Dietary Mineral Could Be One Key to Blood Pressure Control

Sufficient dietary levels of the mineral nutrient magnesium might be a boon to good blood pressure new research suggests.

“Magnesium dilates arteries, and in doing so lowers the blood pressure,” explained Dr. Suzanne Steinbaum, a cardiologist who reviewed the new findings. “Foods high in magnesium include whole grains, beans, nuts and green leafy vegetables,” she added.

The new study was led by Dr. Yiqing Song, associate professor of epidemiology at Indiana University’s School of Public Health. According to the researchers, past studies that focused on the role of magnesium in regulating blood pressure have been relatively small, and produced mixed and controversial results.

To help sort the data out, Song’s group pooled the data from 34 clinical trials on magnesium supplements, which together involved more than 2,000 people.

The daily dosage of magnesium supplements used ranged from 240 mg to 960 mg. Most trials had participants meet or exceed the U.S. Recommended Dietary Allowance for daily magnesium intake.

Sifting through the collected data, Song’s team detected a small but significant link between magnesium intake and healthy reductions in blood pressure.

Song and his colleagues believe that the benefits of magnesium in regulating blood pressure may only apply to people with a magnesium deficiency or insufficiency.

Still, the finding “underscores the importance of consuming a healthy diet that provides the recommended amount of magnesium as a strategy for helping to control blood pressure,” American Heart Association Spokeswoman Penny Kris-Etherton said in an AHA news release.

“This amount of magnesium [368 mg/day] can be obtained from a healthy diet that is consistent with AHA dietary recommendations,” said Kris-Etherton, who is a professor of nutrition at the University of Pennsylvania.

Acupuncture Might Help Ease High Blood Pressure

Researchers found that blood pressure levels declined slightly in a small group of patients treated 30 minutes a week with “electroacupuncture” - where needles carry low-level electrical stimulation - at specific points of the body.

“Potentially, blood pressure can be kept low with a monthly follow-up treatment,” said study co-author Dr. John Longhurst, a cardiologist at the University of California, Irvine.

A estimated 70 million U.S. adults - one in 3 - have high blood pressure, according to the U.S. Centers for Disease Control and Prevention. It’s believed that only half have their condition under control. High blood pressure can lead to stroke and heart disease.

Blood pressure can often be lowered by becoming more fit, taking medications or both. But these approaches don’t work for everyone, and the medication can cause side effects, especially among the elderly.

Acupuncture, an ancient Chinese therapy, is increasingly viewed as a possible alternative, the researchers said in background notes with the study. Practitioners insert thin needles into key points on the body in an attempt to rebalance the flow of energy.

High blood pressure was defined as 140-180 mm Hg over 90-99 mm Hg. None of the participants was taking blood pressure medication.

Wisdom Wednesday: Coenzyme Q-10

Coenzyme Q-10 (CoQ-10) is a very popular supplement. Many people use CoQ-10 for heart conditions, chest pain, diabetes, breast cancer, Parkinson’s disease, muscular dystrophy, chronic fatigue syndrome (CFS), Lyme disease and increasing exercise tolerance.

The chemistry of Co Q-10 is well understood. In the mitochondria of every cell, it facilitates electron transport. This is the process by which energy is transferred from the Krebs’s Citric Acid Cycle (glucose metabolism) to make ATP, the energy molecule of the body. Deficiencies of Co Q-10 impair electron transport severely limiting energy production for all body functions.

Your body produces 75% of the Co Q-10 it needs. The rest comes from the diet. Co Q-10 is found in small amounts in most animal foods. Co Q-10 is a fat and requires other fats in the diet for absorption. So a vegan vegetarian restricting their fat intake might develop a deficiency.

However, the overwhelming cause of Co Q-10 deficiency comes from using statin drugs to lower cholesterol. Drugs like Lipitor inhibit the synthesis of Co Q-10 in the same manner as they inhibit cholesterol synthesis. The symptoms of Co Q-10 deficiency are low energy, fatigue, leg weakness and leg pain. The cardiac myopathy (heart muscle damage) that occurs in 10% of patients taking statin drugs is thought to be a result of Co Q-10 deficiency.

BPA Can and Bottle Lining Could Increase Blood Pressure

Biphenol A (BPA) is a common chemical, found in products such as plastic bottles and the inner lining of food cans.

According to the authors of the study, BPA exposure has been detected in more than 95% of the US population.

The research, published in Hypertension, follows up on previous work associating BPA with cardiovascular disorders such as high blood pressure and heart rate variability.

There is also evidence that BPA can leach into food and drinks from the lining of containers. An earlier randomized crossover trial demonstrated that eating canned soup for 5 days running increased urinary BPA concentration by more that 1000%, in comparison with eating soup made from fresh ingredients.

Study authors Dr. Yun-Chul Hong of Seoul National University College of Medicine in South Korea and Dr. Sanghyuk Bae conducted a new randomized crossover trial, whereby participants would be given soy milk to drink, provided in either cans or glass bottles.

Two hours after drinking the soy milk the participant’s blood pressure, heart rate variability and urinary BPA concentration were measured. Participants were asked not to eat or drink any other food for the 2 hours after drinking the soy milk, and for at least 8 hours before each trial.

The researchers chose soy milk as it does not contain any ingredients known to elevate blood pressure.

The participant’s urinary BPA concentration rose by up to 1,600% following the consumption of canned soy milk, compared with consumption of soy milk from glass bottles. Additionally, systolic blood pressure increased by approximately 4.5 mmHg. No statistically significant differences in heart rate variability were observed.

Nearly 3 in 10 Americans with Diabetes Don’t Know It

Almost 8 million Americans have diabetes but don’t know it, a new study shows.

That’s despite the fact that about two-thirds of those with undiagnosed diabetes have seen a doctor two or more times in the past year, according to the researchers.

The study also found that among those who were diagnosed with diabetes, only about one –quarter met three important goals for people with diabetes: managing blood sugar, blood pressure and cholesterol levels.


“Out of 28.4 million people with diabetes, more than a quarter don’t know [it],” said study author Dr. Mohammed Ali, an assistant professor of public health at Emory University School of Medicine in Atlanta.

“About 80% of those people are linked to a health care provider, and two-thirds are seeing them twice a year or more. So, through whatever means, they aren’t being identified with diabetes,” Ali explained.

Symptoms of type 2 diabetes, which may be subtle and come on slowly, include fatigue, blurred vision, slow-healing cuts and scrapes, and the need to urinate more often, according to Dr. Robert Ratner, chief scientific and medical officer for the ADA.

Despite greater awareness in recent years, diabetes remains a major cause of death and disability in the United States. It’s a leading cause of adult-onset blindness, kidney failure and limb amputations, according to the researchers.

MY TAKE:
This is a prime example of a failing heath care system – over 5 million undiagnosed diabetics are seen by a physician a least twice a year, but not properly diagnosed.

As a clinician, you are responsible for the total health of your patient, regardless of their chief complaint on entry. If a patient seeks my help for acute low back pain and they also happen to be an undiagnosed diabetic, I am responsible to diagnose, properly treat, and/or refer that patient for their diabetes.

Diabetes is an easy diagnosis. Occult cancers like breast, lung, and prostate are much more challenging. This is why a good history is so important. I recently had a new patient who was being treated for anemia with iron supplementation by her MD. She had a microcytic anemia, so iron probably would be effective. However, her history included breast cancer. As a clinician, you must assume this patient has metastatic carcinoma until you prove otherwise. You can not just treat the anemia and ignore the potentially fatal diagnosis. My new patient was referred to her oncologist for further evaluation and treatment.

Every patient in my office is evaluated for signs of metabolic syndrome, the precursor to diabetes and heart disease. The signs are central obesity (weight gain around the belly), high blood pressure, high serum lipids, low thyroid function, and insulin resistance. I see these signs all day long. Look around you or maybe look at yourself and you will see them too.

THE BOTTOM LINE:
The fasting glucose only shows how well your body handles sugar without the stress of food for the past 8 hours. You are diabetic long before the fasting glucose is elevated on your lab test.

I recommend all my patients have laboratory testing each year as a preventative tool. Included in that panel of tests is a glycohemoglobin A1c. This test measures the percent of RBCs (red blood cells) that are saturated with glucose. That number should be below 5.7%. Please ask your physician to run an A1c. Don’t wait for your MD to diagnose you as a diabetic.

Source: National Institutes of Health -Tuesday, November 18, 2014

Are We Overdoing Salt Restrictions?

It’s long been known that eating too much salt in your diet will raise your blood pressure, but a comprehensive global study now says that too little salt in your diet also can harm your heart health.

There appears to be a “sweet spot” for daily sodium intake between 3 and 6 grams – equal to 7.5 to 15 grams of salt – associated with a lower risk of death and heart disease that either more or less, researchers report.
“We found that too high levels of sodium are harmful, but also earing a low amount of sodium is harmful,” said study co-author Andrew Mente, an assistant professor of clinical epidemiology and biostatistics and McMaster University in Ontario. “Having a moderate level of intake is associated with the least amount of harm.”

The findings run counter to current guidelines of heart disease prevention, which recommend a maximum sodium intake of 1.5 to 2.4 grams per day. That’s the equivalent to a maximum of just under half a teaspoon of table salt per day.

“Only one in 20 people in the world eat currently what is recommended,” Mente said. “It indicates that we are making recommendations that most people can’t meet. It’s not a practical recommendation. This suggests that rather than focusing on sodium, we should focus on eating an overall health diet and pursuing healthy lifestyle changes.”

Limiting salt consumption is difficult given that 80% of a person’s daily salt intake comes from the foods they eat, rather that the salt shaker, he said.

The researchers’ findings are included in papers published in the August 14 issue of the New England Journal of Medicine. One examines the relationship between salt intake and blood pressure, while another looks at salt and risk of death or heart disease.

Metabolic Syndrome Linked to Poor Breakfast Habits in Childhood

Researchers in Sweden report a link between the incidence of metabolic syndrome in adults and the kind of breakfasts those adults ate as children.
Friday, January 31, 2014

Studies reported in Medical News Today during 2013 suggested that eating a large breakfast could boost fertility for women with PCOS and lower the risk of heart disease, diabetes and high blood pressure.

In addition, skipping breakfast has been said to increase the appeal of high-calorie foods later in the day. Some studies have even suggested that eating breakfast every day can help to lower body mass index (BMI), though other researchers have disputed this.

Researchers at Umea University in Sweden studied a group of Swedish schoolchildren, asking questions about what they ate for breakfast. Twenty-seven years later, the follow-up checked these same subjects for signs of any metabolic risk factors.

The study found that the people who did not eat breakfast (or who ate an insubstantial breakfast) as children were 68% more likely to have adulthood metabolic syndrome that their peers who ate substantial breakfasts.

MY TAKE:
It is estimated that 34 percent of the U.S. adult population meets the criteria for a diagnosis of metabolic syndrome. The high prevalence and spectrum of diseases associated with metabolic syndrome make it the number one public health issue in the this country.

You qualify for the diagnosis of metabolic syndrome if you have three or more of the following:

• Waist circumference > 39 inches in males, > 33 inches in females.
• Blood pressure 130/85 or higher.
• Fasting blood sugar of 100 or higher.
• Triglycerides of 150 or higher.
• HDL less than 40 in males, 50 in females

People with metabolic syndrome are three times more likely to have a stroke or heart attack, and twice as likely to die from these events. The risk of developing type 2 diabetes is five times higher in people with metabolic syndrome.

The good news is that this syndrome is preventable and even reversible. Dietary changes, including eating a good breakfast, are a good start. Regular exercise habits and proper nutritional support are also vital.

THE BOTTOM LINE:
Assess your current health status. Have fasting blood tests annually. In addition to the tests noted above, check your glycohemoglobin A1c. It will predict the rise in fasting blood sugar years before it gets out of control. Also check thyroid function. The TSH (thyroid stimulating hormone) normally ranges from 0.4 to 4.5, but levels above 2.0 are also associated with metabolic syndrome, especially in women. Consult with a qualified nutritionist to reverse the diseases associated with this epidemic in our nation. Finally, make sure your children do not leave home in the morning without a good meal to start their day.

New Blood Pressure Guidelines

Fewer people should take medicine to control their high blood pressure, a new set of guidelines recommends.
Wednesday, Dec. 16, 2013

Adults age 60 or older should only take blood pressure medication if their blood pressure exceeds 150/90, which sets the bar higher than the current guideline of 140/90, according to the report, published online in the Journal of the American Medical Association.

The guidelines also recommend that diabetes and kidney patients younger than 60 be treated at the same point as everyone else that age, when their blood pressure exceeds 140/90. Until now, people with those chronic conditions have been prescribed medication when their blood pressure reading topped 130/90.

Blood pressure is the force exerted on the inner walls of blood vessels as the heart pumps blood to all parts of the body. The upper reading, the systolic pressure, measures the force as the heart contracts. The lower reading, the diastolic pressure, measures the residual as the heart relaxes between contractions. The normal adult blood pressure is 120/80.

The recommendations are based on clinical evidence showing that stricter guidelines provided no additional benefit to patients, explained guidelines author Dr. Paul James, head of the department of family medicine at the University of Iowa Carver College of Medicine.

“We really couldn’t see additional health benefits by driving blood pressure lower than 150 in people over 60,” James explained. “It was very clear that 150 was the best number.”

The American Heart Association (AHA) and the American College of Cardiology (ACC) did not review the new guidelines, but the AHA has expressed reservations about the panel’s conclusions.

About one in three adults in the United States has high blood pressure, according to the U.S. National Heart, Lung, and Blood Institute.

MY TAKE:
These new guidelines are a step in the right direction. Although the existing guidelines from both the AHA and ACC call for lifestyle changes in additional to medication, the reality is most physicians just place their patients on medication with little or no attempt at reversing the cause of high blood pressure.

I loved the quote from Dr. James about no additional health benefit from driving the blood pressure down below 150. That’s what beta blockers, calcium channel blockers, and ACE inhibitors do, drive down blood pressure.

One in three Americans has high blood pressure. Seventy-five percent remain undiagnosed, just treated with medication. Kidney, lung, and liver dysfunction are the most common causes. High blood pressure is also one of the indicators for metabolic syndrome.

High blood pressure is not a disease. It is not even a symptom, although symptoms are associated with it. Blood pressure is a test. Treating the test is not the answer. Finding out why the blood pressure is elevated and correcting the health problem causing this abnormal test is the real solution.

THE BOTTOM LINE:
If you have high blood pressure find a doctor who will investigate the cause and help you to reverse the problem. Take a good look at your lifestyle – Are you overweight? Do you exercise on a regular basis? Don’t settle for just medicating the test.