Life Extension Magazine May 2005
WARNING! Normal Blood Pressure May Be High Blood Pressure!
By William Davis, MD, FACC
By William Davis, MD, FACC
To Solve Hypertension, Address Metabolic Syndrome
Metabolic syndrome is by far the leading trigger for hypertension today. It is also a very correctable cause. Correcting metabolic syndrome can have a tremendous impact on blood pressure. The most powerful way to regain control of multifaceted metabolic syndrome is to lose weight, and there are many ways to do it. People with metabolic syndrome respond especially well to diets that restrict carbohydrates and focus on low “glycemic index” foods that blunt the release of blood sugar. Several low-carb diets are very popular now, largely due to the exaggerated success of carbohydrate restriction in a world overrun with metabolic syndrome.6 These diets come in a variety of names and packages, including Atkins, South Beach, Zone, and others. If you succeed in losing weight on any of these programs, you are very likely to reduce your blood pressure enough (frequently by 10-40 mmHg systolic) to cut down your list of medications. Of course, discontinuing medications should be done only under a doctor’s supervision.
If you are contemplating one of these diets but would like to accelerate your weight-loss and metabolic-control efforts, the following supplements and strategies can boost your chances of success.
Glucomannan is a unique fiber from konjac root that soaks up huge quantities of water. When taken as a capsule, it provides the effect of filling the stomach and creating a feeling of fullness and satiety. The result is that your appetite is diminished and you eat less. Glucomannan works best when taken before meals with plenty of water. People using glucomannan alone and without a specific diet program generally lose 4-7 pounds a month.7,8 Glucomannan is available in a novel fiber supplement called PGX™.
White bean extract can accelerate weight loss, particularly if you have a pattern of low HDL and high triglycerides. A dose of 1500 mg taken twice daily with meals can lead to 3–4 pounds of weight loss in the first month. White bean extract inhibits an enzyme involved in carbohydrate digestion. While some people may experience gas or mild bloating, white bean extract generally has few side effects.9
DHEA’s effects on weight loss have been inconclusive, with some studies demonstrating benefit and others failing to show any difference. However, a recently reported, well-conducted study at Washington
University in St. Louis described dramatic results in a group of 56 participants aged 65–78. Over a six-month period, a daily dose of 50 mg of DHEA taken at bedtime yielded significant reductions in abdominal fat (the kind that causes metabolic syndrome) as measured by highly accurate abdominal MRI (magnetic resonance imaging). Along with a loss of abdominal fat, the study’s subjects also saw marked improvement in insulin sensitivity. By contrast, the comparison placebo group experienced an increase in abdominal fat and a deterioration in insulin sensitivity over the same period.10 Although more data are needed, this study argues powerfully in favor of DHEA supplementation to accelerate weight loss, trim abdominal fat, and improve insulin sensitivity. By assisting in weight loss and addressing the symptoms of metabolic syndrome, DHEA holds great promise for helping to manage hypertension.
Calcium pyruvate accelerates weight loss, usually cutting a few extra pounds over several weeks, while also making exercise easier and more enjoyable, thus enabling you to exercise longer and harder with faster recovery. Despite its effects in accelerating weight loss, calcium pyruvate is not a stimulant and has been found to be safe and effective.11
Losing weight and improving metabolic syndrome will yield many benefits, including higher HDL, lower triglycerides, less inflammation, improved insulin sensitivity, and lower blood pressure. The amount of weight loss required to improve metabolic syndrome and decrease blood pressure varies among individuals. Some people experience dramatic improvement in all measures with a modest loss of 10 pounds, while others may need to lose significantly more weight to achieve the desired effects. The best course is to work with your physician to devise an effective weight-loss plan.
How Nitric Oxide Controls Blood Pressure
High blood pressure signifies an abnormal tendency for the body’s arteries to constrict. This is true of arteries in the arms and legs, the brain, the heart, and other areas. The ability to correct this abnormal effect may be essential to controlling blood pressure.
This insight dates back to 1980, when Dr. Robert Furchgott of the State University of New York conducted experiments on rabbit arteries, trying to decipher how arteries control their state of constriction or tone. Entirely by accident, he noticed that arteries constricted when their inner linings were removed. Dr. Furchgott theorized that the inner lining, or endothelium, is necessary to permit the normal dilating behavior of arteries, and that a damaged endothelium prevents this phenomenon.
What followed was a concerted effort to identify the factor or factors produced by the endothelium that governed relaxation. Dr. Furchgott originally called this mysterious substance “endothelium-derived relaxation factor,” or EDRF. For several years, identification of EDRF proved elusive, as it persisted for a mere few seconds before disappearing.12 In 1986, EDRF was discovered to be nitric oxide.13 This discovery initially drew skepticism, as nitric oxide is a common gaseous byproduct of nitrogen combustion, which is plentiful in automobile exhaust. How could it be the critical cellular messenger controlling arterial tone?
Dr. Furchgott’s discovery has endured intense scrutiny and was honored by the 1998 Nobel Prize for Medicine, which he shared with his colleagues Drs. Louis Ignarro and Ferid Murad for their related work. Today, nitric oxide is recognized as the signaling molecule for many physiological processes, as well as the single most powerful artery-dilating agent known to medicine.12-14
“We now know that the endothelium exerts tremendous control over blood flow. First, its prime location plays a role. Because the endothelium is the inner-most lining of the blood vessel, it has direct contact with blood and, as such, serves as an interface between the blood and the vessel wall . . . We now know that this delicate tissue, only one cell layer in thickness, is a dynamic factory, producing a myriad of substances that maintain vessel health. It is, in essence, a silver lining—since when it’s healthy, it produces its own forms of heart medicine.”
—Dr. John Cooke,
Because of nitric oxide’s extremely short life of no more than 10 seconds, a constant supply is required to keep arteries dilated and relaxed. Any drop in nitric oxide production causes arteries to constrict. Cholesterol abnormalities, high blood pressure, inflammation, high blood sugar or diabetes, a high-fat diet, and sugary, refined foods all impair the endothelial cells’ ability to produce nitric oxide. Metabolic syndrome has the same effect, leading to repeated damage to the artery linings that triggers atherosclerotic plaque formation, or “endothelial dysfunction.” When arteries are lined with even a microscopically thin layer of plaque, they are less able to produce nitric oxide, yielding even more injury.
How can factors as diverse as diabetes, fatty foods, and inflammation all disrupt the endothelium’s control over arterial relaxation? Much of this abnormal arterial constriction, or endothelial dysfunction, occurs in situations involving high cholesterol, high blood pressure, high triglycerides, diabetes and insulin resistance, high homocysteine, and atherosclerotic plaque.15-18
What About Antioxidants?
In addition to the previously discussed mechanisms, hypertension may also be induced by the presence of oxidative stressors. This theory arises from the observation that hypertension can be produced experimentally by various oxidative molecules, such as superoxide. Superoxide disables the vasodilator nitric oxide by forming peroxynitrite, a potent constrictor of arteries.19 Thus, antioxidants may play a role in maintaining healthy blood pressure levels.
Vitamin C is an antioxidant whose role in helping to regulate blood pressure has been the subject of numerous of clinical trials. To date, the study results have been mixed, with some showing that vitamin C reduces blood pressure and others showing no effect.20
Based on existing clinical studies, the one antioxidant that stands out as truly effective by itself in lowering blood pressure is coenzyme Q10 (CoQ10). Eight studies have examined CoQ10’s effects on blood pressure, and the pooled data show that CoQ10 supplementation helped lower systolic pressure by an impressive 16 mmHg and diastolic pressure by 10 mmHg. The doses studied generally ranged from 50 to 200 mg a day.21
Recent reports have suggested that lowering blood pressure is not enough to eliminate high blood pressure’s contribution to cardiovascular events such as heart attack and death. Reduction of abnormal heart muscle thickening, or “hypertrophy,” as measured by ultrasound, may also be a necessary component of treatment.22 This effect is not accomplished by every prescription antihypertensive medication. Interesting data from the University of Texas-Austin suggest that abnormal hypertrophy resulting from high blood pressure can be substantially regressed with CoQ10 treatment.23,24
The growing prevalence of metabolic syndrome has made it an increasingly important contributor to hypertension. Metabolic syndrome is a controllable and largely correctable condition. Weight loss is the principal means of regaining control over this process, by improving blood pressure and numerous other markers of health.
Antioxidant research has great potential in the field of blood pressure control. By reducing such blood vessel constrictors as the oxidant peroxynitrite, antioxidants may hold great benefits for the cardiovascular system. In particular, significant data support the use of coenzyme Q10 for reducing blood pressure.
Hypertension is a silent, potentially deadly condition that affects millions of Americans. Through a combination of lifestyle modifications and nutritional strategies, it is possible to improve your blood pressure by natural means. Optimizing blood pressure is a critical part of a daily wellness program for those seeking to live long, healthy lives.
Dr. William Davis is an author, lecturer, and practicing cardiologist focusing on coronary disease regression. He is the author of the book Track Your Plaque. He can be contacted at www.trackyourplaque.com.
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