Philip J. Goscienski, M.D.
December 2005
Hypertension, the medical term for abnormally high blood pressure, is so common in modern America that many people accept it as part of the aging process. It is not. In primitive cultures even those individuals who live beyond the sixth or seventh decade of life have normal blood pressure.
Among Americans over the age of 55 years about one half have blood pressure above 140 (systolic) over 90 (diastolic) and about a third of them don't know it. Its reputation as a silent killer is well deserved. Fully half of its victims have no clue of its presence until they suffer their first stroke or heart attack.
High blood pressure is very rare in native Africans that still maintain the hunter-gatherer lifestyle. More than a third of African-American adults, on the other hand, are hypertensive.
Excessive salt intake is one cause of high blood pressure. The high incidence of hypertension among African Americans is partly related to their salt intake. It is far greater than that of their genetic cousins in Africa whose blood pressure tends to be normal. Native Africans, like their Stone Age counterparts did, take in about 600 milligrams of sodium per day. Americans and Europeans take in about 6 or 8 times as much. An intake of 1000 milligrams is considered 'low sodium' in the United States but it clearly is not, compared to what our bodies are designed for. No wonder that low-sodium diets don't work to lower blood pressure! They're not really low sodium.
A high intake of fruits and vegetables is associated with a low incidence of stroke, as long as that diet does not contain processed foods with their high salt content. Those who eat plenty of fruits and vegetables tend to have other good health habits, such as not smoking, exercising regularly and maintaining normal body weight, all of which lower the risk of high blood pressure.
The term prehypertension applies to persons whose systolic pressure is between 120 and 139, and whose diastolic pressure is between 80 and 89. New guidelines from the Joint National Committee on Prevention, Detection, Evaluation and Treatment of High Blood Pressure recommend that anyone whose blood pressure is more than 120 over 80 should take steps to lower it. That's because even small increases raise the risk of heart attack and stroke.
There's another problem that needs to be addressed immediately: childhood hypertension. It is directly related to the frank epidemic of obesity that has reached down to preschoolers. Hypertension is the single most important factor in heart disease and stroke, and even a modest increase in blood pressure produces measurable changes in brain function. Today's infants will reach middle age with disease and dementia that previous generations of physicians only saw among the elderly.
Anyone can take the simple steps that will usually bring blood pressure closer to the normal range:
1. Lose weight. Dropping only a few pounds will lower blood pressure significantly.
2. Eat more fruits and vegetables.
3. Reduce your salt intake. Never add salt to prepared food, and limit your intake of processed foods.
4. Exercise regularly. That means at least 4 times a week for 30 minutes or more.
Philip J. Goscienski, M.D. is the author of Health Secrets of the Stone Age, Better Life Publishers 2005. Contact him at drphil@stoneagedoc.com.