Wednesday, November 17, 2010

Preventing Cardiovascular Disease - Part 2

Lifestyle and dietary recommendations for hypertension
Note: Persons with blood pressures greater than 160/115 should immediately consult with a physician. Short-term medications may be necessary, but you can also implement the following suggestions until your blood pressure has decreased.
Lifestyle changes:
Increase physical activity
  • When compared with their more active and fit peers, sedentary individuals with normal blood pressure have a 20 to 50 percent increased risk of developing hypertension.
  • Activities could include anything from swimming and running, to the lifting of light weights, yoga, Tai Chi, or many of the other alternatives available to us.
Manage insulin levels
Decrease weight
  • Many CVD patients suffer from weight gain, often due to a decrease in insulin sensitivity and poor diet. Increased weight results in greater stress upon the heart and circulatory system.
  • Weight gain is also linked to insulin resistance and often leads to obesity and cardiovascular disease.
  • Weight gain must be controlled and managed by reducing the glycemic load upon the body, increasing protein intake, reducing saturated fats, avoiding refined carbohydrates, and increasing physical activity.
  • Weight Training is essential - There is a basic equation you can’t get around when it comes to weight loss. The more muscle you have the more calories you will burn and the more fat you will lose. Research has shown that weight training with dietary modifications is almost 45% more effective than just diet alone (Miriam Nelson, Tufts University).
Make dietary changes
  • The majority of CVD patients consume a diet rich in saturated fats and refined carbohydrates. This typically results in an imbalance of the sodium/potassium levels, an increase in cholesterol levels, increased insulin levels, and increased water retention. These factors combine to increase blood pressure.
  • Dietary changes should include the consumption of greater quantities of fresh fruit and vegetables to assist in the balancing of sodium/potassium levels.
  • Avoid all canned fruit and vegetables due to their high sodium content. Studies have shown that an average decrease of 95 mmol per day of sodium can result in a decrease in blood pressure by 6.3/2.2 mm Hg.
  • Dietary potassium can also be increased by eating foods high in fiber and by avoiding all refined carbohydrates.
Stop smoking
Decrease coffee & alcohol consumption
  • Caffeine sensitive individuals are susceptible to increased blood pressure caused by coffee. One cup of coffee at 8:00 in the morning has been shown to cause a measurable increase in blood pressure at 10:00 that evening.
  • Alcohol can be a factor in hypertensive in individuals who consume more than two drinks per day. Low alcohol consumption (1 drink per day) has been associated with an overall decrease in blood pressure (especially in women). There are also indications that light to moderate drinking can have some protective effects in coronary heart disease, but the research is not conclusive in this matter. My advise is moderation, one or two drinks per day (one most days) especially with food to slow absorption will probably be beneficial for most people. For those individuals who are alcohol sensitive and suffer from hypertension alcohol abstinence may be necessary.
Avoid birth control pills
  • Studies have shown that women using birth control pills have 2-3 time the rate of hypertension. The combination of birth control pills and cigarettes can be lethal.
Decrease stress
  • Increased stress results in the production of higher levels of cortisol which has been associated with hypertension.
  • Chronic high stress can lead to high blood glucose levels, weight gain, and increases in LDL and cholesterol levels.
  • Implement stress reducing life-style changes. This could include the incorporation of regular exercise, meditation, and personal time off into their daily schedules.
Nutritional supplements
  • Often dietary and lifestyle changes alone are often not enough to adequately reduce CVD risks. Today's foods are sadly deficient in many essential nutrients and minerals. Supplementation for hypertension should include:
· Multivitamin and mineral tablets to support liver function in the removal of waste products, and to prevent the production of free radicals.
· Vitamin C at 500-1000 mg per day since Vitamin C acts as an anti-oxidant and prevents the harmful breakdown of LDL particles.
· Vitamin E at 400-800 iu. per day since Vitamin E acts as an anti-oxidant and prevents the harmful breakdown of LDL particles.
· Magnesium at 400 - 800 mg per day can help to reduce angina, blood pressure, and heart palpitations.(38)
· Co enzyme Q10 - 50 mg 3 times per day. "Findings indicate that treatment with coenzyme Q10 decreases blood pressure possibly by decreasing oxidative stress and insulin response in patients with known hypertension receiving conventional antihypertensive drugs."
Vascupress - This is a great supplement from AOR, that we commonly prescribe to our patients with hypertension. This supplement is high in antioxidants and nitrates.
AOR info on Vascupress: "Clinical trials have shown that diets high in fruits and vegetables can reduce blood pressure and the incidence of harmful cardiovascular events. The cardioprotective effects of a high fruit and vegetable diet were thought to be related to the high antioxidant content found in those foods, yet clinical trials remain inconclusive as to the exact mechanism of action behind protective effect. The highest protection has been found to come from dark leafy vegetables, like beetroot, spinach and lettuce, which are high in nitrate content. Vegetarians consume up to 10 times more nitrate from vegetable/fruit sources than non-vegetarians, which has been hypothesized to be the key reason for lower rates of hypertension and myocardial infarctions in vegetarians."
Massage Therapy
  • Research has shown that massage therapy can have a significant affect on hypertension. Massage can decrease both systolic and diastolic pressure, decrease cortisol levels, decrease cardiac output, even decrease feelings of anxiety and depression.

In part three of Preventing Cardiovascular Disease we will cover Cholesterol

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Delaney, J.P., Leong, K.S., Watkins, A., & Brodie, D. (2002). -- The short-term effects of myofascial trigger point massage therapy on cardiac autonomic tone in healthy subjects. -- Journal of Advanced Nursing, 37, 364-71.
Hernandez-Reif, M., Field, T., Krasnegor, J., Theakston, H., Hossain, Z., & Burman, I. (2000). -- High blood pressure and associated symptoms were reduced by massage therapy. -- Journal of Bodywork and Movement Therapies, 4, 31-38.

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