How drugs lower blood pressure
Drugs will bring high blood pressure down by an average of 5.5mmHG diastolic (see Measure your Blood Pressure box, below) – but at a cost. They all come with a fairly nasty number of side effects, which is why many people don’t stick to them either. These range from short-term ones like fatigue, muscle weakness and depression, to long-term illness including heart disease and a pre-diabetic state with high levels of insulin and blood sugar. The drugs come in four main types and their mechanisms range from relaxing the muscles of the blood vessel walls to making you pee more. The latest trend is to market a combination of two different types in one, with the promise of even more effective reductions in blood pressure (BP). But if you want to get control of your blood pressure, it helps to have some idea of how the whole system works; that way it’s easier to decide on a treatment plan that’s going to work for you. Unlike the pipes in your domestic plumbing system, your blood vessels play an active role in speeding up or slowing down your blood circulation. Their muscular walls tense and relax all the time. When you’re frightened or exercising you need them to tense and narrow to pump more blood around the body, but then they should relax. When they stay tense for too long the result is high blood pressure – or hypertension.
Understanding Blood Pressure
Blood pressure control is a complex, normally self-regulating system that is partly controlled by the ebb and flow of two pairs of minerals in and out of the cells lining the blood vessel walls. One of these pairs consists of sodium (salt) and potassium; sodium inside the cell pushes the pressure up, potassium inside brings it down. The other pair consists of calcium and magnesium – calcium raises while magnesium lowers. This explains why you’re advised to keep your salt intake down (more sodium raises BP) and why one of the types of drug is a calcium channel blocker (keeping calcium out lowers BP). But it also highlights the way that the two halves of the pairs are largely ignored by the conventional approach. As we’ll see below, getting good amounts of potassium and magnesium in your diet or via a supplement is a sensible starting point for any BP lowering regime.
Drink enough water
Understanding how blood pressure is regulated also highlights the downside to some of the drug treatments, such as the diuretics which make you pee a lot. That in turn means there’s less liquid in your blood and so the pressure drops. This downside of this is that a lot of minerals and vitamins are washed out in the process, including potassium and magnesium – precisely the ones you need. There are now potassium-sparing diuretics but typically, they put you at risk of potassium overload! However, drinking enough water – six to eight glasses a day – helps lower blood pressure without the side-effects because a lack of water makes the sodium level inside cells go up, which raises blood pressure. And there are other problems with diuretics. One study of 1860 men followed over 17 years found that those treated with diuretics were more likely to have a heart attack (23%) than those who weren’t. Those who had a heart attack were more likely to have raised their glucose levels, putting them in a pre-diabetic state.  This poor performance by diuretics – an old type of drug but still widely used – is unfortunate since, according to one large study known as ALLHAT, they are more effective than the newer drugs, which includes the calcium-channel blockers and another type known as ACE (angiotensin converting enzyme) inhibitors, which counteracts the effect of angiotensin, a body chemical that contracts blood vessels. .
Drug Side Effects
So given their side effects and the doubts about the effectiveness in the long term, the non-drug approach certainly seems to make sense as a starting point. It also offers you many more options. Besides making use of the mineral-balancing system, you can go on a low glycemic load (GL) diet, which lowers BP, and add in various foods which have the effect of making nitric oxide, which in turn relaxes blood vessels (see below). In addition, this approach is very likely to bring other health benefits and it’s very unlikely to raise your risk of heart attack like diuretics or cause a nasty persistent dry cough as ACE inhibitors can.
The diet favoured by doctors and dieticians to lower BP is a ‘healthy balanced diet’, which usually means a low-fat/high-carbohydrate diet. All too often, though, this allows quite large amounts of sugar, either in fruit juice drinks or in supermarket low-fat meals. A high-sugar diet creates compounds known as aldehydes in the body, which in turn can mess up various proteins that are necessary for calcium channels to work properly; one of the results of this is raised blood pressure.  A version of the low-fat/high-carb diet often used for lowering BP is known as the DASH diet. But it recommends the likes of pasta, rice and potatoes, all of which raise blood sugar levels, which in turn raise your insulin levels. Raised insulin levels stimulate the sympathetic nervous system, the one that primes you for action – and this releases chemical that tighten the arteries. Too much insulin also encourages the body to hold on to both salt and water which also raises blood pressure.  To avoid the BP-raising potential of sugar and other refined carbohydrates, the best option is the low glycemic load diet (see www.holforddiet.com). In a trial on 16 volunteers, blood pressure dropped by 6 points in eight weeks on my low GL ......
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