What is Hypertension?

Hypertension, or high blood pressure, affects about 50 million Americans. The U.S. Public Health Service reports that hypertension affects more than half of all Americans over the age of 65. The percentage of African Americans with high blood pressure is onethird higher than that for whites. Most people develop a problem with blood pressure between ages 20 and 55, but a few cases begin before the age of 20; in these very early cases, there is usually some abnormality of the kidneys, their blood supply, or narrowing of the major blood vessels leading into the lower body that causes the elevation in pressure. Unless you fall into this youngest category, your high blood pressure most likely is not the result of any structural abnormality in blood vessels or the kidneys themselves. You, like 95% of Americans with high blood pressure, probably have what your physician calls "essential hypertension," which basically means high blood pressure without certain cause. That phrase is a little misleading, however, because as advances in medical technology have expanded our understanding of human biology to the microscopic and even submicroscopic level, we are now much more certain about what causes "essential" hypertension.

HypertensionSome people with essential hypertension produce an overabundance of adrenaline under stress, and their blood pressure rises markedly during these times but is normal in between. Others produce too much of the body chemicals called angiotensin II that act to powerfully constrict the blood vessels, which raises the blood pressure. In some cases, the kidney, though normal to look at, cannot normally rid the body of excess sodium, and where sodium goes, so goes water. Increased body water may mean increased pressure. One reason that a seemingly normal kidney might hold on to sodium more tightly is that it is being driven to do so by a high level of insulin in the blood. This last cause may explain elevated blood pressure in the vast majority of Americans. But the list goes on as new causes come to light.

A number of external causes also contribute to your risk of developing high blood pressure: Cigarette smoking raises blood pressure; alcohol raises blood pressure; taking estrogen, vitamin E, and decongestant medications can increase blood pressure; and obesity raises blood pressure (usually because of excess insulin). Exercise helps to reduce blood pressure and so does weight loss. What does nutrition have to offer in combating hypertension? Let's take a look in Hypertension diet.

What makes Hypertension worse?

• Drinking alcohol in more than very modest amounts causes an elevation in blood pressure. When you stop drinking, your blood pressure falls rapidly, usually within a week, sometimes as quickly as within 24 hours. Recommendation: Sharply curtail your alcohol intake to no more than 2/3 ounce of distilled spirits, 4 ounces of wine, or 1 "lite" beer per day.

•  HypertensionBecause caffeine does increase blood pressure briefly, especially in men prone to high blood pressure, you should avoid excessive consumption of caffeinated coffee, tea, and chocolate. The blood pressure rise that comes after drinking caffeine doesn't last long, with pressure soon returning to its usual level. An occasional cup of caffeinated coffee or tea is not going to cause a problem; however, if you measure your coffee in pots and not cups, you would do well to cut it back. According to The New England Journal of Medicine, coffee, when consumed in large quantities, can elevate blood cholesterol levels and more than double the risk of heart disease. Recommendation: Drink no more than 1 to 2 cups of caffeinated coffee or tea per day. If you currently drink coffee or tea heavily, you will need to reduce your intake slowly to avoid the headache and sleepiness that accompany caffeine withdrawal. Please refer to the caffeine listing under the heading Breast Disease (Benign) for a guideline to help you taper your caffeine intake without misery.

• If you are taking an MAO inhibitor (a drug prescribed to lower blood pressure and counter depression), avoid the chemical tyramine and its precursor, tyrosine. Tyramine-containing foods include almonds, avocados, bananas, beef or chicken liver, beer, cheese, chocolate, fava beans, herring, meat tenderizer, peanuts, pickles, pineapples, pumpkin seeds, raisins, sausage, sesame seeds, sour cream, soy sauce, wine, yeast extracts, and yogurt.

•  For years, physicians told their patients with high blood pressure to restrict their intake of sodium (salt). Recent medical data suggests that simply restricting salt has very little effect on hypertension unless you also correct imbalances in calcium, magnesium, and potassium. Once these nutrients are back in line, sodium intake ceases to be a factor influencing blood pressure as long as the kidneys are "normal." Recommendation: Don't be misled into thinking that all you have to do is eat a diet low in salt to reduce blood pressure. While we would not recommend that you bury your food in salt, neither would 1 advise your going to great lengths to purchase special foods low in salt unless you have a severe kidney problem and your physician has advised you to. Or you may be one of the 80 million Americans who have an increased sensitivity to dietary sodium; you need to assess your needs based on your circumstances. Adding a dash of it will not adversely affect your pressure if you take care of the basics in diet as outlined above.

•  Avoid obesity. Although the association is not 100%, many overweight people also suffer from high blood pressure, probably because the high insulin that promotes fat storage also promotes their hypertension. The two problems, then, are both just different symptoms of another bigger problem: hyperinsuiinemia or Syndrome X. Please refer to the discussion of this problem under the heading Obesity for more information. Recommendation: Begin now to reduce your weight and body fat to normal levels. The fundamentals of this kind of diet are: 45% lean protein (mostly chicken, fish, veal, and egg white); 35% nonstarchy carbohydrate (mainly from green vegetables and a little fruit); 20% monounsaturated fats, such as olive oil, canola oil, and 10% animal fat. Your diet should contain no sugar, corn syrup, high-fructose corn syrup, or products made with these substances, and no refined starches or meals or products made with these.

• Limit your intake of red meat and egg yolk because both these foods contain high amounts of arachidonic acid, a forerunner of the "bad" prostaglandins that cause constriction of blood vessels and increase blood pressure. Recommendation: Eat red meat no more than once a week, and limit egg yolk to 1 a day (white of the egg is all protein and therefore contains no arachidonic acid).

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