High Blood Pressure, Hypertension by Jeffrey Dach MD
Jeffrey Dach MD
them, then your doctor has you on pressure pills costing 3 billion
dollars a year nationwide. Despite over 100 antihypertensive
medications that have been approved, sadly, we have been unsuccessful
in controlling hypertension. A survey reported in the July 9 issue of
The Journal of the American Medical Association (JAMA) found that
"Almost 30 percent of people with high blood pressure are unaware of
their illness and 42 percent are not being treated".(1) (2)
The reason high blood pressure is bad for you is that it can damage
the arteries causing heart disease, kidney damage, and stroke. There
are two major types of hypertension with pills that work best for each
type. Natural alternatives like Co-Enzyme Q-10 and Nattokinase can
reduce reliance on blood medications.
Dr. John H. Laragh is the Expert on Hypertension:
My pick for best expert on hypertension is John H. Laragh, M.D., who
founded the American Society of Hypertension in 1986. He is chief
editor of the American Journal of Hypertension, and has written over
900 articles and several textbooks dealing with hypertension. He was
featured on the cover of Time magazine in 1975 for discovering the
role of the renin-angiotensin-aldosterone system in regulating blood
pressure. (3)(4)(5)
Hypertension is Caused by Renin:
Dr. Laragh says that common hypertension is caused by excess renin in
sixty percent of cases and can be permanently controlled with one drug
by measuring blood renin activity, a procedure that Dr. Laragh
pioneered and perfected over thirty years at his lab. This test is
called the PRA test (plasma renin activity). As a hospital based
interventional radiologist for over 25 years, I sometimes did renin
measurements by placing small catheters into each renal vein and
collecting blood samples from the kidneys. (6) This is unnecessary for
most people, because a routine blood sample from an arm vein is all
that is needed to run the PRA test.
We also used captopril renography to identify patients with renal
artery stenosis who would benefit from renal artery angioplasty (7)
Two types of essential hypertension:
Dr Laragh says that essential hypertension exists in two forms. The
first form is low renin hypertension, occuring in about a third of
hypertensives. This is called Volume (V) hypertension. The plasma
rennin activity PRA test shows low renin (less than 0.65 ng/m/hr) and
the "water pills" such as the thiazides and calcium channel blockers
work best for this type of low renin hypertension.
The second type is high renin hypertension, occurring in the other two
thirds of hypertensives, is labeled (R) for Renin Hypertension, and
the PRA levels are greater than 0.65 ng/m/hr. This hypertension is due
to the renin-angiotensin system, and the newer drugs such as the ACE
Inhibitors (angiotensin converting enzyme inhibitors) and Beta
Blockers work best for this type.
Measuring renin allows your doctor to identify which type of
antihypertensive medication is most likely to be effective and
possibly safer for you. If the "water pills" have been tried and dont
work for you, then you are probably have high renin hypertension and
need one of the newer drugs such as an Ace Inhibitor. The advantage
here is that once this is established, it is possible for you have
your blood pressure controlled with one drug permanently. Single drug
therapy for life is the major goal of treatment.
Problems with older "water pills":
Whats really worrisome is the harm that can result from traditional
diuretic "water pills". The thiazide diuretic, hygroton, produced an
11 percent incidence of permanent diabetes over five years in the
ALLHAT drug study. (8) (9) Diabetes is a super high risk factor for
heart disease. In other studies, thiazide "water pills" have been
shown to regularly produce potassium and magnesium depletion that
leads to cardiac arrhythmias, muscle weakness, EKG changes and fatal
heart problems. All of these thiazide "water pill complications can be
avoided by using a spirolactone type water pill instead (called
aldactone). This is off patent and therefore inexpensive costing 22
cents per tablet. The aldactone corrects the sodium-volume related
hypertension without ever causing diabetes or depletion of potassium
and magnesium.
It hard to understand why Dr. Laragh's information has been overlooked
(if not deliberately omitted) in official recommendations for the
treatment of hypertension. And as a result, your doctor may not do the
renin test for high blood pressure unless you bring it up.
Alternatives to Drug treatment: Coenzyme Q-10 and Nattokinase:
Co-Enzyme Q-10 is a vitamin like nutritional supplement that has been
useful in eliminating the need for blood pressure medications in about
half the people who try it. (10)(11) One such program is advocated by
Stephen Sinatra, M.D. in his books, "The Sinatra Solution, Metabolic
Cardiology" and "Lower Your Blood Pressure in 8 weeks". (12)
Co-Enzyme Q-10 has also been credited with saving many people from
death from congestive heart failure when other drugs have failed. In
addition, since the statin anti-cholesterol drugs cause depletion of
Co-Enzyme Q-10 in the body, all patients on a statin drug should be
supplementing with Co-Enzyme Q-10. Since Co-Q10 is not a drug, your
doctor may not be aware of it.
The Benefits of Nattokinase on Blood Pressure
In 1980, while studying physiological chemistry at the University of
Chicago Medical School, Japanese researcher Hiroyuki Sumi accidentally
discovered that a traditional Japanese soy cheese which had been
consumed for centuries, called "natto", had the ability to dissolve
clots. His research group published a paper on the discovery in 1987.
(13)
Traditionally, Natto has been consumed not only for cardiovascular
support, but also to lower blood pressure. This was confirmed by
several clinical trials in 1995, at Miyazaki Medical College and
Kurashiki University in Japan where the effects of nattokinase on
blood pressure in both animal and human subjects was studied. The
researchers found that natto inhibits angiotensin converting enzyme
(ACE), which has a lowering effect on blood pressure. In one Human
Study, Nattokinase ingestion was associated with a 10 percent drop in
blood pressure. Natto is a nutritional supplement which is considered
safe, However, people with bleeding disorders or on blood thinners
should use nattokinase only under medical supervision. (14) (15) (16)
Check your own blood pressure:
If you are not sure what you blood pressure number is, you can have
your doctor check it, or you can check it yourself with your own
inexpensive machine obtainable from most drug stores. The normal blood
pressure is commonly stated as 120 over 80 mm Hg.
disclaimer (c) 2007 Jeffrey Dach MD
Jeffrey Dach MD
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References:
(1) July 9 JAMA hypertension survey
http://pubs.ama-assn.org/media/2003j/0708.dtl#hypertension
(2) Trends in Prevalence, Awareness, Treatment, and Control of
Hypertension in the United States, 1988-2000 Ihab Hajjar, MD, MS;
Theodore A. Kotchen, MD JAMA. 2003;290:199-206.
http://jama.ama-assn.org/cgi/content/abstract/290/2/199
(3) John Laragh MD
http://hcr3.isiknowledge.com/author.cgi?id=2331&cb=2453
(4) Cover of Time Magazine 1975
http://www.time.com/time/covers/0,16641,1101750113,00.html
(5) http://www.time.com/time/magazine/article/0,9171,917084-1,00.html
(6)Hypertension and renovascular disease: follow-up on 100 renal vein
renin samplings
http://www.nature.com/jhh/journal/v16/n4/full/1001365a.html
(7) Procedure Guideline for Diagnosis of Renovascular Hypertension
http://jnm.snmjournals.org/cgi/reprint/39/7/1297
(8) Water Pills Help All With Hypertension
http://www.medicinenet.com/script/main/art.asp?articlekey=51967
(9) Water Pills Increase Diabetes Risk in Major Study
http://www.diabetesincontrol.com/modules.php?name=News&file=article&sid=1189
(10) Coenzyme Q-10 Page at the Linus Pauling Inst.
http://lpi.oregonstate.edu/infocenter/othernuts/coq10/
(11) Effect of coenzyme Q10 on blood pressures in hypertensive
patients with coronary artery disease.
http://www.ncbi.nlm.nih.gov/sites/entrez?db=pubmed&cmd=Retrieve&dopt=AbstractPlus&list_uids=10204818&query_hl=71&itool=pubmed_docsum
(12) Dr. Steven Sinatra Web Site: http://www.drsinatra.com/index.asp
(13) Nattokinase and Serrapeptase: Nature's Clot-Busters James South,
M.A.
http://www.vrp.com/art/1227.asp?c=1177727946671&k=/det/6251.asp&m=/&p=no&s=0
(14) Nattokinase Research
http://www.wellnesstrader.com/herbal-remedies/natto-nattokinase/nattokinase-research
(15) Nattokinase research at Mercola.com
http://www.mercola.com/forms/cardioessentials_scientific_research.htm
(16) Nattokinase at Smart Punlications, Links to abstracts
http://www.smart-publications.com/heart_attacks/nattokinase.php
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