-IBIS-1.7.6-
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cardiovascular system
hypertension
Nutrition
dietary guidelines
» eating principles:
low fat diet of unsaturated fats
calorie percentages: 70% complex carbohydrates, protein 12-15%, fat 15-18%
low cholesterol
decrease sodium and increase potassium It has been found that as the extracellular level of potassium increases, the sodium-ATP pump is activated which causes a decrease in intracellular sodium.
(Patki PS. Brit J Med 1990;521-523:301; Cappuccio FP, et al. J Hypertension 1991;9:465-473.)
increase fiber As the level of fiber goes up blood pressure invariably goes down. In parts of the world where fiber intake is very high blood pressure tends to be very low.
decrease sucrose Sucrose can impair insulin function and can indirectly cause blood pressure to rise.
decrease serum glucose (Salomaa VV, et al. Brit Med J 1990;302:493-496.)
1-2 week fast on alkaline juices or watermelon fast, followed by a vegetarian diet
if overweight, reduce weight to normal range
in extreme hypertension, restrict diet to 500 mg Sodium
elimination/rotation diet, rotation diet, rotation diet expanded
» therapeutic foods:
foods rich in Potassium and Magnesium, diuretic foods; millet, buckwheat, oats, rice, raw goat's milk, raw leafy vegetables, watermelon, garlic, onions, foods rich in rutin, cornsilk tea, garlic, broccoli, celery, cherries, nectarines, pineapple, kumquats, watermelons, squash, pomegranate, guava, parsley, cucumber, dandelion greens, cornsilk and white mushroom soup (Ni, p. 136.)
increase omega-3 and omega-6 fatty acids: vegetable, nut, seed oils, salmon, herring, mackerel, sardines, walnuts, flaxseed oil, evening primrose oil, black currant oil
» fresh juices:
carrot, parsley and celery (Jensen, p. 50.)
lime and whey powder (Jensen, p. 50.)
grape and carrot (Jensen, p. 50.)
grapefruit - Note: adverse interaction with nifedipine (Procardia, Adalat)
carrot, spinach, beet, and parsley (Walker, p. 126.)
celery and apple (Walker, p. 126.)
watermelon (Shefi)
cornsilk tea (Shefi)
1/2 cup fresh snowpea
soybean sprout tea (Ni, p. 136.)
carrot, beet, and cucumber (Walker, p. 126.)
carrot and spinach (Walker, p. 126.)
warm celery (Ni, p. 136.)
mung bean soup (Ni, p. 136.)
chrysanthemum and spinach tea (Ni, p. 136.)
persimmon (Yin-fang and Cheng-jun, p. 63.)
radish (Chao-liang, Qing-rong, Bao-zhen, p. 12.)
cucumber vine tea (Chao-liang, Qing-rong, Bao-zhen, p. 57.)
» specific remedies:
take 60 g of banana skins or stems, steam in water and eat three times daily (Yin-fang and Cheng-jun, p. 65.)
» Liver Yang Rising:
one cup of grape juice and celery juice each, taken with warm water three times daily for 20 days. After one 20-day course of treatment, a 5-7 day rest, then resume another course.
drink the decoction of: 10 water chestnuts and 25 g each of kelp and corn silk
soak peanuts in vinegar for 5 days, eat 10 peanuts every morning
take a handful of sunflower seeds every morning and evening with 1/2 cup of celery juice for one month
drink one small "wine glass" of turnip juice morning and evening for 10 days
decoct 250 g celery (1/2 lb.) and drink, at same time eat 10 large Chinese dates
soak 6 g black fungus in water overnight; steam for one hour; sweeten with sugar to taste. Take one time per day in evening before bed until the symptoms and blood pressure have improved.
for constipation caused by hypertension: take 500 g of peeled banana and mash together with 15 g black sesame seed. Eat per day (Yin-fang and Cheng-jun, p. 65.)
take 60 g of water chestnuts and 30 g of fresh orange peel. Add water, steam until cooked and serve two to three times daily (Yin-fang and Cheng-jun, p. 68.)
take 30 g dried green peach (pitted young green fruit left to dry in the sun) cover with water and simmer until cooked and drink in place of tea. (Yin-fang and Cheng-jun, p. 69.)
» avoid:
Food intolerances; rule out food sensitivities: consider hypoallergenic diet; almost always will lower blood pressure 5-15 points diastolically within one week.
(Grant C. Lancet May 5, 1979.)
Salt, salty foods: pickles, olives, chips, packaged snacks, meat, (especially ham, frankfurters, bacon, bologna, corned beef, lunch meats, frozen fish fillets, sardines, herring, caviar, anchovies, shellfish), dairy products, spicy foods: salsa, white and black pepper, mustard, ginger, canned tomato juice, V-8 juice, processed cheese, canned, dried or instant soups, frozen peas and beans, most processed and refined foods, MSG, mayonnaise, salad dressings, gravies, ketchup, food with Sodium benzoate as a preservative, Sodium proprionate in cheese and bread, baking powder, baking soda, ice cream, milkshakes, soft drinks, smoked meats and fish, Jello, pretzels, potato chips, salted nuts, candy, rennet tablets, pudding mixes, beverage mixes, spicy foods, alcohol, fried foods, fatty foods, pork,
Overeating
Low levels of Calcium
Alcohol: Some people have a genetic hypersensitivity to alcohol which causes an increase in blood pressure.
Decrease sucrose: Sucrose can impair insulin function and can indirectly cause blood pressure to rise.
Avoid caffeine: A subset of the population may be sensitive to caffeine.
Trans-fatty acids, hydrogenated oils (margarine, vegetable shortenings, imitation butter spreads, most commercial peanut butters), oxidized fats (deep fried foods, fast food, ghee, barbequed meats)
Avoid foods containing tyramine (see materia medica)
Grapefruit juice and drug interaction: grapefruit juice increases the bioavailability of nifedipine (Procardia, Adalat) by 8-69%, possibly through bioflavonoid interfernece with cytochrome P450 (Cantoni, et al., 1982; 307; 1079.)
supplements
Calcium citrate: 1 gm per day. It may take up to 6 weeks to have an effect. One study showed 90 patients, ages 16-29, with mild hypertension had a median drop in their diastolic blood pressure of about 6 points. 1-2 grams per day (McCarron, 1985, 1392ff.); avoid Calcium supplementation if taking verapamil for hypotensive effect (see below)
Magnesium: 500 mg per day. The average American gets 250mg per day. (RDA is 300-350 mg per day). In one study, even a poorly absorbed form such as magnesium oxide, containing 200 mg/day of elemental magnesium, provided for both a significant reduction in systolic pressure and an improvement in quality of life factors such as reduced incidence of chest pain, increased physical activity, and improved respiratory function, alertness and emotional behavior.
(Dyckner, 1983:1847ff; Kawano Y, et al. Hypertension 1998 Aug;32(2):260-265; Borrello, G, et al. Curr Ther Res 1996;57:767-774.)
Note: supplement "several hundred" mg per day if patient is on thiazide medication or digitalis to prevent weakening of cardiac muscle caused by the increased excretion of Magnesium
Essential Fatty Acids, linoleic acid or Flax oil: 1 tbs per day. It takes 4-8 weeks, but it can decrease the diastolic level up to 10 points.
Omega-3 fatty acids 10-15 g per day (Norris, 1986, 104.)
Omega-6 fatty acids (Evening Primrose Oil) (Soma, 1985:325.)
Max EPA
Coenzyme Q10 60 mg per day (Yamagami, 1975: 273); 100-300 mg per day Coenzyme Q10 is especially indicated where there are other cardiovascular complications. (Digiesi V, et al. Curr Ther Res 47:841-845, 1990; Digiesi V, et al. Molec Aspects Med 15(suppl):S257-63.)
Garlic: lowers systolic and diastolic blood pressure.
(Petkov VA. J Chinese Med 1979;7:197-236.)
Vitamin A (McCarron, 1984; 1392ff.)
Vitamin B-complex (Vodoevich, 1986; 9ff.)
Vitamin B3
Vitamin C (McCarron, 1984; 1392ff.)
Vitamin D (Sowers, 1985; 135ff.)
Antioxidant vitamins: One study found a drop in blood pressure, especially systolic, for a group of twenty-one patients using a combination of vitamin C (500 mg). vitamin E (600 mg), beta-carotene (30 mg) and zinc (45 mg). This group suffering from hypertension was treated, in random order, with a combination of antioxidant nutrients for eight weeks and a placebo for an additional eight weeks. Systolic blood pressure was significantly lower after antioxidant treatment than after placebo with an average difference of 9mm Hg. After antioxidant treatment diastolic pressure was also lower, but not statistically significant, with an average reduction of 3.8mm Hg. (Galley HF, et al. Clin Sci (Colch) 1997 Apr;92(4):361-365.)
Potassium: 100 mg per day (Ophir,1983; 963ff)
Potassium supplements, such as Slow-K or Micro-K, are generally used to compensate for depletion in patients on thiazide medication
Chelate cadmium or lead, if appropriate (Marz, p. 265, 1997)
Treat thyroid condition: Either high or low thyroid can cause hypertension.
» drug interactions:
Calcium and verapamil (Calan, Isoptin, Verelan): Calcium interferes with the hypotensive effect of this drug which is intended to act as a Calcium channel blocker; avoid Calcium supplementation if taking verapamil for hyotensive effect
Vitamin B1 and furosemide (Lasix): causes increased urinary excretion of Vitamin B1 (thiamine) (Seligman, et al., 1991;91:151.)
Vitamin B6 and hydralazine (Alazine, Apresoline, Apresazide, Unipres): causes increased excretion of vitamin B6 (Trovato, et al., 1991;44:1651-1658.)
MAO inhibitors, esp. pargyline (Eutonyl), and tyramine: gastrointestinal MAO is essential for adequate breakdown of tyramine (Sullivan and Shulman, 1984;29:707-711.)
Sodium, Chloride and furosemide (Lasix): furosemide interferes with renal absorption of both. Note: this is the inteded purpose of the drug
Potassium, Magnesium, Calcium and furosemide: causes urinary excretion of all
Grapefruit juice and nifepidine (Procardia, Adalat): Grapefruit juice has been shown to increase the bioavailability of the drug
Thiazides: Thiazides, such as chlorthiazide (Diuril, Aldoril, Diachlor) and hydrochlorthiazide (Hydrodiuril) increase urinary excretion of Sodium, Potassium and Magnesium; depletion of Magnesium interferes with functioning of cardiac muscle; thiazides also decrease urinary excretion of Calcium. Consequently, risk of osteoporosis may be reduced in patients on thiazides, likewise Calcium supplementation may be effective at lower doses.
(Riis and Christiansen. 1985;34(5):421)
footnotes
Borrello G, et al. The effects of magnesium oxide on mild hypertension and quality of life. Curr Ther Res 1996;57:767-774.
Cappuccio, FP et al. Does potassium supplementation lower blood pressure? A metaanalysis of published trials. J Hypertension 1991;9:465-473.
Abstract: A meta-analysis was performed on 19 clinical trials that examined the effect of K supplementation on all people and people with hypertension. In people with high BP K suppl had the greatest effect lowering systolic Bp an avg of 8.2 pts and 4.5pts diastolically. In people who had normal BP it only lowered BP 5.9 and 3.4 pts respectively.
Digiesi V, et al.. Effect of coenzyme Q10 on essential arterial hypertension. Curr Ther Res 1990;47:841-845.
Abstract: 18 patients with essential hypertension received 100mg/day of coenzyme Q10 or placebo, each for 10 wks. with a 2 wk washout period, in a double-blind crossover trial. Mean systolic BP dropped by 10.6 pts and diastolic BP by 7.7 pts.
Digiesi V, et al. Coenzyme Q10 on essential hypertension. Molec Aspects Med 15 (suppl):S257-263.
Abstract: 26 patients with essential hypertension received 50 mg 2x per day for 10 weeks. Mean systolic Bp decreased an avg of 18 pts systolically and 12 pts diastolically (98.1 to 86.1).
Galley HF, Thornton J, Howdle PD, Walker BE, Webster NR. Combination oral antioxidant supplementation reduces blood pressure. Clin Sci (Colch) 1997 Apr;92(4):361-365.
Abstract: 1. Hypertension affects 30% of adults and low intakes of antioxidants have been associated with increased risk of hypertension and cardiovascular disease. To investigate the effect of short-term high-dose antioxidant supplementation on blood pressure in hypertensive and normotensive outpatients, we undertook a randomized, double-blind, crossover design placebo-controlled study. 2. Forty subjects were recruited from medical outpatient clinics, of whom 38 completed the study. Twenty-one were attending for treatment of hypertension and 17 were normotensive, attending for minor gastrointestinal complaints. Subjects were randomly assigned to receive either 8 weeks placebo followed by 2 weeks washout then 8 weeks antioxidants or vice versa. The combination of antioxidants consisted of 200 mg of zinc sulphate, 500 mg of ascorbic acid, 600 mg of alpha-tocopherol (sodium succinate salt) and 30 mg of beta-carotene daily. 3. Systolic blood pressure fell at the end of the antioxidant phase compared with the placebo phase both in subjects receiving anti-hypertensive therapy (P < 0.01) and those who were normotensive (P = 0.067). Circulating levels of beta-carotene and alpha-tocopherol increased in all subjects during supplementation (P < 0.01) and urine nitrite increased in hypertensive patients (P < 0.05). 4. Short-term oral high-dose combination antioxidant therapy reduces blood pressure, possibly via increased availability of nitric oxide. This study may have implications for the innovative use of antioxidants as an adjunct to anti-hypertensive therapy.
Grant C. Food allergies and migraine. Lancet May 5, 1979:966-969.
Abstract: 15 migraine patients with diastolic blood pressure of 100mm Hg or greater followed a 5 day elimination diet consisting of lamb and pears. A reduction in diastolic blood pressure to 90 mm Hg or lower was noted in every patient. When offending foods were reintroduced, blood pressure rose again. Upon avoidance of the offending foods blood pressures fell again to normal
Kawano Y, Matsuoka H, Takishita S, Omae T. Effects of magnesium supplementation in hypertensive patients: assessment by office, home, and ambulatory blood pressures. Hypertension 1998 Aug;32(2):260-265.
Abstract: An increase in magnesium intake has been suggested to lower blood pressure (BP). However, the results of clinical studies are inconsistent. We studied the effects of magnesium supplementation on office, home, and ambulatory BPs in patients with essential hypertension. Sixty untreated or treated patients (34 men and 26 women, aged 33 to 74 years) with office BP >140/90 mm Hg were assigned to an 8-week magnesium supplementation period or an 8-week control period in a randomized crossover design. The subjects were given 20 mmol/d magnesium in the form of magnesium oxide during the intervention period. In the control period, office, home, and average 24-hour BPs (mean+/-SE) were 148.6+/-1.6/90.0+/-0.9, 136.4+/-1.3/86.8+/-0.9, and 133.7+/-1.3/81.0+/-0.8 mmHg, respectively. All of these BPs were significantly lower in the magnesium supplementation period than in the control period, although the differences were small (office, 3.7+/-1.3/1.7+/-0.7 mmHg; home, 2.0+/-0.8/1.4+/-0.6 mmHg; 24-hour, 2.5+/-1.0/1.4+/-0.6 mm Hg). Serum concentration and urinary excretion of magnesium increased significantly with magnesium supplementation. Changes in 24-hour systolic and diastolic BPs were correlated negatively with baseline BP or changes in serum magnesium concentration. These results indicate that magnesium supplementation lowers BP in hypertensive subjects and this effect is greater in subjects with higher BP. Our study supports the usefulness of increasing magnesium intake as a lifestyle modification in the management of hypertension, although its antihypertensive effect may be small.
Patki PS. Efficiency of potassium and magnesium in essential hypertension: A double-blind, placebo-controlled, crossover study. Brit J Med 1990;301:521-523.
Abstract: 37 adults with mild hypertension were treated with either 1) 2.5gms of K, 2) 2.5gms & 480mg mag or, 3) placebo for 8 wks. They then crossed over for another 8 wks. Results showed that K lowered systolic BP an avg of 12pts and diastolic BP of 16pts! The 8 wk period where magnesium was added to the K made no difference in BP.
Petkov V. Plants with hypotensive, antiatheromatous and coronary dilating action. Am J Chinese Med 1979;7:197-236.
Abstract: In humans garlic was found to lower systolic and diastolic blood pressure by 20-30 points and 10-20 points respectively.
Salomaa VV, et al. Glucose tolerance and blood pressure: long term follow up in middle aged men. Brit Med J 1990;302:493-496.
Abstract: 1815 men were studied from 1974-86. In 1974, about half were normal and the other half had at least one risk factor for cardiovascular disease such as hypertension or glucose intolerance. Those who were hypertensive in 1986 had higher glucose levels in 1974. Glucose concentration in 1986 correlated with hypertension in 1986, even amongst those who were normotensive to begin with.