Two forms of high blood pressure have been described -- essential (or primary) hypertension and secondary hypertension. Essential hypertension is a far more common condition and accounts for 95% of hypertension. The cause of essential hypertension is multifactorial, that is, there are several factors whose combined effects produce hypertension. In secondary hypertension, which accounts for 5% of hypertension, the high blood pressure is secondary to (caused by) a specific abnormality in one of the organs or systems of the body.
Essential hypertension affects approximately 72 million Americans, yet its basic causes or underlying defects are not always known. Nevertheless, certain associations have been recognized in people with essential hypertension. For example, essential hypertension develops only in groups or societies that have a fairly high intake of salt, exceeding 5.8 grams daily. Salt intake may be a particularly important factor in relation to essential hypertension in several situations, and excess salt may be involved in the hypertension that is associated with advancing age, African American background, obesity, hereditary (genetic) susceptibility, and kidney failure (renal insufficiency). The
Approximately 30% of cases of essential hypertension are attributable to genetic factors. For example, in the
The vast majority of patients with essential hypertension have in common a particular abnormality of the arteries: an increased resistance (stiffness or lack of elasticity) in the tiny arteries that are most distant from the heart (peripheral arteries or arterioles). The arterioles supply oxygen-containing blood and nutrients to all of the tissues of the body. The arterioles are connected by capillaries in the tissues to the veins (the venous system), which returns the blood to the heart and lungs. Just what makes the peripheral arteries become stiff is not known. Yet, this increased peripheral arteriolar stiffness is present in those individuals whose essential hypertension is associated with genetic factors, obesity, lack of exercise, overuse of salt, and aging. Inflammation also may play a role in hypertension since a predictor of the development of hypertension is the presence of an elevated C reactive protein level (a blood test marker of inflammation) in some individuals.
High blood pressure is often accompanied by high blood levels of insulin. High insulin levels may cause high blood pressure. High levels of insulin will also make weight loss more difficult. A diet high in carbohydrates may not be ideal for hypertensives, for it will perpetuate high insulin levels. It will also worsen food cravings. Hypertensives who are overweight should restrict carbohydrates-grains, beans, legumes, and fruits - to no more than 40% of their diet in an effort to get their insulin levels back to normal.
High blood pressure is unknown in primitive cultures that eat a diet of unprocessed foods. Hypertension is another ailment that we bring upon ourselves with refined grains, sugar, refined oils, margarine, overeating, inactivity, stress, and smoking.
If you are overweight, begin a program of gradual weight loss. Even beginning to lose weight will lower blood pressure. Keeping weight off is one of the most important strategies for controlling blood pressure. Even losing a pound a week is a significant stride in the right direction. In fact, for hypertensives, slow weight loss of one to two pounds a week is ideal. Anything faster may deplete important blood-pressure-regulating minerals such as magnesium and potassium.
Foods that must be eliminated from the diet of hypertensives:
•Salty foods or processed foods high in sodium
•Caffeinated coffee
•Caffeinated tea
•Alcohol
•Sugar
•Margarine and fried foods
•Refined white flours and supermarket oils
•Stimulants such as ephedra (ma huang) and kola nut
•Regular aerobic exercise such as walking can help lower blood pressure. It should be done only with your physician's approval.
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