This week’s troubling announcement by the NHS drug watchdog that beta-blockers, once the most popular high blood pressure drugs, increase the risk of strokes, heart attacks and diabetes, has no doubt sent some people’s blood pressure rising. After all, if you’re given a drug to lower your blood pressure you don’t expect to increase your risk of a heart attack or stroke. Studies also show that those on beta blockers are also up to 30 per cent more likely to develop diabetes.

So, what's the solution? More expensive drugs – ACE inhibitors – along with  diuretics, neither of which are more effective than a nutritional approach. To understand why let me explain how your blood pressure works.

Understanding Blood Pressure
A normal blood pressure reading is around 120/76 mmHg (mmHg stands for “millimeters of mercury”). The higher “systolic” number on top measures the pressure when your heart is contracting to force blood out; the lower “diastolic” number on the bottom is more important, because it measures the pressure when your heart is at rest. If your blood pressure is above 140/90, you have hypertension and are at much greater risk for heart disease. Every 10-point increase in your diastolic pressure above 76 doubles your risk.

However, you shouldn’t rely on just one blood pressure measurement taken at your doctor’s office. According to a study published in the Journal of the American Medical Association, “21 percent of the patients diagnosed as having borderline hypertension in the clinic were found to have normal blood pressure on ambulatory monitoring.” Anything that makes you nervous—including having your blood pressure taken by a doctor—will temporarily push your blood pressure up. Insist that your blood pressure be measured a few times over a 24-hour period to get a much more accurate picture.

What Increases Blood Pressure?
Think of your heart as a pump and your arteries as pipes. Your arteries are surrounded by muscle cells that can either cause them to constrict (tense up) or relax. They may also become narrower due to deposits on the artery walls and inflammation. Tense arterial muscles or clogged-up arteries are the two main causes of high blood pressure.

So, what is it that makes arterial muscle cells tense? It has to do with the balance of minerals inside and outside the cells. There are two pairs of minerals that move between the cells’ interior and exterior walls—a sodium/potassium pairing, and a calcium/magnesium pairing. The more sodium and the less potassium inside your cells, the higher the tension—which raises your blood pressure. Similarly, the more calcium and the less magnesium inside your cells, the higher your blood pressure.

You can instantly control your blood pressure either by decreasing your sodium intake (eating less salt) and increasing potassium (eating more vegetables), or by boosting your magnesium intake (eating more seeds, nuts, and green vegetables) and cutting down on calcium (most of us get more than we need, with at least three times as much calcium as magnesium in our diets). Calcium channel-blocker drugs work by stopping calcium from getting into your cells. However, you can achieve a greater effect by eating the right kind of diet.

There’s one other vital factor in this pump/pipe system—the amount of liquid or blood in your body. If your blood level goes down, so does your blood pressure. The organ that controls the amount of blood in your system is your kidneys. By extracting water and other substances (including minerals) from your blood, your kidneys help to control your blood pressure. If you force your kidneys to work harder—which is what diuretics do—your blood pressure does come down. But you also lose valuable minerals such as magnesium and potassium.

You’d do better by drinking more water. Although it seems that drinking lots of water would raise your blood pressure, the reverse is true. Normally, your kidneys have no problem removing excess water. But when there’s a lack of water, your body does everything it can to reserve what it has for your cells. That means the sodium level inside your cells goes up, because sodium can hold water inside cells. Consequently, your blood pressure goes up. Also, your body shuts down tiny blood vessels to conserve more fluid. As a result, your blood volume goes up—further increasing blood pressure. That’s why it’s so important to drink lots of water every day. I recommend at least eight glasses.

So, getting enough water, potassium, and magnesium can lower your blood pressure. Getting too much sodium can raise it. You also need to have the right balance between calcium and magnesium. Most people get too much of the former and not enough of the latter, so I advise limiting dairy products (which are high in calcium and low in magnesium) and eating more seeds, nuts, and beans (which are high in both).

Blood Pressure Drugs
Of all the cardiovascular medications, more prescriptions are written for blood pressure drugs than any other kind—about 40 million prescriptions each year. There are many different blood pressure medications on the market, but they all tend to produce similar results—a drop of about 5.5 mmHg in diastolic blood pressure. While beta-blockers are now out of favour,  there has been a big debate in the last few years about whether the newer, more expensive ACE inhibitors are actually any better than the older, less expensive diuretics. A major research trial published in 2002 found no difference between the two types of drugs.1

Whatever their relative merits, all blood pressure drugs come with considerable risks—a fact that has been known by doctors for many years. For example, one of the first controlled trials on diuretic drugs was conducted more than 20 years ago. The Multiple Risk Factor Intervention Trial (nicknamed MRFIT) involved 12,800 men at high risk for heart attack from smoking, high cholesterol, and high blood pressure. The trial compared “usual care” at the time with the aggressive use of diuretics. Although the diuretics did lower blood pressure, there was no reduction in risk of death among those taking them. In addition, for patients with only borderline hypertension, diuretic use was linked to a higher risk of death.

Effective Natural Alternatives
If you are taking one or more blood pressure drugs, it’s highly likely that they can cause an unbalance in the various complex systems of your body—possibly putting you at risk for a number of other health problems in the future. A combination of the following steps is far more likely to control your blood pressure than the usual mix of drugs:

• Eat more mineral-rich foods for lowering blood pressure.
• Get more antioxidants, especially high amounts of vitamin C, to both reduce damage to your arteries and keep them more flexible.
• Take B vitamins to lower your homocysteine.
• Consume more omega-3 fish oils for both lowering overall cardiovascular risk and keeping the blood thin.

Get More Minerals
Instead of lowering blood pressure with a calcium channel blocker or a diuretic, the natural alternative is to drink enough water, eat more fruits and vegetables high in both potassium and magnesium, and eat more seeds high in magnesium. You should also avoid excess salt and sodium.

Magnesium ensures that the muscle cells in both your arteries and your heart don’t get too tense, thereby improving heart muscle function and blood pressure. In fact, magnesium has been shown to lower blood pressure by about 10 percent,2 (as well as reduce cholesterol and triglycerides,3), thus substantially lowering risk of death from cardiovascular disease.

Unfortunately, many people are deficient in magnesium (a topic I discussed in last month’s newsletter). The average daily intake in the US is around 200 mg, while an ideal amount is probably 500 mg—especially if you have high blood pressure. The richest food sources are dark green vegetables, nuts, and seeds, so be sure to include them in your diet each day. A good multinutrient should provide at least 150 mg.

Although increasing your potassium does lower blood pressure, it isn’t worth supplementing extra. The amount you’d get is just a fraction of what you’d manage to pack away by eating your greens (a serving will do it). And don’t forget to drink at least eight glasses of purified water a day, since a lack of water raises blood pressure by increasing the sodium level inside your cells.

Coenzyme Q10
Coenzyme Q10 (CoQ10) is an antioxidant that helps your heart and all muscle cells work more efficiently. It’s also excellent for lowering your blood pressure. Although your body can make CoQ10, levels of this enzyme begin to gradually decline after the age of 40. Production falls off precipitously in your 80s—a drop that comes just at the time congestive heart failure becomes more common.

CoQ10’s positive effects on heart health are documented in more than 100 clinical trials.4 For example, in a joint study by the University of Texas at Austin and the Center for Adult Diseases in Osaka, Japan, 52 patients with high blood pressure were treated either with CoQ10 or a placebo. There was an 11-percent decrease in blood pressure for those on CoQ10, compared to a 2-percent decrease for those on placebo. In another human trial, 60 mg of CoQ10 given twice a day for 12 weeks helped promote normal blood pressure levels by reducing systolic blood pressure. And yet another trial showed that supplementing 200 mg of CoQ10 a day helped promote normal blood pressure.

It’s hard to get enough CoQ10 from food alone, so supplements are the way to go. Based on all the research, I recommend 90 to 120 mg of CoQ10 per day if you have high blood pressure, or 30 to 60 mg per day if you want to prevent it.

Other Important Antioxidants
Vitamin C is another antioxidant that can lower high blood pressure and reduce the risk of heart attack. A number of studies have shown that the higher a person’s vitamin C status, the lower their blood pressure. In one double-blind study, researchers gave 1,000 mg of vitamin C or a placebo to participants. The group taking the vitamin C showed a significant reduction in systolic blood pressure, but not diastolic.5 In another trial, participants given 2,000 mg of vitamin C showed a 10-point drop in systolic blood pressure in only 30 days.6

Many other studies have demonstrated that 1,000 to 2,000 mg of vitamin C a day can lower blood pressure, as well as cholesterol levels. It’s also good for prevention. In a 2004 review of studies on antioxidant intake, researchers found that participants supplementing more than 700 mg of vitamin C a day cut their risk of developing cardiovascular disease by a quarter.7

Supplementing vitamin C and vitamin E together has been shown to cut the risk of death from a heart attack by 52 percent and the overall risk of death by 42 percent.8 If you have cardiovascular disease, I recommend supplementing 4,000 mg of vitamin C and 400 mg of vitamin E every day, in addition to a good antioxidant formula. For prevention, supplement half the levels of vitamin C and E.

Please note: If you are taking a blood-thinning drug, limit your daily intake of vitamin E to 300mg—or speak with your doctor about reducing the drug. When choosing a vitamin E supplement, it is better to select one that has mixed tocopherols, including d-alpha tocopherol, gamma tocopherol, and tocotrienols.

Homocysteine-Lowering B's
There’s no question that having a high homocysteine level is a significant and independent risk factor for cardiovascular disease. What’s still open for debate is how best to lower homocysteine, and then what level of risk reduction you can achieve by doing it.

Your body only makes high levels of homocysteine if you aren’t getting enough B vitamins, zinc, magnesium, or trimethylglycine (TMG). Of these nutrients, the most powerful for preventing homocysteine accumulation, which damages the arteries, are folic acid, vitamin B12, and vitamin B6 (in that order). High homocysteine also causes rapid depletion of magnesium from the smooth muscles that line the arteries, making them more likely to go into spasm. This can precipitate a heart attack or a stroke, so magnesium is important as well.

The current consensus is that lowering your homocysteine level by 25 percent should result in about a 10-percent drop in heart disease risk and about a 20-percent drop in stroke risk.9 The best results might be achieved by getting the right levels of all the homocysteine-lowering nutrients: vitamin B2, B6, B12, folic acid, zinc, magnesium, and TMG. These nutrients can usually be found together in a homocysteine-lowering supplement formula.

If you do have high blood pressure, I strongly recommend that you ask your doctor to check your homocysteine level. It is often high in such cases and, if so, it gives you a direct means of preventing a very important underlying cause of restricted arteries. Valda is a case in point.

At age 73, Valda had suffered from high blood pressure for more than 30 years. She also had a touch of arthritis. Her doctor had prescribed an ACE inhibitor and aspirin to take every day. These medications helped a bit, but her blood pressure was still high at 150/80. So, she decided to have a homocysteine test.

Valda’s homocysteine level was 42.9, putting her in a very high-risk category. She went on a homocysteine-lowering diet (eating more fish, greens, beans, and garlic, and less alcohol, sugar, and caffeine) and supplement program. After two months, she had her homocysteine re-tested and it had dropped by 88 percent to a healthy level of 5.1. In addition, her blood pressure had dropped and stabilized at 132/80. Today, she no longer needs medication, she has much less joint pain, and she feels healthier overall.

Last but Not Least: Omega-3s
Omega-3 fish oils are a must for anyone with cardiovascular risk. A 2004 review of 10 randomized, controlled trials showed that fish oils reduce triglycerides by an average of 29 percent, lower LDL (bad) cholesterol by 32 percent, increase HDL (good) cholesterol by 10 percent, and lower total cholesterol by 12 percent.10 They also offer anti-inflammatory benefits. Basically, they’re a lot more effective than statins and have a range of other beneficial effects.

Omega-3s also lower blood pressure. A daily intake of 1,500 mg of EPA plus DHA equates to a 3-percent drop in blood pressure. In this case it’s the EPA that seems most important.

The strongest evidence for the effectiveness of omega-3 fats lies in their ability to reduce the risk of a heart attack if you’ve already had one. Eating only one serving of oily fish a week cuts your likelihood of having another heart attack by a third. Research also shows that supplementing omega-3 fish oils cuts your risk of dying from cardiovascular disease by 21 percent.11

Fish oils contain both EPA and DHA. A serving of oily fish, such as a piece of wild salmon, can provide around 3,000 mg of omega-3 fats. Of this, perhaps a quarter (800 mg) is EPA. You should aim for a minimum of 400 mg EPA per day. That’s either two high-potency omega-3 fish oil capsules a day, or half a serving of an omega-3 rich fish such as sardines, herring, or mackerel. Having three servings of fish a week and an omega-3 fish oil supplement providing around 200 mg of EPA a day is a good place to start. If you already have high blood pressure, I recommend supplementing 400 mg of EPA a day, unless you are on blood thining medication, in which case stick to 20mg a day.

My Blood Pressure Plan—Here’s What Works
• Exercise every day, stop smoking, and lose weight if you need to.
• Avoid excess salt. Cut back on processed meats, cheeses, soups, tomato sauce, frozen meals, canned vegetables, and other foods high in sodium.
• Drink at least eight glasses of purified water every day.
• Get your B vitamins to lower homocysteine. First, have your doctor check your homocysteine level. If it’s high, take a homocysteine-lowering supplement formula or see my supplement recommendations in the June 2006 issue. In any case, make sure you are taking 50 mg of B6, 400 mcg of folic acid, and 250 mcg of B12, as well as eating plenty of greens and beans.
• To ensure your diet is rich in antioxidants, eat lots of fruits, vegetables, fish, and seeds. Also supplement 200 mg of vitamin E (400 mg if you have cardiovascular risk and are not on a statin, together with 30 to 60 mg of CoQ10 (90 to 120 mg if you have cardiovascular disease or are taking a statin) and 2,000 mg of vitamin C (4,000 mg if you have cardiovascular disease). Also be sure to take a good, all-round antioxidant formula.
• In addition to eating plenty of mineral-rich vegetables, leafy greens, nuts, and seeds (especially pumpkin seeds), supplement 150 mg of magnesium every day, or 300 mg if you have cardiovascular disease.
• For omega-3 fats, think fish. Have three servings a week of oily fish such as mackerel, wild or organic salmon, herring, or sardines. Also take a daily omega-3 fish oil supplement providing about 200 mg of EPA a day. Supplement 400 mg of EPA a day if you already have high blood pressure.