Read an Excerpt

Chapter 1  
Understanding the Problem  

The doctor of the future will give no medicine, but will interest his patients in the care of the human body, in diet, and in the cause and prevention of disease.  
—­Thomas Alva Edison

LOOSENING THE GRIP OF HIGH BLOOD PRESSURE  
Why do so many people in this country have high blood pressure? What triggers the squeeze on the arteries that puts you at grave risk for heart disease and stroke, the ­first-­ and ­third-­leading causes of death in the United States?  

We used to think that high blood pressure was an inevitable consequence of aging. But in recent decades, research has revealed a surprising truth: high blood pressure ­doesn’t have to be a ­by-­product of getting older. It is a ­lifestyle-­borne illnessthat is more related to our daily habits than to our biological clock. A toxic mix of calorie ­overload—­especially from processed foods high in salt, sugars, and damaging ­fats—­inactivity, and ­middle-­aged spread instigates the rising squeeze on the arteries,a relentless pressure cooker that eventually injures the fragile cells that line our inner arterial walls, causing irreparable and ­life-­threatening damage. The good news? All this means that high blood pressure can be prevented and treated.  

In the chapters that follow, you will discover how, when, and why your blood pressure began to rise. You will then learn about the exciting world of nonmedicinal approaches to lowering blood pressure and how you can take control of your blood pressurethe Blood Pressure Down way. These tools will allow you to conquer high blood pressure, reverse the course of your disease, and ultimately protect yourself against heart attacks and ­stroke—the most likely end product of years of uncontrolled high blood ­pressure—­formany decades to come.   

America’s Blood Pressure Burden  
If you have been diagnosed with high blood pressure, you are certainly not alone. The number of Americans who have high blood pressure has risen sharply in the past few decades. According to the most recent Centers for Disease Control and Prevention estimate,more than 76 million adult ­Americans—­about ­one-­third of the population—­suffer from this ­life-­threatening condition. Early high blood pressure, which is also known as prehypertension and describes a blood pressure measurement that is higher than normalbut not yet in the high blood pressure range, afflicts an additional ­one-­third of adult Americans. In fact, new survey data show that approximately 70 percent of adult Americans have an unhealthy blood pressure level (34 percent have ­full-­blown hypertensionand 36 percent have prehypertension).1 The incidence of high blood pressure rises with age, such that more than half of all Americans ­sixty-­five and older have the condition. This disease damages not only our nation’s health but also our wallets: high bloodpressure is estimated to cost the United States approximately $74 billion in health care services, medications, and missed days of work annually. Of all the cardiovascular diseases (high blood pressure, heart disease, heart failure, and stroke), hypertensionis the most expensive, with annual costs projected to increase to $200 billion by the year 2030.2  

What Is Hypertension?  
Hypertension is the medical term for high blood pressure. It is an extraordinarily common cardiovascular disease (CVD) in the United States. In fact, it is the most widespread chronic disease in Western society. Despite major medical advances in the understandingand treatment of high blood pressure over the past several decades, the disease remains the most common medical diagnosis in the United States and the condition that doctors write the most prescriptions for. It is also the number one cause of stroke and kidneydisease and a principal cause of heart disease and blindness. High blood pressure ranks among the most powerful risk factors for developing CVD and accounts for about 30 percent of all cardiovascular events (primarily heart attacks or stroke). No wonder yourdoctor is so concerned! Blood pressure is the vital sign that doctors monitor most often and treat most aggressively. And rightly ­so—­in simple terms, walking around with untreated high blood pressure makes you a ticking time bomb, liable to suffer a heartattack or stroke.  

You should also know that the odds are very good that you will die from some form of ­CVD—­our nation’s deadliest epidemic. In the United States, one person dies from CVD approximately every ­thirty-­nine seconds.3 Combine that overwhelming death tollwith the staggering direct cost to the global health care system of more than $500 billion annually and you will begin to grasp the magnitude of this huge public health concern.4  

High blood pressure is also known as the “silent killer” because it is a largely symptomless disease. This is what makes high blood pressure so insidious: you can’t see or feel it, yet if it is left untreated, it will kill you. It is no wonder that 8 percentof the adult U.S. population has undiagnosed high blood ­pressure—­they can’t feel that anything is wrong. Perhaps this is one reason that, of the over 76 million adult Americans already diagnosed with high blood pressure, a whopping 56 percent do not have it under control. If you are one of the people who believes that if there was ­really a problem you would feel it, think again. You are taking a chancewith your life. The fact is, the higher your numbers and the longer you have uncontrolled high blood pressure, the greater your risk of developing the devastating health consequences that often accompany high blood ­pressure—­all the more reason for you tofind out your numbers and start today to get your blood pressure down.  

Prolong Your Life, Preserve Your Health  
The good news is that high blood pressure is one of the few risk factors for cardiovascular disease that is recognized as reversible. Scientific studies have proven that getting your blood pressure under control will preserve your health.5 High blood pressureis a lifestyle disease. So modifying your lifestyle is your most powerful protection against diseases of the heart and blood vessels. Healthy lifestyle modifications (exercise, consuming certain foods, and reducing intake of other foods) have proven to be themost effective medicine both for preventing ­new-­onset high blood pressure and for reducing diagnosed high blood pressure quickly and safely.  

What Do the Blood Pressure Numbers Mean?  
Your blood pressure is one of the main vital signs, or measures of your physiology, that give your health care provider a picture of your general state of health. (Other vital signs typically include your heart rate, body temperature, and respiratory rate.)But what do the numbers mean? The heart is a muscle with the primary function of pumping blood. When the heart beats, it pumps blood around the large network of blood vessels in your body, and it must create pressure to propel the blood. The term blood pressure(also known as systemic blood pressure) typically refers to the pressure in the arteries, excluding those between the heart and lungs. (This is different from pulmonary blood pressure, which refers to the pressure in the specific arteries circulating bloodbetween the heart and the lungs.) Your blood pressure normally rises when the heart ­beats—­when blood is being propelled out from the heart into the aorta or main ­artery—­and falls when the heart relaxes.  

More specifically, the systemic pressure is actually the result of two forces. The first, the systolic pressure, is the force of the blood on the artery walls as it is ejected out of the heart. The second is the diastolic pressure, the pressure in yourarteries when the heart rests between beats and is refilling with blood. Blood pressure is therefore written as two numbers. The top number is the systolic ­pressure—­the peak pressure in the arteries. The bottom number is the diastolic ­pressure—­the lowestpressure in the arteries, which occurs near the beginning of the cardiac cycle. Your blood pressure reading is expressed as a ratio of these two numbers, and is always written as systolic (top number) over diastolic (bottom number). A reading of 140/90 mm Hg,for example, means your systolic blood pressure is 140 mm Hg (the peak pressure in your arteries) and your diastolic pressure is 90 mm Hg (the pressure in your arteries when your heart is at rest, between beats).  

How Low Can You Go?  
Your blood pressure changes throughout the day depending on many factors, including activity level, stress, sleep, and exercise. If you have a low blood pressure reading (defined as a reading less than 90 systolic or less than 60 diastolic), great. Thereis no ­day-­to-­day pressure that is considered too low unless there are noticeable symptoms such as dizziness, fainting, or excessive fatigue. This would alert your physician to a potential problem that needs to be remedied, often by lowering the dosage ofcertain medications. In rare instances, unusually low pressure could also be a sign of a serious illness, so be sure to check with your doctor.