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How's your blood pressure?

We all know it, the blood pressure cuff, proffered by the doctor or the nurse every time you visit a medical establishment. So they pop it on, the numbers go up, the numbers come down, you feel a disconcerting pumping sensation under the cuff. Then they look at you, either with a “that’s all fine” or a “mmm, that’s a bit on the high side….”

High blood pressure, or hypertension, is not an “illness” as such, and it often presents without symptoms, but if it starts creeping up, then it is not something you should ignore. High blood pressure can be an indicator of cardiovascular disease, now or in the future; or of kidney problems and other associated illnesses such as vascular dementia.

What do the numbers mean? The top number (systolic) represents the pressure on the arteries at the “top” of the heartbeat, i.e. when the pressure is the greatest, and the bottom number (diastolic) between beats, when the pressure is lowest. Ideally, you want the top number to be between 90 and 120, and the bottom number to be between 60 and 80.

There are multiple factors that contribute to whether our blood pressure is on the high side

(or on the low side … but that’s for another day). Blood pressure is regulated by hormonal messages to multiple organs. There is a feedback loop initiated by the kidneys whenever the blood volume passing through drops. This stimulates the secretion of renin by the kidneys, which in turn stimulates the liver to release angiotensinogen. This gets converted to inactive angiotensin 1 in the blood, then ACE (angiotensin converting enzyme) converts this to the active form angiotensin 2. This does 2 jobs: it stimulates vasoconstriction (or narrowing) of the blood vessels, bringing up blood pressure, but it also stimulates the adrenals to release aldosterone, which tells the kidneys to reabsorb blood sodium (and so blood volume goes up – water always follows sodium) and to excrete potassium. There is another feedback loop involving blood potassium levels; when this goes up, then aldosterone is also released.

But don’t forget there are other mechanisms which also contribute to narrowing of the blood vessels….top of the list is being in a “fight or flight” state, or to use the lingo, in the sympathetic branch of the autonomic nervous system. You know this feeling…the perception of some kind of stress or overwhelm prompts the adrenals, via the HPA axis, to pump out adrenaline and noradrenaline (and later cortisol) as a reaction to the perceived stress, narrowing the blood vessels and making the heart beat faster, pumping blood to the muscles and preparing for said fight or flight. Except in modern times the stressor isn’t the sabre tooth tiger outside the cave, it’s the looming deadline, the gazillion things a modern working mum has to do, or the corporate and governmental induced fear and anxiety of living in these modern times……(aha, bit too political perhaps????)

Because there are multiple factors which contribute to rises in blood pressure, so there is a huge range of pharmaceutical medications available to control blood pressure is an indicator of this. They include:

  • ACE inhibitors (these block the enzyme that converts inactive angiotensin 1 to angiotensin 2)

  • Beta blockers (essentially, these block the action of the stress hormones adrenaline and noradrenaline on the heart muscles)

  • Calcium channel blockers (muscle contraction is always dependent on an influx of calcium; these medications reduce the amount of calcium entering the heart muscle and the muscle of the blood vessel wall)

  • Diuretics (essentially, these work by increasing urination and thereby decreasing blood volume).

All of these medications have complications and side effects. Diuretics by their very nature can upset essential mineral balance (they make you pee more, you lose minerals). ACE inhibitors can deplete zinc. Beta blockers can deplete co-enzyme Q10 and melatonin. Calcium channel blockers have a list of side effects as long as your arm, including constipation, dizziness, palpitations, fatigue, headaches and nausea.

But what all these medications ignore is that in general, there is an inflammatory background to high blood pressure. Years of living in the “fight or flight” loop, of eating an inflammatory diet (a diet based on sugared, refined, processed, nutrient-depleted non-food), of too much coffee to wake us up and too much booze to bring us back down again, of getting poor quality or insufficient sleep, of not getting out in nature, etc etc – these are the bedrock of inflammation.

So this is where you start, the basics. There are supplements you can take; there are practices you can do (barefoot grounding for increasing your nitric oxide, anyone? In February?) but you start with the basics. Clean up your diet, get out in nature, find an activity that soothes. Keep the walls of your arteries flexible. But if that blood pressure is creeping up, don’t ignore it….

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