What is blood pressure?
Blood pressure (BP) is the force circulating blood exerts on the artery walls. This pressure is vital and allows blood to flow to all areas of the body.
Systolic and diastolic
There are two measurements of blood pressure: systolic and diastolic. Systolic is the pressure exerted on the artery walls right after the heart beats; this is when blood pressure is the highest.
Diastolic is the pressure in the arteries when the heart is resting between beats, and thus is lower than systolic.
Blood pressure is measured in systolic over diastolic; an ideal blood pressure reading is 120/80 (or less) mmHg. Anything above that could be classified as prehypertension (120-139/80-89) or hypertension (140+/90+) [1].
High blood pressure
High blood pressure, or hypertension, means the heart is working harder to push blood through the body which damages blood vessels. This can lead to atherosclerosis (hardening of the arteries), stroke, a heart attack, cardiovascular disease, coronary artery disease, kidney disease, or heart failure, among other unwanted complications [2].
High blood pressure is known as the “silent killer” because it often doesn’t have symptoms and will be undetected until you get your blood pressure taken. With over 100 million U.S. adults having high blood pressure, it’s another reason why it’s important to keep up with routine doctor’s visits and to prioritize your health.
Essential versus secondary hypertension
First, it’s important to note high blood pressure is organized into two groups: essential (or primary) and secondary.
High blood pressure that doesn’t have a known cause is primary, or essential, hypertension. 95% of hypertension cases fall into the essential category.
Secondary hypertension is the result of another health condition. Some diseases that cause secondary hypertension are kidney disease, adrenal disease, hyperparathyroidism, thyroid problems, or obstructive sleep apnea. This secondary version is rare, with only around 5-10% of the population being diagnosed with secondary hypertension [3].
What influences blood pressure
Some factors that can influence blood pressure are genetics, stress, alcohol or drug use, smoking, diet/lifestyle factors, age, race, and salt intake.
Genetics
Many conditions and diseases have a genetic factor at play, and high blood pressure is no exception. Unfortunately, it’s not a simple answer. It’s well accepted that high-blood pressure has a high rate of heritability, but the exact mechanisms are still being studied.
Researchers have identified over 100 genetic variations associated with essential hypertension [4]. In a study where over 340,000 participants were screened, researchers were able to identify many blood-pressure associated regions of the genome but there was no single predominant gene found responsible for causing high blood pressure [5].
Further research on this is ongoing and it will be interesting to learn in the future what they uncover.
There are several well studied components that can play into the genetic component of essential hypertension.
RAAS
The first is with the genes involved in the renin-angiotensin-aldosterone system (RAAS). The RAAS is a hormone system that regulates blood pressure and fluid balance in the body.
It’s a complex system, but in short one of its jobs is to regulate blood volume, and when blood volume goes up, its more work on the heart to pump it throughout the body.
An analogy that conveys the same principle is how it would be harder to push a 50 pound grocery cart through a store versus a 20 pound one. When you increase the volume, you increase the force needed to move it.
Blood vessel lining genes
Another genetic components that has been identified to affect essential hypertension is with the genes that affect the lining of the blood vessels. Abnormalities in these genes could cause the vessels to be narrowed, which raises blood pressure.
Folate Metabolism
Lastly, researchers have observed abnormalities in the gene responsible for folate metabolism. An alteration in this gene “causes an increased requirement for the B-vitamins folic acid and riboflavin, and more importantly results in an increased risk of developing high blood pressure” [17].
These are just a few examples of why it’s important to test your genes and biomarkers. Everyone’s body has different nutritional needs based on their unique set of DNA. Rootine has an advanced at-home test kid (which can be completed in under 5 minutes) that identifies and addresses your key nutritional weaknesses and uses the results to create a unique multi-vitamin supplement personalized to you.
Stress
Stress is a big risk factor blood pressure. Stress isn’t inherently a bad thing, the body encounters stressors throughout the day and is well adept at handling it.
Eustress
A type of stress, eustress, is known as the “good” stress; it’s the type that results from exciting activities like hearing good news or going on a first date. It keeps us excited about life [6].
Acute stress
Another type of stress is acute stress, or short-term stress. Things like exercising are an acute stress, because after working out for an hour or so the stressor stops.
A popular health activity that has been around for ages but recently gained traction is cold exposure therapy, where people submerge themselves or shower in cold water. It’s a short-term stressor on the body, specifically on the mitochondria (the cells that create energy). It improves mitochondrial health through biogenesis, or producing more of them. Only a minute or two in the cold environment is needed which is why it’s a short-term stressor.
Chronic stress
Long-term, chronic stress however is not supportive of health. When we’re stressed out all day, the body constantly feels under attack and leads to increased heart rate and narrowed blood vessels.
Chronic stress doesn’t give the body any time to access the rest and relaxation state from the parasympathetic nervous system, which is the system responsible for “rest and digest”. It keeps our sympathetic nervous system, which drives the “fight or flight” response, turned on. This leads to many negative health effects like increased inflammation, decreased cellular repair, and chronic fatigue.
Things like an unhappy home environment or always feeling stressed out at your job can cause negative health effects, both physically and emotionally.
Research shows chronic stress contributes to high blood pressure, promotes the formation of artery-clogging deposits, and can contribute to anxiety, depression, and addiction [7].
Alcohol and Drug Use
Both alcohol and drug use can raise blood-pressure. Alcohol increases the hormone renin in the bloodstream, which makes blood vessels constrict, or get narrower. It also increases fluid levels in the body. When the body has more fluid in it and smaller blood vessels, blood pressure will rise.
Drugs operate similarly in that they narrow the arteries which increases heart rate and blood pressure.
If you’re struggling with alcohol or drug use, please reach out to a health professional for support.
Smoking
Cigarette smoking is one of the leading causes of preventable death in the U.S, and it’s no secret smoking increases blood pressure.
Nicotine increases heart rate, blood pressure, and myocardial contractility, the forcefulness of the heart’s contraction. It has been shown as little as 1 day after a person quits smoking their blood pressure begins to drop and oxygen levels increase [8].
Diet and Lifestyle Factors
Diet and lifestyle play a huge role in your overall health.
What you eat can truly make or break your health. Eating a healthy diet with mostly unprocessed foods like high-quality meats, vegetables, fruits, fiber, complex carbohydrates, and healthy fats support the body to function optimally. It also helps you take in the essential vitamins and minerals needed to regulate blood pressure, like magnesium and potassium. Fish oil is also great to incorporate as the omega-3 fatty acids have been shown to help control high blood pressure.
Avoiding large amounts of added sugar is also helpful as low insulin sensitivity, which happens when your body is used to lots of processed sugars and carbohydrates, has been known to worsen blood pressure.
What can help lower blood pressure
Better diet (Dash)
The recommended diet for those with high blood pressure to follow is the DASH diet.
DASH stands for “Dietary Approaches to Stop Hypertension”. The diet promotes a low-sodium, low saturated fat meal plan with plenty of potassium, calcium, magnesium, dietary fiber, and protein. It includes grains, vegetables, fruits, low-fat dairy products, lean meats and fish, nuts, seeds, legumes, and healthy fats.
Following the DASH diet is a great way to improve blood pressure- it includes lots of whole foods and minimizes processed food. Salt is a preservative so any processed food is going to be loaded with sodium, even if it doesn’t taste particularly salty.
Key nutrients
There are several key nutrients that have been linked to controlling blood pressure and are important to include in your diet. They are: magnesium, potassium, calcium, vitamin D, vitamin C, CoQ10, quercetin, and B vitamins. Please consult with your doctor before making any dietary changes to adjust blood pressure, especially if you are on blood pressure medication.
Magnesium
Magnesium is arguably the most important nutrient in maintaining healthy blood pressure. Magnesium helps regulate blood pressure, blood sugar, muscle and nerve function, energy production, and bone development. It’s involved in over 600 cellular reactions, but more than half of U.S adults don’t get enough magnesium daily [10].
It’s known as the “relaxation mineral” as it can relax blood vessels and has been shown to improve sleep quality. It’s also important because it affects the metabolism of sodium, potassium, and calcium, which all play a role in blood pressure.
How it works
Magnesium is important to maintain a healthy heartbeat. Calcium and magnesium have opposite actions: calcium stimulates muscle fibers to contract while magnesium counters this effect, making them relax.
The combination of calcium and magnesium moving across heart cells maintains a healthy beat. Without proper amounts of magnesium present to keep calcium in balance, calcium can overstimulate the heart, leading to a rapid heartbeat [10].
In skeletal muscles, calcium binds to proteins to stimulate a contraction. Magnesium binds to these same proteins to relax the muscle and is why magnesium is often recommended for muscle spasms or cramps.
Doctor's experience
Dr. Mark Hyman wrote an article on magnesium on his website blog and talked about its use in emergency situations. He said while working in the emergency room if people came in with life-threatening arrhythmia (irregular heart beat) or pregnant women came in with pre-term labor or pre-eclampsia (high blood pressure during pregnancy) they were given high doses of magnesium supplements as the first step in treating high blood pressure [9].
A study found upon magnesium supplementation, systolic blood pressure fell by 20.4 and diastolic blood pressure fell by 8.7, which are substantial improvements [10].
Potassium
The American Heart Association recommends having adequate potassium intake to prevent and treat hypertension. To fully understand how potassium helps regulate blood pressure, a clear understanding of how the kidneys interact with sodium is important.
All the fluid in the body is filtered by the kidneys and they excrete excess fluid and compounds out in urine. Sodium likes to bind to water, so when we have increased levels of sodium in the blood stream, water binds to the sodium and stays circulating in the blood. This increases the volume of the blood, which increases blood pressure. This is also why eating salty foods can make your body or face “puffy”.
Potassium helps the kidneys excrete excess sodium instead of keeping it in circulation, which will reduce blood pressure. Potassium also relaxes blood vessels so blood flows easier and it supports proper conduction of electrical signals in the nervous system and heart [11].
Calcium
As mentioned above, calcium is responsible for muscle contraction which allows us to move and have a beating heart. It also plays an important role in blood clotting, regulating healthy heart rhythm and nerve function, and increasing bone health.
Vitamin D
Vitamin D deficiency is linked to an increased heart disease risk and hypertension [12]. In a study with over 10,000 participants from around the world, the systolic and diastolic blood pressure “were significantly and positively associated with distance from the equator”, meaning as you get farther from the equator and get less vitamin D from sunlight blood pressure increases [13].
Vitamin D is also important in calcium regulation as adequate levels of vitamin D must be present in order for calcium to be absorbed. Low vitamin D levels lessen the amount of calcium absorbed in the intestine; without enough vitamin D, the body absorbs only about 10% of dietary calcium [14].
This causes an upregulation of the parathyroid hormone (PTH), the hormone responsible for calcium regulation. PTH will pull calcium from the bones to raise calcium levels. While this increases blood calcium to a healthy level, it consequently weakens the bones.
If this is a regular occurrence, it can head to osteoporosis. In short, your body needs calcium for heart and muscle function among other processes and it will pull from the bones if needed, so ensure you’re getting adequate vitamin D and calcium to keep this from happening.
Vitamin C
Vitamin C is well known for its antioxidant properties. A recent study suggests that low antioxidant intake is associated with increased blood pressure [14].
While there is mixed data out there, some studies show an inverse correlation with vitamin C and blood pressure, so as you increase vitamin C intake it lowers blood pressure naturally. More evidence is needed on this particular topic, but adequate levels of vitamin C could potentially improve blood pressure and heart health.
Coenzyme Q10
Coenzyme Q10 is an antioxidant naturally produced by the body. Its present in every cell and has two main functions.
First, it helps make ATP (adenosine triphosphate). ATP is a compound that stores and transfers energy so cells can carry out their many functions; it’s a vital part of any living organism.
Its second function is to serve as an antioxidant and protect cells from oxidative damage. The body does produce coenzyme Q10 on its own but production decreases with age.
Several studies have shown that after several weeks of taking CoQ10 it has the potential to lower both systolic blood pressure by 17 mm Hg and diastolic BP by 10 mm Hg [16]. It’s important to note that these studies were on the smaller scale and larger studies will be needed to further confirm these results.
Quercetin
Quercetin, a flavonoid, is a plant compound found in fruits, vegetables, coffee, tea, and grains that has beneficial properties. It’s one of the most abundant antioxidants in our diet with many health benefits like reducing inflammation and controlling blood pressure. It can boost the immune system, fight inflammation and allergies, help with exercise performance, and help fight cancer.
Focusing on its effects on blood pressure, quercetin appears to have a “relaxing effect” on blood vessels. A study on 580 people found that supplementing with quercetin reduce systolic blood pressure by 5.8 mm Hg and diastolic by 2.6 mm Hg [17].
B Vitamins
Lastly, several B vitamins may help reduce blood pressure. Vitamin B-12 is involved in the production of red blood cells and supports nerve function. A study found that a higher intake of B-12 was associated with lower systolic and diastolic blood pressure [18].
Niacin, or B3, increases circulation and supports healthy skin, digestion, and mental functioning. Niacin releases prostaglandins, a compound that widens the blood vessels which can help lower blood pressure.
And lastly, folic acid, or B9, can help blood vessels relax and improve blood flow.
A simple but effective way to meet all your micronutrient requirements is by taking Rootine’s high-quality multi-vitamin supplement. It’s almost impossible to eat enough of every single vitamin and mineral needed daily, so opt for dietary supplements to get everything your body needs in one step.
Exercise
Always seek professional medical advice beforehand, but adding exercise into your daily routine can lower high blood pressure.
Aerobic exercises like walking, jogging, swimming, or biking make your heart stronger, help regulate blood sugar, decreases risk of heart disease, and keeps your arteries clear. Exercising also creates endorphins which boosts mood and can help you make healthier choices in the kitchen, as exercise can decrease cravings for processed foods.
Improved healthy lifestyle
Getting enough sleep each night, going outside often, surrounding yourself with positive relationships, and doing things you enjoy each day can improve overall life quality and help manage blood pressure.
It’s also important to know how to regulate your stress levels, whether that’s with meditation, exercising, or talking with a friend about how you feel. These little actions can add up in a big way and improve overall health and happiness.
Medication
Prescription medications for blood pressure have saved many people’s lives. Some of the most common medications are ACE inhibitors, calcium channel blockers, and amlodipine besylate.
ACE inhibitors prevent the body from producing angiotensin II. Angiotensin II can narrow blood vessels and release a hormone that raises blood pressure.
Calcium channel blockers prevent calcium from entering the cells of the heart and arteries. Since calcium causes muscle to contract, by blocking it blood vessels are more relaxed and open.
Amlodipine besylate works by relaxing blood vessels and allowing for easier blood flow. It can also help with chest pain (angina).
It’s important to talk with your doctor about the different options out there and find what works best for you.
Uncontrolled high blood pressure levels are extremely dangerous and your medical provider can help you in managing it, whether it’s with medication, diet and lifestyle changes, stress management, or all of the above.
Key Takeaways
High blood pressure is extremely common, affecting every 1 in 3 Americans
If often has no symptoms and is known as the “silent killer”, so be sure to get your blood pressure checked regularly
Uncontrolled high blood pressure can lead to life threatening consequences: stroke, heart disease, kidney disease, and heart failure
Fortunately, there are lots of ways out there to improve blood pressure like exercise, stress management, lifestyle changes, adequate sleep, medication, and diet
Pay attention to what's causing you stress. If its chronic stress, figuring out a solution to ease tension is important for both physical and mental health
The right diet is so important, in both what you’re cutting out and what you’re adding it.
Cutting out (or at least minimizing): processed foods (junk food), foods high in added sugar, sodium, and refined carbohydrates
Adding in: whole foods, making sure you’re getting enough vitamins and minerals- especially magnesium and potassium
Consult with a doctor and/or a dietician to figure out the best treatment plan for you
Sources
1. Centers for Disease Control and Prevention. (2021, May 18). High blood pressure symptoms and causes. Centers for Disease Control and Prevention. Retrieved May 4, 2022, from https://www.cdc.gov/bloodpressure/about.htm
2. WebMD. (2021, August 6). Hypertension / high blood pressure guide. WebMD. Retrieved May 4, 2022, from https://www.webmd.com/hypertension-high-blood-pressure/guide/default.htm
3. Secondary hypertension; causes, symptoms, treatment, prevention. Cleveland Clinic. (2019, May 3). Retrieved May 4, 2022, from https://my.clevelandclinic.org/health/diseases/21128-secondary-hypertension
4. U.S. National Library of Medicine. (2019, January 1). Genetic conditions. MedlinePlus. Retrieved May 4, 2022, from https://medlineplus.gov/genetics/condition/
5. Hicklin, T. (2022, April 26). NIH Research Matters. National Institutes of Health. Retrieved May 4, 2022, from https://www.nih.gov/news-events/nih-research-matters
6. Elizabeth Scott, P. D. (2020, June 29). How good stress can add excitement to your life. Verywell Mind. Retrieved May 4, 2022, from https://www.verywellmind.com/what-kind-of-stress-is-good-for-you-3145055
7. Harvard Health. (2020, July 6). Retrieved May 5, 2022, from https://www.health.harvard.edu/topics/staying-healthy
8. Fletcher, J. (2018). What happens after you quit smoking? A timeline. Medical News Today. Retrieved May 5, 2022, from https://www.medicalnewstoday.com/articles/317956
9. Hyman, M. (2021, November 2). Magnesium: Meet the most powerful relaxation mineral available. Dr. Mark Hyman. Retrieved May 5, 2022, from https://drhyman.com/blog/2010/05/20/magnesium-the-most-powerful-relaxation-mineral-available/
10. Raman, R. (2018, June 9). What does magnesium do for your body?Healthline. Retrieved May 5, 2022, from https://www.healthline.com/nutrition/what-does-magnesium-do
11. Grieger, L. (2018, January 19). Potassium and your blood pressure. Baltimore Cardiologists - Woodholme Cardiovascular Associates. Retrieved May 5, 2022, from https://woodholmecardio.com/potassium-blood-pressure/
12. Chebib, F. (2021, July 1). High blood pressure (hypertension). Mayo Clinic. Retrieved May 5, 2022, from https://www.mayoclinic.org/diseases-conditions/high-blood-pressure/symptoms-causes/syc-20373410
13. Ullah, M., Uwaifo, G., Nicholas, W., & Koch, C. (n.d.). Does Vitamin D Deficiency Cause Hypertension? Current Evidence from Clinical Studies and Potential Mechanisms. National Center for Biotechnology Information. Retrieved May 5, 2022, from https://www.ncbi.nlm.nih.gov/pmc/
14. Kazai, N., Judd, S., & Tangpricha, V. (2008). Calcium and Vitamin D: Skeletal and Extraskeletal Health. National Center for Biotechnology Information. Retrieved May 5, 2022, from https://www.ncbi.nlm.nih.gov/pmc?db=PMC
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17. Blood pressure lowering effect of B-vitamins in adults with a genetic pre-disposition to elevated blood pressure.Blood Pressure Lowering Effect of B-vitamins in Adults With a Genetic Pre-disposition to Elevated Blood Pressure. - Full Text View - ClinicalTrials.gov. (2020). Retrieved May 5, 2022, from https://clinicaltrials.gov/ct2/show/NCT04278378
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