Have you ever felt like your doctor’s advice on high blood pressure just doesn’t quite hit the mark? It’s a common feeling, and today, we’re going to dig into some of the most common, yet often unhelpful, pieces of advice given about high blood pressure. In this article, Dr. Sten Ekberg explains why some of these ideas might be misleading and what you can do to truly understand and manage your health. It’s time to get real about what’s going on with your body and how to make changes that actually stick.
The “It’s Genetic” Myth
One of the most frustrating things people hear about high blood pressure is, “It’s genetic, your dad had it, so you’re going to get it, and there’s nothing you can do.” This idea is just not true. While you do inherit genes from your parents, how those genes act is heavily influenced by your lifestyle. This is called epigenetics. Think of it this way: you might have a gene for something, but whether it actually shows up depends on how you live your life.
Often, people end up with high blood pressure like their parents because they eat, think, and live in similar ways. Our brains have these things called mirror neurons, which basically make us copy what we see. So, if you grew up watching your parents’ habits, you might naturally pick them up, from how you stand to how you react to situations. By the time you’re two years old, a lot of your personality and reactions are already set. This is why we can be so much like our parents.
But here’s the good news: you can learn, make different choices, change your lifestyle, and even shift your beliefs. Saying it’s just genetic and there’s nothing to do is really discouraging. Most of us are born with pretty good DNA. Sure, there are small differences between people, and some might be more likely to get certain things, but for the most part, your health is shaped by how you live.
The “Just Take This Pill” Approach
Another common piece of advice is, “Just take this pill and keep taking it forever. If it doesn’t work, we’ll try another one.” This is a big part of how traditional medicine often works. If you have a symptom, you get a pill for it. But we need to ask: Why is your blood pressure high in the first place?
High blood pressure isn’t just something you “have.” Your body and nervous system are creating it all the time. If it’s too high for too long, it means something is out of balance. Your body is designed to keep things steady, but sometimes that ability gets messed up. It’s not random; there’s always a reason. Your body is always trying to do things in a certain way. If something is off, it’s because your body is reacting to something, or it can’t keep things balanced anymore.
The “Don’t Worry, It’s Not That High” Line
This one can be tricky because it can go both ways. Sometimes people worry too much, but other times, we don’t worry enough. If your blood pressure is super high, like 180/120, that’s a hypertensive crisis. It’s serious, and you need to get help right away. The next level is stage two hypertension, which is 140/90 or higher. These numbers show your systolic (when your heart squeezes blood) and diastolic (when your heart relaxes) pressure.
Below that is stage one hypertension, around 130-139 over 80-89. And then there’s prehypertension, which is 120-129 over 80-89. This isn’t a huge problem yet, but it’s something to watch.
So, what do these levels mean? The top level is an emergency. Imagine your car’s engine pressure getting too high – it could blow. High blood pressure can cause a stroke and damage your body. If you can’t get it down in a couple of days, you might need medicine until you figure out what’s going on.
The next level down, the mild hypertension, probably won’t cause immediate damage. But we’ll talk about why you should still care. For numbers below 130, I don’t really see that as hypertension for everyone. For some, it might be a bit high; for others, it’s normal. It’s also important to see if these numbers are a trend or just a one-time thing. Was it measured several times over a week, or just once? Was it taken at home when you were relaxed, or in a stressful doctor’s office with bright lights and rushing people? These things can make a big difference.
Don’t assume you have high blood pressure from just one high reading. On one hand, we worry too much; on the other, we don’t worry enough. And by “worry,” I don’t mean stress, because stress itself can raise blood pressure. I mean, we don’t pay enough attention to the right things.
If your blood pressure is between 121 and 140, there’s a small link to heart problems or poor health. But it’s probably not the blood pressure itself causing the harm, because this level is unlikely to cause physical damage like a crisis would. But if there’s still a link to long-term sickness, it means something else is going on. This is where we often get it wrong. We worry too much about the wrong thing. When you take medicine to lower your blood pressure, you might be hiding the real problem. If a doctor tells you, “Just take this pill, it will fix your problem, and you don’t have to worry about it,” that’s not the best approach.
The “Eat Less Salt” Fallacy
Here’s a classic piece of bad advice: “Eat less salt.” This might be one of the most important things to understand. Right now, over a billion people worldwide have high blood pressure, and almost all of them have been told to eat less salt, as if that’s the main answer. The idea is that salt holds onto water, especially in your kidneys. So, if you eat more salt, you keep more water, which increases the fluid in your blood and raises blood pressure. This theory sounds right so far. But it also assumes your body is dumb and can’t adjust to different situations.
However, your body has a clever system called pressure diuresis or pressure natriuresis. Don’t worry about the fancy words; it just means your body can get rid of extra fluid and salt through urine. A tiny rise in blood pressure makes your kidneys work harder, so they reabsorb less salt. If they reabsorb 98.5% instead of 99% of salt, that’s a big drop, meaning more salt leaves your body. This gets rid of more fluid, lowering blood pressure.
Experts say this system is super powerful at keeping your blood pressure steady over time. “Uniquely powerful” means it can override other reactions. “Stabilizing long-term pressure around a set point” means your blood pressure should go up and down depending on what you’re doing, but your body tries to keep a long-term average. They also say that if your blood pressure stays high for a long time, it means this regulating system isn’t working right. This system is so strong that your blood pressure should go back to normal unless something is stopping it. Your body is always deciding whether to keep blood pressure high for a reason or lower it when it’s not needed anymore.
The Real Causes of High Blood Pressure
So, what’s really causing high blood pressure? There are two main types of causes: metabolic and neurologic.
Metabolic Causes
In the metabolic group, we often see insulin resistance. If you’ve heard me talk before, you know I mention insulin resistance a lot because it’s a huge factor in many long-term health problems, including high blood pressure. Insulin resistance leads to:
- Sodium retention: Your body holds onto more salt.
- Increased AGEs (Advanced Glycation End-products): These are toxic, inflammatory compounds that damage blood vessels.
- Chronic inflammation: Ongoing inflammation in your body.
- Oxidative stress: Damage to your cells.
- Vascular dysfunction: Your blood vessels don’t work as well.
- Decreased kidney function: Your kidneys don’t filter as well.
- Increased RAAS (Renin-Angiotensin-Aldosterone System): A system that controls blood pressure and fluid balance.
Insulin resistance means higher blood sugar, and in its advanced stage, it becomes type 2 diabetes. AGEs mess up your blood vessels, making them stiff and scarred, which can lead to kidney problems and bad signaling. All of these things can make your RAAS system work overtime.
Neurologic Causes
The neurologic response is on purpose. When you’re in a fight-or-flight situation, your sympathetic nervous system kicks in, raising blood pressure to send more energy to your body. This part works mainly through holding onto salt and the RAAS system.
Think about exercise. When you work out, your body needs more energy, so it sends more blood to your muscles. Your blood pressure can go way up during intense exercise. If you jump into ice water, your blood pressure can also spike because your blood vessels tighten up.
So, does this mean every time your blood pressure goes up, you’ll start peeing a lot? No, because when you exercise, your body is supposed to have high blood pressure. Your body has a way to handle this. When you’re stressed, exercising, or in a fight-or-flight mode, your sympathetic nervous system is active, and your kidneys release a hormone called renin (the ‘R’ in RAAS). Renin starts a chain reaction where another hormone, angiotensin, makes your blood vessels tighten. Imagine putting your thumb over a garden hose – the water shoots out faster. That’s how your body raises blood pressure.
But there’s also a balancing system: aldosterone, another hormone from your adrenal glands. Aldosterone makes your kidneys hold onto more salt. This makes sure that when your body needs a lot of energy, like during exercise, it keeps enough fluid to maintain blood pressure and blood volume. So, while RAAS can raise blood pressure, diuresis can lower it. These two systems work together to make sure your body doesn’t lose too much fluid during a temporary rise in blood pressure.
If you understand how this works, it’s clear that salt isn’t the cause of long-term high blood pressure. Salt just follows your body’s orders, being let go or held onto as needed. Salt is super common on Earth, and many living things, including us, grew up in places with lots of salt, like the ocean. It’s not some strange thing your body doesn’t know how to handle.
The real problem happens when your body’s control system is broken, maybe because of insulin resistance, kidney failure, or other metabolic issues. In these cases, eating extra salt can make things worse because your body can’t handle salt and fluid properly anymore. But that doesn’t mean salt caused the high blood pressure; it just means your body lost its ability to deal with it.
This misunderstanding is where we often go wrong, especially with the common advice to “just avoid salt.” We’ve been told salt is bad, and people with high blood pressure are always warned to eat less. But salt doesn’t break your body’s control system. It’s other things, like insulin resistance and inflammation, that mess up your body’s ability to control blood pressure. If you have serious insulin resistance or kidney failure, you might need to eat less salt, and you should talk to your doctor about it. But if you’re healthy, salt won’t give you high blood pressure or damage your control systems.
The “Just Avoid Stress” Advice
Another common piece of advice is, “Just avoid stress.” This sounds nice, but it’s pretty useless unless you really get what stress is and how it affects you. Stress isn’t just about avoiding certain things in your life, because let’s be real, you can’t avoid everything. Stress is about how your body reacts to those things. Two people can go through the exact same event, and one might barely notice it while the other is completely overwhelmed. It’s not the event itself that causes stress; it’s how your nervous system is set up to respond.
Stress can be broken down into three main types:
- Chemical stress: This comes from things like blood sugar going up and down. When you eat sugar or processed foods, your blood sugar spikes, and your body has to release insulin to bring it down. When it drops, your body releases cortisol, a stress hormone, to raise it back up. These constant ups and downs are a huge stress on your system. Then there are toxins like heavy metals, pesticides, fake sweeteners, and preservatives. All these things mess with your body’s control systems and cause inflammation.
- Structural (or mechanical) stress: This comes from not moving enough, bad posture, or physical injuries. If you sprain your ankle and limp, you’ll start moving in new ways that stress your body unnaturally. Not moving enough, like sitting all day, can mess up the signals your body sends to your brain. Things like chiropractic care can help by making sure your spine moves right, which is important because most of the signals that keep your brain working come from your spine.
- Emotional stress: This isn’t just about big events that make you cry or angry. It’s also the constant, low-level stress many people deal with every day – worrying, anger, and feeling like you need to control everything. Many people don’t even realize that when they try to control something, that thing actually ends up controlling them. Why? Because if you’re emotionally tied to controlling something, and you can’t, then the situation controls how you feel, which is super stressful.
This is why it’s so important to learn to let go and have a more relaxed view on life. If you try to control things you can’t, you’re just adding to your stress.
The “Just Lose Some Weight” Mantra
I’m sure you’ve also heard, “Just lose some weight.” It doesn’t matter if you go to the doctor for knee pain, back pain, or high blood pressure – the advice is often the same. There’s nothing wrong with losing weight, but it’s not the main answer for many health problems. Most people don’t know how to lose weight well, and even the doctors giving the advice often don’t either. Weight itself isn’t the problem; the real issue is the things that lead to weight gain, especially insulin resistance.
Insulin resistance is at the root of so many health problems because it causes ongoing, low-level inflammation, which creates a bad cycle. This cycle gets worse because of the processed, nutrient-poor foods we eat, like white sugar, white flour, and processed vegetable oils. These “white trash” foods make up a huge part of what people eat in many places. Add to that the toxins in our food, water, and air, and you have a recipe for long-term health problems and weight gain.
If you want to lose weight and lower your blood pressure, it’s not just about eating less or avoiding fat. You need to deal with the underlying metabolic, structural, and emotional issues causing these problems. For example, bad fats, like those in processed vegetable oils, are harmful. But good fats, like those in extra virgin olive oil, grass-fed beef, and wild-caught fish, are good for you. It’s not about avoiding fat completely; it’s about picking the right kinds of fat.
What You Can Do
So, if high blood pressure is really about your metabolism and nervous system, you need to know where you stand with your metabolic health. To do that, you need to check your risk factors, and these aren’t the usual things most doctors check, like total cholesterol. You need to look at things like:
- C-reactive protein: This shows inflammation.
- Insulin levels: These are the best signs of insulin resistance.
- LDL particle count and size
- Homocysteine
- LP(a): This is a genetic risk factor for sticky cholesterol.
Once you know these things, you can make changes to deal with your real risk factors, instead of just covering them up with medicine. I talk a lot about these things in my videos, and I’ve made a course to help you understand what to look for in your blood tests and how it all fits together. If your doctor won’t check these things, you can find resources to help you.
The other part of blood pressure is your nervous system, so you need to understand how stress works and how to change your stress reactions. You can’t change the world, but you can change how your body reacts to it. Your automatic reactions can be rewired through things like deep breathing and meditation. These practices literally change your nervous system so it doesn’t react the same way anymore. There are also tools like BrainTap and HeartMath that can help speed up this process, especially for beginners, by helping you stay focused and get consistent results.
Key Takeaways
- High blood pressure is not just genetic; lifestyle plays a huge role.
- Taking a pill for high blood pressure often hides the real problem without addressing the root cause.
- Understanding your blood pressure numbers and their context is important; one high reading doesn’t mean you have chronic high blood pressure.
- The advice to “eat less salt” is often misleading, as salt isn’t the primary cause of chronic high blood pressure; a broken regulatory system is.
- Stress is more than just emotional; chemical and structural stressors also impact your health.
- “Just lose weight” is often unhelpful advice; addressing underlying issues like insulin resistance is key.
- Focus on understanding your metabolic and neurological health through specific blood markers and stress management techniques.
Source: Dr. Sten Ekberg