Reducing 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.

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.

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. 

 

I’ve written a lot about healthy blood pressure over the past few weeks, and there’s good reason for that. Controlling chronic hypertension is one of the best ways to reduce your risk of heart attack and stroke.

Today I want to go back to the relationship between diet and blood pressure levels, and talk specifically about salt.

Most people think they’re doing a good job cutting down on their salt intake simply by sitting down for a meal and not reaching for the salt shaker. Unfortunately, that’s not the case. What you eat is just as important.

The majority of salt we consume is hidden in the ingredients used to increase the shelf-life of processed and fast foods. Some salty choices, like potato chips, are obvious, but others you may not be aware of.

I’ll never forget a hypertensive patient of mine who ate his fill of canned ham (packed with salt) one Easter Sunday. The next day he was in the emergency room in hypertensive crisis, having an episode of acute congestive heart failure. His heart couldn’t handle the enormous amount of salt he’d eaten.

Now, I’ll admit that was an extraordinary situation, but it happens, and it underscores the need to be careful with salt intake—especially if you have high blood pressure levels, bad circulation, or other cardiovascular problems.

So the next time you reach for something to eat, make sure it’s not full of "hidden salt." I’ve put together a partial list of products that are loaded with it, to help you steer clear of some of the worst offenders:
 

• Canned and dried (packaged) foods, especially soups
• Potato chips, pretzels, saltines
• Salty or smoked meats—bacon, bologna, corned beef, luncheon meats, sausage—canned meats, and pickled meats
• Salty or smoked fish—anchovies, caviar, herring, and sardines
• Pickles and sauerkraut
• Salted nuts
• Olives
• Processed cheese and cheese spreads
• Macaroni and cheese
• Canned vegetables and vegetable juices
• Ketchup and tomato sauce
• Soy sauce
• Frozen pizza

Earlier this week, a study in the Archives of Internal Medicine reported a link between the amount of sodium and potassium you consume and your risk of developing cardiovascular problems. Even though this isn't big news, I'm glad it was published. It reinforces the importance of keeping minerals in the body properly balanced--especially if you are trying to control high blood pressure.

If you have hypertension, you already know that it's important to limit your sodium intake. Sodium promotes water retention, and excess water in the body drives up blood pressure.

But I've found that many people are unfamiliar with the need to consume extra potassium in this situation. Potassium relaxes arterial walls, which helps bring blood pressure back into a healthy range, as well as helping to prevent heart attacks and strokes. As much as 10 years ago, Harvard researchers found that a diet high in potassium helps protect against stroke-related death in people who have high blood pressure. They studied more than 43,000 men over an eight-year period and found that the men who consumed an average of 4.3 grams of potassium a day had a significant reduction in stroke risk compared to those who consumed an average of only 2.4 grams. The study in this week's Archives of Internal Medicine concluded that for people with blood pressure readings at the high end of the normal range, the risk of heart disease increased by 24 percent for every unit increase in a person's sodium-to-potassium ratio.

For best health, always strive to consume more potassium than sodium, and make 3 grams of potassium a day your minimum goal. You'll have the best odds for success if you follow a cardiovascular nutrition plan like my Pan Asian Modified Mediterranean (PAMM) diet, which features lots of whole grains, fruits, vegetables, nuts, and healthy fats like olive oil. Some foods that are especially high in potassium include raisins, prunes, apricots, papaya, dates, avocados, bananas, cantaloupe, oranges, beets, strawberries, watermelon, greens, spinach, peas, squash, tomatoes, mushrooms, beans, and baked potatoes. (A baked potato alone has about 800 mg of potassium.) Avoid packaged foods like the plague--they're loaded with sodium.

I'm also not a huge fan of potassium supplements because the amount of potassium that products may contain is limited to 99 mg per daily dose, or about the amount in two bites of a banana. You're much better off consuming potassium in foods.

Finally, if you're taking a diuretic to maintain healthy blood pressure, pay special attention to this information. Diuretics are notorious for draining the body of minerals, so you need to be especially careful of your potassium level.

For more information on reducing hypertension, visit www.drsinatra.com.