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Written By Nicole Crane, BS, NTP
In the United States alone, 72 million adults, nearly one third of all people over the tender age of 20, have high blood pressure, according to the National Heart and Lung Association. Worldwide, the number of people expected to have elevated blood pressure has been estimated to climb to 1.56 billion by 2025. When blood pressure remains uncontrolled, it can have serious consequences like damage to the heart, arteries and other organs. This can increase the risk of a heart attack, stroke, or other heart diseases like congestive heart failure, atherosclerosis (fatty buildup in arteries causing hardening of the arteries) peripheral artery disease and other heart and vascular problems. Over time, high blood pressure can also do damage to the kidneys, allow for fluid to accumulate in the lungs and affect the healthy flow of blood to the brain and around the body. i Having normal, healthy blood pressure is an important aspect of overall wellness.
Blood pressure is considered normal when it is 120/80 ml/mg. The top number is a systolic reading and measures the pressure as the heart pumps blood around the body. The bottom number, the diastolic reading, measures pressure as the heart relaxes and refills with blood. Once those readings reach over 140/90, it is considered to be high blood pressure, also known as hypertension. There are many factors that get the blame when someone had high blood pressure, like inactivity, being overweight, excess sodium intake, a diet high in processed and fatty foods, and alcohol and tobacco use. Stress, age, ethnicity and metabolic problems like diabetes can also affect blood pressure.
Nutritionally, too much sodium is often vilified as a cause of hypertension. More recently, research has shown us that it is not necessarily an excess of sodium alone, but also a deficiency of potassium that elevates blood pressure. Potassium is an essential mineral and electrolyte that a number of body mechanisms are dependent on for normal function. Potassium and sodium are partners in governing the electrical activity of our bodies at the cellular level. Having a tight regulation of potassium concentrations both inside and outside of cells is essential for life. Potassium concentrations are 30 times higher on the inside of our cells, while sodium concentrations are more than ten times higher outside the cell than inside. This difference in concentration inside and outside of the cell creates what is known as a membrane action potential, an essential electrical and chemical gradient that helps to create energy for cells. This trading of sodium for potassium, which requires a minimum of a 2:1 balance of potassium to sodium, generates 20-40% of a typical adult's resting energy.ii Having enough potassium to maintain tight control of cell membrane potential is critical for nerve impulse transmission, muscle contraction, and heart function. Potassium is essential for supporting healthy insulin sensitivity and blood sugar balance, reducing oxidative damage and inflammation, all which support normal blood pressure.
Potassium also contributes to healthy blood pressure by supporting the release of nitric oxide, (NO) an essential gas released by the lining of blood vessels to dilate and open blood vessels. NO allows blood vessels to remain wide open, which supports healthy blood flow. When the blood vessels remain open and blood flows freely, blood pressure often returns to normal levels. NO also makes blood less sticky and thick by supporting healthy platelet function, which also contributes to healthy blood pressure.iii Healthy circulation is what keeps blood vessels healthy, flexible and strong and brings oxygen and nutrients to every cell in the body. Considering we have 60-100,000 miles of blood vessels, circulation is a critical aspect of heart health. Potassium also helps the kidneys remove excess sodium so it can be eliminated from the body. Excess sodium increases the constriction of blood vessels by making them more sensitive to hormones like norepinephrine and angiotensin II.iv By keeping sodium in balance, potassium supports healthy circulation, energy production and fosters normal electrical signaling (communication) between cells.
While nearly everyone gets plenty of sodium, nearly no one (just 2% of Americans) gets enough potassium. Research published in the American Journal of Clinical Nutrition based on research from the 2003-2008 NHANES (National Health and Nutrition Examination Survey) trial showed that 98% of people fail to get the recommended 4,700 mg of potassium per day.v Missing this key nutrient alone can be a factor in elevated blood pressure levels. An earlier NHANES, which gathered data on more than 17,000 adults, showed that higher dietary potassium intakes were associated with significantly lower blood pressure, while diets high in sodium, alcohol and protein were associated with higher blood pressure.vi Other research yields similar results. A high potassium, low sodium diet called the DASH (Dietary Approaches to Stop Hypertension) diet further emphasized the role of potassium-sodium balance in normal blood pressure. One study compared to a control diet providing only 3.5 servings/day of fruit and vegetables and 1,700 mg/day of potassium to the study diet, which included 8.5 servings/day of fruit and vegetables and 4,100 mg/day of potassium. The high potassium diet lowered blood pressure by an average of 2.8/1.1 mm Hg in all subjects and by an average of 7.2/2.8 mm Hg in those who had been diagnosed with hypertension.vii Meeting the recommended intake of potassium, around 4000 mg daily, can significantly lower blood pressure levels in as few as 4 weeks.
Potassium is found widespread in fruits and vegetables, especially dark leafy greens like spinach and kale, pinto and kidney beans, sweet potatoes (in the skin), papaya and avocados, all of which have at least double the potassium of a banana. You may be surprised to learn that a banana will barely meet 10% of your daily potassium needs. If eating a diet rich in fruits and vegetables is difficult for any reason, consider taking a high potency potassium supplement to support optimal levels of blood pressure.
Another electrolyte and mineral, magnesium, also plays a vital and versatile role in overall health. This essential nutrient is required for the basic functioning of over 320 different enzymes, supporting nerve and muscle function, energy production, balanced brain chemistry, healthy blood sugar balance and insulin sensitivity, cell communication, bone health and much more. Magnesium really shines when it comes to heart health and supporting normal blood pressure. Every time the heart beats, calcium is what causes the heart to constrict, but it is magnesium that allows the heart to relax again and fully fill back up with blood. If the heart muscle does not get to relax in between beats, it can have a negative effect on heart rhythm, blood pressure and overall heart muscle function.viii Magnesium also helps the body physically and mentally cope better with stress. Stress hormones like cortisol and adrenaline and the fight or flight cascade can be a major contributing factor to hypertension. During the fight or flight response, the body gets primed for a battle or a sprint: more blood flows to the muscles, the lungs open wide in order to take in as much oxygen as possible with each breath, the heart beats much faster than normal and blood pressure soars. The body is so efficiently hard wired that the different parts of the brain, like the amygdala, which processes emotions, and hypothalamus, the control center of the brain stay primed for this cascade even when stress is triggered by emotions. Emotional stress initiates the same stress responses, but without the physical action involved in fighting or fleeing, the accompanying high pulse rate and elevated blood pressure can damage cardiovascular health. Chronic stress leads to a large amount of magnesium being released into the bloodstream, from where it is excreted into urine. The higher the level of stress, the greater the loss of magnesium, which can prevent the body from having normal stress coping mechanisms. With magnesium loss compounded with poor dietary intake, stress hormone levels can soar, leading to a vicious cycle of even greater losses of magnesium and higher levels of stress hormones. With 80% of Americans deficient in magnesium, it does not take much for someone to lose the ability to cope well with stress. Good intake of magnesium restores the ability to properly handle and resist stress, supporting normal heart rate and healthy blood pressure.
Magnesium deficiency has numerous health consequences, including increasing the risk of a cardiac event, like a heart attack or stroke.ix A 2013 study followed 5,511 men and women for an average of 7.6 years linked consuming the recommended daily intake of magnesium (350 – 450 mg) to healthy blood pressure. This study found that the highest levels of urinary magnesium loss, which is reflective of a higher magnesium intake, corresponded to a 25% reduction in risk of hypertension.x Many studies have demonstrated similar results. A 10 year study of over 28,000 healthy female health professionals over the age of 45 show the benefits of magnesium for the heart. Women with the highest intake of magnesium (434 mg daily on average) had the healthiest levels of blood pressure compared to women with the lowest intake of magnesium (256 mg on average). Those who had a high intake of magnesium had a 7% lower risk of developing hypertension when no history of high blood pressure or heart disease was present.xi Magnesium is a vital nutrient for protecting the heart, brain and the rest of the body.
As essential as magnesium is for health, it can be difficult to get enough from food alone. Nuts and seeds, beans and leafy greens are all good sources, but have antinutrients like phytates and oxylates that prevent optimal absorption of this important mineral. Magnesium supplements for many are the simplest, most effective way to meet daily magnesium needs. Avoid oxide forms and seek out citrate and glycinate forms, which offer much better absorption. Men need at least 425 mg daily and women need at least 325 mgxii , but those who have chronic stress often require much more.
High blood pressure can be very dangerous to ignore. Dubbed the “Silent Killer” because it has little to no symptoms, hypertension takes a huge toll on the heart and the rest of the body. Good nutrition can address the root of this serious health issue. With intakes of potassium and magnesium on a steady decline for the last several decades, it is quite possible that deficiency of these precious minerals is an overlooked contributor to hypertension. Potassium and magnesium are minerals that most of us just do not get enough of, for several reasons. Only 25% of U.S. adults eat enough vegetables, our soil is depleted of minerals and many of us have stress that depletes the body of these vital minerals. Potassium and magnesium can be safely taken with most medications, including those for high blood pressure. These essential electrolyte minerals support the heart in a fundamental way, but are also essential for our bodies to function properly at the cellular level. When internal biochemistry is balanced and well supported, the whole body is healthier and feels vibrant. The road to good health is paved with potassium and magnesium. Are you getting enough?
Read Nicole Crane, BS, NTP's Natural Remedies for Healthy Blood Pressure Part 2 for more information on healthy blood pressure!
iv Houston MC. The importance of potassium in managing hypertension. Curr Hypertens Rep. 2011;13(4):309-317
v Cogswell ME, Zhang Z, Carriquiry AL, et al. Sodium and potassium intakes among US adults: NHANES 2003-2008. Am J Clin Nutr. 2012;96(3):647-657
vi Hajjar IM, Grim CE, George V, Kotchen TA. Impact of diet on blood pressure and age-related changes in blood pressure in the US population: analysis of NHANES III. Arch Intern Med. 2001;161(4):589-593
vii 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
ix Reffelmann T, Ittermann T, Dorr M, et al. Low serum magnesium concentrations predict cardiovascular and all-cause mortality. Atherosclerosis. 2011;219(1):280-284
x Joosten MM, Gansevoort RT, Mukamal KJ, et al. Urinary magnesium excretion and risk of hypertension: the prevention of renal and vascular end-stage disease study. Hypertension. 2013;61(6):1161-1167
xi Song Y, Sesso HD, Manson JE, Cook NR, Buring JE, Liu S. Dietary magnesium intake and risk of incident hypertension among middle-aged and older US women in a 10-year follow-up study. Am J Cardiol. 2006;98(12):1616-1621
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