Chronic Hypertension

• Your body requires sodium (a component of salt) to regulate fluid balance and distribution, as well as nerve and muscle cell function. Although you need some sodium, the standard diet includes way too much.
• “Salt sensitivity” is a key factor in determining the response to dietary salt intake. Cardiovascular problems, including heart attack and stroke, are more common in “salt sensitive” patients than in “salt resistant” ones.
• The current recommendation for salt consumption is less than 2,400 mg of sodium a day, which amounts to about one teaspoon of salt. Recent research suggests that people ingesting less than 1,500 mg of sodium a day are better able to control high blood pressure. If you have high blood pressure, you should definitely aim for that kind of level. Don’t use salt from the shaker, and read labels to add up the amount you’re taking in.
• Many items at fast food restaurants are high in salt, so you can easily exceed the recommended level with one serving.
• You can easily make up for the reduced salt in your diet by cooking with fresh herbs and spices such as basil, garlic, oregano, rosemary, chives, parsley, and onion. What’s more, all of these flavorings contain natural substances that are good for your health. Garlic, in particular, has been shown to have a positive effect on blood pressure when consumed on a daily basis.
• Beware of cutting your salt consumption too much. You need a minimum amount of sodium in your system to maintain proper electrolyte balance, regardless of your blood pressure status. For that reason, don’t let your daily salt intake fall below about 500 mg.

Maintaining good cholesterol levels is  important, but, contrary to popular belief, cholesterol is not a villain. Your body needs cholesterol to synthesize certain nutrients and hormones, construct the semi-permeable membranes around each of the 100 trillion cells that make up your body, and facilitate cell communication and memory in the brain.

Cholesterol moves through the body with the help of two proteins: LDL, or low-density lipoprotein, and HDL, or high-density lipoprotein. LDL carries ready-to-use cholesterol molecules that can be absorbed by cells that need it, and HDL picks up excess cholesterol and carries it back to the liver for recycling and excretion.

Healthy LDL cholesterol levels are always of great concern, as they should be, but few people know that it’s impossible for your cells to absorb too much of it. LDL becomes unsafe only when it interacts with molecular fragments called free radicals. The effect of such interaction is that the LDL becomes oxidized. Unlike normal LDL, oxidized LDL has toxic effects on the cells it attaches to.  

When you get down to it, though, the real problem is not cholesterol—it’s whether your body’s antioxidant system can effectively neutralize the free radicals that damage LDL molecules.

Here’s what you need to remember about cholesterol: It’s a relative heart risk factor and it’s influenced by other factors. You should also keep in mind that good cardiovascular nutrition and a cholesterol lowering diet can go a long way to helping you keep good cholesterol levels.

For more information on cholesterol guidelines, reducing hypertension, and overall heart health, visit www.drsinatra.com. While there, sign up for FREE e-letters or subscribe to Dr. Sinatra’s monthly newsletter, Heart, Health & Nutrition.

While exercising, I urge you to learn to listen to your body. Is the exercise you’re doing causing pain? Tight muscles? Does it hurt your posture? Is it affecting your sleep? Is it disturbing your breathing, digestion, vision, or other functions not normally associated with fitness?

If you experience any of the following symptoms, stop immediately.

• Lightheadedness or dizziness
• Palpitations
• Shortness of breath (unable to carry on a conversation)
• Jaw pain
• Arm tingling or numbness
• Tight feeling in the lungs (bronchospasm)

Resveratrol, commonly found in grapes and other plants, is being studied for its antioxidant properties and its ability to minimize cardiovascular problems. That’s why I encourage my patients to drink grape juice and red wine, both of which are made with grapes (in moderation, of course). You can also get resveratrol in supplement form. I recommend 2–5 mg of resveratrol daily. It's simply good cardiovascular nutrition.

I also encourage my patients to drink flavonoid-rich green tea. Doing so is an easy way to promote good health and encourage resistance against chronic degenerative diseases, including chronic hypertension. While plain green tea itself has a delicate flavor, try it in one of the many formulas combining it with lemongrass and other herbs. Add a little honey and lemon, and I think you will find that this healthy heart nutrition tip really is quite delicious.

If you can break your coffee habit in the process, you’ll be doubly rewarded, as you’ll also be reducing the amount of caffeine you ingest.

For more information on cardiovascular nutrition, visit www.drsinatra.com.

Early childhood experiences governed by conditional love form the basis for the Type A person, who is driven to achieve as a way to overcome low self-esteem due to early rejections.

In the pursuit to gain lost parental love and overcome such profound heartbreak, children begin to sacrifice their true self for the illusion of success. Schoolwork and performance, newly substituted passions, displace lost love. If children become too involved in their image at the expense of who they really are (i.e., emphasizing who they wish to be as opposed to who they actually are), they can lose the capacity to experience the present moment.

If this pattern continues into adulthood, whereby true feelings are denied, an individual becomes increasingly vulnerable to pushing and striving beyond healthy limits.

It is the denial of feeling, or repression of feeling that contributes to cardiovascular problems, including heart attack and stroke and chronic hypertension. 

But, don’t despair.  There are things you can do to fight back, many of which you’ll find in my blog postings. 

I’m especially passionate about eating for good cardiovascular nutrition.  Take some time to visit my web site page where I provide smart tips and tasty recipes to help you along the way.  

For more information on cardiovascular problems, including heart attack and stroke, visit www.drsinatra.com.

There really is a link between heartbreak, chronic hypertension, heart attack and stroke, and other cardiovascular problems. Let me explain.

I’m sure you are familiar with the Type A personality—a volatile mixture of aggressive, impatient and hostile behavior. And you know that certain aspects of Type A behavior, especially uncontrolled anger and hostility, can be a risk factor for cardiovascular problems.

But let’s delve a little deeper—what creates Type A behavior? Many doctors and holistic health practioners believe that it comes from a lack of love and intimacy. I agree with them and I fully acknowledge that noted research has shown that lack of love can set the stage for Type A behavior.

Few people will admit that they were unloved as children. Even patients undergoing psychotherapy have considerable difficulty accepting this possibility. Generally, it is only after they have experienced the pain of their heartbreak that they are willing to recognize that one or both parents had considerable negative feelings toward them. Parental love is a human need; unfortunately, it is not always a reality in life.

Type A behavior often develops in a family situation in which love for the child is conditional upon the child’s accomplishments and achievements. In Western culture, where success has become the most important “virtue,” many parents see their child’s success as a mark of their own narcissistic desires. Too often, parents’ egos are involved in their children’s status and performance in school, or in extracurricular activities like music and sports. But, love conditioned upon performance is not love at all.

Conditional love always carries with it the possibility that at some time or another the parents will withdraw their love if the child’s performance has not met their expectations. True love surrounds people with warmth and affection for who they are, not for what they do. If young children receive the message: “You are not acceptable the way you are,” basic insecurities may develop.

In my next post, I’ll discuss how Type A kids become Type A adults and run the risk of developing a myriad of cardiovascular problems.

To read more about preventing cardiovascular problems, visit www.drsinatra.com.
 

Grape juice, like red wine, can help prevent blood clots and improve blood circulation.  Resveratrol, commonly found in grapes and other plants, is being studied for its antioxidant properties and its ability to minimize cardiovascular problems.  The “Dr. Sinatra recommended dosage” of Resveratrol is 2–5 mg daily.

Secondly, drinking flavonoid-rich green tea is an easy way to avoid cardiovascular problems and encourage resistance against chronic degenerative diseases, including chronic hypertension, heart attack and stroke.

While plain green tea itself has a delicate flavor, try it in one of the many formulas combining it with lemongrass and other herbs. Add a little honey and lemon, and I think you will find that this healthy heart nutrition tip really is quite delicious. If you can break your coffee habit in the process, you’ll be doubly rewarded, as you’ll also be reducing the amount of caffeine you ingest.

For more information on improving blood circulation, visit www.drsinatra.com.

For years now, I’ve been telling my readers and patients to avoid acetaminophen—especially the extra-strength variety—because of the potential for liver problems. I’ve also said to avoid NSAIDs because of the potential for gastrointestinal bleeding, liver damage, and kidney dysfunction.

My advice is clearly supported by a report from the Harvard School of Medicine’s ongoing Nurses' Health Study that suggests that the use of painkillers can make it difficult for women to control high blood pressure. 

The report, published in the September 2005 issue of Hypertension, concluded that women are at increased risk for high blood pressure if they take daily doses of non-aspirin painkillers—such as extra-strength acetaminophen (Tylenol) and ibuprofen (Advil and Motrin).

This observation is especially troubling for pain-ridden patients looking for alternatives after learning a few years ago that prescription NSAID painkillers (such as Vioxx) are associated with higher risk for cardiovascular problems. 

The Harvard study involved 5,123 women age 34 to 77, none of whom had high blood pressure at the onset. Here are the results:

• For women not taking painkillers, the risk of developing high blood pressure levels was about 1 to 3 percent a year.
• Women who were taking an average daily dose of more than 500 mg of acetaminophen (one extra-strength tablet) had a 93 to 99 percent increased risk of developing high blood pressure (and, most likely, a more difficult time maintaining healthy blood pressure) within three years, compared to women taking less than 500 mg.
• Women who were taking more than 400 mg a day of over-the-counter NSAIDS (the equivalent of two ibuprofen) had a 60 to 78 percent increased risk of developing high blood pressure levels, compared to women taking less than 400 mg.
• The widespread use of acetaminophen and over-the-counter NSAIDs may contribute to the high prevalence of chronic hypertension in the United States.

Please take this information to heart. If you take painkillers regularly, please inform your doctor. He or she may have some safer recommendations. Here are a few of mine:

• White willow bark (180 mg twice a day); or
• Low-dose aspirin (325–650 mg a day as tolerated, but discontinue if you experience abdominal discomfort); or
• SAM-e (200–400 mg, once or twice a day as needed).

Remember, there are always safer alternatives to “the business-as-usual” drugs we’re being marketed in the media.
 

As a cardiologist and a holistic health practitioner, I take blood pressure levels of every patient who comes into my office. And sadly enough, oftentimes, I find that that their blood pressure levels are too high. As you probably know, high blood pressure levels are often a precursor to serious cardiovascular problems, including heart attack and stroke, so this is a situation that I take very seriously.

Some of these patients, however, tell me that they are doing all they can to control high blood pressure and that when they go home and measure it themselves, their blood pressure levels are normal. Occasionally they’ll ask if the instruments in my office are off, or if my staff misread the result.

The actual problem, however, is a common condition called white-coat hypertension (WCH). It’s used to describe people who become anxious over a visit to a physician, dentist, or medical facility. The visit evokes a fight-or-flight response, and their blood pressure levels go up.

Research has shown that abnormally high blood pressure readings in a medical setting could be more than just a benign byproduct of anxiety.  Although the condition is poorly understood, WCH could be a precursor to high blood pressure levels, poor blood circulation, and other cardiovascular problems.

A Danish study published in the Journal of Human Hypertension found a heightened cardiovascular event risk for patients with WCH over a 10-year period. A Japanese study reported in the journal Hypertension Research suggests that WCH contributes to carotid arteriosclerosis. And in another Japanese medical report, based on eight years of observation, researchers suggest that WCH is a “transitional condition to hypertension” and may carry a “poor cardiovascular prognosis.”

If you experience WCH, I suggest you take the following high blood pressure remedies to get it under control and avoid potential cardiovascular problems:

• Introduce a regular stress-reduction program into your life. That could include activities such as exercise, tai-chi, meditation, or yoga. This is a wonderful way of lowering blood pressure naturally.
• Watch the salt (again). This cardiovascular nutrition tip can’t be stressed enough.
• Start taking blood pressure-friendly supplements on a daily basis—such as fish oil (2,000-3,000 mg), magnesium (400-800 mg), hydrosoluble CoQ10 (50-150 mg), and a garlic supplement high in allicin (500-1,000 mg). You can find these supplements in most health food stores.

For decades I’ve been making spaghetti sauce for family and friends. As I prepare the sauce over the course of a day, I repeatedly taste it to make sure that I get it just right.

Twenty or so years ago, I noticed that the day after the meal I had gained a few pounds—and I was unusually thirsty as well. I was perplexed until I investigated and learned that the canned tomatoes, pastes, and purees I was using were high in salt.

Here I was, a cardiologist, as well as a holistic health practitioner, and I hadn’t made the connection. Excess salt contributes to water retention, and that was my problem. Of course, too much salt also makes it difficult to control high blood pressure and contributes toward a myriad of other heart risk factors.

I quickly changed my ways and my spaghetti sauce recipe. I started avoiding foods high in salt, which meant reading labels on foods in the grocery store. (This one act alone is an excellent way to naturally maintain good blood pressure levels.)  Most people don’t think they eat too much salt because they didn’t use a salt shaker. Unfortunately, that’s simply not the case.

The average adult consumes the equivalent of nearly two teaspoons of salt a day—practically two times the upper limit for good health. And the majority of that excess salt is hidden in processed foods, such as canned spaghetti sauces, soups, and dill pickles.

I’ll never forget a patient of mine who had chronic hypertension and ate his fill of canned ham (packed with salt) on Easter Sunday. The next day he was in the emergency room with a hypertensive crisis and acute heart failure. His heart just couldn’t handle the large amount of salt he had consumed.

His was an extraordinary situation, but it underscores the need to be careful with salt intake. So let his story and mine be lessons for you as well. 

You may remember that last month, I wrote about breast cancer awareness and the importance of raising awareness about this dreaded disease. Today I want to share another message of urgent importance to women: As bad as breast cancer may be, you are far more likely to die of heart disease. 

Women are often surprised to learn that their chance of dying from heart disease is six times greater than their chance of dying from breast cancer. But statistics show that while four percent of women will die of breast cancer, more than 30 percent will die of heart disease. So you need to pay attention to your heart risk factors, especially as you pass menopause and lose the natural protection against heart attack and stroke provided by estrogen.

Fortunately, you can reduce your chance of heart attack and stroke by eating a healthy PAMM diet, exercising regularly, and taking nutritional supplements that support heart health (fish oil and CoQ10 are two of my favorites). You should also do the following:

• Get regular blood tests to monitor your heart risk factors. Cholesterol fractionation tests are essential. Known as the VAP and LPP, these tests measure the various components of cholesterol and more accurately assess your risk of heart disease than standard blood lipid tests. The tests also measure Lp(a), a highly inflammatory form of LDL cholesterol that causes blood clots. Lp(a) rises in menopausal women so it’s important to watch your level. In addition, ask your doctor to check your levels of C-reactive protein (CRP), homocysteine, and fibrinogen. These biochemicals help predict cardiovascular disease. CRP is a marker of chronic inflammation, and homocysteine is a toxic amino acid involved in the early stages of arterial damage. Fibrinogen is a protein with inflammatory and clot-forming properties. It rises during menopause, particularly among smokers.

• Refuse to take cholesterol-lowering statin drugs unless you have evidence of inflammation, advanced cardiovascular disease, or have had a prior cardiac event or procedure. Many doctors prescribe statins at the first sign of high cholesterol, but I believe statins should be prescribed only to people with advanced arterial disease. Not only do the drugs inhibit your body’s production of CoQ10, but depletion of CoQ10 levels can lead to low energy and muscle weakness. Moreover, statins may increase Lp(a), one of the most dangerous heart risk factors.

• Avoid hormone replacement therapy that uses synthetic hormones. Conventional HRT drugs (Premarin, Provera, Progestin) have been documented as dangerous to the cardiovascular system. I recommend biodentical hormones instead. These natural plant-based substitutes that have chemical structures identical to those in the body, and they achieve excellent results without serious side effects.

• Lower your stress level. Happiness is a healer. Stress is a killer. Be happy—and stay healthy!

For more information on cholesterol guidlines, reducing hypertension, and overall heart health, visit www.drsinatra,com. 

 

In my last blog post, we talked about the importance of monitoring your blood pressure regularly. But what do you do if your blood pressure levels are high, or borderline high? There are several things you can (and should) do to control high blood pressure as a woman.

1.      To Control High Blood Pressure, Be Careful with Hormone Replacement Therapy (HRT): In 2004, results were published from the Women’s Health Initiative, a study including women taking Premarin. The women taking this pharmaceutical form of estrogen, (made from the urine of pregnant mares), were observed to have “skyrocketing” blood pressure levels. But Premarin is not the only HRT that causes high blood pressure.

Dr. Sinatra has noted that Provera, another HRT mainstay, drove up blood pressure in the women he treated, many of whom were no longer hypertensive once they discontinued the drug.

What we’re learning is that to control high blood pressure, individually tailored bio-identical hormone therapy from more natural plant and synthetic sources are better for women. Combining estradiole, estriol, estrone, testosterone, and progesterone may soften those arterial walls that can stiffen with age, and may even intercept elevating blood pressure.  So please consider this approach if you are on the traditional HRT medications, especially if you’re trying to control high blood pressure.

2.      Watch the Painkillers: A report from the Harvard School of Medicine’s ongoing Nurses Health Study, published in the September 2005 issue of Hypertension, concluded that women are at increased risk for high blood pressure if they take daily doses of non-aspirin painkillers such as extra-strength acetaminophen and ibuprofen.

If you take painkillers regularly and are trying to control high blood pressure, please ask your doctor for safer recommendations. What we use at our house—and it works well for various muscle aches and pains—is Traumeel, a homeopathic remedy you can find in health food stores. Traumeel is available in both a topical cream and a tablet that you place under your tongue.

3.      Control High Blood Pressure with Some Simple Changes to Your Diet: To control high blood pressure and keep your heart healthy, you want to increase your intake complex carbohydrates (like oatmeal); low-glycemic vegetables such as asparagus, broccoli and kale; legumes like chick peas and lentils; fruits; cold-water fish (especially fatty ones); organic eggs; olive oil; and nuts, seeds, and flaxseed.

At the same time, to control high blood pressure you want to decrease your intake of refined white flour and sugar, partially hydrogenated oils, starchy vegetables like corn and peas, processed fruit juices, organ meats, cashews (because they’re high in saturated fat), full-fat dairy products, and omega-6 oils (such as corn, safflower, and sunflower). 

4.      Eat More Garlic:   An Australian review of 11 studies in which hypertensive patients were randomly given a garlic supplement or placebo, found that garlic can lower blood pressure as effectively as some drugs. On average, the mega-analysis turned up blood pressure reductions of 8.4 systolic points, and 7.3 diastolic points. The higher a patient’s blood pressure was at the beginning, the more it was lowered by taking garlic.

To control high blood pressure, I recommend four cloves of raw garlic (about four grams) daily to achieve a noticeable blood pressure lowering effect. You could also toss crushed garlic into food for the last few minutes of cooking, but anything more than lightly warming it will destroy its medicinal properties to control high blood pressure.

5.      Control High Blood Pressure with Exercise:  Regular exercise is a sure way to help control high blood pressure. Physical activity also lowers levels of stress hormones circulating in the blood, which is important since stress tends to constrict arteries and drive up blood pressure. To control high blood pressure, you want to strive to exercise three to four times a week. Try taking a brisk walk, getting on your bicycle, playing noncompetitive golf or tennis, or even dancing —all of which are great for your blood pressure and your stress level. Even simple day-to-day activities like taking the stairs instead of the elevator, parking further back in a parking lot, or a leisurely walk, are helpful to control high blood pressure.

6.      De-Stress—It’s a Surefire Way to Control High Blood Pressure: Stress is a major mitigating factor when it comes to your blood pressure, so be aware of the psychological pressures you’re juggling. Overachieving and time urgency are all-too common “normals” for women. We juggle multiple roles as breadwinner, wife, daughter, mother, and friend that often involve nurturing others at our own expense if we don’t refuel.

Some good ways to de-stress and control high blood pressure include meditation, relaxation, imagery, yoga, prayer, Tai Chi, exercise, reading, listening to calming music, or playing with children and friends into your daily life.  

Also remember that not all venting is “complaining.” Talking with someone you trust about the stresses in your life, benefits your wellbeing—and helps you control high blood pressure.

Lastly, remember to stay positive! No woman is sentenced to a life of high blood pressure because of her DNA. It’s not our destiny! Our blood pressure reading is only a number, and it’s one we can lower with our own conscientious lifestyle changes, and medication if needed.

Watch for more information about women and high blood pressure in Dr. Sinatra’s monthly newsletter, Heart, Health & Nutrition.  You can also visit www.drsinatra.com for more information on natural ways to lower blood pressure.

Years ago, high blood pressure was something adults developed as they got older. But given our modern day lifestyles—filled with fast-food based, high fat diets, and sedentary activities—record numbers of children have hypertension. 

As caretakers for our children during their early lives, it’s really up to adults to help our children maintain healthy blood pressure. After all, we’re the ones prepping their meals, supervising their out-of-school hours, and taking them to the pediatricians. And moms, dads and grandparents call all team up together to help the children we love.

So, how can we help our children achieve healthy blood pressure?

Keep Them Active: Studies show that more active kids tend to have healthy blood pressure. So, the best thing we can do is keep our kids physically active. When I raised my children, all we had to monitor was television viewing.  Now we have the internet, cell phones, and electronic games to contend with. So, get the whole family off the couch and go out for a walk, bike ride, or toss the ball around in the yard.