Causes of High Blood Pressure

There is no “ideal” blood pressure.

We generally think of 120/80 as ideal, but this is not true.  This number was determined as an average of a large group of military personnel.  And not really decided based on what is related to health.

There are lots of guidelines for what your blood pressure should be.  But there’s a problem with these guidelines…

They are ALL about the drugs.  These guidelines are used to decide when you should be medicated.  Studies are done to determine when the benefits of using a drug outweigh the risks and costs.

This same scenario does not exist with lifestyle choices for blood pressure.  There are no risks and the costs are already part of your daily life.  No one ever dies from taking better care of themselves.

This means that, with lifestyle, lower is always better.

When you’re dealing with medications, many times driving down your blood pressure with medications brings higher risks when higher dosages are used.  For this reason, there are “ideal” blood pressure numbers when you are using medications.

Causes of High Blood Pressure – Prediabetes

There is one condition that contributes more to blood pressure than just about anything else.

Prediabetes.  aka Metabolic syndrome or dyglycemia.

But society does not view prediabetes as a problem.  Rather we think of full blown diabetes as the issue and prediabetes is just a “warning.”

I have met with many patients who were well on their way to becoming diabetic, but when I bring this up, they assure me that their doctor checked them and they were “ok.”

You can almost hear the audible “whew…”

The reality is that being prediabetic is massively damaging to your health.  Many patients who are prediabetic will become diabetic because they will die of a heart attack, stroke or cancer first—caused by prediabetes.

Make no bones about it—being prediabetic is very, very bad for your health.

And it is THE biggest contributor to blood pressure problems.  It is a player in almost every case of high blood pressure.

If your doctor called your blood pressure “idiopathic” (meaning we didn’t find an obvious case like kidney problems), if really means that he or she isn’t aware of the relationship between prediabetes and blood pressure.

Just how does prediabetes affect blood pressure?

I’m glad you asked.

I’ve already mentioned that Nitric Oxide (NO) is critically important for blood pressure control.

Well, NO has an arch enemy called ADMA (asymmetrical dimethylarginine).  When ADMA levels are higher, NO can’t do its good work on the blood vessels.

One of the hallmarks of prediabetes is elevated insulin.  When insulin is elevated it slows down the enzyme that breaks down ADMA.  In other words, higher insulin = lower NO.

If you do not fix the prediabetes, you CANNOT fix blood pressure.  Period.

Prediabetes and the Heart…How Bad is it?

Surely, I’m exaggerating.  Otherwise your doctor would’ve explained all of this to you.

Let me put the relationship between prediabetes and heart health into perspective by pointing out a study looking at the risk of heart disease in those with prediabetes.

While this study did not look at blood pressure specifically, BP is so integral into heart and brain health that the risk for each are the same.

In this study, those patients having all 5 components of prediabetes (high blood pressure, low HDL cholesterol, high triglycerides, increased blood sugar and increased waist-to-hip ratio) had a whopping 624% higher risk of heart disease.

There’s no beating around the bush here. This is a dangerous condition and needs to be treated as such.

Causes of High Blood pressure: Chronic Infections

Chronic inflammation is a killer.

Doesn’t matter about whether it causes cancer, heart disease, stroke or Alzheimer’s—the end result is the same.

Chronic inflammation will aggravate your blood vessels, destroying blood vessel health in the long run and leading to hardening of your arteries and high blood pressure.

So where does chronic inflammation come from?

Poor dietary choices are the major driver of inflammation in the body.  It’s beyond the scope of this article to go into detail on diet-driven inflammation, but you can make a good guess as to the foods that drive inflammation in your body.

Sneakier sources of inflammation can include the entire gastrointestinal tract (from mouth to colon), the respiratory tract and the urinary tract.

The gut is an obvious factor to most of us.  Everyone understands that bacteria grow in the gut and have a strong impact on health.  This can be positive or negative, depending upon a very large number of factors.

As an example, antibiotics in the first year of life destroy the friendly relationship between the immune system and resident bacteria in the gut.  That is why first-year antibiotic use massively increases later development of inflammatory bowel diseases like Crohn’s or Ulcerative colitis.

The oral cavity is another source.  Gingivitis and general poor oral health provide a 24-7 source of inflammation to the body.  For this reason, I’m always a strong supporter of good dental health—from using a sonic toothbrush as well as a good quality tongue scraper.

In just the past few years the respiratory tract is being recognized as a source of chronic infection and inflammation.  The respiratory tract is NOT sterile.  Researchers have realized that the airway contains its own microbiome.

While likely not as diverse as the gut microbiome, the respiratory microbiome is likely a major player in conditions like asthma and allergies.  These conditions, as well as other conditions like emphysema and chronic obstructive pulmonary disease will drive chronic inflammation in the body.

Just how strong is the association between some infections and blood vessel health and the heart?

In one study, researchers looked at the relationship between urinary tract infections and heart disease.  They found that patients with heart disease were 300% more likely to have a UTI/

This shows you how powerful inflammation from a chronic infection can be at damaging the cardiovascular system.

Causes of High Blood Pressure: Mouthwash and Acid-Blocking Drugs

But, just in case you were beginning to think that the presence of all bacteria in your body is bad,

When you hear the term “infection,” it’s likely that your mind goes right to a bad place, thinking that some bacteria needs to be eliminated with deadly force.

But bacteria in you body is more likely to help than harm.  And they can help in unexpected ways.

Follow this…healthy nitrate is a chemical found in vegetables you eat.  But nitrate doesn’t help us; rather, it has to be converted by nitrate-reducing bacteria in your mouth to nitrites.

Nitrites are then converted by stomach acid to nitric oxide.

As I mentioned earlier, nitric oxide is well known to be anti-inflammatory and to protect the cardiovascular system by relaxing the blood vessels.  It’s one of the good guys.

But what happens if these special bacteria in the mouth are not present because you destroyed them with antiseptic mouthwash?  Or what happens if you’re on Prilosec or Nexium or omeprazole because some misguided doctor told you that you make too much stomach acid?

You lose all this protection.  (Just to make matters worse, this will also increase your risk of developing gastric ulcers).

Just in case you think I’m off my rocker because you’ve never heard of this before, That is exactly what researchers found out in a small study where 19 participants were given a chlorhexidine-based antiseptic mouthwash for 7 days.  Here’s what they found:

• Oral nitrite levels tanked 90%.
• Nitrite levels in the blood dropped by 25%.
• Systolic and diastolic blood pressure increased by 2–3 .5 mm Hg.
• The increase in blood pressure showed up within day 1 of using the mouthwash.

While this increase may seem small, it is still one piece of the puzzle when it comes to controlling high blood pressure.

And it’s a factor that I’m pretty darn sure you haven’t taken into account.

Once you don’t destroy your oral microbiome with mouthwash anymore, you’re going to have to make sure your stomach acid is up to par.

This means that anything that lowers stomach acid production can actually increase your blood pressure. This includes stress, age and acid blocking drugs like Nexium, Prilosec and antacids.

This idea was supported by a study, finding that the use of omeprazole to block stomach acid in rats stopped the ability of a solution of sodium nitrite to lower blood pressure.

Chalk up another benefit of hydrochloric acid in the stomach and another unexpected and damaging side effect of medication.

Causes of High Blood Pressure; Salt Restriction

You’ll notice that I put this one at the bottom of the list.

I’m pretty sure I have never recommended a salt-restricted diet for any patient with blood pressure issues.

I can hear the disbelief in your head.

How can my stand differ so much from every public health, primary care and cardiologist recommendation?

Because it is a recommendation by people who don’t have anything more to give.

I have always considering targeting salt as the “low hanging fruit.”  It’s easy lower sodium intake.  No one loses.  Campbell’s soup can come up with low-sodium soup.  Triskets can produce low-sodium crackers.

No big confectionary company’s pockets get hit.

Forget the fact that most high-sodium foods are heavily processed with refined carbs, saturated fats and omega-6 fatty acids that promote diabetes.

The DASH approach (Dietary Approaches to Stop Hypertension) was mainstream medicines’ answer to the belief that lowering sodium was the answer to blood pressure.

Well, mainstream medicine has never been known for its nutritional prowess.

While the DASH diet was effective at lowering blood pressure, it never performs as well as other, more solid dietary approaches like the Mediterranean, the Ketogenic and the Paleo diet produce better results.

The other thing to consider about the DASH diet was that it did not just focus on lowering sodium, but also promoted foods that were higher in potassium, calcium and magnesium.  It is likely that this is the power behind the benefits and very little of this had to do with lowering the intake of sodium.

In case you think that I should be more fearful of sodium intake, studies for more than a decade have consistently shown that dietary restriction does NOT save lives, and in some cases may actually speed along death.

This particular review identifies some of the negative consequences of a low sodium diet. In particular:

1. Worsening of prediabetes
2. Worsening of serum lipids (cholesterol, triglycerides)
3. Worsening of neurohormonal pathways, leading to higher risk of actually developing cardiometabolic disease as well as the severity of existing cardiac disease.
4. An overall higher rate of cardiovascular and all-cause mortality.

Wow. Sounds like we put all our eggs into the wrong basket.