Topics » Disease » Managing and Preventing High Blood Pressure
T. Colin Campbell Center for Nutrition Studies

What epidemic condition causes more death and disability in industrialized countries than any other? What is a leading reason for doctor visits and drug prescriptions? What condition affects the majority of Americans over 65, often has no symptoms, and is referred to as the silent killer?

If you answered high blood pressure, hypertension, you would be correct.[1][2][3]

Blood Pressure Basics

Blood pressure measurements are recorded as two distinct numbers, the first over the second. The top number, systolic blood pressure (SBP), represents the pressure in the vessels during the heart’s contraction; the bottom number, diastolic blood pressure (DBP), represents the pressure when the heart relaxes. Both measurements are important risk factors associated with morbidity and mortality, meaning your risk of becoming ill or dying.

(Blood pressure numbers are labeled in this article as “points” without the associated terminology of “millimeters of mercury,” indicated by “mm Hg.” The technically correct way to describe blood pressure of 120/80 is “120/80 mm/Hg.”)

For every point your SBP rises above the optimal level, there is an increased mortality risk. This also means that for every point your SPB drops, down to the optimal level, there is a reduction in mortality. Even individuals who measure at around 120 (considered normal) can benefit from reducing their blood pressure.[4] It has been found that in those individuals without classical risk factors and with SBP less than 130, atherosclerotic lesions and risk of adverse events increase above any SPB as low as 90.[5] Researchers recently “found that lowering [SBP] by 5 mm Hg reduced the risk of heart attack, stroke, or death from heart failure by about 10%.”[4]

Blood Pressure Matters

When blood pressure is elevated, the increased wear and tear on the blood vessels and the turbulence created in the bloodstream appear to increase the formation of fatty sores called plaques.[5] When they rupture, these plaques may lead to a blockage of the blood vessels that feed circulation to the heart or brain, resulting in a heart attack or stroke. These incidents are the leading cause of death in industrialized countries.

Interestingly, the majority of heart attacks and strokes occur in individuals whose blood pressure is not yet elevated enough to justify the risks associated with taking blood pressure-lowering medications.[6][7] All blood pressure medications have significant risks and side effects, and these dangers may outweigh the potential benefits of taking the medication until blood pressure is more significantly elevated.[8] Fortunately, many nonpharmaceutical options can safely lower blood pressure, thereby reducing the risk of premature death and disability.

high blood pressure

What Works

Numerous scientifically proven approaches can safely reduce blood pressure. For example, for every kilogram (just over two pounds) of weight loss, systolic blood pressure reduces by an average of 1.6 points.[9] Adopting a high-fiber vegetarian diet also reduces systolic blood pressure by an average of 2.8 points.[10] Restricting alcohol and sodium can reduce systolic blood pressure by 4.8 and 16 points respectively.[11][12] The sodium reduction is particularly noteworthy: a 16-point reduction in systolic blood pressure is a larger effect size than would be expected from standard antihypertensive drug treatment.[7] Finally, exercise has been shown to have a powerful normalizing effect on blood pressure.[13] A regular walking program of 45 minutes four to five times a week may reduce blood pressure by an average of about 7 points.

Water-Only Fasting and Blood Pressure

In a study conducted at the TrueNorth Health Center in California and published in the June 2001 issue of the Journal of Manipulative and Physiological Therapeutics, the use of water-only fasting followed by a low-fat, low-salt vegan diet demonstrated the largest effect on lowering blood pressure of any study in the scientific literature.[6] The average drop in systolic blood pressure in 174 consecutive patients was 37 points. In patients with even higher blood pressure, starting at what is called stage 3 hypertension (for which the systolic blood pressure exceeds 180 points), the average reduction was 60 points!

In a second study, also conducted at the TrueNorth Health Center and published in the October 2002 issue of the Journal of Alternative and Complementary Medicine, a group of 68 patients with borderline high blood pressure (systolic blood pressure between 120 and 140 mm Hg) underwent a period of water-only fasting for an average of two weeks.[14] The average reduction in blood pressure exceeded 20 points, resulting in a final average blood pressure of 96/67. This is a level similar to what is considered the evidence-based optimum, at which point treatment would no longer be expected to lower blood pressure.

It’s Worth Getting Healthy

In 2001, California’s largest labor union, The International Union of Operating Engineers, elected to make the TrueNorth Health residential health education program a fully covered medical benefit offered to all active and retired union members and their families suffering from high blood pressure or diabetes. This represents the first time ever that a major medical payer has agreed to provide water-only fasting as a fully covered medical benefit.

The Operating Engineers Union is self-insured, and all information concerning medical expenses is centralized. This has allowed us to accurately evaluate the effect of the fasting program on the cost of medical treatment and drugs in the years before and after participation in the TrueNorth Health program. The results have been clinically and economically impressive. The cost of medical and drug treatment was reduced by an average of over $2,700 per member in the first year alone. These savings exceeded the program cost, demonstrating that fasting can be both clinically and economically effective. TrueNorth Health Center will continue to track the outcomes of the Union members in the years to come, and we expect the long-term results to be outstanding.

Feeding After the Fast

The effect of fasting on blood pressure can seem like a miracle, as patients who have been told they will need to take medications for the rest of their lives can throw away those medications. However, the results do not sustain themselves. To maintain healthy blood pressure, we must continue choosing a health-promoting lifestyle, including proper diet, sleep, and exercise habits.

We instruct our patients to avoid all processed foods that contain added salt, bread, cheese, certain salad dressings, soups, sauces, soda, coffee, alcohol, and chocolate. Instead of a conventional American diet, we encourage a diet of minimally processed foods, including fruits, vegetables, unprocessed whole grains, beans, and raw nuts and seeds.

Breakfast is often fresh fruit, perhaps with oatmeal and ground flaxseed. Lunch is often a large raw vegetable salad, steamed vegetables, and minimally processed complex carbohydrates, including steamed or baked potatoes, yams, squash, etc. Dinner may include another large raw vegetable salad, more steamed vegetables, and rice, millet, or a dish out of The Health Promoting Cookbook.

By avoiding all meat, fish, fowl, eggs, and dairy products as well as added oil, flour, salt, and sugar, our patients eliminate the dietary excess that contributes so heavily to high blood pressure. Combined with a program of proper sleep and exercise, the dietary changes produce consistently outstanding results. By utilizing fasting to jump-start a new lifestyle, patients can break bad habits and gain control of their health. High blood pressure is just one of many major health concerns that can be successfully treated with this approach, and it is one health concern that you can definitely learn to live without!

References

  1. Mills KT, Stefanescu A, He J. The global epidemiology of hypertension. Nat Rev Nephrol. 2020;16(4):223-237. doi:10.1038/s41581-019-0244-2
  2. Leszczak J, Czenczek-Lewandowska E, Asif M, Baran J, Mazur A, Wyszyńska J. Risk factors and prevalence of hypertension in older adults from south-eastern Poland: an observational study. Sci Rep. 2024;14(1):1450. Published 2024 Jan 16. doi:10.1038/s41598-024-52009-3
  3. U.S. Food and Drug Administration (FDA). High blood pressure—Understanding the silent killer. Web page accessed June 24, 2024. https://www.fda.gov/drugs/special-features/high-blood-pressure-understanding-silent-killer 1
  4. LeWine HE. What is the ideal blood pressure number? Harvard Health Publishing. August 1, 2022. https://www.health.harvard.edu/staying-healthy/what-is-the-ideal-blood-pressure-number
  5. Poznyak AV, Sadykhov NK, Kartuesov AG, et al. Hypertension as a risk factor for atherosclerosis: Cardiovascular risk assessment. Front Cardiovasc Med. 2022;9:959285. Published 2022 Aug 22. doi:10.3389/fcvm.2022.959285
  6. Goldhamer A, Lisle D, Parpia B, Anderson SV, Campbell TC. Medically supervised water-only fasting in the treatment of hypertension. J Manipulative Physiol Ther. 2001;24(5):335-339. doi:10.1067/mmt.2001.115263
  7. Kaplan NM. Clinical hypertension. 7th ed. Baltimore: Williams & Wilkins; 1998. P. 13, 14, 133-363
  8. Kramer H, Cooper R. Pros and Cons of Intensive Systolic Blood Pressure Lowering. Curr Hypertens Rep. 2018;20(2):16. Published 2018 Mar 6. doi:10.1007/s11906-018-0806-x
  9. Staessen J, Fagard R, Lijnen P, Amery A. Body weight, sodium intake and blood pressure. J Hypertens Suppl. 1989;7(1):S19-S23. doi:10.1097/00004872-198902001-00006
  10. Appel LJ, Moore TJ, Obarzanek E, et al. A clinical trial of the effects of dietary patterns on blood pressure. DASH Collaborative Research Group. N Engl J Med. 1997;336(16):1117-1124. doi:10.1056/NEJM199704173361601
  11. Puddey IB, Parker M, Beilin LJ, Vandongen R, Masarei JR. Effects of alcohol and caloric restrictions on blood pressure and serum lipids in overweight men. Hypertension. 1992;20(4):533-541. doi:10.1161/01.hyp.20.4.533
  12. MacGregor GA, Markandu ND, Sagnella GA, Singer DR, Cappuccio FP. Double-blind study of three sodium intakes and long-term effects of sodium restriction in essential hypertension. Lancet. 1989;2(8674):1244-1247. doi:10.1016/s0140-6736(89)91852-7
  13. Arroll B, Beaglehole R. Does physical activity lower blood pressure: a critical review of the clinical trials. J Clin Epidemiol. 1992;45(5):439-447. doi:10.1016/0895-4356(92)90093-3
  14. Goldhamer AC, Lisle DJ, Sultana P, et al. Medically supervised water-only fasting in the treatment of borderline hypertension. J Altern Complement Med. 2002;8(5):643-650. doi:10.1089/107555302320825165

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