Hypertension: The Silent Killer.......east and west.
by Dr. Alex Pozhitsky (Summer 2005)

In my daily practice as a San Diego chiropractor I reguarly check my patients blood pressure. As I tell my patients, "Ignoring high blood pressure is like playing Russian Roulette". By that I mean to say, to ignore the risk factors contributing to hypertension and instead of trying to prevent it - to treat it with only anti-hypertensive medication and their numerous side effects, would produce the same risk as engaging in the dangerous 50-50 play of "Russian Roulette". Instead, my approach is to screen my patients for high blood pressure , educate them as to the non-medicinal preventative measures, and then refer them to a physician for further evaluation especially since other factors such as genetic disposition and renal disease must be considered when high blood pressure is detected during a routine chiropractic exam.

One of the widest spread and common problems in developed countries such a Russia and the USA is hypertension. Classically defined, hypertension is having an average systolic blood pressure of 140 mm Hg or higher or a diastolic blood pressure of 90 mm Hg or higher or both. Some consider it to be the number one risk factor for causing strokes and heart attacks. With continuous and constant pressure, the risk of blood vessels bursting, becoming inflexible and hardening increases. Known as the "silent killer", if left untreated, chronic hypertension may lead to congestive heart failure, renal disease and peripheral vascular disease. It is widely studied, endlessly researched and easily detected. Yet it still continues to act as a silent killer, a slowly progressive disease which may remain asymptomatic until it is too late for the patient.

Approximately 1 in every 4 American adults has hypertension. In almost 95% of the cases of hypertension, the cause can not be determined and is referred to as essential or primary hypertension. Even though the most common types of hypertension can not be completely cured, hypertension can be controlled. In fact, the first line of treatment is usually a nonpharmacological approach focusing on effectively changing diet and life style modifications. Life style modifications may include reducing stress, decreasing alcohol and caffeine consumption, ceasing to smoke, and increasing physical activity. Changes in diet may focus on some factors such as obesity, low fiber, high sodium, fat, sugar intake, and increased consumption of other minerals such as potassium, magnesium, and calcium. In fact, if a patient were to focus on factors such as being overweight, high salt intake, alcohol consumption and physical inactivity, the incidence of hypertension would be lessened.

In Russia arterial hypertension remains a classical risk factor for heart disease. Its prevalence in middle-aged groups throughout the Soviet Union has been estimated at about the 30 per cent level with only 5 to 13 per cent of those within that group receiving adequate therapy. In 1997- 55% of all deaths in Russia were due to cardiovascular disease (CVD). Why is the rate of CVD so high in Russia?

ALCOHOL USE IN RUSSIA- Russians drink on average 3 liters of high-proof vodka a week. -Smoking: smoking puts one at great risk for CVD because it damages the vascular lining, increases heart rate,decreases oxygen delivery, adds more carbon dioxide intoxications, increases LDL cholesterol, and increases blood pressure by adding cadmium to the system. It is estimated that 25% of all CVD deaths are a direct result of smoking. 1990's- around 60% of Russian males and 10% of Russian females smoke.1997- smoking was linked to 280,000 Russian CVD deaths (32% of male deaths/5% of females) 1995= 1/3 of CVD mortalities in Russia attributed to alcohol. -Nutrition: A typical Russian meal for an adult might include black bread, cheese, eggs, sausage, butter, and tea for breakfast; pickled fish, bread, soup, meat or fish, potato, and stewed fruit for dinner;and the same for supper as dinner but without the fruit.In other words, the Russian diet consists of too much protein and saturated fat and not enough fruits and vegetables- obvious risks for CVD Families living in poverty have no choice but to substitute cheap fat for higher quality fats and proteins * Over 50% of the population drinks unhygienic water . Oftentimes soft water has sodium added to replace missing nutrients. Excess sodium is also a risk for CVD

As one modifies their dietary patterns, individuals faced with hypertension must realize that salt intake must be lowered. In countries with high salt consumption, hypertension runs rampant. The average daily sodium intake in America has been estimated to be approximately 4 to 6 grams (175 to 265 mEq). The two biggest sodium sources come from sodium which is added during processing and manufacturing and the use of table salt. Sodium makes up about 40% of salt. One teaspoon of salt contains about 2000mg of sodium, 2300 mg sodium= 100 mEq sodium; 1 mEq sodium= 23 mg sodium. To control hypertension, Americans should cook with as little salt as possible, refrain from adding salt at the table, avoid highly salted, processed foods and learn and remember the "Seven Sneaky (categories of) Sodium Stowaways":
1. Snacks- corn chips, potato chips, pretzels, peanuts
2. Seasonings and non-nutritive sweeteners
3. Soups, especially canned and dried mixes
4. Sauces- dried mixes and bottled which includes ketchup
5. Smoked meats and fish
6. Sauerkraut and other pickled foods
7. Sodium processed luncheon meats such as bologna, salami, had and corned beef
Mineral deficiency may also lead to hypertension. For good blood pressure control, one needs an adequate supply of calcium, magnesium and potassium. Essential fatty acids, especially omega-3 from fish oil or flax oil may have beneficial effects on cholesterol metabolism which deals with hypertension. Coenzyme Q-10 is a powerful antioxidant that helps the heart during stress or physical exertion. Garlic for cardiovascular health, and hawthorn and cayenne for heart health are 3 herbs that have long-standing traditions in supporting healthy blood pressure.

Obviously, what foods one eats has a tremendous impact on hypertension. A low fat, low sodium and high potassium diet will help to lower high blood pressure. Foods that contain animal fat or hydrogenated oils, which contain saturated fatty acids, should be avoided. One should also avoid cholesterol rich foods such as liver, meat, egg yolk, lobster, crab and prawns. Other foods to avoid include soda, salted butter and cheese, sea fish, dried fish, and the previously mentioned foods form the "Seven Sneaky Sodium Stowaways". Foods that one should increase in their diet include: corn oil, olive oil, sunflower oils, apricots, tomato, watermelon, banana, bitter gourd, bottle gourd, potato and other low sodium, high potassium foods. With herbs, nutritional guidelines, and a change for healthier lifestyle, our goal of reducing hypertension and finding a way to manage it, can be achieved.

Reference:
Foundations and Clinical Applications of Nutrition- A Nursing Approach Grodner, M., Anderson, S., DeYoung, S. Mosby, Inc.-2000- 2nd edition

Krause's Food, Nutrition, and Diet Therapy Mahan, L., Escott-Stump, S. W.B. Saunders Company- 2000- 10th edition

www.rxwellnesscenter.com/hypertension.asp
www.bawarchi.com/health/hypertension-diet.html
www.nhlbi.nih.gov/hbp/treat/treat.htm
biology.beloit.edu/emgdis/2001pages/russia/page3.html
www.lituanus.org/1982_4/82_4_01.htm