Do You Really Have Hypertension #1 - Bill Sardi

8/13/2019 Do You Really Have Hypertension #1 - Bill Sardi

http://slidepdf.com/reader/full/do-you-really-have-hypertension-1-bill-sardi 1/12

Report: Part 1 - Hypertension © Bill Sardi | June2004 | www.askbillsardi.com |

Preface: Blood pressure is the amountof mercury (Hg) displaced in a column,measured in millimeters. There aretwo numbers for blood pressure. Thefirst number (systolic) measuresthe pressure when the heart pumps,

and the second number (diastolic)measures the pressure when the heartis momentarily at rest. Treatment forhypertension may begin if your bloodpressure rises above 140/90. Forsimplicity, this report refers to bloodpressure in “points” and refers tothe “first” and “second” numbers soreaders do not get confused.

Introduction

pressure. It’s meant to ave t e oppos te e ect.

Americans are living longer and that means 9 out of

0 will face the diagnosis of hypertension during their

et me. J Amer can Me ca Assn 287: 1002-1010,

2002 Every Amer can am y s e y to ave a ove

one treate or g oo pressure, or e agnose

with hypertension themselves. At least this is what

we are to y ea t aut or t es. But o m ons o

Amer cans rea y ave ypertens on? Do t ey nee

e- ong me cat ons? Do oo -pressure ower ng

medications really prevent strokes and heart attacks? .

W en you go to t e octor you see t e nee e ounce

on t e oo pressure a an you can see t at your

pressure s g . But was your oo pressure ta en

properly? A slight shift in your arm position could

pro uce a se rea ngs an you m g t e nee ess y

p ace on me cat on.

ou may e surpr se to n t at t e aggregate

care of hypertension provided by physicians and

p armaceut ca compan es s n a s oc ng state osarray. Ant - ypertens ve rugs on’t wor an may

ncrease t e r s o su en eat . Pat ents t emse ves

are not compliant with dietary recommendations and

are ust a y even ess comp ant w t onerous rug

reg mens. A ter a care u rev ew o t e sc ent c

terature t can on y e conc u e t at t e mo ern care

o ypertens on s tse a azar to your ea t .

T ere s an urgent nee or s mp er, ess pro emat c

ess cost y tec no og es to contro ypertens on. Some

prom s ng s mp e tec no og es ex st, ut are e ngoverlooked by modern medicine.

Here are the details:

Arm position

mproper arm pos t on w en measur ng oo

pressure w t a cu s o ten e y to over- agnose

ypertens on an cause

nappropriate treatment.

T e arm s ou e e

or zonta y, an at

e e g t o t e eart,

during blood pressure

easurement. Failure to perform blood pressure

easurements n t e proper arm pos t on can cause

a pressure o 155 85 to ncrease y 25 11, or rea as

Part I:DO YOU REALLY HAVE HYPERTENSION

AND DO YOU NEED MEDICATION?

By Bill Sardi

“Measure of blood

pressure is probablythe most frequentlyperformed medical act,and the least reliable.”

[Rev Med Liege 57: 250-52, 2002]




80 96. Accor ng to one stu y, ess t an 8 percent o

nurses an octors measure oo pressure ut z ng t e

proper arm pos t on.

“A relatively small downward arm movement in a pa-

tient’s with high normal blood pressure could inuence

the diagnosis and treatment of hypertension.” Errors

in blood pressure measurement are so widespread

that this casts doubt upon estimates of the preva-lence of hypertension in the population at large and

uncertainty regarding the effectiveness of many

medicines used to treat hypertension. [Internal

Medicine Journal 34: 290-91, 2004]

In anot er stu y, oo pressure was measure n

t e proper or zonta pos t on an t en t e arm was

roppe to t e s e an anot er measure was o ta ne .

For adults with normal blood pressure, their numbers

rose y 8 7. Among ypertens ve pat ents t e num errose y 23 10. J Human Hypertens on 17: 389-95,

2003 Anot er stu y s owe t at t e erence n

arm position results in a 11/12 point difference among

hypertensive patients. [Br Med J 288: 1574-75, 1984]

W enever oo pressure s measure t e arm pos t on

s ou e ocumente . J C n Hypertens on 3: 624-

30, 1987

Proper arm position for measurement

of blood pressure

There are many other reasons why blood pressure

measurement may e naccurate.

• Doctors an nurses may e us ng t e wrong s ze oo

pressure cuff on your arm, which would raise the blood

pressure rea ng. T e s ze o t e cu nee s to matc

your arm s ze.

• One o t e pro ems w t oo pressure measurement

n t e octor’s o ce s t at pressure may e c arte

ur ng a s c v s t. B oo pressure may e e evate

w en you are . A “we visit” to t e octor’s o ce

ay give you a more accurate reading.

• Anot er screte actor may art c a y ra se your

oo pressure. Doctors o ten ut ze a r g t- g t

ophthalmoscope to examine the back of the eyes duringa p ys ca exam nat on. Br g t g t as een s own

o ra se oo pressure n norma y ea t a u ts

Arc ves Env ronmenta Hea t 42: 37-43, 1987

• Another problem in monitoring blood pressure is

at n an attempt to remove mercury- e oo

pressure gauges rom osp ta s an octor’s o ces

or env ronmenta reasons, news ev ces are not as

accurate. Accurate blood pressure measurement may

not e poss e us ng non-mercury nstruments. Newor T mes June 16, 2002

or all of these reasons, some authorities believe

one third to one half of the blood pressure readings

per orme n c n cs an octor’s o ces are wrong

New Yor T mes August 1, 2000

White coat hypertension

any pat ents exper ence anx ety n a octor’s o ce

t’s enoug to ra se oo pressure. Just t e s g t o t edoctor’s white coat can trigger a rise in blood pressure

This has been termed “white coat” hypertension.

n one stu y 20 percent o ma es an 54 percent o

ema es a a “w ite coat” response w en t e r oo

pressure was measured.

Cana an Me ca Assn

ourna 161: 265-69, 1999

any patients diagnosed with

drug resistant hypertension

rea y ave w te coat

ypertens on. T e r oo pressure s e evate n t e

octor’s o ce or c n c, over-r ng t e pressure contro

of medication. When a doctor records blood pressure

one stu y s owe t s ra se oo pressure y 16 to

6 po nts an w en a nurse too t e oo pressure t

ra se t e num ers y 9 to 17 po nts systo c pressure)

Patients see thedoctor’s white coat,

and their bloodpressure rises

above norma[Blood Pressure Monitoring 7293-300, 2002




Reuters Hea t Dec. 21, 2001; Amer can Journa

Hypertens on 14: 1263-69, 2001

Researc ers est mate t at 25 percent o ypertens ve

patients can postpone drug treatment and 15 percent

can avo mu t p e- rug t erapy y mon tor ng t e r

oo pressure away rom octors an nurses. J Am

Me ca Assn 278: 1065-72, 1997; 279: 197-98, 1998

Home oo pressure mon tor ng appears to e a etter

a ternat ve, away rom t e stress- n uc ng r se n

oo pressure at t e

doctor’s ofce (white

coat hypertension).

A recent stu y o

ome oo pressure

mon tor ng revea s

more of these patients

are e y to a an ont e r me cat ons

25.6%) t an pat ents

being monitored at the

doctor’s ofce (11.3%) and that their blood pressure

was more e y to e out o contro . Fe ruary 291:

955-64, 2004

OES HOME BLOOD PRESSUREMONITORING IMPROVE COMPLIANCE?

Survey o 1452 patientsHypertens on Researc 23: 21-24, 2000

Frequency o use o omemonitoring o oo pressure

Occasiona ymisse ta ing

their medications

very day 6.5%

Severa times a wee .

Severa times a mont 11.0%

ever c ec e t eir oopressure

14.5%

Millions are/aren’t hypertensive

More t an 16 on o ant ypertens ve rugs were

sold in 2000. More than half of the patients on these

me cat ons ave or er ne or m ypertens on. I

sma ec nes n oo pressure cou e ac eve ,

ons o peop e may not even nee t ese

e cat ons.

A out 50 m on Amer cans ave g oo pressure

and about half are being treated. Only about 27 million

ave t e r oo pressure un er contro .

Accor ng to t e preva ng cr ter a, one t r o

American adults are hypertensive and don’t know itReuters Hea t May 19, 2000 While 140/90 is the

ong-standing point where treatment is started

ow investigators say the desired point for blood

ressure is now 115/75. The once-healthy 120/80 is

now considered to be “ pre-hypertension. ” That means

anot er 45 m on Amer cans are n or a surpr se on

e r next octor’s v s t. T e Lancet Dec.14, 2002

ut do you really have high blood pressure? Are you

really at an increased risk for stroke or a heart attack?

Accor ng to a s oc ng stu y con ucte y Un vers ty

o Ca orn a at Los Ange es researc ers, illions of

eople are taking blood pressure-lowering drugs

or no good reason. Flawed statistics have been

use to eca es to prescr e t ese rugs. P ys c ans

now cons er t e rst oo pressure num er systo c

pressure) as t e mportant n cator o a uture mortaevent like a stroke or heart attack. Usually pressure-

owering drugs are prescribed when the rst pressure

num er r ses a ove 140, ut rev se gures w c ta e

age nto cons erat on n cate an ncrease r s o

y ng oes not start t pressure reac es 148 or ma es

and 158 for females age 55-64 years. For adults age 65

74, t e gures r se to 159 or ma es an 167 or ema es

Lancet 355: 175-80, 2000 T s re-ana ys s o oo

pressure r s s as een suppresse . Hea t aut or t es

are in denial that their long-standing numbers used to

determine when treatment should be prescribed areat y wrong.

he diastolic blood pressure (second number)

hich has been the main criterion used by most

hysicians to determine effective drug control

of hypertension, appears to be of little value in

redicting future adverse health events such as

At least a third ofpatients who exhibita high blood pressurereading in the doctor’sofce do not exhibit thesame problem whentheir blood pressure is

taken by a nurse.[Am J Hypertension 14: 1263-69,2001; BMC Cardiovascular Disorders4: 2, 2004]

120/80 used to be considerednormal blood pressure.

Now it is considered pre-hypertension.




stroke or heart attack. The systolic blood pressure

rst num er) s a goo pre ctor o t ese events.

Arc ves Interna Me c ne 162: 577-81, 2002 T e

Nat ona Heart, Lung an B oo Inst tute now says t e

rst blood pressure number is more important than the

secon an t at t s ou e ept e ow 140, regar ess

o age. CNN May 4, 2000 For decades physicians

had been gauging the severity of blood pressure byt e wrong num er.

Does drug therapy work?

The quoted gures are that drug therapy may reduce

mortality rates by 12 percent, coronary heart disease

by 20 percent and stroke by 36 percent. [Biomed &

harmacotherapy 51: 208-12, 1997] The problem is

at t ese are elative, not hard numbers.

Statistics tell doctors whether blood pressure therapy

orks, but it doesn’t tell them who will benet.

esearc s ows t at to prevent 1 eat , 11 pat ents

w t ypertens on ave to ower t e r oo pressure

y a out 12 po nts over a 10-year per o . Drug Top csan. 26, 2004 In ot er wor s, 10 o 11 pat ents ta ng

anti-hypertensive drugs will not experience a health

ene t. T e ant - ypertens ve rugs are proven to e

ore e ect ve t an not n arge popu at ons, ut many

ons ta e t ese rugs w t no ea t ene t so a ew

will be spared of a mortal health event.

edical treatment of hypertension may reduce

strokes but have no effect upon lowering the rate of

eart attac s. J Hypertens on 18: S3-7, 2000

n France, a study showed that drug therapy did not

control elevated blood pressure among 85 percent of

714 men. Arc ves Interna Me c ne 162: 577-81

002

Ot er stu es s ow as tt e as 6 n 100 ypertens ve

pat ents are a e to contro t e r oo pressure to

below the target number of 140/90. [J Hypertension

6: 747-52, 1998

A study in Germany found that on an average

day over 700,000 patients are seen by physicians

ith high blood pressure and only 132,000 of these

atients have well-controlled pressure. Better t an 8

out o 10 o t ese pat ents were ta ng oo pressure

e cat ons. J Hypertens on 22: 479-86, 2004

REVISED TOP BLOOD PRESSURE NUMBER WHICH

INDICATES NEED FOR TREATMENT

ge - ge 55-64 Age 65-7

Top oo pressurenumber that

in icates increase

ris o ying anneed for medication

a es 141

Fema es 142

Ma es 148

ema es 158

Ma es 159

ema es 167

Source: Los Ange es Times January 14, 2000

ARE YOUNG ADULTS REALLY ATRISK FOR HYPERTENSION?

High blood pressure may often be misdiagnosed

in young adults. In a stu y o more t an 13,000

n v ua s w ose oo pressure a een measure

annua y or t ree years, o 36 men age 16 to 34 to

who had been classied as needing treatment, only

1 rea y nee e treatment. On y 5 o 19 womenactua y nee e treatment. BBC News Apr

5, 2004; Br t s Me ca Journa , Apr , 2004

The numbers used to determine the point when

treatment should be prescribed may not apply to

young a u ts. The absolute risk of experiencing a

major cardiovascular event over a 10-year period

amounts to only 1% for hypertensive young

adults, age 25-34 years. But this gure is said to rise

to 30 percent among o er a u ts, age 65-74 years.

B ome & P armacot erapy 51: 208-12, 1997




S ng e ant - ypertens ve rugs genera y are not

e ect ve. Most o t e t me more t an one rug s

requ re to r ng pressure un er contro .

rug: 50-60% un er contro

2 drugs 80% under control

3 rugs: etter t an =80% un er contro

Two or t ree ant - ypertens ve me cat ons are y no

means t e en o t e rug st prescr e y p ys c ans.

Low-dose aspirin therapy to prevent blood clots andstat n rugs or c o estero are o ten prescr e n

a t on to t e pressure- ower ng rugs. An ant -

a et c me cat on may a so e nee e or n v ua s

with blood sugar issues. [J Human Hypertension 18:

39-85, 2004] Now you have polypharmacy – a patient

e ng overw e me y too many me cat ons an

ac ng rugs t at on’t wor we w t eac ot er, an

t at n uce nutr ent e c enc es as we . Var ous reports

admit to the problem of juggling so many drugs while

st attempt ng to avo s e e ects. Car ovascu arDrugs & T erapy 12: 186-98, 1998

A recent study attempted to determine if simpler

dosage regimens, such as one pill a day, would increase

a erence to treatment. Re uct on n t e num er

o a y oses appears to ncrease comp ance n

some stu es. Coc rane Data ase System Rev ew

CD004804: 2004

Desp te t e act t ere are our ma or c asses o oo

pressure lowering drugs and over 100 varieties of these

drugs available, less than 50% of patients who begin

treatment continue taking any of these drugs sixmonths after initial use. Cana an J Car o ogy 15:

39-41F, 1999

Side effects with drug therapy

Far more side effects occur from anti-hypertensive

medications than are reported. Sometimes it is

difcult for patients to connect a side effect with a

drug. In one study conducted in Norway with 2,586

pat ents ta ng oo pressure- ower ng rugs, t e

spontaneous reporte s e e ects were on y 16%. But

upon genera nqu ry 24% reporte s e e ects an

when specic questions regarding common side effects

were as e 62% reporte rug- n uce symptoms

B oo Pressure 8: 94-101, 1999

A survey published in 1999 revealed that about 3 in

0 patients taking blood pressure medications report

s e e ects t at a tere t e r ves. T e most common

s e e ects are at gue, potass um oss an zz ness

Near y 4 o every 10 pat ents a cons ere en ng

heir medication treatments due to adverse side effects

T e survey part c pants were ta ng 3 ant - ypertens ve

rugs, on average. Me ca Tr une, Novem er 12

999

MOST COMMON SIDE EFFECTS OF BLOODPRESSURE DRUGS

Source: Doctor s Gu e Nov. 10, 1999

eta oc ers Fatigue 34%

iuretics water pi s Minera im a ance 30%

Ca cium c anneblockers

Swe ing e ema 26%

CE in i itors Coug 21%

Alpha blockers Cramping 7%

e p ys c ans an p armaceut ca compan es

cont nue to c a m t e raw ac s o t e r rugs are ar

outweighed by their benets, the Agency for Health

Care Po cy an Researc states t at t e potent a

ene ts o these drugs “may not outweigh their

egative effects on quality of life.” Stomac ac es

fatigue, nausea, impotence, headaches, urinary tract

problems, and many other side effects are common. [J

C n ca Ep em o ogy 49:1239-45, 1996; Agency or

ea t Care Po cy Researc report No. 201, 1997

Anti-hypertensive drugs are intended to reduce the

r s or car ovascu ar sease, ut ACE n tors, a

common type o rug use to contro oo pressure

ay ra se omocyste ne eve s y as muc as 16

percent. [Metabolism 52: 261-63, 2003] Homocysteine

s an undesirable blood protein linked with blood vessel

sease. The reduced risk for cardiovascular disease

People who take acetaminophen (Tylenol) or

ibuprofen (Motrin) may double their risk for

hypertension. These drugs may raise blood

pressure by blocking the production of hor-

mone-like substances that widen blood vessels

and can also increase sodium retention.[Curhan G, Archives Internal Medicine, October 2002;

New York Times Oct. 28, 2002]




via blood pressure control is offset by elevated

homocysteine which raises the risk of hypertension

and cardiovascular disease.

It’s no won er ma es o not ta e a ng to ant -

hypertensive drugs. One study shows that 4 out of 10

ma es n o t e onset o t e r use o oo pressure

ower ng rugs w t mpotence. Am J Hypertens on

2: 271-75, 1999

There is also such a thing as too low blood pressure.

When the second number (diastolic) goes below 65

there is actually an increased risk of stroke, the very

adverse health event drugs are intended to prevent.

[Hypertension 34: 1179-85, 1999] Some hypertensive

pat ents exper ence an a norma y ow oo pressure

ur ng s eep an awa en to n t e v s on n one eye s

gone ecause o a ac o oxygen supp y.

For a long time physicians prescribed calcium

blockers for hypertension without knowing the

drug increased the risk of a heart attack. In 1995

t e p armaceut ca compan es a to per orm a U-turn

and convert patients to slower-acting calcium channel

oc ers a ter t was oun t at t e ast-act ng vers ons

o t s rug actua y ncrease t e r s o eart attac s

y 60 percent. S x m on Amer cans were ta ng t ese

calcium blockers at the time. [Associated Press, March

1, 1995] How many patients died prematurely before

t ese rugs were remove rom use s un nown.

Beta oc ers are anot er c ass o ant ypertens ve

drugs. Since beta blockers increase insulin

resistance, they have been shown to increase the risk

of diabetes. New Eng an J Me 342: 905-12, 2000

D a etes t en astens t e onset o ypertens on. It’s a

self-perpetuating disease.

Lifestyle and health habits

P ys c ans appear to g ve p serv ce to etary an

lifestyle measures to control blood pressure. Here

s w at a report n one ourna sa : “Non- rug

t erapeutic options s ou e imp emente in a

patients. However, since t ere is overw e ming evi ence

to suggest that antihypertensive drugs offer protection

against comp ications o ypertension, a vast majority

wi require p armaco ogica treatment to ac ieve goa

lood pressure levels.” Am J Car ovascu ar Drugs 2

77-89, 2002 In ot er wor s, t e rugs wor , so w y

ot er w t etary approac es to ypertens on?

The British Antihypertensive Society says advice on

e-sty e mo cat ons s ou e prov e peop e

w t g oo pressure. But t e r gu e nes a so

state t at every pat ent

with a sustained systolicoo pressure a ove

60 s ou e starte on

rug t erapy outr g t.

urthermore, diabetics

with hypertension are at

ncrease r s s ou e

starte on me cat ons

e r susta ne oo pressure excee s 140 90. Among

people whose systolic blood pressure is 140-159 and

asto c pressure 90-99, p ys c ans s ou ma e anassessment o car ovascu ar sease r s , say Br t s

gu e nes. A sease r s greater t an 20 percent over

a 10-year period is considered reason to prescribe

edications. The British guidelines concede that

ost pat ents w requ re at east two oo -pressure

ower ng rugs. It’s easy to see ow et an esty e

c anges get pus e as e or t e rugs.

ut can the drugs overcome a poor diet? Inside

he “stroke belt,” the southeastern U.S., anti-

ypertensive drugs are far less effective thann other parts of the country. [Archives Interna

edicine 160: 825-31, 2000] Surveys reveal people

v ng n t e sout ern stro e e t consume t e most

sa t an ower amounts o potass um, magnes um an

ot er nutr ents. Journa Nutr t on 133: 211-14, 2003

The lesson here is that drugs can’t always overcome

e e eter ous e ects o a poor et. But octors eep

prescr ng t e rugs.

lderly patients tend to have more fatty tissue and

his dulls the effect of fat-soluble drugs such as the

eta blockers. This is an admission the beta blockers

are far less effective against a primary group that is at

risk for stroke and hypertension, the obese.

T ere s strong ev ence t at a num er o sma

a terat ons n et an esty e can prevent ypertens on

or ower ex st ng g pressure. Researc ers at t e

How do drugsovercomehypertension in

a patient whocontinually consumes

excessive sugar,salt and alcohol and

smokes?




Nat ona Car ovascu ar Centre n Osa a, Japan, us ng

ome oo pressure mon tor ng, report t e o ow ng

factors reduce blood pressure:

Accor ng to pu c ea t aut or t es, a re uct on as

sma as 2 po nts n t e average Amer can’s rst oo

pressure num er cou save more t an 70,000 ves a

year.

Hea t pract ce ressure re uct onmm mercury

Top pressure num ersysto c ottom pressure

num er asto c

Weig t re uction

Low ca orie iet 10

Dai y wa ing 2-3 1-2

ow-sa t iet 9 4

otassium

supp ementation

3-4/1-2

Ca ciumsupp ementation

1-2 1

co o restriction 3 2

B oo Pressure Mon tor ng 7: 51-54, 2002

Poor patient compliance is often blamed for the

failure to successfully treat high blood pressure in

the population as a whole. It can be said that it may

be difcult to change simple dietary habits among

hypertensive patients. But half of the patients on

drug therapy abandon their medications as well. Asmuc as 16 to 50 percent o pat ents stop ta ng t e r

oo pressure rugs w t n t e rst year o treatment.

S nce oo pressure s a s ent er, an t e rugs

often cause fatigue, dizziness and other side effects,

t e pat ents o ten ee etter w en not ta ng t e rugs.

Drug Top cs Jan. 26, 2004 P ys c ans conce e rugs

nee to e more amena e to t e pat ents so t ey won’t

stop ta ng t em ue to s e e ects.

Blood pressure lowering drugs

T e rst e ect ve oo pressure ower ng rug ecame

ava a e n t e 1950s. T ere are our ma or c asses o

anti-hypertensive drugs.

THE FOUR CLASSES OFANTI-HYPERTENSIVE PILLS

uret cs ove water an sa t outo t e o y

Beta blockers Slow the heart rate and thusre uce oo pressure

ACE in i itors e uces t e pro uction oa chemical (angiotensin II)t at narrows t e arteries

Ca cium c anneoc ers

lock the inux of calciuminto ce s; re uces orce o

contraction in eart musc e

very anti-hypertensive drug depletes the body of

nutrients. Because of this, there is no way hypertensive

pat ents w ever get we . T ey w su er nutr ent-

re ate s e e ects rom t e var ous rugs see c art on

o ow ng page).

Which pill should be used first?

he conicting reports

octors are involved in a

ong-stan ng e ate on

w c rug to use rst to

reat ypertens on. See

you can make sense of these conicting reports:

WHY YOU WILL NEVER GET WELL TAKINGBLOOD PRESSURE DRUGS

Source: Drug Sa ety: 14: 355-64, 1996

Increasesinsu in

esistance

Raises totac o estero

Raises LDLc o estero

Raisestrig yceri es

Diuretics X X X X

eta oc ers X X X X




DRUG CLASS GENERIC BRAND NAME NUTRIENT DEPLETED

Ca cium oc er Ateno o Tenormin Coenzyme Q10

Beta oc er Di tiazem Car izem None reporte

Lowers me atonin, a rainormone t at in uces

sleep; drug may cause sleepistur ance Eur J C in P arm

55: 111-15, 1999

Beta oc ers raise c o estero ;c romium supp ements s ou

e ta en to counter t ispro em Ann Interna Me

115: 917-24, 1991

p to 25% of beta blockerusers wi eve op a nee or

anti epressants

ACE in i itor Captopri Capoten ,Benazepri LotensinEna apri Vasotec ,

Lisinopril (Prinivil) QuiniprilAccupri

nc

iuretic Hy roc orot iazi e Coenzyme Q10, magnesium ,osp orus, so ium, zinc, o ic

aci

VasodilatorHydralazineApreso ine

Coenzyme Q10, magnesium,potassium, vitamin B6, zinc,

COMPANION DRUGS OFTEN PRESCRIBED TO HYPERTENSIVE PATIENTS

Acetysa ici ic aci sp r n o ic aci , potassium, so ium,vitamin C, iron

nti-diabetic Glyburide (Micronase

et ormin G ucop age

Coenzyme Q10

o ic aci , vitamin B12

* Magnesium shortage mayresu t in su en- eat eart

attac




• “ACE inhibitors should be preferred to diuretics in

e er y patients.” Expert Op n on P armacot erapy

4: 825-88, 2003

• Diuretics are considered the rst line of treatment for

e evate oo pressure. Expert Rev ew Car ovascu ar

T erapy 1: 35-41, 2003 “An o as ione iuretic is

as goo , i not etter, t an some newer more expensive

medicines for treating high blood pressure, accordingto a government sponsored study.” Assoc ate Press,

Dec. 17, 2002; J Am Me Assn 288: Dec. 18, 2002

• “The lack of benet and potential side effects of

beta blockers are overstated. Some investigators

recommen t ese agents not e use in t e management

o ypertension in t e e er y. T ere are numerous

reasons w y t ese recommen ations s ou not e

followed. There is abundant evidence that beta blockers

are e ective t erapy.” J C n ca Hypertens on 10 082002

Most hypertensive patients are placed on more

than one medication but unless the drug regimen

includes a diuretic, patients will be at increased risk

for stroke. Arc ves Interna Me c ne 161: 37-43,

2001

At one time the Joint National Committee on

Detection, Evaluation and Treatment of High Blood

Pressure erroneously recommenced beta blockers as

rst-line treatment in the elderly, but beta blockersare inappropriate “and should no longer be used as

initial antihypertensive therapy.” This means that

more t an 7 m on e er y pat ents w t g oo

pressure are expose to t e cost, nconven ence an

s e e ects o eta oc ers w t out any potent a

for health benets whatsoever. [Archives Internal

Me c ne, Ju y 26, 1999

Despite the myriad of side effects, lack of patient

acceptance and ineffectiveness of the drugs, Dr.

Donald Lloyd-Jones at Northwestern University

says elderly patients with high blood pressure need

to be treated more aggressively, with ore rugs.

T e ma or ty o pat ents are e ng treate w t ust one

drug, he claims. [American Society Hypertension 19th

Annua Meet ng, New Yor , May, 2004 Dr. L oy -

Jones says t ey nee more me cat ons.

So which drug is the drug physicians should prescribe

rst? Beta blockers or diuretics? Both of these drugsncrease t e r s o su en eat .

Going off drugs cold turkey

Can ypertens ve pat ents go o t e r rugs co

ur ey? In a Br t s stu y, 22 percent o pat ents w o

stoppe ta ng t e r rugs ne t er su ere a re apse or

related problems after three years. One in three men

and one in six women succeeded at stopping their

e cat on. Br t s Journa Genera Pract ce 49: 977-

0, 1999, BBC News, January 31, 2000

Does weight influencehigh blood pressure?

The literature regarding weight and blood pressure

is conicting.

A study of overweight individuals over a period of 8

years did not show that weight reduction lowers el-evated blood pressure. [Hypertension 36: 20, 2000]

However, another study showed that exercise drops

blood pressure by 2 to 3.5 points, and exercise plus

weight reduction drops blood pressure by about 6 to

8 points. [Hypertension, August 2000]

Another report claims an overweight person may

reduce pressure by about 1 point for every 2 pounds

of weight loss. [Hypertension 42: 878-84, 2003]

Oddly enough, overweight individuals with high

blood pressure are less likely to die prematurely

or have heart attacks or strokes than thinner

people. Fat dulls the heart muscle excitability from

adrenal stress hormones like adrenaline. In thin

people these stress hormones can increase the size

of the heart and cause stiff arteries. [J Am Medical

Assn 285: February 28, 2001]




The root causes of hypertension

There are four main root causes of hypertension

t at never seem to e proper y a resse . T ese are

ca c cat on, sugar, sa t an n tr c ox e.

Calcification

W en arter es ecome st an n ex e ue to

ca c cat on, ypertens on may eve op. Hypertens on

Research 27: 47-52, 2004] Women develop

ypertens on at an a arm ng rate a ter menopause. T e

re ease o ca c um rom ones n t e post-menopau sa

per o t en accumu ates n arter es w c can resu t

n ypertens on. B o Trace E ement Researc 63:

05-11, 1998] Calcication of arteries in the breast of

ema es, v s e n mammograms, s a so a mar er or

ypertens on. It s nterest ng to note t at arter es n

t e reast on’t eg n to ca c y n women unt age 40and rises with advancing age. [Clinical Radiology 59:

92-95, 2004 But anot er stu y n cates age or gen er

o not n uence ca c cat on. Ra o ogy 224: 235-42,

2002

In one study, coronary artery calcication was found

among 62% o men w t norma oo pressure an

4% o men w t g oo pressure. Coronary artery

ca c cat on s more o ten assoc ate w t ypertens on

in women than men. This is likely due to the loss

o ca c um rom ones n post-menopause, w t t eca c um e ng epos te n arter es. In t e same stu y

c te a ove, 23% o women w t coronary artery

ca c cat on a norma oo pressure w e 62% o

the hypertensive women had calcied coronary arteries.

Me Sc Mon tor ng 2002; 8: CR775-81, 2002

Ca c um- oc ng rugs stop t e n ux o ca c um nto

cells, but they don’t stop arterial calcications per se.

Hormones suc as estrogen, w c sen s a s gna or

ones to reta n rat er t an re ease t e r ca c um, an

v tam n K an magnes um e p to retar ca c cat ons.

Nitric oxide

N tr c ox e s a trans ent gas t at w ens ates)

arter es an contro s oo pressure. It s pro uce

from the amino acid arginine. At low concentrations

n tr c ox e can mprove c rcu at on, ut at g

concentrat ons t can cause c rcu atory s oc an

n uce ce eat .

A recent report n cates t e ec ne n pro uct on o

nitric oxide is a major cause of high blood pressure

oo pressure ower ng rugs ave on y s own m te

a ty to restore n tr c ox e. Current P armaco og ca

es 10: 1695-98, 2004

ecause n tr c ox e s t e agent t at ates oo

esse s an mproves c rcu at on as we as oo

pressure, t e ast o n tr c ox e s assoc ate w t

erectile dysfunction in males. About 4 in 10 males with

erectile dysfunction also have high blood pressure

Journa Uro ogy 171: 2341-45, 2004

n a a oratory researc ers emonstrate t a

agnesium enhances the production of nitric oxide

n t e ce s t at ne t e ns e o arter es. T usagnes um p ays a ro e n w en ng oo vesse s

prevent ng ypertens on an oo c ots. B oc m

iophys Acta 1689: 6-12, 2004]

strogen s e eve to p ay a ro e n contro ng

ypertens on. In an ma s w ose ovar es ave een

remove , supp ementa estrogen as een s own to

ncrease blood serum levels of nitric oxide. [Clin Chim

Acta 344: 53-57, 2004

T e prov s on o p ytoestrogens p ant estrogens) maycounter this problem. In an animal study, female mice

whose ovaries had been surgically removed to stop

pro uct on o estrogen, a g so um et ra se t e r

arter a pressure ut a norma so um et not. T s

eans t e oss o estrogen may ma e ema es more sa t

sensitive. The provision of plant estrogens to these

an ma s on a g so um et re uce t e r arter a

pressure. Am J P ys o Regu Integr Comp P ys o

81: R1934-39, 2001 An exce ent source o p ant

estrogens are lignans found in axseed meal.

Natura mo ecu es ca e po yp eno s, oun n grapes

err es, tea eaves an w ne can n uce n tr c ox e

ormat on. C n C m Acta 344: 53-57, 2004

e w ne mo ecu es ave een s own to en ance t e

oo -pressure ower ng e ects o ot acetyc o ne




m n s e sense o taste or sa t. N ger Postgra uate

Me ca Journa 10: 96-98, 2003 T ey can eat ots o

sa t w t out sens ng t ey are consum ng too muc .

More than half of the patients with diagnosed

ypertens on are sa t sens t ve. Sa t sens t ve means

a g ven amount o so um n t e et may ra se oo

pressure, ut not among a n v ua s, on y t e sa t-

sensitive.

A stu y n France est mates 5 to 16 percent o ea t y

a u ts ex t a “sa t epen ent oo pressure.”

[Journal Hypertension 21: 289-94, 2003]

O er a u ts can re uce t e r nee or me cat ons to

contro oo pressure y 30 percent y e t er os ng

poun s or re uc ng sa t consumpt on y a out 920

milligrams per day. [Hospital Medicine, October

998

One stu y est mates sa t re uct on wou re uce stro e

deaths by 14 percent and mortal heart attacks by 9

percent among hypertensive individuals and strokes by

6 percent an morta eart attac s y 4 percent among

a u ts w t norma oo pressure. Journa Human

Hypertens on 16: 761-70, 2002

A stu y con ucte n Israe s owe a ow so um et

on y re uce oo pressure y 4 po nts rst num er)

among a u ts w t m ypertens on. J HumanHypertension 11: 765-66, 1997]

Surpr s ng y, w en government ea t researc ers

rev ewe a o t e stu es on etary so um an ea t ,

t ey cou on y n ev ence or a mo erate re uct on

in salt intake, certainly less than the current 4000 to

6000 mg per ay consume y many US a u ts, an

pro a y a out 2400 mg a y nta e. J Am Co ege

Nutr t on 16: 192-203, 1997

Lead

At eve s o nta e e ow current US occupat ona

exposure gu e nes, 40 m crograms per ay, ea s

associated with elevation of blood pressure and this

s pronounce among postmenopausa women. J Am

Me Assn 289: 1523-32, 2003 .

Iron

ron load (ferritin) is considered a risk factor for

elevated blood pressure. [Am J Clinical Nutrition 76

256-60, 2002 E evate ron storage s a so assoc ate

w t g oo sugar eve s w c n turn ra ses oo

pressure. En ocr ne Researc 29: 299-306, 2003

iddle-age males have about twice the iron load as

enstruat ng ema es an ave a g er preva ence or

ypertens on. J Hypertens on 20: 1513-18, 2002

any health practices that help to control blood

pressure, such as a vegetarian diet, juicing, teas, etc

or examp e, a water-on y ast or 14 ays as een

s own to re uce oo pressure to at east 120 80 n

2 percent o 68 pat ents w o a m ypertens on

The fast produced a drop of about 20/7 points. [J

A ternat ve Me c ne 8: 643-50, 2002 Fast ng re uces

ron consumpt on.

Copyright 2004 Bill Sardi, Knowledge of Health, Inc.

Peter S e g t MD, Pro essor Emer tus o

Car ovascu ar Me c ne at t e Un vers ty o

Ox or says “re ative y sma rops (2 to 5

points) in blood pressure in the whole population

—achieved by modest salt reduction—will do more

oo t an arger c anges pro uce y rugs in

e sma er group o a u ts wit ypertension.”

Me ca Tr une August 14, 1997

Do You Really Have Hypertension #1 - Bill Sardi

Documents

Transcript of Do You Really Have Hypertension #1 - Bill Sardi