discussing with their patients first and foremost before re-sorting to monotherapies including pharmaceuticals and nutraceuticals. Salt reduction: Probably one of the first things that one would think of about high blood pressure is reducing salt. Salt makes it more difficult for the kidneys to remove water, which contributes to water retention in the blood and put more pressure on the heart and blood vessels. A meta-anal-ysis in 2013 gathered a modest decrease of 5.8mmHg in systolic blood pressure from reducing six grams of salt intake after adjusting for age, ethnicity and pre-existing blood pressure status (He et al., 2013). There are a couple considerations to sodium. With the convenience of processed and packaged foods, consumers do not realize how much sodium is contained in these foods even when they’re avoiding added sodium. Consuming a whole foods diet will have better control over how much sodium is consumed. According to the WHO, an estimated 46% of adults are unaware they have high blood pressure. blood pressure greater than 140/90mmHg, is at an approx-imate 20% increase risk of developing cognitive impairment if left untreated. Cardiovascular disease can be highly prevented; treating for cardiovascular disease can also prove to benefit our cognitive health which further adds to the interconnected-ness of our human organ systems. A meta-analysis con-ducted by Ding et al. (2019) referenced over 31,000 older adults aged 55+ that were treated for hypertension. Regard-less of the antihypertensive medication, risk of dementia and developing Alzheimer’s disease were reduced by 12% and 16%, respectively (Ding et al., 2019). It is interesting to note that screening for hypertension is very often underperformed. According to the World Health Organization (WHO), an estimated 46% of adults are una-ware they have high blood pressure. In addition, less than half of adults with hypertension are properly diagnosed (WHO, 2021). Ensure that when seeing the older adult patient, to have a thorough assessment. Early detection, adequate first-line treatment and discussions of lifestyle factors are key. Potassium deficiency: Potassium may also be a factor in hypertension as it aids in the removal of sodium through urine, and also eases the tension in the blood vessels (Aburto et al., 2013). Could it be excess sodium, or a potassium deficiency? A systematic review by Aburto et al. (2013) compiled 22 randomized control trials and 11 cohort stud-ies and observed a 7.16mmHg reduction in systolic blood pressure when 90-120mmol/day of potassium was con-sumed. Potassium-rich foods include bananas, dates, dark choc-olate, avocadoes, sweet potatoes and root vegetables. (Lan-ham-New & Lambert, 2012). There is the idea of the sodi-um:potassium relationship in food to consider as well. Food groups that have a high sodium:potassium ratio, meaning foods much higher in sodium than their potassium counter-part, are processed meats, white bread, and condiments (O’Halloran et all, 2016). DASH Diet: Both sodium reduction and potassium in-take ratio are elements of the Dietary Approaches to Stop Hypertension (DASH) diet, as well as incorporating foods higher in calcium and magnesium (Bensaaud et al., 2020). Appel et al. (1997) has observed participants undergoing the DASH diet to have their systolic and diastolic blood pressure reduced by 11.4 and 5.5 mmHg, respectively. Nitric Oxide Production: Nitric Oxide (NO) helps support endothelium-depend vasodilation to maintain nor-mal blood pressure (Sweazea et al., 2018). There are a few ways to generate NO. Dietary nitrates can contribute to NO September/October 2022 Chiropractic and Naturopathic Doctor 7 Naturopathic approaches to hypertension Controlling high blood pressure can reduce damage to the capillaries and vasculature of the brain. It is no reason why hypertension can be termed the ‘silent killer,’ as it may pertain to mortality, but also our brain health. There are many lifestyle recommendations when it comes to con-trolling high blood pressure that clinicians need to be www.Cndoctor.ca
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