Dear Doctor: I am 31 and my blood pressure is 132/88. Is this something I need to worry about? If it is, is there a naturopathic way to treat high blood pressure?

- J.M.

Congratulations on being proactive about your health. This is the perfect time to make changes to prevent hypertension in your future. Your blood pressure is above the normal range, putting you in the 'pre-hypertension' category. Pre-hypertension has a high likelihood of becoming Stage I hypertension, and with that you will have increased risk of developing heart disease and dying of a heart attack, heart failure, a stroke or kidney disease. The good news is that you are young and have the chance to prevent increases in your blood pressure and all the associated problems.

Blood pressure is made of two numbers; systolic and diastolic. Systolic is the measure of the pressure in your arteries when your heart contracts measured in millimeters of mercury (mm Hg). Diastolic is the measure of the pressure in your arteries when your heart is filling. Systolic is read first and it is the most important in predicting your risk of cardiovascular complications. If the systolic pressure increases in isolation from the diastolic pressure, there is a 2 to 4 times increased future risk of an enlarged heart, a heart attack, a stroke and death from heart disease. Reducing the systolic blood pressure by at least 20 mm to a level below 160 mm Hg reduces these increased risks.

There are two hypes of hypertension; essential and secondary. Essential hypertension is more common and is associated with high salt intake, heritage/genetics, obesity, aging, metabolic syndrome and kidney failure/renal insufficiency. Secondary hypertension is much less common and is caused by renal artery stenosis, adrenal gland tumors and coarctation of the aorta.

A systolic blood pressure of 120 to 139 over 80 to 89 diastolic is considered pre-hypertensive. Treatment recommendations include making lifestyle modifications including losing excess weight, exercising, limiting alcohol, following a heart-healthy diet, dietary salt reduction and smoking cessation. Salt restriction is recommended because salt/sodium intake increases blood pressure by increasing fluid retention.

The DASH study (Dietary Approaches to Stop Hypertension) found that a diet high in fruits and vegetables with reduced saturated fat, total fat and cholesterol with moderately increased protein reduced systolic and diastolic blood pressure by 5.5/3.0 mm Hg compared to the average American diet; a diet rich in fruits and vegetables without regard to fat and cholesterol intake reduced blood pressure by about half as much. The DASH diet lowered blood pressure in all groups regardless of race, sex, age, body mass index, education, income, physical activity level, alcohol intake and hypertension status. It was particularly effective in blacks and those with hypertension. The DASH diet offers an additional nutritional approach to preventing and treating high blood pressure.

Naturopathic diet strategies include eating plenty of fruits, vegetables, whole grains, unsalted nuts and seeds, beans/legumes and fish/lean meats. It is also imperative that you avoid smoked and processed meats, refined sugar and flour, foods high in saturated fats and cholesterol, margarine and partially hydrogenated fats/oils, caffeine/coffee and alcohol.

In addition to making lifestyle changes, there are supplements that support cardiovascular health and work to lower blood pressure. Magnesium is a mineral that is required in the diet. It works to decrease smooth- and skeletal-muscle contraction.

Potassium is a mineral that is known to lower blood pressure. Food sources of potassium citrate include molasses, sweet yams, bananas, dates and figs, tomato juice, raisins, oranges and almonds.

I definitely want to encourage you to take steps now to prevent big problems later, J.M., and hopefully now you have some ideas about where to start. Making lifestyle changes that involve weight loss, exercise, limited alcohol, a heart-healthy diet, salt reduction, and smoking cessation can be difficult, but such changes are the most productive place to start.

Dr. Christina Amicone is a resident physician in naturopathic medicine at Yellowstone Naturopathic Clinic and St. Vincent's Cancer Care. She can be reached at 259-5096. Send future naturopathic health questions to ync@180com.net.

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