An unrecognized sign of high blood pressure

This article was previously published on May 18, 2019 and has been updated with new information.

Blood pressure is a measure of the force your blood exerts as it presses against your arteries. Blood pressure will normally rise and fall throughout the day, but when it remains consistently high it becomes a major concern as this pressure can damage your heart and cause other health problems.

In 2017, the American Heart Association (AHA) and the American College of Cardiology, along with nine other health organizations1, changed the threshold for the diagnosis of high blood pressure from 140/90 to 130/80.2 This slight shift increased the number of people diagnosed to include many previously considered healthy.

According to the AHA, an estimated 103 million American adults have high blood pressure using these new measurements.3 Your blood pressure can be measured at a healthcare provider’s office or at home using a self-measured blood pressure monitoring system.4

The top number of your blood pressure reading is called systolic blood pressure, and it measures the pressure in your arteries as your heart beats. The bottom number, called the diastolic number, measures the pressure in your arteries when your heart is at rest.

Both numbers are important in determining how much damage can occur to your blood vessels and other organ systems over time. Usually there are no warning signs or symptoms of high blood pressure.

The only way to know for sure is to have your blood pressure measured.5 A recent study published in the Journal of the American Heart Association6 found that urinating at least twice a night can be a symptom of uncontrolled high blood pressure.

Nocturia may indicate unrecognized high blood pressure

Nocturia is a condition that causes you to wake up at night to urinate. It may be related to high late-night fluid intake, sleep disturbance or bladder obstruction.7 Researchers from Cedars-Sinai and UCLA School of Medicine8 sought to determine whether nighttime urination is a potentially reversible symptom of uncontrolled high blood pressure.

The researchers conducted face-to-face health interviews and measured blood pressure in a large community sample of 1,673 black men ages 35 to 49. Those with high blood pressure were 56% more likely to get up at night to urinate.

They found that men with untreated high blood pressure were 39% more likely to experience nocturia than men with normal blood pressure or men whose high blood pressure was under control. They concluded: 9

“Uncontrolled hypertension was an independent determinant of clinically important nocturia in a large cross-sectional community study of non-Hispanic black males, ages 35 to 49 years.”

Results from another study were presented at the 83rd Annual Scientific Meeting of the Japanese Circulation Society in Yokohama, Japan.10 According to the researchers, previous research from Japan had shown that high salt intake was associated with nocturia in a country where individuals eat more salt in compared to western countries.

The study looked at the association between high blood pressure and nighttime urination in the general population, enrolling 3,749 residents who had annual checkups in 2017. There were 1,882 who completed the questionnaires. The researchers used 140/90 as the threshold for high blood pressure and not the new threshold of 130/80.11

Nocturia was described as getting up one or more times during the night, in contrast to the study in the Journal of the American Heart Association12, which defined it as two or more nocturnal toilet visits. Despite these differences, the Japanese researchers found similar results, as urinating at night was linked to a 40% greater chance of high blood pressure.13

Potassium deficiency raises blood pressure

Potassium is a naturally occurring mineral that your body uses as an electrolyte. It is one of the most abundant intracellular cations and is essential for normal cell function.14 The relationship between potassium and sodium is strong and is the main regulator of extracellular fluid volume, including your plasma (blood).

You can lose potassium through diarrhea, vomiting, excessive sweating, or taking certain medications, including excessive alcohol consumption.15 However, the most common reason potassium levels aren’t within normal limits is related to your dietary intake.

According to the US Department of Agriculture16, the average intake of potassium in the US population is 2,640 milligrams (mg) per day, which has remained unchanged since the mid-1990s. However, the Institute of Medicine recommends 4,700 mg per day for adequate intake.

Your body works most efficiently when there is a balance between your potassium and sodium.17 Potassium helps the walls of your blood vessels relax and lowers your blood pressure. Potassium also helps protect against muscle cramps, and Harvard Health18 states that people with high systolic blood pressure can lower their blood pressure simply by increasing their potassium intake.

Many potassium-rich foods are also low in calories and carbohydrates, such as broccoli, spinach and other leafy greens. For people with current kidney problems, it is important to ask your doctor for advice before taking potassium supplements, as it can lead to irregular heart rhythms.19

Excessive salt consumption can contribute to an imbalance in potassium and sodium, which is more important than your total salt intake. An imbalance in this ratio can lead not only to high blood pressure, but also to kidney stone formation,20 osteoporosis,21 cataracts22 and more pain in rheumatoid arthritis.23

High blood pressure causes health problems

According to the Centers for Disease Control and Prevention24, 13 million American adults with high blood pressure do not know they have it and are not being treated. Nearly half of those with high blood pressure have it out of control.

Uncontrolled high blood pressure is the leading cause of heart disease and stroke and increases the risk of heart or kidney failure and heart failure.25 High blood pressure puts the strain on your heart muscle, which can lead to heart failure and damage to the arteries that supply the muscle with blood. with oxygen, which can lead to a possible heart attack.

High blood pressure can also damage small arteries, reducing the amount of oxygen delivered to your organs such as your kidneys and eyes. Over time, this can lead to kidney failure and vision loss

The term for damage to smaller blood vessels is microvascular disease and can lead to angina,27 or chest pain that occurs when the heart muscle is not getting enough oxygen, as well as sexual dysfunction.28

Another form of damage to the arterial system from high blood pressure is atherosclerosis,29 which can lead to peripheral artery disease. Atherosclerosis is a narrowing of the arteries that can occur in the arteries that supply the legs, arms, stomach, or head, causing pain and fatigue.

Diet Strategies to Maintain Normal Blood Pressure

In addition to eating foods rich in potassium, there are additional nutritional strategies you can use to maintain normal blood pressure. The Mediterranean region is known for its rich olives and olive oil, fresh vegetables, fruits, seafood and the rare consumption of red meat. The people who live there are known to be some of the healthiest, longest-living people in the world.30

Most of the health benefits of the diet are probably due to it being low in sugar, with moderate protein and plenty of fresh fruits and vegetables, along with healthy fats. Dr.’s PAMM Diet Stephen Sinatra, or Pan-Asian Modified Mediterranean, is a modification of the Mediterranean diet.31

The PAMM diet emphasizes the critical nature of eating a “high fiber, healthy fat, Mediterranean-type, heart-healthy diet,” emphasizing healthy fats and vegetables while minimizing synthetic fats.32

There has also been success33 in lowering blood pressure using the Dietary Approaches to Stop Hypertension (DASH) diet, which consists largely of fresh vegetables, fruits, lean proteins, whole grains and low-fat dairy products. While the results are often believed to come from the low sodium content in the diet, the diet is more likely to be effective because it is low in sugar and fructose.

Eating right to help optimize your blood pressure, lowering your risk of kidney disease, heart disease, stroke and dementia, is extremely important. It’s also important to note that what you don’t eat is just as crucial as what you do eat, and I recommend avoiding the following foods, which are notorious for raising blood pressure:34

Sugar, processed fructose and processed foods, grains Partially hydrogenated oils (synthetic trans fats), which are found in many processed foods, including packaged cookies, crackers, chips, and other snacks. Processed omega-6 oils, especially those found in vegetable oils such as corn, rapeseed, soybean and safflower oil

Include exercise to control blood pressure

Inactivity and blood pressure are also closely related — so closely that exercise has been endorsed by several health authorities, including the World Health Organization, the International Society of Hypertension, and the U.S. Joint National Committee on Detection, Evaluation and Treatment of High Blood Pressure.35

Research shows that inactive individuals have a 30% to 50% greater risk of high blood pressure than their active counterparts.36 As noted in a review of the literature on exercise and high blood pressure published in Australian Family Physician:37

“Depending on the extent to which the patient’s blood pressure is normalized by drug therapy, regular aerobic exercise significantly reduces blood pressure, the equivalent of 1 class of antihypertensive drugs (chronic effect) …

In general, resistance training has a beneficial chronic effect on resting blood pressure, but the magnitude of the drop in blood pressure is less than that reported for an aerobics-based exercise program…

For most hypertensive patients, exercise is fairly safe. Caution is advised in individuals over 50 years of age and individuals with established cardiovascular disease (CVD) (or at high risk of cardiovascular disease) and the advice of a clinical exercise physiologist is recommended.”

The key is to participate in activities to get your heart rate up and increase your blood flow. Many activities can achieve this, such as yard work, brisk walking, swimming, cycling and sports such as tennis, skiing, rowing and football. Boosting your nitric oxide release also helps normalize your blood pressure by relaxing your blood vessels.

The nitric oxide dump is a high-intensity exercise I recommend that you can easily incorporate into your daily routine at home or work. Read more about it in my previous article, “Incorporate the Nitric Oxide Dump.”

More drug-free methods to control your blood pressure

Factors that can affect your blood pressure vary. While diet and exercise are important strategies for managing high blood pressure, there are others you can use to positively affect your blood pressure and improve your overall health.

Some of these factors include lifestyle choices, such as quitting smoking and addressing your potassium-sodium ratio. Walking barefoot to the floor, intermittent fasting, and reducing stress can also affect your blood pressure readings.

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