A Primer on Blood Pressure – High, Low, Dysregulated

[Guest guest]

Poster's Comment: Exposure to chemicals also causes high blood pressure in

those whom are chemically sensitive: Dr G Ziem

_http://chemicalinjury.net/MedicalCare.htm_

(http://chemicalinjury.net/MedicalCare.htm)

 

 

A Primer on Blood Pressure – High, Low, Dysregulated

_http://www.immunesupport.com/library/showarticle.cfm?id=8998 & T=CFIDS_FM & B1=EM

072308F_

(http://www.immunesupport.com/library/showarticle.cfm?id=8998 & T=CFIDS_FM & B1=EM07\

2308F)

 

by Dr. Sarah Myhill, MD*

ImmuneSupport.com

 

07-21-2008

 

" The brain provides nerves connecting to muscles in the blood vessel walls,

telling them either to contract or relax. If this automatic control is damaged

… then postural hypotension is one result. " – Sarah Myhill, MD

Dr. Sarah Myhill, MD, is a UK-based ME/CFS/FM specialist focused on

nutrition, preventive medicine, and patient education. This information is

reproduced

with kind permission from her educational website (_DrMyhill.co.uk_

(http://www.drmyhill.co.uk/) ).*

BLOOD PRESSURE, THE CAUSES OF, AND TREATMENT

Blood pressure is necessary for blood to circulate around the body. Too

little pressure causes fatigue. Low blood pressure in this country is usually a

cause for congratulation by the medical profession, when for some people it

makes them feel awful!

Blood pressure is created as a combination of three factors.

In order of importance:

 

1. Peripheral resistance - i.e. how open are the arteries [the blood vessels

that carry oxygen & nutrients from the heart to the rest of the body].

2. How hard the heart is working. The heart is responsible for 60% of blood

flow. The other 40% is generated by the muscular walls of arteries. Arteries

pick up the pressure wave sent out from the heart and add their own booster

in a wave of contraction that flows down arterial walls.

3. The blood volume, and to a lesser extent the " thickness " of the blood -

if there is too much blood (as in smoking) the pressure will be high, anemia

or diuretics reduce the blood volume.

Arteries can be narrowed for two reasons:

Arteriosclerosis

Firstly they may be narrowed and stiffened as a result of arteriosclerosis

[stiffening, narrowing of the arteries, which when healthy are flexible and

elastic]. If this is the case, then the blood pressure is fairly fixed and

there is a wide pulse pressure - that is to say the difference between the top

reading (systolic) and bottom reading (diastolic).

A typical reading in this case would be 170/100. Furthermore, every time it

is measured it is about this level.

These are the hardest patients to treat, since all one can do is prevent

deterioration by aggressively tackling the arteriosclerosis. These patients

need:

* Drugs to keep their blood pressure down and prevent accelerating

arteriosclerosis,

* Whilst one puts in place nutritional interventions. (See below.)

[For more on the problems associated with poor blood supply to different

organs, see _“Arteriosclerosis – The Symptoms Ofâ€_

(http://www.drmyhill.co.uk/article.cfm?id=102) ]

Spasm/Thickening of Arterial Muscle Walls

The second reason for arterial narrowing is spasm or thickening of the

muscle walls. There are several reasons for this:

* Hypoglycemia [low blood sugar]

* Stress

* Allergies

* Mineral imbalance, especially magnesium deficiency and excess salt

(sodium) in the diet

* Sleep problems - especially sleep apnea syndrome

* Hormones - particularly female sex hormones as in the Pill and HRT

[hormone replacement therapy] - cause muscle thickening.

Telling the Difference

You can tell the difference between the two causes of high blood pressure

[arteriosclerosis or muscle spasm] by measuring your blood pressure regularly.

* Arteriosclerosis causes a fixed blood pressure and wide pulse

pressure between systolic and diastolic (e.g., 170/100) because the arteries

are

stiff and do not absorb the pressure wave created by the heart beating).

* Muscle spasm causes a variable blood pressure with a narrow pulse

pressure between systolic and diastolic (e.g., 120/90 one day, 135/104

another).

In Practice, the Two Problems Often Co-exist…

And all the possible causes of blood pressure need tackling at the same

time.

CAUSES of ARTERIAL SPASM/CONTRACTION

Hypoglycemia [low blood sugar]

This in my view is the single most important cause of high blood pressure.

The problem with sugar and carbohydrates is that they are addictive. In the

short term a high blood sugar brings desirable effects on the brain because:

* They allow it to work efficiently

* Whilst at the same time releasing the happy neurotransmitters that

improve mood.

We all lead stressful lives and in stressful situations one needs one's

brain to be working efficiently - but feeling cool calm and chilled out at the

same time. To achieve this we go for our comfort foods, which nearly always are

composed of carbohydrates such as chocolate, sweets, crisps, bread, bananas

or whatever.

The problem with running a high blood sugar is that it is potentially

damaging to muscles. The little arteries that supply blood to muscles

constantly

monitor levels of blood sugar and if they rise too high then these arteries

will contract, thereby cutting off the blood supply to muscles, increasing the

peripheral resistance and this results in high blood pressure.

At the same time, insulin is released to bring the blood sugar down - which

it does by shunting sugar into fat. So the sufferer tends to gain weight

easily. As the blood sugar falls, the sufferer ends up with foggy brain and

inability to think clearly, combined with irritability and mood swings - and

therefore goes for their comfort food again and so the cycle repeats itself.

Thus the carbohydrate addicts end up with middle-aged spread, high blood

pressure, mood swings and fatigue. In the longer term these are all major risk

factors for heart disease, cancer and accelerated ageing.

[see Dr. Myhill’s articles _“Hypoglycemia (low blood sugar) – a problem

for

many chronic fatigue syndrome and fibromyalgia patients, but treatableâ€_

(http://www.immunesupport.com/library/showarticle.cfm?id=8170) , and

_“Stoneage

diet – More reasons why we all should eat itâ€_

(http://www.drmyhill.co.uk/article.cfm?id=367) ]

Stress

Arterial muscle spasm is a normal response to stress. Homo sapiens evolved

leading a very physical life fraught with danger. He had to be able to react,

at a moment's notice, to physical danger. This would mean some intense

physical activity - running, fighting or whatever.

To prepare for this the heart would beat faster and stronger and the

arteries would narrow to " hold back " the extra blood (thereby affecting blood

pressure) so that the blood could be made immediately available to wherever it

was

needed - usually the muscles.

So there would be a momentary rise in blood pressure - followed by a fall as

the blood was utilized. These changes would be mediated by the stress

hormones adrenaline, noradrenaline, and in the longer term cortisol.

The trouble nowadays is that we have plenty of stress, which causes the

" fight or flight " response, but we don't burn it off. So we have high

circulating

levels of stress hormones which cause high blood pressure through muscle

spasm. This probably explains why the " type A " personality (the aggressive

go-getter) is more prone to arteriosclerosis.

The problem is compounded when the go-getter turns to sugar, fast carbs, and

junk food or alcohol or smoking to help control his/her stress symptoms. A

certain amount of stress is good for you. It is a case of getting the balance

right.

Allergies

Allergies to foods and chemicals can certainly cause arterial muscle spasm.

Indeed, this is the mechanism by which allergies cause migraine. Allergies to

foods can also cause the heart to go faster and in some cases palpitations.

Mineral Imbalance

Magnesium is necessary for muscles to relax. So a deficiency will cause

arterial muscle spasm with consequent rise in blood pressure.

Calcium probably also has a lesser role. It has been known for years that

drinking hard water (rich in calcium and magnesium) is protective against the

development of heart disease.

Salt (sodium chloride) has long been recognized as a cause of high blood

pressure. The trouble is that the food industry loves to add salt to food -

firstly because it disguises poor quality food, and secondly because it makes

you

thirsty so you then need to buy an expensive drink - wonderful for profits!

MAKING THE BLOOD PRESSURE DIAGNOSIS

Measure it. I would want to see at least 3 readings consistently high before

treating. You can leave this to your doctor. The only problem is that some

people suffer from " white coat " hypertension, i.e., the stress of going to see

their doctor puts their blood pressure up. [see _“Need blood pressure

checked? You may want to sit down for this news.â€_

(http://www.immunesupport.com/library/showarticle.cfm/ID/8847) ]

The other possibility is to measure it yourself. There are now many

excellent idiot proof blood pressure cuffs on the market.

Rare Causes of High Blood Pressure [and Tests]

These should always be considered at the first sign of high blood pressure,

but in practice they are often overlooked because they are uncommon causes.

However, especially if your blood pressure does not respond to treatment, then

they should be reconsidered as causes:

* Any kidney disease - check for with _Multistix_

(http://www.drmyhill.co.uk/test.cfm?id=53) [one brand of the over-the-counter

reagent strips

used to screen for multiple urine chemistry indicators – any positive

findings

to be investigated by a physician].

* Overactive thyroid – _thyrotoxicosis or hyperthyroidism_

(https://www.virginiamason.org/home/body.cfm?id=600) - diagnosed by blood test

for

thyroid hormones. [Thyroid profile testing: _free T3, free T4, and

thyroid-stimulating hormone (TSH)_ (http://www.drmyhill.co.uk/test.cfm?id=51) ]

* Overactive adrenal gland as a result of a tumor (_phaeochromocytoma_

(http://www.wrongdiagnosis.com/medical/phaeochromocytoma.htm) ). Suspect

this if there are recurrent odd attacks of flushing, sweating, anxiety,

headache

and/or palpitations. May be misdiagnosed as a panic attack. Test for by

doing urinary VMA [vanillylmandelic acid test, measures for evidence of hormone

substances that such a tumor would secrete].

* Overactive adrenal gland as a result of autoimmunity - _Cushing's

syndrome_ (http://www.endocrine.niddk.nih.gov/pubs/cushings/cushings.htm) .

Check for by doing blood cortisol level.

* Overactive adrenal gland causing _Conn's syndrome_

(http://www.cushings-help.com/conns_syndrome.htm) (very, very rare!) - low

blood potassium

levels. This test does not last in the post so you would have to travel to a

laboratory to get the blood done.

* Poor blood supply to the kidneys - _renal artery stenosis_

(http://kidney.niddk.nih.gov/kudiseases/pubs/renalarterystenosis/index.htm) .

Can

present with high blood pressure. A narrow aorta causes the same problem for

the

same reason. These diagnoses are difficult to make - they must be suspected

clinically and tested for by rapid magnetic resonance angiography. I would like

to think that soon these scans should be available to make these diagnoses.

* Drugs - don't forget _the Pill and hormone replacement therapy or

HRT_ (http://www.drmyhill.co.uk/article.cfm?id=55) (I hate them both!), and

_monoamine oxidase inhibitors_ (http://www.mayoclinic.com/health/maois/MH00072)

in conjunction with the wrong foods. [individuals taking an MAOI, the

longest-used antidepressant type, need to restrict tyramine-containing foods

including many cheeses, pickled foods, chocolates, certain meats, beer and

wine, and

more.]

* Pregnancy - See _“Pre-eclampsiaâ€_

(http://www.drmyhill.co.uk/article.cfm?id=424) – high blood pressure during

pregnancy.

LOW BLOOD PRESSURE AND POSTURAL HYPOTENSION

During evolution, a stage arrived when monkeys and apes decided to stand up.

They also liked hanging upside down in trees. This presented a terrible

problem for the circulation because unless the blood pressure was kept constant

in all departments, some would get too much blood, some too little.

The only way this could be done was by allowing the brain to control blood

supply by providing nerves connecting to muscles in blood vessel walls telling

them either to contract or relax. Contracting would reduce blood supply,

relaxing would increase. So when the ape stood up suddenly, the arteries to the

leg and gut would contract a bit, the arteries to the head and arms would

relax a bit. If this did not happen, the ape would fall over in a dead faint as

blood followed gravity and pooled in the legs.

Control of blood pressure is done without us having to think about it -

thank goodness! This automatic control is carried out by the autonomic nervous

system. If the autonomic nervous system is damaged by pesticides, chemicals,

free radicals or nutrient deficiencies then postural hypotension is one result.

 

Symptoms of Postural Hypotension

You faint if you don't sit down (or lie down) quick. If you don't actually

faint, blood supply to the brain is reduced, resulting in feeling dizzy,

spaced out, or not with it.

Postural hypotension usually occurs when you stand up. It is worse if you

are hot, because blood is already diverted to skin, so it often happens to

people getting out of bed.

There are some funny reflexes which can result in postural hypotension - for

example having a pee. This may explain why some men faint in the night when

nipping out for a slash.

Any drug for blood pressure could worsen a tendency to postural hypotension.

 

Treatment

Try to identify and avoid obvious causes - think about pesticides,

chemicals, free radicals or nutrient deficiencies. Diabetics may get autonomic

neuropathy.

Give your body time to adjust - don't jump up too quickly.

Work the muscles of your legs for a few seconds before standing up - this

prevent blood pooling in legs as the muscles squeeze the blood out of the veins

back to the heart.

I would treat postural hypotension as a sort of _peripheral neuropathy_

(http://www.drmyhill.co.uk/article.cfm?id=187) , and use high dose B vitamins

and

possibly vitamin B12 injections to encourage the nerves to heal and repair. I

would also check _DHEA levels_ (http://www.drmyhill.co.uk/article.cfm?id=51)

on the grounds that this encourages repair of tissues.

[Note: for a brief explanation of “Neurally-Mediated Hypotension†in ME/CFS

and FM patients, and a protocol Dr. Paul Cheney, MD, has recommended, _click

here_ (http://www.immunesupport.com/library/showarticle.cfm/ID/3499)

_http://www.immunesupport.com/library/showarticle.cfm/ID/3499_

(http://www.immunesupport.com/library/showarticle.cfm/ID/3499) ]

____

* This material is reproduced with generous permission from Dr. Myhill’s

patient-information website (_DrMyhill.co.uk_ (http://www.drmyhill.co.uk/) ). R

Sarah Myhill Limited, Registered in England and Wales: Reg. No. 4545198.

Note: This information has not been evaluated by the FDA and is not meant to

prevent, diagnose, treat, or cure any illness, condition, or disease. It is

essential that you make no decision about additions to or changes in your

health support plan or regimen without first researching and discussing it in

collaboration with your professional healthcare team.