by Kavitha M. Chinnaiyan, MD
(Article originally published in The Llewellyn Journal.)
Last month, the American Heart Association, along with numerous other societies, released the updated guidelines for diagnosing and treating high blood pressure (hypertension). Examining the evidence from many studies, the guideline committee found that the harmful effects of hypertension begin at much lower levels than what we had previously thought.
Previously, only blood pressure values of greater than 140/90 mmHg were called hypertension. The new guidelines suggest that blood pressure values greater than 130/80 mmHg are too high, and that we diagnose them as such.
With this shift in how we define high blood pressure, nearly half of all adults in the US are going to be hypertensive, particularly among individuals under forty-five years of age. Three times as many men and twice as many women will now fall under the "hypertensive" category. By no means do the guidelines suggest that we start treating everyone with medications. In fact, lifestyle changes are strongly recommended as the first step in all individuals with hypertension.
For me, as an integrative cardiologist, the question is this—why are so many young people walking around with high blood pressure? To cue into this, we need to look at the various ways in which our blood pressure becomes a problem; only then can we start to put in place the various ways to address it.
What is Blood Pressure?
The heart pumps blood out into the big arteries, which carry it to the rest of the body. Blood flowing in the arteries of the body exerts a pressure on the artery walls. This is known as blood pressure, and it has two components—systolic and diastolic. Systolic blood pressure is the amount of pressure exerted on the arteries while the heart is actively pumping blood into them. Diastolic blood pressure is the amount of pressure on the artery walls in between heart beats.
Blood pressure varies throughout the day, based on exercise, eating, emotional reactions, stress, sleeping, and other factors. It is highest in the early morning and lowest at night, and is highly responsive to everything going on in our bodies, minds, and lives.
What Causes High Blood Pressure?
"Essential" or "idiopathic" hypertension is the most common form of the disease, accounting for 95% of all cases where we can't pinpoint to one factor as being the cause for it. This form of hypertension is usually the result of a whole host of factors, including age, race, gender, smoking, stress, excessive body weight, excessive alcohol intake, poor eating habits, and a lack of physical activity.
"Secondary" hypertension afflicts the remaining 5% of individuals, where high blood pressure is a direct result of some other problem. Thyroid or adrenal gland disorders, artery and kidney disorders, sleep disorders (particularly sleep apnea), and certain tumors that release blood pressure-altering chemicals are the most common ones.
Stress and Hypertension
When we are stressed, our bodies produce a host of hormones to cope with the physiological processes that are stimulated to deal with the situation. The adrenal glands produce adrenaline and cortisol, which increase heart rate and constrict blood vessels to increase blood flow to the muscles of the legs and arms and decrease it in the digestive system. Digestion slows down and senses become more heightened. These acute processes make up what we call the "fight or flight" response. When the stress stimulus subsides, the hormones dissipate and we return to normal.
The stress response is a very useful one, and is a brilliant adaptation of our bodies to deal with imminent threats. However, this response doesn't differentiate between a real threat and an imagined one. Whether we are facing a real physical threat (such as a potential car crash) or a mental one (like what we should say or should have said to the coworker we dislike), the stress response takes over.
While a normal stress response is one that peaks and comes down in a few hours, an abnormal one is sustained over days (and sometimes, for weeks). If we tend to simmer over things, it is likely that we have the latter kind of abnormal stress responses. If we are the kind that can't relax because we are constantly worried about how are perceived or how everyone around us must behave, stress becomes our chronic companion.
While research is still underway to determine the link between stress and hypertension, there is a strong suggestion that chronic stress damages our arteries, triggers an ongoing inflammatory response, and leads to heart disease and other chronic illnesses. As we might expect, constant stress interferes with healing, delaying recovery after a heart attack, procedures, or surgeries, and significantly impairs our quality of life quite.
If we look at our modern lives, it should come as no surprise that chronic stress is a huge factor for many. When we live in a world where the rat race is the norm, we come to accept the constant rushing, jarring interactions with others, lack of quiet time, eating on the go, and being on the edge as normal phenomena. This is especially true if everybody around us is living a hectic, stressful life. It is no wonder then that hypertension will be diagnosed more frequently in young individuals.
In fact, this revelation speaks volumes about what we have come to value. The new guidelines should come as a wake-up call for us as a society, because they point to the non-serving ways in which we live, sacrificing what is good in favor of instant gratification or the tremendous pressure to "get somewhere."
A wake-up call is one that gives us an opportunity to cultivate the intention to change these non-serving patterns and to cultivate new ones that foster our journey toward health and happiness. And what this takes is a deep and loving commitment to ourselves, where we become willing to do whatever it takes to regain our sense of wellbeing while opening to joy, sweetness, and harmonious relationships with others.
In my book, The Heart of Wellness, I describe the nuances of the mind-body relationship as we know it, not only from the standpoint of modern medicine but also from the deeply holistic perspectives of Ayurveda, Yoga, and Vedanta. What is our purpose as human beings treading this unique planet for the very limited time we have here? What is the cause of our suffering, whether or not it is related to disease? Can we find joy and inner bliss even when afflicted with incurable disease? These are some of the themes discussed in the book, along with a detailed Bliss Prescription to regain our understanding of our inherent blissful nature.
Whether it is hypertension or any other chronic illness caused by an imbalanced lifestyle, some of the fundamental remedies remain the same. And they have to do with a total reset of our lives, as outlined below.
- Maintain a regular schedule. By eating and sleeping at the same time every day, we bring our neuro-hormonal pathways into a state of balance. Working with our naturally occurring circadian rhythms ensures that our metabolism and regenerative functions are working optimally. Go to bed by 10 PM, wake up by 6 AM. Don't skip meals.
- Bring digestion to balance. One of the key elements of a holistic lifestyle is to bring the digestive system back into balance. Each of us has different digestive issues based on our unique body-mind properties and previously ingrained habits. One size doesn't fit all. Take the Blissful Gut Quiz on my website to receive a personalized plan to balance your digestion.
- Meditate. Meditation has a very powerful effect on our neuro-hormonal pathways and the stress response. Many studies have demonstrated the potent effect of meditation on lowering blood pressure, the inflammatory response, and the risk of chronic illness. It has also demonstrated a potent anti-aging effect by working on our genetic material. You can enroll in my free Bliss Meditation Course, with ongoing support to maintain the practice.
While there are other lifestyle changes that can further our journey into wellness and bliss, the above steps are the most important. Making these three changes forces us to slow down and prioritize our health and wellness, bringing mindfulness into our daily activities and clearing our perspective about ourselves and the world. Our emotional resilience begins to strengthen while our bodies become radiant and supple.
Now, more than ever, it is important for us to turn our lives around since the old patterns are clearly not working to promote health in our society. It is critically important that we change ourselves so that our children can model their behavior after ours to find different ways to deal with the stressors that will come their way.
Article originally published in The Llewellyn Journal. Copyright Llewellyn Worldwide, 2018. All rights reserved.