Will My Hot Flash Lead to a Heart Attack?

Last week I was in Tucson, facilitating workshops at the Institute of Functional Medicine. It is such an honor to be asked to facilitate and assist in training so many brilliant minds and amazing health professionals.

I love working with like-minded professionals and I get excited about sharing my knowledge, passion and energy with my peers. I know I’ll return to the clinic re-charged. One of the benefits of traveling (and having my plane delayed for mechanical reasons) is that I had the chance to get caught up on reading a number of new research studies that I’ll be sharing more about with you over the coming weeks.

I always love it when I see studies come forward that make the connections that we have seen in our patients at Women to Women and have been talking about with you in our newsletters for years. I’m a Functional Medicine practitioner and what that means is that we know that everything is connected; Functional Medicine practitioners understand that if we can learn more about what is happening “upstream,” we can begin to prevent and cure the symptoms and conditions that ultimately occur “downstream.” So I love to see research that helps us to “connect the dots.”

While I try to stay up to date on all the latest studies, I always pay extra close attention to research that confirms what we believe about the connection between symptoms of hormonal imbalance and other health concerns. That’s because we usually find that the “downstream” symptom has an “upstream” cause. One study recently connected the dots between hot flashes and heart health and I’d like to sum up the major conclusions and share what it really means for YOU.

The study, which was conducted by the University of Pittsburgh, found that women who have hot flashes at younger ages, and who have them more frequently, might have a greater risk of heart disease.

Specifically, the research showed that when a woman experiences her first hot flash at age 42 or younger, her endothelial function (which is tied to heart attack risk and is considered an indicator of heart health) is significantly poorer than in women who had their first hot flash at an older age.

In addition, the more hot flashes the women in the age group of 52 and younger had in a 24-hour period, the less healthy their endothelial function was and the greater their heart attack risk.

While we know that this is not conclusive and further study is warranted, it is an interesting connection and one that makes sense to us since we know that hormonal imbalance is something that does not occur in isolation. We know that insulin resistance plays a role in heart health and also leads to menopausal symptoms such as hot flashes so that is just one way that these two may be connected. It will be exciting to see if more research can probe the link and make the insulin connection in the future.

As we wait for further information, however, one thing these results do suggest is that women at younger ages experiencing hot flashes should be more vigilant of their heart health.

One way you can take better care of your heart is to engage in regular exercise, especially exercise that raises the heart rate. Exercise is known to force blood vessels to dilate and to help them remain healthy, improving the poor endothelial function that the study found which was so concerning; women in this group should be even more conscious of ensuring they remain active and exercise regularly as they age.

We have talked about the burst form of high intensity interval training with you before, as this is the form of exercise that we always recommend. Exercising for too long a period of time actually can increase oxidative stress.

In addition, managing other factors such as weight, blood pressure, and diet, especially glucose levels are important for long-term heart health; as we’ve seen and shared with you, correlations have been proven between internal inflammation, blood sugar levels, and heart attacks.

At Women to Women, we think it’s important for all of us, but especially women with frequent hot flashes and flashes occurring at younger ages, to take preventive action with respect to heart health. But we also know that it is equally, if not more, important to try to prevent or eliminate hot flashes before they do damage to the endothelium and ultimately, the heart.

To bring hormones back into balance, we work with our patients to focus on what they eat and how they live: we know that a good night’s sleep, reducing stress, regular exercise, and a healthy whole food diet, which includes being aware of the overall carbohydrate content and quality, will go a long way toward restoring wellness.

In our nutritional guidelines, we recommend high-quality proteins such as grass fed meat and wild caught fish, fresh fruits and vegetables (organic if you can) and minimizing packaged and processed foods. If organic is not possible all the time, at least buy organic when consuming the toxic 12 fruits and vegetables. (Link to our article.)

We see so many patients in our clinic who tell us that it is extremely difficult today to eat all the nutrients needed for hormonal balance during perimenopause, even if they do try to eat a healthy and balanced diet. Numerous studies show us that the nutritional content of food today is diminished due to farming practices, long transportation times, and our desire for perfectly beautiful produce.

So in addition to eating well, the body may require more support, especially if you experience a lot of stress in your life. We have found that we can reduce or eliminate hot flashes with our patients by supporting the body’s hormonal balance with a pharmaceutical grade multi-vitamin and omega-3 supplement.

We actually went out and created our own to ensure it had the ingredients and the purity we knew women needed to restore balance and feel well. Our patients have had great success with them for over 3 decades and we take them too!

In our clinic, these two products help virtually all patients we see to reduce symptoms, whatever they may be, and to feel like themselves again: whether they suffer from hot flashes or not!

If hot flashes or other menopausal symptoms are causing discomfort, we also recommend a third product that is formulated specifically to alleviate symptoms of hormonal imbalance. Our proprietary and proven Menopausal Support System can reduce or eliminate annoying symptoms, including potentially heart-unhealthy hot flashes, so you can feel like yourself again.

This week, to celebrate spring (which is hopefully coming to Maine soon!), we are offering 10% off any of our proven Menopausal Support System products. Use coupon code springsale at checkout. If you’d like to learn more, click here.

To learn more about heart health, hot flashes or how to manage your blood sugar levels, see our library at www.womentowomen.com/health-library/

Stroke And Heart Attack Symptoms In Women

by Marcelle Pick, OB/GYN NP

For so many women, it is easy to miss the signs of a heart attack, and that’s because the symptoms that women have are very different from men. They are often misdiagnosed, especially the top four symptoms, such as heartburn and digestive disorders. Understanding that immediate action is needed if a heart attack occurs, can mean the difference between whether a woman lives or dies, making it that much more compelling to be aware of the warning signs.

Symptoms of a heart attack in women

For most people the symptoms of a heart attack start slowly with mild discomfort or pain.  Below are the symptoms women tend to experience when having a heart attack.

  • Shortness of breath. This may occur with or without chest discomfort.
  • Nausea and light-headedness.
  • Flu-like symptoms, including chills and cold sweats.
  • Heart palpitations or an irregular heart beat.
  • Chest discomfort ( also known as angina) – pain, tightness or pressure in the center of the chest that lasts more than just a few minutes, or that comes and goes.
  • Discomfort or a heaviness in other areas, including a pain or discomfort in one or both arms (especially the left arm), in the back, in the upper back between the shoulder blades, in the neck, and/or in the jaw or stomach.
  • Heartburn or indigestion.
  • Extreme fatigue, a sense of not being able to have the energy to do normal activities.

Symptoms of stroke in women

Strokes are not nearly as common as heart attacks, but they can – without any warning signs – occur very quickly. Following are some of the signs that a stroke may be occurring:

  • A very sudden numbness or weakness of the face, arms or legs, generally it is seen on one side of the body.
  • Sudden confusion, difficulty speaking or comprehending even simple conversation.
  • Sudden difficulty with sight in one or both eyes.
  • Sudden difficulty with walking, dizziness with movement, a severe loss of balance or coordination.
  • A very sudden, intense headache with no obvious reason.

One of the difficulties is that some of the symptoms of a heart attack or heart problems such as palpitations, dizziness, and feeling faint are also seen by some in perimenopause.  It is important to understand that any symptoms that may be related to your heart health should be evaluated by your healthcare practitioner first.

Symptoms of inflammation

The most recent scientific information is showing that inflammation and heart disease go hand in hand. Closely monitoring any and all symptoms of inflammation is a very important preventive tool to help asses your risk and also help you prevent future issues with your heart. Here are some of the tests to look which indicate a risk in the future.  For more information, read our multiple articles on inflammation.

  • Elevated levels of HS-CRP, homocysteine
  • High blood pressure
  • Insulin resistance diagnosed with an elevated fasting or 2hr pp insulin
  • Diabetes, diagnosed with elevated fasting blood sugars or elevated Hgb A1C
  • Joint pain or diagnosis of arthritis
  • Chronic headaches
  • GI distress, bloating, constipation/diarrhea, gas/ IBS, Chrohns or colitis, diverticulitis
  • Ulcers/heartburn
  • Food and other allergies/sensitivities
  • Chronic respiratory difficulties, asthma, or bronchitis
  • Dry skin, itchy skin, rashes, psoriasis or eczema
  • Weight gain/obesity as this is now known to increase inflammation
  • Fever or chronic infection
  • Other autoimmune diseases
  • Elevated fibrinogen
  • High ferritin levels
  • Elevated Lp(a)

 

Preventing Heart Disease – The Natural Approach

by Marcelle Pick, OB/GYN NP

Every day, minute by minute, our hearts beat – pumping life sustaining blood through our bodies – keeping our vital organs healthy and functioning – and many of us never even think about the power of this tremendous organ. Nurturing your heart, even in the smallest of ways, is vital to your health. Nurturing can take many forms – eating a heart healthy diet, managing stress, maintaining an exercise routine and keeping joy in your life are all important in keeping your heart healthy!

Some women have genetic factors or a family history which brings more attention to their heart health. Having this information is a real plus! It gives opportunity to change diet and lifestyle factors which gives great promise for lifelong heart health!

There are some specific things you can do to help reduce your risk of heart disease. Below are my top 5.

  •  Your heart is a muscle and needs exercise! If you haven’t exercised in a while, then build slowly.  Start with 5-10 minutes a day and work up to the current guideline of 30 minutes of moderate exercise per day. Women who find a form of exercise they love have the most success – for some it is walking 30 minutes per day with a friend. For others, it is walking 30 minutes a day alone. Other people love yoga, some zumba – and some like to do something different every day!
  • Practice good eating! What you eat definitely affects your insulin levels which will affect your metabolism and your cholesterol. A diet high in vegetables and low in simple carbohydrates and saturated fat can reduce cholesterol levels – sometimes as effectively as statin drugs – without the side effects! I’ve seen many patients change their insulin resistance and lower their cholesterol by following these proven dietary guidelines.
  • Create some good stress management techniques. We all have stressors in our lives – and some we don’t have much control over. What we can control is our reaction to the situation – and we can control what we can do to relieve stress. If it is in your belief system and financially available, therapy can often work to keep stressors in perspective. Journaling, mediation, talking with a friend and support groups can also help. Making a list of those things which cause stress can be helpful, too. Some women find this a powerful tool – they can see exactly how much they are doing – and then make good, realistic decisions about what they want to continue.
  •  Incorporate a medical grade multivitamin-mineral dietary supplement. Its difficult today to get all the nutrients we need from our American diet. We recommend adding a fish oil supplement to your daily regime as well. Nutritional gaps can lead to an inefficient metabolism, inflammation and elevated homocysteine levels which can all affect cardiac function.
  • If testing reveals high levels of CRP (C-Reactive Protein) and LDL, you may want to consider medication. A statin drug such as Lipitor may be warranted, even for a short time to help protect your heart until your dietary and lifestyle changes take effect. I would always recommend taking the lowest effective dose recommended in combination with ribose, L-carnitine, Co-Q10 and selenium supplements to reduce any side effects. Recent studies show that statin drugs do effectively reduce inflammation and cholesterol. If you do take a stain, its important to have your liver enzymes tested regularly to monitor side effects. Aspirin (80-100 mg daily) can also have significant preventative effects.

Some patients who come to see me are just not ready to make lifestyle changes – some don’t feel they have the energy, some don’t see the need, and some tell me that they don’t have the time. My message to patients who feel this way are two fold – first – if you don’t change your life, your life may change you – and sometimes those changes are really hard ones to accept. Secondly, I know you can make changes – one step at a time and those steps are very much worth it, particularly when it comes to your heart health. While a change in heart health along the lifespan is not inevitable, it does affect many of us. Think of the feeling of empowerment when you decide that YOU can take part in the outcome of your health!

So many women come to my office asking about a low fat diet plan for their heart health – and while many are surprised by my answers to them, I am so glad I have the opportunity to set this myth aside. Switching to a low fat diet or low fat food products is not the answer for your heart! This can accelerate the development of a heart condition! A diet rich in healthy fats – unsaturated oils that come from plans and relatively moderate amounts of saturated fats found in meat and dairy products are all heart healthy. Essential fatty acids are vital to your health – they are critical to control insulin, reduce inflammation and most importantly for your heart health to metabolize cholesterol. Avoiding trans fats is paramount. These fats are primarily found in processed foods.

If you are a smoker, I have to implore you to find the support you need to stop. Heart disease and smoking are deathly companions. Smoking increase inflammation, diminishes oxygen uptake, irritates the lungs and makes artherosclerosis worse.

Heart disease doesn’t have to be in your future – you can take control over your heart health! We know that there’s so much that can be done to keep your heart healthy – AND it doesn’t have to be an either/or situation. IF you need the support of a statin drug now it doesn’t mean that you will need this forever – there are changes that you can make which will make a difference!

We all want our hearts to stay healthy, beat strong and sing with joy! Do your part in keeping yours healthy!

Stroke And Heart Attack Symptoms In Women

by Marcelle Pick, OB/GYN NP

You may be surprised to learn that when it comes to women and heart attacks, it is extremely easy to overlook or miss the signs and symptoms of a heart attack because they show up in different ways in women than they do in men. It is important for women to understand that the signs and symptoms of a heart attack are different for them.

It is very important that if any of the below listed warning signs start to appear that you should seek immediate medical attention. It could mean life or death, which is why I feel that it is vitally important for all women to be aware of the warning signs of a heart attack.

Symptoms of heart attacks in women

In women, almost all heart attacks start slowly with mild pain or discomfort. Below are common symptoms of a heart attack in women:

  •  Shortness of breath may occur with or without chest discomfort
  •  Nausea and light-headedness
  •  Flu-like symptoms, including chills and cold sweats
  •  Heart palpitations
  •  Chest discomfort (angina): pain, tightness or pressure in the center of the chest that lasts more than a few minutes, or that goes away and comes back, this is seen less often in women than men
  •  Discomfort in other areas, including pain or discomfort in: one or both arms (especially the left arm), the back, between the shoulder blades, neck, jaw or stomach – this is the most common set of symptoms we see
  •  Heartburn or indigestion
  •  Extreme fatigue

Strokes are as well-known as heart attacks, but tend to come on unexpectedly. Allow me to share some of the signs and symptoms that a stroke may be occurring:

  • Sudden numbness or weakness of the face, arm or leg, especially on one side of the body
  • Sudden confusion, trouble speaking or understanding
  • Sudden trouble seeing in one or both eyes
  • Sudden trouble walking, dizziness, loss of balance or coordination
  • Sudden, severe headache with no known cause

I feel that is worth noting that in certain women, symptoms such as palpitations, chills, or faintness could actually be symptoms of perimenopause. If you happen to be experiencing any of these symptoms, please see your doctor immediately to rule out a heart attack. It could save your life.

Symptoms of inflammation

Heart disease often occurs together with inflammation. Monitoring any inflammation indicators you might have is a helpful way to assess your risk of heart attack or stroke.

Below are some of the symptoms to take into consideration (for more information read our articles on inflammation):

  •  Elevated levels of CRP, homocysteine, LDL or triglycerides
  •  High blood pressure
  •  Insulin resistance or diabetes
  •  Joint pain or arthritis
  •  Headaches
  •  GI distress, bloating, constipation/diarrhea
  •  Ulcers/heartburn
  •  Food and other allergies/sensitivities
  •  Chronic respiratory difficulties, asthma, or bronchitis
  •  Dry, itchy skin, rash, psoriasis or eczema
  •  Weight gain/obesity
  •  Fever or chronic infection
  •  Other autoimmune diseases
  •  Achiness all over
  •  Digestive issues, bloating, gas, chronic abdominal discomfort

To learn more about the underlying causes of heart disease, see our articles about risk factors for heart disease.

High Blood Pressure — Lowering The Strain

by Marcelle Pick, OB/GYN NP

What makes your blood pressure rise to unhealthy levels, and what can you do to bring it back down naturally? Here’s our guide to the prevention and cure of hypertension.

  • What is blood pressure?
  • Conventional treatment for hypertension
  • Risks associated with high blood pressure
  • What causes high blood pressure?
  • Blood pressure and stress
  • High blood pressure in women
  • Diet, syndrome X, and high blood pressure
  • Salt and high blood pressure
  • How to prevent or treat high blood pressure with a healthy lifestyle

With one in four women in America being diagnosed with high blood pressure, chances are you or a woman you love will be affected. Cases of hypertension (the medical term for high blood pressure) in the US have jumped 30% in just the last decade. Though this doesn’t quite mean it’s an epidemic, numbers like this are cause for concern.

Just because you don’t have a diagnosis of high blood pressure now doesn’t mean you aren’t at risk. Hypertension is often thought of as a condition that doesn’t afflict women because until they reach menopause, their risk of developing it is much lower than males their same age. But once women lose the protection of estrogen after menopause, the incidence of high blood pressure rises sharply to reach levels similar to men’s.

Sadly, most people experience no discernable sign of high blood pressure until the damage is done and cannot be reversed. Chronic high blood pressure can shorten your lifespan by 10–20 years and is linked with some of our most entrenched degenerative problems, like type 2 diabetes and coronary heart disease (CHD). Ultimately, hypertension places you at high risk for stroke, heart attack, and renal failure.

So high blood pressure is a serious women’s health problem. If you are on medication or need to be, I fully support that as a starting point. But more women need to understand that hypertension is not an inevitable part of aging or genetic destiny. Nor is a lifetime of medication the only course of action!

The truth is that this is one area of your health that is fully modifiable if you are willing to commit to some positive changes in your diet and lifestyle. You can begin to prevent or treat your high blood pressure today. Let’s find out how.

What is blood pressure?

I like to associate the role blood plays in the body with the role many women play in the lives of those around them. Women shuttle between home, work, community and family, nourishing and nurturing, forming a conduit through which life is constantly protected and supported. Likewise, blood circulates tirelessly through the body, feeding and oxygenating our cells, removing toxins, and defending our organs from disease and degeneration.

Blood pressure is the force exerted by the flow of blood on the walls of major arterial blood vessels — similar to the flow of water through a garden hose. It is determined by the amount of blood being pumped by the heart in a minute (cardiac output) compared to the resistance of the arterial vessel walls.

This explains why both the amount of fluid in your arteries and the relative elasticity, or “hardening” of the arteries, are factors in high blood pressure. Again, think of a hose. If the water is turned on full blast and there is a kink in the tubing, the pressure builds up. Likewise, the higher the volume of blood and the stiffer the artery, the harder the heart has to work to pump the blood around your system.

Because blood is the foundation of life, nature is mainly concerned with a loss of blood pressure. If your blood pressure drops suddenly, during shock or in reaction to medication for example, our bodies have multiple protective measures to instantly restore homeostasis.

But nature has fewer mechanisms to address high blood pressure, so the best defense is a good offense. How do you know if you have high blood pressure? Up to a third of the people who have it don’t even know it. Since there are virtually no symptoms until hypertension is advanced, the best way to tell is to get regular blood pressure readings.

Conventional treatment for hypertension

If your doctor diagnoses you as prehypertensive, you will most likely be told to modify your diet and lifestyle. If no significant changes are seen at your next visit, or if your initial reading was above 140/90 mmHg, there’s a high probability you will be given a prescription for one of the many potent antihypertensives on the market. These medications continue to work only while you’re taking them. For many, this means a lifetime of drugs.

Antihypertensives work in one or more ways: by decreasing blood volume via increased urine production (diuretics); by facilitating blood flow through dilation of blood vessels (alpha-blockers, ACE inhibitors, and sympathetic nerve inhibitors); or by decreasing the rate and/or force of heart contractions, thereby decreasing volume of blood pumped through arteries (alpha-beta blockers, beta-blockers, and calcium channel blockers). Other drugs, like angiotensin blockers and mineralocorticoid receptor antagonists, block natural chemicals produced by the body to combat low blood pressure.

These medications treat the symptom of hypertension but do little to heal the underlying causes. Some may not even control your blood pressure over a full 24–hour period. They also come with their own side effects, such as annoying cough, dizziness, hyperglycemia, dangerously low blood pressure, kidney problems, and worsening congestive heart disease. In addition, some antihypertensives have adverse interactions with other conventional medications and medicinal herbs.

Because the dangers of high blood pressure are very real, I advise women with troubling high blood pressure to use medication to avert any immediate threat. But I proceed from there with the understanding that the medication is only treating the symptom of hypertension, not the root problem, and that by working on addressing the root, we can eventually come off the medication.

Risks associated with high blood pressure

High blood pressure does its damage over time by undermining the entire cardiovascular system and kidneys. Tight arterial walls stress not only your heart but all your major organs. The higher your blood pressure rises, the greater the stress on the blood vessels, leading to abnormal tissue deposits, clogging, hardening and narrowing (arteriosclerosis), congestive heart disease, enlargement of the heart, and other heart damage.

If arteries become stiff, inflamed, or blocked, or if too much fluid is trying to circulate, the heart must labor too heavily. Over time, circulation suffers, even though blood pressure stays high, putting the whole body into a deficit state. The heart must struggle to compensate. Poor circulation is one reason why women with high blood pressure often experience cold hands and feet. (This is also true for women with low blood pressure; they have poor circulation too, just for the opposite reason). Headaches, dizziness, palpitations and fatigue are other possible symptoms, but keep in mind that hypertension for the most part is asymptomatic.

As for graver risks, when the arteries serving your kidneys are affected, the kidneys must struggle to remove wastes and extra fluid from your body. Impaired kidney function and high blood pressure compound one another, and in severe cases, the kidneys give out in progressive renal failure. The retained fluid in your vessels raises blood pressure even higher, and now the situation is very serious. Does this seem extreme? Yes, but high blood pressure results in about 25,000 new cases of kidney failure per year in this country, more than double what it was in 1982.

What causes high blood pressure?

The major body systems and chronic high blood pressure affect one another in a highly complex and individualized way, and it has proven difficult to pinpoint the responsible mechanisms — but that doesn’t mean there isn’t one. Most practitioners agree that the renal (kidney), hormonal, nervous, and vascular systems are most highly involved, with input from various genetic and environmental factors.

Some factors that affect blood pressure can’t be helped, like age, race, heredity, and gender. Then there are other predominant factors, such as diet, lifestyle, environment and emotional state, that are just as important and wholly within your control. Being overweight, smoking, high alcohol intake, elevated cholesterol, inflammation, insulin sensitivity, and emotional history all affect the progression of high blood pressure — and you can change them.

Blood pressure is like a reflex, dependent on a wondrous interplay between your parasympathetic and sympathetic nervous systems. When activated, the sympathetic nervous system, which governs your fight or flight response, causes your heart rate to increase and blood pressure to rise. The role of the parasympathetic nervous system is to lower heart rate and blood pressure back to normal once the “threat” has passed. This elegant dance evolved over the millennia as an automatic survival mechanism. The problem is that such stress has become a constant in modern life.

Blood pressure and stress

For millennia, blood pressure was kept healthy by the nature of daily life: alternating periods of intense physical activity, stress, and rest; hard work for limited calories; and a restricted salt intake. All that has changed in the past 500 years. As our “civilization” developed so did chronic high blood pressure, rightfully seen as a rich man’s (and woman’s) condition because it was found almost exclusively in the developed world.

One study quoted in the Textbook of Natural Medicine followed residents of remote, agrarian areas in China, New Guinea, and Brazil (among others). Individuals showed almost no evidence of hypertension until they made the shift to industrialized societies. The incidence of high blood pressure then increased in proportion to changes in diet, lifestyle, environment, and body mass.

Some argue there is a genetic component involved. In poorer countries like Haiti and the Dominican Republic, high blood pressure is now rampant. But this may well be due to the stress of poor diet, poverty and crowding. In industrialized urban areas, African–Americans are four times as likely to have hypertension as their Caucasian counterparts. Here again, while a variant DNA sequence in these populations may be part of the picture, major studies have shown that it is exacerbated by environmental factors, including issues of class and racism. There are some cultures in Africa who have zero incidence of hypertension, and don’t even have a word for it.

Even if high blood pressure is the price many of us will pay for modern life, it is more important for you to remember that your blood pressure reading is not your destiny. It is just a number that will respond to any positive modifications you make. Even something as simple as learning how to breathe deeply can lower your blood pressure. Imagine what other changes might do!

High blood pressure in women

The prevalence of hypertension among men and women is closely correlated with age. At age 35, a woman is only one-third as likely to have high blood pressure, and fares better in her prognosis, than a man her same age. By age 65, this gap evens out, with women running the same risk as men.

Estrogen levels appear to play a significant role in modulating blood pressure, but this mechanism isn’t yet known. Many women with normal blood pressure readings throughout their earlier years develop hypertension after menopause. One element might be that when estrogen levels decline, arteries lose some of their elasticity. For more information, read our articles about women and heart disease.

The WHI study seemed to indicate that Hormone Replacement Therapy (HRT) mimics estrogen’s soothing effects on the cardiovascular system for a brief time following menopause. Within five years, however, HRT appeared to have the opposite effect.

Bear in mind that the WHI study was conducted with one-size-fits-all Premarin, a synthetic form of HRT that caused the participants’ estrone levels to skyrocket. Estrone is just one of three estrogen forms in your body. The question this begs for me is whether this is not more about hormonal balance than just estrogen: it is possible that a sprinkling of bioidentical hormones (including estradiol, estrone, and estriol, progesterone and testosterone), tailored to a woman’s own needs, may indeed prove to soften arteries over the long term. I think we’ll know the answer soon.

Diet, syndrome X, and high blood pressure

Being overweight or obese is a leading factor in high blood pressure. Fat that accumulates deep in the belly (visceral fat) has been linked with high blood pressure, high cholesterol, insulin sensitivity and heart disease.  If you are overweight and have high blood pressure, losing just five percent of overall body weight has been shown to significantly lower blood pressure. So don’t give up, thinking it’s impossible to make a difference — even a minimal decrease in weight will help.

The mechanisms behind weight gain and hypertension are complex. Almost every major system in the body plays a part. I believe inflammation plays a critical role too, and research has suggested how. Foods that lead to weight gain such as saturated fat, trans fats, simple carbs, and refined sugar, elevate levels of inflammation–provoking fatty acids in the blood. Inflammation is directly linked with atherosclerosis and other cardiovascular problems that stiffen and gum up arteries. In addition, a higher body mass stresses the heart, raising cardiac output.

Insulin resistance, type 2 diabetes and other endocrine concerns often co-exist with high blood pressure. The prevalence of syndrome X, also known as metabolic syndrome or MetS — marked by central obesity, elevated triglycerides and high blood pressure — has engendered a new field of study around the relationship between diet, metabolism, and blood pressure.

We are just beginning to understand how insulin resistance affects sodium retention and sympathetic nerve activity. It appears to reduce the elasticity of cellular walls by affecting the ion transport across the cell membranes, inadvertently increasing sodium and calcium levels and making the vessels more reactive.

A 1997 study called DASH (Dietary Approaches to Stop Hypertension) concluded that a diet high in fruit and vegetables and low-fat dairy products lowers hypertension, while a diet high in animal fat and simple carbohydrates does the opposite. The DASH diet, which is similar to a Mediterranean diet, has been found to significantly raise below-average potassium levels, and to decrease blood pressure. Interestingly, the blood pressure benefits of the DASH diet are most pronounced in individuals whose potassium intake was lowest, and in those whose sodium intake was highest.

This leads us to the matter of salt. Because after sugar and fat, what is the most common ingredient in the American diet? You guessed it — salt.

Salt and high blood pressure

In conventional medicine, salt is bad. This is too simplistic a view. Let’s start with understanding sodium, the essential nutrient in ordinary table salt.

On average, we humans need only about a gram of sodium (less than a half-teaspoon of table salt) per day to keep our systems functioning and ward off dehydration. Naturally, needs vary according to climate and how physically active we are, which govern how much we sweat. But between the huge amount of hidden sodium in processed food and liberal use of iodized table salt (sodium chloride, which is about one-quarter sodium), most Americans are getting four times their daily requirement per meal.

In most healthy people, the kidneys can manage all that extra sodium, but there are many people whose kidneys are unable to excrete salt efficiently. The result of keeping too much sodium on board is fluid retention, which raises blood volume and pressure. It is estimated that 20% of people with hypertension are “salt-sensitive,” particularly African-Americans and people of advanced age. This means that their blood pressure is highly sensitive to even small changes in sodium intake, rising 5 mmHg with each additional gram.

While you may or may not have a genetic predisposition to salt sensitivity, your chances of developing it become higher with age. An overabundance of salt in our diets, especially the hidden salt in processed foods, puts everyone at risk, and more so with each passing year. When our taste buds build up a tolerance to salt, we need more and more to get satisfaction. This can lead to salt sensitivity over time. Have you ever watched someone raining salt from the shaker down upon their food — sometimes without even tasting it beforehand?

Another point missing in the salt debate is that it is not just about the quantity of salt you consume, it is the type — and salt comes in many forms! Though we’ve been lectured ad nauseum that high sodium is the culprit when it comes to high blood pressure, we’re beginning to see that low potassium may play the more significant role. Supplementing with “good” salt while decreasing “bad” salt intake has been shown to successfully lower blood pressure.

So eat a diet high in potassium–rich foods. Good sources include avocados, bananas, and yogurt. Read the labels on your favorite packaged foods to check for hidden sodium forms of salt (e.g., MSG), which are often significant. And stick to a good quality sea salt when cooking and setting the table — you’ll get vital trace minerals without so much of the sodium and chloride found in ordinary table salt. By any and all means, substitute fruits, nuts, vegetables, and natural juices for low-potassium processed foods and soda.

In his book, What Your Doctor May Not Tell You about High Blood Pressure, author Mark Houston relates his amazing success at treating hypertension through diet, nutrient therapy, emotional techniques and biofeedback. As the DASH study shows, you can achieve many of the same beneficial effects on blood pressure through diet and lifestyle modification without resorting to drugs.

So don’t buy into the idea of a lifetime of medication without at least trying to change your diet first. But in addition to what you eat, it’s also important how you live.

How to prevent or treat high blood pressure with a healthy lifestyle

Managing blood pressure with a healthy lifestyle can be approached in many ways. Just take it one step at a time. You don’t have to fit everything in all at once to do yourself good. Real transformation takes place over time through small but steady changes.

  • Engage in some form of physical activity every day. 

When it comes to lowering blood pressure, exercise has proven as effective as medication. And you can start exercising right now! Get up and walk. Learn how BreathWalk can help lower your blood pressure by integrating walking with breathing. Try to exercise 30–60 minutes almost every day. Start out slowly, walking to the mailbox, taking the stairs, or leaving your car at the far end of the parking lot. Then, add time and distance as you build up strength and endurance. If that sounds too much like work, look into a ballroom dancing class or the neighborhood pool. It really doesn’t matter so much what you do, only that you enjoy it enough to stick with it over time.

Now if you think you can’t handle it, you should probably check in with your healthcare provider first. But consider the fact that for 99% of human history we were on the run, hunting and gathering — humans are adapted for endurance exercise! Vigorous physical exercise is the number-one way to prevent and treat hypertension. There are so many benefits to exercise that many practitioners regard it as the fountain of youth.

Regular exercise helps individuals maintain a healthy weight, lose fat, and build muscle. Exercise boosts metabolic function, which helps control insulin and other hormones. It soothes inflammation, supports detoxification, combats the stress response, boosts serotonin output, and wards off almost every age-related condition we know. What’s more, exercise purportedly makes artery walls more elastic. And that helps explain why it’s so great at reversing high blood pressure.

  • If you are overweight (BMI over 25) or obese (BMI over 28), try to lose ten pounds. 

Even a moderate amount of weight loss can really improve your blood pressure. Again, start slowly. Eliminate junk food and soda and try not to eat after 7:00 pm, earlier when you can. Keep some nuts or a yogurt to snack on so you won’t be tempted to binge on sweets and other carbs. Read about and follow our lifestyle and nutritional guidelines. This will ensure that you get an adequate amount of complex carbs, lean protein, healthy fats, and fiber to keep your blood pressure stabilized.

Here’s more good news for women: recent reports show that eating dark chocolate (over 70% cocoa) has a positive effect on blood pressure and insulin resistance — so go ahead and reward yourself with an occasional chocolate delight.

  • Practice emotional stress management. 

Poor stress management — or more accurately, emotional stress blockage — raises your risk of high blood pressure. Unexpressed emotions, particularly anger and fear, constitute a form of stress. Souring relationships, job strain, and childhood trauma all have negative health effects.

Many of us have been conditioned to discount or conceal our emotions. What we are not often taught is that emotions manifest themselves in a physiological way in the body, especially if they’re repressed. In addition, nearly everyone experiences some kind of emotional stress. Whether it makes us sick or not appears to be determined by how well we deal with it. Social support is certainly a factor. In one telling report, people with supportive spouses and a job they liked were found to have significantly lower blood pressure than those who did not, given the same amount of external stress. In another, loneliness was found to be associated with high blood pressure.

It’s clear that certain variables like family history and temperament, which can be codependent, can increase your risk (see our article about emotions and your health). There may seem to be no end to factors over which you feel powerless. The good news is that you can offset these legacies by learning how to calm your mind, support your physiology, and recalibrate your emotional responses.

  • Let’s revisit the autonomic nervous system for a moment.

We often regard the functions it regulates, such as heartbeat and blood pressure, as involuntary. But this is not entirely so. The age-old practices of yoga and meditation alter a number of autonomic functions, including heart rate and blood pressure. Visit the ABC-of-Yoga for poses and breathing exercises that can help you stabilize your blood pressure, or consider other modalities such as biofeedback or brain–heart integration systems like HeartMath. Other ways to get at the emotional root of your reaction to stress include talk therapy, which can help uncover hidden trauma and subconscious patterns that are blocking your ability to manage stress. Freeing yourself through the help of an experienced counselor will make it easier to learn a new tune! Look into EFT or the Hoffman Quadrinity Process for inspiration.

  • If you self-medicate, quit or wean yourself off. 

Women often turn to psychotropic substances to help them cope with the stress in their lives. Of these, the most common — alcohol, caffeine and nicotine — are all implicated in high blood pressure. These substances affect the nervous system, artificially stimulating or inhibiting the various neurotransmitters involved in the fight or flight response. Over time, higher dosages are needed to get the desired effect, which ultimately throws the nervous system off-balance and raises blood pressure. Alcohol and nicotine use can also accelerate the degenerative effects of high blood pressure once it’s in place.

You may want to consider a course of acupuncture, which has been shown to be very effective in reducing cravings, minimizing withdrawal symptoms, and breaking stubborn addictions. Look for a practitioner experienced with addictive behavior. Techniques like yoga and meditation can be used as adjunctive therapy to help calm your heart and quiet your compulsions.

  • Minimize environmental stress and toxic body burden. 

Everyone has a certain level beyond which the body ceases to be able to detoxify efficiently. The main organs of detoxification — the liver, kidneys, and skin — eliminate internal toxins through feces, urine, and sweat. If any of these organs become overburdened by toxins, many symptoms arise, and at the top of the list is hypertension.

The most direct way to eliminate toxins is through cleaning up your diet, drinking lots of filtered water, and adding certain antioxidant and supportive nutrients to your daily regime. So stay hydrated. Flush toxins and excess salt by drinking eight to ten 8–oz glasses of filtered water every day. This will assist your renal function and weight loss. Take a pharmaceutical-grade multivitamin every day to help compensate for and metabolize the toxic load. Make sure your multi contains calcium, magnesium, and potassium to offset sodium salts, as well as essential fatty acids to protect your blood vessels. For more information, read our articles on detoxification.

Lowering your blood pressure may take a combination of any or all of the above, depending on your individual biology. Always work closely with a trusted professional, especially if you have a family history or already show elevated readings, to monitor your response to conventional or integrative therapies.

I can’t underscore enough the real, measurable effect that optimal nutrition, physical exercise, and positive lifestyle habits have on your blood pressure. My father has hypertension and serious congestive heart disease. After several very scary experiences, he finally decided (at age 85) to commit to restructuring his priorities, cleaning up his diet and undertaking some nutrient and alternative therapies — including a heavy metal detox. After just a few months he went for an ultrasound and his condition was improved markedly. To me this is proof positive that holistic measures will work if you do the work — at whatever age.

If you are under a lot of pressure, serving as the lifeblood of your family, friends and community, doesn’t it stand to reason that your own blood vessels would mirror that pressure? So take the cue. Commit to small changes in a consistent way over time, and the happy culmination will be a healthier life and more ideal blood pressure levels. You, together with everyone around you, will thrive on your transformation.

For more information, please read our informative article, “Blood Pressure Readings – Taking Your Vital Signs.”