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High Blood Pressure Increases Stroke Risk Even When Controlled with Drugs

High blood pressure increases risk for heart attacks and strokes, even if you take medications to lower it to normal. Hypertensives who take three medicines to lower their blood pressure to normal are 250 percent more likely to suffer a stroke than people who have normal blood pressure without medication (Stroke, June 2015). Most hypertensives have to take at least three medications to lower their high blood pressure to normal.

In this study, 12,327 people successfully lowered their high blood pressure below 140 with medications, while 4,090 could not get under 140 even with medication. The participants were followed for 6.3 years and during that period, more than 820 suffered strokes: The number of strokes increases 33 percent with each blood pressure medicine taken. The authors concluded that people who have their high blood pressure controlled to normal with medication still are at high risk for strokes. This means that if you have high blood pressure, you should change the lifestyle factors that cause high blood pressure; just taking drugs is not enough.

What is Essential Hypertension?
If your systolic blood pressure is greater than 140 at any time of day or it is greater than 120 just before you go to bed, your doctor will tell you that you have essential hypertension. This means that he doesn't have any idea why you have high blood pressure. It also means that you are at high risk for heart attacks, strokes and premature death. If he has read the latest literature, he will tell you that a high rise in blood sugar after meals is the most common known cause of essential hypertension. You probably will not be given tests for other known causes of high blood pressure because they come out normal more than 99 percent of the time, so your doctor probably will not check your adrenal glands by testing for abnormal levels of aldosterone in your blood and won't assess kidney function by testing renin concentrations.

A high rise in blood sugar after meals is a major known cause of high blood pressure (Open Heart, December 2014). One 24 ounce sugared soda raises blood pressure 15 mm hg and increases heart rate nine beats per minute in people with normal blood pressure (Metabolism 2012;61:641–51). Doctors have caused normal rats to develop high blood pressure and rapid heart rates just by feeding them extra sugar (Hypertension 1983;5:218–25). Eating sugar turns on your sympathetic nervous system to raise insulin levels and constrict arteries to raise blood pressure (Am J Clin Nutr 1979;32:2206–16). Overweight adults with high blood pressure who drank one less serving of sugary soda per day had a significant decline in blood pressure (Circulation, May 25, 2010).

Many people still believe that a low-salt diet is the most important dietary treatment for high blood pressure. However, a low-salt diet reduces systolic blood pressure by less than 5 mm Hg in most adults with hypertension, and the average reduction in diastolic blood pressure associated with a low-salt diet among adults with high blood pressure is 2.5 mm Hg (JAMA Intern Med, 2014;174(4):516-524). Low-salt diets are associated with increased risk for death in people who also have diabetes. It now appears that sugar is a stronger dietary cause of high blood pressure than salt.

The people who are most likely to get high blood pressure from taking in too much salt are those whose cells are insulin resistant. Their cells do not respond well to insulin (Hypertension, Jan 2013), so the pancreas keeps on releasing large amounts of insulin to try to lower high blood sugar levels. High levels of insulin constrict arteries to cause high blood pressure. People with high insulin levels are the ones who get high blood pressure when they take in too much salt (Am J Hypertens, 1998 (Apr);11(4 Pt 1):397-402). For them, a high salt intake increases blood pressure, insulin and blood sugar. See Added Sugars Linked to High Blood Pressure

My Recommendations
If your blood pressure is greater than 120 before you go to bed, or if you take medication to control your blood pressure, you should:
• lose weight if overweight
• exercise every day
• grow muscle
• avoid sugar-added foods, all drinks with sugar, red meat, processed meats and fried foods
• eat large amounts of fruits and vegetables
• get blood levels of hydroxy vitamin D above 20 ng/ml

Checked 8/12/18

June 7th, 2015
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About the Author: Gabe Mirkin, MD

Sports medicine doctor, fitness guru and long-time radio host Gabe Mirkin, M.D., brings you news and tips for your healthful lifestyle. A practicing physician for more than 50 years and a radio talk show host for 25 years, Dr. Mirkin is a graduate of Harvard University and Baylor University College of Medicine. He is board-certified in four specialties: Sports Medicine, Allergy and Immunology, Pediatrics and Pediatric Immunology. The Dr. Mirkin Show, his call-in show on fitness and health, was syndicated in more than 120 cities. Read More
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