Blood Pressure and Diet

[weinoo]

For about the last 10 years, I've been on blood pressure medication. My blood pressure has never been exorbitant, more pre-hypertensive than hypertensive, but those standards are always changing anyway. And of course, big pharm wants to sell meds, so. And no, don't go off on a rant about big pharm, please.

In any event, my bp problems probably are genetic, as both parents were hypertensive, though they lived good, long lives (and both had non-fatal heart attacks, as a matter of fact). The drug I started with is atenolol (tenormin), a fairly benign beta blocker which has been around for a long time (almost 40 years). Five or so years after starting atenolol, my bp crept up a bit, and my doctor recommended adding another med, this time Benicar (olmesartan), an angiotensin 2 receptor antagonist. All well and good - the 2 drugs together have worked to keep my bp below the threshold of hypertension for the last 5 years. Much of the literature I've read also says that often multiple drugs are needed to keep bp in check.

OK - fast forward to recently, and bp creeping up once again. And guess what - a new drug, a diuretic prescribed as an every-other day med, with my doc stating that if it works well, then sometimes all it takes is to take it 1 day a week. Also, as a well-known self-prescriber, I actually don't take the Benicar on the day that I take the diuretic. And my bp is as low as it's been in 20 years. Cool, right?

But now I'm thinking that all these medications annoy me and maybe I should really try to work on my diet and perhaps wean myself off of a drug or two. I'm not overweight (hey, who couldn't stand to lose 10 pounds, right?) and I (try to) exercise fairly regularly - living in NYC, of course, means a lot more walking than your average person does in the U.S.

But - I love salumi, I love pizza, I love Asian food, I love everything salty, I love chips, I love candy, I love ice cream, yada yada yada.

So - my question to any and all that might have high bp - have you tried dietary mods? If so, have they worked? I mean, literally, what was your bp before and after dietary mods? And I'm not talking about insane dietary mods, like in the documentary Forks Over Knives, because even though I think that would help immensely, I'm not about to start eating alfalfa sprouts and mashed yeast every freakin' day. I need my mortadella once in a while!

[Okanagancook]

You might find this interesting: http://en.wikipedia.org/wiki/DASH_diet

[weinoo]

Oh yes, I know all about the DASH diet. I just want to hear some evidence, if there is any, from the posters here.

[gfweb]

Reasonable diet modifications eg low salt and making sure you have enough potassium can help mild hypertension and might even get you off a med, but it is asking a lot of diet alone to correct bad genes. You probably won't get off all meds.

The issue of what constitutes worrisome hypertension is a great question. Is 135/90 worth treating or is the added risk from that BP trivial? Some of that calculation has to include your age, family history of vascular disease, your glucose and cholesterol. I'd take it up with your doc.

[Darienne]

It would be nice to have a doctor with whom one could take up anything of a dietary or exercise nature. I wish.

OK. Weinoo's post could not have been more timely for me. Just very recently I gave up my now 6-year passion making chocolates and other confections. Loved it. But it didn't fit into the new high...and I do mean high, very high...BP problem. Am now on two drugs, Mavik and Amlodipine. (Must check those names against the ones mentioned by Weinoo. Canadian and American names for the same drug often don't match.) And must read the rest of the article cited by Okanagancook. Mind you, it's pretty much the way we eat and have eaten for decades.)

I know nothing of my Mother's heart. She lived till 97, demented for the last 10 years after lots of TIAs. My Father had high cholesterol...and so is mine...and no, I don't take Statins. He lived to 83, after a mild heart attack at 60, changed his life radically to basically the life DH and I have always led, and died of a non-heart-related problem. He could have lived much longer. I have no idea of whether he took statins or not. So where do I stand?

And what on earth should I eat? We don't eat commercially prepared food...never have...and don't eat out much either. And now practically never. And yes, I could lose 20 pounds in my case. And the BP meds are not controlling my blood pressure very well. It's between 180/70-80 and 135/70-80. Diastolic never goes above 80.

OK. Someone tell me what to change in my diet, besides giving up sugar completely. Thank you.

I might have added that I have an excellent BP machine at home and take it a few times a day.

Edited September 14, 2013 by Darienne (log)

[annabelle]

Definitely: see your doctor. He's there to help you, not to try to hasten your demise.

Folk remedy-wise: don't eat black licorice, quit drinking alcohol and lose weight if you're heavy.

[weinoo]

Reasonable diet modifications eg low salt and making sure you have enough potassium can help mild hypertension and might even get you off a med, but it is asking a lot of diet alone to correct bad genes. You probably won't get off all meds.

The issue of what constitutes worrisome hypertension is a great question. Is 135/90 worth treating or is the added risk from that BP trivial? Some of that calculation has to include your age, family history of vascular disease, your glucose and cholesterol. I'd take it up with your doc.

Fortunately, I have a cardiologist who takes a lot of time with each patient (my GP, not so much). But you raise a good point, and we have discussed it - there are many risk factors in heart disease. And also fortunately, both my glucose and cholesterol are fine at this point.

I've given up real licorice, because I believe that's more than folk stuff. Giving up alcohol - that's a whole other story.

[annabelle]

The licorice thing is true and not just folklore, for sure. Alcohol-wise, cut back to two or one and not daily.

And the ever popular quit smoking. I refuse to do this one.

[rotuts]

if what your have is "essential hypertension" then by all means loose weight, and start exercise by walking.

drop the exogenous salt that others add to your food.

then see what happens. you will have to ask your cardiologist about KCl for table use.

Do Not Take It w/o Medical Approval.

thats what Im doing and so far so good.

essential hypertension has been well studied and its damage is insidiuous.

Edited September 14, 2013 by rotuts (log)

[Darienne]

Not sure to whom the various advices are given. I'll assume they are directed at me.

- see my doctor. I have have him and a heart specialist. Not all doctors are equal. And we do eat simply and well.

- yes, by all means, lose 20 pounds (and keep it off)

- we do walk around the perimeter of the farm twice a day with the dogs. I can't always do two. Nothing to do with my heart. I'll go back to my actives when I am able.

- don't eat licorice. Have no more than 2 drinks per WEEK. Don't smoke and never have.

- my blood potassium is too high

- my glucose is fine and so is my homocystein

- the jury is still out about statins and my cholesterol levels are apparently genetic according to my GP

- there are no others who salt my food.

Thanks for all the advice.

One of my best friends laughed at me once. His cholesterol was now under control and mine wasn't, not even on maximum dosage of a statin. In fact, I had to go off the statin because of rampant side effects. He was slim, played squash three times a week, etc, etc. Unfortunately he was also dead of a massive heart attack two days later. He was 56 then.

Edited September 14, 2013 by Darienne (log)

[quiet1]

There was something recently about how actually going too low in sodium intake is apparently as problematic or worse than a diet a little high in sodium. My dad was telling me about it, I'll see if he can find a reference. My general takeaway from it after talking to him was basically that eating a lot of high-sodium processed food is probably not good for you, but skipping salt as seasoning on home cooked foods isn't necessary.

(I have hereditary high BP also, thanks mom.)

[annabelle]

Eliminating salts from your diet is potentially deadly, quiet1. Salts and potassium work in tandem in the ion exchange that removes wastes from the blood and keeps us oxygenated.

Darienne, if you are showing too much potassium in your blood, eliminate bananas and other high potassium foods and supplements and then retest. You eat a lot of fruits and vegetables so you may not need a supplement at all.

Beware the peddlers of "natural" medicines, in particular homeopathic medicines. People love to sneer at Big Pharma, yet will embrace Big Witchdoctor.

For more information on these topics try quackwatch.org.

[GlorifiedRice]

If you are a female past 40 check into Bioidentical Hormone Replacement Therapy, balance your hormones, lower your bp.

If you eat something salty, balance it with something potassium rich..

People (especially women) who hit 40 NEED TO START WALKING daily.

Get out of your house with your family and take an evening stroll after supper.

Eat a lot of fiber and veggies.

Join an adult sports league or YMCA...

Give up the Starbucks and drink water.

[Darienne]

Darienne, if you are showing too much potassium in your blood, eliminate bananas and other high potassium foods and supplements and then retest. You eat a lot of fruits and vegetables so you may not need a supplement at all.

Eliminated supplement. Don't like bananas and don't eat them. I think the supplement should do it. Thanks.

[Katie Meadow]

High blood pressure and high cholesterol are two of the not-so-wonderful things I got from my Dad, or at least as much as that's fair to say. I tried all kinds of dietary mods for the high blood pressure, including limiting salt, but it made no difference so I went on meds. My doctor had a very peculiar theory based on her own high blood pressure and other patients and prescribed Toprol XL (generic is metaprolol). Her theory derived from the fact that she had great results using this drug with Ashkenazi jews. Go figure! Anyway it works like a charm for me with no side effects and I've resolved not to resent that I take a drug for high blood pressure.

As for the high cholesterol, dietary changes made an enormous difference, so I have not had to go on meds for that. Everyone is different, and just because you may have a genetic propensity for a condition doesn't mean that changes in diet won't work. And they may not work even if you don't. Just luck of the draw I think, but always worth a try if you can avoid one more drug.

The Dash Diet looks to be a pretty standard diet for cholesterol control. I never heard of it before but it's one of those hard-to-argue-with regimens and is pretty much the way I eat now, although I cheat once in a while--as is only sensible. I don't believe it has helped my blood pressure, only the cholesterol.

Edited September 14, 2013 by Katie Meadow (log)

[annabelle]

Your doctor is right, Katie. There are a great many medical issues of the blood that are prevalent in Ashkenazi Jews. This is also true of persons who are Sicilian. Some of these disorders are quite devastating and all are genetic.

Diet alone may not help everyone.

[Darienne]

Hmmm...my Mother was an Ashkenazi Jew. Father mixture of French, Irish, etc.

My cholesterol was the worst on a fairly high carb vegetarian diet. (I was making the most delicious bread and we were really eating it.) I've been on several statins...20 years ago...and they did NOTHING to alter my numbers.

Something is gonna get ya in the end.

[Martin Fisher]

I'm 48 years old.

I've had hypertension issues for 27 years.

I've tried many a dietary way to control it.

A diet low in carbohydrates and a good salt to potassium ratio is what has worked best for me.

"While weight loss typically induces improvements in blood pressure, it may be that the low-carbohydrate diet has an additional effect."

http://www.dukehealth.org/health_library/news/low_carb_diet_effective_at_lowering_blood_pressure

"Public health recommendations should emphasize simultaneous reduction in sodium intake and increase in potassium intake."

http://archinte.jamanetwork.com/article.aspx?articleid=1106080

Simply cutting salt didn't make a bit of difference in my case.

http://www.scientificamerican.com/article.cfm?id=its-time-to-end-the-war-on-salt

~Martin

[weinoo]

Civil Eats weighs in on the salt to potassium ratio - especially noting that just lowering sodium doesn't work nearly as well as lowering sodium AND increasing potassium intake:

Where does one find potassium? Vegetables, fruits, beans, nuts, seeds, and whole grains (don’t forget “pseudograins” like quinoa, buckwheat, and amaranth, too). In a “nature sure is neat!” twist, these foods are also naturally low in sodium. Too bad nature doesn’t have access to an $80 million advertising budget.

This important potassium piece is where lower-sodium packaged foods and focusing on sodium reduction ultimately fail. Ultimately, if potassium is not simultaneously increased when sodium is lowered, we can’t expect much of a health boost.

[weinoo]

I have been actively working on increasing my K intake over the past month. Not that easy, but I make sure to get 6 oz. of good orange juice (360 mg K), and a banana (450 mg K) daily. I also found this Knudsen Very Veggie low sodium juice that has 35 mg. sodium and a whopping 740 mg of potassium per cup with only 70 calories. These 3 items really boost the daily K intake.

[rotuts]

consider Eating that Orange: trim off most of the skin leave some of the pulp if you can and eat it.

slice it etc. this has far more healthy items in it than just the juice.

[HungryC]

Don't overlook the weight factor. If you haven't carried much extra weight throughout your life, it doesn't take much gain/loss to impact BP, especially if you have a small frame. Also look at your OTC meds: Aleve (naproxen sodium) can shoot up BP, as can decongestants, bronchiodialating meds, etc. You don't want to be medicating your BP x 3 while inadvertently increasing it through your painkiller choices.

[quiet1]

Don't overlook the weight factor. If you haven't carried much extra weight throughout your life, it doesn't take much gain/loss to impact BP, especially if you have a small frame. Also look at your OTC meds: Aleve (naproxen sodium) can shoot up BP, as can decongestants, bronchiodialating meds, etc. You don't want to be medicating your BP x 3 while inadvertently increasing it through your painkiller choices.

All NSAIDs (ibuprofen, naproxen, etc.) can raise your BP. Some of it seems to depend on how sensitive you are - all of the women in my family seem to need very little in the way of NSAID intake to start retaining fluid like a sponge, which of course cranks up your BP. I always have fun because I have arthritis and so doctors tend to want to put me on this NSAID or that NSAID for additional pain relief and I get to explain that they tend not to agree with me very well.

The thing is really just to spend some time paying attention to what you're doing NOW before trying to make changes - if nothing else it will inform the changes you make. (For example, if you find you take more NSAIDs over the course of the day than you thought, perhaps you just need to try to limit those a little to see improvement without having to majorly overhaul your diet, that sort of thing. Maybe there are a couple of bad food choices you make regularly where it would take only a small amount of extra effort to make a different choice.)

It's generally pretty hard to make sweeping diet changes, so if you can avoid that approach you're more likely to be successful. Food is such an important part of a lot of social activities, plus people on this forum are probably particularly interested in food, that to go right to a restricted diet that eliminates most of your usual meals/recipes tends to leave you feeling pretty crummy emotionally/mentally.

Of course, the benefit to being interested in cooking is that you probably have more options in making dietary changes than someone who is dependent on primarily prepared items like microwave meals. You can tweak something by using a different cut of meat or changing the amount of sauce you have with it, or changing the accompaniments, and still have enjoyable food that resembles something you like.

[annabelle]

consider Eating that Orange: trim off most of the skin leave some of the pulp if you can and eat it.

slice it etc. this has far more healthy items in it than just the juice.

Correct, rotuts. Eating fruits will also keep you feeling full whereas juice will not stick with you. This is one of the drawbacks to the juicing craze. Juice will also skyrocket your blood glucose and then crash you to the ground. Whole fruits will satisfy both hunger and thirst and will keep you on an even keel.

[weinoo]

Don't overlook the weight factor. If you haven't carried much extra weight throughout your life, it doesn't take much gain/loss to impact BP, especially if you have a small frame. Also look at your OTC meds: Aleve (naproxen sodium) can shoot up BP, as can decongestants, bronchiodialating meds, etc. You don't want to be medicating your BP x 3 while inadvertently increasing it through your painkiller choices.

Yeah, I don't take any of those. I prefer painkillers that are narcotic. Or aspirin.

consider Eating that Orange: trim off most of the skin leave some of the pulp if you can and eat it.

slice it etc. this has far more healthy items in it than just the juice.

Correct, rotuts. Eating fruits will also keep you feeling full whereas juice will not stick with you. This is one of the drawbacks to the juicing craze. Juice will also skyrocket your blood glucose and then crash you to the ground. Whole fruits will satisfy both hunger and thirst and will keep you on an even keel.

Correct on the eating of whole fruit. I try. I try. Citrus season is right around the corner.

I think there are benefits to be had from juicing as well - depends on what you're juicing.