People are like cars. If you do a few simple things, they go a lot farther with little or no trouble. Drivers understand this. If you own a Honda car, and you keep the tire pressure, oil, and water levels right, you might get 300,000 trouble-free miles from that automobile. If you don’t, it might break down after only 50,000 miles and cost you a lot of money. I just drove 1000 miles on the interstate, and I saw no Hondas smoking on the side of the road.
If you don’t maintain the air pressure and tread depth in an automobile, bad things happen. If there is not enough tread, you may not stop in time or you may have a blowout on a hot highway. If the air pressure is too low, the tire wears out more quickly and gas mileage falls. Maintaining a blood pressure under 130/80 is even more important.
If your blood pressure is over 130/80, that is not a disease. It is a measurement. That measurement tells you that your arteries are already damaged. The processes that caused the pressure to go up already made your artery thicker than normal. They changed the artery so that it does not expand to produce more blood flow when you exercise to supply more oxygen and fuel to your muscles. Your artery is damaged because you are producing too many oxidants. In an automobile, oxidants cause rust. In your body, oxidants produce the same kind of damage. Rust damages steel. Oxidants kill the good cells that expand the artery and increase scar tissue that makes the artery thicker.
You can measure your air pressure in your tire and adjust it. A blood pressure measurement at home is more accurate than an office blood pressure and you can adjust that too. You want your blood pressure to be 130/80 or less. When you lower your blood pressure with losartan or lisinopril and spironlactone or eplerenone, you are not just preventing a blowout with bleeding into the brain. You are reducing the oxidants that cause the damage to the artery in the first place. Losartan and eplerenone are antioxidants that return the artery to a more normal condition. Your artery becomes thinner and it expands better.
A high blood pressure measurement means that your arteries are damaged already. It means your heart is getting bigger and your kidneys are being damaged. Yes, you should eat real food, cut back salt, and lose a pound a month if you are heavy, but that is not the whole story. Even if your pressure goes back to normal, you have already switched on genes that produce too many oxidants. Losartan and eplerenone block oxidant production and protect your organs. You should continue a small dose of those medications even if your pressure returns to normal. If you are using these medicines and your pressure is still over 130/80, you can protect your arteries and organs by adding a fluid pill like hydrochlorothiazide (HCTZ). If your pressure is still over 130/80, add amlodipine. If the pressure is still high, circle back and double the doses until your pressure is 130/80.
These simple maintenance measures will help your body function well longer. You can interfere with the oxidants that cause chronic illnesses and make you age faster. These medications are best because they interfere with the processes that damage your body directly. Even if you need all four, you can buy them all for a month for $21 at Walmart even if you don’t have insurance. They are especially good because they cause very few side effects early in disease. If your pressure gets a lot better, you can drop amlodipine and HCTZ, but I would maintain small doses of losartan and spironolactone or eplerenone indefinitely. They are protecting your organs and arteries. If you have questions, please let me know. I love to hear about your success stories.
excellent discussion. It should be said that 95% of high blood pressure is curable. for all practical purposes, ideal blood pressure while on no medication is 110-115/60-70. Above that the risk for the future development of heart attack and stroke begin to increase. Because of the frequency of large arms, I have recommended wrist blood pressure cuffs (all blood pressure cuffs need to be verified for their accuracy) and specifically the Omron brand is the most accurate although any brand can be). Every published article written about the treatment of hypertension starts off discussing "lifestyle" changes first with the implication that high blood pressure is, which it is in fact, essentially curable by changing what people do: reduce percent body fat to a BMI of nearly 23 or percent body fat around 15-20% for men and 18-22% for women. Get rid of salt/sodium in the cooking, bearing in mind that almost all fish-chicken-turkey-meat-eggs are cooked with salt-so limit these profoundly and move towards a more ideally organic unprocessed whole foods plant-based diet which is natively low in sodium and high in both potassium and magnesium. Both of these lower blood pressure if it is elevated. Limit alcohol to less than 1 drink a day. H. Robert Silverstein, MD, FACC
Excellent article!