Many of the decisions you make each day, including what you eat and drink, how much you exercise and even how you breathe, have a compound effect on your overall health. Making small changes can pay big dividends. The same is true of the small unhealthy decisions you make.
Lifestyle choices also affect your blood pressure and your risk for heart disease and stroke. According to the Centers for Disease Control and Prevention (CDC), 1 nearly 33 percent of American adults have high blood pressure (hypertension) and another 33 percent have prehypertension — blood pressure higher than normal but not high enough to be classified as high blood pressure.
Only half of those with high blood pressure have the condition under control, and hypertension was a primary or contributing cause of death for more than 410,000 Americans in 2014. This is equal to more than 1,100 deaths every day. High blood pressure costs the U.S. $48.6 billion each year in health care services, medications and missed days of work. 2
Medications for high blood pressure, also known as antihypertensives, come with a laundry list of side effects. Those side effects are related to how the medication interacts with your body. The U.S. Food and Drug Administration (FDA) recently recalled two antihypertensive medications after it was discovered the active ingredient was contaminated with a known human carcinogen. 3
Blood Pressure Medication Recalled Due to Toxic Contaminants
The antihypertensive medication Valsartan is commonly used to control hypertension and heart failure. Only after being recalled by 22 other countries due to concerns over the active ingredient, sourced from China, 4 the FDA issued a press release 5 alerting health care professionals and patients of a voluntary recall.
The FDA estimates nearly 80 percent of active ingredients used in medications in the U.S. originate abroad, the majority of which come from China and India. The first recall in the U.S. occurred in July after the drug was being recalled across Europe following information that an impurity, N-nitrosodimethylamine (NDMA), had been identified as part of the manufacturing process.
NDMA was originally produced in the U.S. and used to make rocket fuel. It was discontinued when the chemical was detected in air, water and soil samples and was found to contribute to the development of liver and lung cancer. Consumption is also known to cause severe liver damage accompanied by internal bleeding, and potentially death.
Not all Valsartan products were recalled, only those from Major Pharmaceuticals, Solco Healthcare and Teva Pharmaceutical Industries. After 22 other countries, including Canada and the United Arab Emirates, had recalled the medications did Dr. Janet Woodcock, director of the FDA's Center for Drug Evaluation and Research, issue a statement saying: 6
"We have carefully assessed the valsartan-containing medications sold in the United States, and we've found that the valsartan sold by these specific companies does not meet our safety standards. This is why we've asked these companies to take immediate action to protect patients."
The active ingredient was produced by Standard Chemical and Pharmaceutical Company in Taiwan. A spokesperson for the company commented in the newscast video above, saying, "We are victims too. The active pharmaceutical ingredient came in. We took it and conducted all the required tests."
Antihypertensive Medications Trigger Dangerous Side Effects
A Danish study, in collaboration with Florida State University, found one of the most popular drugs used to treat hypertension, hydrochlorothiazide, raises your risk of skin cancer sevenfold. The findings published in the Journal of the American Association of Dermatology 7 demonstrated an association between the medication and squamous cell and basal cell carcinomas.
They looked at other antihypertensive medications but did not find associations between those and skin cancer . The results were based on data from over 80,000 individuals, compared against 1.5 million healthy control subjects. While squamous cell carcinoma has a low mortality rate, the treatments carry a risk of impairment and potential the cancer may spread.
Antihypertensive medications also increase your risk of more common side effects associated with how the medication works in your body or affects other organ systems. Although experts recommend starting any antihypertensive drug at the lowest possible dose and increasing gradually, even at low doses these drugs can trigger: 8
Weight loss or gain
The usual course of treatment is to begin with one drug and add a second if your blood pressure measurement does not fall to the desired level. 9 As with any chemical added to your body, the more you add, the greater the risk you will experience side effects.
Current Hypertension Guidelines and Potential Measurement Inaccuracies
Maintaining your blood pressure within healthy limits is one of the more important methods of reducing your risk of cardiovascular disease and stroke. Recently, the American Heart Association (AHA) introduced new blood pressure measurements for the diagnosis of hypertension. 10
Using this new criteria, it's estimated nearly half of American adults could be diagnosed with hypertension. Previously, readings of 140/90 and above were considered hypertension, but the newest guidelines lower those numbers to 130/80. Using these new guidelines, it's estimated the number of men and women under 45 with hypertension will triple and double respectively.
Health experts from the organizations who formulated the new guidelines, the AHA and the American College of Cardiology, stressed the importance of getting an accurate pressure measurement to ascertain the necessity for medications. It's also important to have at least two elevated readings on two separate occasions before a diagnosis of hypertension is issued. 11
Blood pressure measurements in the doctor's office usually measure the pressure of the brachial artery in your upper arm. Central blood pressure (CBP) is considered a better prognostic marker of cardiovascular disease and indicator of the pressure experienced by your organs, 12 but requires an invasive procedure.
Inaccuracies are related to several factors, including the size of the cuff, the placement of the cuff, calibration of the machine, body position and activity. Researchers also encourage health care providers to measure blood pressure once in each arm.
A number of studies have revealed a significant difference between your right and left arm pressure may indicate circulatory problems that raise your risk for stroke, peripheral artery disease or other cardiovascular issues. 13 For further discussion of how to get the best blood pressure measurement at your doctor's office, see my previous article, " Blood Pressure Testing Is Mostly Inaccurate ."
What Triggers a Rise in Blood Pressure?
Knowing what triggers a rise in blood pressure may assist you in determining the lifestyle choices needed to normalize your readings and reduce the risk of conditions linked to hypertension, such as kidney disease, cognitive decline and Alzheimer's disease. The health problems associated with hypertension have nearly doubled in the past four decades.
As much as 95 percent of high blood pressure is called essential hypertension, meaning the underlying cause is unknown. However, a number of identifiable factors found globally contribute to the rise in blood pressure. This includes but is not limited to:
- Insulin and leptin resistance. As your insulin and leptin levels rise, it causes your blood pressure to increase. 14 , 15
- Elevated uric acid levels are also significantly associated with hypertension, 16 so any program adopted to address high blood pressure needs to normalize your uric acid level as well.
- Poor nutrition in childhood has been shown to raise the risk of high blood pressure in adulthood. 17
- Lead exposure 18
- Air pollution affects blood pressure by causing inflammation while noise pollution asserts an effect via your nervous and hormonal systems. Air pollution 19 has been shown to increase your risk of high blood pressure to the same degree as having a body mass index of 25 to 30.
Living in an area plagued by constant noise pollution (busy city streets with night time traffic) has also been shown to increase the risk of hypertension. 20
Dietary Changes Can Help Normalize Your Blood Pressure
For an in-depth discussion of how blood pressure affects your body, see my previous article, " An Introduction to High Blood Pressure ." As noted by Majid Ezzati, Ph.D., a professor of global environmental health at Imperial College London and author of an analysis 21 of worldwide data evaluating blood pressure trends: 22
"The perception is that people are not getting enough calories, but the reality is, they're not getting healthy calories. Making fresh, healthy food affordable and accessible for everybody should be a priority."
One of the most important dietary changes you can make to affect your blood pressure is to eliminate or dramatically reduce sugar and processed fructose from your diet. The easiest way is to replace processed foods with real, whole foods.
This not only addresses insulin and leptin resistance but also helps reduce elevated uric acid levels, both of which are significant factors in blood pressure. In one study, 23 researchers discovered those who consumed 74 grams or more per day of fructose had a 77 percent greater risk of high blood pressure.
It also increased the risk of a reading of 135/85 by 26 percent and a reading of 140/90 by 30 percent, both which fall in the range of hypertension. By checking your fasting insulin level, you can see whether insulin and leptin resistance is at play.
Aim for a fasting insulin level of 2 to 3 microU per mL (mcU/mL). If it's 5 mcU/mL or above you definitely need to lower your insulin level to reduce the risk of high blood pressure and other cardiovascular health problems.
Nitric Oxide Helps Relax Your Arteries and Reduce Blood Pressure
Your body naturally produces nitric oxide to relax your arterial walls. You lose 10 percent of your body's ability to make nitric oxide for every decade of life, which is why it's important to take steps to improve your production as you age.
Beets contain nitrates that are converted into nitric oxide in your body. Raw beets may also boost stamina 24 during exercise, and concentrated beet juice has led to improvements in those suffering from heart failure. 25
However, they are also high in sugar, which is why I recommend only limited amounts, or eating them in fermented form. Fermenting beets gives you all the health boosting benefits without the concerns of high sugar content. Dark leafy greens or another good source of naturally-occurring nitrates that are converted into nitric oxide in your body.
You can also increase your nitric oxide levels by doing the Nitric Oxide Dump workout two to three times a day. These short bursts of high-intensity activity help release nitric oxide, relax your arterial walls and reduce your blood pressure. For a demonstration, see the video above. You can read more about each of the movements and the benefits in my previous article, " Incorporate the Nitric Oxide Dump ."