Today’s post comes from Amy Campbell, MS, RD, LDN, CDE. Campbell is a registered dietitian and certified diabetes educator at Joslin Diabetes Center. She is actively involved in education initiatives, both at Joslin and with the American Association of Diabetes Educators, the American Diabetes Association and the Academy of Nutrition and Dietetics. She has authored several books published by the American Diabetes Association and recently received the 2012 Will Solimene Award for Excellence in Medical Communication. Campbell is also a member of the Egg Nutrition Center’s Health Professional Advisor panel.
According to the CDC, about 1 in 3 U.S. adults (68 million people) have high blood pressure. We know that uncontrolled blood pressure can lead to a host of problems, including heart attack, stroke and kidney disease. Below are some recent developments in the area of blood pressure management.
Blood pressure target for diabetes
When it comes to diabetes management, guidelines and goals are often different compared to the general population. For most people without diabetes, the blood pressure goal is less than 120/80 mm Hg, and the call to action is when systolic blood pressure climbs above 140. For diabetes, this goal is set even higher. As many as 2 out of 3 adults with diabetes have high blood pressure. Previously, the blood pressure guideline for most people with diabetes was less than 130/80 mm Hg. This year, it has been changed to less than 140/80 mm Hg. Clinical trials have shown a benefit in keeping systolic blood pressure under 140. Trying to get it much lower than this, however, does not significantly reduce the risk of heart attack or death. While a lower blood pressure may further reduce the risk of stroke, researchers believe the benefit is overshadowed by the need to take more medication and possibly experience more side effects. However, for younger adults with diabetes, the blood pressure goal may still remain at less than 130/80, so as always it is important for people to check with their provider to discuss their own goals.
Treating blood pressure effectively generally involves a combination of medications ( healthy eating plan, weight loss, and exercise. The April issue of the American Heart Association’s journal Hypertension stated that “alternative approaches” can be helpful for people whose blood pressure levels are higher than 120/80 and for those who don’t tolerate or respond well to blood pressure medicine. An expert panel examined three alternative remedy categories: exercise, behavioral therapies, and non-invasive procedures or devices. Here are their findings:
- Exercise: All three types of exercise (aerobic, resistance, and isometric) are effective at reducing blood pressure. Walking provides a modest benefit while isometric exercises, such as hand grip exercises, can lead to up to a 10 percent drop in both systolic and diastolic blood pressure.
- Behavioral therapies: Biofeedback and transcendental meditation can modestly lower blood pressure. Other types of meditation, as well as yoga and relaxation exercises unfortunately do not seem to have the same effect.
- Non-invasive procedures or devices: Device-guided slow breathing, when performed for 15 minutes, 3 to 4 times a week is effective in lowering blood pressure. Acupuncture, however, has not been shown to lower blood pressure.
The above approaches may lower systolic blood pressure between 2 and 10 points while on average, blood pressure medications tend to lower blood pressure between 10 and 15 points. Using these approaches in conjunction with medications can have an even greater blood pressure lowering effect.
Eggs may help
Many of us are familiar with the health benefits of eggs, but may not connect egg nutrition to blood pressure. However, research presented at a meeting of the American Chemical Society from Jilin University in China indicates that a component found in egg whites has the same blood pressure lowering properties as captopril. Captopril is known as an ACE inhibitor and is a medication commonly used to treat high blood pressure. ACE inhibitors lower blood pressure by blocking angiotensin, a hormone, from constricting blood vessels. A peptide in egg whites, called RVPSL seems to work in the same manner. Researchers fed this peptide to rats and their blood pressure dropped without any adverse effects. The hope is that future studies show egg white peptides can be used, either in eggs or in the form of a supplement, along with medication to effectively control blood pressure.