Hypertension and Hyperlipidaemia

Hypertension

About 25% of the world population is suffering from hypertension. It is also considered to be the leading cause of mortality to the mankind, a silent killer. It is one of the leading causes of heart disease, end stage kidney failure, stroke, blindness, dementia, sexual malfunction, peripheral artery disease.

Primary treatment of medication in conventional system is not always effective as it has many side effects. There are so many other ways to treat hypertension besides pharmaceutical agents. It is important to note here that by treatment of hypertension by pharmaceutical agents reduces the risk of many complications.

As B.P. fluctuates normally during different times of the day, the reading in doctor’s clinic may not be enough to diagnose the hypertension. So, it is important to monitor 24-hour ambulatory blood pressure.

Mostly to begin with hypertension is diagnosed as essential hypertension when there is no other proximate cause identifiable.

Insulin resistance and sleep apnea are the two most important causes of hypertension often overlooked. People with insulin resistance develop belly fat and this belly fat is responsible for many conditions like hypertension, cancer, heart disease, diabetes, dementia, depression etc.

Insulin resistance drives inflammation through out the body. Belly fat acts like an immune organ that drives inflammation through out the body resulting in oxidative stress which results in rusting, stiffness and hardening of arteries. Insulin resistance is driven by diet. Fasting insulin checking is very essential for identifying insulin resistance.

Sleep apnea is another thing which is often undiagnosed. Obstructive sleep apnea is not only related to obesity but also to upper respiratory anatomy so that it can happen in otherwise persons with normal weight. Sleep apnea means that one is not getting enough oxygen in to the body particularly to brain and blood vessels. This gives rise to increased cortisol levels causing oxidative stress resulting in high blood pressure.

Symptoms of sleep apnea related oxidative stress includes, falling sleep at work, falling sleep in front of TV and snoring.

People who are nutritionally deficient can suffer from hypertension. Magnesium deficiency has been linked to hypertension. Magnesium plays a big role in lowering blood pressure. Among other things omega 3 fats relax blood vessels.

Environmental toxins lead and mercury are potential sources of causing hypertension. Working on stress levels, reducing weight attending to deficiencies all help reduce blood pressure. Other important thing is imbalanced microbiome causing inflammatory condition in body leading to high blood pressure.

Green leafy vegetables are rich sources of potassium which is a great contributing factor in maintain blood pressure.

Everybody need not worry about the salt intake as a potential cause of hypertension except in those where there is genetic sensitivity to salt and are likely to have blood pressure due to this. It is the quantity of excess salt present in the processed foods that is harmful.

Hyperlipidaemia

It is considered that 40% people worldwide have elevated cholesterol, but this in no way suggest that all 40% need to be put on cholesterol lowering drugs. Cholesterol is one of the factors that influences the risk of having a heart disease, for some it may not be important at all as a contributor to heart disease. If plaque is building up in an artery around heart it can cause heart attack and if plaque is building around an artery in brain it can cause a stroke. Two third of people who have heart attack are either prediabetics or have undiagnosed diabetes.

50 % of people having heart attack have normal cholesterol levels. Traditional typical lipid panel tests provide information about HDL cholesterol, LDL cholesterol and total cholesterol.

But the important thing is the size of the cholesterol carrying particles in the blood, the smaller the size and more in number are considered dangerous in comparison to large cholesterol particles that are less in number.

So, we need to get particle size testing which is the real marker of risk of heart disease rather than mere cholesterol levels as indicated in routine lipid panel.

What makes cholesterol carrying particles small and large in number there is the genetic component to it and lifestyle component.

People with metabolic syndrome with insulin resistant getting weight around the belly generally have small dense cholesterol carrying particles which are more concerning. Diet has a great role to play in having small cholesterol carrying LDL particles in large numbers.

It is sugar which drives the high levels of LDL, low levels of HDL, and high triglyceride small particles.

We do get a clue from the lipid panel if the HDL is below 40 and triglyceride around 150, it is a sign of carbohydrate overload. Whereas particle size testing indicates if one has metabolic syndrome with insulin resistance.

Inflammation and oxidative stress are other important driving component of a heart disease. The most important reason of chronic inflammation is belly fat. Belly fat also known as visceral fat acts like immunologically active organ as it produces molecules known as adipose cytokine which led to oxidative stress. When LDL cholesterol gets oxidized excessive oxidized free radicals are produced. Diet lacking in polyphenols and phytonutrients further facilitates this oxidation producing oxidative stress. The oxidized LDL is more damaging and leads to plaque buildup that will lead to heart disease.

Oxidized LDL and eight hydro deoxy guanine lipid peroxide are the biomarker to measure the level of oxidative stress.

Poor diet, dysbiosis, inflammation heavy metal toxin and pollution can all lead to oxidative stress and hence heart disease. Microbiome of the gut as well as the microbiome of mouth are responsible for inflammatory properties.

Genetics, family history, type 2 diabetes, smoking are important risk factors apart from cholesterol for causing heart disease.

Body needs cholesterol to make hormones, cell membrane and brain cells. So, it is about having right type of cholesterol.

The ratio between good cholesterol HDL and bad cholesterol LDL is the best predictor of heart disease. Sugar and carbs disturb this ratio, because they lower the HDL, and they raise the triglyceride and increase the number of bad cholesterol particles. Since cholesterol deposits are found in the arteries of people with heart disease, studies have shown that no link between total fat, dietary cholesterol and heart disease. Studies have also shown that it is trans fats are clearly harmful and omega 3 fatty fats are beneficial. 2015 American dietary guidelines have lifted restrictions on dietary cholesterol. Trans fats and refined oils promotes abnormal cholesterol whereas omega 3 fats monounsaturated fats from nuts and seeds improve the good type and quantity of cholesterol.

Sugar in fructose syrup, sodas, juices, and processed foods cause cholesterol issues in most individuals. Fructose syrup are known to cause lipogenesis and liver which makes most dangerous small LDL which increase triglycerides and lower HDL.

First step is to get the right cholesterol check for particle size and particle number. Insulin levels to rule out metabolic disorder.

Plant based diet with healthy fat, rich in fiber, phytonutrients, and omega 3 fats, good and healthy protein such as beans, seeds and nuts, coconut oil, olive oil and fish. Good fats can improve the quality and type of cholesterol. Exercise and good quality sleep and use of supplements to support the healthy cholesterol.

So, cholesterol is not black and white enemy, you need to take care of lifestyle, your diet, right herbs and take the right action to combat the heart disease.