Alcohol, caffeine and tobacco are best avoided.

Alcohol raises BP via a few mechanisms including increasing the hormones aldosterone, cortisol and renin. During withdrawal excess adrenaline is released. Beer contains hops which have estrogen like compounds. Long term exposure to estrogens may cause excess breast development and raised BP. Not a pretty combination.

Caffeine is not a fun compound for the arteries. It reduces pulse wave velocity, increases the activity of plasma renin, causes arteries to constrict and enhances the effect of norepinephrine a stress hormone.

Tobacco is is dreadful for high BP. Is causes constriction of the arteries and increases the fight or flight reaction. It causes the platelets to clump and the blood to become more prone to clotting. There is increased oxidative stress and inflammation.

Pharmaceuticals that increase blood pressure.

This is a fun list. Are you taking any of these popular items?

Amphetamines. This includes some medication for ADD, ADHD etc.

Anabolic steroids and prednisone.

Antidepressants such as MAO inhibitors.

Antihistamines

Bromocriptine

Combines oral contraceptives

Cyclosporin

Digitalis

Disulfuram

Ergot alkaloids – St Anthony’s Fire from moldy rye.

Erythropoietin compounds

Licorice

Lithium

Metoclopramide

NSAIDs

Tacrolimus

So often in medicine we chase our tales treating the side effects of medication with yet another. We understand how certain pairs of drugs interact but if a patient is on three drugs or more they are beyond medical science in terms of the interactions.

In Functional Medicine we take a detailed history including pharmaceutical use. Sometimes medication produces symptoms as a result of side effects. By looking for the root cause of disease we are often able to deprescribe or cut back on the use of medication.

High blood pressure (BP) or hypertension (HTN) can be the result of a combination of deficiencies and poor diet. Although we may get enough calories on a Standard American Diet (SAD) there is poor nutritional density. As a result we miss out on a lot of vital nutrients. When we eat largely processed foods we crowd out vitamins, minerals and essential fats with sugar, high fructose corn syrup, flour, corn and soy. These are very cheap ingredients that are sold to us in a myriad of permutations devised by food scientists to be addictive and highly profitable.

In Functional Medicine we use foods and supplements to correct the adverse biochemistry that expresses itself through symptoms.

Vitamin D

The recommendation in Canada is for the adult population to take 2,000 IUs/Day. This may be too little for some patients who may need to take 5,000. Please ensure you have your levels measured and adjust the dose according to your response. At the Paleo Medical Clinic we have accurate testing available. Know your level and adjust your dose.

Vitamins E, B2, C and B6.

Vitamin E at 100 IUs/day ideally from mixed tocopherols.

Vit B2 (riboflavin) 25 mg/day. The richest natural sources are eggs, organ meats such as heart, meat and milk.

Vit C 500 mgs twice daily (avoid taking at night time as it is slightly stimulating) is recommended for HTN by the Institute for Functional Medicine.

Vit B6 5mg/kg/day (pyridoxal 5-phosphate). This is one of the most common vitamin deficiencies in North America. It reduces the fight or flight side of the nervous system that typically puts up our BP.

Folate and vitamin B12.

Beware if your homocysteine is above 7 mcmol/L. Normal is defined as being less than 15 by most conventional labs. This value is based on a population that is not healthy. It might mean that levels of folate and vitamin B12 are not ideal. We can also measure the activity of vit B12 by testing for methyl malonate. This is routinely done when we run a test called the DUTCH PLUS which includes organic acid testing. Both folate and vitamin B12 can bring down the level of homocysteine but we would recommend that they be in a methylated form.

Minerals.

Potassium is a useful mineral but we do not recommend supplementation as taking too much can cause the heart to stop. Yes this can be fatal. It is best sourced from foods such as cooked spinach, broccoli, mushrooms, cucumbers and tomatoes if tolerated.

Magnesium is often lacking and we would recommend 500-1,000mgs at night time. The types can be varied say citrate for a couple months then glycinate. There are also products that contain up to seven types of magnesium in a single tablet. Build up the dose until you get loose stools then cut back. The dose varies between individuals and the forms have differing laxative effects.

Calcium supplementation in women is associated in an increase in heart disease. We recommend this is from foods. Small wild fish with their bones are ideal rather than from milk.

Zinc 25-50 mgs /day. In the longer term this needs to be balanced with copper rich foods such as liver, organ meats and oysters.

When we expose our skin to sunlight the UVA creates nitric oxide. This dilates the blood vessels and drops our blood pressure (BP). A key ingredient to this process is L-arginine an amino acid. If we are not digesting protein well we may not have enough L-arginine. So we miss out on some of the benefits of sunlight. There is a link between our gut health, our response to sunshine and high BP.

Top sources of arginine are nuts, seeds, dairy and meat.

High BP damages the internal lining of the blood vessels. This is called the endothelium. It is a single cell layer thick and covers an area equivalent to six tennis courts. Damage can occur due to many factors. Low B vitamin status can raise homocysteine which is a risk for heart disease. Oxidised low density lipoprotein (LDL) is also harmful. Sugar can damage this particle. Low folate from a poor diet can also contribute.

Some compounds in the diet may protect the endothelium such as polyphenols and anthocyanins. These may be found in spices and berries.

Gut and mouth.

Dysbiosis in the gut or the oral cavity releases toxins that again affect the blood vessels and the heart. Gut permeability allows lipopolysaccharides (LPS) to go into the blood. This causes the immune system to panic as the LPS are parts of bacteria. The signal to the body is that there may be impeding sepsis. Inflammation occurs damaging the endothelium.

Autoimmunity.

Co-existing autoimmune conditions such as rheumatoid arthritis can be as bad as smoking for arterial disease. Hypothyroidism can lead to disturbances in our blood fats.

Toxins and deficiencies.

Insulin resistance can also damage this vulnerable layer. Lead and mercury can do this too and are common toxic metals. Cadmium in smokers is also a problem as are some insecticides.

Certain treatments for high blood pressure such as beta blocker reduce CoQ10. ACE inhibitors lower zinc which leaves us more vulnerable to viral infections. Magnesium is a very common mineral deficiency due to levels being depleted in the soil. Deficiency may be contributing to high BP.

In Functional Medicine we look at the root causes of high BP. We then may be able to do away with medication for what is a symptom of a poor lifestyle.