What if “normal” blood pressure is really high blood pressure?

The (Pfizer sponsored) Camelot Study conducted by Dr. Steve Nissen of the Cleveland Clinic has fueled the argument that blood pressure should be lower. In this study of nearly 2000 participants (all of whom had coronary heart disease), reducing blood pressures from the "normal" range of 129/78 down to 124/76 led to 31% (relative) reduction in heart attack, death, and hospitalization. It also resulted in less plaque atherosclerotic growth when patients' arteries were examined with intracoronary ultrasound (Nissen SE et al 2004). It's irresistible to wonder what would have happened had blood pressures been lowered to 100, and perhaps future clinical trials will answer this question for us.

Why is high blood pressure such a large problem?

Take a look down the aisles of your grocery store and you'll see why 47 million adults in the U.S., or 1 of every 4, have the combination of features dubbed the "metabolic syndrome."

Many media reports obsess about the increasingly sedentary lifestyle of Americans and blame the obesity and diabetes epidemic on too much TV and video games. But this clearly is only part of the problem. A big problem--in fact, I believe, the number one principal source of the problem--is modern diet. (You ever wonder why, if lack of physical activity is the cause for obesity, then why are construction workers, laborers, and baseball players--all lead physically active lives, no less active than their predecessors--all fatter than they used to be? It's diet.)

Ninety percent of products lining supermarket shelves are highly processed foods, rich in hydrogenated fats, sugar or sugar-equivalents, and depleted of fiber.

Combined with inactivity, sleep deprivation, and stress, and a constellation of phenomena results, including abdominal obesity, low HDL cholesterol, high triglycerides, increased blood sugar, and high blood pressure, a collection of features known as the "metabolic syndrome."

High blood pressure and metabolic syndrome commonly go hand-in-hand. If you have hypertension, there's a 50:50 chance that you have at least some of the characteristics of the metabolic syndrome, particularly resistance to insulin that precedes development of full-blown diabetes. In fact, the association is so strong that hypertension should be regarded as a significant risk factor for future diabetes, with a 200-300% increased risk of diabetes.

If metabolic syndrome drives your blood pressure, it is also wonderfully responsive to change in food choices, along with increased physical activity and weight loss. There are also fun and unexpected ways to reduce blood pressure, while minimizing or eliminating the need for prescription medication.

(Not all blood pressure, however, is related to development of the metabolic syndrome, or represents a combination of causes, including genetic causes.

Genetic causes are more likely to require prescription medication.)