Mild to moderate essential hypertension is usually asymptomatic.
Chronic hypertension leads to enlargement of the heart, which can cause shortness of breath during exercise or sleep (paroxysmal nocturnal dyspnoea).
Thickening of the heart muscle (Left ventricular hypertrophy).
Insulin resistance, which is a component of syndrome X, or the metabolic syndrome is also thought to contribute to hypertension.
Consuming foods that contain high fructose corn syrup may increase one's risk of developing hypertension.
Certain prescription and illegal drugs.
Cardiac output is raised early in the disease course, with total peripheral resistance (TPR) normal.
Over time however, cardiac output drops to normal levels but TPR is increased.
The kidneys fail to excrete sodium, resulting in natriuretic factors such as Atrial Natriuretic Factor ANP being secreted to promote salt excretion with the side effect of raising total peripheral resistance. ANP, is a powerful vasodilator, released by muscle cells in the heart in response to high blood pressure. ANP acts to reduce the water and sodium, thereby reducing blood pressure. The paradoxical result is to increase Blood pressure as the drop in BP causes the peripheral arterioles to constrict therefore pushes up the BP.
Decrease in blood volume due to dehydration, Na deficiency or haemorrhage, stimulate the renin angiotensin pathway.
Low BP stimulates the juxtaglomerular cells to secrete a hormone, renin.
Angiotensin II has two target tissues. One is the adrenal cortex, where it stimulates aldosterone.
Blood volume increases and blood pressure normalises.(with ADH ). ADH present in neurons of the brain stem and spinal chord improves memory, regulates water resorption by the kidneys and causes vasoconstriction.
3. An overactive sympathetic nervous system, leading to increased stress responses.
Beta blockers such as atenolol, labetalol, metoprolol (Lopressor, Toprol-XL), propranolol. Whilst once were first line agents, now they are less commonly used because they increase the risk of diabetes.
Hyperhomocysteinaemia is a medical condition characterised by an abnormally large level of homocysteine in the blood. Simply put high homocysteine results in low levels of Nitric Oxide NO also know as Endothelial Derived Relaxing Factor EDRF. Whilst adrenalin causes vasoconstriction in peripheral arterioles and raises blood pressure, it is NO that allows these to relax resulting in a decrease in BP.
How does homocysteine decrease Nitric Oxide levels?
Homocysteine elevates blood levels of asymmetric dimethylarginine (ADMA), an endogenous inhibitor of nitric oxide synthase the enzyme involved in the production of NO.The effect is associated with the reduced activity of dimethylarginine dimethylaminohydrolase (DDAH), the enzyme that degrades ADMA.
Homocysteine post-translationally inhibits DDAH enzyme activity, causing ADMA to accumulate and inhibit nitric oxide synthesis. This may explain the known effect of homocysteine to impair endothelium-mediated nitric oxide–dependent vasodilatation.
A high level of homocysteine in our blood makes us more prone to having blood clots which come in heart attacks and strokes.
Hyperhomocysteinaemia also damages the lining of veins and arteries which prevents build up.
The second common defective gene is methioninesynthetase or MS.
Insulin resistance (IR) is a condition in which body cells become less sensitive to the glucose-lowering effects of the hormone insulin. High plasma levels of insulin and glucose due to insulin resistance are a major component of metabolic syndrome.
Many people with hypertension are either diabetic or pre-diabetic and have elevated insulin levels due to insulin resistance.
One of insulin's effects is to control arterial wall tension throughout the body. Insulin forces arterial wall muscle to relax, increasing blood flow, especially in micro arteries; lack of insulin reduces flow by allowing these muscles to contract.
Sugar causes Na retention. This is because insulin pushes calcium and magnesium out of the cells and retains Na.
Hyperinsulinaemia inhibits Delta 6 and Delta 5 EFA pathways. Zn, Mg and B6 are part of Glucose Tolerance Factor GTF and used to make insulin.
Actively increases blood pressure via adrenal stimulation.
Increased body Na due to hyperinsulinaemia or abnormal aldosterone / renin relationship.
Neuroendocrine abnormalities due to increased noradrenergic activity / opiate suppression.
Weight reduction reduces BP in normotensive, hypotensive and hypertensive patients.
NaCl results in deficient potassium resulting in increased ECF volume, which impairs the blood regulating mechanisms. This can causes hypertension in susceptible individuals.
Regular exercise. Regular exercise improves blood flow and helps to reduce the resting heart rate and blood pressure. Exercise increases endothelium- derived relaxing factor (EDRF)/nitric oxide (NO).
Reducing sodium (salt) in the diet.
Additional dietary changes beneficial to reducing blood pressure include the DASH diet (dietary approaches to stop hypertension) which is rich in fruits and vegetables and low-fat or fat-free dairy products.
In addition, an increase in dietary potassium, which offsets the effect of sodium has been shown to be highly effective in reducing blood pressure.
Discontinuing tobacco use and alcohol consumption has been shown to lower blood pressure. The exact mechanisms are not fully understood, but blood pressure (especially systolic) always transiently increases following alcohol or nicotine consumption. Probably something to di with nitric oxide also.
Reducing stress, for example with relaxation therapy, such as meditation and other mindbody relaxation techniques, by reducing environmental stress such as high sound levels and over-illumination can also lower blood pressure.
Data analysis confirmed that the Mediterranean diet as a whole is significantly associated with lower systolic and diastolic blood pressure as were olive oil, vegetables and fruit. On the other hand, consumption of cereals, meat and meat products, and alcohol intake is associated with higher blood pressure.
People who follow a Mediterranean-style diet tend to have higher HDL or “good” cholesterol levels, which help promote heart health. Inuit Eskimos, who get high amounts of omega-3 fatty acids from eating fatty fish, also tend to have increased HDL cholesterol and decreased triglycerides (fats in the blood). Several studies have shown that fish oil supplements reduce triglyceride levels.
Several clinical studies suggest that diets or fish oil supplements rich in omega-3 fatty acids lower blood pressure in people with hypertension.
An analysis of 17 clinical studies using fish oil supplements found that taking 3 or more grams of fish oil daily may reduce blood pressure in people with untreated hypertension. Heart disease One of the best ways to help prevent heart disease is to eat a diet low in saturated fat and to eat foods that are rich in monounsaturated and polyunsaturated fats (including omega-3 fatty acids).
Clinical evidence suggests that EPA and DHA (eicosapentaenoic acid and docosahexaenoic acid, the two omega-3 fatty acids found in fish oil) help reduce risk factors for heart disease, including high cholesterol and high blood pressure.
Fish oil has been shown to lower levels of triglycerides (fats in the blood), and to lower risk of death, heart attack, stroke, and abnormal heart rhythms in people who have already had a heart attack. Fish oil also appears to help prevent and treat atherosclerosis (hardening of the arteries) by slowing the development of plaque and blood clots, which can clog arteries.
Large population studies suggest that getting omega-3 fatty acids in the diet, primarily from fish, helps protect against stroke caused by plaque build-up and blood clots in the arteries that lead to the brain. Eating at least 2 servings of fish per week can reduce the risk of stroke by as much as 50%.
People who eat more than 3 grams of omega-3 fatty acids per day (equivalent to 3 servings of fish per day) may have higher risk for hemorrhagic stroke, a potentially fatal type of stroke in which an artery in the brain leaks or ruptures.
The polyphenols found in olive oil are potent antioxidants that protect LDL (the potentially harmful form of cholesterol) from oxidation (damage by free radicals). Oxidised LDL cholesterol contributes to the development of atherosclerosis.
Central obesity is associated with insulin resistance, which leads to further weight gain and increases risk of type 2 diabetes.
The high carb diet increased abdominal fat compared to the fat-rich diets.
Of the three diets, the diet rich in olive oil prevented abdominal fat accumulation, improved insulin sensitivity and saw an increase in a hormone called adiponectin.
Adiponectin is a hormone produced and secreted by fat cells (adipocytes).
Low blood levels of adiponectin are a marker for metabolic syndrome, are common in obesity, and are also associated with increased heart attack risk.
Research has discovered a compound that suppresses the prostaglandin system, the same pain pathway as non-steroidal anti-inflammatory agents, such as ibuprofen.
Although its chemical structure is quite different from the anti-inflammatory compounds in non-steroidal drugs, olive oil's anti-inflammatory component, which researcher Beauchamp named "oleocanthal," has a similar effect.
Garlic's numerous beneficial cardiovascular effects are due to not only its sulphur compounds, but also to its vitamin C, vitamin B6, selenium and manganese.
Garlic is a very good source of vitamin C, the body's primary antioxidant defender in all aqueous (water-soluble) areas, such as the bloodstream, where it prevents the oxidation of LDL cholesterol.
Garlic's vitamin B6 lowering levels of homocysteine. An intermediate product of an important cellular biochemical process called the methylation cycle, homocysteine can directly damage blood vessel walls.
The selenium in garlic is a cofactor to glutathione peroxidase (one of the body's most important internally produced antioxidants), selenium also works with vitamin E in a number of vital antioxidant systems.
Garlic is also rich in another trace mineral, manganese, which also functions as a cofactor in a number of other important antioxidant defence enzymes, for example, superoxide dismutase.
Studies have found that in adults deficient in manganese, the level of HDL (the "good form" of cholesterol) is decreased.
Garlic, like onions, contains compounds that inhibit lipoxygenase and cyclooxygenase, (the enzymes that generate inflammatory prostaglandins and thromboxanes), thus markedly reducing inflammation.
Individuals whose diets provide greater amounts of omega-3 fatty polyunsaturated fatty acids-and walnuts are an excellent source of these essential fats-have lower blood pressure than those who consume less, shows data gathered in the International Study of Macro- and Micro-nutrients and Blood Pressure (INTERMAP) study (Ueshima H, Stamler J, et al. Hypertension).
Lead author Hirotsugu Ueshima, MD of Shiga University of Medical Science in Japan, noted that the beneficial effect of omega-3 fats was even greater in people who had not yet developed high blood pressure. The researchers also found that omega-3s from nuts, seeds, and vegetable oils-such as walnuts and flaxseed-had just as much impact on blood pressure as omega-3s from fish.
"With blood pressure, every millimeter counts. The effect of each nutrient is apparently small but independent, so together they can add up to a substantial impact on blood pressure. If you can reduce blood pressure a few millimeters from eating less salt, losing a few pounds, avoiding heavy drinking, eating more vegetables, whole grains and fruits (for their fibre, minerals, vegetable protein and other nutrients) and getting more omega-3 fatty acids, then you've made a big difference," said Ueshima.
Previously, the protective effects of a diet high in vegetables was thought to be due to their high antioxidant content, but this study reveals that it is the dietary nitrate in beetroot juice and in all green leafy vegetables can result in a decrease in blood pressure.
The nitrate in beetroot juice is converted by bacteria on the tongue into nitrite and swallowed in saliva, which, in the acidic environment of the stomach, is either converted into nitric oxide or re-enters the circulation as nitrite.
Nitric oxide lowers blood pressure because it signals the endothelium (the lining of our blood vessels) to relax.
In healthy volunteers, blood pressure began to lessen within just 1 hour of drinking beet juice, with the peak drop of -10.48 mm/Hg occurring about 3 hours after ingestion. And beneficial blood pressure lowering effects continued to some degree for up to 24 hours!
Tilia europa Lime flowers – peripheral vasodilator and relaxant aused for arteriosclerosis and hypertension.
Dandelion is used for high blood pressure, and congestive heart failure. In the spring dandelion leaves and roots produce mannitol, a substance used in the treatment of hypertension and weak heart throughout Europe. A tea is made of the roots and leaves are good to take during this period, from about mid-March to mid-May.
Bring 1 quart of water to a boil, reduce heat and add 2 tblsp. of cleaned and chopped fresh roots.
Simmer for 1 minutes, covered, then remove from heat and add 2 tblsp. of chopped, freshly picked leaves.
Strain and drink 2 cups per day.
Shiitake mushrooms contain lentinan. Lentinan has been shown to reduce both blood pressure and cholesterol, suggesting usefulness in preventing and treating heart disease and stroke. In a half-dozen Japanese studies, daily servings of 1/3 of an ounce of shiitakes reduced cholesterol an average of 7%. Every 1% reduction in cholesterol means a 2% reduction in heart attack risk, so the mushroom cut heart attack risk 14%.
Barberry contains chemicals that may help reduce elevated blood pressure by enlarging blood vessels, thus lending support to the herb's traditional Russian use as a treatment for high blood pressure. Bayberry changes the way the body uses sodium and potassium.
A study published in Nature shows black cohosh reduces blood pressure by opening the blood vessels in the limbs (peripheral vasodilation). The herb may help manage high blood pressure, lower cholesterol, helps cardiovascular and circulatory disorders.
Deficiencies of the vitamins folic acid, B6 or B12. results in the poor methylation of homocysteine and thus accumulation. Supplementation with B6, folic acid, B12 or trimethylglycine (betaine) reduces the concentration of homocysteine in the bloodstream.
There is an inverse correlation between low blood levels of vitamin D and increased risk of hypertension.
Coenzyme Q10 (CoQ10) Coenzyme Q10 or CoQ10 is an essential component of the mitochondria. Although CoQ10 can be synthesised within the body, deficiency has been found in 39% of patients with high blood pressure.
In several studies, CoQ10 has been shown to lower blood pressure approximately 10% in patients with hypertension; however, not until after four to twelve weeks of therapy. CoQ10 seems to lower blood pressure by lowering cholesterol levels and stabilising the vascular system via its antioxidant properties. These actions reduce resistance to blood flow through the arteries.
Another study conducted at the University of Western Australia looked at the effect of CoQ10 on blood pressure and glycemic control in 74 people with type 2 diabetes. Participants were randomly assigned to receive either 100mg CoQ10 twice daily, 200mg of the drug fenfibrate, both, or neither for 12 weeks. CoQ10 significantly reduced systolic and diastolic blood pressure(mean reduction 6.1 mm Hg and 2.9 mm Hg respectively). There was also a reduction in HbA1C, a marker for long-term glycemic control.
Vitamin C May Lower Blood Pressure The Lancet December 18, 1999;354.
The study of 45 people with high blood pressure (hypertension) had the levels fall by about 9.1% if they consumed a 500-milligram supplement of vitamin C each day for a month.
Potassium, either from fruits and vegetables or in supplement form, can lower high blood pressure. Anyone who already has hypertension "should eat a diet high in potassium or take supplements," says Harvard researcher Frank M. Sacks, MD.
In a study of more than 300 women, he and colleagues learned that potassium is more important than magnesium or calcium for blood pressure control. "Surprisingly, when we put the three together, the effect was no greater than potassium alone. In fact, it was a little lower," he adds. About 1,600 milligrams of potassium was given to the study participants.
A glass of orange juice or banana contains about 400 milligrams of' potassium.
In a recent large population study in Europe, it was found that low blood levels of vitamin E were much more predictive of heart disease than were high levels of blood cholesterol and elevated blood pressure.
High levels of blood cholesterol were predictive 29% of the time, high blood pressure was predictive 25% of the time, but a low blood level of vitamin E was predictive of a heart attack 69% of the time.
In perhaps, the most impressive study of vitamin E, published in the journal Lancet, daily doses of 400-800 IU of vitamin E were shown to decrease the incidence of heart attacks by 77% in a group of 2,000 people.
L-arginine is a common amino acid from food, but its importance increases in those with hypertension. In the body (specifically within those hard-working blood vessels) it is converted into nitric oxide, a chemical that helps keep the inner walls of blood vessels smooth and normally allows blood vessels to relax (among many other extremely important functions).
Individuals with hypertension have difficulty maintaining normal nitric oxide levels, which may also relate to other significant health issues such as diabetes and heart problems. The kidneys are particularly sensitive to the levels of l-arginine, nitric oxide, and related chemicals. Stressful experiences and aging may also result in lower l-arginine levels.
Dietary intake levels of l-arginine vary considerably, but they range from 1 to over 4 grams per day. The consumption of nuts, which contain relatively high levels of arginine, has a very strong negative correlation to the risk of coronary events. Soy flour, wheat bran, hazelnuts, and walnuts all contain high levels of both arginine and folic acid. Fish contains high levels of arginine and essential fats.
A major source of dietary arginine in the Western diet is meat; however, meat also contains high levels of saturated fats as well as methionine, the precursor to homocysteine. Soy flour, wheat bran, and most nuts contain relatively low levels of methionine.
It is advisable to limit arginine intake in those with active or latent herpes simplex or herpes zoster infections.