Change Your Brain Every Day - Hypertension - 3 Things to Take Care of for Better Blood Pressure To Live Longer with Dr. Mark Houston

Episode Date: March 24, 2017

Statistics show that 30% of America has high blood pressure and another 30% are pre-hypertensive. This is a huge number and it's terribly dangerous. However, there's something you can do about it to turn things around to reduce if not eliminate your possibility of getting hypertensive. Be sure to listen to the full episode to learn the top three things you need to take care of for better blood pressure.

Hi, I'm Donnie Osmond, and welcome to The Brain Warrior's Way, hosted by my friends Daniel and Tana Amon. Now, in this podcast, you're going to learn that the war for your health is one between your ears. That's right. If you're ready to be sharper and have better memory, mood, energy, and focus, well then stay with us. Here are Daniel and Tana Amen.

Welcome back to The Brain Warrior's Way. We're here with Dr. Mark Houston. Tana and I are having such fun with him and learning so much. That's why I love doing this podcast. Thank you, Mark, for being with us. Thank you, Daniel and Tana. Today, we're going to talk about hypertension. And what did I read recently? 30% of America has high blood pressure and another 30% are pre-hypertensive. It's crazy. It's actually virtually the same as diabetes and pre-diabetes. and both diabetes and hypertension significantly increase the risk for dementia. So it's really important for us to talk about as your blood pressure goes up, blood flow to the brain goes down. Right. So hypertension is clearly the number one reason that patients go to see their physician and your numbers are dead on. About 30 to 40% are hypertensive defined as greater than 140 over 90 millimeters of mercury.

And then the prehypertensive is another whole group of another 20 or 30%, which is defined as greater than 121 over 89. So in that range, but hypertension is really not a disease. This is an important concept. It's a process. Hypertension is related to three finite responses in the artery, inflammation, oxidative stress, and vascular immune dysfunction. And what we've determined recently is that if you look at children of hypertensive parents, they already have abnormalities of their structure and function of their cardiovascular system. They have endothelial dysfunction. They have diastolic dysfunction, which is thickness of the heart muscle.

They have left ventricular hypertrophy, which is enlargement of the heart. And they even have carotid IMT issues that are going on at an early age. And it's because the disease is a vascular disease. It's a vascular biology permutation that's dysregulated early on so that the hypertension actually becomes a marker of the diseased artery. And then you have this bi-directional communication. Blood pressure goes up, more damage to the artery. But I think the disease really starts as a process in the artery, and the blood pressure is simply a marker for a dysregulated problem in the arterial system. When you started your career, was hypertension as prevalent as it is today?

I think it was probably less prevalent and less diagnosed because we didn't have all the automated blood pressure machines. People were not going to their doctor's office to get it checked. So it may have been there, but honestly, I think it's increased because of our sedentary lifestyle and our very poor nutritional habits. So what are the best things if someone's blood pressure is high or it's creeping up? Their doctor wants to put them on medication or in many cases, multiple medication. What are the best things people can do to take care of their blood pressure?

There are three top ones and two others I mentioned. Number one is optimal nutrition. And that's basically a plant-based diet with low sodium, high potassium, high magnesium. And the name for that is called DASH-2 or the typical Mediterranean diet, PrettyMed. Those are well-studied and show reductions in blood pressure and heart disease. Second is a supervised exercise program where you're doing both aerobics as well as resistance training. Weight management, but it's really more than weight.

It's body fat, particularly visceral fat, which is associated with inflammation of the arteries. And then of course, you've got sleep and you've got to reduce your stress and meditate. But those are the top five things that you have to do. So when you talk about a plant-based diet, are you saying no meat? No, I'm not saying no meat. I think that you've got to have the protein and you really need quality protein.

I stay away really from processed totally, whether it's bread meat or other meats. Try to go organic. And I typically more in the way of cold water fish that I can have a good source, particularly New Zealand has some good cold water fish you can ship. You can get wild salmon from the Northwest Territory. Those I do. So I'm more of a paleolithic vegetarian, so to speak. But I think you've got to have more emphasis on the vegetables, particularly the vegetables, multicolored, and then the fruit, depending on your dysglycemic response. So you'd say 70% to 80% plants and then a little bit of high-quality protein? That would be a good number to shoot for, yeah.

Okay. It's right in line with what we say. So I was just curious. I thought I had heard you say before that you did recommend some high-quality protein. Yes. Okay. It's right in line with what we say. So I was just curious. I thought I had heard you say before that you did recommend some high quality protein. Yes. Okay. So vegans have better blood pressure or not? Vegans, depending on how you define the vegan. So a pure vegetarian diet that has no meat whatsoever, typically have the lower blood pressures and the lowest risk for corny heart disease. And as you add things to it, like a Pesco vegetarian or up the food line, the risk will change a little bit. But in general, when you put an omega-3 diet, either supplement or fish, cold water fish, with the plant base, there seems to be a little extra

benefit in both cardiovascular events, but also blood pressure and maybe even in lipids. Excellent. Because I'm just thinking vegans really don't get EPA and DHA in their diet because they come from meat sources. And when those are low, inflammation goes up, depression goes up. But they will claim that they do get omega-3s from plant sources, but only 5% converts, correct? So you have to be careful. Yeah, you don't get that much from alpha-linic acid, but you can get algae-based omega-3s. That's what I want them to hear is you can get an algae supplement.

Right, for DHA, but not EPA. And EPA, it's interesting from a brain perspective, DHA doesn't help depression and it doesn't help ADHD, which is one of our specialties. But EPA does, which goes against common wisdom that DHA is more brain and EPA is more heart. But given that your brain and heart really are in love with each other and critical to each other, all the studies point to EPA being much more effective for ADHD and depression. And I want to point one more thing out because we have a lot of people who come in here claiming that they're vegan, so they don't understand why they're having health problems, but they're eating French fries, rice, potatoes.

Okay. So vegan and health are not synonymous. We have to point that out. He means when he's talking about a plant-based diet, he's not talking about fried zucchini and French fries. So we're talking about a seriously plant-based diet. Yeah. And the other thing, as you consume more omega-6s, as you know, you deplete your omega-3 pathway. Right. So that's a bad thing. And what I typically do in our patients, we give a balanced EPA, DHA at a three to two ratio for most patients, unless we need to tweak it for one thing or another. With the other things I mentioned earlier with GLA and the tocopherols, that way you get kind of what's in nature when you eat, because that's typically a normal ratio in the plant and not in a plant-based,

but in your omega-3 dietary intake. So three... Three to two ratio of EPA to DHA. Right. Yes. That's so helpful. Hypertension. How often should people measure their blood pressure and in what situations should they measure their blood pressure? Because sometimes when they go to the doctor, that makes them anxious all by itself. And I want to add one thing to that. At what point is it time to consider medication? Because I mean, a lot of people don't want to do medication. We always want to tell them, do everything you can that's natural, but there's a point where medicine plays a role, right? So talk to us about that.

So let's talk about the real issue with hypertension in a diagnosis, which is, again, another myth out there. We've typically used office blood pressures to diagnose hypertension. Now we've moved to home blood pressures with automated cups, which helps you get out of the white coat hypertension, which you mentioned. But honestly, the only way to really diagnose hypertension correctly and get all the parameters within the hypertension context is a 24-hour blood pressure monitor. And here's the reason for that. An office blood

pressure or even a home blood pressure is a point in time, and it's not going to give you the parameters you need to either diagnose and or treat appropriately, either with supplements, nutrition, or even exercise and drugs, because you can't time when the blood pressure is high or low by doing only one reading. So the parameters you have to use are blood pressure variability, blood pressure load, that's the mean average, the dipping status, that is what is your blood pressure at night. In other words, nocturnal blood pressure, the mean average at night compared to the mean average during the daytime is the driving force for stroke and heart attack, not your daytime pressure. You don't get that when you do home monitoring. You don't get that when you do office readings. You only get it with a 24-hour monitor.

And the other issue is how quickly do you go from your resting blood pressure at 3 a.m. in the morning when you're getting ready for your day, the pressure shoots up not only quickly, but to very high levels. That's also a risk. Now, the second thing you ask is, how do you decide what medicines to give? Well, it's based on the 24-hour ABM. And this is where we've gone to a whole new standard of care. We used to say, well, if it's above a certain level and you have so many risk factors, you need to start a medication. And that's still true. But how do you know when the blood pressure is up? What time of day is it up? Are they a dipping patient? Should you give your medications

in the morning or at night, depending on what is the highest reading. And here's where you get into trouble. And this is one of my pet peeves about treatment. If you are a non-dipping patient, meaning your nighttime pressure is really high, you should be giving your antihypertensive medicines in the evening, not in the morning. But if you're an excessive dipper, meaning your nocturnal pressure gets really low at night, to give it at night would actually increase their risk of a stroke. And Daniel will love this one because it reduces blood flow to the brain. So, an excessive dipper, medications at night is dangerous.

Oh, how interesting. Really interesting. So, I read a study just recently about non-dippers. And if you eat before bedtime, you are more likely to be a non-dipper, which means your blood pressure doesn't naturally drop. So give yourself three hours from the time you have dinner until the time you go to bed. Stop munching. Yeah. And the reason for that is most people are not eating a non-inflammatory diet. I was going to say, because I tend to be hungry at night, but I eat really well and I'm

on the thinner side. Is it a big deal for... And I have low blood pressure. Is it a big deal for someone like me to have a snack before bed? Well, if you eat a good diet in the evening, your pressure may not go up. It's when you eat an inflammatory diet, which most people do, and that's when it goes up and it'll stay up for sometimes four to six hours. Okay. And no, mine high for me is 110. Two other questions quickly. What about the issue of iron and heart disease and blood pressure? Lots of questions about that. And if you have the steak with red wine, you're going to be accumulating more iron. And people think, well, that's healthy for me. And

I'm like, maybe not. And if you have high iron, what are the best ways to lower it? So an elevated serum iron or a ferritin level, which is storage form of iron, is associated with strokes and heart attack and myocardial infarction in both men and women. Men in particular, women mostly after menopause. And there's very specific levels that you want to measure. Iron is a catalyst for oxidative stress, just like copper. And if you have high iron levels, you can have all these cardiovascular events. We try to get the serum ferritin in all men at 80 or less.

That's our goal. And if you're over that level, there's an increasing risk. And there's a genetic SNP for hemochromatosis, very common in Western Europeans. And I check that iron level in every patient and it's elevated iron or ferritin. I get their hemochromatosis genetics. And if it's elevated, the only way you can get the iron out is phlebotomy. I was going to say. So it's donating blood or being bled by leeches.

Yeah. Or a really good hematologist who's not a leech. Let's go for the hematologist. But for those of us with low iron, especially women, say premenopausal, it's okay to take some ferritin. Yeah. Obviously, low iron is just as bad as high iron is for a lot of things. I don't want people to go, oh, well, it's good that I'm low because it makes you feel lousy. No, you don't want to get too low either.

No, and you won't make dopamine, which would be a bad thing. Yeah, because you feel terrible. Right. Last question on hypertension. So hypertension is a risk factor for dementia, except in the old, old people where actually low blood pressure is a higher risk for dementia. So if we have somebody who has low blood pressure, what are some strategies to help get it in the normal range? We bring up a great point about the elderly because they have very stiff arteries, which means their systolic pressure is typically high, but their diastolic pressure is very low. It gives them a high pulse pressure, which means they don't perfuse well when their diastolic is low because that's when your diastolic perfusion is going on. So those people have a very high risk for not only MIs, but also for CVAs because of the low perfusion in both organs. So if you have that problem, you have to be careful about what you give,

particularly medications, not just hypertensive meds. There are a lot of meds that can alter those hemodynamics in an elderly patient and alter their cerebral blood flow. Awesome. You're here at the Brain Warriors Way. We're here with Dr. Mark Houston. Stay with us. We're going to talk about cholesterol and pick up his book, What Your Doctor May Not Tell You About Heart Disease, or go to his websiteorswaypodcast.com, that's brainwarriorswaypodcast.com, where Daniel and Tana have a gift for you just for subscribing to the show. And when you post your review on iTunes, you'll be entered into a drawing where you can win a VIP visit to one of the Amen Clinics. I'm Donnie Osmond, and I invite you to step up your brain game by joining us in the next episode.