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Dr Sarah Brewer EXCLUSIVE Interview
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Dr Sarah Brewer is a licensed doctor and registered nutritionist in the UK, she is also an award winning health writer who has written many books including: “Overcoming High Blood Pressure: The Complete Complementary Health Programme” and “Cut Your Cholesterol: A Three-month Programme to Reducing Cholesterol”
(Questions asked by BPcharts, answers all by Dr Sarah Brewer)
Everyone is at risk, but especially those who have certain risk factors. One of the main causes is hardening and furring up of the arteries. Known as atherosclerosis, this reduces the elasticity of your arteries so they don’t absorb the ‘shock’ as blood pulses through your system. Atherosclerosis naturally occurs with increasing age and comes on more quickly if you:
High blood pressure also runs in some families so, if your parents, brother or sister have a raised blood pressure, it's important to have yours checked regularly, too. New research suggests this genetic effect may relate to how well your body juggles the regulation of blood pressure and body temperature by directing blood away from your internal organs towards
your skin. In some people, this juggling effect causes
changes within the walls of tiny arteries that lead to hypertension.
When blood is forced through your circulation at high pressure, it damages your artery linings and increases your risk of suffering a heart attack, heart failure, stroke, kidney failure, peripheral arterial disease and dementia. Your risk of developing any of these complications increases progressively as blood pressure rises, so someone with a BP of 135 over 85, for example, is twice as likely to have a heart attack or stroke as someone with a reading of 115 over 75.
Although this all sounds rather frightening, the good news is that early diagnosis and treatment can control your blood pressure before it harms your health. Reducing your BP by as little as 5 mmHg can decrease your risk of coronary heart disease by 14%, and your risk of a stroke by 42% , so you can achieve big health gains by bringing your blood pressure down to normal levels.
Maintain a healthy diet and lifestyle, and maintain a healthy weight. Cut right back on salt intake, moderate alcohol intake, and take regular, brisk, daily exercise. Although this won’t guarantee your BP stays low, it will help to keep it as low as your genes allow.
Your BP varies naturally throughout the day and night in response to your emotions and level of activity. An ideal blood pressure reading is between 90/60 and 120/80 mmHg. Hypertension is diagnosed when your BP consistently reads 140 over 90 mmHg or higher, even at rest. Overall, one in every three adults in the UK has high blood pressure, and it becomes more common with age so that two in every three people over the age of 65 are affected.
The stress of having your blood pressure checked by a doctor or nurse can boost your readings by as much as 20/10 mmHg. This phenomenon, known as white coat hypertension, affects as many as one in four people. Research suggests that averaging your blood pressure over a 24 hour period is a better predictor of long-term health risks than isolated readings taken in a clinic or surgery. So, new guidelines recommend that those with suspected hypertension have their BP recorded with an ambulatory monitor. You simply wear an arm cuff, attached to an automatic device, that checks your BP every 30 minutes during the day and hourly overnight. This will detect which people have ‘white coat hypertension’ and which have true hypertension that needs medication. If your BP is only slightly raised, your GP may see if you can improve your BP through diet and lifestyle changes before prescribing antihypertensive medication. It will depend on your overall health and any other risk factors.
People with a blood pressure between 120/80 and 140/90 mmHg also have a higher risk of circulatory problems. This is known as pre-hypertension, as many adults whose blood pressure is in this range will progress to full hypertension. If your BP is in this range, you should take steps to keep your BP down or to stop it rising any further.
NICE guidelines now state that a diagnosis of primary hypertension should be confirmed using 24-hour ambulatory blood pressure monitoring (see question above), or home BP monitoring, rather than relying solely on BP measurements taking in the clinic. Hopefully your experience will become a thing of the past. Here’s a link to give your readers. http://www.nice.org.uk/newsroom/pressreleases/HypertensionGuidance.jsp
When you have high blood pressure, it’s a good idea to check your blood pressure at home. A wide range of devices are available. The Blood Pressure Association advise the following:
Read their full advice watch video clips, and see a list of clinically validated monitors here: http://www.bpassoc.org.uk/BloodPressureandyou/Homemonitoring/Choosingyourmonitor
NB When measuring your BP, ensure the cuff is level with your heart, with any difference in height adjusted by placing a cushion under your elbow.
Both yoga and meditation help to reduce high blood pressure by slowing the heart rate, relaxing muscles, reducing secretion of the stress hormone, cortisol, and allowing blood vessels to dilate. Benefits appear quite quickly with average systolic blood pressure reducing by an average of 10 mmHg after 12 weeks daily practice.
Writing in the Journal of Clinical Hypertension, Dr Bisognano and colleague Dr Kevin Woolf point out that many food supplements and herbal remedies have blood pressure lowering effects, including calcium, magnesium, folic acid, vitamin D, omega-3 fish oils and garlic. In particular they suggest that Coenzyme Q10 (200mg per day) can reduce systolic blood pressure by 16mmHg, while garlic can reduce systolic blood pressure by 10 - 16mmHg.
There is a great deal of interest in the fact that people with the greatest consumption of dairy products tend to have the lowest blood pressure. To begin with, it was assumed that calcium was the beneficial ingredient. New research now indicates that dairy lactotripeptides are the active component responsible for the reduction in blood pressure. These dairy peptides naturally block the action of an enzyme, called ACE, to promote blood vessel relaxation. This is exactly the same enzyme targeted by ACE inhibitor drugs prescribed by doctors to treat high blood pressure. For those with hypertension, a supplement containing dairy peptides is a natural way to help lower blood pressure.
Exercise is as important as diet for health and well-being. Back in the 1960s, the Honolulu Heart Study showed that active men were less likely to develop CHD, diabetes, obesity, raised cholesterol levels, high blood pressure and stroke than sedentary males. In the Harvard alumni study (1983), researchers found that men who took part in vigorous sports were 35% less likely to develop hypertension over a 10 year period than those who were physically inactive. A year later, both men and women in the Aerobics Center Longitudinal Study who had low fitness levels were 52% more likely to develop hypertension than those with the highest fitness level.
Researchers now know that regular exercise lowers ‘bad’ LDL-cholesterol and triglyceride levels, reduces abnormal blood clotting, increases glucose tolerance and ‘good’ HDL-cholesterol, as well as lowering a raised blood pressure. As a result, regular exercise reduces your risk of premature death from coronary heart disease (CHD) by more than 40%, and your risk of age-related death from all causes by around a quarter - even if not started until middle age. Even among people with pre-existing CHD, those who exercise regularly have a 25% lower risk of death at any age compared with those who do not exercise.
Exercise dilates blood vessels and reduces the force against which your heart has to pump blood out into the circulation (peripheral resistance). It expands the circulation in your muscles so blood and oxygen are brought in more quickly, and increases the efficiency of your heart and lungs. Exercise also promotes relaxation by stimulating the release of opium-like endorphins in the brain.
As well as reducing blood pressure at rest, increased fitness reduces the rise in blood pressure that occurs during intense physical activity and emotional distress. In a study published in Circulation (1991), exercise reduced diastolic blood pressure in a group of men with hypertension by 8 mmHg for 12.7 hours, and systolic blood pressure by 5mmHg for 8.7 hours, independent of the exercise intensity. In another study involving sedentary, obese, hypertensive males, published in the American Journal of Hypertension (2000), a single session of aerobic exercise, lasting 45 minutes, of moderate intensity, significantly reduced average systolic blood pressure by between 6 mmHg and 13 mmHg for the first 16 hours after exercise, compared to a day in which the men did not exercise. Overall, their average systolic and diastolic blood pressures remained significantly lower for 24 hours after exercise.
These and other studies suggest it’s wise to exercise regularly, every day, so the benefits of a single bout of exercise persist. As soon as you stop exercising, the beneficial effects on blood pressure, cholesterol levels and glucose tolerance are rapidly lost.
Dr Sarah Brewer is the author of over 50 popular health books, including Overcoming High Blood Pressure (Duncan Baird) www.naturalhealthguru.co.uk. To read more of her articles, visit www.yourwellness.com. She also provides diet and lifestyle advice at a new men’s health website, We Love Our Men, which you can find at www.wlom.co.uk.
High Blood Pressure Causes 62% of all Strokes and 49% of all Heart Attacks... Check your BP on the blood pressure chart. If the chart shows you are in the prehypertension or hypertension ranges, do something about it, even if it is just having a chat with your doctor. The blood pressure chart is for all adults regardless of age, as whilst your age rises, the thresholds for prehypertension and hypertension don't! (there is no blood pressure chart by age!) No matter what your age - if your BP is above 140/90 you should set about lowering it. You can record and monitor your readings on our printable blood pressure log.