Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.


Meditate or take slow, steady deep breaths to calm the nervous system, relax and your dilate blood vessels. Breathing exercises help calm your sympathetic nervous system and your fight-or-flight response. This technique also encourages blood flow to your body’s tissues and causes your diaphragm to move up and down, which eases blood flow to your heart.
Blood pressure refers to the force exerted by circulating blood on the walls of blood vessels and constitutes one of the principal vital signs. The pressure of the circulating blood decreases as blood moves through arteries, arterioles, capillaries, and veins; the term blood pressure generally refers to arterial pressure, i.e., the pressure in the larger arteries, arteries being the blood vessels which take blood away from the heart.
Some high blood pressure medications can, in fact, lead to weight gain. Common offenders include older beta blockers such as propranolol (Inderal) and atenolol (Tenormin). There could be several reasons for this -- including the fact that the medications can make patients feel tired and thus less likely to exercise. Minoxidil tablets (Loniten) -- used only when other antihypertensive medications have failed -- can also cause weight gain. Weight gain is also listed as a common side effect of doxazosin (Cardura). Diuretics are more likely to cause weight loss.
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:
Your total blood pressure reading is determined by measuring your systolic and diastolic blood pressures. Systolic blood pressure, the top number, measures the force your heart exerts on the walls of your arteries each time it beats. Diastolic blood pressure, the bottom number, measures the force your heart exerts on the walls of your arteries in between beats.
Finding out what genetic patterns contribute to high blood pressure risk. NHLBI-funded researchers identified dozens of new genetic variations that affect blood pressure. Scientists discovered the new genetic regions—and confirmed the role of many previously known ones by looking specifically at cigarette smoking behavior, one of many lifestyle factors that impact blood pressure. The analysis of the large samples was possible through the work of researchers in the Gene-Lifestyle Interactions Working Group of the Cohorts for Heart and Aging Research in Genomic Epidemiology (CHARGE) Consortium.
^ Roerecke, Michael; Tobe, Sheldon W.; Kaczorowski, Janusz; Bacon, Simon L.; Vafaei, Afshin; Hasan, Omer S. M.; Krishnan, Rohin J.; Raifu, Amidu O.; Rehm, Jürgen (27 June 2018). "Sex‐Specific Associations Between Alcohol Consumption and Incidence of Hypertension: A Systematic Review and Meta‐Analysis of Cohort Studies". Journal of the American Heart Association. 7 (13): e008202. doi:10.1161/JAHA.117.008202.
Yes, exercise is an excellent way to help lower your blood pressure. Of course, before you start any exercise program, be sure to talk to your doctor. With your doctor’s guidance, exercise can be a healthy way to help get your blood pressure under control. Exercise strengthens your heart and makes it work more efficiently. This means it won’t have to pump as hard, which leads to lower blood pressure.
Research shows that turmeric can reduce hypertension by regulating the activity of angiotensin receptors and thereby preventing the blood vessels from constricting. Not only curcumin, turmeric oil fraction, and turmerone also demonstrate similar activity. Turmeric by itself is not easily absorbed into the body. When speaking with a cardiac-surgeon I know, he told me that I needed to put a pinch of fresh black pepper on my tongue. This allows the body to absorb the turmeric increasing the efficacy. A WARNING: Taking turmeric over an extended period of time can cause bleeding. My clotting factors were off when I had been on it long term postponing my surgery by 2 weeks.
Lowering your blood pressure requires more than just cutting back on sodium, Prevention.com reports. You also need to eat foods high in at least two of these three minerals: calcium, magnesium, and potassium. With white beans, you get the jackpot for all three. Just one cup contains 13 percent of the calcium, 30 percent of the magnesium, and 24 percent of the potassium needed for your daily recommended servings. Here are 7 things your doctor isn’t telling you about your blood pressure.
An adult's blood pressure level should be below 140/90. The American Heart Association states that "One in three adults in the U.S. has high blood pressure. About 30 percent of them don't know they have it." About 73 million Americans have high blood pressure. It is crucial to get regular checkups with a doctor to monitor blood pressure levels. Keep a log of all reports of blood pressure levels and alert the doctor if your blood pressure changes suddenly.
These drugs block the effects of angiotensin, a chemical that causes the arteries to become narrow. Angiotensin needs a receptor- like a chemical "slot" to fit into or bind with- in order to constrict the blood vessel. ARBs block the receptors so the angiotensin fails to constrict the blood vessel. This means blood vessels stay open and blood pressure is reduced.
Essential hypertension is also greatly influenced by diet and lifestyle. The link between salt and high blood pressure is especially compelling. People living on the northern islands of Japan eat more salt per capita than anyone else in the world and have the highest incidence of essential hypertension. By contrast, people who add no salt to their food show virtually no traces of essential hypertension. 

A study published in the Journal of Bioscience, Biotechnology and Biochemistry looked at the effect that vinegar has on blood pressure if it is introduced to your diet. The results of the research showed that consumption of acetic acid (which is found in apple cider vinegar) caused a significant reduction in hypertension (high blood pressure). The research found that the acetic acid reduced blood pressure by lowering the renin activity. Renin is an enzyme which helps regulate blood pressure. I mix 1-2 tablespoons in a glass of warm water in the morning. I have found like I like Braggs ACV with the mother.
Hypertension clinical guidelines from the American Heart Association are comprehensive guidelines for healthcare professionals for the detection and treatment of high blood pressure in a wide range of patients. Included in the 2018 hypertension clinical guidelines are proper methods for measuring blood pressure, risk factors for hypertension, and hypertension treatment for different populations.
The guidelines also say that a patient's blood pressure levels should be based on an average of two to three readings on at least two different occasions. It's also reasonable for doctors to screen for "white-coat hypertension," which occurs when blood pressure is elevated in a medical setting but not in everyday life, the authors said. This can be done by having patients measure their blood pressure at home. 
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