Health: Disease: Hypertension
Hypertension is a silent
disease, usually discovered through a physical examination. Blood
pressure readings are taken to identify the symptoms of hypertension.
When the top number of millimeters of mercury is higher than 140 mm Hg
(systolic reading) and the bottom number is higher than 90 mm Hg
(diastolic reading), there is cause for concern.
NIH: Seventh Report: Prevention,
Detection, Evaluation and Treatment of High Blood Pressure (JNC 7):
"The National High Blood Pressure Education Program presents the
complete Seventh Report of the Joint National Committee on Prevention,
Detection, Evaluation, and Treatment of High Blood Pressure. Like its
predecessors, the purpose is to provide an evidence-based approach to
the prevention and management of hypertension. The key messages of this
report are these: in those older than age 50, systolic blood pressure
(BP) of greater than 140 mm Hg is a more important cardiovascular
disease (CVD) risk factor than diastolic BP; beginning at 115/75 mm Hg,
CVD risk doubles for each increment of 20/10 mm Hg; those who are
normotensive at 55 years of age will have a 90% lifetime risk of
developing hypertension; prehypertensive individuals (systolic BP
120-139 mm Hg or diastolic BP 80-89 mm Hg) require health-promoting
lifestyle modifications to prevent the progressive rise in blood
pressure and CVD; for uncomplicated hypertension, thiazide diuretic
should be used in drug treatment for most, either alone or combined
with drugs from other classes; this report delineates specific
high-risk conditions that are compelling indications for the use of
other antihypertensive drug classes (angiotensin-converting enzyme
inhibitors, angiotensin-receptor blockers, beta-blockers, calcium
channel blockers); two or more antihypertensive medications will be
required to achieve goal BP (<140/90 mm Hg, or <130/80 mm
Hg) for patients with diabetes and chronic kidney disease; for patients
whose BP is more than 20 mm Hg above the systolic BP goal or more than
10 mm Hg above the diastolic BP goal, initiation of therapy using two
agents, one of which usually will be a thiazide diuretic, should be
considered; regardless of therapy or care, hypertension will be
controlled only if patients are motivated to stay on their treatment
plan. Positive experiences, trust in the clinician, and empathy improve
patient motivation and satisfaction. This report serves as a guide, and
the committee continues to recognize that the responsible physician's
judgment remains paramount."
This special version of the updated
clinical practice guidelines for hypertension is written for the busy
Primary Care Clinician.(pdf)
Seventh Report of the Joint National
Committee on Prevention, Detection, Evaluation, and Treatment of High
Blood Pressure (JNC 7)(pdf)
My Blood Pressure Wallet Card(pdf)
Your Guide to Lowering Blood Pressure(pdf)
DASH Eating Plan(pdf)
Physician Reference Card(pdf)
and Stroke Foundation: Your Blood Pressure: Action Plan:
" There are many things you can do to treat and prevent high blood
pressure. Find out what you can do to live a healthier life.
Based in Canada
Dietitians of Canada:
"Tools that assess food choices and nutrition knowledge, FAQs and
factsheets on current healthy eating topics, and tasty recipes.
Based in Canada
Solving Hypertension Without Drugs:
" The good news is that prehypertension should not be treated with
medication. The role of the health professional should be to stress
maintaining a healthy weight, increasing physical activity, reducing
stress and anxiety, and eating a healthy diet. The ideal dietary plan
adopts many principles of the DASH (Dietary Approaches to Stop
Hypertension) plan with other important additions."
Based in Chicago, IL 60610
Angiotensin Converting Enzyme (ACE)
" Angiotensin II is a very potent chemical that causes the muscles
surrounding blood vessels to contract and thereby narrows the blood
vessels. The narrowing of the vessels increases the pressure within the
vessels and can cause high blood pressure (hypertension). Angiotensin
II is formed from angiotensin I in the blood by the enzyme, angiotensin
converting enzyme (ACE). ACE inhibitors are medications that slow
(inhibit) the activity of the enzyme, which decreases the production of
angiotensin II. As a result, the blood vessels enlarge or dilate, and
the blood pressure is reduced"
Angiotensin II Receptor Blockers:
"The final active messenger of the renin-angiotensin pathway
is angiotensin II. Angiotensin II binds to AT1 receptors to cause
vasoconstriction and fluid retention, both of which lead to an
increase in blood pressure. The angiotensin II receptor blockers
lower blood pressure by blocking the AT1 receptors. Therefore
they have similar effects to angiotensin converting enzyme (ACE) inhibitors,
which inhibit the synthesis of angiotensin II by ACE (see illustration).
However, non-ACE pathways can produce some angiotensin II. ACE inhibitors
also decrease bradykinin breakdown and this action could be involved
in some of the beneficial and adverse effects of that class of drugs.
Therefore, a potential for differential clinical effects exists for
these two classes of drugs."
Cardiovascular Physiology Concepts: Histamine and Bradykinin:
"Histamine, released by mast cells in response to injury,
inflammation and allergic responses, causes arteriolar
vasodilation, venous constriction in some vascular beds,
and increased capillary permeability (by causing
endothelial cell contraction). Both H1 and H2 receptors
may be involved in the vascular effects of histamine.
The actions of bradykinin are similar to histamine.
Bradykinin is a potent stimulator of nitric oxide
formation by vascular endothelium. It also stimulates
Taking Blood Pressure:
How to take blood pressure with a blood pressure cuff and a
Mayo Clinic: Hypertension and High
"Doctors at Mayo Clinic published a study that shows high blood
pressure found during an exam not only puts you at increased risk for
heart disease and stroke, but it also may be a sign that you're
cholesterol is too high. And that high cholesterol can lead to blocked
arteries. Here's what you should know about cutting your risk of heart
OSU: Linus Pauling Institute:
"The renin-angiotensin system plays an important role in the regulation
of blood pressure (13). Renin is an enzyme that catalyzes the cleavage
(splitting) of a small peptide (Angiotensin I) from a larger protein
(angiotensinogen) produced in the liver. Angiotensin converting enzyme
(ACE) catalyzes the cleavage of angiotensin I to form angiotensin II, a
peptide that can increase blood pressure by inducing the constriction
of small arteries and increasing sodium and water retention. The rate
of angiotensin II synthesis is dependent on renin (14). Recent research
in mice lacking the gene encoding the VDR, indicates that 1,25(OH)2D
decreases the expression of the gene encoding renin through its
interaction with the VDR (15). Since inappropriate activation of the
renin-angiotensin system is thought to play a role in some forms of
human hypertension, adequate vitamin D levels may be important for
decreasing the risk of high blood pressure."
MGH: BrainTalk: Vitamine D:
"Here's how it works: According to a study published in 2002 in the
Journal of Clinical Investigation, one of your genes (a tiny part of
your DNA) leads to the formation of a molecule called renin. Renin
breaks down another molecule, called angiotensinogen, into angiotension
I. Angiotensin I is converted into angiotensin II by ACE. Vitamin D
persuades the renin-controlling gene to become less active, and the
whole process slows down.5 The end result is less angiotensin II and
lower blood pressure."
National Sleep Foundation: Myths And
Facts About Sleep:
"Studies have found a relationship between the
quantity and quality of one's sleep and many health problems. For example,
insufficient sleep affects growth hormone secretion that is linked to obesity;
as the amount of hormone secretion decreases, the chance for weight gain increases.
Blood pressure usually falls during the sleep cycle, however, interrupted sleep can
adversely affect this normal decline, leading to hypertension and cardiovascular problems.
Research has also shown that insufficient sleep impairs the bodyÕs ability to use
insulin, which can lead to the onset of diabetes. More and more scientific studies are showing
correlations between poor and insufficient sleep and disease."
Didgeridoo Playing as alternative treatment for obstructive sleep apnoea syndrome: randomized controlled trial:
Conclusion: "Regular didgeridoo playing is an effective treatment alternative well accepted by patients with moderate obstructive sleep apnoea syndrome."
CPAP Machines & Information:
A US based vendor that provides lots of good information.
Sleepreview: Hypertension and OSA:
"Sleep-disordered breathing (SDB) plays a causal or contributing role
in the development of comorbidities such as hypertension and
cardiovascular events. Snoring, SDB, and obstructive sleep apnea (OSA)
have been reported to be associated with hypertension since the early
1980s.1 There is substantial epidemiological and pathophysiological
evidence to suggest that SDB causes hypertension. Moreover, an
association between sleep apnea and hypertension that is independent of
age, sex, and body weight has been reported."
MGH: Hypertension and Obstructive
Current Hypertension Reports 2003, 5:380 "Obstructive sleep apnea is a
common disorder that is often unrecognized and underappreciated.
Emerging evidence suggests that there is a causal link between
obstructive sleep apnea and hypertension."
Medically supervised water-only
fasting in the treatment of hypertension
"Almost 90% of the subjects achieved blood pressure less than 140/90 mm
Hg by the end of the treatment program. The average reduction in blood
pressure was 37/13 mm Hg, with the greatest decrease being observed for
subjects with the most severe hypertension. Patients with stage 3
hypertension (those with systolic blood pressure greater than 180 mg
Hg, diastolic blood pressure greater than 110 mg Hg, or both) had an
average reduction of 60/17 mm Hg at the conclusion of treatment. All of
the subjects who were taking antihypertensive medication at entry (6.3%
of the total sample) successfully discontinued the use of medication.
CONCLUSION: Medically supervised water-only fasting appears to be a
safe and effective means of normalizing blood pressure and may assist
in motivating health-promoting diet and lifestyle changes. "
Water As Medicine (Pani Prayog):
"Drink 1.25 liters of water (4 glasses), which has been kept overnight,
early morning before sunrise & before brushing the teeth.
DonÕt eat & drink for 45 min. of course you wash
& brush, after drinking. Do not exercise for 30 min. While
following this treatment one can drink water only 2 hrs after meals.
Even a healthy person can do this therapy to prevent illness in future.
Beginners can start with 2 glasses of water & then increase it
to 4 glasses."
"Hypertension is a state of adaptation of the body to a generalized
drought, when there is not enough water to fill all the blood vessels
that diffuse water into vital cells. As part of the mechanism of
reverse osmosis, when water from the blood serum is filtered and
injected into important cells through minute holes in their membranes,
extra pressure is needed for the "injection process." Just as we inject
I.V. "water" in hospitals, so the body injects water into tens of
trillions of cells all at the same time. Water and some salt intake
will bring blood pressure back to normal! Tragedy: Not recognizing
hypertension as one of the major indicators of dehydration in the human
body, and treating it with diuretics that further dehydrate the body
will, in time, cause blockage by cholesterol of the heart arteries and
the arteries that go to the brain. It will cause heart attacks and
small or massive strokes that paralyze. It will eventually cause kidney
disease. It will cause brain damage and neurological disorders, such as
Cholesterol": A Myth and a Fraud!:
" We in the medical profession, totally oblivious of the vital roles of
cholesterol in the body, have been duped into thinking that it is this
substance that causes arterial disease of the heart and the brain. The
pharmaceutical industry has capitalized on the slogan of "bad
cholesterol" and has produced toxic-to-the-body chemicals that
minimally lower the level of cholesterol in the body and in the process
cause liver damage to thousands of people, some who die as a result of
using the medication. "
Water - The Stuff of Life:
"The human body is a bio-electrical water machine that requires a quart
a day for every 50 lbs of body weight. The blood alone is made up of a
large percentage of watery serum. The lymph fluids which transport
waste and nutrients, comprising four times the volume of blood in the
body, are made from the water we consume. Every cell that makes us who
we are literally owes its life to an adequate supply of fresh, clean
water. When the body does not receive a constant, reliable supply of
water, it has to ration what is available and cut back on certain
functions to make the supply go round. Essential systems like the brain
are prioritised, others are impaired or cut back until the brain has
decided a reliable source of water has been garnered."