There are many factors that can raise your blood pressure. In this podcast we discuss:
Primary Care Medicine 8th Edition
Blood Pressure is about much more than the numbers. In my upcoming book, Heart of Being, I will share my advice for approaching the mind and body when healing high blood pressure.
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Hello and welcome back to the Art Healing Podcast. This is Charise and thank you for joining me for today's topic. Last week's topic, we talked about blood pressure and we got into details of what it is. We also discussed how to check your blood pressure. We discussed, um, what type of blood pressure cuff you might want to look for. And then of course, if you are told by your healthcare provider, your physician, that you need to check your blood pressure and you're not sure where to start in the show notes of August 2nd, 2021, um, you'll see a link for BP validate that can help you do your shopping. For today's topic, I wanted to discuss why someone may have high blood pressure. I'll point out really briefly that general high blood pressure is far more common, the problematic issue of blood pressure rather than low blood pressure. That's a separate topic which actually gets more into like a critical care or endocrinology type topic. So not, not too relevant for what we're focusing on, but um, so we'll discuss what could be going on inside your body that could be leading to high blood pressure. Um, once again, and just to sort of reiterate, um, you probably heard the disclaimer at the beginning that reminds you that I'm, although I'm a physician, this doesn't count as a visit and doesn't count as, um, me caring for you personally just by listening to this podcast. So if you have concerns over your blood pressure, that's a good reason to reach out to your doctor. And if you have, don't have a doctor, definitely to find one so that you're not trying to do this all by yourself. So, um, we use the term clinically essential hypertension to mean that we don't have a readily identifiable cause of someone having high blood pressure. In medicine, we have the term essential hypertension and secondary hypertension. Secondary hypertension means that we actually can't identify that one medical disorder or derangement in the body is leading to blood pressure being high. We make the distinction because in secondary hypertension, we have to manage and treat that first cause so that we can make the blood pressure better. So examples of secondary hypertension are issues like, um, problems of the adrenal gland, where the adrenal glands make too much of a particular hormone. Sleep apnea where disrupted and disordered sleep raises the blood pressure and certain problems with the arteries in which the arteries are narrowed from some kind of damage. So those are different from essential hypertension cuz we know that in those issues we can treat the high blood pressure with medications and we can be using all kinds, but unfortunately the blood pressure may not respond until we take care of the primary issue. When we say essential hypertension, the catchall term, basically that means one or multiple der arrangements inside the body are changing or going wrong and it's creating high blood pressure that could go on to cause damage in the body to the arteries, to the heart and to the brain. So essential hypertension is believed to be the cause of about 95% of why people may have high blood pressure. So it's the most common. And when we're treating essential, we're dealing with, um, essential hypertension. Um, in a clinical setting we tend to kind of not spend time on what could be leading to the blood pressure or what are the nuances inside of the body that are causing it. Um, so during this podcast we'll talk a little bit about a few issues that could be going on that clinically for the most part we may not be measuring or checking, but they could be leading to it and it, and it helps to kind of understand. Um, now the end result in essential hypertension is that we're going to be managing the blood pressure, which, um, will involve modification to a healthier diet that supports a healthy cardiovascular system, um, engaging in physical activity if it has been deemed safe by your healthcare provider. Um, medications if needed, if all those things aren't working and the blood pressures remaining high. And of course if we have an issue like smoking in the mix, working on a way to discontinue smoking or, um, or vaping, um, if that, if the person is ready for that. So the relationship of high blood pressure to salt. So, uh, when we're working with the diet, we're often advising, um, folks, and you may have heard that you need to switch to a low sodium or a low salt diet. Um, and the reason why is that the overall body of evidence from decades of research, massive large trials that um, likely you have heard some form of in commercials or public outreach or something like that, is that, um, salt, which we do need in our body. Our body readily uses the element sodium, but then we actually use salt, which is actually sodium chloride. Our body needs that for a number of super important functions. But when we're taking in an excessive amount of it, which unfortunately the um, standard American diet, uh, often inadvertently includes large amounts of, of uh, salt, um, salt has an effect on our arteries in the periphery. So in the last podcast we talked about the artery that we use to check our blood pressure for the most part, the break your artery. So the arteries that are in our arms and our legs respond to salt. Actually all of our arteries respond to salt, but too much salt can make those arteries too reactive and make them squeeze down too much, which makes our blood pressure high. So, um, in our limbs we don't like that cuz that means the limbs aren't getting enough blood flow that could be really dangerous in our legs and feet. Um, especially in diabetics. If we don't get enough blood flow in those areas, we could get dangerous infections in things that are much worse. But of course the brain, which, um, a lot of the functions that are going on in the body are to support the big massive brains that we walk around as humans. Those big brains take a lot of maintenance. Those big brains take a lot of energy and our big giant brains that do all of our thinking, our listening, um, they require a lot of blood flow. The arteries going into the brain and the arteries within the brain need to be tightly controlled. They really don't need lots of stress. They don't need lots of flexing contracting and relaxing as best. If they can stay sort of in a neutral state and when we consume too much salt, we may be causing those arteries to contract too much and to change too much. Um, also it may be that too much salt in the diet coming into the diet, maybe making the body respond too much to stress hormones. So we need our stress hormones such as the, um, adrenaline that our adrenal glands make. There are times that we really need that. Um, we also need, um, our cortisol at times, but these need to be regulated and we don't want to be using those all the time because if we do, um, that makes the heart race and makes the arteries in the periphery, which you've heard me say become tighter, but also the peripheral arteries include the arteries in the brain and we don't want those being too tight or too constricted cuz of course that can lead to dangerous problems, problems in the nervous system leading all the way up to stroke. So that's one of the reasons why we care so much about blood pressure. So we know that having a healthier weight is important to having a healthier blood pressure. And the reason why this is, is it turns out that if our weight is too high for where our body wants to be, you may likely have elevated insulin levels, um, separate from the issue of being diabetic. Um, but when we know that the metabolism is not working correctly so that we're carrying too much weight, um, there's an issue going on between the pancreas, the liver, the muscles, and the fat. Where the sun total is that over time there's too much circulating insulin, which can drive a number of issues, definitely can drive waking, but when your insulin levels are too high, it may make your body too sensitive too. Stress hormones like the adrenaline and then no adrenaline and all the stress hormones that are made in the adrenal glands. So this is one of the reasons, not all of the reasons, but one of the reasons that when we're working with getting to healthier blood pressure, if someone is not at a weight where they're healthy, um, where they're feeling their best, that may be one of our targets when it comes to discussing weight and weight in the clinical setting. Um, I always try to be very careful and very sensitive and point out to individuals that, um, when I'm discussing healthy weight and healthy body, this has nothing to do with, um, how you should feel about yourself has nothing to do with outward appearance. Um, these are very, very separate issues and the healthy weight for your body to be healthy is very individual and may take some time to piece out and parse out, but has nothing to do with some of the, um, issues that we see. Uh, I mean basically what I mean to say is that healthy weight, healthy blood pressure is separate from some of the images you see in the media as far as what health looks like. So, uh, please know that if this comes up or you've been advised, you know, to manage weight, to help manage your blood pressure is vastly different from just, you know, just to look good. Um, and one of the reasons why is that if the insulin levels are starting to climb, it's could be driving the blood pressure up. Of course, chronic stress is going to cause high blood pressure, not absolutely in everyone and everyone's body will respond to chronic stress differently. But probably needless to say that if stress levels are high, if there are a lot of stressful events going on in your life, would this be leading to high blood pressure? Absolutely, absolutely. And I often, uh, attribute, uh, 95% of my patients with high blood pressure is having chronic unremitting unabsorbed, unrecognized unacknowledged stress. Now, I, I do observe that it appears the set point for their tolerance for stress has gone up, which unfortunately is humans and is human conditioning, human life, that there'll be events that we just simply, we gotta take on more. We have to show up, we have to be there for others or be there for ourselves. But I have noticed in some individuals that they have learned to tolerate stress for so long that some of the internal triggers they may have had as younger adults have turned off and they no longer notice. And now this chronic unre remaining stress is showing up in my office or showing up in the readings of their blood pressure is that they're reading high all the time. There are many articles particularly in the source that I am using the Primary Mary care medicine, um, a edition textbook that remind us that um, there are certain personality types that tend to have more heart disease, tend to carry more stress. Um, we used to call this sort of the type A personality. Uh, these are, um, individuals that, um, tend to approach life with more of a can do, will do more of a controlling aspect, may be in leadership positions. Number of things are roll into it. I don't wanna stereotype too much because to some extent we all have to adapt sort of a type A personality at our lives at times, but it's worth observing and definitely later this month we, we get more into the woohoo of blood pressure, um, and worth observing. If, uh, personally if you feel that you're gripping onto many aspects, gripping with people, with objects and with things and with your jobs and you've got like a firm grip on how it should be, um, is that leading to stress inside your body? Oh yeah. Oh yeah, definitely. And we all do this. I'm not saying, I mean I do this, we all do this, but um, as you learn to work with yourself, I learn to work with myself, our bodies, it's worth acknowledging that, um, as a mindset, what does that do to us? And it could definitely lead to your blood pressure being high most of the time. External stressors absolutely cause stress. Um, one of the biggest that I observe, of course I've personally felt it being a black female in the United States is, um, the overarching, um, theme of systemic racism definitely leads to health related consequences. And right up at the top is gonna be high blood pressure. I won't get too much into all of the physiology behind this, but essentially, um, and as I speak to you listeners, um, I have to keep in mind that we're all different and we're all from different backgrounds. I have never been white<laugh>. I've never been Korean. Um, I don't know what it's like to be British, so I can only speak at from my perspective as a black woman in the United States, but um, any sort of cultural setting where um, people feel restricted or um, feel that, you know, everything is against them because of the outward appearance. There's a very natural layer of stress that is pervasive, um, that starts pretty much from the waking hours and continues all throughout the day cuz it's gonna impact almost every aspect of that person's life. Um, I pick racism, but it could also be, um, um, you know, it could also be, um, homophobia. It could be, um, uh, being against someone that's not a native speaker of the language. Um, it could be anything where basically you, you feel discriminated against any sort of external discrimination. I mean I just picked race, but there's so many. If you are living sort of under that umbrella that the pervasive what's there all the time and it impacts every part of your life, um, can definitely impact your health, may very well be doing it by raising your blood pressure, by keeping your stress hormones a little bit too high all the time. Um, that doesn't mean that you can't learn to work with your body and your mind and learning from this experience. And in fact, um, we won't, I wasn't gonna go woo woo on this, this podcast, but you know, in fact your soul may have picked this, this may have been your chosen journey that you are here to learn from that experience of being not of the mainstream, of being different or or feeling the effects of discrimination, but there's much internal work, internal growth that you can gain from that with patients and with self love. But one of the observations you can make is if that sort of feeling is starting to impact your health, is it raising your blood pressure very well? It could be and absolutely we have so much that to show that it could be finally one of the most important aspects of um, what could be raising your blood pressure is sleep, are you getting enough? Is the quality of sleep good enough? Um, are you allowing yourself enough time to sleep? So this is separate from sleep apnea, which I briefly mentioned earlier in the podcast, which is a clinical diagnosis where the respiration is disrupted and leads to cardiovascular illness. Um, oftentimes just at I I started just outta pure curiosity. Now I sort of try to as a mandatory, um, discuss with my patients, my reiki clients. It's a little, little easier, but um, how much are you sleeping? What is your bed time? What is your wake time? What's happening the hours before sleep or even that, you know, few minutes or so after you get up, are you allowed enough time to sleep? So, um, quite typical these days. I'm noticing a lot of my patients have, um, you know, really late times they're getting to sleep and really early wake times and because, you know, they're no longer kids cuz kids have a whole different, um, sleep recommendation that should allow for plenty of sleep. Um, they assume they really need much less sleep than their children or younger people. But if your sleep times like, you know, 11:00 PM or midnight and then you've gotta be up by five or five 30 or six, um, and if you've been doing that for more than a week, you got sleep deprivation that's chronic you got, that's just pure, you're not sleeping enough. And an end result of that day after day after day is that your whole system begins to kick into a chronic stress mode. The hormone system in your body alters itself because it is perceiving that survival. It must be a survival mode and that's going to day by day raise your blood pressure so that you are no longer even returning to a normal blood pressure, but you're staying high. Then of course there are times of stress you're starting to spike. So once again, thank you so much for joining me for today's podcast, which is what raises your blood pressure. Um, I appreciate your listeners so much and I hope you find this information useful for yourself or for your family. And if you do find it useful, if you wouldn't mind leaving a review on any listening platform you have and um, for this topic and actually even for last week's, feel free to share with your family or friends, anyone who's discussing their blood pressure is curious or wants to understand more. Um, definitely I think these topics can help sort of any sort of human. Next week we're gonna go a little woo woo. Um, if you've listened to any of my content, I love to go from left brain to right brain, from hard science to fluff. And so this podcast and last were a little bit more science, a little more hardcore. Well we're moving on time to get weird. So<laugh> the next week, um, we are gonna discuss, uh, mindfully approaching your blood pressure, um, how to do that. And then we'll, um, little bit later get into a little bit of a meditation together, um, that we can use, um, to help with that. So thank you so much. Please re leave a review if you don't mind and have a wonderful rest of your day. Thank you. Bye-bye.