Tuesday, July 14, 2009

Healthy Looking but Still High Blood Pressure?

I recieved an email from a mom who shared with me few details about her 16 year old, healthy looking son's high blood pressure problems. She is very concerned about her son's future health risks associated with hypertension and is looking for some answers. I did respond to her email below, but I would appreciate comments from my readers and if any one has any suggestions in this case.

Mom: Dr. Kapur, My son, who is 16 years old, has been running a “borderline” blood pressure. He had an athletic physical last year and this year where the nurses repeated his pressures multiple times. He is 6’2” and 172 pounds. He plays basketball and soccer. He does not like, thus does not drink any type of soda pop...but he does drink gatorade type of drinks as well as lots of water. He is diet is good, but not great. We rarely eat fast food. I do grow my own garden and can/freeze food. BUT, being busy with an athletic schedule, he does occasionally eat food that is not healthy.
Family history includes a grandmother that died about 2 years ago at the age of 58 due to an apparent heart attack. She did have issues with hypertension. She was 5' 8" and 220 pounds. She was extremely active/busy. BUT she did have a lot of stress....mother of 12 children, drove school bus, and owned a restaraunt. She was asymptomatic expect for the hypertension that was being treated by 3 antihypertensive agents....Catapress Patch, Tenormin, and Hydrochlorothiazide. She had a similar diet to my son....probably better. Her activity did not include a regular exercise plan or a cardio plan....my son has a vigorous exercise plan as he continuously plays basketball and soccer. She was overweight....my son does not have any extra weight on his body.

What can be done to improve my son's blood pressure??? He is passing his physicals now, but I am concern that with time he will need medication to maintain a normal blood pressure. AND the diastolic number is more of the issue than the systolic. Nothing has been done at this point. If I do a cardioprofile, will you be able to guide me if his numbers are out of range???? Is it genetic? Or is there a mineral or nutrient lacking in his diet that is the factor. My mother and my son have always lived in the same town. We do live in a rural farming community. My parents farmed organically, but neighbors do not farm in the same way...thus I understand that the air, water, etc is contaminated.

My Response: Thank you for sharing this information about your son. His BMI (Body Mass Index) is 22.08. This BMI puts him under the body classification of “Average” type. So, for him losing weight should not be the focus for controlling the blood pressure, however he still should keep healthy lifestyle to stay fit. This is good that he does not drink any type of soda pop; at the same time drinking Gatorade type of drinks may not be recommended for people with borderline or high blood pressure because of their high sodium content. Sodium in Gatorade is about 450 mg per liter. According to FDA the sodium content should not exceed 360 mg per serving for individual foods and about 480 mg per full serving for full meal. For individuals at risk, these limits are even lower, so it is good to consume less of any such drink types with high sodium content.

The American Heart Association recommends that people with high blood pressure should eat foods with low-sodium, low-fat, and low-cholesterol. So read food labels and check for any names with “sodium” like sodium hydroxide, sodium benzoate, monosodium glutamate or disodium phosphate etc. You mentioned that you grow your own garden. This is excellent because consumption of processed foods should be minimal as those are usually high in sodium. Any type of canned or pre-packaged frozen food should be avoided. Herbs and spices like garlic and onion, basil, parsley, thyme, black pepper, turmeric, etc are should be used for cooking.

Few researchers have been able to identify some abnormalities in a gene that have been linked with hypertension and therefore, there may be some increased likelihood of problems related to high blood pressure in individuals with variations in this gene. It is difficult at this time to clearly identify the genetic cause of high blood pressure because it is the interaction of inherited mutations/ genes with other genes and the environment that we all live in. A test is available to detect such type of inherited genetic variations that encode for a protein called G-protein coupled receptor kinase type 4 (GRK4). An individual carrying this variation is more prone to conditions like hypertension. This type of genetic variation is linked with inability to eliminate sodium from the body. So, even without going for this type of genetic testing, limiting sodium consumption should help control blood pressure in healthy looking individuals like your son. Other than that, foods rich in potassium are good. Foods like soya, wheat bran, tomato, raisins, unsalted nuts, potatoes, spinach, zucchini, bananas, melons, oranges, and figs etc. have high potassium content. Potassium and sodium work together to control blood pressure. Honey and fish oils have also shown to regulate blood pressure in normotensive individuals.

Your son is 16 and very young and so I am sure alcohol consumption is not an issue in his case. Drinking alcohol also raises blood pressure in otherwise healthy looking people. Hypertensive patients should always stay away from alcohol.

Please look at the link below for few important ADA guidelines on regulating blood pressure.