Hypertension and Sodium...Just Another Scare?
The common notion that sodium causes high blood pressure is erroneous. In some people with existing high blood pressure, excessive sodium may magnify the problem. But only about 30%-40% of hypertensives are sodium sensitive. For these individuals, even moderate amounts of sodium can increase their blood pressure further. Obviously, these people should regulate their sodium intake. But salt modification for those who have normal blood pressure is not necessary, as sodium will not raise blood pressure in normal individuals.
Sodium is a necessary nutrient, essential for good health. An average healthy man of 150 pounds has about 90 grams of sodium in his body. One third of this is in the bones and most of the remaining two thirds surrounds the cells throughout the rest of the body, where sodium is a major player in their regulation. Balanced with potassium, sodium acts as an "electrochemical pump" in accomplishing this remarkable feat.
Sodium also helps regulate acid/alkaline balance, water balance, the heart beat, muscle contractions, sugar metabolism and even blood pressure balance.
The problem of hypertension should not be taken lightly, as it is a serious health risk. But how is hypertension defined? Experts disagree on the definition of high blood pressure. In the U.S., pressures of 140/90 are often considered borderline hypertension and are sometimes medicated. But many doctors still consider those numbers normal. In people over the age of about 60, the "normals" tend to be higher: up to 160/95. (Blood pressure ordinarily rises with age.) In Canada, physicians generally do not consider blood pressures up to 200/110 mm Hg in the elderly a problem requiring medication. It's obvious that this situation is not black and white, and people must be treated individually.
Normally, everyone's blood pressure varies hourly, and tends to be higher with more stress. At times, some people with normal pressures show more significant increases when at their doctors office. This "white coat hypertension," as it's been termed, is usually benign.
One factor does have general acceptance: certain individuals, due to some genetic or acquired problem in their kidneys, are unable to process sodium normally. This results in an increased blood pressure.
Despite the fact that the American Heart Association and the Surgeon General recommend sodium restriction to prevent hypertension, other equally valid scientific opinions disagree. The American Council on Science and Health state in their literature that "stronger evidence should be available before persons are advised to alter their diets, and further caution that the possibility of harmful effects (of sodium restriction) cannot be totally discounted."
In 1988, the British Medical Journal (297:307) reported on the Intersalt Cooperative Research Group's international study on sodium and hypertension. The group demonstrated that a large reduction in sodium intake would result in an insignificant decrease in blood pressure. Specifically, an average decrease of 2.2 mm Hg systolic and 0.1 mm Hg diastolic blood pressures.
Almost everyone, however, agrees that hypertensive persons sensitive to sodium should restrict its use. But not as a primary treatment.
Other Factors Associated with Hypertension
Treatment of hypertension should be preceded by an attempt to find its cause. Two common reasons for high blood pressure include kidney problems and narrowed or "clogged" arteries. Other causes may be nutritional. When certain nutrients are low, such as vitamin A and C, and calcium, the blood pressure may elevate. primary role. In other cases, emotional factors can play a role. A lack of exercise has also been linked to hypertension.
In the U.S., over 3 billion dollars is spent annually for blood pressure medication. Ideally, correcting hypertension without medication is the healthiest approach. But when drugs are required, the proper medication and dose, along with careful observation for side effects is vital. Although high blood pressure is dangerous, lowering it too much is not without potential problems. The findings of Dr. Michael Alderman and co-workers of the Albert Einstein College of Medicine show that too much lowering of blood pressure may reduce blood flow to the heart, which can put the heart at risk. The safest approach is a 10% reduction in blood pressure in a person with hypertension.
Many people do not realize they can often control their own hypertension. Here are some examples:
… Exercise is a very important factor in controlling high blood pressure. Studies show unfit (non-exercising) persons are 1.5 times more likely to develop hypertension than fit individuals. Even in children, higher blood pressures are seen in those most inactive. Not only does increased activity in children result in lower blood pressures, but those who are active in sports have a lower incidence of hypertension later in life.
… Hypertension has also been associated with dietary fats. Unfortunately, the common belief is that a low fat diet lowers blood pressure. This is untrue. Actually, studies have shown just the opposite. Unsaturated vegetable oils can lower blood pressure in many individuals. In one study (American Journal of Cardiology, 6/88), low levels of substances called prostaglandin E2 (derived from fats in egg yolk, butter and cream) were related to the inability of the kidney to eliminate salt causing higher blood pressures.
… Another factor associated with high blood pressure is weight The prevalence of hypertension is 50% higher in overweight individuals aged 40-64 years of age. A New England Journal of Medicine (1978;298:1) report showed 75% of the hypertensive patients who lost weight (without sodium restriction) reduced their blood pressures to normal. In another study (Journal of the American Medical Association 1985; 253:657), 325 patients with high blood pressures who were on medication for at least 5 years were divided into three groups. One group for weight reduction, one for sodium restriction, and one where no change in the diet was made. All were taken off their medication for the one year duration of the test. The result: 60% from the weight loss group maintained normal blood pressures without medication, far more than the other test groups.
… It's also known that children and adolescents who are overweight are much more likely to have high blood pressure as adults. Weight loss can easily be maintained when the person is healthy all around. This means a good diet without extreme caloric restriction, including natural carbohydrates, proteins and fats, and regular exercise. Finding a doctor who can help in these areas is sometimes the first step.
Hypertension is a serious health problem. Attempting to find the cause may give a clue as to the best treatment. Assuming no emergency exists, after a thorough evaluation, where no cause can be found, conservative measures should be considered first. These include weight control, exercise, diet and nutrition.