High Blood Pressure May Be a Choice

September 9, 2019

“High Blood Pressure
May Be a Choice” For the first 90% of our evolution,
we ate diets containing less than a quarter
teaspoon of salt a day, because for the first 90%
of our evolution we ate mostly plants. We went millions of years
without salt shakers, and so our bodies evolved into
salt conserving machines, which served us well until
we discovered salt could be used to
preserve foods. Without refrigeration,
this was a big boon to human civilization. Of course this may have led to a
general rise in blood pressure, but who cares if the alternative
is starving to death since all your food
rotted away. But where does that
leave us now, when we no longer have to live
off of pickles and jerky? We are genetically
programmed to eat ten times less salt
than we do now. Even many low salt diets can
be considered high salt diets. That’s why it’s critical
to understand what the concept of “normal” is
when it comes to salt. Having a “normal” salt intake can
lead to a “normal” blood pressure, which can help us to die from
all the “normal” causes, like heart attacks
and strokes. Doctors used to be taught that
a “normal” systolic blood pressure is approximately
100 plus age. “Systolic” blood pressure
means the top number, and indeed that’s about
what we’re born with. Babies start out with a blood
pressure around like 95 over 60, but then as we age that 95
can go to 120 by our 20’s then 140 in our 40’s (the official
cut-off for high blood pressure), and keep climbing
as we age. That was considered normal,
since everyone’s blood pressure creeps up as
we get older. And if that’s normal then heart
attacks and strokes are normal too since risk
starts rising once we start getting above
the 100 we had as a baby. But if blood pressures over a
100 are associated with disease, maybe they should be
considered abnormal, perhaps caused by our
abnormally high salt intake— ten times more than what our
bodies were designed to handle. Maybe if we just ate a
natural amount of salt, our blood pressures naturally
would not go up with age, and we’d be
protected. Of course to test that theory
you’d have to find a population in modern times that
doesn’t use salt or eat processed food
or go out to eat. For that you’d have to go deep
into the Amazon rainforest. Meet the Yanomamo people,
a no-salt culture. Lowest salt intake
ever reported, which is to say normal-for-
our-species salt intake. And so what happens to
their blood pressure? They start out with a blood
pressure of about 100 over 60 and end up with a blood pressure
of about 100 over 60. Though theirs is described
as a salt deficient diet, that’s like saying they have a
diet deficient in Twinkies. They’re the ones, it seems,
eating normal salt intakes apparently leading to truly
normal blood pressures. Those in their 50’s have the
blood pressure of a 20 year old. The percentage
of the population tested that had high
blood pressure? Zero. Whereas elsewhere
in Brazil, up to 38% of the population
may be affected. The Yanomamos probably represent
the ultimate human example of the importance of
salt on blood pressure. But look it could have
been other factors: they didn’t drink alcohol,
ate a high-fiber, plant-based diet,
lots of exercise, no obesity. There’s a number of plant-based
populations eating little salt that experience no rise in
blood pressure as they age, so how do we know what
exactly is to blame? Ideally we’d do an
interventional trial. Imagine, if you took people
literally dying from out of control high
blood pressure, so called malignant
hypertension where you go blind from
bleeding into your eyes, your kidneys shut down,
your heart fails, and then you withhold from those people
blood pressure medications so their fate is
certain death, and THEN you put them on a Yanomamo
level of salt intake, a normal-for-the-human-
species salt intake, and if instead of dying,
they walked away cured of their
hypertension, that would pretty
much seal the deal. Enter, Dr. Walter Kempner
and his rice and fruit diet. Patients came in
with blood pressures of 210 over 140 dropping down
to 80 over 60. Now, the reason he
could ethically withhold all modern blood pressure medications
and treat with diet alone? The drugs hadn’t
been invented yet— this was back
in the 1940’s. Now, the diet wasn’t just
extremely low salt, but strictly plant-based, extremely
low fat, protein, and calories. But there is no doubt that Kempner’s
rice diet achieved remarkable results and Kempner is now
remembered as the person who demonstrated beyond
any shadow of a doubt that high blood pressure
can often be lowered by a low enough
salt diet. Forty years ago
it was acknowledged that the evidence is very
good if not conclusive that a low enough reduction
of salt in the diet would result in the prevention
of essential hypertension— that rising of blood
pressure as we age— and its disappearance as a
major public health problem. It looks like we knew how to
stop this four decades ago. In that time, how many
people have died? Today, high blood
pressure may wipe out 400,000 Americans
every year. 1,000 unnecessary
deaths every day.

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