About 30 years ago, I learned that food restriction/weight loss was one cure for high blood pressure. Since, I’ve come to see overall stress management is THE answer.
Through the course of my professional journey I’ve directly observed some people eliminate high blood pressure in the first week of exercise/dieting, the first few days of a fast, or the first 4 days of ketogenic nutrition. And long before any of these observations, most people associated stress reduction with hypertension amelioration. Why?
Insulin is at the center of it all. In an unhealthy body, stress hormones and insulin aren’t “used up.” Insulin retains sodium. Blood volume increases. More mass crammed within the same vessels means more pressure.
Rather than focus on the underlying cause, a lot of the initial clinical focus 90 years ago was on sodium reduction. It tended to worsen long term outcomes since all tissue requires sodium to recover and regenerate. Thus, although short term symptoms would look better with lower salt, the very organs which we need to regulate blood pressure take more damage. Low salt intake reduces lifespan: https://pubmed.ncbi.nlm.nih.gov/24651634/
This is why we see exercise as effective. It uses up stress hormones. It assists insulin clearance and the entry of energy into cells. And as a person has less body mass, he has less blood volume. Less volume equals less pressure. What we don’t think about is how that person’s tissues are also becoming better at listening to insulin all the time.
We also tend not to think about how perception of stress impacts glucose volatility and subsequently insulin. Frustration and anger create insulin mismanagement: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3652917/ . That insulin retains blood volume. More volume means more pressure.
What’s most curious is that the strongest proponents of salt restriction have almost no evidence even in their own studies. Severe salt restriction only lowers blood pressure 2 - 5 points: https://pubmed.ncbi.nlm.nih.gov/15266549/. This is the BEST outcome touted by proponents of the “eat less salt” school of thought.
2 - 5 points. Ok. Why is it so ineffective? Because we didn’t try to impact insulin.
Meanwhile, just restricting carbohydrates makes blood pressure plummet: https://www.eurekalert.org/news-releases/664732. In fact, I’ve had some clients who only do moderate carb restriction and they have to immediately get off of blood pressure medication because their numbers are TOO LOW. Why? Because we began managing stress and insulin better.
Likewise, the widely-accepted average blood pressure drop during weight loss is about 1.6 points per kilo: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6695889/.... Basically, for every two pounds lost, pressure averages drop 1 point. Is it because each two pounds lost is removing salt from the person’s diet? Or is it because insulin is increasingly better managed in a smaller animal who is exercising?