Blood pressure, hypertension and calcium channel blockers
What is the best approach for high blood pressure?
Are you taking a blood pressure medication to treat hypertension? If so, do you know some of the implications are for the modern-day solutions to high blood pressure? What are the benefits versus the risks? We will look at calcium channel blockers specifically in this article. First, let’s talk about some of the basic considerations around blood pressure.
What is high blood pressure?
Your body has the ability to regulate the pressure within your circulatory system. When you begin to exercise or require more blood to carry oxygen and nutrition to the cells, your blood pressure may go up. For example, if you grab your running shoes right now and go run 3 miles, then while you are running your blood pressure must go up. This is a natural function that will meet all the needs to get oxygen and nutrition to your legs, arms and the brain during exercise.
When you stop exercising, the pressure will reduce. It is normal for blood pressure to go up at different times. It can also increase when you are under emotional stress because the body is anticipating some event where you might have to fight to protect yourself or you might choose run away from the threat. Having the ability to increase the blood flow through increased blood pressure is a normal and necessary function of the body. The human body has a built-in mechanism, knowing when to raise blood pressure to meet the needs at that time as well as when to lower it.
So, what exactly is the problem around blood pressure? When blood pressure remains high for an extended amount of time, this can become a risk factor. The risk is that a stroke or heart attack may occur as a result of these conditions. Blood pressure would not ever normally remain elevated. You would have the “threat” - a tiger chasing you - and then after you run away your blood pressure would decrease. Blood pressure that remains elevated is a product of stress levels but is much more directly related to damage that is taking place within the vessels. This damage is almost always related to lifestyle factors.
Because the Western diet is a diet that is typically relatively high in fat, for some as much as 25-40% fat consumed on a regular basis, this is directly related to the changes in the vessels. This is known as atherosclerosis. This process causes the vessels to narrow. When vessels narrow over time, it will cause more pressure to be placed on the walls of the vessels to get the same amount of blood flow through those vessels. If you narrow vessels and attempt to send the same amount of fluid through the vessels, the pressure in the system will increase. A good way to look at this is that if you have elevated blood pressure on a consistent basis, you want to consider that you probably have this kind of changes in your vessels and would want to consider the different ways this process could be halted and reversed.
One solution you could see immediately would be to change the diet and lower the fat consumed. If the diet is changed, the vessels can begin to heal. If this happens, blood pressure will naturally drop on its own as it is now able to get blood through the system without the resistance of the walls (of the build up of atherosclerosis). The endothelial lining, which produces nitric oxide, will begin to heal and be restored to proper function once the diet is changed. This has been well documented by the work of Dr. Caldwell Esselstyn in his book, Preventing and Reversing Heart Disease.
Why is high blood pressure recommended to be treated with medication?
If there is buildup in the walls (atherosclerosis), then over time it is possible that there will be a stroke or other cardiovascular event. We generally take the high blood pressure readings as a sign that a person is at a higher risk for one of these events. Lowering the blood pressure seems like a logical strategy to protect that person. However, the real issue is the high fat food intake causing the damage to the vessels. The blood pressure is only a symptom of this.
Today, most medical doctors do not receive more than 2 hours of formal training in human nutrition. Therefore, they do not understand the association between the effects of the high fat diet on the vessels or the urgent need for change when the high blood pressure readings are there. They have been taught that if the readings are high, then it is time to use a blood pressure medication to lower the number. However, this will not solve the underlying problem of the vessel damage. The patient will also find that they are now on a medication for life.
One of the most popular drugs used for this purpose is a type drug called a calcium channel blocker. Again, the doctor might be very successful in getting your blood pressure to come down through this “forced” method but it will not solve the underlying issue. The way to solve the underlying issue is to work on the health of the vessels. We will talk about calcium channel blockers in detail, but first let’s look at blood pressure monitoring.
The very best place to monitor blood pressure is with an automated blood pressure cuff that you can use at home. If your doctor has mentioned concern about your blood pressure, then get a high quality cuff and monitor it at home. This is when you are most relaxed and likely to get an accurate number. If you have in measured in the doctor’s office, you are more likely to be stressed out about the exam, the results, the traffic you raced against in coming over to the doctor’s office, etc. This nervousness at the doctor’s office even has a name: it is called White Coat Hypertension. It means that blood pressure numbers taken in the doctor’s office are very likely to be inaccurate because of the stress the patient is under and should not be relied on as a means of determing whether or not a medication should be prescribed. Take the readings at home, document them and share them with your physician to determine if action should be taken.
What about the optimal number for blood pressure? The number that the medical authorities establish the optimal blood pressure at appears to keep coming down to a lower systolic and diastolic number. Well, the more people you have as classified as hypertension, the more potential customers you have that need hypertensive medication. In 2017, the goal post was moved down to 130/80 mm Hg from 140/90mm Hg. The claim, of course, is that research revealed that lower blood pressure readings reduced the chance of heart attacks and heart failure. While it sounds very plausible and makes sense, the question is how do we get to that lower blood pressure? We have to solve the issue that caused this to happen in the first place.
Is lower blood pressure achieved through changing the health of the vessels or is it a forced outcome achieved with medication? If it is achieved with medication, the underlying root cause has not been resolved. And every medication should be weighed against potential side effects or results of toxicity from taking the drug day after day. What if there are side effects like changes in the brain or increased risk of cancer? Shouldn’t these be considered before taking on the medication that will always be part of your life?
Another thing to remember with high blood pressure medications - they override your own natural regulation of blood pressure. Could that artificial regulation be problematic? Consider this paper - “Low blood pressure and the risk of dementia in very old individuals” This was published in the Journal of Neurology in 2003 by J, Vergehese, et al.
The conclusion in this study was that blood pressure that is too low is associated with a higher risk of dementia in individuals over the age of 75. In plain language, if you force blood pressure to go too low in someone who may have some narrowing in the vessels (as many older people do), you then may have a scenario where they are not having sufficient perfusion of oxygen and nutrition to the brain which will result in a risk for dementia.
Let’s look a little more at one of the most commonly prescribed drugs for hypertension, which is the calcium channel blocker.
What do we know about calcium channel blockers?
The circulatory system of the heart is regulated by an influx of calcium to the system. These regulating aspect is the calcium channels. They specifically help the heart to contract more strongly. The arteries also will contract in order to get more blood flow to the system. When the calcium channels are working properly, you can elevate blood pressure as needed in order to bring blood flow to the brain or to the muscles as may be needed at the time.
The pharmaceutical companies have come up with an interesting solution and that is to block these channels as a way to lower blood pressure. This solution only solves the symptom and not the underlying issue. What happens when you really need increased flow to the body, which the body in all it’s wisdom regulates perfectly, but now it becomes blocked due to the drug?
Some calcium channel blockers also slow the heart rate of the heart. This can further lower blood pressure. The medicines also may be prescribed to relieve chest pain, called angina, and control an irregular heartbeat but once again has not resolved the underlying issue. The underlying issue is a progression of damage to vessels due to taking in too much fat on a regular basis. Adopting a low fat diet of predominantly starch-based foods can remedy this. This would be including foods like potatoes, rice, pasta, corn, peas, lentils as well as fruits and vegetables. Get your nutrition from whole, unprocessed foods that are known to not injure the endothelium. This is the inner lining of the blood vessel.
What are the effects of taking calcium channel blockers?
Calcium channel blockers may cause changes to the brain, shown on MRI, within just 5 years of taking the drug. Once a drug like this is prescribed, the patient is very rarely cycled off the drug. Within 5 years of taking the drug, changes can be seen on MRI imaging that show the brain shrinking away from the skull. There has also been shown a loss of decision-making abilities, reflexes, memory, emotional control and more. This was noted in the study, “The association of antihypertensive agents with MRI white matter findings and with modified mini-mental state exam in older adults” (J Amer Geriat Soc 45: 1423-1433) 1997
Do the drugs work? When a doctor recommends a drug for you, it is very good to question whether your ultimate outcome will be improved. Even if it does mechanically provide the means to lower the blood pressure, will it actually prevent the stroke or heart attack which was the concern for which the blood pressure needed to be reduced? These are good questions to ask.
It turns out that calcium channel blocking drugs provide less than .01 mm Hg of reduction in blood pressure compared to other classes of blood pressure drugs. We now know through the work of Dr. John McDougall that when people are taken off the high fat foods for even a week, they get significant shifts in their blood pressure and much more than 0.1 mm Hg decrease and without the side effects. They may reduce their blood pressure as much as 10-20mg Hg diastolic in the first 10 days and are often assisted in cycling off their medications by medical professionals after that time. This is accomplished by consuming a diet that is primarily starches, including potatoes, rice, sweet potatoes, lentils, peas as well as fruits and vegetables.
Calcium channel blockers may also change the functioning of the calcium channel over time. The drug causes the pores in the cell membrane to stop admitting calcium into the channel (this is the method to lower the blood pressure). It is possible over time that this affects the overall health and function of the cell membrane. It has even been suggested that over time the membrane gates in the channels are destroyed. What would be the result of affecting the cell membrane? This could perhaps increase your risk of cancer over the long-term, since the integrity of the cell membrane is crucial to good cellular and overall health.
Maybe most unbelievably is the finding that using calcium channel blockers may actually increase your risk of having a heart attack. This was written about in this paper published in the Journal of the American Medical Association in 1995 (“The risk of myocardial infarction associated with antihypertensive drug therapies”). In this study, using calcium channel blockers compared with using a beta blocker was associated with a 60% increased risk of myocardial infarction (a heart attack).
Drugs come with risks that must be weighed against their benefits. It is always best to consider the root cause of the problem and solve it that way, rather than with a medication when that is prudent and possible. There is no risk in working toward moving from a high-fat western diet to a low-fat starch-centered plan of whole, unprocessed foods. This includes delicious foods like potatoes, rice, pasta, sweet potatoes, corn, peas as well as a variety of fruits and vegetables. You can see more about this in my course, Potatoes, Rice, Pasta Plan, to understand why and how to make these changes in your life.
Ariel Policano is a naturopathic doctor specializing in starch-centered food plans, education about how the body works, as well as a deeper look at commonly prescribed medications and medical interventions & more. She also educates about new and exciting technologies in the field of frequency therapies. See more about her work at arielpolicano.com and geniusbiofeedback.com