All this time, I've been blaming my high blood pressure on my genes. I mean, my BMI is 19.1. I exercise like mad. I try to eat right. I have very little stress in my life (except when I have a 3 foot putt). I'm a model of good health. Or so I thought.

Then I read this book Blood Pressure Down. It's about how to drop ones blood pressure without medication. I take lisinopryl (for 3 years). I evidently need it. When I went on vacation last spring and forgot to bring it, my BP soared to 160/95. With it, I'm at 115/70 average.

I'm thinking the culprit is not so much my genetic predisposition as much as it is my salt intake. Although I THINK I watch my sodium, it appears (according to the book) I ingest far more than I realize. For example, I thought tomatoes with cottage cheese and a dash of salt would be healthy. Wrong. The cottage cheese (and most other cheeses) is loaded with salt. And sprinkling a "dash" here and there adds up. What is sweet corn without butter and salt? I have that all summer long.

We only need a fourth of a teaspoon of salt a day. Americans use far more that that. From now on, I'm going to be one diligent person regarding my salt intake. Sodium chloride is a killer (in excess). 

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Comment by Luara on September 13, 2013 at 5:44pm

avoiding medications seems an almost anti science approach, like approaching diabetes by cutting sugar but avoiding insulin.

I ran into this recently. I have Hashimoto's (autoimmune thyroid disease) and I got mildly hyperthyroid recently (insomnia, increased appetite, jitteriness, irritability)
Hashimoto's may be aggravated by excessive iodine, I found. Iodized salt has been introduced in many countries because iodine deficiency has disastrous effects, like mental retardation.  This cures the iodine deficiency problem, BUT it raises the rate of Hashimoto's!  Iodine is needed to produce thyroid hormones - but it also stimulates the production of thyroid peroxidase - which most people with Hashimoto's are making antibodies to!  So iodine can aggravate the autoimmune activity in Hashimoto's. 

There was even a small study where a low-iodine diet (< 100 mcg iodine/day) caused remission of Hashimoto's in some of the patients.

But a lot of "alternative" advice has apparently been to take iodine - lots of it - if you have a thyroid problem.  Rather than taking Synthroid - synthetic (evil) thyroid hormone.  This has aggravated Hashimoto's in some people.  It's much better to take the synthetic thyroid hormone and rest the thyroid so the immune system can forget about it. 

I recently started taking a multimineral that gives me 225 mcg of iodine/day.  That isn't much more than the RDA, but when I read about iodine being bad for Hashimoto's, I wondered if the extra iodine could be aggravating my autoimmune problems and maybe making my allergies worse also. 

That's another hazard of eating too much salt - excessive iodine.  At least for women, who are usually the ones who get Hashimoto's.  I don't use iodized salt. 

Our modern salt intake is higher than it was for prehistoric peoples (though people living next to the ocean probably used a lot of salt).  So it makes a lot of sense for Randy to do what he can for hypertension by avoiding salt - correct the underlying problem rather than doing a probably crude fix with a drug. 

Comment by Michael Penn on September 13, 2013 at 7:41am

I take lisinopryl 10 mg. for BP and the doctor was having me work with him to adjust the dosage. If they went to 15 mg it would have worked perfectly, and I told them so, but the nurses working with the doctor decided I needed a water pill added in there. Everyone forgot the fact that I also have gout, and I drink extra water daily and take my gout meds. This kept me peeing like crazy until they added the water pill to my BP meds. Now the water pill in my lisinopryl appears to be causing an opposite effect.

I like my doctor but don't like paying so much to see him, even with Medicare. Since I'm a veteran, I'm about ready to go see the VA with this and pay a $15 co pay for the doctor visit. That should fix the problem.

Comment by jay H on September 11, 2013 at 9:00am
Of course it's your choice, but simply avoiding medications seems an almost anti science approach, like approaching diabetes by cutting sugar but avoiding insulin.
Medicine has made substantial progress, take advantage of what science offers.
Comment by Luara on September 8, 2013 at 12:05pm

I looked into this a couple years ago and the evidence for the harmful effects of salt looked quite solid.

From animal studies, there's a component of salt-sensitive hypertension which takes place on the scale of the animal's whole lifespan, and some of the blood pressure increase does not reverse with a low-salt diet. With a high salt diet, slowly over a lifespan blood pressure increases. This was shown in rats, with a salt intake comparable to a human high-salt diet in Chronic sodium toxicity in the albino rat". There seems to be a component of salt-sensitive hypertension that develops slowly, over decades, and is somewhat irreversible. See "The time course of salt-induced hypertension, and why it matters", http://www.nature.com/ijo/journal/v32/n6s/full/ijo2008205a.html and http://www.med.mun.ca/getdoc/96bf37c1-1ab3-49d1-af24-3293264153e1/B...
Thus, if the number of people who are salt-sensitive is estimated by the number of people whose blood pressure goes down a certain amount on a low-salt diet, this would underestimate how many people are salt sensitive.
I’ve read that the rise in blood pressure with age is thought to be mostly due to salt. So if almost everyone’s blood pressure goes up with age, this may mean that almost everyone has this kind of long-term salt sensitivity.

Also Denton's studies on chimpanzees, where a high salt diet, similarly salty to human high salt diets, caused blood pressure to rise in chimpanzees: see http://www.ncbi.nlm.nih.gov/pubmed/7489355 and http://circ.ahajournals.org/content/116/14/1563.long

When epidemiological studies are confusing, I like to look at animal studies. That doesn't seem at all ambiguous, that salt causes hypertension.

A high salt diet also causes cardiovascular problems besides hypertension, and probably causes osteoporosis and stomach cancer.

55% of white people with hypertension are salt sensitive, and 30% of the white people in general are salt sensitive. Black people are more salt sensitive than white people. I don’t know about other races.

"Harmful effects of dietary salt in addition to hypertension": http://www.nature.com/jhh/journal/v16/n4/full/1001374a.html - full text.

Comment by Luara on September 8, 2013 at 11:41am

From the Dietary Reference Intakes publication, which gives an overview of the research,

While blood pressure, on average, rises with increased sodium intake, there is well-recognized heterogeneity in the blood pressure response to changes in sodium chloride intake. Individuals with hypertension, diabetes, and chronic kidney disease, as well as older-age persons and African Americans, tend to be more sensitive to the blood pressure-raising effects of sodium chloride intake than their counterparts.2 Genetic factors also influence the blood pressure response to sodium chloride. There is considerable evidence that salt sensitivity is modifiable. The rise in blood pressure from increased sodium chloride intake is blunted in the setting of a diet that is high in potassium or that is low in fat, and rich in minerals; nonetheless, a dose-response relationship between sodium intake and blood pressure still persists. In nonhypertensive individuals, a reduced salt intake can decrease the risk of developing hypertension (typically defined as systolic blood pressure ≥140 mm Hg or diastolic blood pressure ≥ 90 mm Hg). ...  For adults, a UL of 2.3 g /day is set.

Comment by jay H on September 8, 2013 at 11:25am

Hypertension is, unfortunately a metabolic problem more than a dietary problem (within reason). Normal excess amounts of salt are shed by the body, but if that mechanism is not adequate, restricting the salt intake might help, but it's an indirect treatment, like restricting the fuel to your furnace because your thermostat keeps running too hot.

Comment by Joan Denoo on September 8, 2013 at 8:44am

Good information and description of what happens to you with your lovely corn and salt plus other pleasures. 

Comment by Luara on September 8, 2013 at 7:33am

Unfortunately hypertension from excessive salt intake may be permanent after awhile, so when people go on low-salt diets and it doesn't lower their BP much, they figure salt intake doesn't matter much. 

Potassium tends to lower blood pressure, so it may make sense to use potassium chloride as a salt substitute.  Also lots of dietary sources of potassium, like lots of fruit and vegetables

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