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Understanding Blood Pressure
Posted by Dr. Ben Kim on Feb 23, 2009
Updated on February 23, 2009
With a baby on the way, I thought that it would be prudent to apply for a life insurance policy. After doing some research, I decided to go with a term life insurance policy with a well known company in Canada. During the application process, I discovered that this particular company offers four different rates for their policies, called N1, N2, N3, and N4. Each person is assigned one of these rates based on the results of a nurse's visit, during which time questions are asked about medical history and current lifestyle, blood pressure and pulse rate are checked, and blood and urine samples are taken. I was told that the vast majority of people are put into the most expensive category, N4, while a small percentage of people in especially good health with low to no risk factors for disease are put into a less expensive category, with N1 being the least expensive.
For the life insurance policy that I chose, I was told that being put in the N4 category would cost me around $28.00 per month, while N1 would cost me about $21.00. You better believe that I was zoned into getting N1. Seven bucks a month, every month, for many years to come? We're talking about a lot of lettuce and beans here.
Even though I knew that there was little that I could do to improve my readings during the nurse's visit, I was pretty anxious about it. I knew that I would get good grades for my family medical history, personal history, and current food and lifestyle choices. I figured that the only area that could hurt me was blood pressure and pulse rate, since both can be affected by anxiety. And I was feeling a tad anxious about getting N1.
The nurse reached over to take my blood pressure the minute we sat down. I asked if she could ask her questions first to give me a chance to settle down, as I had just finished running around the clinic doing morning rounds. Not to worry, she said, as it was standard policy to take three readings, spaced out during the visit, and to take the best score. So she took her first reading.
Yikes. N2 was starting to look more realistic.
About five minutes of rest while she asked some questions was all that I needed to calm down and get my blood pressure back to its normal level of around 115/75, I thought.
Five minutes later, she reached over to do her second reading.
What? I couldn't believe it. I was folding under the pressure. Could I even get N3?
I just knew that my pressure was high in the moment because I was so anxious about getting N1. So while she spent the next five minutes asking more questions, I started taking deep breaths, knowing that this would help calm down my sympathetic nervous system and produce a relaxation response.
Although I had to continue answering all of her questions, I did my best to continue with slow, steady breaths, and to visualize my blood vessels relaxing. It was a chance to practice guided visualization and relaxation techniques that I teach to guests of our fasting clinic.
As the nurse set her clipboard down and reached in to wrap my arm with her cuff, things seem to move in slow motion. I almost felt like I was under water. Slow, deep breaths.
Amazing! I was relieved and quite happy with myself. It wasn't my usual 115/75, but it was enough to give me a shot at something between N1 and N3 and a few extra beans each month.
This experience inspired me to write about blood pressure. What is high blood pressure, exactly? Should you be worried if you have it? What are the root causes of high blood pressure and what can you do to consistently experience healthy blood pressure?
Your blood pressure is the amount of pressure that the inner walls of your blood vessels face as blood travels through them. This pressure is no different than the pressure that the inner walls of a garden hose faces as water travels through it.
The difference between the pressure in your blood vessels and the pressure in a hose is that the pressure in your blood vessels constantly goes up and down, while the pressure in a garden hose is constant.
The pressure in your blood vessels is at its highest point with each beat of your heart. This makes sense, doesn't it? When your heart is maximally contracted, it has just sent a substantial volume of blood through your blood vessels, so the pressure on those blood vessel walls in that moment is going to be as high as it can be. This pressure is called your systolic blood pressure, the top number when you get a reading like 120 over 80.
The pressure in your blood vessels is at its lowest point whenever your heart is fully relaxed. Your heart has to fully relax after each full contraction in order to fill up with more blood that it can pump out through your blood vessels. This low point of pressure is called your diastolic blood pressure, the bottom number of your reading.
Blood pressure is absolutely necessary for you to live. Just like pressure in your garden hose is needed to deliver water to your garden, pressure in your blood vessels is needed to deliver blood to your cells.
Conventional medicine has a dangerously simplistic view of blood pressure that looks something like this:
High blood pressure causes your heart to work harder and your blood vessel walls to take a beating. Both of these circumstances can increase your risk of suffering a heart attack, stroke, and kidney failure. Therefore, if you cannot fix your blood pressure on your own, you need to take medication to lower it to acceptable levels.
I completely agree with the idea that consistently having high blood pressure can increase your risk of suffering a heart attack, stroke, and kidney problems. What I don't agree with is the approach of lowering blood pressure without doing one's best to discover and address the root causes of high blood pressure for each person.
Please don't miss this point: in the vast majority of cases of high blood pressure, the pressure is high because it needs to be.
Let's think back to the example of your garden hose delivering water to your lawn. If, for some reason, there isn't enough pressure in your hose to deliver water to all parts of your lawn, you know that an easy solution is to partially cover the opening of your hose with your thumb. By decreasing the amount of space that is available for the water to travel through, you can effectively increase the pressure in your garden hose to a degree that allows the water to reach all areas of your lawn.
This is no different than what is happening in the vast majority of cases of high blood pressure. If, for some reason, there isn't enough pressure in your blood vessels to deliver blood to all of your cells, your body must find a way to increase this pressure, usually by having the heart work harder or by decreasing the size of your blood vessels.
For example, one of the most common causes of high blood pressure is arteriosclerosis, also known as hardening of the arteries. When poor food choices cause hardening of your arteries, your heart must work harder to deliver the same amount of blood to your cells, simply because hardened arteries don't provide as much space as healthy arteries to deliver blood. In this case, blood pressure is going to be higher than what is considered normal, but only because it has to be in order to get the right amount of blood to your cells.
In this example, I believe that it is wrong and dangerous to simply prescribe a pill that is aimed at lowering blood pressure. A diuretic (water pill) or beta blocker might be effective at decreasing the pressure in your blood vessels, but this will mean that your cells may struggle to receive an optimal amount of blood and the nutrients and oxygen that blood provides.
A better approach is to discover and address the root causes of arteriosclerosis. Is it that you have high blood sugar and insulin levels? Is it that you are eating damaged fats and oils? Sugar, refined carbohydrates, and damaged fats and oils are guaranteed to eventually cause arteriosclerosis if eaten on a regular basis.
The reality is that high blood pressure is usually caused by a combination of factors, with diet, exercise, weight, quality of sleep, and the way that you manage stress being the major ones.
Here is a summary of some key points to keep in mind regarding blood pressure:
Many people are misdiagnosed with high blood pressure because of temporary emotional stress. When you visit with your doctor, ask to have your blood pressure checked at least two times. Ideally, one reading should be taken after you've had enough time to feel as emotionally and physically comfortable as possible.
Don't go overboard with liquids prior to your reading. The average adult has around 5 liters of blood in her blood vessels at any given time. Drinking large amounts of water right before a reading can cause high blood pressure simply because there is more water than normal in your system.
Be sure not to have caffeine or to use over the counter drugs that contain caffeine or nasal decongestants before your visit.
Ask your doctor or nurse to use the appropriate size cuff for your arm. A cuff that is too large or too small for your arm can produce an inaccurate reading. If your arm is large or small compared to the average adult but your practitioner blows off this request, it's best that you get another reading from someone who will pay attention to this important detail.
A good practitioner will examine and consider your eyes, nails, skin tone, peripheral pulses, and other indicators of your health status along with your blood pressure reading to give you proper guidance and recommendations. Even with a blood pressure of 160/110 or higher, it may not be in your best interest to take medication if you don't show any other signs of cardiovascular or kidney disease.
Remember that your blood pressure is almost always exactly where it needs to be. If it's high, it's usually because for one reason or another, it needs to be. Since high blood pressure over the long haul does increase your risk for cardiovascular and kidney disease, it is in your best interest to align your food and lifestyle choices with a healthy blood pressure - somewhere around 120/80 for most people.
The most common causes of high blood pressure are: regular consumption of sugar, refined carbohydrates, unhealthy fats and oils, regular exposure to nicotine, caffeine, ineffective management of emotional stress, being overweight, and not getting enough restful sleep. Managing these factors is the best approach to achieving and maintaining healthy blood pressure.
If you are doing a relatively good job with managing the factors listed above but still have high blood pressure, it's important to work with a good practitioner who can help you rule out other causes of high blood pressure such as renal artery or kidney disease, a congenitally narrow aorta (coarctation of the aorta), a tumour in the inner portion of your adrenal glands (pheochromocytoma), a problem in the outer portion of your adrenal glands (primary aldosteronism and Cushing's disease), or specific nutritional deficiencies like calcium and magnesium deficiencies. For women, pregnancy and use of oral contraceptives can also be causes of high blood pressure.
For stress management via meditation, relaxation and visualization sessions: EarthRain
For higher quality sleep: Soft Ocean Dreamland
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