. Nitrate from vegetables are part of the process by which the body can make more nitric oxide, this in part relies on beneficial bacteria in the mouth!
The body can make nitric oxide from other nutrients such as arginine through a different pathway. Yep – your mum was right, eat your veggies!
 
Oh and take your NO2 pre-cursors too….These ones will also help with exercise capacity and lowering blood pressure.
 
How homocysteine ties in with all this is interesting. Again another topic for more in depth discussion in another article, however measuring homocysteine and making sure you take steps to regulate this potentially damaging molecule is important if the levels are too high. This normally involves taking some b-vitamins, betaine, cysteine and so on as you can see in the diagram below. Excessive homocysteine levels are implicated in early onset cardiovascular disease probably in part due to the role this plays in increased arterial stiffness and arterial calcification. 
 
If in doubt take a good b-vitamin complex or quality multi vitaminto ensure the homocysteine pathway is well oiled.
 
Exercise stimulates blood flow and vasodilation as well as helping prevent arterial stiffness. Vessels and capillary systems remain more vibrant and youthful with regular stimulation. It’s important to remember the positive effects exercise has on blood pressure are normally after the session as during exercise blood pressure will often increase to supply tissues or as part of the rigours of the exercise itself. Interval training often appears to be the most effective form of exercise for reducing blood pressure although of course all forms of exercise will help.
 
All exercise is good, interval training appears to be best.
 
Stiffness and pliability of all cells is regulated by fatty acid balance within the cell wall structure. The collagen matrix and degree of calcification is also a major player in cell wall pliability and arterial stiffness. Regulating calcification and keeping calcium in the right areas of the body is another topic for another time. For the purposes of blood pressure understanding the role other nutrients play in calcium metabolism is important to avoid excessive calcification in soft tissues like the endothelium. Vitamin D levels help regulate blood pressure indirectly. Vitamin K levels are required to prevent calcification of soft tissues. Magnesium regulates calcium metabolism and also has a direct effect on relaxing smooth muscle and lowering blood pressure. Interestingly garlic possesses various heart healthy properties one of which is helping stop aortic stiffness. It’s best consumed raw for these benefits and it helps if you crush it and wait 10 minutes before consuming it.
 
Ensuring adequate levels of vitamin D and cofactors to protect against calcification.
 
The collagen matrix is susceptible to faulty cross linkage and sugar damage. Advanced glycation end products (AGE’s) contribute to this effect.  Protecting against glycation and cross linkage is also an important part of anti-aging strategies and keeping blood pressure regulated. Lowering sugar intake is associated with lowering blood pressure. There is a link between insulin production and higher blood pressure.
 
The simplest way to protect against excessive glycation is to eat less sugar and foods which contain high levels of AGE’s you can see a list in the inflammation chapter, but anything highly heated which caramelises or burns can contribute to forming AGE’s and also will increase oxidative burden.
 
SUMMARY
 
Circulatory supporting nutrients are obviously essential to a health cardiovascular system. A blockage in the system or heart itself leads to a heart attack or stroke. Stiff vessels or arterial stiffness is another risk factors for heart disease, the heart itself can also become stiff. The overall process of the stiffening of vessels and the arterial system needs to be avoided and is associated with calcification. Keeping cells and vessels fluid and flexible is the key here. There are many nutrients which help with healthy circulatory system, omega 3 fat, full complement of b-vitamins, especially folate, B12 and B6.
 
Calcification can be avoided by following optimum bone building protocols and nutrients which keep the calcium in the bones and away from the soft tissues. 
 
Generally heart healthy practices and nutrients are also very healthy for the brain and preventing dementia and Alzheimer’s. You can get vascular dementia which is a furring up of vessels and the blood supply to the brain. Atherosclerosis is a furring up of the arteries and is essentially calcification of the inner wall of the artery. It is possible to get a stiffening of the vessels themselves also called arterial stiffness which is an independent risk factor for heart disease and cardiovascular events.
 
Some key factors which speed up the calcification process include:

• Inflammation including low EPA and DHA intake and poor n-3/n-6 ratio
• Processes and lack of nutrients which accelerate calcification
• Homocysteine – take care of methylation pathways 
• Oxidation of low density lipoproteins (LDL and VLDL)
• Oxidation in general
• Thick blood, thick from excess fat and clotting factors like fibrinogen
• Low NO2
• Stress
• High Blood pressure 
• Low testosterone levels
• Progression of metabolic syndrome

What else we can do to keep the heart and vascular system healthy?

• Exercise – stressing this system is the best way to keep it functioning in a healthy manner
• Aim for 10-12 servings of vegetables and fruit each day 9-11 veggies and 1-3 fruits.
• Eat at least 2 servings of wild oily fish each week, ideally up to 4 servings – if you don’t like fish or don’t eat that many servings take a clean fish oil
• Eat the rainbow and all the spices.
• Eat garlic.
• Make sure you take a good multi to cover your b-vitamin requirements.
• Use NO2 booster like beetroot juice, citrulline and vinitroplus
• Take time to destress and manage your stress levels
• Monitor blood pressure and take steps to keep this in check
• Follow all testosterone boosting protocols
• Use additional magnesium, taurine and Co Q 10 as part of your supplementation protocol

Salicylates are natural chemicals in food which help thin the blood. The strongest source of these naturally occurring is white willow from which aspirin is formed.

• Herbs and spices high in salicylates include: 
• Curry powder 
• Cayenne pepper 
• Ginger 
• Paprika 
• Thyme 
• Cinnamon 
• Dill 
• Oregano 
• Turmeric 
• Licorice 
• Peppermint
• Tree Ear 
• Jicama 
• Garlic 
• Onions 
• Olive Oil 
• Fruits high in salicylates include
• Raisins 
• Prunes 
• Cherries 
• Cranberries
• Blueberries
• Grapes 
• Strawberries
• Tangerines
• Oranges 
• Other substance high in salicylates: 
• Chewing gum – yep! Probably the peppermint
• Honey 
• Peppermints
• Vinegar 
• Wine (obviously in moderation)
• Cider (same)
• FISH OILS
• VITAMIN D