Metabolic health is defined as having optimal levels of five factors: blood pressure, triglycerides, high-density lipoprotein cholesterol, blood glucose, and waist circumference, without the need for medications. Do not assume that because you aren’t obese you are okay. According to research, only 12% of adults are metabolically healthy! Having poor metabolic health increases our chances of developing diabetes, heart disease, and stroke.
High blood pressure is known as the silent killer, so as we think about health and wellness these are numbers that are really important to know, while often elevated blood pressure does not impact how we feel and goes undiagnosed! Good news…this factor of metabolic health is impacted by our choices, and therefore, we can do something about it.
New Guidelines:
In 2017, new guidelines from 12 health organizations lowered the numbers for the diagnosis of hypertension (high blood pressure) to 130/80 mmm Hg or higher for ALL adults. The previous guidelines set the threshold at 140/90 mm Hg for people younger than age 65 and 150/80 mm Hg for those ages 65 and older.
This means if you didn't have high blood pressure before, there's a good chance you do now! For example, up to 79% of men ages 55 and older are now classified as having hypertension.
“Over all the new guidelines may help people get more involved with monitoring their blood pressure, which can hopefully prevent complications from hypertension.”
The Systolic Blood Pressure Intervention Trial (SPRINT), studied more than 9,000 adults ages 50 and older, aimed to find out whether treating blood pressure to lower the systolic number to 120 mm Hg or less was superior. The results found that having a systolic pressure of no more than 120 mm Hg reduced the chance of heart attacks, heart failure, or stroke over a three-year period!
What is Blood Pressure?
According to the American Heart Association:
Systolic blood pressure (the first number) – indicates how much pressure your blood is exerting against your artery walls when the heart beats.
Diastolic blood pressure (the second number) – indicates how much pressure your blood is exerting against your artery walls while the heart is resting between beats.
How To Measure Blood Pressure:
Often our doctor’s office is measuring our blood pressure wrong!! Do you see any of the American Heart Association guidelines that are being missed at your visits?
Avoid caffeine, exercise and smoking at least 30 minutes before testing
Make sure bladder is empty
Sit down for at least 3-5 minutes, but according to Attia preferably 10 minutes
Don’t talk or have someone talking to you during the rest period
Have feet flat and sitting straight up leaning against back of chair
Make sure to elevate the arm to the level of their heart
Do not measure over clothes
Use an arm cuff (not finger or wrist) that has been validated
There is value in measuring blood pressure at home. Some have “white-coat syndrome” where their blood pressure readings are elevated at the doctor’s office, while others actually have periods of higher readings throughout their week that are not observed at a single visit to the doctor. There are many home devices that are good. Dr. Attia’s favorite is the Omron upper arm monitor, because of its accuracy. At home measure twice 1 minute apart and then average those numbers. If those two numbers are significantly different from each other, measure a third time and average all three. Do this daily for a couple of weeks for a clear baseline.
Does salt raise blood pressure?
According to Rick Johnson, notable researcher and professor of nephrology out of the University of Colorado, it isn't the amount of salt that elevates blood pressure, but the CONCENTRATION OF SALT. Therefore, by drinking water in combination with eating salt, you can prevent a rise in blood pressure.
Fructose and Sodium:
FRUCTOSE (a form of sugar) causes elevated blood pressure! This 2018 study showed that increases in the sodium concentrations cause fructose to be made in the body, which results in raised blood pressure. Fructose, whether in eating it or our body making it, results in raised blood pressure, and inflammation in the kidneys makes the elevation persistent. In animals, when you block the metabolism of fructose, you actually block the rise in blood pressure.
Uric Acid Levels:
Photo by Katie Smith on Unsplash
The first thing to check when you have elevated blood pressure is your uric acid level. According to Attia, the relationship between uric acid and hypertension is one of the least well known facts among physicians. He believes that before medically correcting hypertension it is important to make sure the uric acid levels are above 5 (within the normal reference range is not necessarily optimal), and if they aren’t start there. Dietary methods to improve levels include lowering fructose ethanol and meat intake.
The kidneys!
There’s no organ that is more sensitive to hypertension than the kidney, so Dr. Peter Attia, MD with a focus on longevity, recommends using kidney function in addition to blood pressure readings and uric acid levels when seeking to maintain a healthy blood pressure. He tests kidney function using Glomerular filtration rate (GFR); it’s a scale that goes up to about 120, with normal being above 90. Attia says that if you’re at 75, you’re in no danger of needing dialysis anytime soon, however, if you are only 50 years old, and have a GFR of 75 that is concerning. By the time your GFR is 20 to 30, you do need dialysis!
Nutrition, sleep, and body weight:
The goal of correcting nutrition and improving sleep is that of weight and fat loss. The more weight we put on, the more our blood pressure goes up.
Past blogs that might be helpful include ones on sugar, sleep and weight loss.
fasting:
There is some interesting research behind fasting and wellness. Check out this podcast/interview with Dr. Jason Fung for a good starting point. The short version, as seen in this paper and this paper, is that one of the areas that benefit from fasting includes blood pressure. In both studies, after just a few days of fasting, patients were seeing their systolic and diastolic numbers coming down. For more information on fasting upload the Zero - Fasting app to find an entire section of articles and videos.
Medically treating blood pressure:
There are different classes of drugs for treating high blood pressure and some of them include beta blockers, calcium channel blockers, ACE inhibitors, and angiotensin receptor blockers. According to Attia, there’s an entire algorithm for figuring out what combination of drugs will work best in a particular individual.
warning!
Those on meds for diabetes it is somewhat dangerous for them to either fast or go on a low carbohydrate diet without the doctor watching the medication.
Omron Arm Cuff Blood Pressure Monitor Amazon associate’s link here.
Wendy Dellis is a certified wellness coach. She joins years of training and work in the area of behavior change, experience as a fitness instructor and run club coordinator with a passion for adventure and people. She lives in Minnesota with her husband, Jay, and two sons.
Enjoying our MN winter!
The information contained on this page is for general information purposes only. Nothing here should be construed as medical or healthcare advice, but only topics for discussion. No physician-patient relationship exists; please consult your physician before making changes in diet or lifestyle.
This is an update of a blog written in July of 2019.