Ep 38 - HEALTH HACK: Are You at Risk of Uncontrolled High Blood Pressure?

High blood pressure is a serious health condition that affects millions and in this episode, Dr. Alka Patel shares how you can take control of your numbers naturally.

She stresses the importance of comprehensive testing to uncover the root causes driving your hypertension. This includes metabolic panels to check nutrients like magnesium and vitamin D, as well as testing for heavy metals, insulin resistance, gut and hormone imbalances.

Dr. Patel speaks on how a change in diet and supplementation in conjunction with losing weight is shown to lower BP.

The right data, devices and lifestyle decisions empower you to optimise - and potentially reverse - your high blood pressure.

Dr. Alka Patel is a UK based longevity doctor, health activist and biohacker. Through her private practice, programs and podcast Health Hacktivators, she helps people discover their personal health hacking code to optimise their healthspan and lifespan through strategic self care and lifestyle medicine.

For more information about the Hacktivation Bio-Hacking click here.

To read the blogs that accompany the show and for even more focused health hacks, head here.

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Find out what most other Doctors don’t tell you, with cutting-edge health-hacktivating advice from Lifestyle Medicine Doctor, GP and Longevity Expert Dr Alka Patel.

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Podcast Transcript

PLEASE NOTE these transcripts are auto-generated and may not be wholly accurate.

Dr Alka Patel (00:01.282)

Hi, hey, and hello health activators. Today I'm talking about blood pressure. So what I want to do by the end of today's episode is to give you at least five effective ways to evaluate and to lower your blood pressure. Five ways that you probably haven't considered before. So let me start first of all by clarifying what blood pressure is and also how high blood pressure, hypertension is defined and why you need much more.

than a medication only approach. So what is blood pressure? Well, blood pressure is a force. It's the measure of the force of your blood pushing against the walls of your arteries as your heart contracts and relaxes. And that's why there are two important numbers involved in your blood pressure reading. So that top number is your systolic pressure. So that's the pressure that's felt in your arteries when your heart contracts to pump blood out. And the bottom number,

That's your diastolic pressure. That's the pressure in between your heartbeats when your heart muscle relaxes. So if we just look at the numbers then, if you're measuring your blood pressure at home, which is what I certainly encourage you to do, then a reading of 135 over 85 or above is defined as hypertension.

I'm going to give you quite a lot of numbers. So you might want to just grab a pen and paper at this stage. So as I said, a reading of 135 over 85 or above is defined as hypertension. Then 115 over 75 or below is defined as normal. And remember that's based on you measuring your readings at home. And then we've got this in between set. We've got numbers from

116 over 74 to 136 over 84. And that we can call pre-hypertension, which means you're at risk of a diagnosis of hypertension. Now I have to say, I have always found all of these numbers to be rather, well, rather arbitrary. Now why do I say this? Well, I say this because, well, think about it, blood pressure is on a continuum.

Dr Alka Patel (02:14.59)

It fluctuates, it's continuously responding to your needs. And what epidemiological studies have shown us is that there's a relationship between high blood pressure and disease risk, and that relationship is also on a continuum. It's not a linear risk. And more specifically, again, looking at epidemiological data, above a blood pressure of that number, 115 over 75,

that's when your risks of the consequences of blood pressure increase, but not necessarily in a linear way. So what difference does this make? Well, even though we know that there's not a direct linear relationship and that above 115 over 75 is when your risks of the consequences of blood pressure start to increase, there are guidelines in the UK, they're called NICE guidelines and the guidelines suggest aiming to reduce blood pressure to below

135 over 85 rather than to below 115 over 75. Now I have wondered why this might be and you might be wondering, well, why this gap? And I think it's really likely to be based on findings on other studies which show that your cardiovascular risk, so that's the risk of things like heart disease and heart attacks, strokes and circulation issues, your cardiovascular risk. And remember,

Cardiac disease, cardiovascular disease, is the number one cause of morbidity as well. That risk, it doubles for every 20 millimeter rise in your systolic blood pressure, that top number, or for every 10 millimeter rise in your diastolic number, that bottom number. So that's where this cutoff of 135 over 85 seems to have come from. But here's the thing, there are still risks from above.

115 over 75. Even if they're not double the risks, there are still added risks. So it makes sense for you to target your blood pressure to be less than 115 over 75, not 135 over 85. Now I say these numbers, but these targets depend on a lot of other factors as well, things like your age or whether you've got other medical diagnosis. So

Dr Alka Patel (04:35.054)

please, please do discuss your very personal blood pressure targets directly with your doctor. But for the purposes of this episode, I'm talking about 115 over 75 as being a target blood pressure or less. And the other thing, the other thing with high blood pressure that I want to point out is its classification. And more specifically, its classification when it comes to usual treatment recommendations.

So as I said, hypertension is diagnosed when your blood pressure is persistently above 135, over 85. And then it's been classified into three stages. So we've got stage three hypertension, which is above 180 over 120. And that's the level that needs immediate intervention. So if you get a reading like that at home, contact your doctor immediately, right?

Now we've got stage two hypertension and that's above 150 over 95. And this is a level at which the guidelines say you must treat. And then there's stage one hypertension and that's above 135 over 85. And the guidance here suggests to treat only, think about this, only if there are signs that your blood pressure has already damaged your organs or if you're at very, very high risk of organ damage.

So again, that doesn't make sense to me. What doesn't make sense here is why wait? Why wait to treat your blood pressure after you've damaged your organs? Doesn't make any sense at all. And yet that is what the conventional medical pharmaceutical approach suggests. So just want you to think about that. But you might also be wondering at this stage, but what are the risks of

walking around with a high blood pressure. What is all the fuss about? Well, high blood pressure is called the silent killer and it's called this for a reason. And the reason is because most people are completely unaware that they have high blood pressure until it shows up with its consequences. And its consequences are pretty significant. So you've already heard me mention heart disease. So that's heart attacks, heart failure.

Dr Alka Patel (06:49.51)

arrhythmia, so issues with the electrical activity in your heart and its rhythm, or strokes as well. And high blood pressure can also damage your peripheral circulation, so causing pain in your legs, for example, when you walk because of peripheral artery disease. Also causes kidney disease and blindness. So with all of these risks and all these consequences, you can see why it is so important to keep your blood pressure down. High blood pressure is the leading factor.

cause of dying around the world. So the first and most important thing to do is to measure it. And more specifically, to measure it yourself at home. Now, why do I say this? Well, I say this because blood pressure is constantly fluctuating. So it can be hard to know if you've got hypertension based on a single reading at your doctor's surgery. And plus, there's this issue of what we call

coat hypertension, which means that simply having your blood pressure checked can be enough to just push it up. What's more important than a single reading is knowing what your average blood pressure is on an average day for you. And it's those home readings that give you a much, much clearer picture. Now in last week's episode, I did talk about a, what I consider a revolutionary way to measure your blood pressure at home using a bracelet monitor Actia.

So if you haven't already, go and have a listen to my conversation last week with Dr. Shay Shah, who's the medical director for Actier as well. It's a really, really useful conversation that we had in terms of getting into how the device works, how accurate it is, how reliable it is. And I'll put a link in the show notes as well with the discount code for you for an Actier device, if that's something you want to explore as well. Now.

One more thing to highlight is that previously we used to diagnose people with what's called essential hypotension. What's the essential bit? Well, essential has come about because, well, we didn't really know what caused it. And also because there was this long standing view that high blood pressure was sometimes essential in order to make sure that blood reached the organs where arteries were thickened. You just needed a

Dr Alka Patel (09:08.098)

higher pressure to get blood to flow through areas where arteries were thickened. But what we know now is that that's actually not the case. What we know now is that the thickened arteries are the result of hypertension. So we no longer say essential hypertension, but instead diagnose people with primary hypertension instead. So what this means is that most people with high blood pressure,

that's saying about 90% of people, they're diagnosed with primary hypertension, which means that there is no identifiable cause. And 10% of people are diagnosed with secondary hypertension for which a specific cause has been found. So that's things like kidney disease or other diseases called Cushing's disease or Kahn's disease. Now, I have to say, I've always felt pretty uneasy telling my patients, you've got high blood pressure, but we don't know why.

It sort of feels, well, far too defeatist, like a, sorry, there's nothing more we can do. You see, telling someone they just need medication for life for their blood pressure has never felt like the right solution because, well, because high blood pressure doesn't just happen. It isn't really true that hypertension is either primary or secondary. I mean, everything has a cause. It's just a matter of finding.

that cause the root of the issue and then addressing it. You see, the traditional approach to high blood pressure has been to first diagnose it and then to treat it, invariably with medication. But my approach is to diagnose it and then ask, why? Why do you have it? My approach really isn't to treat your blood pressure, but to treat what's causing your high.

blood pressure. And that might sound a bit odd to say, I'm treating your blood pressure by not treating your blood pressure. But that's what works because there's so many things that contribute to high blood pressure. What we have to do is simply find out what your personal pressure pathway is and address that. Now most doctors you'll find will say hypertension is a lifelong diagnosis. It's a chronic condition, something you can't get rid of, but something you can control.

Dr Alka Patel (11:30.346)

And what I see a lot of is people on one medication and then another and then the third to get that blood pressure under control. But it's not true, again, that high blood pressure is not something you can't get rid of. What I say is if you get to the cause of high blood pressure, if you get to your personal root causes and address those, then it is possible for you to be free of a diagnosis of hypertension.

and all of its consequences. So keep listening. Keep listening to the rest of this episode. If you have blood pressure above 150 over 75, persistently, or if you've been diagnosed yourself with hypertension at stage one, two or three, or if you're taking medication but your blood pressure is still raised, or if you want to consider ways to banish high blood pressure because I now want to share with you things that you might not have considered before.

and take a look at a much more lifestyle and functional approach to high blood pressure. So let's look at the health hacking code and let's look at using data and devices to make decisions about your blood pressure. So what data can you look at that will help you to address the root cause, the root cause of your high blood pressure? Well, here's what you need to measure. Number one, metabolism. Measure your...

metabolic markers, have a comprehensive metabolic evaluation. So what does this mean? This means looking at nutrients. It means looking at your macronutrients, micronutrients, vitamins, minerals, acids, organic acids, amino acids, omega-3 fatty acids. All of these will give you a good clear picture of your nutritional status, your metabolic status. So having a metabolic evaluation, it's not about looking for

of the disease, but it's looking at dysfunction or blocks in your metabolic pathways that stop your body doing what it's meant to do, what it's supposed to do in order to regulate your blood pressure. Now, the metabolic panel that I run, it's not one that you'll find done by your traditional GP. What your traditional GP will do will be look at things like your full blood count, your kidney function, your liver function, your lipid profile, and they are all important as well.

Dr Alka Patel (13:51.902)

What GPs don't usually look at is your full metabolic nutritional profile. And why then is a metabolic panel important? Well, let me give you a few examples. Take magnesium, for example. I come across many, many people with a low magnesium level. And the reason magnesium is important is because it plays a big role in lowering blood pressure, because what it does is it relaxes your blood pressure.

your blood vessels, it relaxes the diameter of your blood vessels. So it's an important thing to measure because for you, it could be low magnesium that's driving your high blood pressure. And here's another interesting thing about magnesium as well. Interestingly, if you're taking acid blocking medication or PPIs, proton pump inhibitors, and there's thousands and thousands of people who take these drugs, drugs like omeprazole or lamzoprazole, did you know?

that they could also be contributing to your raised blood pressure. How is that? Well, it's because what they do is they inhibit acid production. And by doing that, they also inhibit absorption of magnesium because you need acid in order to efficiently and effectively absorb magnesium. So that's magnesium. What other what other examples of nutrients? Well, consider omega-3 fatty acids. Again, I see a lot of people with low levels of omega-3.

or an imbalanced omega-3 to omega-6 ratio. And what omega-3s do is they also relax your blood vessels. So again, it's important that you have good levels of omega-3 either from foods or from supplements. And also, well, vitamin D. Vitamins D is another important consideration. What vitamin D does is it regulates inflammation. And there are several observational studies that show that in people that have low levels of vitamin D,

If you replace it and increase your vitamin D levels, you also lower blood pressure levels. So, well, most people don't see this connection then between blood pressure and metabolism, between blood pressure and nutrition, but it's so tightly connected. So really would encourage you to get as much data related to your metabolism as possible so that you can then start to target your personal interventions.

Dr Alka Patel (16:10.646)

So that's metabolism, your metabolic mark. A second key thing to measure is heavy metals. So there's a urine test that I do in my clients with high blood pressure that looks at heavy metals. And the reason I measure this is because things like lead and mercury increase your blood pressure. So high levels of mercury, for example, they cause changes in your vessels, which then cause this dysfunction in the lining of your blood vessels, your endothelial lining. And for you,

that could be an important area to target if your blood pressure is raised. If you eat a lot of fish to get omega-3s in your diet, which could be a good thing, you could at the same time be consuming high levels of mercury. So testing this is very, very useful. Third area. Third area to look at is something called insulin resistance. So resistance to insulin, which is a hormone that metabolizes your sugar.

insulin resistance is what contributes to weight gain. And at a cellular level, what insulin does is it causes inflammation and oxidative stress, which is like a rusting process. So not insulin, insulin resistance. If you're resistant to insulin, what happens is you create more oxidative stress. And so when this occurs in your arteries, they harden, they get stiff, and that results in high blood pressure.

So again, testing for insulin resistance and testing for markers of insulin resistance is a useful way to get clues about your own active blood pressure pathways. So what are these markers? Well, a blood test will give you a direct measure of your insulin levels, of your glucose levels, and of your HbA1c. And HbA1c tells you how much glucose is being carried by your red blood cells. And there's also useful proxy markers of insulin resistance as well. And that means measuring your weight.

and measuring your waist and hip circumference because it's the ratio of your waist to hip circumference that's a good marker of insulin resistance. So an ideal waist hip ratio, it's less than 0.8 for women and less than 0.9 for men. So here's a quick few pointers if you want to take your waist hip ratio measurements. So for your waist, what you need to do is wrap a measuring tape across your back just above.

Dr Alka Patel (18:35.106)

the highest point of your hip bones. To feel where that highest point of your hip bone is, it's usually just above your belly button, and that's where you want to be measuring from. Keep your tape snug, but don't compress your skin. You should be able to breathe normally. And then for your hips, measure around the widest point. So that's right below the bones of your pelvis around your glutes. And then you simply divide your waist measurement by your hip measurement, and that gives you your waist-hip ratio.

Okay, number four in terms of useful data is your gut microbiome. Get to know your gut microbiome. Because if you're in good balance, if you've got the right ratios of gut flora present, they produce nitric oxide. And what nitric oxide does is it's a natural vasodilator, it dilates your vessels and opens up your blood vessels, which then keeps your blood pressure down.

And the reason that I carry out a comprehensive stool analysis on my clients really is to assess the gut microbiome and check for any dysbiosis or any imbalance that contributes to nitric oxide deficiency and also to look for any inflammation which can also then set off high blood pressure as well. And finally, the fifth data set that I wanted to highlight today for you to look at is your hormones. So, hormone tests look for endocrine causes of high blood pressure.

And there's quite a few here that can contribute. So things like a thyroid function test to check for an overactive or an underactive thyroid. Both of them can be associated with high blood pressure. Cortisol tests are useful to diagnose something like Cushing syndrome. Urine metanephrines, they check for something called a pheochromocytoma, which can be related to high blood pressure. And also things like renin and aldosterone levels, then they check for something called hyperaldosteronism, which is also.

a cause of high blood pressure. So I hope you can see just from those five kind of key areas that I've highlighted, and there are others as well, that just accepting hypertension as a diagnosis without a cause is not acceptable. Accepting hypertension as a diagnosis without a cause is not acceptable. Because there's a lot of data that will give you a much, much more clearer focus for where to...

Dr Alka Patel (21:01.038)

target your interventions. And so far, what I've mentioned to summarize is looking at your metabolic panels, and that includes vitamins like vitamin D, and minerals like magnesium, looking at omega threes. Also, number two, looking at heavy metals. Number three, checking for insulin resistance. Number four, checking your gut microbiome. And number five, looking at your hormones, the clues, I promise you the clues will be there. So what about devices then?

What devices can help with blood pressure? Well, I've already talked about Actier. Actier is my go-to blood pressure monitoring device. And the reason I say that is because it's reliable and it's accurate and it's so convenient. It gives you 24-7 round the clock measurement of your blood pressure without you needing to feel that inflation of the cuff, which can then give you perhaps white coat readings as well.

And it gives you these readings every two hours, whether you're asleep or whether you're awake. And what's lovely is that it's also connected to an app. So you get a really useful graphical representation of the patterns of your blood pressure as well. So that's Actier. And as I mentioned already, if you want to have a listen to last week's episode, I was in conversation with Dr. Jay Shah last week and my dogs here agreeing that it's a great episode. So do go and have a listen. There's another.

very interesting device as well that I want to highlight today, and that's called Respirate. Respirate is a device which slows down your breathing and it slows down your breathing with a prolonged exhalation. What that does is it reduces sympathetic activity, it relaxes your constricted blood vessels, which then result in blood pressure reduction. So it's a device that's been developed by a Harvard physician, Dr. Herbert Benson.

and he showed that 15 minutes of deep breathing daily can lower your blood pressure. And he developed Respirate to guide you to engage your diaphragm for slower, deeper breaths. So if stress, for example, or anxiety is a trigger pathway for your blood pressure, then this device will certainly be worth looking at. Respirate, R-E-S-P-E-R-A-T-E. And in some studies it's shown

Dr Alka Patel (23:23.058)

a 10 millimeter systolic, so that top number, and a five millimeter diastolic, that bottom number, reduction in blood pressure, reduction of 10 over five. So that's a really potentially useful way to lower your blood pressure. So that's a couple of devices. So finally then, data, devices, decisions. What decisions can you make right now to optimize your blood pressure? Well, here's three hacks.

Dr Alka Patel (23:52.934)

nutrition. I want to highlight here the DASH study, the DASH approach, the dietary approaches to stop hypertension. This is a dietary approach that can reduce blood pressure by 11 millimetre systolic top number and 4.5 millimetres diastolic bottom numbers. It makes it an effective intervention. And what the DASH diet is, is it's focused on foods that are high in vegetables and fruits primarily.

low fat dairy, whole grains, poultry fish and nuts. And what these foods are, well, they're inherently rich in potassium, rich in magnesium, rich in calcium, protein and fiber, and they're low in saturated fat and refined sugars and sodium as well. So this is a great way to get that kickstart into a nutritional focus to lower your blood pressure. And an easy starter here is simply to get more

colour onto your plate, primarily through fruit and veg. Spinach, strawberries, peppers, blueberries, just add more colour onto your plate. Now you might be wondering why I haven't mentioned salt so far. So let's talk about salt because when people think about blood pressure, most people immediately do think that they need to reduce salt in their food, which can be important, but isn't necessarily the case for everybody because it depends how sensitive to salt you are.

and your genes can have an effect here. And there are DNA tests that I do to show if you have genes that make you more susceptible to the effects of salt, because it might not be something that you specifically need to be super, super focused on, or it might be something that's gonna be a big driver for you. But as a general guide, aim to consume less than 2,300 milligrams of sodium a day. So that's just.

a general guide, but having genetic testing is a much more useful way for you to streamline your focus as well. And it's not so much the salt that you add to your food when cooking or salt that you add on the table that's a problem. What the problem usually lies in is the hidden salt in processed food. So if you minimise processed food, go back to a more whole food, plant-based way of eating with

Dr Alka Patel (26:11.314)

natural foods, fruit, veg, as I've highlighted in the DASH diet, that's automatically going to be a way to bring your sodium levels down. And another way, another way to blunt the effects of hidden sodium is to increase your levels of potassium by eating potassium rich foods. Again, fruit and veg, more specifically things like kidney beans, spinach, lentils, apricots, leafy green veg as well. Okay, that was hack number one. Hack number two is...

Drop some weight. Drop some weight because for every two pounds that you drop in weight, your blood pressure drops by one millimeter. So even a small amount of weight loss can make a difference. And third hack is to consider supplements. Now you'll know if you've been a listener of this show that my approach to supplements is based on what I consider to be two layers of supplements. So foundational and functional.

Foundational supplements are those that I consider to give you a very firm nutritional base and functional supplements are those which are targeted at a more specific need. So for high blood pressure, functional supplements I use, they include things like magnesium, which I've already mentioned, which you can then have in supplement form. A magnesium supplementation has been shown to reduce blood pressure by up to 5.6 systolic top number.

and 2.8 diastolic bottom number. Also coenzyme Q10, coenzyme Q10 is an antioxidant and that's shown to lower blood pressure by a bigger number, 17 over 10. So that might be something useful to have a look at as well. Another supplement is one called lycopene. So lycopene is an antioxidant and you'll find it in red fruit and red veg. It's what's responsible for giving things like tomatoes their color.

And studies on this meta-analysis has shown that high dose of lycopene has an overall antihypertensive effect of 10 over 4. And garlic, think about garlic. Garlic's interesting because what garlic does is it's thought to stimulate production of nitric oxide. Remember, I mentioned this earlier. It's a vasodilator. It opens up your blood pressure, opens up your arteries and then reduces your blood pressure. So.

Dr Alka Patel (28:32.622)

garlic supplementation or even more garlic in your food is also a useful choice to make as well. So there you go, a much more comprehensive and holistic approach to high blood pressure. Instead of thinking diagnose then treat with pills, it's diagnose then question. Ask why. If you've received a diagnosis of high blood pressure, of hypertension, ask why.

individualize your approach. It's not a one drug fits all approach and if one drug doesn't fit then add another one. It's not that at all. For you it might be loose some weight. For someone else it might be stop sugars or it might be have more magnesium or detox to mercury. What's super, super important is that you find your personal triggers and you intervene with a much more precise approach and don't accept a response.

that says, we don't know why you have high blood pressure. Not knowing is not the answer. Now my private practice in my programs, I have a long assessment form. It's about 15 pages. It's a lifestyle assessment form, which my clients complete before consulting with me. Now I've had some people initially a little reluctant to fill out a long form, but that's where your answers lie. Your answers lie in your story.

in your history on everything that's gone on for you before. It's all there in the detail, just waiting to be unraveled. So if you're worried about your blood pressure or there's someone that you know with high blood pressure, please, please do share this podcast episode with them. And I encourage you to get your history, your story, your timeline on paper and to have the right test done so that then you can use your personalized data and use...

devices as well to make decisions about your blood pressure with much, much more precision. And as always, I say this every time, please do contact me if you'd like to explore this further with me through my longevity concierge, wherever you are in the world, all my programs are delivered remotely as well. All my test kits can be sent to most parts of the world. So do get in touch with me either through my website, dralkapetel.com or DM me, message me via the socials at Dr Alka Patel UK.

Dr Alka Patel (30:56.45)

So before I say goodbye for this week, what I also want to let you know about is something very, very exciting, something that I am super excited to share with you. And that is that I'm launching the UK's first ever, first ever, doctor-led biohacking retreat here in the UK. Super, super excited about it. It's called Hacktivation and it's an immersive experiential retreat.

where you'll have the chance to get your hands on some of the devices that I've mentioned through this year's episodes on this show. And it's an event, a retreat, where we'll be dropping straight into some of the biohacking practices that I've discussed throughout the show as well. Things like intermittent fasting, for example. And you'll be using things like light therapy and cold therapy and heat therapy, as well as joining me in my master classes and coaching sessions directly with me as well.

Plus, I'll be doing some live blood testing as well. So I'm so, so excited about HACTIVATION, priority registration, it's open right now. And I've got just 24 places for the retreat because I do want to keep this a very safe, secure, close-knit event. So what I'll do is I'll pop a link into the show notes for you. And you can also find more details on my website as well, dralkapetel.com.

Get registered super quick so that you don't miss out and the first retreat is running from the 12th to the 14th of October, this year, 2023. I will see you there and I wish you a health activating day.