Wonderfully Made

The Cause Of Hypertension

Three Angels Broadcasting Network

Program transcript

Participants: N. David Emerson

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Series Code: WM

Program Code: WM000429


00:01 The following program presents principles designed to
00:03 promote good health and is not intended to take
00:05 the place of personalized professional care.
00:08 The opinions and ideas expressed are those of the
00:11 speaker. Viewers are encouraged to draw their
00:13 own conclusions about the information presented.
00:35 Hello, I'm Dr. Emerson. I'm Medical Director
00:38 at Eden Valley Lifestyle Center. And I wanted to
00:40 talk to you today about hypertension.
00:43 This is actually part of the insulin resistance syndrome.
00:45 It's part of a package that we've been exploring
00:48 in the series. Like to talk to you about a patient
00:53 we had Guam. He was the president of the
00:59 University of Guam and I was called to the emergency room
01:03 to see him. He was a VIP and so I was little bit apprehensive
01:08 about going up. But on the way up I reviewed his case
01:11 as I was driving up to the hospital. We've seen him
01:14 a couple of weeks earlier in the urgent care in a clinic
01:17 and at that his blood pressure was 220 over 120.
01:23 I said to him you know, really with this blood pressure
01:27 this high we usually like to admit you to hospital and try
01:29 to get it down with medications.
01:31 And he said oh no, no don't do that.
01:33 Anything, can't you do anything to keep it down here
01:35 in the clinic. Oh, we gave him a couple of medications.
01:37 His blood pressure did come down. He did respond.
01:40 We gave him prescriptions and some medications and
01:43 told him to follow up with us, because we would need
01:46 to adjust his medications. Well, he then asked,
01:51 do I have to take this the rest of my life?
01:54 I said well that depends. Now if you don't make any
01:57 changes probably so that would be advised.
02:02 On the other hand, if you make some changes you maybe able
02:07 to get off your medications. Well, one of his situations
02:11 at that time he was overweight,
02:13 had a stressful job, he had a high flesh food intake,
02:17 he smoked, he drank caffeine, he drank alcohol
02:21 and he got no exercise. And I said if you would want
02:26 to get off your medicines, if you make some changes,
02:28 you've a very good chance of getting off the medications.
02:33 First thing to do would be to stop the flesh foods
02:37 and get rid of the animal products.
02:39 Go to a plant based product. This will lower you
02:41 insulin resistance and start dropping your blood pressure.
02:49 I told him to start walking. Walking program will be
02:52 very helpful. Avoid the caffeine. Stop the alcohol.
02:58 And if you do these things, you'll find that your mind
03:04 will start clear and you might have a better experience
03:07 at work which would decrease your stress level at work.
03:13 Well when I got up to the hospital, I got to hear the rest
03:19 of the story. He had again done something
03:23 little bit unusual. He had actually done everything
03:26 I asked him to do. He is very type-A personality,
03:29 very motivated. So he actually took a week off the work
03:32 to make all of these changes. He'd gone on complete
03:36 vegan diet. He had stopped smoking. He stopped
03:38 the alcohol. He stopped the caffeine. He started walking.
03:44 And something he noticed was that when he returned to
03:49 work about a week later, his mind was clear and
03:53 he was actually on top of his job, instead of trying
03:57 to catch up. Putting out fires, now he was actually
04:01 planning how to avoid fires in the future.
04:04 His stress level was markedly decreased and he is
04:07 feeling a lot better. Well we had told him to call us
04:13 if he made any of these changes and he started feeling
04:16 lightheaded. Well he told his wife at one point,
04:20 he says you know, I was getting out a chair
04:23 I felt lightheaded. She says well I'll your doctor.
04:25 You know, I said to call me if he started feeling
04:28 lightheaded. And he said well I'm going to seem him
04:30 a couple days all. I'll give him a call then.
04:32 Next day he was getting out of car,
04:35 opening the trunk and he has told his wife,
04:37 he said yeah you know I feel a little lightheaded
04:39 again today. She says well, give your doctor a call.
04:42 I said give me a call if you feel lightheaded.
04:45 And he said well. I'm going to see him tomorrow.
04:47 I'll talk to him about it tomorrow. Well that evening,
04:51 a very special occasion at the University of Guam,
04:55 because he was a president there.
04:57 It was graduation night and all the faculty was there
05:01 and all the students were there and all the press
05:03 were there. And he was handing out diplomas and
05:07 he passed out. Well, when I examined him there
05:13 I told him you know. I've some good news and some
05:16 bad news. So the good news is, as that you've made
05:19 all these changes your blood pressure has come down
05:22 to normal and you don't need your blood pressure
05:25 medications anymore. The bad news is,
05:29 is that you're still taking your blood pressure medications
05:32 when your blood pressure was now being controlled
05:35 with your lifestyle and your blood pressure dropped
05:38 too low and you passed out.
05:40 And I'm sorry you had to pass out in front of all
05:42 those people, and that's the bad news.
05:44 But the good news was as long he stayed on that
05:48 program his blood pressure stayed normal and
05:51 he didn't need medications. If he strayed from programs
05:54 right to getting back on American lifestyle
05:56 which Guam had adopted since World War II,
05:59 blood pressure started increasing and
06:02 we needed to get him back on his medications.
06:07 So, how big a problem is hypertension in America?
06:17 Well, it's actually one of the second leading cause
06:25 for office visits in United States,
06:27 accounting for about nine percent of all office visits.
06:32 And it's also one of the most common class of drugs
06:38 that are prescribed for hypertension medications.
06:42 We find that in America blood pressure as people get
06:47 older increases and the prevalence and incidence
06:52 increases as we get older. Especially with men actually
06:56 over age 65 blood pressure is over160 over 85
06:59 or common in fact more than half of men over age 65
07:03 have blood pressures in that range.
07:07 Women also have blood pressures increasing as time
07:11 goes on as they get older. American blacks tend to get
07:17 high blood pressure sooner and more frequently
07:21 than the whites or even Hispanics.
07:24 Is this because they are more sick?
07:26 Actually as we're gonna find out later on
07:30 high blood pressure is a response to a disease
07:34 circulatory system. A system that is being blocked,
07:39 blocked up and clogged up and narrowed.
07:41 And hypertension is a response to this.
07:44 Blocks being generally more muscular, more strong,
07:49 react more violently to this diseases vascular problem
07:54 with a higher blood pressure. Unfortunately it causes
07:59 complications, which we're gonna talk about as well.
08:06 Now we used to think high blood pressure was a part
08:11 of aging. We used to have a formula of what a normal
08:14 blood pressure was and it included your age in that
08:18 formula. It determined what a normal or expected
08:20 blood pressure was or would be for you.
08:23 However in later years we found that in countries that
08:29 are on vegan type diet or plant based diet,
08:32 the Third World countries blood pressure does not
08:34 increase with age. So, what we find in American
08:38 is that blood pressure doesn't necessarily increase with age,
08:41 it increases with the length of time you're on the
08:43 American diet. That's the problem with blood pressure.
08:49 We find that in China. There are three aboriginal groups
08:52 in China that basically subsist on cereals and vegetables
08:57 blood pressure stays the same throughout the lifetime.
09:01 In Kenya nomads consisting mainly of milk,
09:04 the blood pressure stays the same throughout their
09:07 lifetime as well. In urban Africa, we find
09:13 that blood pressures are high and rise again significantly
09:17 with age. But in the tribal African areas,
09:22 blood pressure stays the same, no matter how old
09:26 they get. It stays constant. In fact urban Africa weight
09:33 is also a problem, but in the tribal communities its not.
09:37 Now we had a problem at one point, a lady came to us
09:43 in Guam and she was complaining that her
09:47 blood pressure was high and that she should be getting
09:50 workmen's compensation for it. Because it was her job
09:53 that was stressing her out and causing her
09:55 blood pressure to be too high. I was kind of thinking
09:59 that if I give her workmen's compensation then half of Guam
10:03 would be needing workmen's compensation.
10:06 What we found in the literature actually was that
10:10 with people with Hypertension, stress does
10:13 cause the blood pressure to go higher,
10:16 but it's related to their vascular problem which
10:19 we gonna look at little bit later.
10:21 And that a normal person under stress blood pressure
10:23 will go up, but if they don't have Hypertension
10:26 blood pressure doesn't go up as high.
10:29 So I shared with her that your stress can cause
10:32 blood pressure to go up but if we get to the underline
10:34 problem of why you have Hypertension to begin with,
10:37 stress will not cause it to go as high.
10:40 I said you know in tribal Africa, they're under stress.
10:44 When they've tribal wars, they're afraid to go the
10:47 bathroom behind a tree because they're afraid
10:49 their enemy is gonna come up and kill them.
10:51 I said now that's stress and they don't have Hypertension.
10:55 And anyway I didn't give her workmen's compensation.
11:01 Now among vegetarians here in United States,
11:05 we find that blood pressure also does not rise with age,
11:09 stays very constant. However on the American diet,
11:13 blood pressure does rise. In Third World communities
11:18 where stroke and heart disease is fairly rare
11:22 and they eat plant based diets,
11:24 again their blood pressure stays fairly constant,
11:28 strokes, heart attacks are virtually unknown.
11:30 But in America blood pressure
11:32 rises from the teens to the 70's.
11:40 So, another question we would like to ask is, is
11:44 Hypertension genetic? Is this one of the problems
11:50 that we really can't address because we don't know
11:52 how to change genetics? Again we look at the African
11:56 cultures and the tribal Africans blood pressures today
12:01 are still in the normal healthy range but their ancestors
12:05 who came over to America centuries ago,
12:08 their blood pressures are very high.
12:10 Some are genetics different environment.
12:14 And we find today that when blacks move from their
12:16 tribal communities to urban areas in the cities,
12:21 blood pressures go up, obesity becomes a problem,
12:24 atherosclerosis becomes a problem and they develop
12:27 our problems that we've in the western culture.
12:33 Well, some may say you know, I feel okay,
12:37 why should I try to bring my blood pressure down?
12:42 Well Hypertension does increase your risk of morbidity
12:47 and mortality, Morbidity meaning sickness,
12:49 Mortality of course meaning death.
12:52 What they found is that if you have Hypertension
12:55 your chance of dying of anything is usually twice as great.
13:00 You've two times of chance of closure in left artery,
13:03 artery narrowing in climbing off.
13:06 You've three times of chance of dying of a heart attack.
13:09 Four times of chance of dying of heart failure,
13:12 where the heart can no longer pump effectively to do the
13:15 job that it needs to do. Seven times a risk of a stroke.
13:22 And these are all risks with Hypertension and are usually
13:26 a result of years of the effects of Hypertension on the body.
13:33 It's usually not considered an acute problem,
13:39 because friends since weightlifters
13:42 when they're pressing their weights their blood pressures
13:45 can get up to 300 to 400 systolic and they don't have
13:49 strokes or heart attacks because they got
13:51 healthy arteries. But you combine the Hypertension
13:54 with unhealthy arteries then you have problems.
14:01 Are there other risk factors for heart diseases,
14:04 heart attacks and strokes? Yes. Hypertension is just
14:08 one risk factor. And now risk factor is something that
14:11 increases your risk of a certain disease.
14:15 Other risk factors include being a male, male sex,
14:23 older age, race, smoking, high cholesterol levels,
14:30 and diabetes is a very strong risk factor, obesity,
14:34 stress, physical inactivity. These are all risk factors.
14:39 Some of them are major risk factors.
14:42 Last ones I mentioned are more minor risk factors,
14:44 like physical inactivity and stress.
14:49 How do these risk factors combine?
14:52 Well, if you just have for instance high blood pressure,
14:56 five, the ten year risk of heart attack,
15:00 be lessen about five percent. However if you had
15:04 other risk factors to Hypertension such as high
15:07 cholesterol or a low HDL, which is a good cholesterol
15:12 or diabetes, cigarette smoking, and then large heart,
15:18 as you add each risk factor to the previous ones your risk,
15:24 your ten year risk of heart attack increases dramatically,
15:27 so that if you have all of those risk factors,
15:29 your risk of heart attack or stroke in ten years
15:32 about 60 percent. So generally physicians will
15:38 work with you to try to decrease those risk factors,
15:42 decrease your chance of getting those complications.
15:48 Well blood pressure what is it, and how low is safe?
15:54 Well, blood pressure is the pressure in your arterial
15:59 walls that occurs after the heart contracts.
16:02 When the heart contracts it shoots blood out of left
16:06 ventricle into the aorta. The aorta, if its healthy will
16:09 actually stretch and expand and when the heart then
16:13 relaxes the aorta starts contracting and the aortic valve
16:19 prevents blood from going back into the heart and
16:21 helps keep the blood pressure up so it can profuse
16:24 to rest of the body. The aorta will continue to contract
16:28 until the heart relaxes and then expands and then gives
16:32 another squeeze and pushes out another ejection of blood.
16:36 The peek is called your systolic blood pressure.
16:39 The drop of the blood pressure between beats,
16:42 the low part is called the Diastolic Blood Pressure.
16:46 What's normal? Well high normal is considered 140 over 90,
16:51 but if you check the literature that is not optimal.
16:57 Optimal is less than 120 over 90.
17:01 And how do you get optimal blood pressures?
17:07 Well, there are lifestyle approaches which we're
17:13 going to talk about shortly, ways of getting your
17:17 blood pressure down. Typically medications are given
17:22 but again many cases these can be avoided or eliminated
17:26 if we approach it from a lifestyle point of view.
17:34 What's a difference between optimal and normal or
17:37 again high normal 140 over 90, optimal 120 over 80
17:43 or less? If a person has a diastolic of 90,
17:51 they have what would be called an average risk of
17:53 a stroke or heart attack. If they get that blood pressure
17:58 from 90 down to 80 with lifestyle approach,
18:02 their risk of heart attack and stroke is cut in half.
18:05 So going from normal to optimal can cut your risk of
18:09 heart attack or stroke in half. And there are countries
18:14 where this is normal, 120 over 90,
18:18 or even less is normal. As I was doing a medical,
18:27 some medical training in one of our little Adventist
18:32 clinics down in Mexico, took two weeks and went
18:35 down there, I was helping the little country a physician
18:38 down there and he had just delivered baby and I think
18:42 he is trying to find something from me.
18:43 He says why don't you go and check her blood pressure.
18:45 And I went and I checked her blood pressure.
18:47 I came out and I was shocked.
18:49 I said her blood pressure is 90 over 60.
18:51 She must be hemorrhaging. And he looked over me
18:54 and he smiles and says they are all 90 over 60
18:57 down here because they are all on plant based diet.
19:00 They couldn't afford meat products and that's why their
19:02 blood pressure ran. They've actually shown that the
19:05 lower you get your blood pressure if it's with lifestyle,
19:08 the less your risk of heart attacks and strokes.
19:13 High blood pressure can also cause problems such
19:16 as kidney failure. The higher your blood pressures overtime,
19:22 the higher your risk of kidney failure.
19:25 And this is a very real problem. We had a black
19:29 woman coming to the emergency room.
19:32 Young girl in her 20s blood pressure is very high.
19:36 We started her on a couple medications and we're trying
19:39 to get her, we got her blood down in the hospital.
19:42 And I share with her. I said you've got very high
19:43 blood pressure. We need you do workouts and
19:46 we need to get you started on some medications
19:47 and continue to follow you and make sure blood pressure
19:49 is controlled. Well I think we saw her one time in the
19:52 office afterwards and she stopped coming.
19:57 We then saw her about a year and half later.
20:00 She is in emergency room and now she had again
20:03 very high blood pressure but her kidneys were in failure.
20:07 We got her blood pressure down but we were unable
20:10 to get her kidney function, to be restored and she
20:14 went on dialysis, young girl. It's tragic, now on dialysis.
20:21 So blood pressure is something to take seriously
20:23 and to get it addressed if it is elevated.
20:30 In Guam, we had some wonderful toping nurses
20:37 there but I was always kind a worried about how
20:41 technical proficient they were coming from America
20:44 of course as I had them. And one of the problems
20:46 was they would get their blood pressure and whenever
20:49 I would take the blood pressure in the room,
20:51 blood pressure is always 10 points higher and I thought
20:54 can't these nurses take the blood pressures.
20:57 And then I read about the white Coat Syndrome.
21:01 White Coat Syndrome is very well documented that
21:03 when nurse takes a blood pressure for the first
21:06 four visits, blood pressure generally 10 to 13
21:09 points higher. When the physician takes it,
21:12 it runs anywhere as high as 22 points higher.
21:15 Now this effect will attenuate after about four minutes
21:18 of the visit. We've also found that the effect of the
21:25 White Coat Syndrome that will also usually go away
21:29 after the fifth visit once the patient gets familiar
21:32 with the physician and the nurse and
21:33 then no longer seems to be a problem.
21:39 Well the question then comes up what essentially
21:42 causes Hypertension or Essential Hypertension?
21:46 Essential Hypertension is a term used for the
21:49 blood pressure elevation we see in 95 percent
21:53 of patients. There is a five percent of the people
22:01 that have Hypertension that's caused by something else.
22:03 Either Hyperthyroidism or Renal Artery Stenosis or
22:09 an Endocrine Tumor or something of this nature can
22:11 cause Hypertension as well. But 95 percent of patients
22:15 is what they call Essential Hypertension and that is
22:18 what responds most readily to a vegan type diet.
22:25 So what causes Hypertension anyway?
22:27 Well we go back to the Insulin Resistance Syndrome
22:31 and we'll be talking a little bit more about this in our
22:34 next talk on Hypertension. But in general,
22:37 briefly the insulin, its job in is to get sugar from the
22:46 intestines into the cells to get burned.
22:49 So part of what insulin does is a key and it opens a
22:53 little door to the cell and opens a cell,
22:55 allows sugar to leave the blood go into the cell and
22:57 get burned and that brings your blood sugar down.
23:00 The other thing that insulin does is it dilates arterioles
23:04 to help the blood flow, get from the intestines to the
23:07 kidney or wherever else it needs to get to.
23:13 This is, has been demonstrated in many tests
23:19 and they've actually found the mechanism by which
23:21 insulin dilates arterioles. It's a same mechanism
23:25 by which nitroglycerin under the tongue dilates
23:28 arterioles. Insulin goes into the arterioles and there
23:33 are little endothelial cells lining arterial walls insulin
23:36 stimulate search those endothelial cells to release
23:40 Nitric Oxide Synthase which changes Arginine into
23:44 Nitric Oxide and that's similar to the Nitroglycerin
23:48 that you put under your tongue,
23:49 and that nitric oxide dilates the arterioles and gives
23:53 you laser dilation. They have done tests where
23:58 they have measured nitric oxide levels after infusions
24:02 of insulin and found the nitric oxide levels increase
24:05 in a dose-dependent way. This was true in both
24:11 venous vessels and also arterial vessels.
24:17 It was also shown to be true.
24:22 In patients with type 2 diabetes this relationship is
24:26 disturbed. And even in non diabetics patients said
24:30 are obese, have Hypertension this insulin resistance
24:34 prevents the insulin from dilating those arterioles.
24:42 So, insulin stimulates nitric oxide release and causes
24:48 laser dilation and this in turn helps blood flow.
24:56 What can block this effect? Insulin resistance can
25:00 block this effect. So that insulin no longer has that
25:03 laser dilatory effect that it had before.
25:07 And this can cause Hypertension.
25:11 We're going to look into this in more detail in our next talk
25:15 on Hypertension. But in brief the kidneys get blood
25:21 flow from the heart and in fact these little organs get
25:26 about 25 percent of your total blood flow out of
25:30 the heart. When there is no insulin system shows
25:34 arterioles are nice and open and there is a good blood
25:36 flow through the kidneys. When there is insulin
25:39 resistance on the other hand, the kidneys say you know
25:42 at a blood pressure 120 over 80, I'm not getting the
25:44 blood flow I need I'm going to turn the blood pressure
25:47 thermostat up. So hangs on the salt water,
25:50 blood pressures rise, the perfusion through the
25:55 kidney improves to some extent.
25:58 And the kidney says well this is a better.
26:00 I'm gonna leave this new blood pressure thermostat
26:02 let's say 160 over a 100. And it maintains this
26:07 as long as there is that, there is our construction
26:12 from the insulin resistance. We find that patients who go
26:18 on a plant based diet usually take a week or two the
26:22 arterioles open up and you get better perfusion and
26:26 the kidney says oh no the blood pressure of
26:28 160 over 100 I'm getting too much flow I can go
26:33 ahead and turn down the blood pressure thermostat.
26:37 Gets rid of the extra salt and water, many times
26:40 people with edema on the legs usually takes about a week
26:43 and their edema can go away. That's something
26:45 we see commonly in people that make these
26:47 lifestyle changes. And then the blood pressure drops
26:52 and many times we can get them off the medications.
26:57 This is something that can be done at home but again
27:01 its good to be working with your physician so that he
27:03 can adjust your medications if indeed your
27:07 blood pressure starts to respond to this and help
27:10 prevent you from passing out like our university
27:15 president did at the beginning of our talk.
27:18 Plant based foods tend to take anywhere from three,
27:23 seven, fourteen days before we see this response
27:27 but its good to get blood pressure cuff of your own.
27:30 Monitor your blood pressures and as you see changes
27:33 stay in touch with your physician and monitor
27:36 that blood pressure and make the adjustments as needed.
27:40 Next time we're going to be talking more about the
27:42 mechanisms by which a plant based diet helps alleviate
27:46 hypertension, and some of the studies done by a
27:50 famous physiologist Arthur Guyton to
27:53 demonstrate this. We're hoping you can
27:57 join us with, join us at that time and pray that you can,
28:03 if you have Hypertension you might
28:05 experience Gods healing. Thank you.


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Revised 2014-12-17