Hypertension Basics

by Iva Lloyd, ND

Hypertension, or high blood pressure, affects about 25% of Canadian adults under fifty and over 50% of those over the age of sixty. It also accounts for about 20% of deaths in Canada. Hypertension is considered a lifestyle disorder as it is strongly affected by diet, exercise, stress, smoking and other factors.

Whether you choose to treat your hypertension with prescription medication or natural therapies it is important to be aware of the impact that caffeine and salt have on your blood pressure.

There is a lot of debate as to the long-term risk and/or benefits of consuming caffeine on cardiovascular health, but what is known for sure is that for many individuals with hypertension there can be a significant short-term (roughly 3 hours) spike in blood pressure after drinking a coffee or having a caffeine drink (cola). The spike in blood pressure generally affects both the systolic and the diastolic aspects of blood pressure.

Consuming too much salt can not only spike blood pressure but it can put additional strain on the heart, arteries, kidneys and the brain. The impact of a high-salt meal on your blood pressure can last for hours or even a day or more.

Measuring The Impact of Caffeine on Blood Pressure

To measure the impact of caffeine on your blood pressure follow these steps:

1. Either first thing in the morning (ideally) or three hours after a meal (without caffeine) take your blood pressure.
2. Have your cup of coffee or other caffeine drink (cola).
3. Thirty (30) minutes later take your blood pressure again.

If your blood pressure increases more than 10 points you may have caffeine-induced hypertension.  If you have been diagnosed with hypertension and if your blood pressure rises with caffeine you may want to reduce your caffeine consumption. The more profound the spike in blood pressure the more cautious you need to be with your total caffeine consumption.

Measuring The Impact of Salt on Blood Pressure

To determine the impact of salt on your blood pressure follow these steps:

1. Ensure that you have at least two days with minimal salt and no caffeine in your diet.
2. First thing in the morning take your blood pressure.
3. Have a meal with added salt.
4. Thirty (30) minutes later take your blood pressure again.
5. Continue taking your blood pressure twice a day to determine how long it takes for your blood pressure to return to normal.  

If your blood pressure increases more than 10 points you may have salt-induced hypertension. If you have been diagnosed with hypertension and if your blood pressure rises with salt you may want to reduce your salt consumption.

Because both salt and caffeine are known to spike blood pressure it is helpful if you test them separately.  When determining the impact of caffeine, avoid salt.  When determining the impact of salt, avoid caffeine.  Generally you only have to do the test once. A person's response to salt and caffeine is fairly consistent.  If your blood pressure rises due to consumption of either one, it will generally always rise when you consume them.

The Perfect Storm

Most heart attacks and strokes occur due to a sharp rise in blood pressure over a short period of time due to multiple factors that have a cumulative effect. The more that you are aware of the factors that increase your blood pressure, the more control you will have over your blood pressure.

It is not always advisable or feasible to take your blood pressure multiple times a day, or even frequently during a week, but if you have been diagnosed with hypertension it is important to know your typical blood pressure and what affects you. Unless advised otherwise by your doctor, monitoring your blood pressure means taking your readings once or twice a month under the same conditions - i.e., same time of day.  Whenever you change medication or change a treatment plan for hypertension it is important to monitor more frequently (often daily or at least a couple times a week) to understand the impact of the new treatment on your blood pressure. 

To really understand what affects your hypertension, I recommend that you take a couple of weeks and do the following:

• Monitor the impact of caffeine and salt on your blood pressure.
• If you work out, take your blood pressure before and after a normal workout.  A "good" work-out will decrease your blood pressure as you are improving the circulation of blood throughout the body.  If your exercise regimen is too intensive, too focused on weights versus cardio or if you are dehydrated after your workout you may find that your workout is actually increasing your blood pressure. 
• Stress can have a significant impact on blood pressure. During an acute stressful situation take your blood pressure so that you know the impact that it is having on your readings.
• Being dehydrated will generally increase your blood pressure. If you have a day that you know was more dehydrating -- lack of drinking water, higher stress, diet that was dehydrating, a busy day, etc - take your blood pressure at the end of the day and monitor the impact.
• Whenever you feel lightheaded, have a strange headache or feel weak, take your blood pressure and see if there is any correlation.  If you suffer with any of these symptoms frequently, you are best to talk to your naturopathic doctor.

The value of knowing the impact that different lifestyle factors have on your blood pressure is that you can avoid doing multiple things that increase your blood pressure simultaneously.  For example, when under stress you would know whether or not to avoid that extra cup of coffee and the high-salt meal.  You would know whether going to the gym will add to the problem or whether it would be beneficial. 

Knowing the impact that different lifestyle factors have on your blood pressure also allows your naturopathic doctor to tailor a treatment plan specifically for you.  For example, hypertension that is driven more by stress than by dietary factors would benefit from herbs or nutraceuticals focused on stress management.  Treating chronic dehydration (a common cause of hypertension) requires a different treatment approach than if the cause of hypertension if due to a high-salt diet or chronic stress.

Other Resources

To learn more about hypertension check out the following other resources:

• www.ndhealthfacts.org/hypertension
• Blog: Heart Health - A naturopathic perspective
• Blog: Cardiovascular Events - A Perfect Storm

Talk to your naturopathic doctor to learn more about how to manage your hypertension and to receive a treatment plan tailored specifically to you.

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Heart Health - A Naturopathic Perspective

Cardiovascular disease is one of the most common causes of death in North America.  For the most part, cardiovascular disease is preventable. It depends slowly over time due to lifestyle, chronic stress and environmental factors.  Although prevention of heart disease is the primary goal of naturopathic medicine, there are many naturopathic therapies that are very effective in the treatment of disease as well.

Categories of Heart Disease

Cardiovascular disease can be grouped into four main categories: generalized cardiovascular disorders, disease of the heart, peripheral vascular disorders and blood disorders.

• Generalized Cardiovascular Disorders include:
• Hypertension (high blood pressure)
• Hypotension (low blood pressure)

• Diseases of the Heart include:
• Congestive heart failure
• Angina pectoris
• Myocardial infarction (heart attack)
• Arrythmia

• Peripheral Vascular Disorders include:
• Atherosclerosis
• Hemorrhoids
• Intermittent Claudication
• Raynaud's Syndrome  / Disease
• Stroke
• Transient Ischemic Attack (TIA)
• Varicose Veins

• Blood Disorders include:
• Anemia
• Polycythemia

Factors that Contribute to Cardiovascular Disease

a) Lifestyle Factors

The lifestyle factors that may increase a person's risk of cardiovascular disease include:

• Water
• Dehydration, especially chronic dehydration

• Food Choices and Dietary Regimen
• food sensitivities can contribute to heart disease
• diets high in animal protein, cholesterol and fat 
• high glycemic foods or foods high in salt or sugar
• nutrient deficiencies
• consuming large meals and eating too close to bedtime

• Lack of Movement
• lack of overall physical activity
• sedentary lifestyle
• lack of flexibility
• excessive weight lifting, especially if focused on the upper body

• Lack of Sleep
• Insomnia, shortened sleep cycle and disrupted sleep can all contribute to heart disease.

b) Stress Factors

• Chronic stress is a contributing factor to cardiovascular disease. It is also commonly associated with cardiovascular events such as stroke or heart attack.

c) Environmental Factors

• Environmental toxins, such as heavy metals and chemical contribute to the development of heart disease. Air and water quality also play a role.
• Pathogens, such as viruses and bacteria can result in acute and chronic cardiovascular disease.

d) Other Factors

• Smoking, both first-hand and second-hand, is associated with increased risk of cardiovascular disease.
• Genetics can play a role, especially if a parent or first-degree relative experienced a cardiovascular event early in life. 
• Prescription medication is commonly associated with chronic cardiovascular disease.

Conditions Associated with Cardiovascular Disease

There are a number of conditions associated with cardiovascular disease. When treating or preventing cardiovascular disease it is often important to address these conditions as well.

• obesity
• diabetes
• high cholesterol
• kidney disease
• thyroid disease
• endocrine disorders

Testing for Cardiovascular Disease

Standard medical testing often relies on cholesterol levels as the primary indication of cardiovascular health and/or risk of a cardiovascular event such as a heart attack or stroke.  There are a number of other blood markers that can be very effective in both determining the degree of cardiovascular disease and the best treatment options.  They include: (to learn more about these test click on the word)

• Creating Kinase or Creatine Kinase-MB
• proBNP
• hs-CRP
• apolipoprotein B
• homocysteine
• blood gases
• electrolytes
• Hb1aC
• Uric acid
• Ferritin
• CBC

Testing for the factors that contribute to cardiovascular disease is an important part of treatment and prevention.  This testing may include:

• Food sensitivity testing
• Environmental toxin exposure
• Adrenal stress testing

If you have a family history of heart disease or would like to assess your risk for heart disease talk to your naturopathic doctor about the tests above to see if they are appropriate for you.

Treating Cardiovascular Disease

The treatment strategy that is required depends on the current health risk and the severity of the disease process.  In high risk or progressive states medication may be required.  The general naturopathic treatment strategy is as follows:

1. Determine the degree of health risk and stage of disease.
2. Addressing the lifestyle factors such as diet, movement, water intake; stress and environmental factors needs to be part of every treatment strategy - whether one chooses naturopathic treatments or conventional treatments.
3. Herbs, nutraceuticals and other naturopathic treatments are used to:

• effectively lower cholesterol or high blood pressure
• address atherosclerosis or other vascular disorders
• address the mental-emotional impact of stress on cardiovascular health
• balance out and address the side-effects of many cardiovascular medications, such as those taken for hypertension or high cholesterol.

The advantages of the naturopathic approach to heart disease is that it focuses on treating the causes of disease, it recognizes that integration of a person's lifestyle and environment with their health status and it utilizes effective therapies without many of the side-effects of prescription medications.

For more information on how naturopathic medicine can assist you in achieving and maintaining a healthy heart talk to one of our naturopathic doctors.