Certain groups of people—the elderly, African Americans, and those with a family history of high blood pressure—are more likely than others to have blood pressure that's particularly salt-sensitive. But because there's no way to tell whether any one individual is at risk, everyone should consume less sodium, says Eva Obarzanek, PhD, a research nutritionist at the National Heart, Lung, and Blood Institute. 

Blood pressure control is a lifelong challenge. Hypertension can progress through the years, and treatments that worked earlier in life may need to be adjusted over time. Blood pressure control may involve gradually making lifestyle changes like diet, weight loss, exercise, and possibly taking medicine if necessary. In some situations, medications may be recommended immediately. As with many diseases, you and your doctor should work together to find the treatment plan that works for you.

Manual wheelchairs are self-propelled or companion-propelled, allowing chair owners to propel themselves by pushing the wheel rims forward and backward. The best manual wheelchair for you is the one that meets your daily requirements. Some prefer an ultra-lightweight chair for portability and travel and others need a wheelchair with a comfortable seat for home use. Whatever your needs, we have you covered.
I just started using high blood pressure medication and purchased a blood pressure meter at age 72. what concerns me is that the BP readings I get have a very wide variance in. I measure every morning as soon as I wake up, while still in bed and prior to having any coffee. I take 3 or 4 readings. I have found that on any given day my reading can vary from 126 to 143 systolic and the diastolic reading from 68 to 87. this wide variance makes it very difficult to track trends. My questions are: is this normal? is my instrument possibly defective? How can my cardiac doctor make a decision to put me on life long medication based on SINGLE reading in his office?
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If your blood pressure is 120/80 millimeters of mercury (mm Hg) or lower, it’s considered normal. Generally, if the blood pressure reading is under 90/60 mm Hg, it is abnormally low and is referred to as hypotension. Some adults regularly have a blood pressure in the hypotensive range, but have no symptoms at all and do not require treatment. In serious cases, though, hypotension can result in a decreased supply of oxygen and nutrients to your brain, which can eventually lead to life-threatening shock.
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Blood pressure rises as we get older but some people defy this seemingly inevitable development. Regular exercise, maintaining a healthy weight, a low fat (especially saturated animal fat) and low salt diet, quitting smoking and reducing the amount of alcohol consumed will all have an effect. Even allowing for all that, the blood pressure of vegetarians doesn’t increase in the same way as meat eaters’ – in fact, it goes up little with age. It’s not surprising, then, that a vegetarian diet can be used to treat high blood pressure. It is the totality of the vegetarian diet that works, not any specific ingredient. Vegetarians’ lower risk of high blood pressure is considerable and can be anywhere between 33-50 per cent. There is an inescapable link with meat and a Californian study as long ago as 1926 showed this.

Your circulatory system is very much like the hot tub’s. Your blood is like the water. Your heart is like the pump, and your blood vessels are like the pipes. Your heart pumps your blood through the circulatory system in order to feed oxygen and nutrients to cells throughout your body, and to remove waste products. By circulating through the system, your blood is filtered and re-utilized, again and again.
Spironolactone is a medication that has been used to treat high blood pressure since the 1960s. While there is some belief spironolactone reduces blood pressure, there are concerns due to the potential for this drug to cause adverse effects. The aim of this review was to determine the extent to which spironolactone reduces blood pressure, the nature of spironolactones adverse effect profile, and to determine the clinical impact of its use for hypertension. The search revealed 5 cross-over trials with a total of 137 patients that received both spironolactone followed by placebo or vice verse, in a random order. One other trial was found that randomly gave 42 patients either spironolactone (22 patients) or placebo (20 patients). The daily doses of spironolactone used in these studies ranged from 25-500 mg daily. Studies followed patients for 4 to 8 weeks of therapy. None of the studies reported on the clinical impact of spironolactone (i.e. whether spironolactone reduced heart attacks or strokes compared to placebo). Overall reporting of adverse effects was poor so no conclusions can be drawn about the adverse effect profile. This meta-analysis shows that spironolactone reduces systolic/diastolic blood pressure by approximately 20/7 mm Hg compared to placebo.
If an underlying medical condition causes hypertension, you’ll need to treat this condition to maintain a healthy blood pressure. For example, people with sleep apnea tend to develop high blood pressure. Treatment of sleep apnea with a CPAP machine can help to lower your high blood pressure due to sleep apnea. Another example is high blood pressure associated with obesity that improves after weight loss.
Garlic: Garlic has long been thought to reduce hypertension. Studies show that garlic extract can lower blood pressure, although the optimal dose, frequency, and form are not well established. Garlic may produce this effect by acting directly on the kidneys to eliminate excess salt. It is considered a safe spice to consume, although it can cause some stomach upset. 
If you have hypertension, ask your doctor if OSA could be behind it. (In addition to loud snoring, common symptoms include excessive daytime tiredness and early morning headaches.) Getting your sleep apnea under control could be helpful for improving your blood pressure, says Robert Greenfield, MD, Medical Director of Non-Invasive Cardiology & Cardiac Rehabilitation at MemorialCare Heart & Vascular Institute at Orange Coast Medical Center in Fountain Valley, CA.
Healthy blood pressure in adults is a reading below 120 systolic and 80 diastolic. Blood pressure between 120 to 129 systolic and under 80 diastolic is considered elevated. Elevated blood pressure means you have a greater risk of developing high blood pressure later on. Your doctor may suggest eating less salt, eating a heart healthy diet, or living a more active lifestyle.

Exercise could be just as effective in lowering high blood pressure as prescribed medication. Researchers pooled data from nearly 400 trials and found that for people with high blood pressure, activity such as walking, swimming and simple weight training seemed to be just as good as most drugs used to treat it. However, the team warns people should not stop taking their medication until further studies are carried out.

Blood pressure monitors for use at home can be bought at drug stores, department stores, and other places. Again, these monitors may not always give you a correct reading. You should always compare your machine’s reading with a reading from your doctor’s machine to make sure they are the same. Remember that any measurement above normal should prompt a visit to the doctor, who can then talk with you about the best course of action.

Healthcare professionals use a stethoscope and a manual sphygmomanometer to measure your blood pressure. Typically they take the reading above your elbow. The sphygmomanometer has a bladder, cuff, bulb, and a gauge. When the bulb is pumped it inflates the bladder inside the cuff, which is wrapped around your arm. This inflation will stop the blood flow in your arteries. The stethoscope is used to listen for sound of the heartbeat, and no sound indicates that there is no flow. As the pressure is released from the bladder, you will hear the sound of the blood flowing again. That point becomes systolic reading. The diastolic reading is when you hear no sound again, which means that the blood flow is back to normal.


Studies even show that blood pressure measurements outside a doctor’s office are at least as accurate as those in the office (provided the equipment works well). If your results are high, take another reading. Try, try again. If they’re still high, see your healthcare provider and get checked out. Your doctor may order blood and urine tests or an EKG to diagnose other causes for your hypertension.
Exercise could be just as effective in lowering high blood pressure as prescribed medication. Researchers pooled data from nearly 400 trials and found that for people with high blood pressure, activity such as walking, swimming and simple weight training seemed to be just as good as most drugs used to treat it. However, the team warns people should not stop taking their medication until further studies are carried out.
Alpha methyldopa (Aldomet)* may produce a greater drop in blood pressure when you're in an upright position (standing or walking), and it may make you feel weak or faint if the pressure has been lowered too far. This drug may also cause drowsiness or sluggishness, dryness of the mouth, fever or anemia. Male patients may experience impotence. If this side effect persists, your doctor may have to change the drug dosage or use another medication.

Enlarged heart. High blood pressure increases the amount of work for your heart. Like any heavily exercised muscle in your body, your heart grows bigger (enlarges) to handle the extra workload. The bigger your heart is, the more it demands oxygen-rich blood but the less able it is to maintain proper blood flow. As a result, you feel weak and tired and are not able to exercise or perform physical activities. Without treatment, your heart failure will only get worse.
For infants, toddlers, and pre-adolescent aged children, doctors follow separate guidelines and standards to define high blood pressure. Average readings tend to be lower at a younger age and increase as you grow older . During late adolescence (around 17-19 yrs old) doctors typically begin to follow the standard adult guidelines for high blood pressure.
Eat a heart-healthy diet. Eating a well-balanced diet with lots of fruits, vegetables, whole grains, nuts, and seeds that is also low in sodium, saturated fat, added sugar, and cholesterol is important for your heart. There is a diet specifically geared toward lowering blood pressure. It’s called the DASH diet, which stands for dietary approaches to stop hypertension. Talk to your doctor or make an appointment with a dietitian if you need help making changes to your diet.
Obesity: As body weight increases, the blood pressure rises. Obesity is defined as having a body mass index (BMI) greater than 30 kg/m. A BMI of 25-30 kg/m is considered overweight (BMI=weight in pounds x 703/ height in inches). Being overweight increases the risk of high blood pressure. Healthcare professionals recommend that all individuals who are obese and have high blood pressure lose weight until they are within 15% of their healthy body weight.

Some heart attacks are sudden and intense, however most heart attacks start slowly with mild pain and discomfort. Most heart attacks involve discomfort in the center of the chest that lasts more than a few minutes, or that goes away and comes back. It can feel like uncomfortable pressure, squeezing, fullness or pain. Shortness of breath may occur, as well as nausea, or lightheadedness. It is vital to get help immediately if any of these symptoms occur.
"The implications and potential benefits of such healthier lifestyles could be great, particularly since about 22% of the adult population falls into the prehypertensive category," says Chobanian, who is also dean of the Boston University School of Medicine. "In fact, the blood pressure effects of weight reduction or adoption of the DASH eating plan can be comparable to those achieved with any single blood pressure medication." 

According to the CDC, a whopping 75 million Americans—that’s nearly 1/3 of the adult population—are struggling with high blood pressure, increasing their risk of heart attack, stroke, and other life-altering health consequences along the way. Skipping the salt and squeezing in some regular workouts can help keep your blood pressure from reaching dangerous levels, but it takes a more proactive approach to keep your blood pressure under control in the long run.
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What makes this study valuable is that it documents real world experience. Guidelines are frequently made from trials conducted with more aggressive follow-up and monitoring than is typical in usual care. That fuels the medical community’s perspective that drug interventions are the best course of care, which is why we need more studies like this one from Dr. Sheppard et. al. showing us how low risk patients probably do not benefit from drug therapy in real world scenarios.
Up to 40% of patients taking clonidine (Catapres) will experience dry mouth and about a third will have drowsiness, headache, and sleepiness. Other common side effects include constipation, dizziness, and local skin reactions with use of the Catapres-TTS skin patch. Reserpine use is linked with possible side effects including nightmares, stuffy nose, depression, and an inability to fall asleep. Diarrhea and heartburn are also possible. Guanadrel and guanethidine can cause diarrhea and other gastrointestinal issues – as well as dizziness and drowsiness.
Blood pressure is the force of blood pushing against the walls of arteries. When the doctor measures your blood pressure, the results are given in two numbers. The first number, called systolic blood pressure, is the pressure caused by your heart contracting and pushing out blood. The second number, called diastolic blood pressure, is the pressure when your heart relaxes and fills with blood. Your blood pressure reading is usually given as the systolic blood pressure number over the diastolic blood pressure number, such as 138/72. Normal blood pressure for adults is defined as a systolic pressure of less than 120 and a diastolic pressure of less than 80. This is stated as 120/80.
Elevated blood pressures in the medical setting may not necessarily reflect the individuals real status. "White coat hypertension" describes a patient whose blood pressure is elevated because of the stress of the visit to the doctor or other healthcare professional, and the worry that their blood pressure might be elevated. Repeated blood pressure checks at the doctor's office or the use of a home blood pressure monitoring device may be used to confirm that you have high blood pressure.
Stress hormones constrict your blood vessels and can lead to temporary spikes in blood pressure. In addition, over time, stress can trigger unhealthy habits that put your cardiovascular health at risk. These might include overeating, poor sleep, and misusing drugs and alcohol. For all these reasons, reducing stress should be a priority if you're looking to lower your blood pressure.
7. Visit your chiropractor. A special chiropractic adjustment could significantly lower high blood pressure, a placebo-controlled study suggests. “This procedure has the effect of not one, but two blood–pressure medications given in combination,” study leader George Bakris, MD, told WebMD. Your chiropractor can create an effective protocol that helps normalize blood pressure without medication or other invasive procedures.
Physical changes: If something in your body changes, you may begin experiencing issues throughout your body. High blood pressure may be one of those issues. For example, it’s thought that changes in your kidney function due to aging may upset the body’s natural balance of salts and fluid. This change may cause your body’s blood pressure to increase.

You shouldn't ignore the fact that you may have elevated blood pressure readings in the doctor's office but not other places like a health fair, on a home monitor or a drugstore blood pressure machine. This "white-coat hypertension," as it's known, shouldn't be disregarded. A study found that people with this sign of raised blood pressure under stress showed early signs of stiff arteries and an overworked heart that could lead to higher blood pressure later on.
Hypertension Stage 1 is when blood pressure consistently ranges from 130-139 systolic or 80-89 mm Hg diastolic. At this stage of high blood pressure, doctors are likely to prescribe lifestyle changes and may consider adding blood pressure medication based on your risk of atherosclerotic cardiovascular disease (ASCVD), such as heart attack or stroke.

How low should you go? Aim to keep your sodium intake below 1,500 mg for healthy blood pressure, recommends the American Heart Association. That’s about half of what most Americans consume per day. Going easy on the saltshaker can help, but you’ll make a bigger impact by watching the sodium count in packaged or processed foods, Obarzanek says. (Pay extra attention to bread and rolls, pizza, soup, cold cuts, poultry, and sandwiches, which tend to pack the most salt.) Then try these other simple ways to slash your salt intake.

Imagine a garden hose hooked up to a spigot. When the hose is flexible and there are no kinks in it, you can turn on the water full blast and it will flow easily through the hose. But if there’s a kink in the hose, the water doesn’t flow as well beyond the kink. And the pressure inside the hose builds up behind the kink. Or imagine there is gunk inside the hose blocking the path of the water. Your arteries are a lot like that garden hose.
Recent research shows that lowering your blood pressure below these levels decreases your risk of heart attacks and all-cause mortality. That’s right—lowering your blood pressure has a direct impact on your life expectancy. In fact, a person with a systolic pressure of 135 has double the risk of heart disease as someone with a systolic pressure of 115. Same goes for a diastolic pressure of 85 instead of 75. 10 points might not seem like much, but every blood pressure increase has a big impact on your health.
Blood pressure is more than just a number. Managing hypertension can reduce your risk of heart attack, stroke, and early death. If you’re committed to making positive lifestyle changes and managing your blood pressure, you can reduce or even eliminate your need for blood pressure medication. Lower your blood pressure and take control of your health.

Some of these drugs may decrease your body's supply of the mineral potassium. Symptoms such as weakness, leg cramps or being tired may result. Eating foods containing potassium may help prevent significant potassium loss. If your doctor recommends it, you could prevent potassium loss by taking a liquid or tablet that has potassium along with the diuretic. Diuretics such as amiloride (Midamar)*, spironolactone (Aldactone)* or triamterene (Dyrenium)* are called "potassium sparing" agents. They don't cause the body to lose potassium. They might be prescribed alone, but are usually used with another diuretic. Some of these combinations are Aldactazide*, Dyazide*, Maxzide* or Moduretic*.


With age, comes an increased risk for systolic hypertension which can be aggravated by severe atherosclerosis. According to one study, the diuretic chlorthalidone (Hygroton) had significant benefit in elderly patients with systolic hypertension. Along with a diuretic, some calcium channel blockers, ACE inhibitors and angiotensin II receptor blockers may also be good choices. However, beta blockers may not be as effective for hypertension in those over 60; though they may be good choices if co-existing heart disease is present. It also may be preferable in elderly patients to give two high blood pressure medications at a low dose versus one at a higher dose.
The brain requires unobstructed blood flow to nourish its many functions. Very high, sustained blood pressure will eventually cause blood vessels to weaken. Over time these weaken vessels can break, and blood will leak into the brain. The area of the brain that is being fed by these broken vessels start to die, and this will cause a stroke. Additionally, if a blot clot blocks a narrowed artery, blood ceases to flow and a stroke will occur.

But the dark chocolate should be 60 to 70 percent cacao. A review of studies on dark chocolate has found that eating one to two squares of dark chocolate per day may help lower the risk of heart disease by lowering blood pressure and inflammation. The benefits are thought to come from the flavonoids present in chocolate with more cocoa solids. The flavonoids help dilate, or widen, your blood vessels (25).


Americans eat far too much dietary sodium, up to three times the recommended total amount, which is 1,500 milligrams (mg) daily for individuals with high blood pressure, says Dr. Fisher. It doesn't take much sodium to reach that 1,500-mg daily cap — just 3/4 of a teaspoon of salt. There's half of that amount of sodium in one Egg McMuffin breakfast sandwich. Weed out high-sodium foods by reading labels carefully. "It is very difficult to lower dietary sodium without reading labels, unless you prepare all of your own food," says Dr. Fisher. Beware in particular of what the American Heart Association has dubbed the "salty six," common foods where high amounts of sodium may be lurking:


Garlic: Garlic has long been thought to reduce hypertension. Studies show that garlic extract can lower blood pressure, although the optimal dose, frequency, and form are not well established. Garlic may produce this effect by acting directly on the kidneys to eliminate excess salt. It is considered a safe spice to consume, although it can cause some stomach upset. 
Primary (or essential) hypertension is when the cause is unknown. The majority of hypertension cases are primary. When there is an underlying problem such as kidney disease or hormonal disorders that can cause hypertension, it is called secondary hypertension. When it is possible to correct the underlying cause, high blood pressure usually improves and may even return to normal.
While you shouldn't shrug off the change, there's also no need to panic. "Obviously, nothing happened overnight inside a woman's body or to her health with the release of the guidelines," says Dr. Naomi Fisher, director of hypertension service and hypertension innovation at the Brigham and Women's Hospital Division of Endocrinology, Diabetes, and Hypertension, and associate professor of medicine at Harvard Medical School.

In most cases, the goal of treatment is to bring down the systolic pressure to less than 140 mm Hg and the diastolic pressure to less than 90 mm Hg. For people with diabetes, target blood pressure goals are lower (e.g., less than 130/80 mm Hg). For some people are who at high risk of cardiovascular complications such as stroke or heart attack, your doctor may recommend a systolic pressure target of less than 120 mm Hg. Your doctor will determine the most appropriate goal for you.

Unfortunately, this seems like a common scenario — medical guidelines recommend more aggressive medication use for minimal potential benefit despite potential harm. A new study published in the Journal of the American Medical Association (JAMA), suggests the blood pressure guidelines go too far for low risk individuals, and the risk of harm outweighs the potential benefits.
Without proper diagnosis, you may not know that your blood pressure is increasing. Uncontrolled high blood pressure can lead to serious health problems. High blood pressure is a major risk factor for stroke and kidney failure. The damage to blood vessels that occurs due to chronic high blood pressure can also contribute to heart attacks. If you’re pregnant, high blood pressure can be especially dangerous for both you and your baby.
If you had previously been diagnosed with high blood pressure, the new guidelines don't affect you too much, says Dr. Conlin, as you still need to continue your efforts to lower it through medication, diet, exercise, and weight loss. "However, based on new information in the guidelines, your doctor may propose treating your blood pressure to a lower level," he says.
A class of drugs called angiotensin receptor blockers (ARBs) is commonly used to lower high blood pressure. This class includes drugs such as losartan (brand name: Cozaar), candesartan (Atacand), eprosartan (Teveten), irbesartan (Avapro), telmisartan (Micardis) and valsartan (Diovan). We asked how much this class of drugs lowers blood pressure and whether there is a difference between individual drugs within the class. The available scientific literature was searched to find all trials that had assessed these questions.

One reason to visit your doctor regularly is to have your blood pressure checked. Routine checks of your blood pressure will help pick up an early rise in blood pressure, even though you might feel fine. If there's an indication that your blood pressure is high at two or more checkups, the doctor may ask you to check your blood pressure at home at different times of the day. If the pressure stays high, even when you are relaxed, the doctor may suggest exercise, changes in your diet, and, most likely, medications.
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Obesity: As body weight increases, the blood pressure rises. Obesity is defined as having a body mass index (BMI) greater than 30 kg/m. A BMI of 25-30 kg/m is considered overweight (BMI=weight in pounds x 703/ height in inches). Being overweight increases the risk of high blood pressure. Healthcare professionals recommend that all individuals who are obese and have high blood pressure lose weight until they are within 15% of their healthy body weight.


According to guidelines from the American Heart Association (AHA) and the American College of Cardiology (ACC), a reading below 120/80 mm Hg is classified as normal blood pressure. Those with a blood pressure reading anywhere from 120/80 up to 129/80 are classified within a category called elevated blood pressure. Hypertension is defined as a reading of 130/80 or higher.
Recurrent headaches: Headaches are fairly common among people with or without hypertension. Some people with hypertension notice changes or worsening of headaches when medications are skipped or when the blood pressure becomes higher than usual. Headaches associated with hypertension can be mild, moderate, or severe and can be of a throbbing nature. 

Beta-blockers cause the heart to slow down and so some of their side effects can be traced to that mechanism of action. Dizziness, weakness, fatigue, and fainting are possible. Beta-blockers also affect the respiratory system, so other side effects include shortness of breath, difficulty breathing, and chest pain. Beta-blockers should not be withdrawn suddenly, as that could result in a heart attack or sudden death.
It is important to go to your regular check-ups with your doctor. Hypertension is a common condition and, if caught, can be treated with medication to prevent complications. However, if you experience any of the symptoms of hypertension, such as frequent headaches, recurrent dizziness, nosebleeds, shortness of breath, nausea or vomiting, don't wait—speak to your doctor immediately.
About This Image: Person receiving a blood pressure test. Medical research shows that as we age blood pressure rises slightly to accommodate an increased demand of oxygen and nutrients. It is completely natural for the first number (systolic) to be 100 plus our age. A recent study by a group of UCLA researchers came very close to corroborating Dr. Piette's guide for blood pressure of 100 plus your age for men, subtracting 10 for women, and this is after this rule had been in use for five or more decades. Are we now being taught that Dr. Piette's guide for blood pressure is wrong merely for drug company profit?
Hypertension is present in many people who are unaware they have this disorder. Hypertension is called a silent killer because too often the first symptom of the disease is a heart attack or stroke. To prevent this, get outside in nature and exercise, enjoy the flowers, and let nature provide a calming respite in life. Also, get regular medical checkups. If hypertension symptoms hypertension arise, seek immediate medical care. Call 911 immediately if someone has passed out unexpectedly.
Over a 12-year period, 174 patients diagnosed with mild to severe high blood pressure were seen at the Center for Conservative Therapy and were placed on a medically-supervised, water-only fasting regime. The treatment procedure included an average water-only fasting period of 10.6 days, followed by a supervised refeeding period of about one week with a whole, natural foods diet. The results of the study are summarized in Figure 2.

Primary (or essential) hypertension is when the cause is unknown. The majority of hypertension cases are primary. When there is an underlying problem such as kidney disease or hormonal disorders that can cause hypertension, it is called secondary hypertension. When it is possible to correct the underlying cause, high blood pressure usually improves and may even return to normal.
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