Lower Your Systolic Blood Pressure 10 Points

Lower Your Systolic Blood Pressure By 10 Points By This Simple Exercise

Ronald Grisanti D.C., D.A.B.C.O., DACBN, MS, CFMP

A recent newly published paper in the British Journal of Sports Medicine suggests that isometric exercises may in fact be a better form of exercise at lowering blood pressure. Isometric exercises, such as wall squats and planks, involve holding your body still while tensing your muscles for set periods of time.

The study looked at 270 trials carried out around the world between 1990 and 2023. In total, this included almost 16,000 participants both with and without health conditions. The researchers compared how much people's resting blood pressure dropped after following one of five different categories of exercise program:

Aerobic exercise, such as cycling, walking and jogging
Resistance training, such as lifting weights
Combined training (weights and aerobic exercise)
High-intensity interval training (HIIT), such as sprint intervals
Isometric exercises, such as wall squats.

While all five programs reduced blood pressure, isometric exercises were the most effective, followed by combined training, resistance training, aerobic exercise, and HIIT.

The study also compared specific exercises, showing that walking was less effective at lowering blood pressure than cycling or running.

In fact, wall squats which involve propping yourself up against a wall with your thighs parallel to the ground, were the most effective exercise out of all those compared.

FROM BBC NEWS

Wall squats involve positioning the feet 2ft (60cm) from a wall and sliding the back down it until the thighs are parallel to the ground.

Although it is commonly recommended to do 150 minutes of some form of cardio (walking, cycling) a week to lower blood pressure the researchers wanted to identify if other forms of exercise could influence blood pressure.

To there surprise it was found that isometric exercises like wall squats, planks and sustained leg extension actually held more promise in lowering blood pressure over the typical cardio.

The senior author of the report, Jamie O'Driscoll, a reader in cardiovascular physiology at Canterbury Christ Church university stated that isometric exercises place a very different stress on the body to aerobic exercise.

He went to say that isometric exercises increase the tension in the muscles when held for two minutes, then cause a sudden rush of blood when you relax. This increases the blood flow, but you must remember to breathe."

It is my opinion that all exercise is good for your heart health and health in general. However it is encouraging to see other forms of exercise explored in this research indeed is good at lowering blood pressure.

It is important not to forget that other lifestyle choices that can benefit your blood pressure. These include keeping to a healthy weight, eating a balanced diet, cutting down on salt, not drinking too much alcohol and taking any prescribed medication.

** Always consult with a physician or healthcare practitioner with significant training in nutritional, integrative and/or functional medicine before starting a new exercise program.

You can find a qualified and certified functional medicine practitioner by going to: www.FunctionalMedicineDoctors.com

References

https://www.bbc.com/news/health-66303982
https://pubmed.ncbi.nlm.nih.gov/23879248/
https://bjsm.bmj.com/content/57/20/1317
https://www.verywellhealth.com/reduce-blood-pressure-by-doing-this-simple-exercise-7642550
https://www.cnn.com/2023/07/27/health/exercises-for-blood-pressure-squats-planks-wellness/index.html
https://www.bloodpressureuk.org/news/news/planks-and-wall-sits-best-exercise-for-lowering-blood-pressure-study-says.html
https://www.bmj.com/company/newsroom/static-isometric-exercise-such-as-wall-sits-best-for-lowering-blood-pressure/

The information on this website is not intended to replace a one-on-one relationship with a qualified health care professional and is not intended as medical advice. It is intended as a sharing of knowledge and information from the research and experience of Dr. Grisanti and his functional medicine community. Dr. Grisanti encourages you to make your own health care decisions based upon your research and in partnership with a qualified health care professional. Visit www.FunctionalMedicineUniversity.com for more information on our training in functional medicine. Look for practitioners who have successfully completed the Functional Medicine University's Certification Program (CFMP) www.functionalmedicinedoctors.com. This content may be copied in full, with copyright, contact, creation and information intact, without specific permission, when used only in a not-for-profit format. If any other use is desired, permission in writing from Dr. Grisanti is required

Blood Pressure Medications & Nutrient Deficiencies

Ronald Grisanti D.C., D.A.B.C.O., DACBN, MS, CFMP

I first want to give you a brief overview on how medications impact important nutrients.

HOW MEDICATIONS AFFECT NUTRIENTS
The following are a few ways that blood pressure medications can affect how our bodies absorb essential nutrients.

The medication can attach itself to a nutrient and pass it out of the body
The medication can alter the pH in the gut so that the nutrient can't be properly absorbed
Some medications need specific nutrients in order for them to be able to work.

The Following are Blood Pressure Medications, Nutrients Commonly Depleted and the Negative Impact of the Deficient Nutrients

ACE INHIBITORS
Angiotensin converting enzyme inhibitors (ACE Inhibitors) are one of the most commonly used families of blood pressure medicines. Examples include; ramipril, enalapril, lisinopril, quinapril, fosinopril, trandolapril and captopril.

Nutrients that can be depleted by these medicines are zinc, magnesium, potassium and calcium.

Deficiencies in these nutrients can cause hair loss, slow healing of wounds, loss of taste or smell, prostate problems, loss of sex drive, frequent infections, leg cramps, weight gain, bone loss, high blood pressure, higher risk of cancer

CALCIUM CHANNEL BLOCKERS
Another commonly used family of blood pressure medicines. Examples include; amlodipine, nifedipine, felodipine, diltiazem and verapamil.

Nutrients that can be depleted by these medicines are potassium, calcium, vitamin D and possibly Co-Enzyme Q10.

Symptoms that can occur due to deficiencies in these nutrients are fatigue, leg cramps, frequent infections, thirst, muscle weakness, bone loss, confusion, high blood pressure, confusion, heart disease and rapid or irregular heartbeat.

BETA BLOCKERS
Examples of beta blockers include; atenolol, metoprolol, sotalol and bisoprolol.

Beta blockers can deplete the body of Co-Enzyme Q10 and melatonin.

Symptoms that can occur due to deficiencies in these nutrients are insomnia, disrupted sleep, increased risk of cancer, autoimmune disorders, muscle cramps, memory loss.

CENTRALLY ACTING BLOOD PRESSURE MEDICATIONS
Clonidine and methyldopa are examples of this.

These blood pressure medications can deplete Co-Enzyme Q10.

Depletion of Co-Enzyme Q10 can result in fatigue, weakness, muscle and leg cramps, memory loss, frequent infection, liver damage, higher risk of heart attack, higher risk of cancer.

Conclusion

The above blood pressure medications may in fact cause nutrient deficiencies making it more important to consider supplementing with these nutrients to decrease the negative symptom consequences

IMPORTANT

Always discuss this important information on blood pressure nutrient deficiencies with your healthcare provider.

References:

Pharmavite. Common drug classes, drug-nutrient depletions, & drug-nutrient interactions. www.aafp.org/dam/AAFP/documents/about_us/sponsored_resources/Nature%20Made%20Handout.pdf. Accessed September 20, 2019.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5874849/
https://nutritionreview.org/2016/12/practical-guide-avoiding-drug-induced-nutrient-depletion/

Compliments of

www.FunctionalMedicineUniversity.com

High Intensity Interval Training & Blood Pressure

Ronald Grisanti D.C., D.A.B.C.O., DACBN, MS, CFMP

When it comes to lowering blood pressure exercise is a non-negotiable factor.

You may be thinking what is the most effective form of exercise to lower blood pressure?

More and more studies are showing the exciting results of something called HIIT in lowering blood pressure. HIIT stands for High Intensity Interval Training

What is HIIT?
HIIT is not any specific exercise, rather, it is a technique. You can apply this technique to almost any kind of exercise whether it be walking, riding a bike, swimming, doing some body weight exercises or even dancing in your living room.

** ALWAYS CHECK WITH YOUR PHYSICIAN BEFORE STARTING ANY FORM OF EXERCISE FOR HIGH BLOOD PRESSURE

HIIT training consists of combining very short bursts of working at your absolute max alternating short periods of active recovery rest. Research has found that this form of exercising gives you more health benefits than any other way of exercising.

It shortens the amount of time you need to spend on exercise and is more effective; you work out for just 10-30 minutes and reap impressive health benefits. You burn more body fat, your metabolism is stimulated for long after you finish exercising, and it also it helps you utilize oxygen more efficiently.

One of the biggest benefits people find from HIIT is the reduction in training time. Through HIIT, you can put in about half the amount of time compared to traditional cardio exercise to reach your goals.

One study found that just 2 minutes of HIIT sprinting increased metabolism as much as 30 minutes of running. HIIT increases the efficiency of your heart and HIIT training also has a major effect on naturally lowering your blood pressure.

HIIT and blood pressure:

Although most any type of exercise has its benefits, HIIT shines when it comes to saving time. Using the HIIT technique is the ultimate short-cut.

Study after study shows that HIIT exercise improves blood pressure in people with hypertension better than any other kind of exercise routine.

HIIT is extremely effective in reducing resting heart rate and blood pressure in overweight and obese individuals.

It has been shown that HIIT exercising just 3 times per week for just 20 minutes at a time lowers blood pressure more effectively than continuous endurance training.

What is the science that makes HIIT so effective?

HIIT training changes something called endothelial function.

The endothelium is a very thin membrane that lines the inside of your heart and your blood vessels. The cells in this membrane release a variety of substances that control how your blood vessels relax and contract.

We know that stiff hard arteries play a role in high blood pressure.

The ability of your artery walls to expand (vasodilate) is very important.

You need to have flexibility in your arteries to allow for appropriate blood flow throughout your body.

HIIT improves endothelial function and reduces the stiffness in your artery walls more so than any other traditional form or exercise.

Just a 1% improvement in your endothelial function can result in a 13% reduction in the risk of cardiovascular events like heart attacks and strokes.

One study showed that 73% of people restored blood pressure to normal using a HIIT training method for just 2 months and 24 exercise sessions. There was a significant reduction in systolic blood pressure from 145.4 (± 9.0) to 118.3 ( ± 15.6) mm Hg.

How to Apply HIIT

With HIIT training you're are going to go ‘all out' at a high intensity for short amounts of time. You then do an ‘active recovery' rest for a short interval. You can apply this technique to any kind of exercise, walking, running, jumping rope, cycling and even to weight training.

I personally prefer using a stationary bike for minimizing injury. It is simply a great option to implement HIIT into your workouts.

Using the HIIT on a stationary bike

Warm-up for 5 minutes on a low setting.

After your 5 minute warm-up increase the tension on the bike and pedal as fast as you can for 20 seconds. This is called the Sprint phase. After the 20 second sprint phase, lower the tension on the bike and comfortably pedal for 2 minutes.

This is one session of HIIT.

Repeat the above 5 times and you are done.

Heart Recovery Tip

After doing your 20 second sprint, lower the tension and wait 60 seconds and check your pulse. You want your elevated pulse to come down between 8-10 beats. This is your heart recovery zone. If for some reason your pulse does not come down 8-10 beats you should stop and call it a day. For example: After you do your all out sprint for 20 minutes your heart rate when go up to 110 beats. After one minute of decreasing the tension and comfortably pedaling, your heart rate should come down to 100-102 beats. That is a good heart recovery.

Although as I mentioned above I prefer the stationary bike this can be applied to walking as well. Simply walking at a comfortable pace for 5 minutes then do an all out "brisk" walk for 20 seconds. Walking comfortably for 2 minutes then repeat five times.

That is all you need to do to maximize this effective form of exercise (HIIT) to lower your blood pressure.

References

https://pubmed.ncbi.nlm.nih.gov/29424402/

https://www.sci-sport.com/en/articles/HIIT-and-hypertension-Improvement-of-cardiovascular-functions-163.php

https://www.healthline.com/nutrition/benefits-of-hiit#TOC_TITLE_HDR_8

https://pubmed.ncbi.nlm.nih.gov/21450580/

https://journals.sagepub.com/doi/abs/10.1177/1741826711400512

https://www.sciencedirect.com/science/article/pii/S0531556516306003

Compliments from Functional Medicine University www.FunctionalMedicineUniversity.com

High Resistance IMST to Lower Blood Pressure

High-Resistance IMST is a Simple Technique to Lower Blood Pressure

Ronald Grisanti D.C., D.A.B.C.O., DACBN, MS, CFMP

Reducing cardiovascular risk should be a goal for anyone suffering from high blood pressure.

Clinical studies have shown that doing High-Resistance Inspiratory Muscle Strength Training (IMST) may reduce systolic blood pressure by 16mmHg and reduce diastolic blood pressure by 7mmHg.

Working out just five minutes daily via a practice described as “strength training for your breathing muscles” lowers blood pressure and improves some measures of vascular health as well as, or even more than, aerobic exercise or medication, CU Boulder research shows.

The study, published in the Journal of the American Heart Association, provides the strongest evidence yet that the ultra-time-efficient maneuver known as High-Resistance Inspiratory Muscle Strength Training (IMST) could play a key role in helping aging adults fend off cardiovascular disease––the nation's leading killer.

The studies attribute the reduction in blood pressure to the increased parasympathetic tone associated with respiratory muscle training.

Here is how to incorporate this amazing BP lowering exercise.

1: Purchase a device called BreatheEasy Lung Exerciser (https://4breatheeasy.com). The cost is approximately $30.00.

2: Perform 30 inhalations at 75 percent maximum inspiratory pressure six days a week.

3: IMST can be done in five minutes in your own home while you watch TV.

Conclusion

Adding this super simple High-Resistance Inspiratory Muscle Strength Training (IMST) could be a game-changer in improving your cardiovascular health leading to a reduced blood pressure.

References

https://pubmed.ncbi.nlm.nih.gov/33630377/
https://pubmed.ncbi.nlm.nih.gov/29178489/
https://www.ahajournals.org/doi/10.1161/JAHA.121.020980
https://www.sciencedaily.com/releases/2021/06/210630135033.htm
https://journals.physiology.org/doi/full/10.1152/japplphysiol.00024.2020
https://www.colorado.edu/today/2019/02/25/novel-workout-improves-health
https://www.health.harvard.edu/heart-health/breath-training-may-lower-blood-pressure

Compliments of www.FunctionalMedicineUniversity.com

Lower Blood Pressure

Lower Blood Pressure: Surprising Study

Ronald Grisanti D.C., D.A.B.C.O., D.A.C.B.N., M.S.,CFMP

There is now a new natural weapon to combat the growing population of high blood pressure sufferers.

Now this new weapon is as close as your backyard.

What I am talking about is good old sunlight.

Blood pressure levels are commonly higher during winter months.

The question you may ask is what is the mechanism that allows sunlight to lower blood pressure?

British researchers have figured out why.

The answer is nitric oxide (NO).

Nitric oxide is known to reduce blood pressure by evoking vasodilation either directly by causing relaxation of vascular smooth muscle or indirectly by acting in the rostral brainstem to reduce central sympathetic outflow, which decreases the release of norepinephrine from sympathetic nerve terminals.

Basically, nitric oxide increases the elasticity of the artery walls and helps to normalize high blood pressure.

An increasingly large body of literature suggests that alterations in the NO system may play an important role in the development or maintenance of clinical hypertension.

What they found is that nitric oxide stored in the top layers of the skin reacts to sunlight and causes blood vessels to widen as the oxide moves into the bloodstream. That, in turn, lowers blood pressure.

According to researcher Martin Feelisch, a professor of experimental medicine and integrative biology at the University of Southampton, exposure to ultraviolet light might help reduce the risk for heart disease.

"This new study finds that UV light exposure to the skin induced nitric oxide release and modestly lowered blood pressure, suggesting that this may play a role in modulating blood pressure," said Fonarow, a spokesman for the American Heart Association.

In 2009, a team led by the University of Edinburgh's Richard Weller showed that human skin and the dermal vasculature contain significant stores of NO—much more than can be found circulating in the blood—and that these stores could be mobilized by UVA (long-wave UV) irradiation.

“This study provides suggestive evidence that skin-derived NO metabolites may have a role in modulation of blood pressure upon UV exposure,” Thomas Michel, a professor of medicine and biochemistry at Harvard Medical School.

Reference:

Donald Liu, Bernadette O Fernandez, Alistair Hamilton, Ninian N Lang, Julie M C Gallagher, David E Newby, Martin Feelisch and Richard B Weller, UVA Irradiation of Human Skin Vasodilates Arterial Vasculature and Lowers Blood Pressure Independently of Nitric Oxide Synthase, Journal of Investigative Dermatology 20 February 2014

Compliments of

www.functionalmedicineuniversity.com

Pulse Pressure Number

A Number You Should Calculate for Optimal Cardiovascular Function

Ronald Grisanti D.C., D.A.B.C.O., DACBN, MS, CFMP

Pulse pressure is an indicator of how stiff or flexible the arteries are and how well the heart pumps blood. Like high blood pressure, high pulse pressure is linked to heart disease.

What Is Pulse Pressure?

Pulse pressure is the difference between your systolic blood pressure (top number) and diastolic blood pressure (bottom number)
For example if your blood pressure is 120/80, your pulse pressure would then be 120-80 equaling 40.

Normal Range
The normal range for pulse pressure is between 40 mmHg and 60 mmHg

(Systolic Blood Pressure) – (Diastolic Blood Pressure) = Pulse Pressure

The pulse pressure essentially tracks how much force the heart creates each time it contracts.

Pulse pressure tends to increase as you age as the arteries become less elastic. High pulse pressure (anything greater than 60 is a major risk factor for heart disease)

Doctors look at pulse pressure to determine how healthy the heart and large arteries are to estimate the risk of heart disease.

Pulse pressure is becoming a major player in the determination of optimal heart health.

Having normal pulse pressure indicates that your heart is pumping blood as it should and your arteries are adapting well by expanding and contracting.

Cardiovascular Complications from Increased Pulse Pressure--aka: Wide Pulse Pressure

Heart Disease
Wide pulse pressure is strongly linked to heart disease.

One study followed over 11k healthy men for 11 years. In those older than 60 years, pulse pressure above 55 mmHg was linked to more than 40% increased incidence of heart disease compared to levels below 44 mmHg

Congestive Heart Failure
A study in the Journal of the American Medical Association (JAMA) found those with a pulse pressure above 67 mmHg had a 55% increased risk of congestive heart failure compared to those with levels below 54 mmHg.

Stroke

High pulse pressure is as strong a risk factor for stroke as systolic and diastolic blood pressure.
High pulse pressure can damage blood vessels in the brain, leading to a stroke.

A study from the medical journal, Clinical Research in Cardiology found that every 10 mmHg rise in pulse pressure increases the risk of stroke by 5-11%

Erectile Dysfunction

Patients with pulse pressure above 60 mmHg were 15% more likely to suffer from erectile dysfunction. Wide pulse pressure has been found to reduce blood flow in the penis.

Irregular Heartbeat
A wide pulse pressure has been found to contribute to atrial fibrillation.

A study in JAMA found that every 20 mmHg increase in pulse pressure increased the risk of atrial fibrillation by 26%.

Heart Attacks
Wide pulse pressure was linked with more than a 2-fold increased incidence of heart attacks.

In a study from the prestigious medical journal Circulation it was found that every 10 mmHg increase in pulse pressure was linked to a 12% increase in the incidence of future heart attacks

Death
Wide pulse pressure increases the chance of death from heart disease.

In a study from the medical journal, Hypertension it was found that each 10 mmHg rise in pulse pressure increased the risk of death due to heart disease by 20%

As a general conclusion it has been found via several medical studies that like high blood pressure, high pulse pressure is linked with an increased risk of heart disease, heart attack, and dying.

What are the Common Causes of Increase Pulse Pressure (Wide Pulse Pressure)

Hardening of the Arteries
Hardened arteries (atherosclerosis) are the most common cause of wide pulse pressure. As we age, the arteries become stiffer due to the buildup of fatty plaques and calcium.

Overactive Thyroid
An overactive thyroid (hyperthyroidism) has been found to be associated with a wide pulse pressure

Aortic Valve Regurgitation
Aortic valve regurgitation is when the aortic valve doesn't close properly. As a result, blood flows back into the heart, which increases systolic and decreases diastolic blood pressure. In turn, pulse pressure widens.

Anemia
Severe anemia has been found to increase systolic and pulse pressures.

Low Testosterone

Older men with low testosterone have stiffer arteries, which can raise their pulse pressure and blood pressure.

In one study those with pulse pressure above 60 mmHg were twice as likely to have low testosterone levels.

Proven Clinical Recommendations to Lower Pulse Pressure

Exercise
The following exercises have been effective in decreasing pulse pressure

Moderate-intensity aerobic exercise such as brisk walking cycling, rowing, etc.
High-intensity interval training (HIIT)
High-intensity interval training (HIIT involves bursts of intense exercise followed by short rest periods.

A study of 245 people found that 3x/week of HIIT for 8 weeks reduced pulse pressure by 13 mmHg.

** Always consult with your physician before you engage in HIIT type of exercises

Stop Smoking
Smoking stiffens the arteries and increases both blood pressure and pulse pressure

Reduce Sodium Intake
Sodium-rich foods and salt harden the arteries making them stiff contributing to increase pulse pressure.

Reduce Alcohol Consumption

Heavy drinkers will commonly have higher pulse pressure than light drinkers

Lose Weight

According to one study of 220 obese people, a 10% reduction in BMI reduced pulse pressure by 9%

Get Enough Sleep
Make sure you are getting consistent, quality sleep every night.

Eat Beets
In one medical study it was found that beetroot juice reduced pulse pressure by 1.5 mmHg over the course of 24 hours

Eat one ounce of Dark Chocolate every other day (70% or greater is needed)
In a study on 32 healthy people, those eating flavanol-rich chocolate had a lower pulse pressure than those who ate chocolate low in flavanols

Omega-3 Fats
In one study 6 grams of fish oil (1:1 EPA:DHA) daily for 16 weeks decreased pulse pressure and reduced arterial stiffness

Vitamin B9 (Recommend methylated folate)
In one study it was found that supplementing with 4 mg/day methylated folate (vitamin B9) lowered pulse pressure by nearly 5 mm Hg and reduced arterial stiffness

Vitamin K

Vitamin K may help prevent artery hardening reduces pulse pressure

Aged Garlic Extract
Garlic has been found to decrease arterial stiffness and in one study taking 1,200 mg of aged garlic extract reduced pulse pressure by 4 mmHg over the course of 12 weeks

**Recommend Garlinex from https://longevinex.com/garlinex-time-release/ or Kyolic aged garlic extract

Dr. Grisanti's Comments:

Pulse Pressure should be added to your cardiovascular assessments and can easily be done at home with a blood pressure monitor. If an increased pulse pressure is found it is important to discuss these findings with your physician and get medical clearance on the above treatment recommendations to improve pulse pressure and of course improved cardiovascular health.

References:

** Always consult with a physician or healthcare practitioner with significant integrative or functional medicine training before starting any of the above recommendations.

You can find a qualified and certified functional medicine practitioner by going to: www.FunctionalMedicineDoctors.com

Lab Marker for Hypertension- TMAO

Trimethylamine N-oxide (TMAO)-- An Underrated Yet Important Cardiovascular Lab Marker

Ronald Grisanti D.C., D.A.B.C.O., DACBN, MS, CFMP

More than 30% (1.38 billion) of the global adult population suffer from hypertension and the leading cause of death worldwide.

It is of the utmost importance to have a better understanding of the underlying mechanisms causing hypertension and other cardiovascular events.

Although there are numerous factors contributing to hypertension and other cardiovascular issues, one under-rated novel contributor is the incidence of elevated TMAO.

A study published in the journal Hypertension looked at the presence of trimethylamine-n-oxide (TMAO), a byproduct from digesting certain meat-based proteins in 100 adults and 22 young adults

Trimethylamine N-oxide (TMAO) is derived from foods rich in choline, phosphatidylcholine, and betaine (e.g., red meat, eggs, milk, etc.)

The researchers found that meat-eaters' TMAO levels rose significantly with age, as did signs of health-threatening tissue and blood vessel damage. This was independent of the damage excess saturated fat in meats can do to your health.

Another study in the Journal of the American Heart Association found that the risk of major cardiovascular events in people with elevated TMAO was 60% greater than for those with normal TMAO.

Additional studies have demonstrated that TMAO is important for the development and progression of cardiovascular diseases (e.g., hypertension, atherosclerosis, coronary artery disease, and heart failure)

It is commonly agreed that TMAO acts as an independent risk factor and a prognostic index for patients with cardiovascular disease and been found to induce aortic stiffening and increases systolic blood pressure.

Studies provide evidence of a causal relationship of TMAO and elevated blood pressure and it is suggested that mediating the production of TMAO would be beneficial for lowering blood pressure.

What also concerned me was evidence that elevated TMAO compromises the release of nitric oxide release in endothelial cells thereby interfering with the vasodilatory mechanism which can contribute to hypertension.

Compliments from the Journal of Hypertension-July 2021

How to Lower TMAO and Reduce Your Cardiovascular Risk Factors

To reduce TMAO levels, you need to minimize and in some people actually eliminate red and processed meats from your diet. In addition, limit lean, skinless poultry to one 3- to 6-ounce serving. Additional recommendations to lower TMAO include diets high in soluble fiber as does supplementation with specific probiotics

Instead, eat fish such as salmon and sea trout, which are loaded with heart-healthy omega-3 fats, twice weekly.

Focus on a Plant Based-Mediterranean diet

Therefore, such dietary-based strategies may help to suppress TMAO production thereby mitigating aortic stiffening and increases in systolic BP.

To be quite honest there are some that will state the studies may indeed be empirical studies and not interventional and data simply does not hold up.

Quite the contrary from my below experience and the experience with several patients.

Dr. Grisanti Personal Comments:

Back in early 2022 I decided to give the carnivore diet (heavy meat based diet) a three month try and was shocked and disappointed with the fact that almost all of the cardiovascular markers (LDL, Lipoprotein Fractionation (LDL Particle Numbers), ApoB and Lp-PLA2 Activity) all were off the charts.:( What was even worse was the fact that my blood pressure stayed significantly elevated. When I changed to a strict Plant Based Diet ALL of my cardiovascular markers and Blood Pressure (now stays around 118/65)) markedly improved.

Click Here to See My TMAO numbers over the course of my experience from eating a strict carnivore diet to a plant based diet.

https://www.functionalmedicineuniversity.com/TMAO4.pdf

My conclusive thoughts are a plant based diet with some emphasis on the Mediterranean diet should take precedence when looking to help patients with cardiovascular issues.

Codes for ordering TMAO:

TMAO (Trimethylamine N-Oxide) Code from Labcorp--123413
TMAO (Trimethylamine N-Oxide) Code from Quest-94154

** Always consult with a physician or healthcare practitioner with significant integrative or functional medicine training.

You can find a qualified and certified functional medicine practitioner by going to: www.FunctionalMedicineDoctors.com

References

https://pubmed.ncbi.nlm.nih.gov/34387163/
https://www.functionalmedicineuniversity.com/TMAO.pdf
https://www.frontiersin.org/articles/10.3389/fcvm.2022.922441/full
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9354484/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8408632/
https://pubmed.ncbi.nlm.nih.gov/35409341/
https://www.ahajournals.org/doi/10.1161/HYPERTENSIONAHA.120.16895
https://respiratory-research.biomedcentral.com/articles/10.1186/s12931-022-02282-5
https://www.sciencedirect.com/science/article/pii/S2213231721002743
https://www.ahajournals.org/doi/10.1161/HYPERTENSIONAHA.121.17487
https://www.ahajournals.org/doi/10.1161/JAHA.120.020646
https://link.springer.com/article/10.1007/s12265-021-10115-x
https://www.functionalmedicineuniversity.com/TMAO3.pdf

Salt and Hypertension

Ronald Grisanti D.C., D.A.B.C.O., DACBN, MS, CFMP

A high-sodium diet can have a seriously detrimental effect on your blood pressure.

According to findings published November 11 in JAMA and presented at the American Heart Association Scientific Sessions 2023 people can significantly lower their blood pressure, even if they are already on blood pressure medication, if they cut down on salt by about a teaspoon a day.

Considered one of the largest studies on sodium and hypertension, Norrina Allen, PhD , a coauthor of the study, a professor of preventive medicine, and the director of the Institute for Public Health and Medicine at Northwestern Medicine in Chicago, it was found that nearly 3 in 4 people saw a decline in their blood pressure in as little as one week when they went from a high salt to low salt diet.

Lead author of the study Deepak K. Gupta, MD, an associate professor of medicine and the director of the Vanderbilt Translational and Clinical Cardiovascular Research Center at Vanderbilt University Medical Center in Nashville, Tennessee also showed that lowering blood pressure through dietary sodium reduction can be achieved safely and rapidly within one week,

“The average amount of blood pressure lowering was about 8 millimeters of mercury (mmHg) for systolic blood pressure, which is similar to the effect produced by medications for high blood pressure,” says Dr. Allen.

Dr. Allen found that 70-75 percent of all people, regardless of whether they are already on blood pressure medications or not, are likely to see a reduction in their blood pressure if they lower the sodium in their diet,

Most guidelines recommend a daily dose of sodium <2 g, yet it was found that most individuals consume about 3,400 mg per day almost double this recommended daily dose. Salt restriction is believed to be a cost-effective measure to reduce population morbidity and mortality. World Health Organization (WHO) is raising awareness about salt restriction, aiming to reduce the global sodium intake by a relative 30% by the year 2025.

The risk of cardiovascular disease increased up to 6% for every 1 g increase in dietary sodium intake.

High sodium intake and the increase in blood pressure levels are related to water retention, increase in systemic peripheral resistance, alterations in the endothelial function, changes in the structure and function of large elastic arteries, modification in sympathetic activity, and in the autonomic neuronal modulation of the cardiovascular system.

This is one of the largest studies to investigate the effect of reducing sodium in the diet on blood pressure that includes people with hypertension and already on medications.

How Much Sodium Per Day?
If you have high blood pressure reducing sodium with a low sodium diet is a priority. Some sodium is necessary for health, but not much: about 1,500 milligrams a day is the minimum daily requirement. The upper limit, 2,300 mg, is equal to only about 1 teaspoon of salt.

How to Reduce Sodium Intake
The best way to combat high sodium in your daily diet is to watch your intake of highly processed foods. Read the Nutrition Facts label and look for the Daily Value of sodium in the foods you eat. And consider these satisfying options to keep sodium under control: fruits and vegetables, unsalted nuts, legumes and whole grains (including brown rice, oats and barley).

Additional ways to lower sodium intake:

Get more natural sources of potassium in your diet by including additional servings of fruits and vegetables.
Watch portion sizes, especially when it comes to already prepared foods.
Limit cured foods, including cold cuts and sausages.
Rinse canned foods or look for no-salt added varieties.
Choose lower sodium packaged foods.
Remove the salt shaker from the table.
Increase your intake of whole grains such as brown rice, quinoa, oats, bulgur, buckwheat and wild rice.
Include beans, peas and more plant-based sources of protein.
Substitute crackers and chips with a small amount of unsalted nuts.

Cooking with Less Salt
There are lots of flavors you can add to your meals to delight your taste buds, without raising your blood pressure.

Ingredients you can use to add flavor include:

fresh, frozen or dried herbs
onion powder
garlic powder
black pepper
dried oregano
dried basil
coriander
shallots
chili powder
curry powder
paprika
thyme
rosemary
turmeric
ginger
cinnamon
cumin
lemon juice
vinegar

In most people, the kidneys have trouble keeping up with excess sodium in the blood. As sodium accumulates, the body holds onto water to dilute the sodium. This increases both the amount of fluid surrounding cells and the volume of blood in the bloodstream. Increased blood volume means more work for the heart and more pressure on blood vessels. Over time, the extra work and pressure can stiffen blood vessels, leading to high blood pressure, heart attack, and stroke. It can also lead to heart failure. There is some evidence that too much salt can damage the heart, aorta, and kidneys without increasing blood pressure, and that it may be bad for bones, too.

Are “natural” salts healthier than table salt?
Salt is harvested from salt mines or by evaporating ocean water. All types of salt including Kosher salt, Sea salt and Himalayan pink salt are made of sodium chloride, and the nutrient content varies minimally. Although less processed salts contain small amounts of minerals, the amount is not enough to offer substantial nutritional benefit.

Dr. Grisanti's Comments:

I have read reports of selected observational studies that have stirred controversy and have become the motivation to abandon recommendations for reduced sodium intake by the US general population. A detailed review of these studies simply do not support the recommendations to relinquish reducing sodium intake in the general population The studies supporting lowering sodium intake are robust and persuasive.

The American Heart Association is committed to improving the health of all Americans through implementation of national goals for health promotion and disease prevention, including its recommendation to reduce dietary sodium intake to <1500 mg/d.

References:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7601012/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6770596/
https://jamanetwork.com/journals/jama/article-abstract/2811931
https://pubmed.ncbi.nlm.nih.gov/31438636/
https://www.sciencedirect.com/science/article/pii/S0735109715000832
https://www.ahajournals.org/doi/full/10.1161/CIR.0b013e318279acbf

** Always consult with a physician or healthcare practitioner with significant integrative or functional medicine training before starting any of the above recommendations.

You can find a qualified and certified functional medicine practitioner by going to: www.FunctionalMedicineDoctors.com

Flaxseed Benefits and High Blood Pressure

Ronald Grisanti D.C., D.A.B.C.O., DACBN, MS, CFMP

It is well documented that high blood pressure is “the single largest risk factor” for death in the world.

Globally, cardiovascular diseases (CVDs) are the number one cause of mortality. Approximately 18 million people died from cardiovascular disease (CVDs) representing more than 30% of all global deaths.

By the year 2025, an estimated 1.6 billion of the world adult population will have hypertension. This is an increase of about 60% compared to the year 2000.

Although the most effective and quickest way to lower blood pressure is medication including the following: Beta Blockers (Atenolol, Metoprolol, Nebivolol and Propranolol), Ace Inhibitors (Benazepril, Captopril, Enalapril, Fosinopril and Lisinopril), Calcium Channel Blocker (Cardizem, Felodipine, Nifedipine and Verapamil), Angiotensin Receptor Blockers (Losartan, Olmesartan, Telmisartan and Valsartan) and Diuretics (Lasix, Hydrochlorothiazide, Indapamide and Metolazone), it is hard to believe that at least 80% of people are non-compliant and stop taking their medication.

The following is the average reduction in blood pressure of the above listed medications:

Beta Blockers lowers blood pressure an average of -10 mmHg (SBP)/-8 mmHg DBP)
Ace Inhibitors lowers blood pressure an average of 8mmHg (SBP)/-5 mmHg (DBP)
Calcium Channel Blocker lowers blood pressure an average of 9.45 mmHg (SBP)
Angiotensin Receptor Blockers lowers blood pressure an average of 8mmHg (SBP)/-5 mmHg (DBP)
Diuretics lowers blood pressure an average of 7.9 mmHg (SBP/ -4.4 mmHg (DBP)

What is of significant importance is adding two tablespoons of flaxseed per day to your diet. (not flaxseed oil)

In an important peer reviewed study from the American Heart Association Journal, Hypertension, it was found that patients who entered the trial with a SBP ≥ 140 mm Hg at baseline obtained a significant reduction of 15 mm Hg in SBP and 7 mm Hg in DBP from flaxseed ingestion.

The magnitude of this decrease is as good or better than many blood pressures listed above.

Flaxseed induced one of the most potent antihypertensive effects achieved by a dietary intervention.

Indeed, the drop in blood pressure the researchers saw in the flaxseed study “was greater than the average decrease observed with the standard dose of anti-hypertensive medications.

In the above peer reviewed study patients (110 in total) ingested a variety of foods that contained 30 g of milled flaxseed or placebo each day over 6 months. Plasma levels of the alpha-linolenic acid (ALA) and enterolignans increased 2- to 50-fold in the flaxseed-fed group but did not increase significantly in the placebo group.

Most omega-6 fatty acids in the diet come from vegetable oils, such as linoleic acid (LA), not to be confused with alpha-linolenic acid (ALA), which is an omega-3 fatty acid.

The most evident reason for the benefits of flaxseeds and decreased blood pressure is thought be due to a change in plasma oxylipins.

What are oxylipins?

Oxylipins are a group of fatty acid metabolites involved in inflammation and have been implicated in many pro-inflammatory conditions, including aging and cardiovascular disease.

The best-characterized oxylipins associated with cardiovascular disease are derived from long-chain omega-6 fatty acid more commonly from linoleic acid. Linoleic acid oxylipins are often pro-inflammatory, associated with atherosclerosis, non-alcoholic fatty liver disease, and Alzheimer's disease. Centenarians have shown reduced levels of linoleic acid oxylipins in their blood circulation. Oxylipins are found preformed in animal products, particularly chicken and eggs, and can be made inside the body from junky oils rich in omega-6, such as cottonseed oil.

Here are oils to avoid and high in linoleic acid. Olive oil, avocado oil and palm oil are ok to consume on a limited basis but much better than the other oils listed below.

OILS HIGH IN LINOLEIC ACIDOils High in Linoleic Acid

Elevated levels of pro-inflammatory, aging-associated oxylipins can be normalized by eating ground flaxseed.

Studies have shown that flaxseed consumption reduces blood pressure in patients with hypertension: by inhibiting the enzyme that makes these pro-inflammatory oxylipins. Eating flaxseeds inhibits the activity of the enzyme that makes these pro-inflammatory oxylipins, called leukotoxin diols, which in turn may lower blood pressure.

Dr. Grisanti's Comments:

Although it has been shown that flaxseeds have an influence on oxylipins it has been proposed that the whole is greater than the sum of its parts. Each of the components of interest within flaxseed, ALA, lignans, fiber, and peptides—the omega-3s, the cancer-fighting lignans, all the soluble fiber, and the plant proteins, for instance all contribute towards BP reduction.

Although not all studies have shown significant blood pressure lowering effects of flaxseed consumption, there have been more than a dozen trials by now, involving more than a thousand subjects. When you put them all together there were “significant reductions in both SBP and DBP”—systolic blood pressure (the upper number) and diastolic blood pressure (the lower number) following supplementation with various flaxseed products.

References:

https://www.ahajournals.org/doi/10.1161/HYPERTENSIONAHA.113.02094
https://pubmed.ncbi.nlm.nih.gov/34119421/
https://pubmed.ncbi.nlm.nih.gov/25740909/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6477925/
https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD007451.pub2/full
https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD010052.pub2/full
https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD003823.pub2/full
https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD003822.pub2/full
https://journals.physiology.org/doi/full/10.1152/ajpheart.00201.2017
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6289399/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9552797/
https://pubmed.ncbi.nlm.nih.gov/25789320/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2951311/
https://www.frontiersin.org/articles/10.3389/fcvm.2021.645786/full
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10093787/://pubmed.ncbi.nlm.nih.gov/25740909/
https://www.ahajournals.org/doi/10.1161/HYPERTENSIONAHA.114.03179
https://www.sciencedirect.com/science/article/abs/pii/S1550830721000938
https://www.healthline.com/nutrition/benefits-of-flaxseeds
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6707798/

** Always consult with a physician or healthcare practitioner with significant integrative or functional medicine training before starting any of the above recommendations.

You can find a qualified and certified functional medicine practitioner by going to: www.FunctionalMedicineDoctors.com

Understanding the Three-Legged Stool

-Concept to Winning the War on Cardiovascular Disease

Ronald Grisanti D.C., D.A.B.C.O., DACBN, MS, CFMP

In my clinical experience and pursuit to clearly understand the key mechanisms of progressive cardiovascular disease (CVD) I have come across three schools of thought that I hope to bring to light in today's article.

I commonly visualize a three-legged stool exemplifying the full understanding of developing atherosclerosis.

The three areas of cardiovascular disease include:

Lipid Dysregulation (Leg #1)
Endothelial dysfunction and inflammation (Leg #2)
Insulin Resistance (Leg #3)

Lipid Dysregulation

The role of abnormal lipid markers (Leg #1) (see Grid Below) is essential in any phase of the atherosclerotic process and has been well established in the peer reviewed literature to be one of keys to establishing cardiovascular treatment protocol to reverse the high risk of atherosclerosis.

Endothelial Dysfunction

Another school of thought (Leg #2) (see Grid Below) is the issue of Endothelial Dysfunction.

The endothelium is a thin membrane that lines the inside of the heart and blood vessels. Endothelial cells release substances that control vascular relaxation and contraction as well as enzymes that control blood clotting, immune function and platelet (a colorless substance in the blood) adhesion.

Endothelial dysfunction has been shown to be of significance in predicting stroke and heart attacks due to the inability of the arteries to dilate fully. The dysfunction may be a result of high blood pressure, diabetes, high cholesterol and smoking.

Studies have shown that endothelial dysfunction precedes the development of atherosclerosis, a chronic disease characterized by abnormal thickening and hardening of the arterial walls with resulting loss of elasticity.

Read and Watch the Following Video from Cleveland Heart Lab:

https://www.knowyourrisk.com/

Insulin Resistance

Insulin resistance (Leg #3) (see Grid Below), also known as impaired insulin sensitivity, happens when cells in your muscles, fat and liver don't respond as they should to insulin, a hormone your pancreas makes that's essential for life and regulating blood glucose (sugar) levels.

The Differing Camps of Thought in the World of Cardiovascular Progression Are All Correct and At the Same Time All WRONG

The battle among different camps of thought of what causes atherosclerosis should not be isolated to one or two legs of the stool mentioned above.

Some thought leaders claim focus needs to be exclusively directed to insulin resistance, while others claim it is all about arterial inflammation/endothelial dysfunction.

Of course, the traditional cardiovascular medical community with their myopic position are ordering ONLY the basic lipid panel (Total Cholesterol, LDL Cholesterol, Triglycerides and HDL).

With hundreds and even thousands of medical records I have reviewed, it is rare to ever see more than the basic lipid panel ordered to establish a cardiovascular risk level.

Based on this limited cardiovascular assessment the treatment of choice is almost always statins.

This article is in no way denying the benefits of addressing the Lipid Dysregulation via diet, lifestyle interventions and in many cases the use of statins.

So this camp of health professionals assume all levels of atherosclerosis is directly associated with Lipid Dysregulation.

My point is quite clear: Atherosclerosis is a multifactorial process regulated by a complex interplay among ALL three legs of the stool discussed above.

To obtain the best clinical outcome in stopping and to be quite honest even reversing atherosclerosis it is IMPERATIVE to carefully evaluate and treat all THREE legs of the stool.

Again, these three legs make up:

Lipid Dysregulation (Leg #1)
Endothelial dysfunction and inflammation (Leg #2)
Insulin Resistance (Leg #3)

LIPID DYSREGULATION, ENDOTHELIAL DYSFUNCTION AND INSULIN RESISTANCELipid Dysregulation, Endothelial dysfunction and Insulin Resistance

Innovative and Advanced Testing as shown above with three legs of the cardiovascular stool analogy is a MUST for providing the absolute best opportunity to aggressively and effectively manage atherosclerosis.

Anything less than the labs mentioned above for all three legs of the stool is bad medicine and bound to result in poor or even deadly clinical outcomes.

I have to wonder why the most prestigious and most well respected medical institutions like the Boston Heart Diagnostics and Cleveland Heart Lab do EXACTLY what I have discussed in this important article on excellence in the cardiovascular management.

As you will clearly see these outstanding forward thinking medical establishments have it RIGHT and have come to realize that to be a leader in cardiovascular management and excel in reversing CVD then you should do nothing short then address ALL three legs of the stool as discussed above.

https://bostonheartdiagnostics.com/
https://www.clevelandheartlab.com/test-menu/

Dr. Grisanti's Comments:

The goal is quite simple: Evaluate Cardiovascular Disease (CVD) risk beyond the standard lipid assessment with the addition of advanced diagnostic markers

Once one has identified the weight of the cardiovascular markers then treatment becomes quite obvious.

From my personal experience, I have many patients with only one leg of the stool resulting in compromised CVD.

On the other hand I have many patients with ALL THREE of the legs of the stool in peril.

The preponderance of the evidence to support carefully testing for ALL of the legs of the stool is simply overwhelming and again makes for OUTSTANDING medical care and the BEST clinical outcomes.

The ultimate goal for all healthcare professional seeking to stop and reverse atherosclerosis is to first test for ALL of the cardiovascular metrics shown and above then with time tested dietary excellence (Mediterranean Plant-Based Diet), lifestyle modifications, personalized approved exercise programs (Zone 2 Cardio), stress reduction management, nutraceuticals and yes even pharmaceuticals, you can commonly witness the miracle of atherosclerosis reversal.

With the above cardiovascular disease management plan and optimizing all of the above detailed recommended labs you will be in a position of ultimate cardiovascular success and save a lot of lives!

References:

Uric Acid and Endothelial Dysfunction
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5237466/
https://www.sciencedirect.com/science/article/pii/S0021915018314266

Insulin Resistance and Atherosclerosis
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10069006/
https://cardiab.biomedcentral.com/articles/10.1186/s12933-018-0762-4
https://pubmed.ncbi.nlm.nih.gov/10418856/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3594115/
https://academic.oup.com/edrv/article/40/6/1447/5482541

Lipid Dysregulation and Atherosclerosis
https://pubmed.ncbi.nlm.nih.gov/36613514/
https://www.ncbi.nlm.nih.gov/books/NBK343489/
https://www.ncbi.nlm.nih.gov/books/NBK343489/
https://www.frontiersin.org/articles/10.3389/fcvm.2021.707529/full

C-Reactive Protein (high sensitivity) and Endothelial Dysfunction
https://www.ahajournals.org/doi/10.1161/01.cir.0000159336.31613.31
https://www.internationaljournalofcardiology.com/article/S0167-5273(11)00771-6/abstract

Homocysteine and Endothelial Dysfunction
https://pubmed.ncbi.nlm.nih.gov/26201664/
https://www.frontiersin.org/articles/10.3389/fcell.2021.672335/full

Apolipoprotein B and Atherosclerosis
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7369156/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8540246/

Lipoprotein(a) and Atherosclerosis
https://www.atherosclerosis-journal.com/article/S0021-9150(22)00181-2/fulltext
https://heart.bmj.com/content/109/1/18

Lp-PLA2 and Endothelial Dysfunction
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6360470/
https://lipidworld.biomedcentral.com/articles/10.1186/1476-511X-10-170

Myeloperoxidase (MPO) and Endothelial Dysfunction
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9112398/
https://pubmed.ncbi.nlm.nih.gov/31043077/

ADMA and Endothelial Dysfunction
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7563400/
https://www.nature.com/articles/s41598-019-50778-w

LDL-C and Atherosclerosis
https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.122.061010
https://academic.oup.com/eurheartj/article/41/24/2313/5735221

sdLDL-C and Atherosclerosis
https://www.frontiersin.org/articles/10.3389/fcvm.2021.804214/full
https://www.mdpi.com/1648-9144/58/2/299

Microalbumin and Endothelial Dysfunction
https://pubmed.ncbi.nlm.nih.gov/12389063/
https://pubmed.ncbi.nlm.nih.gov/11916939/

Ox-LDL and Endothelial Dysfunction
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9199460/
https://pubmed.ncbi.nlm.nih.gov/30806246/

F2-IsoPs and Endothelial Dysfunction
//www.functionalmedicineuniversity.com/F2-IsoPs.pdf

Endothelial Dysfunction
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4723236/

Mediterranean Plant-Based Diet
https://pubmed.ncbi.nlm.nih.gov/37513660/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9566634/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9566634/
https://www.ahajournals.org/doi/10.1161/STROKEAHA.120.033214
https://pubmed.ncbi.nlm.nih.gov/37583985/

** Always consult with a physician or healthcare practitioner with significant integrative or functional medicine training before starting any of the above recommendations.

You can find a qualified and certified functional medicine practitioner by going to: www.FunctionalMedicineDoctors.com

An Underappreciated and Potential Cause of Hypertension

Forest Bathing

Ronald Grisanti D.C., D.A.B.C.O., DACBN, MS, CFMP

Living in urban areas of higher surrounding greenness is associated with lower levels of stress, depression, insulin resistance, diabetes, stroke, all-cause mortality, and cardiovascular mortality.

What does Greenness mean?

Green vegetation refers to all plants and trees.

The concept of "Greenness" reflects the long accepted concept of forest bathing. Forest bathing referred to as “Shinrin-yoku” in Japanese, involves spending time in a natural environment or specifically in a forest environment to improve one's health and well-being.

Forest bathing was first proposed in the belief that spending time in a natural or forested area will have healing effects. Forest bathing, through exposure to natural stimuli such as plants, woods, and flowing water in a forest environment, is regarded as a health promotion strategy to achieve relaxation, resulting in a decrease in heart rate and blood pressure, a release of stress, and a boost to the immune system, all of which facilitate recovery from illness.

During forest bathing, individuals are guided to slow down their pace and are soothed through connecting with a forest environment, using their five senses to listen to birds chirping and streams flowing, looking at trees and seeing sunlight penetrate through tree branches, breathing in natural aromas, tasting the freshness of the air, touching leaves and trees, and lying on the ground.

Time spent walking and relaxing in a forest environment ("forest bathing" or "forest therapy") has well demonstrated anti-stress effects in healthy adults.

In a recent issue of Environmental Health Perspectives, the author of the paper, Zheng reported potential protective effects of neighborhood greenness against incident hypertension.

Zheng compared levels of residential greenness in Taiwan and found that people living in neighborhoods with lower levels of greenness had a higher risk of hypertension compared with those living in neighborhoods with more green space.

These findings are particularly noteworthy because they are derived from a large group of 125,537 participants recruited over a 15-year period. This study strengthens the evidence for an association between exposure to greenness and high blood pressure.

The study revealed a 24% lower risk of hypertension for each 0.1-unit increase in green vegetation.

What is the science behind increase Greenness exposure and/or Forest Bathing?

Studies do indeed find that short-term exposure to particulate matter (PM) increases blood pressure and can lead to chronic hypertension.

What is particulate matter (PM) in air pollution?

PM stands for particulate matter (also called particle pollution): the term for a mixture of solid particles and liquid droplets found in the air. Some particles, such as dust, dirt, soot, or smoke, are large or dark enough to be seen with the naked eye.

PM is closely connected widespread air pollution.

Air pollution is currently one of the most serious public health challenges in the world.

Is particle pollution the same as air pollution?
Many of the particles are so small as to be invisible, but when their levels are high, the air becomes hazy and thick and they become noticeable. Particulate matter is one of six widespread air pollutants for which there are national air quality standards to limit their levels in the outdoor air.

Certain particle constituents (e.g., metals, organic compounds, and ultra-fine particles) are capable of reaching the systemic circulation upon inhalation and thereafter directly impair vascular function.

More and more studies have shown that impaired local and circulating vascular function lead to endothelial dysfunction and the premature onset of coronary artery disease.

For review, the endothelium is a fragile membrane that lines the heart and coronary arteries (blood vessels on the surface of the heart).

Additional studies do show that a short-term increase in fine particulate matter air pollution concentration increases the risk for myocardial infarctions, strokes, and heart failure exacerbations.

Exposure to environmental PM can increase blood pressure within a period of a few days while long-term exposure might also promote the development of chronic hypertension.

This has been extensively confirmed in the past decades.

Studies found that the association between exposure and arterial stiffness was decreased by residential greenness.

Of special interest is the fact it is the presence of greenspaces in urban environments could have more profound effects than we commonly realize. We find that trees around our homes bring comfort and tranquility. They protect us from harsh urban noise and glaring lights of neighborhood streets, promoting better sleep.

Dr. Grisanti's Comments

Studies have shown that participants who were exposed to a forest environment experienced a reduction in blood pressure, pulse rate, and heart rate compared to those exposed to an urban environment.

A study conducted in Japan found forest bathing activities were effective at lowering blood pressure and improving negative emotions in working-age adults. A review of 20 studies compared the effects of a forest environment on hypertensive adults of different age groups. It was found that forest bathing (increased Greenness) was effective at lowering systolic blood pressure in hypertensive middle-aged or older people.

In summary due to the fact that PM can be found almost everywhere with its continuous and often involuntary nature of exposure may be an important and under-appreciated worldwide environmental risk factor for increased blood pressure.

Dr. Grisanti Forest Bathing on his 44th Wedding Anniversary in the Blue Ridge Mountains

References:

** Always consult with a physician or healthcare practitioner with significant integrative or functional medicine training before starting any of the above recommendations.

You can find a qualified and certified functional medicine practitioner by going to: www.FunctionalMedicineDoctors.com

Lower Your Systolic Blood Pressure 10 Points

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https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5874849/ https://nutritionreview.org/2016/12/practical-guide-avoiding-drug-induced-nutrient-depletion/

High Intensity Interval Training & Blood Pressure

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High Resistance IMST to Lower Blood Pressure

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Salt and Hypertension

Salt and Hypertension

Flaxseed Benefits and High Blood Pressure

Flaxseed Benefits and High Blood Pressure

Understanding the Three-Legged Stool

-Concept to Winning the War on Cardiovascular Disease

An Underappreciated and Potential Cause of Hypertension

Forest Bathing

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https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5874849/
https://nutritionreview.org/2016/12/practical-guide-avoiding-drug-induced-nutrient-depletion/