Hypertension

Hypertension

By Dr. Fred Hui, MD

What is hypertension?

Hypertension is the medical term for High Blood Pressure (b.p).  When you measure your b.p at home or at a clinic, what you’re actually measuring is the pressure on the inner walls of your arteries, caused by the blood flowing through them.

THE ‘BLOCK IN THE FLOW’ AND AGING – TWO MAJOR UNDERLYING CAUSES

PLAQUES 

One of the major causes of increase in b.p is the presence of physical blocks, or plaques, in the circulation (atherosclerosis). The formation of these plaques is explained below:

As the body ages, a natural and gradual destructive process called LIPID PEROXIDATION destroys the walls of the arteries. In this process, the lipid content of the cells of the arterial walls, get degraded by free radicals.

This damage is repaired by the body, leaving a scar.

Over time, cholesterol may get deposited at these sitesforming SOFT PLAQUES.

Later, as years go by, calcium and other hard minerals may get deposited over these SOFT PLAQUES, causing the formation of HARD PLAQUES. The difference between soft and hard plaques is the presence   of hard mineral deposition like calcium.

AGE – RELATED HARDENING OF ARTERIES 

This is another major cause of hypertension.

As the body ages, the walls of the blood vessels lose their elasticity and flexibility, and become stiffer with time (arteriosclerosis). This is due to formation of cross-linkages in the connective tissue in the arterial walls. Calcium deposition in the blood vessels, as a result of aging, causes further stiffening.

THE ‘WIND TUNNEL EFFECT’ AND RAISED B.P

PLAQUES HARDENED ARTERIES

(Physical obstruction in the circulation)     (Blood flows through a `rigid pipe`)

NARROWING OF ARTERIES
(`wind tunnel effect`)

Blood has to be pumped with more force to overcome the resistance, so that it can be pushed through these narrowed arteries and be delivered to every organ.
The volume of blood reaching the kidneys per minute decreases due to these reasons. As a result, kidney sensors sense a decreased blood flow and assumes that the body is losing blood (eg: by an active bleeding).
The kidneys now aim to increase blood volume by excreting lesser water and conserving more.
As a result of this, more blood now has to be pumped through these narrowed arteries, with more force.

OTHER CAUSES OF HYPERTENSION

Apart from narrowing arteries and age-related stiffening of arteries, hypertension can also be caused by various other conditions including:

  • adrenal tumours,
  • hyperthyroidism,
  • renal diseases and
  • certain medications

These causes have to be ruled out– and this is where your history of illness, clinical findings and lab investigations play a crucial role.

HYPERTENSION AND MEDICATION

Many people falsely believe that they’re healthy as long as their “numbers are good”. If you are on a BP pill, and your BP is controlled, it only means that it’s ‘controlling’ the problem. BP pills, unfortunately, do not work at the source of the problem and hence conceals its presence. So, in time, you may require higher doses to control your levels. This is the biggest indicator to the fact that the underlying problem exists, and is getting worse.

Apart from concealing the underlying issue, BP medications can have a spectrum of side effects that you must be aware of. BP medications are classified based on the way they work, and each kind comes with its own share of problems.

Find the drug you’ve been taking from the list below. Can you relate to these side effects?

1) Water Pills (Diuretics)

Examples How they work Side effects
 Lasix (Furosemide) Aldactone (Spironolactone) Inspra (Eplerenone) Increases excretion of water and salt from the body, thereby reducing blood volume and blood pressure. Urination, thirst, Dizziness on getting up quickly, Body dryness May sugar levels Impotence, low libido Gout

2) ACE INHIBITORS

Examples How they work Side Effects
Altace (Ramipril) Coversyl ( Perindopril) Zestril or Prinivil (Lisinopril)  See flowchart below Dry cough High potassium levels

How ACE Inhibitors work:

  • Narrowed Arteries.
  • Volume of blood flowing through kidney per minute decreases
  • Sensors in kidneys get activated (they assume that blood volume is low)
  • Causes secretion of Renin as a “YELL FOR HELP”
  • Renin starts a cycle in response, which ultimately causes retention of water, and thereby increases blood volume and blood pressure.
  • ACE Inhibitors block this cycle. They also allow arteries to dilate and hence lower bp.
  • 1) The ARB’s
Examples How they work Side effects
Atacand (Candesartan) Cozaar (Losartan) Avapro (Irbesartan) Diovan (Valsartan) Micardis (Telmisartan) The ARB’s also work by blocking the above mentioned cycle, but at a different stage. DizzinessHigh potassium levels Cough is lesser or absent, when compared to ACE inhibitors.

 

2) Beta Blockers

Examples How they work Side effects
Tenormin (Atenolol)Betaloc/ Lopressor (Metoprolol) Emcor/ Cardicor (Bisoprolol) By dilating blood vessels, as a result of blocking a stimulatory secretion called Adrenaline. Too slow heart rate Depression Tiredness, drowsiness Dizziness Sexual Dysfunction

3) Calcium Channel Blockers

Examples How they work Side effects
 Norvasc (Amlodipine) Adalat/ Procardia (Nifedipine) Cardizem /Tiazac (Diltiazem)Verelan (Verapamil)  It dilates the return pipes. This includes veins and lymph vessels too.  Swelling in feet Constipation Dizziness Painful, bleeding gums

CHELATION AND HYPERTENSION

Chelation works at the root of the problem. Instead of dilating the blood vessels with pills for the rest of your life, it clears the path and allows a smooth blood flow. As an added advantage, you could be free from the side effects of these pills.

Depending on my assessment for your condition, you may be prescribed chelation treatments with EDTA and/ or PLAQUEX to clear your circulation.

Detailed information, testimonials and PROS AND CONS of these treatments are further discussed in detail in the CD, DVD and hand-outs that will be provided to you at the front desk.

A few points on these treatments are given below:

1)  EDTA – Ethylene-diamine-tetra-acetic acid 

  • Used on HARD PLAQUES – EDTA may bind and remove the hard mineral deposits and certain toxic heavy metals like lead, aluminum, cadmium etc.
  • By removing hard plaques, EDTA may help to improve circulation to all organs including the brain, heart, kidneys etc. As a result of this, you may greatly reduce incidence of strokes, heart attacks, angina, peripheral vascular diseases, diabetic complications etc.
  • EDTA may also decrease free radical damage, deposition of calcium in blood vessels, and improve flexibility of arteries in older patients.
  • The treatment is an 90-120 minute intravenous infusion of EDTA in a bag of sterile water containing a mixture of vitamins and minerals.
  • You will typically require 20-30 sessions, depending on the severity of your condition – you may start seeing differences by 10 sessions. You will be reviewed every 10-20 treatments through a follow-up appointment with me, and your progress will be assessed.
  • The frequency of treatments is usually 1-2 times/week. After your prescribed number of treatments and satisfactory progress is achieved, you may taper to a maintenance dose of once/month, to keep the circulation clear from deposits.
  • Every 5 treatments with EDTA, you will be given a Vitamin treatment- this is a 90 minute intravenous infusion of several vitamins and minerals. Along with this vitamin treatment, a blood work to assess your kidney function will also be done.
  • RUSTPROOFING – While you are on EDTA treatments, you will also be put on a vitamin, mineral and antioxidant supplementation called Ultra Balance III – 3 pills twice a day.

A few cons of EDTA treatment:

1) May not be suitable for patients with already-weak kidneys.

  • This is because EDTA binds and removes hard mineral deposits and toxic metals that have accumulated in the body for several years. These have to be excreted, but weak kidneys cannot excrete this load of toxic metals that gets washed out with each treatment.

What can be done about this?

  • EDTA will hence be prescribed only after an initial blood workup is done and your kidneys are found to be in good function. Also, after every 5 treatments with EDTA, another blood work to assess your kidney function will be repeated.
  • If your kidney function is being affected, you may either be given a smaller dose, or switched entirely to Plaquex (which is absorbed through the intestines), depending on my assessment of your condition.

2) May deplete the vitamins and minerals in your body.

  • Along with removing the hard mineral deposits and heavy metals, EDTA may also strip your body of vitamins and minerals.
  • You will hence be put on a vitamin, mineral and antioxidant supplementation called Ultra Balance III – 3 pills twice a day.
  • Every 5 treatments with EDTA, you will be given a Vitamin treatment– this is an intravenous infusion of several vitamins and minerals.

2) PLAQUEX – Phosphatidyl choline 

  • Used for removal of SOFT PLAQUES.
  • Plaquex treatment is used to remove cholesterol deposition (soft plaques) in the arteries. It also decreases the damage to the walls of the arteries caused by lipid peroxidation (explained in pg.1) and thus helps to prevent further damage as well. 
  • It may also improve the flexibility of aging blood vessels by improving elasticity, shape and function of the cells in the arterial walls. 
  • By removing soft plaques and increasing flexibility of arteries, Plaquex improves the circulation to all organs of the body and thus, may help prevent heart attacks, angina, strokes, diabetic complications etc. 
  • Plaquex treatment is a 90-minute intravenous infusion of Phosphatidyl choline in a bag of 5% Dextrose solution.
  • You will typically require 20-30 sessions, depending on the severity of your condition. You may start seeing differences by about 10 sessions.
  • The frequency of treatments is usually 1-2 times/week. After satisfactory progress is achieved, you may taper to a maintenance dose of once/month, to keep the circulation clear.
  • Further information on Plaquex can be available to you at www.plaquex.net.