Thread: Blood Pressure Frustration

Two possibilities: genetic predisposition and lifestyle factors.

We need a dialog to get to the bottom of this problem. I will do this as an exercise in metabolic logic and also as a public service for all of the readership here.

Aim is to correct factors related to liver lipid dysfunction and glucose metabolism. These affect blood pressure response/control. Outcome is normalized blood pressure (below 120) and reduction in anxiety issues, hinted at by your 'white coat syndrome'. These are related conditions that result in autonomic system irregularities.

So lets begin. Need to determine if you have a family history of high blood pressure.

Can you please rattle off the general type health problems, you, siblings, parents, grandparents, aunts and uncles?

This will be a good thread............

Grandparents
Grandfather on Mother's side- Hardening of artiries died at 72
Grandmother on Mother's side- Died of heart attack at 87, no health problems up to that point.
Both had very bad diets. Remember my Granmother eating fried pork fat, very fatty foods.

Grandfather on Dad side- Died of heart problems at 78- diet not good.
Grandmother on Dad side- Died of cancer at 93- not sure of diet.

Mom- Died of cancer at age 79. Never had heart related problems.
Dad- Still alive at 85, Blood pressure has been issue. Has been on BP medication since his 50's Had triple by-pass at 79 but not related to heart attack. Still on BP medication to this date.

Older sister (60)- Blood pressure has been a bit off time to time but she has been able to control it through diet and exercise. Never been on medication except when overweight.

Older brother (49)- Has had slight elevations in BP but has been able to monitor it through diet. No medication needed yet.

Younger sister (42)- Has very bad migraines for at least 10 years now. Eats terrible, never exercises, is overweight, and has no blood pressure problems, in fact it is very low (that really pisses me off).

Also Dads sister had heart attack at 62 but was overweight and never exercised.

Moms brother still alive at 82, no significant health problems.

Forgot to mention my dad smoked from 17 to 77 when he quit. Smoked about 10 cigarettes a day. Aunt who had heart attack smoked also (up until time she had heart attack)

Neither I nor any of my siblings smoke.

Also my dads brother died at a young age (63) of massive heart attack but was overweight, heavy smoker, and ate terribly.

Okey dokey, sounds like you have history cardiovascular disease that runs in the family. Autocrine disorders in blood pressure regulation, that means HPA baro-sensors are over or under-fired. Thats a problem with noradrenaline. In your sisters case, hypotension is the issue. She has her problems with stress response, you should not envy her. You might ask her if she has been evaluated for POTS, posturalorthostatic hypotension syndrome.

Need to know about sleep patterns next.

Time you go to bed and rise in the morning.

Sleep quality, describe it briefly. Number of times you awaken, how easily you are disturbed, do you have to void frequently at night?

Do you use sleep medications?

Do you have early morning nightmares?

Do you snore? Do you know if you have sleep apnea?

Do you find yourself feeling tired in the early to mid afternoon hours? Do you need a nap to recover from these slumps? If so, do you nap frequently?

During the week I go to bed between 10:00 and 10:30 p.m. and wake at 5:45 a.m. then snooze til about 6:00 a.m.

On weekends usually the same but I usually do not get up until I wake up which is sometime between 6:00 a.m. and 7:00 a.m.

I would say I wake up about 2 to 3 times, mostly in the pre-dawn hours (like between 4:00 a.m. and 5:30 a.m.). Usually will go to the restroom then if I have to. Some nights I will wake up more frequently during those hours but I usually always feel rested when I get up. Do not take any sleep medications.

As far as nightmares, snoring, and sleep apnea I have none of those but I do have something else that is somewhat strange. About 2 or 3 times a week, anytime shortly after falling asleep up to about midnight or 12:30 a.m. I will scream out in my sleep and wake up. It does not appear to be related to any dream (at least one that I can remember). I have a panicky feeling for about 10 seconds and then I fall back asleep within a minute or 2. On rare occasions, I would say maybe 3 times a year I am unable to relax and have to get up, have a glass of milk and stay up about an hour and then I am tired again and go back to sleep.

As far as being sleepy during the day, it rarely happens and I never take naps.

Good, you have decent sleep hygiene. The sudden surge of anxiety post at midnight-2 am is an adrenaline surge associated with blood glucose issue.

Couple health history question.

Do you have acid reflux or acid indigestion more a couple times a month?

Do you have any other bothersome symptoms at present? Headaches? Lightheadedness? Do you get hungry during the day.

How is your energy throughout the day? Highest in the morning or evening?

When do you lift? Do you do cardio regularly? Tell me about it, when, how much.

Next we need to know about diet.

Give me a typical days eating patterns, how often, types of foods.

Food allergies? How about seasonal allergies? Frequent post nasal drip?

Ahh, also need to know about prior alcohol and drug use. PM me if you need privacy on this matter. I'm looking for agents that distrupt normal liver function.

Diabetes in the family, you didn't mention it, but it sure seems like it might have been there, type II late onset adult.

How about you, you had your liver lipids and fasting blood glucose tested? Insulin tested?

No acid reflux or acid indigestion issues.

I never get headaches, maybe a slight one once in a great while. The only time I ever get lightheaded is when at the computer too long but never any other time. Since I eat 6 times I rarely get hungry during the day.

Energy is high during the day and lower in the evening.

I lift 3 days a week (Tues/Thur/Sat) and I do cardio 3 days a week (Mon/Wed/Sat). I also use cardio as a warm-up and briefly post-weight lifting sometimes ( 5 to 10 minutes to help lose weight). Weights I do a split of Legs/Back/Biceps/Forearms and Chest/Shoulders/Tri's. Cardio I do the treadmill the most, for 30 minute periods (5 minute warm-up, 5 minute cool down, HIIT for 20 minutes). Also so Elliptical and Stationary Bicycle in the same manner (HIIT with 5 minutes warm-up/cool down) to mix it up. During the week I work out after work (about 4:30 or 5:00 p.m.) for about 50 minutes. On weekends I workout in the morning (about 7:00 a.m.).

Eating pretty much this is my typical pattern.

Meal 1 (6:30 a.m.)- Whey Protein shake with half a banana and blueberries or strawberries, Oatmeal or Cream of Wheat, A cup of coffee.

Meal 2 (9:30 a.m.)- Half a cup of cottage cheese/Half a cup low sodium tomato juice, Green vegetable (Broccoli, Spinach, Green Beans) and an apple.

Meal 3 (12 noon)- Some type of lean meat (fish, chicken, turkey, ground turkey), brown rice or yam, vegetable, piece of fruit (usually an orange)

Meal 4 (3:00 p.m.)- Half a cup cottage cheese, half a cup low sodium tomato juice, banana, if workout day half an oatmeal-whey protein bar

Meal 5 (6:00 p.m.)- Same as Meal 3 except no fruit.

Meal 6 (8:30 p.m.)- Glass of milk and half a banana

No food allergies but I do have seasonal allergies (hay fever) which is accomponied by post-nasal drip.

As far as alcohol and drugs, Up until I was 26 (about 19 to 26) I drank on weekends about once or twice a month. Mostly moderate but a few bad benders. Smoked marijuana probably about 20 times total during that period also. From age 26 on no more weed and hardly any alcohol (Maybe 10 times a year). For the past 4 year only a few drinks socially for the whole year.

The only family member I know that had diabetes was my Mom's father. Neither my Mom, Dad, nor any of my siblings have diabetes. No history of diabetes on my fathers side fo the family.

As far as the tests I know when I first had a problem with blood pressure in my late 30's (actually up until that time I had always been tod it was a little high for someone my age but nothing to worry about unless it got worse) they ran a whole bunch of tests which i am not sure what they were to make sure there was no other cause for it rather than it just being I think it is called "Essential Hypertension" and that Doctor determined there was no secondary cause. I am not sure if they ran any of the tests you mentioned but would assume they did if they were looking for a cause for it.

Very good answers; your doctors are correct. Upper number is more important, be glad your lower number isn't that low, its another type of cardiovascular response problem.

Last set of questions.

Do you hold or retain water in hot weather? What is your daily water intake? Have you ever had to use diuretics?

Are you heat tolerant or intolerant?

Are you deadline driven, highly time conscious? Do you have a long commute in heavy traffic each day?

Do you find yourself hustling to fit your day into 24 hours? Do you feel as though you have time for yourself and family during the week? Are weekends fully scheduled, or left for freeflow of activities?

Are you pushed hard at work, do you consider your job stressful?

Do you have breaks during your workday (other than your meals)?

Do you bruxate (grind your teeth unconsciously) or have nervous habits, tapping your feet, etc. Can you sit still quietly or do you prefer to be constantly on the go?

When you gained excess weight, did you gain it the waist line or was it more evenly distributed?

Do you take breaks from your training, say a week off once every couple of months?

Need a quick list of supplements and any meds you are on at present.

That should do 'ere. Once I have your final set of answers, I'll start providing feedback on what I think if your problem.

I drink almost a gallon of water a day. Have never been on diuretics. I do not think I retain water more during the heat, nothing noticable.

I am heat tolerant.

I would say I am somewhat deadline driven and time conscious. Always worried about not being on time. I do not have a long commute to work and there is no traffic involved 99% of the time.

Sometimes I feel like I have to hustle to get my day in during my busiest time at work (October - April). Things are really calm right now though. My weekends I usually leave free or for family activities, things I enjoy doing.

My job is somewhat stressful but I tend to roll with the flow. I do have breaks during the workday.

I like to sit quietly and am not one to want to be on the go all the time. Do not have any nervous habits like tapping or fidigting. I do not grind my teeth except sometimes when sleeping but that has decreased a lot the last few years and it rarely happens anymore.

When I gained weight it was pretty well evenly distributed, not concentrated in the belly.

I take a week off from all training every 3 months.

Quick list of supplements: Multi-Vitamin, Potassium, Garlic, CoQ10, Calcium/Magnesium, Fish Oil Tablets, Relora, and Protein Powder (Whey mainly, sometimes Casien).

I am on no medications.

Well I am going to hit the gym and going to visit friends tonight.

Let me know if you have more questions or specifics on anything I have answered to this point. I am resigned to get on meds if I have to because I do not want to play around with this but I sure wish I could get it under control with diet, supps, and exercise. From the looks of things not sure if that is possible.

Thanks for all your help and I will be checking for your feedback later.

I wish I could see your face when you read this.

Lifestyle factors are not a good indicator; typically, as in the case of a couple of our mods, there are nongenetic environmental patterns that clearly link cause and effect.

That was not the case with you. The family history suggests that this gene problem runs on the paternal side of the family, athough you may have gotten a dose through your mothers fathers side as well.

Here goes.

I believe you have a relatively common gene polymorphism in the D4 (dopamine 4) receptor in brain. This leaves your dopamine receptor function that controls both sodium excretion and hypertension.

This recent paper describes it quite nicely. You also have some of the personality traits.

In your sister, this disease takes a slightly different form, and in her, the sodium excretion is expressed, but with a different problem: low taurine, a function of lack of exercise and anxiety that alters lipid function (causes bile acid problems). You also lack taurine, but not like she does.

She has low sodium and low taurine that reflects a common profile for autocrine disorder, POTS. It can be solved quite nicely for her, with dietary changes to manage uncountered glutamate excess in pancreas, and exercise, use of magenisum, taurine and gaba to help restore balance to her glutamate dominated neurochemistry, a common feature of stress sensitive and stress hyperresponsive patients who have autocrine disorder.

If she does not do this, she may find herself with one of the more serious autocrine disorder diseases, MS, fibromyalgia or multiple chemical sensitivites.

She needs sam-e and TMG, as she is a severe undermethylator. She probably started out as an over methylator and lost it through taurine loss (poor diet) and stress reaction. This will help with her mild depression, weight gain and hyperinsulinemia (which runs in your family as a consequence of another problem, a polymorphism in the methionine synthase gene.

As for you, sir, you and many of your family members are prone to metabolic syndrome, so called syndrome X, for which dopamine 4 agonists are indicated. Unfortunately, many of these induce undesirable side effects. One hammer approach is the use of bromocriptine.

In you sir, we are going to use a little molecular magic.

I want you to use taurine, gaba and theanine, along with the magnesium you are already taking.

I think you want 150-200 mg doses, several times a day, I also want you to drop the coffee, consider reducing the potassium (you store it and this is further aggravating this condition) and add good quality green tea. Learn how to brew it correctly to extract the theanine. Shop around for Japanese and Korean varieties said to be quite high in theanine.

Your diet has kept you from mayhem. You need to control hypertriglycerides and insulin with a little dietary finetuning. Drop the casein, and remove some of the faster acting carbs. I can elaborate further if you wish.

You can buy theanine in bulk from Bulk Nutrition; Custom Nutrition Warehouse may also carry both GABA and theanine.

Have questions? Just ask.

Wow, thanks for helping me out.

I guess my thinking was that when my dad and siblings had BP problems there were outside factors contributing to it (my Dad smoking, my sister's weight problem).

I just figured if I lost some weight, got on a good weight and exercise program, and took some supplemements that aid in lowering BP I would have no problem. I guess all that potassium was hurting rather than helping.

I do have a few questions.

1. As far as the potassium, I will stop taking 1,000 mg in supplements and lay off the bananas but should I avoid all foods high in potassium?

2. Should the Green Tea be decaffienated?

3. Should I stop taking any of the other supps besides the potassium?

4. What are the faster acting carbs?

5. If I start this regimen how long before I should see results in my BP?

Also the link to the paper did not work for some reason. I would be interested in seeing that.

Thanks again and I will keep you posted on how everything is going.

>I guess my thinking was that when my dad and siblings had BP problems there were outside factors contributing to it (my Dad smoking, my sister's weight problem).

There are environmental influences: smoking increases the imbalance in glutamate and NMDA vs GABA and taurine balancing act in the CNS. It also alters blood lipid chemistry via insulin insensitivity. There is a correlation between the so called thrifty gene that regulates metabolism, homocysteine and methylation pathsways in liver, and addictions like smoking, drug and alcohol use (as self medication for low dopamine and its precusor, serotonin).


>I just figured if I lost some weight, got on a good weight and exercise program, and took some supplemements that aid in lowering BP I would have no problem.

You can try policosanol, but I am pretty sure that you will gain more benefit from continued cardio, careful diet and maintenance of muscle mass - see, thats they key. I've coined a technical term that is spreading in use, critical muscle mass - the mass per foot of linear height necessary to regulate glucose metabolism, and therefore, feedback to liver, the real control center for homeostasis in the body. This chemistry feeds back to brain, and strongly influences the key, the stress response - through the central on and off switch for expression of lifestyle directed gene expression - that is natural antioxidants (made in the liver) that counter oxidative stress damage.

So you have a combination of what we called ancestor inflected gene expression (thats the polymorphisms, the splice and dice alteration of the gene product, RNA template and the receptor it encodes in this case) and life style factors what we call environmental conditions, that also influence the degree and extent plus the complicating symptoms.

So whats this big difference between you and your sister? Well, its diet. Turns out that dietary lipids are actually very very big players in liver and brain gene regulation. Its how we adapt to our nutrient intake. Alongside it, stress and its learned response by the body.

You gave these clues in your excellent answers, that made it relatively simple to see what might be the cause of your blood pressure. Anxiety, mild but always there, very low key, that can flare up under certain conditions, thats the confounding factor. So your job and lifestyle, your diet and your ability to avoid addictions to food, smoking, alcohol - this is what will make your mature years different than that of your parents, siblings, and your relatives.

About that cancer: its the immune system being misdirected. Who does it? More and more, we see that these lipids in diet play a key role in the manipulation of muscle and energy stores...fat and stored glucose. Screw with muscle by lack of exercise and adequate protein (your sisters problem) and it increases the chance that dietary fats, the wrong type present and the right type absent, will reduce our naturally redundant cancer prevention mechanisms.

>I guess all that potassium was hurting rather than helping.

Sodium, potassium, chloride, and magnesium, plus hydrogen (protons) and calcium all work in synergy to balance out mass electrical charges, kinda work like circuits. Charge must be balanced. Your kidneys overexcrete magnesium and sodium, you retain potassium a bit. I would try relying on food for that supply and not feature it in a supplement. Your multi will have some anyway.

>Should the Green Tea be decaffienated?

Depends on how sensitive you are to caffeine. Generally, the theanine in green tea offsets the caffeine. Try both, see if you have a difference in reaction, could make a difference if you end up drinking a lot of tea (its a nice beverage).

>Should I stop taking any of the other supps besides the potassium?

You should go [url=http://www.ironaddicts.com/forums/showthread.php?t=8567]read about under and over methylation. You are an undermethylator. You should be assessed for homocysteine levels, then dose with sam-e and TMG (betaine anhydrous) accordingly. YOu should take the bioactive form of B6 (P5P), taurine, methionine, SAMe, calcium, magnesium citrate, omega-3 essential oils (DHA & EPA), inositol and glucuronolactone, and vitamins A, C, and E. Your diet should feature cruciferous and other vegetables, including the brightly colored ones and berries and apples over other fruits.

4. What are the faster acting carbs?

You need to feature a little more fiber in your diet, and these will provide you with glucans, soluble carbs in grains and also vegetables that help build a healthy intestinal microbial community and they inturn use this glucan to make immune control factors that are important for us. Exnay on the casein, cottage cheese and fruits, keep to just 2 or maybe three servings of the latter, increase the number and variety of fresh vegetables and also whole protein sources. Use rice, barley or oat bran in your shakes to help reduce the hit of glutamine (that can worsen your insulin response, make sure your whey isn't glutamine reinforced).

>If I start this regimen how long before I should see results in my BP?

With tigher control on insulin, restoration of methylation and sulfonation cycles, and theanine to help ease the dopamine and serotonin shortage, couple months, maybe sooner. You go read my posts at IronAddict. You need to work on stress response reconditioning and reprogramming brain waves. That casein and banana combo is causing your anxiety flair up, but only when you have excess stress or missed meals that cause blood sugar swings during the day. Its an echo effect, delayed by hours and not noticible until your body is shut down and your brain trying to figure out what in same hell is causing fight or flight response.

> link to the paper did not work for some reason. I would be interested in seeing that.

http://www-personal.umich.edu/~nesse/Articles/Sen-Nesse-DRD4&BP-AJH-2005.pdf

Is the right link. God knows why it doesn't come up. I used:
http://www-personal.umich.edu/~nesse/Articles
to get to the subdirectory, and yup, the paper is there, under sen-ness..blah blah...click on it and the pdf file will open up.

You do realize that you may have a close relative of this polymorphism, but its fits you and provides us with a little insight into your condition. IF you read the thread link I posted on methylation chem, look for the symptoms, you fit them and it explains why dopamine and serotonin activity are low (you make em, but they don't bind so well). By supplying GABA, as offset glutamate and NMDA imbalances, but we also enhance dopamine and serotonin binding, and we add theanine to increase dopamine and serotonin as well.

Kinda interesting, this chemistry. You see, melatonin is made from serotonin. You must make it, and there fore you do not have a shortage per se, just not good action. I can't reengineer those genes, but its possible to help promote a change up in the gene copying activation (we call these gene expression regulatory proteins). I think you got a shut down from a lack of adequate antioxidant action in the face of your stress response. Its a creeping progress that takes years, decades to manifest, this imbalance.

This all make sense? PM me if you have more questions.

>Thanks again and I will keep you posted on how everything is going.

Do that please. Need you to copy this and give it your sister. Its important she understand her hardwiring problem and make changes to lifestyle before her condition worsens. If she doesn't want to hear it, at least you tried, eh?

You are most welcome. I hope others who have this problem find my explanation and recommendations useful as well.

Just to update eveyone I have started the supps Trouble recommended this past week but just by using the dietary recommendations and the techniques suggested by Trouble I am getting improved readings as follows:

7/8/06 139/79 Pulse 57
7/9/06 138/76 Pulse 58
7/15/06 135/79 Pulse 66
7/16/06 136/71 Pulse 63

The top numbers have come down from the 140 to 150 range and even the lower numbers which had been 80 to 85 are now below 80.

I want to thank Trouble for all the help and want to keep posting what is going on so it might help others who have had this problem. Needless to say I am a lot less frustrated today then I was a week and a couple weeks ago.

Here is another update:

7/15/06 136/74 Pulse 57
7/16/06 139/78 Pulse 67
7/23/06 129/71 Pulse 58
7/24/06 128/72 Pulse 61
7/30/06 126/76 Pulse 49
7/31/06 119/75 Pulse 51

I am very happy with these numbers and again want to thank Trouble again for the suggestions. I am really jazzed today to get that systolic number under 120 and in the normal range.

Really nice results! If you plot the results (systolic pressure and heart rate on opposing Y-axes and date on the x-axis, you see a nice trend. It predicts that systolic will continue to response and should drop as low as 115 in the next several weeks. Pulse should steady out in the low 50s - a very acceptable target.

I'm so pleased you've responded this quickly. Thanks for the posted updates, CJ!

wow thats fantastic ,,if i have any health problems ill be asking for trouble

u make my dr look like a dumb ass trouble good stuff

Just a quick update I have pretty much normal blood pressure now. Taking 12 readings over the last several weeks my average is 120/74. The lowest systolic has been 115 and highest 130. Lowest diastolic 70 and highest 80.

Wunderbar, cjmack! Nice it worked out, close to the trend forecast on 7/31.

You're normal again.. How very, very cool!

I know I have thanked you many times but it is hard for me to express how very grateful I am for your help so I will thank you again.

With your knowledge I was able to make the minor changes to my diet and supplements you suggested with huge results. Thank goodness for someone like you who knows how all these things interact in your body.

Pat yourself on the back for a job well done. You took my recommendations and implemented them carefully and consistantly. You implicitly believed my explanation. Not all here do. This approach, and the ready provision of cause and effect behind the proposed solutions...it is a little unusual. My posts are not soundbites. They often require repeat reading. For some, its not worth the bother.

Your example will, hopefully, catch the eye of your sibling, who may listen a little more carefully to your words of advice on diet and exercise. I wish you both well.

Thank-you, for returning to this thread for periodic reports. Others will have this same problem. They now have the roadmap to its solution.

Your fervent thanks and positive outcome, they please me very much. It is enough to keep me motivated.