Last month I gave you the opportunity to submit the questions you’d like answered by hypertension expert Dr. Mark Houston. Many of you took advantage of the opportunity and asked a question - thank you You’ll be very pleased with the results of this interview and the answers Dr. Houston provided.
Lisa Nelson RD: It is typically recommended that cholesterol medications be taken prior to bed. Would you explain the reason why? Also, is there a best time of day to take blood pressure medication?
Dr. Houston: Statins work best at night to inhibit an enzyme in the liver when cholesterol production is the highest. Blood pressure medications are best taken at night to reduce the early morning increase in blood pressure which is highest between 3 AM and 10AM.
Lisa Nelson RD: If you discontinue a blood pressure medication how long does it stay in your system?
Dr. Houston: It depends on the duration of action of the medication. Some of the longer acting medications may last for 24 to 72 hours. However most are gone in 24 hours or less. Never stop any blood pressure medication abruptly especially beta blockers and clonidine, as withdrawal may occur with rapid increases in blood pressure, heart rate, headache, chest pain, palpitations and even heart attack or stroke.
Lisa Nelson RD: When someone has uncontrolled systolic blood pressure (diastolic tends to be within normal) what are steps they can take to promote control of systolic blood pressure?
Dr. Houston: Low salt, high magnesium intake, high potassium intake, fruits and vegetables, exercise, weight loss. The best medications for Systolic blood pressure are ACEI, ARB and CCB. Diuretics and beta blockers are less effective. High systolic usually means stiff arteries.
Lisa Nelson RD: Is there a connection between blood pressure and heart rate?
Dr. Houston: If blood pressure increases, normally the heart rate should decrease. However, in some patient with dysregulation of the autonomic nervous system the heart rate may increase with the blood pressure.
Lisa Nelson RD: Blood pressure fluctuation - What causes blood pressure to fluctuate drastically throughout the day? Is it something to worry about?
Dr. Houston: Most people have fluctuations during the day due to the normal circadian rhythm (high in AM and low in PM). Stress, anger, eating, exercise, rest, meditation, coffee are some of the things that will alter blood pressure. About 60 % of patients that drink coffee have increase blood pressure for several hours after consumption.
Lisa Nelson RD: What is the risk of not treating high blood pressure? For example, someone has a blood pressure of 160/100, but they feel perfectly fine. Why should they be concerned and seek treatment?
Dr. Houston: Heart attack, stroke, heart failure, kidney failure, loss of vision, aortic rupture, valve dysfunction, atherosclerosis. Hypertension is the silent killer. At this level the arteries will be damaged over time and all of these complications will occur. At that high level of blood pressure one will decrease life expectancy by about 15 years or more.
Lisa Nelson RD: Do blood pressure recommendations change with age?
Dr. Houston: A normal blood pressure is 120/80 regardless of age. If it goes up with age it means the arteries are not healthy, but very stiff.
Lisa Nelson RD: What is a normal blood pressure response post exercise? How quickly should heart rate return to normal post exercise?
Dr. Houston: Blood pressure will fall for several hours after exercise depending on hydration status and severity and length of exercise. Usually systolic (top number) blood pressure falls about 10-15 mm Hg and diastolic (bottom number) 5-10 mm Hg. Heart rate should return to normal within 2 minutes post exercise.
Lisa Nelson RD: If someone has been on blood pressure medication for many years and they take steps to lose weight and improve their diet is it likely they’ll be able to discontinue their medication or will they be on medications for life?
Dr. Houston: About a 60% of patients that follow the guidelines in the book that I wrote on What Your Doctor May Not Tell You About Hypertension can stop meds over 6-12 months if they do everything correct as outlined.
Lisa Nelson RD: If someone is newly diagnosed with high blood pressure, how much time should be allowed if the individual prefers to make diet and lifestyle changes to lower the blood pressure before turning to medication?
Dr. Houston: I recommend getting the blood pressure down soon with both meds and lifestyle changes to protect the arteries and reduce cardiovascular disease based on some recent studies. Later on, if blood pressure is controlled then you can taper the medications.
Lisa Nelson RD: Do any of the over-the-counter meds for high blood pressure and high cholesterol work - or are they just snake oil ads?
Dr. Houston: There are some good supplements that work for blood pressure and cholesterol, but most over the counter are not good. The best source is BIOTICS RESEARCH at 1-800-231-5777. For blood pressure use VASCULOSIRT. Also for blood pressure is CARDIOSIRT BP (this one will be out in the spring). These will reduce blood pressure well along with the lifestyle changes recommended in the book above. The best for cholesterols is LIPIDSIRT. It can be used with the new niacin and red yeast rice from BIOTICS if needed. This may decrease cholesterol with the combination by 40-50%.
Lisa Nelson RD: How effective do you feel the supplements l-arginine, coQ10, and omega 3 are at preventing cardiac problems?
Dr. Houston: I would use omega 3 fatty acids in almost everyone to reduce heart attack, stroke, blood pressure, improve triglycerides and improve memory. The best omega 3 fatty acid on the market is EFA-SIRT SUPREME from BIOTICS research at 1800-231-5777. The CoQ10 is excellent as well. Doses of about 100 to 200 mg of a good quality CoQ10 will lower systolic blood pressure about 15 mm Hg and diastolic blood pressure about 10 mm Hg in 50% of patients. The CoQ10 is in both the VASCULOSIRT AND THE CARDIOSIRT BP from BIOTICS at 1-800-231-5777.
Lisa Nelson RD: Does grape seed really help lower blood pressure?
Dr. Houston: Yes, systolic blood pressure is reduced about 8 mm Hg and diastolic blood pressure 5 mm Hg. It is in the formulas mentioned above.
Lisa Nelson RD: What causes of an enlarged heart and are there ways to reverse an enlarged heart?
Dr. Houston: Hypertension and coronary heart disease are the most common causes. You must control the blood pressure and improve circulation of the heart. Valve problems such as the aortic and mitral valves can also cause heart enlargement.
Lisa Nelson RD: Dr. Houston, I’d like to clarify this issue. Is it possible for an enlarge heart to be corrected/reversed? Or once enlarged always enlarged?
Dr. Houston: If the underlying reason for the enlargement is corrected it may be possible over time for the heart to be reduced in size. In some cases it may return to normal, but in most it will be decreased in size but not necessarily back to completely normal.
Lisa Nelson RD: What happens to blood pressure during a heart attack? Skyrocket? Plummet?
Dr. Houston: It usually falls as the heart is damaged and does not pump well. This is called cardiogenic shock.
Lisa Nelson RD: Can things like metal detectors impact the function of mechanical heart valves?
Dr. Houston: NO** Lisa Nelson RD:** What are your thoughts on the use of statin drugs in children?
Dr. Houston: I would not use them in children. We do not have enough data to support this recommendation in my opinion. They need lifestyle changes. The only exception would be one of the severe genetic forms where drugs may be the only option, but this is rare.
On behalf of myself and the users of The Health Central Network I want to send a heartfelt thank you to Dr. Houston for taking the time to answer our questions. To learn more about Dr. Mark Houston go to The Hypertension Institute.
Be sure to sign-up for the e-course 7 Natural Ways to Lower Blood Pressure today.
Lisa Nelson RD, a registered dietitian since 1999, provides clients step-by-step guidance to lower cholesterol and lower blood pressure, so they can live life and enjoy their family for years to come. Because her own health is the foundation of her expertise, you can trust that Lisa will make it truly possible for you to see dramatic changes in your health, without unrealistic fads or impossibly difficult techniques. She can be found on Twitter @lisanelsonrd and Facebook at hearthealthmadeeasy.